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Disseminated Superficial Actinic Porokeratosis: A Systematic Treatment Review 播散性浅表性角化病:系统治疗回顾。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-01 DOI: 10.1007/s40257-024-00903-x
Stephanie Tan, Ernest Tan

Background

Disseminated superficial actinic porokeratosis (DSAP) is a disorder of keratinization characterised by small, brown plaques with elevated keratotic rims, typically occurring on sun exposed areas. DSAP poses a risk for malignant transformation, emphasising the need for effective management strategies.

Objective

The aim of this study was to review the current reported management options for DSAP.

Methods

This systematic review was based on a comprehensive search of databases (Cochrane, PubMed, Medline, Embase, Emcare, ProQuest, Web of Science, CINAHL) from inception to 15 March 2024. Studies reporting management of DSAP were included irrespective of study design.

Results

Of 923 citations, 61 studies were included, predominantly comprising case reports and retrospective case series. A limited number of randomized and open-label trials were identified. Various treatment modalities were reported, including topical and systemic agents, photodynamic therapy, and laser therapy.

Conclusion

Multiple management options are available for DSAP, including topical and systemic agents, photodynamic therapy and laser treatments. However, these approaches vary in their balance between efficacy and toxicity. Currently, there is a paucity of high-quality clinical trial data to guide treatment decisions. Further studies are required to determine the most effective and safe management strategies for DSAP.

Prospero registration

CRD42024514558.

背景:播散性表浅光化性角化病(DSAP)是一种角质化障碍性疾病,其特征为小的棕色斑块,角化边缘隆起,通常发生在阳光暴露的部位。DSAP 有恶变的风险,因此需要采取有效的管理策略:本研究旨在回顾目前报道的 DSAP 的治疗方案:本系统综述基于从开始到 2024 年 3 月 15 日对数据库(Cochrane、PubMed、Medline、Embase、Emcare、ProQuest、Web of Science、CINAHL)的全面检索。无论研究设计如何,均纳入了报告DSAP管理情况的研究:结果:在 923 篇引文中,共纳入 61 篇研究,主要包括病例报告和回顾性系列病例。此外,还发现了数量有限的随机试验和开放标签试验。报告了各种治疗方式,包括局部和全身用药、光动力疗法和激光疗法:结论:DSAP 有多种治疗方案可供选择,包括局部和全身用药、光动力疗法和激光治疗。然而,这些方法在疗效和毒性之间的平衡各不相同。目前,缺乏高质量的临床试验数据来指导治疗决策。要确定 DSAP 最有效、最安全的治疗策略,还需要进一步的研究。PROCERMO注册:CRD42024514558。
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引用次数: 0
Patient-Reported Hair Loss and Its Impacts as Measured by the Alopecia Areata Patient Priority Outcomes Instrument in Patients Treated with Ritlecitinib: The ALLEGRO Phase 2b/3 Randomized Clinical Trial 利特西替尼治疗脱发患者的患者报告脱发情况及其影响(通过脱发患者优先结果工具进行测量):ALLEGRO 2b/3 期随机临床试验。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-23 DOI: 10.1007/s40257-024-00899-4
Rodney Sinclair, Natasha Mesinkovska, Debanjali Mitra, Dalia Wajsbrot, Ernest H. Law, Robert Wolk, Brett King

Background

The ALLEGRO phase 2b/3 study investigated the efficacy and safety of ritlecitinib in patients with alopecia areata (AA).

Objective

To describe the impact of ritlecitinib on patient-reported hair loss using the Alopecia Areata Patient Priority Outcomes (AAPPO) instrument and evaluate the relationship between clinically meaningful hair regrowth and improvements in patient-reported impacts.

Methods

In ALLEGRO-2b/3, patients aged ≥ 12 years with AA and ≥ 50% scalp hair loss received once-daily ritlecitinib 50 or 30 mg (± 4-week 200-mg daily loading dose), 10 mg, or placebo for 24 weeks and then continued ritlecitinib or switched from placebo to ritlecitinib 200/50 or 50 mg for 24 weeks. The AAPPO instrument evaluated improvement in hair loss, emotional symptoms (ES), and activity limitations (AL) from weeks 4 to 48 (secondary endpoint). Mean changes in ES and AL domain scores and individual items at weeks 24 and 48 were calculated for Severity of Alopecia Tool (SALT) score ≤ 20 responders and nonresponders (exploratory endpoint).

