Liam J. Caffery, Monica L. Taylor, Lisa M. Abbott, Monika Janda, Pascale Guitera, Victoria Mar, Haley Bennett, Chris Arnold, Stephen Shumack, Tony Caccetta, Robert Miller, H. Peter Soyer
In 2020, [the Australasian College of Dermatologists] released its first teledermatology practice guidelines for Australia, with a commitment to regular updates. This article presents the revised guidelines, aimed at educating dermatologists on the benefits and limitations of telehealth, while promoting safer, higher-quality patient care. The updated guidelines harmonise with the Medical Board of Australia's 2023 telehealth guidelines. They address the growing use of telephone consultations—boosted by Medicare subsidies introduced during the COVID-19 pandemic. The latest guidelines provide recommendations on the appropriate choice of modality (telephone versus video) for teleconsultation. They also include updated guidance on clinical image acquisition. The guidelines are divided into two parts: (1) core recommendations and (2) supporting notes for practical application. Topics covered include teledermatology modalities, patient selection and consent, imaging standards, quality and safety, privacy and security, communication, and documentation, including image retention.
{"title":"Practice Guidelines for Teledermatology in Australia: 2025 Update","authors":"Liam J. Caffery, Monica L. Taylor, Lisa M. Abbott, Monika Janda, Pascale Guitera, Victoria Mar, Haley Bennett, Chris Arnold, Stephen Shumack, Tony Caccetta, Robert Miller, H. Peter Soyer","doi":"10.1111/ajd.14599","DOIUrl":"10.1111/ajd.14599","url":null,"abstract":"<p>In 2020, [<i>the Australasian College of Dermatologists</i>] released its first teledermatology practice guidelines for Australia, with a commitment to regular updates. This article presents the revised guidelines, aimed at educating dermatologists on the benefits and limitations of telehealth, while promoting safer, higher-quality patient care. The updated guidelines harmonise with the Medical Board of Australia's 2023 telehealth guidelines. They address the growing use of telephone consultations—boosted by Medicare subsidies introduced during the COVID-19 pandemic. The latest guidelines provide recommendations on the appropriate choice of modality (telephone versus video) for teleconsultation. They also include updated guidance on clinical image acquisition. The guidelines are divided into two parts: (1) core recommendations and (2) supporting notes for practical application. Topics covered include teledermatology modalities, patient selection and consent, imaging standards, quality and safety, privacy and security, communication, and documentation, including image retention.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e553-e564"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038866","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}
<p>The <i>Choosing Wisely</i> campaign highlights the harm of ‘Too Much Medicine’—overdiagnosis and unnecessary interventions. While much has been written about this topic, less attention has been paid to its counterpart—‘Too Little Medicine’. Two examples from the UK exemplify this; where effective treatments are restricted leading to undertreatment.</p><p>Isotretinoin has been linked to psychiatric and sexual side effects, resulting in usage restrictions [<span>1</span>]. Topical steroid withdrawal (TSW) is recognised as a distinct entity linked to prolonged use of topical steroids, prompting mandatory potency labelling and warnings [<span>2</span>]. Our college has issued statements contradicting these views. High-quality studies do not support a causal link between isotretinoin and psychiatric or sexual dysfunction [<span>3</span>]. Similarly, topical steroids are safe and effective, but ‘steroid phobia’ triggers eczema flares in children [<span>4</span>]. These conflicting conclusions cannot both be correct.</p><p>Here, the COVID-19 pandemic offers valuable insights. Policy responses varied widely—from strict lockdowns to minimal ones and from extensive use of drugs to minimal use of antivirals. What lessons can we draw in hindsight?</p><p>First, adhering to evidence-based medicine (EBM) increases the probability of getting things right [<span>5</span>]. Numerous studies confirmed that even during a pandemic, rigorous clinical trials—including randomised controlled trials—are not only feasible but also essential [<span>6</span>]. Quality matters! More information does not mean more truth—of the quarter of a million articles on COVID-19, many were of poor quality, and over 500 have been retracted [<span>7</span>].