Samantha Ting MD, FRACGP, Patricia Lowe MBBS, MMed, FACD, Annika Smith MBBS, MPHTM, FRACP, FACD, Pablo Fernández-Peñas MD, PhD, FACD
Background
The advent of novel biologics has led to an increase in biologic-switching as patients and clinicians pursue improved clinical outcomes. However, guidance on treatment sequencing in an Australian setting is sparse. This study examines the patterns of care across two tertiary centres in Australia and characterizes the factors contributing to biologic-switching.
Methods
A retrospective study of patients who attended the outpatient Dermatology biologic clinics across two tertiary hospitals was conducted. Data on treatment sequencing and patients' PASI at every visit from April 2006 to December 2020 were collected. Patterns of biologic-switching were examined. The speed of treatment response for each biologic was determined by the time to achieve PASI-90 and -100 for each treatment course.
Results
A total of 440 treatment courses were analysed. Ustekinumab and adalimumab were the most frequently prescribed first-line biologics. The highest proportion of biologic-switching was observed among patients on TNF-α inhibitors (63.8%). After 2015, more patients were prescribed IL-12/23 and IL-17 inhibitors in favour of TNF-α inhibitors. IL-17 inhibitors demonstrated the most rapid treatment response and low PASI scores relative to other biologics. Patients who did not switch biologics had lower rates of psoriatic arthritis and lower BMI, compared to patients who switched biologics. The median PASI on discontinuation generally exceeded 3.0, while on continuation, it was less than 1.2, reflecting patients' and clinicians' thresholds for biologic-switching.
Conclusions
This study demonstrates an increased uptake of more novel biologics as they become available, due to improved safety profiles and clinical outcomes.
{"title":"Biologic treatment sequences in moderate-to-severe psoriasis","authors":"Samantha Ting MD, FRACGP, Patricia Lowe MBBS, MMed, FACD, Annika Smith MBBS, MPHTM, FRACP, FACD, Pablo Fernández-Peñas MD, PhD, FACD","doi":"10.1111/ajd.14350","DOIUrl":"10.1111/ajd.14350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The advent of novel biologics has led to an increase in biologic-switching as patients and clinicians pursue improved clinical outcomes. However, guidance on treatment sequencing in an Australian setting is sparse. This study examines the patterns of care across two tertiary centres in Australia and characterizes the factors contributing to biologic-switching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study of patients who attended the outpatient Dermatology biologic clinics across two tertiary hospitals was conducted. Data on treatment sequencing and patients' PASI at every visit from April 2006 to December 2020 were collected. Patterns of biologic-switching were examined. The speed of treatment response for each biologic was determined by the time to achieve PASI-90 and -100 for each treatment course.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 440 treatment courses were analysed. Ustekinumab and adalimumab were the most frequently prescribed first-line biologics. The highest proportion of biologic-switching was observed among patients on TNF-α inhibitors (63.8%). After 2015, more patients were prescribed IL-12/23 and IL-17 inhibitors in favour of TNF-α inhibitors. IL-17 inhibitors demonstrated the most rapid treatment response and low PASI scores relative to other biologics. Patients who did not switch biologics had lower rates of psoriatic arthritis and lower BMI, compared to patients who switched biologics. The median PASI on discontinuation generally exceeded 3.0, while on continuation, it was less than 1.2, reflecting patients' and clinicians' thresholds for biologic-switching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates an increased uptake of more novel biologics as they become available, due to improved safety profiles and clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e178-e186"},"PeriodicalIF":2.2,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747350","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}
Weinan Zhou MD, Yidong Tan MD, Xuanyi Chen MD, Wenqing Zhang MD, PhD, Zhe Sun MD, Yihang Shen MD, Zhirong Yao MD, PhD, Ruhong Cheng MD, PhD, Yan Gu MD, PhD
Infantile bullous pemphigoid (BP) is a rare autoantibody-mediated skin disorder. We report the effective treatment of a 6-month-old infant with BP using baricitinib, a Janus kinase (JAK) inhibitor, after failure with steroids and intravenous immunoglobulin. The patient achieved full remission and discontinued all medications without any relapses. To our knowledge, this is the first case of baricitinib used in an infant with BP.