Results

Overall, 718 patients were randomized. At week 24, 5–36% of patients receiving ritlecitinib 10–200/50 mg reported improvement in scalp hair loss versus 9% receiving placebo. The results for eyebrow, eyelash, and body hair loss were similar. Mean change from baseline in ES and AL scores at weeks 24 and 48 was small and similar between groups. Mean change was larger for individual hair loss and ES items at weeks 24 and 48 in SALT score ≤ 20 responders versus nonresponders.

Conclusions

The AAPPO instrument demonstrated the beneficial impact of ritlecitinib on patient-reported hair growth, which was consistent with improvements in clinician-reported outcomes.

Clinical Trial Registration

NCT03732807.

Infographic

研究背景ALLEGRO 2b/3期研究调查了利特西替尼对斑秃患者的疗效和安全性:使用斑秃患者优先结果(AAPPO)工具描述利特西替尼对患者报告的脱发的影响,并评估具有临床意义的毛发再生与患者报告的影响改善之间的关系:在ALLEGRO-2b/3研究中,年龄≥12岁、头皮脱发≥50%的AA患者接受每日一次的瑞替西替尼50或30毫克(±4周200毫克每日负荷剂量)、10毫克或安慰剂治疗24周,然后继续接受瑞替西替尼治疗或从安慰剂换成瑞替西替尼200/50或50毫克治疗24周。AAPPO工具评估了第4周至第48周脱发、情绪症状(ES)和活动受限(AL)的改善情况(次要终点)。计算脱发严重程度工具(SALT)评分≤20分的应答者和未应答者(探索性终点)在第24周和48周时ES和AL领域评分及单项的平均变化:共有718名患者接受了随机治疗。第24周时,接受利特西替尼10-200/50毫克治疗的患者中有5%-36%报告头皮脱发有所改善,而接受安慰剂治疗的患者中仅有9%报告头皮脱发有所改善。眉毛、睫毛和体毛脱发的结果相似。第24周和第48周时,ES和AL评分与基线相比的平均变化较小,组间相似。在第 24 周和第 48 周,SALT 得分≤20 分的应答者与未应答者相比,单个脱发和 ES 项目的平均变化较大:AAPPO工具显示了利特西替尼对患者报告的毛发生长的有益影响,这与临床医生报告结果的改善是一致的:临床试验注册:NCT03732807。信息图表。
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引用次数: 0
From Compression to Itch: Exploring the Link Between Nerve Compression and Neuropathic Pruritus 从压迫到瘙痒:探索神经压迫与神经性瘙痒症之间的联系。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-17 DOI: 10.1007/s40257-024-00898-5
Kayla D. Mashoudy, Sarah G. Brooks, Luis F. Andrade, Jaxon D. Wagner, Gil Yosipovitch

Neuropathic itch is a type of chronic pruritus resulting from neural dysfunction along the afferent pathway. It is often accompanied by abnormal sensations such as paresthesia, hyperesthesia, or hypoesthesia. This condition, which may involve motor or autonomic neural damage, significantly impacts patients’ quality of life, causing severe itch and associated comorbidities such as depression, disrupted sleep, and social strain. Neuropathic itch accounts for 8% of chronic pruritus cases, though this may be underestimated. This comprehensive review focuses on nerve impingement as the primary pathophysiological mechanism for various forms of neuropathic itch including brachioradial pruritus (BRP), notalgia paresthetica (NP), and anogenital itch. BRP, often seen in middle-aged white women, manifests as pruritus in the dorsolateral forearms typically exacerbated by ultraviolet (UV) exposure and related to cervical spine pathology. NP, prevalent in middle-aged women, presents as pruritus in the upper back due to thoracic spine nerve compression. Anogenital pruritus, affecting 1–5% of adults, is often linked to lumbosacral spine issues after ruling out dermatologic conditions such as lichen sclerosus or lichen simplex chronicus. The pathophysiology of neuropathic itch involves both peripheral and central mechanisms, with nerve damage being a key factor. Diagnosis requires a thorough history, physical examination, and potentially imaging studies. Topical agents such as menthol, capsaicin, and lidocaine are used for mild cases, while systemic medications such as gabapentin, pregabalin, and antidepressants are prescribed for moderate to severe cases; however, no US Food and Drug Administration (FDA)-approved therapies currently exist specifically for neuropathic itch. Understanding the underlying neural dysfunction and appropriate therapeutic strategies is crucial for managing neuropathic itch effectively.