</p><p>Second, the GRADE framework ensures decisions consider benefits, harms, patient values, costs and feasibility [<span>5</span>]. For instance, mandated school closures affected 1.5 billion children globally, yet may not have been necessary to control viral spread [<span>8</span>]. Little attention was given to the negative effects—social isolation, mental health issues and lost education—which could have generational consequences [<span>8</span>].</p><p>It is concerning that policy makers did not grade the quality of evidence nor apply GRADE when evaluating isotretinoin or TSW [<span>1, 2</span>]. A myopic view of risk overlooks the harms of withholding effective treatment.</p><p>At best, isotretinoin restrictions will result in fewer patients receiving effective treatment. At worst, patients may suffer irreversible scarring and serious psychiatric illness, including depression and suicide. Similarly, the cautionary labelling of topical steroids may not improve eczema treatment but at worst, it may increase the risk of misdiagnosis. TSW is not a formally accepted diagnosis, with symptoms that overlap with many conditions. In the worst-case scenario, misdiagnosing cutaneous T-cell lymphoma—that can resemble eczema and is similar
{"title":"Too Much and Too Little Medicine Are Two Sides of the Same Coin","authors":"Eugene Tan","doi":"10.1111/ajd.14598","DOIUrl":"10.1111/ajd.14598","url":null,"abstract":"<p>The <i>Choosing Wisely</i> campaign highlights the harm of ‘Too Much Medicine’—overdiagnosis and unnecessary interventions. While much has been written about this topic, less attention has been paid to its counterpart—‘Too Little Medicine’. Two examples from the UK exemplify this; where effective treatments are restricted leading to undertreatment.</p><p>Isotretinoin has been linked to psychiatric and sexual side effects, resulting in usage restrictions [<span>1</span>]. Topical steroid withdrawal (TSW) is recognised as a distinct entity linked to prolonged use of topical steroids, prompting mandatory potency labelling and warnings [<span>2</span>]. Our college has issued statements contradicting these views. High-quality studies do not support a causal link between isotretinoin and psychiatric or sexual dysfunction [<span>3</span>]. Similarly, topical steroids are safe and effective, but ‘steroid phobia’ triggers eczema flares in children [<span>4</span>]. These conflicting conclusions cannot both be correct.</p><p>Here, the COVID-19 pandemic offers valuable insights. Policy responses varied widely—from strict lockdowns to minimal ones and from extensive use of drugs to minimal use of antivirals. What lessons can we draw in hindsight?</p><p>First, adhering to evidence-based medicine (EBM) increases the probability of getting things right [<span>5</span>]. Numerous studies confirmed that even during a pandemic, rigorous clinical trials—including randomised controlled trials—are not only feasible but also essential [<span>6</span>]. Quality matters! More information does not mean more truth—of the quarter of a million articles on COVID-19, many were of poor quality, and over 500 have been retracted [<span>7</span>].</p><p>Second, the GRADE framework ensures decisions consider benefits, harms, patient values, costs and feasibility [<span>5</span>]. For instance, mandated school closures affected 1.5 billion children globally, yet may not have been necessary to control viral spread [<span>8</span>]. Little attention was given to the negative effects—social isolation, mental health issues and lost education—which could have generational consequences [<span>8</span>].</p><p>It is concerning that policy makers did not grade the quality of evidence nor apply GRADE when evaluating isotretinoin or TSW [<span>1, 2</span>]. A myopic view of risk overlooks the harms of withholding effective treatment.</p><p>At best, isotretinoin restrictions will result in fewer patients receiving effective treatment. At worst, patients may suffer irreversible scarring and serious psychiatric illness, including depression and suicide. Similarly, the cautionary labelling of topical steroids may not improve eczema treatment but at worst, it may increase the risk of misdiagnosis. TSW is not a formally accepted diagnosis, with symptoms that overlap with many conditions. In the worst-case scenario, misdiagnosing cutaneous T-cell lymphoma—that can resemble eczema and is similar","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e486-e487"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013833","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}