{"title":"Successful treatment of infantile refractory bullous pemphigoid with baricitinib","authors":"Weinan Zhou MD, Yidong Tan MD, Xuanyi Chen MD, Wenqing Zhang MD, PhD, Zhe Sun MD, Yihang Shen MD, Zhirong Yao MD, PhD, Ruhong Cheng MD, PhD, Yan Gu MD, PhD","doi":"10.1111/ajd.14345","DOIUrl":"10.1111/ajd.14345","url":null,"abstract":"<p>Infantile bullous pemphigoid (BP) is a rare autoantibody-mediated skin disorder. We report the effective treatment of a 6-month-old infant with BP using baricitinib, a Janus kinase (JAK) inhibitor, after failure with steroids and intravenous immunoglobulin. The patient achieved full remission and discontinued all medications without any relapses. To our knowledge, this is the first case of baricitinib used in an infant with BP.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"642-646"},"PeriodicalIF":2.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730958","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}
{"title":"Unveiling the clinical and epidemiological significance of Mycobacterium lepromatosis detection in a patient with severe lepra reaction from India","authors":"Sukhdeep Singh MD, Itu Singh PhD, Rucha Herlekar MBBS, Vinay Kumar Pathak PhD, Debajyoti Chatterjee MD, Tarun Narang MD, Sunil Dogra MD","doi":"10.1111/ajd.14352","DOIUrl":"10.1111/ajd.14352","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"596-598"},"PeriodicalIF":2.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615866","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}
Georgina Harvey MBBS, MHSc, FACD, FRACP, Diana J. Purvis MBChB, FRACP, FNZDSI, John M. D. Thompson BSc, MSc(Hons), PhD, Libby Haskell NP, MN, PhD, Harriet Kennedy BHB, MBChB, MPhil, FRACP, Karen Hoare NP, PhD, Stuart R. Dalziel FRACP, PhD
Objectives
To determine the prevalence of eczema among children in New Zealand.
Methods
Population-based retrospective observational study utilising national pharmaceutical dispensing records for topical corticosteroids and emollients for all New Zealand children aged 0–14 years from 1st January 2006 to 31st December 2019. Data are reported using descriptive statistics, with comparisons between ethnicities and socioeconomic quintiles undertaken with rate ratios.
Results
Based on dispensing data, the prevalence of eczema for New Zealand children aged 0–14 years in 2018 was 14.0% (95% CI 14.0%–14.1%), with prevalence decreasing in older age groups (children aged <1 year 26.0% (25.6%–26.4%); children aged 10–14 years 8.8% (8.7%–8.9%)). Prevalence was higher in Pacific children (23.6% (23.3%–24.0%)), but slightly lower in Māori children (13.2% (13.0%–13.3%)).
Conclusion
Eczema is a common condition affecting a considerable proportion of children in New Zealand. This study provides nationwide paediatric prevalence data for New Zealand, and highlights the increased burden of eczema in Pacific children. Inequity in dispensing of topical corticosteroids is postulated to explain the reduced rates found for Māori children compared to previous studies. These results support the need for further research to determine factors contributing to differing eczema prevalence rates in New Zealand.
目标：确定新西兰儿童湿疹的发病率：确定新西兰儿童湿疹患病率：基于人群的回顾性观察研究，利用2006年1月1日至2019年12月31日期间所有0-14岁新西兰儿童的局部皮质类固醇激素和润肤剂的国家药品配发记录。数据采用描述性统计方法进行报告，种族和社会经济五分位数之间采用比率进行比较：根据配药数据，2018年新西兰0-14岁儿童的湿疹患病率为14.0%（95% CI 14.0%-14.1%），患病率在较大年龄组中有所下降（0-14岁儿童的患病率为14.0%-14.1%）：湿疹是一种影响新西兰相当一部分儿童的常见疾病。这项研究提供了新西兰全国范围内的儿科发病率数据，并强调了太平洋地区儿童湿疹负担加重的问题。据推测，与以往的研究相比，毛利儿童的湿疹发病率较低的原因是局部皮质类固醇激素配药不公平。这些结果支持了进一步研究的必要性，以确定导致新西兰湿疹患病率不同的因素。
