Anais brasileiros de dermatologia最新文献

英文中文

Efficacy and safety of secukinumab in psoriasis: five-year real life experience secukinumab 治疗银屑病的疗效和安全性：五年真实体验。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-19 DOI: 10.1016/j.abd.2023.12.004

Ersoy Acer , Hilal Kaya Erdoğan , Esra Ağaoğlu , Hatice Baştürk , Muzaffer Bilgin , Zeynep Nurhan Saraçoğlu

Background

The efficacy and safety of secukinumab in psoriasis patients has been demonstrated in randomized controlled clinical trials.

Objectives

The authors aimed to evaluate the efficacy and safety of secukinumab in plaque psoriasis patients followed in our clinic.

Methods

Data from 101 plaque psoriasis patients who received at least 16 weeks of secukinumab treatment between June 2018 and June 2023 were retrospectively analyzed.

Results

Fifty-three (53%) of the patients were bionaive. PASI-75, -90, -100 response rates were 72%, 50%, 30% respectively at week 16 in all patients. PASI-75 and -90 responses were higher in naive patients at weeks 16 and 28 (p < 0.001, p < 0.001, p < 0.01, p = 0.01, respectively). The percentage of patients with PASI ≤ 1, ≤ 3, ≤ 5 were 50%, 77%, and 92%, respectively at week 16. They were higher in the naive group than in nonnaive group at weeks 16 and 28 (p = 0.02, p < 0.01, p = 0.05, p = 0.07, p < 0.01, p = 0.03, respectively). At week 52, PASI-75, -90, -100 responses were significantly lower in smoking patients (p = 0.04, p = 0.03, p < 0.01, respectively). The mean duration of secukinumab treatment was 19.80 ± 12.76 months. Secukinumab was discontinued 14 (26.4%) naive patients and 28 (58.3%) nonnaive patients at one occasion during treatment (p < 0.001). The most common adverse event in patients was mucocutaneous candida infection (8%). No hepatitis B or C reactivation and no active or reactivation tuberculosis were observed in any of the patients during the follow-up period.

Study limitations

This is a single-center retrospective study with relatively few patients including only the Turkish population.

Conclusion

Secukinumab seems to be effective in plaque psoriasis, particularly in bionaive and non-smokers. Moreover, it is safe in patients with inactive hepatitis or tuberculosis.

背景在随机对照临床试验中证实了赛库单抗对银屑病患者的疗效和安全性：作者旨在评估secukinumab在本诊所随访的斑块状银屑病患者中的疗效和安全性：回顾性分析了2018年6月至2023年6月期间接受至少16周赛库单抗治疗的101名斑块状银屑病患者的数据：53名（53%）患者为仿生免疫患者。所有患者在第16周时的PASI-75、-90、-100应答率分别为72%、50%、30%。在第 16 周和第 28 周，天真患者的 PASI-75 和 -90 反应率较高（P 研究的局限性：这是一项单中心回顾性研究，患者数量相对较少，仅包括土耳其人群：结论：塞库单抗似乎对斑块状银屑病有效，尤其是对仿生者和非吸烟者。此外，它对非活动性肝炎或结核病患者也是安全的。

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引用次数: 0

Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials 自体富血小板血浆能增加雄激素性脱发患者的毛发密度吗？随机临床试验的系统回顾和荟萃分析⋆。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-15 DOI: 10.1016/j.abd.2024.01.002

Lucas Kieling , Ana Terezinha Konzen , Rafaela Koehler Zanella , Denis Souto Valente

Fundamentals

Platelet-rich plasma (PRP) has been progressively more used in androgenetic alopecia (AGA).

Objectives

The authors aimed to evaluate PRP efficacy compared to placebo in AGA.

Methods

A comprehensive search was conducted across seven databases, until 01/04/2023. Randomized clinical trials focusing on AGA and PRP use to increase hair density were included. Patients aged between 15 and 63 years, diagnosed with AGA characterized by Norwood I‒VII and Ludwig I‒III scales, were included. Studies with a sample size <10, lacking PRP processing method, focusing on complementary therapies or other alopecias, were excluded. The authors conducted subgroup analysis for activator, spin method, study design, risk of bias, and gender. Meta-regression was conducted for activator, spin method, design, and gender. The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias. Asymmetry was measured through a Funnel plot followed by Egger’s test. The protocol was registered at PROSPERO (CRD42023407334).

Results

The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis, with 13 studies included in the meta-analysis. Meta-analysis demonstrated a mean difference of 27.55 hairs/cm² and 95% CI (14.04; 41.06), I² = 95.99%, p < 0.05. Hair diameter meta-analysis presented a mean difference of 2.02 μm, 95% CI (−0.85 μm; 4.88 μm), and I² = 77.11% (p = 0.02). That is, low quality evidence.