<p>Cardiovascular disease (CVD) is the leading cause of mortality in individuals with psoriasis, driven by shared inflammatory pathways and modifiable risk factors [<span>1</span>]. Given this heightened risk, lifestyle-based prevention and patient activation are essential. Mobile health (mHealth) strategies such as text messaging (TM) have proven effective in chronic disease management, but their role in psoriasis remains underexplored. User feedback is critical to ensure acceptability, engagement and impact. While guidelines now recommend routine CVD risk assessment in this population [<span>2</span>], uptake in clinical practice remains inconsistent [<span>3</span>], compounded by variable clinician awareness of the psoriasis–CVD link [<span>3</span>]. Furthermore, in the absence of definitive evidence demonstrating that highly effective biologic therapies mitigate cardiovascular risk, a renewed focus on primary prevention and novel patient-centred ways to achieve this must be explored [<span>4</span>]. While mobile health (mHealth) tools such as text messaging have demonstrated value in chronic disease prevention, their role in psoriasis is largely underexplored [<span>5-7</span>]. The International Psoriasis Council released a statement in 2021 recommending the integration of digital models of care into routine practice [<span>8</span>].</p><p>This single-centre randomised controlled trial evaluated a text messaging (TM) intervention designed to enhance patient activation and support cardiovascular disease (CVD) prevention in psoriasis. Participants were randomised 1:1 to receive either standard care or a six-month TM programme delivering behaviourally framed, evidence-based messages. At study end, participants completed a structured survey comprising Likert-scale and free-text items assessing message utility, engagement and behavioural impact; controls completed matched questions on lifestyle change. The trial was conducted at a tertiary referral hospital in Sydney, Australia, from February 2024 to January 2025 (HREC 2020/ETH02033; ACTRN12621000141831). Primary and other secondary outcomes are reported separately [<span>9</span>]. This analysis focusses on user feedback to assess feasibility, engagement and acceptability of the intervention. A total of 111 participants were enrolled (mean age 51.8 ± 13.2 years; 65.1% male); 55 were randomised to the intervention. Most had early-onset psoriasis (83.8%), 74.8% were receiving biologics, and 49.5% had ≥ 1 cardiovascular risk factor.</p><p>Structured user feedback was completed by 35 of 55 intervention participants (63.6%) and 34 of 56 controls (60.7%), with both groups answering matched behavioural questions on motivation, physical activity, diet and medication adherence. Free-text responses were collected from both groups; thematic analysis focussed on responses from the intervention arm.</p><p>The text messaging intervention was well-received, with high engagement and self-reported improvemen
{"title":"Integrating Cardiovascular Prevention Into Psoriasis Care Using Text Messaging: Insights From the TEXTME PSO Trial","authors":"Annika Smith, Dominique Hespe, Clara K. Chow","doi":"10.1111/ajd.14595","DOIUrl":"10.1111/ajd.14595","url":null,"abstract":"<p>Cardiovascular disease (CVD) is the leading cause of mortality in individuals with psoriasis, driven by shared inflammatory pathways and modifiable risk factors [<span>1</span>]. Given this heightened risk, lifestyle-based prevention and patient activation are essential. Mobile health (mHealth) strategies such as text messaging (TM) have proven effective in chronic disease management, but their role in psoriasis remains underexplored. User feedback is critical to ensure acceptability, engagement and impact. While guidelines now recommend routine CVD risk assessment in this population [<span>2</span>], uptake in clinical practice remains inconsistent [<span>3</span>], compounded by variable clinician awareness of the psoriasis–CVD link [<span>3</span>]. Furthermore, in the absence of definitive evidence demonstrating that highly effective biologic therapies mitigate cardiovascular risk, a renewed focus on primary prevention and novel patient-centred ways to achieve this must be explored [<span>4</span>]. While mobile health (mHealth) tools such as text messaging have demonstrated value in chronic disease prevention, their role in psoriasis is largely underexplored [<span>5-7</span>]. The International Psoriasis Council released a statement in 2021 recommending the integration of digital models of care into routine practice [<span>8</span>].