{"title":"Childhood eczema prevalence in New Zealand using topical corticosteroid dispensing data","authors":"Georgina Harvey MBBS, MHSc, FACD, FRACP, Diana J. Purvis MBChB, FRACP, FNZDSI, John M. D. Thompson BSc, MSc(Hons), PhD, Libby Haskell NP, MN, PhD, Harriet Kennedy BHB, MBChB, MPhil, FRACP, Karen Hoare NP, PhD, Stuart R. Dalziel FRACP, PhD","doi":"10.1111/ajd.14347","DOIUrl":"10.1111/ajd.14347","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the prevalence of eczema among children in New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based retrospective observational study utilising national pharmaceutical dispensing records for topical corticosteroids and emollients for all New Zealand children aged 0–14 years from 1st January 2006 to 31st December 2019. Data are reported using descriptive statistics, with comparisons between ethnicities and socioeconomic quintiles undertaken with rate ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on dispensing data, the prevalence of eczema for New Zealand children aged 0–14 years in 2018 was 14.0% (95% CI 14.0%–14.1%), with prevalence decreasing in older age groups (children aged <1 year 26.0% (25.6%–26.4%); children aged 10–14 years 8.8% (8.7%–8.9%)). Prevalence was higher in Pacific children (23.6% (23.3%–24.0%)), but slightly lower in Māori children (13.2% (13.0%–13.3%)).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Eczema is a common condition affecting a considerable proportion of children in New Zealand. This study provides nationwide paediatric prevalence data for New Zealand, and highlights the increased burden of eczema in Pacific children. Inequity in dispensing of topical corticosteroids is postulated to explain the reduced rates found for Māori children compared to previous studies. These results support the need for further research to determine factors contributing to differing eczema prevalence rates in New Zealand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"576-584"},"PeriodicalIF":2.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603211","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}
Roberto Fernandes Soares-Neto MD, Antônio Roberto de Oliveira Ramalho MD, Martha Débora Lira Tenório MD, Jonnia Maria Sherlock Araújo PhD, Lana Luiza da Cruz Silva PhD, Pedro Dantas Oliveira PhD, Paulo Ricardo Martins-Filho PhD, Fedro Menezes Portugal MD
{"title":"Anetoderma as an initial presentation of leprosy in a patient with prolonged steroid use","authors":"Roberto Fernandes Soares-Neto MD, Antônio Roberto de Oliveira Ramalho MD, Martha Débora Lira Tenório MD, Jonnia Maria Sherlock Araújo PhD, Lana Luiza da Cruz Silva PhD, Pedro Dantas Oliveira PhD, Paulo Ricardo Martins-Filho PhD, Fedro Menezes Portugal MD","doi":"10.1111/ajd.14348","DOIUrl":"10.1111/ajd.14348","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e215-e218"},"PeriodicalIF":2.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578882","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}
<p>Vulvovaginal lichen planus (VLP) is a chronic inflammatory dermatosis of the vulva with or without vaginal involvement. Its diagnosis can be challenging due to variations in morphology and histopathological findings. In 1988, Edwards and Friedrich reported a case series of VLP patients whose clinical presentation mimicked desquamative inflammatory vulvovaginitis (DIV).<span><sup>1</sup></span> DIV is an uncommon non-infective vulvovaginitis, characterised by pain, dyspareunia, pruritus and white or green non-offensive discharge. However, unlike VLP is not a scarring condition.<span><sup>2</sup></span> Herein we present a case series of women who were initially diagnosed with DIV but did not respond to treatment with topical clindamycin which is usually highly effective (Table 1). When their diagnosis was revised, they improved following treatment appropriate for VLP.</p><p>To our knowledge, this is the only other case series since 1988 to report patients with DIV-like VLP. DIV and VLP can pose significant diagnostic challenges as both have a wide range of clinical manifestations and histopathological findings, which often overlap. On histology, lichenoid infiltrate can be found in either condition, and the observed changes are often reported as ‘non-specific’. Additionally, the two conditions have a predilection for peri-/post-menopausal women.