Study limitations

Studies were highly heterogeneous, of low quality, and presented evident publication bias.

Conclusions

Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA, so further high-quality randomized clinical trials are recommended to strengthen the evidence.

基本原理：富血小板血浆（PRP）在雄激素性脱发（AGA）中的应用越来越广泛：作者旨在评估 PRP 在 AGA 中与安慰剂相比的疗效：方法：作者对七个数据库进行了全面检索，检索期至 2023 年 4 月 1 日。方法：在 7 个数据库中进行了全面搜索，直至 2023 年 4 月 1 日。纳入了以 AGA 和使用 PRP 增加头发密度为重点的随机临床试验。纳入的患者年龄在 15 至 63 岁之间，根据诺伍德 I-VII 和路德维希 I-III 量表被诊断为 AGA。有样本量的研究结果：作者筛选了 555 份登记资料，纳入了 14 项研究（涉及 431 名患者）进行定性综合，并将 13 项研究纳入了荟萃分析。荟萃分析表明，平均差异为 27.55 根头发/平方厘米，95% CI (14.04; 41.06)，I2 = 95.99%，P 2 = 77.11% (P = 0.02)。即证据质量较低：研究的局限性：研究高度异质性，质量较低，存在明显的发表偏倚：结论：具有发表偏倚的高度异质性研究表明，PRP 可有效增加 AGA 患者的毛发密度，因此建议进一步开展高质量的随机临床试验以加强证据。

{"title":"Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials","authors":"Lucas Kieling , Ana Terezinha Konzen , Rafaela Koehler Zanella , Denis Souto Valente","doi":"10.1016/j.abd.2024.01.002","DOIUrl":"10.1016/j.abd.2024.01.002","url":null,"abstract":"<div><h3>Fundamentals</h3><div>Platelet-rich plasma (PRP) has been progressively more used in androgenetic alopecia (AGA).</div></div><div><h3>Objectives</h3><div>The authors aimed to evaluate PRP efficacy compared to placebo in AGA.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across seven databases, until 01/04/2023. Randomized clinical trials focusing on AGA and PRP use to increase hair density were included. Patients aged between 15 and 63 years, diagnosed with AGA characterized by Norwood I‒VII and Ludwig I‒III scales, were included. Studies with a sample size <10, lacking PRP processing method, focusing on complementary therapies or other alopecias, were excluded. The authors conducted subgroup analysis for activator, spin method, study design, risk of bias, and gender. Meta-regression was conducted for activator, spin method, design, and gender. The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias. Asymmetry was measured through a Funnel plot followed by Egger’s test. The protocol was registered at PROSPERO (CRD42023407334).</div></div><div><h3>Results</h3><div>The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis, with 13 studies included in the meta-analysis. Meta-analysis demonstrated a mean difference of 27.55 hairs/cm<sup>2</sup> and 95% CI (14.04; 41.06), I<sup>2</sup> = 95.99%, p < 0.05. Hair diameter meta-analysis presented a mean difference of 2.02 μm, 95% CI (−0.85 μm; 4.88 μm), and I<sup>2</sup> = 77.11% (p = 0.02). That is, low quality evidence.</div></div><div><h3>Study limitations</h3><div>Studies were highly heterogeneous, of low quality, and presented evident publication bias.</div></div><div><h3>Conclusions</h3><div>Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA, so further high-quality randomized clinical trials are recommended to strengthen the evidence.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"99 6","pages":"Pages 847-862"},"PeriodicalIF":2.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Vascularized parallel-ridge pattern: dermoscopic sign in acral melanoma with anatomopathological correlation 血管化平行脊模式：与解剖病理学相关的尖锐湿疣黑色素瘤皮肤镜征象。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-15 DOI: 10.1016/j.abd.2023.09.010

Elisa Scandiuzzi Maciel , Masiel Garcia Fernandez , Milvia Maria Simões e Silva Enokihara , Sérgio Henrique Hirata

引用次数: 0

Dermoscopic monitoring of pediatric melanocytic nevi regarding pattern and diameter changes 皮肤镜监测小儿黑素细胞痣的形态和直径变化。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-14 DOI: 10.1016/j.abd.2024.01.004

Dilara İlhan Erdil , Ayşe Esra Koku Aksu , Vefa Aslı Turgut Erdemir , Duygu Erdil , Cem Leblebici , Asude Kara Polat

Background

Childhood and adolescence are dynamic period in terms of nevogenesis, and the development and growth of new melanocytic nevus are frequently observed. In this study, the aim was to examine the pattern and diameter changes seen in the follow-up of pediatric melanocytic nevus.