</p><p>This single-centre randomised controlled trial evaluated a text messaging (TM) intervention designed to enhance patient activation and support cardiovascular disease (CVD) prevention in psoriasis. Participants were randomised 1:1 to receive either standard care or a six-month TM programme delivering behaviourally framed, evidence-based messages. At study end, participants completed a structured survey comprising Likert-scale and free-text items assessing message utility, engagement and behavioural impact; controls completed matched questions on lifestyle change. The trial was conducted at a tertiary referral hospital in Sydney, Australia, from February 2024 to January 2025 (HREC 2020/ETH02033; ACTRN12621000141831). Primary and other secondary outcomes are reported separately [<span>9</span>]. This analysis focusses on user feedback to assess feasibility, engagement and acceptability of the intervention. A total of 111 participants were enrolled (mean age 51.8 ± 13.2 years; 65.1% male); 55 were randomised to the intervention. Most had early-onset psoriasis (83.8%), 74.8% were receiving biologics, and 49.5% had ≥ 1 cardiovascular risk factor.</p><p>Structured user feedback was completed by 35 of 55 intervention participants (63.6%) and 34 of 56 controls (60.7%), with both groups answering matched behavioural questions on motivation, physical activity, diet and medication adherence. Free-text responses were collected from both groups; thematic analysis focussed on responses from the intervention arm.</p><p>The text messaging intervention was well-received, with high engagement and self-reported improvemen","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"489-491"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022791","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}
Rebecca Shackle, Samir Burhan, Samuel Der Sarkissian, Haady Fallah
{"title":"Superficial Granulomatous Pyoderma: A Case Report With Diffuse Cutaneous Involvement and a Systematic Review of the Literature","authors":"Rebecca Shackle, Samir Burhan, Samuel Der Sarkissian, Haady Fallah","doi":"10.1111/ajd.14596","DOIUrl":"10.1111/ajd.14596","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"492-494"},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Generalised Bullous Fixed Drug Eruption (GBFDE) is a subtype of Fixed Drug Eruption (FDE) characterised by the development of generalised blisters on the background of dusky macules. There is no gold standard treatment, but the condition is conventionally managed with supportive care, topical and oral steroids and occasionally ciclosporin. We describe the case of a 75-year-old female with GBFDE, who demonstrated a rapid halt in disease progression and re-epithelialisation following a single dose of etanercept. This case highlights the potential role of etanercept in the management of GBFDE.
{"title":"The Use of Etanercept in the Palliative Treatment of a Patient With Generalised Bullous Fixed Drug Eruption","authors":"Olga Pawlik, Timothy Cowan, Andrew Miller","doi":"10.1111/ajd.14577","DOIUrl":"10.1111/ajd.14577","url":null,"abstract":"<p>Generalised Bullous Fixed Drug Eruption (GBFDE) is a subtype of Fixed Drug Eruption (FDE) characterised by the development of generalised blisters on the background of dusky macules. There is no gold standard treatment, but the condition is conventionally managed with supportive care, topical and oral steroids and occasionally ciclosporin. We describe the case of a 75-year-old female with GBFDE, who demonstrated a rapid halt in disease progression and re-epithelialisation following a single dose of etanercept. This case highlights the potential role of etanercept in the management of GBFDE.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e471-e473"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940303","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}
Joseph Joseph, Alexandra Murray, Kelvin Truong, Artiene Tatian
Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited progressive blistering skin disorder caused by mutations in the COL7A1 gene. Chronic wounds lead to cycles of scarring and healing, causing severe functional deformities. Losartan is an angiotensin II type 1 receptor (AT1R) antagonist that has been shown to have antifibrotic activity via inhibiting the production of transforming growth factor beta (TGF-B) and has a favourable safety profile in children. In this systematic review, there were five studies found, with a total of 59 patients including case series, case–control and an open label phase 2 clinical trial. These studies have demonstrated the safety of losartan with no significant adverse effects such as hypotension, hyperkalaemia and hypersensitivity. They have also demonstrated evidence of efficacy utilising subjective assessments and objective criteria such as the Birmingham Epidermolysis Bullosa Severity score (BEBS) and Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI). Although safe and effective, further clinical trials are required to fully elucidate the role of this treatment; whether this approach should be standardised across the RDEB patient cohort is yet to be determined from the current evidence.