神经性瘙痒是一种慢性瘙痒症,由传入通路的神经功能紊乱引起。它通常伴有异常感觉,如麻痹、过度感觉或感觉减退。这种疾病可能涉及运动神经或自主神经损伤,严重影响患者的生活质量,导致剧烈瘙痒以及抑郁、睡眠紊乱和社交压力等相关并发症。神经性瘙痒占慢性瘙痒症病例的 8%,但这一比例可能被低估了。这篇综合性综述主要探讨神经撞击是各种神经性瘙痒症的主要病理生理机制,包括肱动脉瘙痒症(BRP)、神经性瘙痒症(NP)和肛门瘙痒症。肱动脉瘙痒症常见于中年白人女性,表现为前臂背外侧瘙痒,紫外线照射会加剧瘙痒,与颈椎病变有关。NP多见于中年女性,由于胸椎神经受压,表现为上背部瘙痒。肛门瘙痒症影响着1%-5%的成年人,在排除皮肤病(如硬化性苔藓或慢性单纯性苔藓)后,通常与腰骶部脊柱问题有关。神经性瘙痒的病理生理学涉及外周和中枢机制,其中神经损伤是一个关键因素。诊断需要详尽的病史、体格检查和可能的影像学检查。薄荷醇、辣椒素和利多卡因等外用药可用于轻度病例,而加巴喷丁、普瑞巴林和抗抑郁药等全身用药可用于中度至重度病例;但是,目前还没有美国食品药品管理局(FDA)批准的专门针对神经性瘙痒的疗法。了解潜在的神经功能障碍和适当的治疗策略对于有效控制神经性瘙痒至关重要。
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引用次数: 0
Authors’ Reply to Wang et al., “Comment on ‘Efficacy and Safety of Brodalumab, an Anti‑interleukin‑17 Receptor A Monoclonal Antibody, for Palmoplantar Pustulosis: 16‑Week Results of a Randomized Clinical Trial’” 作者对 Wang 等人 "关于'抗白细胞介素-17 受体 A 单克隆抗体 Brodalumab 治疗掌跖脓疱病的疗效和安全性:随机临床试验 16 周结果'的评论 "的回复。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-15 DOI: 10.1007/s40257-024-00896-7
Yukari Okubo, Satomi Kobayashi, Masamoto Murakami, Shigetoshi Sano, Natsuko Kikuta, Yoshiumi Ouchi, Tadashi Terui
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引用次数: 0
Comment on “Efficacy and Safety of Brodalumab, an Anti‑interleukin‑17 Receptor A Monoclonal Antibody, for Palmoplantar Pustulosis: 16‑Week Results of a Randomized Clinical Trial” 关于 "抗白细胞介素-17 受体 A 单克隆抗体 Brodalumab 治疗掌跖脓疱病的疗效和安全性:随机临床试验 16 周结果 "的评论。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-15 DOI: 10.1007/s40257-024-00895-8
Lu-Ying Wang, Yi-Hang Ding, Xiu-Juan Hou, Chen Li
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引用次数: 0
Oral Roflumilast in Patients with Psoriasis: A Real-World Cohort Study 银屑病患者口服罗氟司特:真实世界队列研究
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-13 DOI: 10.1007/s40257-024-00897-6
Mette Gyldenløve, Christoffer Valdemar Nissen, Sascha Dinsen Wreschner Stave, Simon Francis Thomsen, Alexander Egeberg, Nikolai Loft
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引用次数: 0
Pembrolizumab for the First-Line Treatment of Recurrent Locally Advanced or Metastatic Merkel Cell Carcinoma: Results from the Single-Arm, Open-Label, Phase III KEYNOTE-913 Study Pembrolizumab 用于复发性局部晚期或转移性梅克尔细胞癌的一线治疗:单臂、开放标签、III 期 KEYNOTE-913 研究结果。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-08 DOI: 10.1007/s40257-024-00885-w
Laurent Mortier, Lisa Villabona, Ben Lawrence, Ana Arance, Marcus O. Butler, Marie Beylot-Barry, Philippe Saiag, Mahtab Samimi, Paolo A. Ascierto, Francesca Spada, Michel De Pontville, Michele Maio, Alfonso Berrocal, Enrique Espinosa, Jaume Capdevila, Max Levin, Debasmita Das, Clemens Krepler, Dmitri Grebennik, Vanna Chiarion-Sileni