Objectives

To describe the pattern and diameter changes seen in the follow-up of pediatric melanocytic.

Methods

Our study involved the assessment of 301 pediatric melanocytic nevi in 50 patients attended at the Dermatology Clinic of Istanbul Training and Research Hospital between January 2008 and 2022. The pediatric melanocytic nevi were diagnosed clinically and dermoscopically. Subsequently, we conducted video-dermoscopic monitoring of these nevi over a span of 3 months to 3 years.

Results

46% of our patients were female (n = 23), with a mean age of 11.5 years. While the pattern of nevi was globular in 40% patients, the rate of globular pattern decreased to 30% in the follow-up. The basal homogeneous nevus pattern was seen in 10% patients, but was detected in 13.9% in the follow-up. Peripheral globules were observed in 19.3% of the cases, but in the follow-up, 61.1% of the globules regressed completely. Nevus excision was indicated in only 11 of 301 nevi.

Study limitations

Single-center study and a small of studies available on this subject.

Conclusions

Pediatric melanocytic nevi can show dynamic changes compared to nevi in adults. In this study, growth rates, dermoscopic features, and pattern changes seen in the follow-up of melanocytic nevi were evaluated. The globular pattern was observed most frequently. The presence of peripheral globules is frequently observed in pediatric melanocytic nevi with regression during the follow-up period.

背景：儿童和青少年时期是痣生成的动态时期，经常可以观察到新的黑素细胞痣的发育和生长。本研究旨在观察小儿黑色素细胞痣随访中的形态和直径变化：描述小儿黑色素细胞痣随访中出现的形态和直径变化：2008年1月至2022年期间，伊斯坦布尔培训与研究医院皮肤病诊所对50名就诊患者中的301个小儿黑素细胞痣进行了评估。这些小儿黑素细胞痣是通过临床和皮肤镜诊断出来的。随后，我们对这些痣进行了 3 个月至 3 年的视频皮肤镜监测：结果：46%的患者为女性（23 人），平均年龄为 11.5 岁。40%的患者痣的形态为球状，但在随访中，球状形态的比例降至30%。10%的患者出现基底均质痣形态，但在随访中，13.9%的患者发现了这种形态。19.3%的病例观察到周边球状痣，但在随访中，61.1%的球状痣完全消退。301个痣中只有11个需要切除：研究局限性：单中心研究，相关研究较少：结论：与成人黑素细胞痣相比，小儿黑素细胞痣会出现动态变化。本研究评估了随访黑色素细胞痣的生长率、皮肤镜特征和形态变化。最常观察到的是球状形态。在小儿黑素细胞痣中，经常可以观察到外周球状物，并在随访期间消退。

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引用次数: 0

Acquired ichthyosis as a messenger to gastric diffuse large B-cell lymphoma 后天性鱼鳞病是胃弥漫大 B 细胞淋巴瘤的信使。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-14 DOI: 10.1016/j.abd.2023.08.020

引用次数: 0

Two years of innovative dermatological care: the first public health consultation service for the transgender and gender diverse community in Argentina 两年的创新皮肤病护理：阿根廷首个变性和性别多元化社区公共卫生咨询服务。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-14 DOI: 10.1016/j.abd.2024.03.003

Lola Kuperman Wilder , Valeria Orsi , Gonzalo Chebi , Maria Agustina Balague , Luciana Cabral Campana

Background

The LGBTQI + community encounters distinct healthcare challenges due to discrimination and inadequate understanding of their needs. Dermatologists play a crucial role in addressing this by fostering inclusiveness, recognizing individual concerns, and adopting tailored approaches, thereby promoting a more equitable healthcare system.

Objective

To address the need for an inclusive healthcare space, the authors established the first dermatological practice exclusively for transgender and non-binary patients. This article presents a comprehensive two-year experience in a public hospital.

Methods

The authors conducted a retrospective and descriptive study, analyzing the medical records of 114 patients evaluated at a specialized dermatological practice between June 2021 and May 2023. Key variables assessed included self-identified gender, age, residence, access to private healthcare, human immunodeficiency virus status, hormonal treatment, surgical interventions, consultation motives, employment stability, and family support during gender expression transition.

Results

The present study included 114 patients, 49.1% trans men, 39.5% trans women, and 8.8% non-binary individuals. Trans men, on average younger than trans women (p < 0.001), predominantly sought care for body modification-related concerns, particularly acne and androgenetic alopecia. In contrast, trans women exhibited a more diverse range of consultation motives typically unrelated to hormonal or surgical procedures.

Study limitations

This study is retrospective and limited in geographic scope. Additionally, the patient population lacked diversity in terms of Black ethnicity.