{"title":"Safety and Efficacy of Angiotensin Receptor Antagonists in Recessive Dystrophic Epidermolysis Bullosa","authors":"Joseph Joseph, Alexandra Murray, Kelvin Truong, Artiene Tatian","doi":"10.1111/ajd.14594","DOIUrl":"10.1111/ajd.14594","url":null,"abstract":"<div>\u0000 \u0000 <p>Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited progressive blistering skin disorder caused by mutations in the COL7A1 gene. Chronic wounds lead to cycles of scarring and healing, causing severe functional deformities. Losartan is an angiotensin II type 1 receptor (AT1R) antagonist that has been shown to have antifibrotic activity via inhibiting the production of transforming growth factor beta (TGF-B) and has a favourable safety profile in children. In this systematic review, there were five studies found, with a total of 59 patients including case series, case–control and an open label phase 2 clinical trial. These studies have demonstrated the safety of losartan with no significant adverse effects such as hypotension, hyperkalaemia and hypersensitivity. They have also demonstrated evidence of efficacy utilising subjective assessments and objective criteria such as the Birmingham Epidermolysis Bullosa Severity score (BEBS) and Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI). Although safe and effective, further clinical trials are required to fully elucidate the role of this treatment; whether this approach should be standardised across the RDEB patient cohort is yet to be determined from the current evidence.</p>\u0000 <p><b>Trial Registration:</b> PROSPERO ID: CRD42024557126</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e414-e419"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case series of four patients who had scabies diagnosed while on Dupilumab treatment for atopic dermatitis. The Type 2 immune response is the primary immune response for both ordinary and crusted scabies, and Dupilumab inhibits this response. This inhibition could be the reason behind treatment resistance and crusted presentations in this case series. Clinicians should be aware of the possible development of scabies in patients on Dupilumab and the potential of scabies masquerading as atopic dermatitis at the time of instituting this medication.
{"title":"Case Series: Scabies Complicating Dupilumab Therapy for Atopic Dermatitis","authors":"Madeleine Louise Kelly, Robert M. Miller","doi":"10.1111/ajd.14589","DOIUrl":"10.1111/ajd.14589","url":null,"abstract":"<div>\u0000 \u0000 <p>We present a case series of four patients who had scabies diagnosed while on Dupilumab treatment for atopic dermatitis. The Type 2 immune response is the primary immune response for both ordinary and crusted scabies, and Dupilumab inhibits this response. This inhibition could be the reason behind treatment resistance and crusted presentations in this case series. Clinicians should be aware of the possible development of scabies in patients on Dupilumab and the potential of scabies masquerading as atopic dermatitis at the time of instituting this medication.</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"422-424"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Cascio Ingurgio, A. Alfano, E. Matteodo, M. Stark, M. Valenti, A. Narcisi, A. Costanzo, D. F. Murrell
Background
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with systemic implications. While biologic therapies have demonstrated efficacy in controlling cutaneous lesions, their systemic effects, particularly on lipid metabolism as a marker of systemic inflammation, are less understood.