Background

The phase III KEYNOTE-913 study was conducted to evaluate the efficacy and safety of pembrolizumab as first-line therapy in patients with advanced Merkel cell carcinoma (MCC).

Objective

The aim was to report results from the primary analysis of KEYNOTE-913.

Patients and Methods

Patients with recurrent locally advanced or metastatic MCC received pembrolizumab 200 mg intravenously every 3 weeks for up to 35 treatments (~ 2 years). The primary end point was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) by blinded independent central review (BICR). Secondary end points were duration of response (DOR) and progression-free survival (PFS) per RECIST v1.1 by BICR, overall survival (OS), and safety and tolerability.

Results

Fifty-five patients were treated with pembrolizumab. The median time from first dose to data cutoff (February 15, 2024) was 50.3 months (range 38.7–59.4). The ORR was 49% (95% confidence interval [CI] 35–63), with 12 complete responses and 15 partial responses. The median DOR was 39.8 months (range 4.8–52.5+), and the 24-month DOR rate was 69%. The median PFS was 9.3 months (95% CI 3–26), and the 24-month PFS rate was 39%. The median OS was 24.3 months (95% CI 12.4 to not reached), and the 24-month OS rate was 51%. Any-grade treatment-related adverse events (AEs) occurred in 38 patients (69%); 13 patients (24%) experienced grade 3–5 AEs. The most common treatment-related AEs were fatigue (n = 12 [22%]), pruritus (n = 12 [22%]), and lipase increase (n = 10 [18%]). One patient died of treatment-related Guillain-Barré syndrome.

Conclusions

Pembrolizumab provided durable antitumor activity and promising survival and had a manageable safety profile in patients with recurrent locally advanced or metastatic MCC, supporting its use in this population.

Trial Registration

Clinicaltrials.gov, NCT03783078.