Conclusions

The pioneering dermatological practice for transgender and non-binary patients exemplifies healthcare equity and cultural competence. Effective LGBTQI + healthcare requires addressing unique dermatological concerns while fostering inclusiveness and continuous learning within the medical community.

背景：LGBTQI +群体由于受到歧视和对自身需求了解不足，在医疗保健方面面临着独特的挑战。皮肤科医生在解决这一问题方面发挥着至关重要的作用，他们促进包容性，认识到个人的关切，并采取量身定制的方法，从而促进医疗保健系统更加公平：为了满足对包容性医疗空间的需求，作者建立了第一家专为变性和非二元患者服务的皮肤科诊所。本文全面介绍了一家公立医院两年来的经验：作者进行了一项回顾性和描述性研究，分析了 2021 年 6 月至 2023 年 5 月期间在一家皮肤科专科诊所接受评估的 114 名患者的医疗记录。评估的主要变量包括自我认定的性别、年龄、居住地、获得私人医疗服务的机会、人类免疫缺陷病毒感染状况、激素治疗、手术干预、就诊动机、就业稳定性以及性别表达转换期间的家庭支持：本研究共纳入 114 名患者，其中变性男性占 49.1%，变性女性占 39.5%，非二元个体占 8.8%。变性男性平均比变性女性年轻（p 研究局限性：本研究为回顾性研究，地域范围有限。此外，就黑人种族而言，患者人群缺乏多样性：针对变性和非二元患者的皮肤科开创性实践体现了医疗公平和文化能力。有效的 LGBTQI + 医疗保健需要解决独特的皮肤病问题，同时促进医疗界的包容性和持续学习。

{"title":"Two years of innovative dermatological care: the first public health consultation service for the transgender and gender diverse community in Argentina","authors":"Lola Kuperman Wilder , Valeria Orsi , Gonzalo Chebi , Maria Agustina Balague , Luciana Cabral Campana","doi":"10.1016/j.abd.2024.03.003","DOIUrl":"10.1016/j.abd.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The LGBTQI + community encounters distinct healthcare challenges due to discrimination and inadequate understanding of their needs. Dermatologists play a crucial role in addressing this by fostering inclusiveness, recognizing individual concerns, and adopting tailored approaches, thereby promoting a more equitable healthcare system.</div></div><div><h3>Objective</h3><div>To address the need for an inclusive healthcare space, the authors established the first dermatological practice exclusively for transgender and non-binary patients. This article presents a comprehensive two-year experience in a public hospital.</div></div><div><h3>Methods</h3><div>The authors conducted a retrospective and descriptive study, analyzing the medical records of 114 patients evaluated at a specialized dermatological practice between June 2021 and May 2023. Key variables assessed included self-identified gender, age, residence, access to private healthcare, human immunodeficiency virus status, hormonal treatment, surgical interventions, consultation motives, employment stability, and family support during gender expression transition.</div></div><div><h3>Results</h3><div>The present study included 114 patients, 49.1% trans men, 39.5% trans women, and 8.8% non-binary individuals. Trans men, on average younger than trans women (p < 0.001), predominantly sought care for body modification-related concerns, particularly acne and androgenetic alopecia. In contrast, trans women exhibited a more diverse range of consultation motives typically unrelated to hormonal or surgical procedures.</div></div><div><h3>Study limitations</h3><div>This study is retrospective and limited in geographic scope. Additionally, the patient population lacked diversity in terms of Black ethnicity.</div></div><div><h3>Conclusions</h3><div>The pioneering dermatological practice for transgender and non-binary patients exemplifies healthcare equity and cultural competence. Effective LGBTQI + healthcare requires addressing unique dermatological concerns while fostering inclusiveness and continuous learning within the medical community.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"99 6","pages":"Pages 869-874"},"PeriodicalIF":2.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

8-Hydroxy-2’-deoxyguanosine protein immunoexpression is associated with the pathogenesis of actinic cheilitis - Replay 8-羟基-2'-脱氧鸟苷蛋白免疫表达与光化性咽颊炎的发病机制有关 - Replay。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-08 DOI: 10.1016/j.abd.2024.04.003

引用次数: 0

Transient neonatal zinc deficiency or acrodermatitis enteropathica? 一过性新生儿锌缺乏症还是肠病性肢皮炎？

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.abd.2023.08.018

引用次数: 0

Acquired dermal melanocytosis restricted to the hand 局限于手部的获得性真皮黑素细胞增多症。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-06-29 DOI: 10.1016/j.abd.2023.05.013

引用次数: 0

Psoriasiform rash following maculopapular eruption during the continued administration of pembrolizumab 在持续服用 pembrolizumab 期间，继斑丘疹后出现牛皮癣样皮疹。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2024-06-29 DOI: 10.1016/j.abd.2023.03.012

引用次数: 0

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