Objectives
To evaluate the impact of biologic therapy on clinical severity and lipid profiles in HS patients in a real-world setting, comparing outcomes between Early and Late Responders at Week 24 ± 4.
Methods
Twenty-four patients with moderate-to-severe HS on biologic therapy were monitored prospectively at Baseline, Week 24 ± 4, Week 52 and Week 104. Clinical parameters (IHS4, A/N, HS-IGA) and lipid profiles (cholesterol, triglycerides) were analysed. Patients were categorised as Early (IHS4 ≤ 10) or Late Responders (IHS4 ≥ 11) at Week 24 ± 4. Statistical analysis included t-tests; significance was set at p < 0.05.
Results
Early Responders showed significant clinical improvement and reductions in lipid levels, suggesting a systemic anti-inflammatory effect of therapy. However, lipid reductions did not reach statistical significance (p > 0.05); likely due to the small sample size. Late Responders demonstrated less pronounced changes.
Conclusions
Biologic therapy appears to improve both clinical and systemic inflammatory markers in HS, highlighting the value of metabolic monitoring in routine care.
{"title":"Effectiveness of Biologic Therapy in Hidradenitis Suppurativa: Real-World Clinical Outcomes and Lipid Profile Evaluation","authors":"R. Cascio Ingurgio, A. Alfano, E. Matteodo, M. Stark, M. Valenti, A. Narcisi, A. Costanzo, D. F. Murrell","doi":"10.1111/ajd.14592","DOIUrl":"10.1111/ajd.14592","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with systemic implications. While biologic therapies have demonstrated efficacy in controlling cutaneous lesions, their systemic effects, particularly on lipid metabolism as a marker of systemic inflammation, are less understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the impact of biologic therapy on clinical severity and lipid profiles in HS patients in a real-world setting, comparing outcomes between Early and Late Responders at Week 24 ± 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four patients with moderate-to-severe HS on biologic therapy were monitored prospectively at Baseline, Week 24 ± 4, Week 52 and Week 104. Clinical parameters (IHS4, A/N, HS-IGA) and lipid profiles (cholesterol, triglycerides) were analysed. Patients were categorised as Early (IHS4 ≤ 10) or Late Responders (IHS4 ≥ 11) at Week 24 ± 4. Statistical analysis included <i>t</i>-tests; significance was set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Early Responders showed significant clinical improvement and reductions in lipid levels, suggesting a systemic anti-inflammatory effect of therapy. However, lipid reductions did not reach statistical significance (<i>p</i> > 0.05); likely due to the small sample size. Late Responders demonstrated less pronounced changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Biologic therapy appears to improve both clinical and systemic inflammatory markers in HS, highlighting the value of metabolic monitoring in routine care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"468-474"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940344","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}
Andjela Arandjelovic, Andrew Awad, Jenny Nicolopoulos, Con Dolianitis
Buerger's disease or thromboangiitis obliterans is a nonatherosclerotic inflammatory disease that affects the small and medium-sized arteries in the extremities. We describe a 46-year-old man with Buerger's disease, who achieved regression of acute ulceration of his lower limbs and remission of his disease with pentoxifylline. Usually thought to just improve pain-free walking distance, this is the first case that demonstrates pentoxifylline may in fact improve the acute cutaneous features and progression of Buerger's disease.
