Actas dermo-sifiliograficas最新文献

Generalized pustular psoriasis (GPP) is an autoinflammatory disease characterized by primarily sterile pustules, with a widespread distribution, and flares that can be associated with life-threatening complications. Spesolimab (Spevigo®) is the only drug approved for treatment and prevention of GPP flares, and there are uncertainties that justify the development by the Psoriasis Group (GPs) of the Spanish Academy of Dermatology and Venereology (AEDV) of a Delphi consensus on the diagnosis and treatment of this rare disease. A panel of experts, starting from a literature search in PubMed (since 2014), designed a structured questionnaire with assertions that were evaluated (Likert scale from 1 to 7) by 38 members of the PWG with experience in GPP. Following two rounds, between October 2024 and January 2025, agreement (≥80% of participants) was reached on 50 out of of 70 statements, including the definition of GPP outbreak, infection screening, medium- and long-term treatment goals, and criteria for initiation of maintenance treatment. This Delphi consensus is intended to support clinicians in the diagnosis and treatment of patients with PPG in our setting.

Background: Bimekizumab is the first and only dual selective inhibitor of IL-17 A and IL-17 F that has been proven effective and safe in Phase 3 clinical trials and has been approved by the European Medicines Agency (EMA) for the treatment of hidradenitis suppurativa (HS).

Objectives: To assess the safety and efficacy profile of bimekizumab in patients with moderate-to-severe HS across multiple centers in Spain.

Methods: We conducted a retrospective cohort study including 84 patients treated with bimekizumab. Efficacy was assessed using an intention-to-treat approach, with patients who discontinued treatment for any reason or were lost to follow-up considered nonresponders. Data were collected at baseline, week 16, and week 24.

Results: The analysis included a total of 84 patients at 16 weeks, with 43 having completed the 24-week follow-up assessment (56 men [66.67%] and 28 women [33.33%]) with a mean age of 44.17 (13.43) years and a mean baseline IHS4 of 23.75 (12.87) were included. By week 24, IHS4 scores dropped by 16.73 points (p < 0.0001); a HiSCR50 of 55.95% was achieved at week 16, which was maintained with a HiSCR50 of 55.81% at week 24; DLQI scores improved by 10.67 points (p < 0.0001); pain scores dropped by 3.42 points (p < 0.0001); and flare counts were reduced by 1.53 (p = 0.0006). Adverse events were reported in 20.24% of patients by week 16, mainly candidiasis, and dropped to 11.90% by week 24. 53.57% (45/84) of patients achieved IHS4-55 by week 16, and by week 24, 60.47% (26/43) of patients maintained or reached this response level.

Conclusions: Bimekizumab is effective for the treatment of HS in real-world clinical practice, with a manageable safety profile over the 24-week period. Our findings are consistent with those reported in phase 3 clinical trials.

Background and aims:  Stage III cutaneous melanoma affects a heterogeneous group of patients. AJCC staging subdivides stage III according to micro- or macroscopic lymph nodes or in transit/cutaneous locoregional metastasis, without accounting for whether locoregional involvement is identified at diagnosis or post-progression. Information on potential divergent behavior among these subgroups is lacking. The aim of the study is to analyze the differences in survival of melanoma patients with stages IIIB-IIID at diagnosis vs stages IIIB-IIID after relapse.

Materials and method:  We conducted a cohort study with patients diagnosed with cutaneous melanoma between 1998 and 2022. Patients in stage III (AJCC 8th) were identified and divided into 2 cohorts: initial stages IIIB-D (iSIII) and stages IIIB-D during progression (pSIII). We analyzed the clinical and histopathological characteristics and performed Cox regression analysis for melanoma specific survival (MSS) and overall survival (OS).

Results:  Of Of the 939 patients included, 608 had incident stage III (iSIII) melanoma and 331 had progressive stage III (pSIII) melanoma. Primary melanomas in the iSIII cohort showed greater Breslow thickness and higher mitotic indices and were more frequently ulcerated than those in the pSIII group (P < .001). Multivariable Cox regression analysis showed a slightly worse MSS and OS for patients in the pSIII cohort with an HR of 1.32 (95%CI, 1.05-1.66; p = 0.017) and an HR of 1.40 (95%CI, 1.14-1.72; p = 0.001) respectively.

Conclusions:  Although patients from the pSIII cohort initially exhibited primary tumors with fewer aggressive features than primary tumors of the iSIII, after progression to stage III they showed a slightly worse MSS and OS than the iSIII cohort.