研究背景III期KEYNOTE-913研究旨在评估pembrolizumab作为晚期梅克尔细胞癌(MCC)患者一线疗法的有效性和安全性:目的:报告KEYNOTE-913的主要分析结果:复发性局部晚期或转移性 MCC 患者接受 pembrolizumab 200 mg 静脉注射,每 3 周一次,最多治疗 35 次(约 2 年)。主要终点是根据实体瘤反应评估标准 1.1 版(RECIST v1.1)通过盲法独立中央审查(BICR)得出的客观反应率(ORR)。次要终点是BICR根据RECIST v1.1标准得出的反应持续时间(DOR)和无进展生存期(PFS)、总生存期(OS)以及安全性和耐受性:55名患者接受了pembrolizumab治疗。从首次给药到数据截止(2024 年 2 月 15 日)的中位时间为 50.3 个月(38.7-59.4 个月)。ORR为49%(95%置信区间[CI] 35-63),其中12例完全应答,15例部分应答。中位DOR为39.8个月(范围4.8-52.5+),24个月的DOR率为69%。中位 PFS 为 9.3 个月(95% CI 3-26),24 个月的 PFS 率为 39%。中位OS为24.3个月(95% CI 12.4至未达到),24个月OS率为51%。38名患者(69%)发生了任何等级的治疗相关不良事件(AEs);13名患者(24%)发生了3-5级AEs。最常见的治疗相关不良反应是疲劳(12 例 [22%])、瘙痒(12 例 [22%])和脂肪酶升高(10 例 [18%])。一名患者死于治疗相关的格林-巴利综合征:Pembrolizumab为复发性局部晚期或转移性MCC患者提供了持久的抗肿瘤活性和良好的生存期,并具有可控的安全性,支持在这一人群中使用:试验注册:Clinicaltrials.gov,NCT03783078。
{"title":"Pembrolizumab for the First-Line Treatment of Recurrent Locally Advanced or Metastatic Merkel Cell Carcinoma: Results from the Single-Arm, Open-Label, Phase III KEYNOTE-913 Study","authors":"Laurent Mortier,&nbsp;Lisa Villabona,&nbsp;Ben Lawrence,&nbsp;Ana Arance,&nbsp;Marcus O. Butler,&nbsp;Marie Beylot-Barry,&nbsp;Philippe Saiag,&nbsp;Mahtab Samimi,&nbsp;Paolo A. Ascierto,&nbsp;Francesca Spada,&nbsp;Michel De Pontville,&nbsp;Michele Maio,&nbsp;Alfonso Berrocal,&nbsp;Enrique Espinosa,&nbsp;Jaume Capdevila,&nbsp;Max Levin,&nbsp;Debasmita Das,&nbsp;Clemens Krepler,&nbsp;Dmitri Grebennik,&nbsp;Vanna Chiarion-Sileni","doi":"10.1007/s40257-024-00885-w","DOIUrl":"10.1007/s40257-024-00885-w","url":null,"abstract":"<div><h3>Background</h3><p>The phase III KEYNOTE-913 study was conducted to evaluate the efficacy and safety of pembrolizumab as first-line therapy in patients with advanced Merkel cell carcinoma (MCC).</p><h3>Objective</h3><p>The aim was to report results from the primary analysis of KEYNOTE-913.</p><h3>Patients and Methods</h3><p>Patients with recurrent locally advanced or metastatic MCC received pembrolizumab 200 mg intravenously every 3 weeks for up to 35 treatments (~ 2 years). The primary end point was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) by blinded independent central review (BICR). Secondary end points were duration of response (DOR) and progression-free survival (PFS) per RECIST v1.1 by BICR, overall survival (OS), and safety and tolerability.</p><h3>Results</h3><p>Fifty-five patients were treated with pembrolizumab. The median time from first dose to data cutoff (February 15, 2024) was 50.3 months (range 38.7–59.4). The ORR was 49% (95% confidence interval [CI] 35–63), with 12 complete responses and 15 partial responses. The median DOR was 39.8 months (range 4.8–52.5+), and the 24-month DOR rate was 69%. The median PFS was 9.3 months (95% CI 3–26), and the 24-month PFS rate was 39%. The median OS was 24.3 months (95% CI 12.4 to not reached), and the 24-month OS rate was 51%. Any-grade treatment-related adverse events (AEs) occurred in 38 patients (69%); 13 patients (24%) experienced grade 3–5 AEs. The most common treatment-related AEs were fatigue (<i>n</i> = 12 [22%]), pruritus (<i>n</i> = 12 [22%]), and lipase increase (<i>n</i> = 10 [18%]). One patient died of treatment-related Guillain-Barré syndrome.</p><h3>Conclusions</h3><p>Pembrolizumab provided durable antitumor activity and promising survival and had a manageable safety profile in patients with recurrent locally advanced or metastatic MCC, supporting its use in this population.</p><h3>Trial Registration</h3><p>Clinicaltrials.gov, NCT03783078.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 6","pages":"987 - 996"},"PeriodicalIF":8.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Potential Role of Cannabidiol in Cosmetic Dermatology: A Literature Review 大麻二酚在皮肤美容中的潜在作用:文献综述。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-05 DOI: 10.1007/s40257-024-00891-y
Ai Kuzumi, Asako Yoshizaki-Ogawa, Takemichi Fukasawa, Shinichi Sato, Ayumi Yoshizaki

Cannabidiol (CBD) is a non-psychotropic cannabinoid with multiple pharmacological properties. Cannabidiol has attracted growing attention in the cosmetic industry, with an increasing number of CBD-containing skincare products on the market in recent years. The aim of this review is to evaluate the current evidence on the use of CBD for cosmetic purposes. Following an overview of CBD and the endocannabinoid system in the skin, we summarize pre-clinical and clinical studies that address the potential of CBD in cosmetic dermatology. Available in vitro and in vivo evidence suggests that CBD has anti-oxidant, anti-inflammatory, moisturizing, anti-acne, wound-healing, and anti-aging properties. However, only a few clinical studies have been conducted on the use of CBD in the skin. In addition, there is a critical need to develop an efficient drug-delivery system for topical/transdermal application of CBD. Further research, including clinical and pharmacokinetic studies, are needed to fully evaluate the role of CBD in cosmetic dermatology.