{"title":"Buerger's Disease: Successful Management of Acute Cutaneous Features and Achieving Disease Remission With Pentoxifylline","authors":"Andjela Arandjelovic, Andrew Awad, Jenny Nicolopoulos, Con Dolianitis","doi":"10.1111/ajd.14593","DOIUrl":"https://doi.org/10.1111/ajd.14593","url":null,"abstract":"<div>\u0000 \u0000 <p>Buerger's disease or thromboangiitis obliterans is a nonatherosclerotic inflammatory disease that affects the small and medium-sized arteries in the extremities. We describe a 46-year-old man with Buerger's disease, who achieved regression of acute ulceration of his lower limbs and remission of his disease with pentoxifylline. Usually thought to just improve pain-free walking distance, this is the first case that demonstrates pentoxifylline may in fact improve the acute cutaneous features and progression of Buerger's disease.</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e466-e470"},"PeriodicalIF":1.8,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ugochukwu Kingsley Odega, Wilson Omesiete, Adam Carlson, R. Hal Flowers
Background
Psoriatic arthritis (PsA) is a chronic inflammatory arthritis involving axial and peripheral joints and tendons that affects a subset of patients with psoriasis (PsO). PsA can be a debilitating disease and warrants prompt rheumatologic evaluation and management. The diagnosis of PsA can be challenging for the practising dermatologist as there is often an overlap in the symptoms of PsA and non-inflammatory musculoskeletal conditions such as osteoarthritis, tendonitis and myofascial pain.
Aims
The primary aim of the study is to examine psoriasis patients seen at our tertiary institution's combined rheum-derm clinic for a concern for PsA, specifically examining the revised diagnosis and the joint symptom similarities to psoriatic arthritis.
Methods and Material
We performed a retrospective chart review of patients referred to the rheumatology-dermatology clinic (RDC) at our institution between November 2019 and March 2022. Our review included 242 patients, of which 34 (14%) were psoriasis patients specifically referred due to suspicion for PsA. Each patient underwent a comprehensive rheumatic evaluation, including history, physical examination, laboratory tests and imaging as needed.
Results
Fourteen (41.2%) of the 34 patients referred for suspected PsA were diagnosed with non-inflammatory musculoskeletal conditions, primarily mechanical joint pain. Stiffness and/or swelling were significantly more common among patients with confirmed PsA.
Conclusions
These findings underscore the importance of thorough evaluation of musculoskeletal symptoms, particularly stiffness and swelling, in patients with psoriasis. Improving education on distinguishing non-inflammatory musculoskeletal conditions may enhance diagnostic accuracy and optimise referral practices.
{"title":"Characterising Alternative Diagnoses to Psoriatic Arthritis in a Rheumatology-Dermatology Combined Clinic","authors":"Ugochukwu Kingsley Odega, Wilson Omesiete, Adam Carlson, R. Hal Flowers","doi":"10.1111/ajd.14585","DOIUrl":"10.1111/ajd.14585","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psoriatic arthritis (PsA) is a chronic inflammatory arthritis involving axial and peripheral joints and tendons that affects a subset of patients with psoriasis (PsO). PsA can be a debilitating disease and warrants prompt rheumatologic evaluation and management. The diagnosis of PsA can be challenging for the practising dermatologist as there is often an overlap in the symptoms of PsA and non-inflammatory musculoskeletal conditions such as osteoarthritis, tendonitis and myofascial pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The primary aim of the study is to examine psoriasis patients seen at our tertiary institution's combined rheum-derm clinic for a concern for PsA, specifically examining the revised diagnosis and the joint symptom similarities to psoriatic arthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Material</h3>\u0000 \u0000 <p>We performed a retrospective chart review of patients referred to the rheumatology-dermatology clinic (RDC) at our institution between November 2019 and March 2022. Our review included 242 patients, of which 34 (14%) were psoriasis patients specifically referred due to suspicion for PsA. Each patient underwent a comprehensive rheumatic evaluation, including history, physical examination, laboratory tests and imaging as needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen (41.2%) of the 34 patients referred for suspected PsA were diagnosed with non-inflammatory musculoskeletal conditions, primarily mechanical joint pain. Stiffness and/or swelling were significantly more common among patients with confirmed PsA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings underscore the importance of thorough evaluation of musculoskeletal symptoms, particularly stiffness and swelling, in patients with psoriasis. Improving education on distinguishing non-inflammatory musculoskeletal conditions may enhance diagnostic accuracy and optimise referral practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"462-467"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940300","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}
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