Acta dermato-venereologica最新文献

Emerging evidence has suggested a link between new-onset psoriasis and both COVID-19 infection and vaccination, though findings have been limited by small case numbers and lack of adequate control groups. This retrospective cohort study used electronic health records from the US Collaborative Network of TriNetX from January 2020 to January 2025 to compare the risk of developing new-onset psoriasis in individuals with confirmed COVID-19 infection and no vaccination history vs those vaccinated without prior infection. Propensity score matching was applied to balance demographics, comorbidities, and psoriasis risk factors. The primary outcome was a new diagnosis of psoriasis (ICD10-CM: L40.0-5) within 3 months following infection or vaccination. Subgroup analyses assessed the specific codes L40.0-5 separately. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare outcomes. Patients with COVID-19 infection had a significantly higher risk of developing psoriasis compared with vaccinated individuals (HR 1.30; 95% CI, 1.14-1.49; p < 0.001). Increased risks were also observed for psoriatic arthritis and pustulosis palmaris et plantaris. These findings suggest a potential triggering role of infection in psoriasis pathogenesis and support the safety profile of vaccination. Further studies are needed to confirm causality and guide clinical decision-making.

MicroRNA-processing enzymes - Dicer and DGCR8 - have been found to be dysregulated in melanoma. This study investigated whether these microRNA-processing enzymes could be used as risk factors for mortality. A retrospective cohort including medical history and samples of 74 patients was reviewed. Clinical and pathological variables were compared with mortality. Percentage of immunoreactive tumour cells (%IRC) for each enzyme was evaluated using immunohistochemistry. A dichotomous breakdown of DGCR8 and Dicer expression (negative or positive test) was performed using a cut-off of 80% IRC. The 5-year survival rate of stage 0-I-II was 89.5% and stage III-IV was 18.5%. In the bivariate analysis, variables associated with lower survival were: aged over 42 years, histologic subtypes, Breslow thickness ≥ 0.8mm, ulceration, vascular invasion, metastatic melanoma, positive sentinel node, more than 1 positive node, LDH > 200 IU/L, distant metastasis, and stage III-IV. In the multivariate Cox model, the analysis for stage III-IV showed a significantly lower survival curve in patients with a positive DGCR8 test and aged ≤ 42 years (p = 0.0152, Wald test). The Cox proportional hazards model showed that a positive DGCR8 test was a predictive factor for mortality in patients aged ≤ 42 years (HR = 14.3, 95%CI 1.5-140, p = 0.024). This study highlights a potential biomarker for melanoma survival and its utility in stratifying high-risk patients.

This study investigated the incidence, mortality, and causes of death in Finnish patients with mycosis fungoides (MF) or Sezary syndrome (SS). The study population consisted of 450 patients with MF and 23 with SS and their 1:1 matched controls. Data were collected from nationwide Finnish healthcare registries. The average incidence of MF was 0.38 and of SS 0.02 per 100,000 persons in 2007-2019 and was highest among older adults. Patients with SS had a low 5-year overall survival of 33.5% vs 64.5% in their controls (p = 0.0046), whereas 62.3% of patients with MF were alive 10 years after diagnosis vs 71.4% of their controls (p = 0.0011). SS diagnosis (hazard ratio [HR] 11.85 [5.08, 27.65]; p < 0.001) and higher age (HR 1.07 [1.01, 1.12]; p = 0.01) were risk factors of poorer disease-specific survival. Moreover, patients with MF had a 2.38-fold [1.07, 5.27] risk of thyroid diseases (p = 0.033) and over 1.5-fold [1.17, 2.07] risk of cardiovascular diseases (p = 0.002) compared with controls. In conclusion, in the Finnish population, patients with MF or SS had a higher incidence and mortality and more late comorbidities than controls. More awareness, earlier diagnostic tools, and more effective treat-ment for MF/SS are needed.

Various scoring systems for atopic dermatitis assess different aspects of the disease, but the supporting data on their validation and reliability are often limited. To ensure accurate interpretations, it is essential to conduct thorough reliability and agreement testing. This study aimed to evaluate the reliability and reproducibility of 5 atopic dermatitis assessment tools - Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis Index (oSCORAD), validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD), Three Item Severity (TIS) score, and Six-Area, Six-Sign Atopic Dermatitis (SASSAD) severity score - among trained dermatology residents. Thirteen patients were assessed twice by 11 raters using each scoring system. Intrarater and interrater reliability were evaluated. EASI demonstrated the highest interrater reliability (ICC = 0.768 and 0.796); SASSAD and oSCORAD followed closely (ICC = 0.741 and 0.772; ICC = 0.723 and 0.709, respectively). The TIS (ICC=0.553 and 0.584) and IGA (Kendall's W=0.273 and 0.315) exhibited the lowest reliability. Given the generally higher reliability in this study compared with previous research, implementing standardized training on atopic dermatitis scoring systems early in the education of resident physicians may improve the reliability of these tools, equipping future dermatologists to perform effectively in clinical trials and drug programmes.

The increasing use of JAK inhibitors in clinical practice is raising concerns regarding the potential risk of cutaneous lymphoma. This study aimed to conduct a comprehensive search for cases of cutaneous lymphoma associated with JAK inhibitors in the Food and Drug Administration's Adverse Event Reporting System. The clinical characteristics of cases from January 2004 to September 2023 were retrieved from the FAERS database. Disproportionality and Bayesian analyses were performed to detect signals for cutaneous lymphoma associated with JAK inhibitors. In total, 24 cases of cutaneous lymphoma were identified associated with JAK inhibitors, including tofacitinib, ruxolitinib, baricitinib, upadacitinib, and abrocitinib. The majority of patients (64%) were aged 60 or older, with no significant difference in incidence between genders. The average onset time was 8.64 months. One patient with ruxolitinib experienced a fatal outcome, and 1 patient with tofacitinib had a life-threatening event. Cutaneous lymphoma associated with baricitinib has the highest reporting odds ratio (23.91, 95% confidence interval 10.71-53.4), proportional reporting ratio (23.88, χ2 = 103.67), information component (4.57, IC025 = 2.05), and empirical Bayes geometric mean (23.73, EBGM05 = 12.12). The occurrence of cutaneous lymphoma associated with JAK inhibitors highlights the importance of pharmacovigilance studies to deepen our understanding of both the medications and associated conditions.

Hypopigmented mycosis fungoides is a rare variant of mycosis fungoides often seen in younger patients and individuals with darker skin tones and is characterized by hypopigmented patches or plaques. The lesions are usually asymptomatic and respond well to topical treat-ment or phototherapy. This article presents a case of an adult Caucasian male with a rare variant of CD8-negativeh hypopigmented mycosis fungoides, with a rapid progression to erythrodermic lesions, failure of standard treatment, and a good response to mogamulizumab.