大麻二酚(CBD)是一种非精神类大麻素,具有多种药理特性。近年来,随着市场上含有 CBD 的护肤品越来越多,大麻二酚在化妆品行业引起了越来越多的关注。本综述旨在评估目前将 CBD 用于美容目的的证据。在概述了 CBD 和皮肤中的内源性大麻素系统之后,我们总结了有关 CBD 在皮肤美容方面的潜力的临床前和临床研究。现有的体外和体内证据表明,CBD 具有抗氧化、抗炎、保湿、抗痤疮、伤口愈合和抗衰老等特性。然而,只有少数临床研究对 CBD 在皮肤中的应用进行了研究。此外,亟需开发一种高效的药物输送系统,用于 CBD 的局部/透皮应用。要全面评估 CBD 在皮肤美容方面的作用,还需要进一步的研究,包括临床和药代动力学研究。
{"title":"The Potential Role of Cannabidiol in Cosmetic Dermatology: A Literature Review","authors":"Ai Kuzumi,&nbsp;Asako Yoshizaki-Ogawa,&nbsp;Takemichi Fukasawa,&nbsp;Shinichi Sato,&nbsp;Ayumi Yoshizaki","doi":"10.1007/s40257-024-00891-y","DOIUrl":"10.1007/s40257-024-00891-y","url":null,"abstract":"<div><p>Cannabidiol (CBD) is a non-psychotropic cannabinoid with multiple pharmacological properties. Cannabidiol has attracted growing attention in the cosmetic industry, with an increasing number of CBD-containing skincare products on the market in recent years. The aim of this review is to evaluate the current evidence on the use of CBD for cosmetic purposes. Following an overview of CBD and the endocannabinoid system in the skin, we summarize pre-clinical and clinical studies that address the potential of CBD in cosmetic dermatology. Available in vitro and in vivo evidence suggests that CBD has anti-oxidant, anti-inflammatory, moisturizing, anti-acne, wound-healing, and anti-aging properties. However, only a few clinical studies have been conducted on the use of CBD in the skin. In addition, there is a critical need to develop an efficient drug-delivery system for topical/transdermal application of CBD. Further research, including clinical and pharmacokinetic studies, are needed to fully evaluate the role of CBD in cosmetic dermatology.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 6","pages":"951 - 966"},"PeriodicalIF":8.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering the Etiologies of Adult Erythroderma: An Updated Guide to Presentations, Diagnostic Tools, Pathophysiologies, and Treatments 解密成人红斑病因:关于表现、诊断工具、病理生理学和治疗的最新指南》。
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-30 DOI: 10.1007/s40257-024-00886-9
Yanzhen Pang, William Q. Nguyen, Liliana I. Guerrero, Lauren P. Chrisman, Madeline J. Hooper, Morgan C. McCarthy, Molly K. Hales, Rachel E. Lipman, Amy S. Paller, Joan Guitart, Xiaolong A. Zhou

Erythroderma, an inflammatory skin condition characterized by widespread erythema with variable degrees of exfoliation, pustulation, or vesiculobullous formation, is associated with high morbidity and mortality. Determining the underlying cause of erythroderma frequently presents a diagnostic challenge, which may contribute to the condition’s relatively poor prognosis. This review covers the clinical presentation, pathophysiology, diagnosis, and treatment of erythroderma. It discusses similarities and differences among the many underlying etiologies of the condition and differences between erythrodermic and non-erythrodermic presentations of the same dermatosis. Finally, this article explores current research that may provide future tools in the diagnosis and management of erythroderma.