<span><sup>3, 4</sup></span></p><p>Desquamative inflammatory vulvovaginitis is typically characterised by vulval pain, dyspareunia and purulent white or green non-offensive discharge.<span><sup>5, 6</sup></span> Erythema and petechiae or punctate erosions are usually observed on examination.<span><sup>2, 3</sup></span> Meanwhile, in VLP, purulent discharge is not normally observed. DIV does not result in scarring, whereas VLP typically presents with glazed erythema, erosions and hyperkeratosis and frequently, if untreated causes scarring, loss of vulval structure and stenosis of the vagina.<span><sup>7</sup></span> There can also be associated oral mucosal involvement (oral lichen planus) which is not observed in DIV. In our case series, petechiae were consistently observed in all patients. This suggests that although petechiae are not common findings in VLP,<span><sup>8</sup></span> these may re-present a small sub-type of VLP mimicking DIV. Additionally, as in case 3, oral mucosal involvement may provide an additional clue pointing to a diagnosis of VLP.</p><p>Treatment resistance should also prompt clinicians to consider an alternative diagnosis, as DIV usually responds promptly to topical antibiotic treatments, particularly 2% clindamycin. A study by Bradford et al. compared 101 cases of DIV to 75 cases of VLP.<span><sup>2</sup></span> The majority of DIV patients (94%) were responsive to 4–6 weeks of intravaginal clindamycin 2%, with 35% requiring maintenance therapy. In another study by Sobel et al. of 130 DIV patients over a 12-year period, 86% of the patients reported significant symptom improvem
外阴阴道扁平苔藓（VLP）是一种慢性外阴炎症性皮肤病，可累及或不累及阴道。由于形态学和组织病理学结果的差异，其诊断可能具有挑战性。1 DIV是一种不常见的非感染性外阴阴道炎，以疼痛、排便困难、瘙痒和白色或绿色非致病性分泌物为特征。1 DIV 是一种不常见的非感染性外阴阴道炎，其特征是疼痛、排便困难、瘙痒和白色或绿色非排泄性分泌物，但与 VLP 不同的是，它不是一种瘢痕性疾病。2 在此，我们介绍了一组病例，这些妇女最初被诊断为 DIV，但对通常非常有效的外用克林霉素治疗无效（表 1）。据我们所知，这是自1988年以来报告的唯一一个类似DIV的VLP患者病例系列。DIV和VLP会给诊断带来巨大挑战，因为这两种疾病的临床表现和组织病理学检查结果多种多样，而且往往相互重叠。在组织学上，这两种疾病都会出现苔藓样浸润，而观察到的变化往往被报告为 "非特异性"。5、6 检查时通常会观察到红斑、瘀点或点状糜烂。2、3 同时，在 VLP 中通常观察不到脓性分泌物。DIV 不会导致瘢痕形成，而 VLP 通常表现为釉面红斑、糜烂和角化过度，如果不及时治疗，常常会导致瘢痕形成、外阴结构缺失和阴道狭窄。在我们的病例系列中，所有患者均可观察到瘀斑。这表明，虽然瘀斑在 VLP 中并不常见，8 但这些瘀斑可能是模仿 DIV 的 VLP 的一个小亚型。此外，与病例 3 一样，口腔粘膜受累也可能为 VLP 诊断提供额外线索。耐药性也应促使临床医生考虑其他诊断，因为 DIV 通常对局部抗生素治疗反应迅速，尤其是 2% 的克林霉素。Bradford 等人的一项研究比较了 101 例 DIV 和 75 例 VLP。2 大多数 DIV 患者（94%）对阴道内使用 4-6 周 2% 的克林霉素有反应，其中 35% 需要维持治疗。在 Sobel 等人对 130 名 DIV 患者进行的另一项为期 12 年的研究中，86% 的患者在开始使用 2% 的克林霉素或 10%的氢化可的松乳膏 3 周内症状明显改善。在 Bradford 等人的研究中，半数以上的 DIV 患者（56%）报告了历史诱因，而 VLP 组仅为 15%（p < 0.0001）2。在本系列病例中，有两名患者疑似患有慢性外阴阴道念珠菌病（CVVC）。一名患者在发病前曾因服用拉莫三嗪而出现伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）。我们的患者中只有一人能够通过外用皮质类固醇得到控制，其他人都需要系统治疗。对于已确诊为 DIV 并表现出抗药性的患者，应考虑 VLP 的替代诊断。其他身体部位（如口腔粘膜）受累也有助于 VLP 的诊断。所有患者均同意将其病例纳入本报告并在期刊上发表。本报告中包含的患者照片已征得患者同意。
{"title":"Vulvovaginal lichen planus mimicking desquamative inflammatory vulvovaginitis: A case series","authors":"Marlene Wijaya BMed, MD, MPhil, Rebecca Bronwyn Saunderson BMedSci (hon1), MBBS (hon), MPhil (Cantab), FACD, Gayle Fischer MBBS (hon1), MD, FACD","doi":"10.1111/ajd.14344","DOIUrl":"10.1111/ajd.14344","url":null,"abstract":"<p>Vulvovaginal lichen planus (VLP) is a chronic inflammatory dermatosis of the vulva with or without vaginal involvement. Its diagnosis can be challenging due to variations in morphology and histopathological findings. In 1988, Edwards and Friedrich reported a case series of VLP patients whose clinical presentation mimicked desquamative inflammatory vulvovaginitis (DIV).<span><sup>1</sup></span> DIV is an uncommon non-infective vulvovaginitis, characterised by pain, dyspareunia, pruritus and white or green non-offensive discharge. However, unlike VLP is not a scarring condition.<span><sup>2</sup></span> Herein we present a case series of women who were initially diagnosed with DIV but did not respond to treatment with topical clindamycin which is usually highly effective (Table 1). When their diagnosis was revised, they improved following treatment appropriate for VLP.