Acta dermato-venereologica最新文献

Hyperspectral imaging is a non-invasive imaging modality showing potential in delineating tumour margins preoperatively. This pilot study evaluated the feasibility of using hyperspectral imaging to demarcate lateral margins of high-risk facial basal cell carcinomas (BCC) prior to Mohs micrographic surgery. Thirty patients with high-risk BCCs were recruited from the Department of Dermatology, Sahlgrenska University Hospital, Sweden. Lesions were initially demarcated using dermoscopy, followed by hyperspectral imaging scans. During the first stage, a superficial vertical incision was performed along the demarcation line before adding a 3-mm clinical margin for the bowl-shaped excision of the tumour. Hyperspectral imaging-based tumour margins were compared with histopathologically verified borders, serving as ground truth. The data analysis used supervised learning; 2 complementary validation strategies were employed: a half-split approach where the left half of each annotated image was used for training and the right half for testing, and a leave-one-out cross-validation at the image level. A pixel-wise classification approach was used, treating each pixel as an independent sample. Hyperspectral imaging achieved a pixel-wise classification accuracy of 0.76, sensitivity of 0.75, specificity of 0.78, and an area under the receiver operating characteristic curve of 0.84. Hyperspectral imaging demonstrated potential for tumour demarcation, providing a basis for future research.

Delusional infestation is a rare but severe dermatopsychiatric disorder. The diagnosis is associated with great suffering for the patients and their relatives, as well as substantial use of healthcare resources. It has been observed that patients with delusional infestation often have psychiatric comorbid conditions. Neurodegenerative diseases like dementia have been reported to be associated, but only in a few case reports. An observational, retrospective search was conducted in the institutional database and all medical records of patients with a diagnostic ICD code in the range F40.0-F40.9 (i.e., phobic anxiety disorders) were collected. A total of 146 patients met the criteria of delusional infestation; 42% were observed to have a former or current psychiatric comorbidity. Half the group, 50%, had more than 1 concomitant psychiatric diagnosis; depressive and/or anxiety disorder was the most common (62%). Furthermore, 9.6% developed dementia during the investigation period. Psychiatric comorbid conditions are common in this patient group. Such conditions should be diagnosed and treated. Further, delusional infestation could be an early sign of dementia and if signs of cognitive impairment are noted, further investigations and follow-up regarding dementia are recommended.

Chronic prurigo (CP) is a distressing dermatological condition lacking effective topical therapies. This randomized, double-blind, vehicle-controlled trial evaluated the efficacy and safety of Cryosim-1, a TRPM8 agonist cream, in 30 adults with CP. Participants were assigned to apply Cryosim-1 0.1%, 0.5%, or vehicle cream 3 times daily for 4 weeks. Both active formulations significantly reduced Prurigo Activity Score (PAS) compared with vehicle, with 0.1% Cryosim-1 showing a mean PAS reduction of -7.3 (p < 0.001). Significant improvements were observed in 24-h itch intensity, quality of life (DLQI), transepidermal water loss, and stratum corneum hydration. While both concentrations were effective, the 0.1% formulation showed superior tolerability with fewer reports of stinging and erythema. These findings support the potential of TRPM8-targeted therapy in managing CP through dual mechanisms of itch inhibition and skin barrier restoration.

Abrocitinib, an oral small-molecule Janus kinase 1 (JAK1) inhibitor, is used for the treatment of -moderate-to-severe atopic dermatitis (AD). However, due to safety concerns, further clinical experience is warranted, especially for elderly patients with AD. The aim of this study was to assess the rapidity, effectiveness, and safety of short-term abrocitinib in combination with medicated topical therapy for managing -moderate-to-severe AD in elderly patients. A total of 57 elderly patients (≥65 years old) with moderate-to-severe AD who received oral abrocitinib at a dose of 100 mg/day, combined with topical medicated therapy for a minimum of 2 weeks, were included in the analysis. Results indicated that 91.23% of patients achieved the PP-NRS response at Week 2, and itching remained well controlled at Week 12. Additionally, 47.37% of patients achieved EASI-50, and 14.04% reached EASI-75 by Week 2. Notably, none of the 57 patients experienced any adverse events during the 12-week follow-up period. A shorter duration of AD was associated with better efficacy. Short-term abrocitinib in combination with medicated topical therapy may represent a new treatment approach in clinical practice for elderly AD patients, offering a rapid-onset and convenient treatment option to alleviate itching, achieve treatment goals, and manage medication risks simultaneously.

Janus kinase 1 (JAK1) inhibitors are effective for atopic dermatitis, but carry risks of adverse events. Dose reduction may mitigate these risks, although real-world evidence of dose reduction strategies is limited. This prospective, real-world study investigated JAK1 inhibitor dose reduction among 60 adults with controlled atopic dermatitis treated with abrocitinib or upadacitinib for ≥ 3 months. Doses were halved or administered every other day, as capsules cannot be split. Patients could resume their original dose if needed. The primary outcome was the proportion of patients maintaining the reduced dose at week 12. Secondary outcomes included physician- and patient-reported measures at baseline, and weeks 4, 8, and 12, analysed using linear mixed-effects models. At week 12, 80% (48/60) maintained the reduced dose. All outcomes remained within treat-to-target goals for atopic dermatitis at week 12, except for POEM (mean 8.87, 95% CI 7.43-10.31). While disease activity was significantly increased at week 8, no changes were seen at week 12. Absolute changes did not exceed the minimal clinically important difference. All 8 patients who resumed their initial dose regained disease control at week 12. In conclusion, JAK1 inhibitor dose reduction was feasible in 80% of patients without a clinically meaningful increase in disease activity.