红斑狼疮是一种炎症性皮肤病,其特征是广泛的红斑伴有不同程度的剥脱、脓疱或疱疹形成,发病率和死亡率都很高。确定红斑痤疮的病因常常是一个诊断难题,这可能是该病预后相对较差的原因之一。本综述涵盖红皮病的临床表现、病理生理学、诊断和治疗。文章讨论了红皮病的多种潜在病因之间的异同,以及同一种皮肤病的红皮病和非红皮病表现形式之间的差异。最后,本文探讨了当前的研究,这些研究可能会为红皮病的诊断和治疗提供未来的工具。
{"title":"Deciphering the Etiologies of Adult Erythroderma: An Updated Guide to Presentations, Diagnostic Tools, Pathophysiologies, and Treatments","authors":"Yanzhen Pang,&nbsp;William Q. Nguyen,&nbsp;Liliana I. Guerrero,&nbsp;Lauren P. Chrisman,&nbsp;Madeline J. Hooper,&nbsp;Morgan C. McCarthy,&nbsp;Molly K. Hales,&nbsp;Rachel E. Lipman,&nbsp;Amy S. Paller,&nbsp;Joan Guitart,&nbsp;Xiaolong A. Zhou","doi":"10.1007/s40257-024-00886-9","DOIUrl":"10.1007/s40257-024-00886-9","url":null,"abstract":"<div><p>Erythroderma, an inflammatory skin condition characterized by widespread erythema with variable degrees of exfoliation, pustulation, or vesiculobullous formation, is associated with high morbidity and mortality. Determining the underlying cause of erythroderma frequently presents a diagnostic challenge, which may contribute to the condition’s relatively poor prognosis. This review covers the clinical presentation, pathophysiology, diagnosis, and treatment of erythroderma. It discusses similarities and differences among the many underlying etiologies of the condition and differences between erythrodermic and non-erythrodermic presentations of the same dermatosis. Finally, this article explores current research that may provide future tools in the diagnosis and management of erythroderma.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 6","pages":"927 - 950"},"PeriodicalIF":8.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing Tretinoin to Other Topical Therapies in the Treatment of Skin Photoaging: A Systematic Review 比较曲安奈德与其他治疗皮肤光老化的外用疗法:系统回顾
IF 8.6 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-30 DOI: 10.1007/s40257-024-00893-w
Zoya Siddiqui, Alina Zufall, Marissa Nash, Divya Rao, Rahim Hirani, Marian Russo

Background

Many morphological and histological changes take place in aging skin. Topical tretinoin is the gold standard anti-aging agent used to reduce signs of aging through stimulation of epidermal growth and differentiation and inhibition of collagenase.

Objective

The aim of this systematic review is to summarize studies evaluating the efficacy of tretinoin compared with other topical medications and cosmeceuticals in reducing the appearance of skin aging.

Methods

A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. The literature search was conducted using the PubMed and Embase databases from conception to December 2023. Studies were included if they compared anti-aging outcomes of topical medications with those of topical tretinoin (also called all-trans retinoic acid and retinoic acid). Studies were excluded if they compared non-topical anti-aging treatments with tretinoin or were conducted on animal models.

Results

The literature search resulted in 25 studies that met all inclusion and exclusion criteria. The most common study comparators to tretinoin included other forms of vitamin A. Outcomes were reported on the basis of visual reduction of aging signs, histological assessment of the epidermis and dermis, and protein expression. Although comparators to tretinoin had variable efficacy (greater in 7 studies, equivalent in 13 studies, and less in 3 studies), most studies found the comparator to be less irritating and better tolerated by patients than tretinoin.

Discussion

Tretinoin is currently the gold standard therapy for the treatment of photoaging, but its poor tolerability often limits its use. Unfortunately, given that most studies comparing topical therapies with tretinoin are of poor quality and/or demonstrate bias, there is a lack of substantial evidence to support an alternative first-line therapy. However, given there are some data to support the efficacy of retinoid precursors, namely retinaldehyde, pro-retinal nanoparticles, and conjugated alpha-hydroxy acid and retinoid (AHA-ret), these agents can be considered a second-line option for anti-aging treatment in patients who cannot tolerate tretinoin.

背景:衰老的皮肤会发生许多形态学和组织学上的变化。外用维A酸是抗衰老的金标准药物,通过刺激表皮生长和分化以及抑制胶原酶来减少衰老迹象:本系统综述旨在总结评估曲安奈德与其他外用药物和药妆品在减少皮肤老化外观方面的功效的研究:按照《系统综述和元分析首选报告项目》(PRISMA)指南进行了系统综述。文献检索通过 PubMed 和 Embase 数据库进行,检索期从概念期到 2023 年 12 月。如果研究比较了外用药物与外用维甲酸(也称为全反式维甲酸和维甲酸)的抗衰老效果,则纳入这些研究。将非外用抗衰老疗法与维A酸进行比较或在动物模型上进行比较的研究则排除在外:文献检索结果显示,有 25 项研究符合所有纳入和排除标准。最常见的与维A酸比较的研究包括其他形式的维生素A。研究结果根据衰老迹象的视觉减少、表皮和真皮的组织学评估以及蛋白质表达进行报告。尽管与维A酸相比,对比药物的疗效各不相同(7 项研究的疗效较好,13 项研究的疗效相当,3 项研究的疗效较差),但大多数研究发现,与维A酸相比,对比药物的刺激性较小,患者的耐受性较好:讨论:维甲酸是目前治疗光老化的金标准疗法,但其较差的耐受性往往限制了它的使用。遗憾的是,由于大多数将外用疗法与曲安奈德进行比较的研究质量不佳和/或存在偏差,因此缺乏大量证据来支持替代性一线疗法。不过,鉴于有一些数据支持视黄醇前体(即视黄醛、原视黄醇纳米颗粒和共轭α-羟基酸和视黄醇(AHA-ret))的疗效,这些药物可被视为不能耐受维A酸的患者进行抗衰老治疗的二线选择。
{"title":"Comparing Tretinoin to Other Topical Therapies in the Treatment of Skin Photoaging: A Systematic Review","authors":"Zoya Siddiqui,&nbsp;Alina Zufall,&nbsp;Marissa Nash,&nbsp;Divya Rao,&nbsp;Rahim Hirani,&nbsp;Marian Russo","doi":"10.1007/s40257-024-00893-w","DOIUrl":"10.1007/s40257-024-00893-w","url":null,"abstract":"<div><h3>Background</h3><p>Many morphological and histological changes take place in aging skin. Topical tretinoin is the gold standard anti-aging agent used to reduce signs of aging through stimulation of epidermal growth and differentiation and inhibition of collagenase.</p><h3>Objective</h3><p>The aim of this systematic review is to summarize studies evaluating the efficacy of tretinoin compared with other topical medications and cosmeceuticals in reducing the appearance of skin aging.</p><h3>Methods</h3><p>A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. The literature search was conducted using the PubMed and Embase databases from conception to December 2023. Studies were included if they compared anti-aging outcomes of topical medications with those of topical tretinoin (also called all-trans retinoic acid and retinoic acid). Studies were excluded if they compared non-topical anti-aging treatments with tretinoin or were conducted on animal models.</p><h3>Results</h3><p>The literature search resulted in 25 studies that met all inclusion and exclusion criteria. The most common study comparators to tretinoin included other forms of vitamin A. Outcomes were reported on the basis of visual reduction of aging signs, histological assessment of the epidermis and dermis, and protein expression. Although comparators to tretinoin had variable efficacy (greater in 7 studies, equivalent in 13 studies, and less in 3 studies), most studies found the comparator to be less irritating and better tolerated by patients than tretinoin.</p><h3>Discussion</h3><p>Tretinoin is currently the gold standard therapy for the treatment of photoaging, but its poor tolerability often limits its use. Unfortunately, given that most studies comparing topical therapies with tretinoin are of poor quality and/or demonstrate bias, there is a lack of substantial evidence to support an alternative first-line therapy. However, given there are some data to support the efficacy of retinoid precursors, namely retinaldehyde, pro-retinal nanoparticles, and conjugated alpha-hydroxy acid and retinoid (AHA-ret), these agents can be considered a second-line option for anti-aging treatment in patients who cannot tolerate tretinoin.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 6","pages":"873 - 890"},"PeriodicalIF":8.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Clinical Dermatology
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