</p><p>To our knowledge, this is the only other case series since 1988 to report patients with DIV-like VLP. DIV and VLP can pose significant diagnostic challenges as both have a wide range of clinical manifestations and histopathological findings, which often overlap. On histology, lichenoid infiltrate can be found in either condition, and the observed changes are often reported as ‘non-specific’. Additionally, the two conditions have a predilection for peri-/post-menopausal women.<span><sup>3, 4</sup></span></p><p>Desquamative inflammatory vulvovaginitis is typically characterised by vulval pain, dyspareunia and purulent white or green non-offensive discharge.<span><sup>5, 6</sup></span> Erythema and petechiae or punctate erosions are usually observed on examination.<span><sup>2, 3</sup></span> Meanwhile, in VLP, purulent discharge is not normally observed. DIV does not result in scarring, whereas VLP typically presents with glazed erythema, erosions and hyperkeratosis and frequently, if untreated causes scarring, loss of vulval structure and stenosis of the vagina.<span><sup>7</sup></span> There can also be associated oral mucosal involvement (oral lichen planus) which is not observed in DIV. In our case series, petechiae were consistently observed in all patients. This suggests that although petechiae are not common findings in VLP,<span><sup>8</sup></span> these may re-present a small sub-type of VLP mimicking DIV. Additionally, as in case 3, oral mucosal involvement may provide an additional clue pointing to a diagnosis of VLP.</p><p>Treatment resistance should also prompt clinicians to consider an alternative diagnosis, as DIV usually responds promptly to topical antibiotic treatments, particularly 2% clindamycin. A study by Bradford et al. compared 101 cases of DIV to 75 cases of VLP.<span><sup>2</sup></span> The majority of DIV patients (94%) were responsive to 4–6 weeks of intravaginal clindamycin 2%, with 35% requiring maintenance therapy. In another study by Sobel et al. of 130 DIV patients over a 12-year period, 86% of the patients reported significant symptom improvem","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e203-e207"},"PeriodicalIF":2.2,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496961","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}
Wenjie Li MD, Zhongyun Deng MD, Ge Yang MD, Wei Liu MD, Zhen Rang MD, Tingting Wang MD,PhD, Mi Wang MD, Fan Cui MD,PhD
{"title":"Therapy of pemphigus foliaceous with prominent neutrophilic pustules with Acitretin: A case report and literature review","authors":"Wenjie Li MD, Zhongyun Deng MD, Ge Yang MD, Wei Liu MD, Zhen Rang MD, Tingting Wang MD,PhD, Mi Wang MD, Fan Cui MD,PhD","doi":"10.1111/ajd.14346","DOIUrl":"10.1111/ajd.14346","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e211-e214"},"PeriodicalIF":2.2,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496960","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}
Min Jae Kim MD, Bo Ri Kim MD, PhD, Ji Su Lee MD, PhD, Je-Ho Mun MD, PhD
{"title":"Clinical and dermoscopic features of onychomatricoma in Korean patients","authors":"Min Jae Kim MD, Bo Ri Kim MD, PhD, Ji Su Lee MD, PhD, Je-Ho Mun MD, PhD","doi":"10.1111/ajd.14332","DOIUrl":"10.1111/ajd.14332","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"e117-e120"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465879","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}
In comparison with TNF-α inhibitors, anti-IL-17A agents are considered to have a lower risk of active tuberculosis (TB) or latent TB infection (LTBI) reactivation.
Methods
In this study, we aimed to evaluate the TB infection status and serial QuantiFERON-TB-Gold in tube test (QFT) results of psoriasis patients using IL-17 inhibitors (secukinumab [SEC] and ixekizumab [IXE]) in a real-world setting from a tuberculosis-endemic country. Patients who used an anti-IL-17 agent for at least 3 months in our follow-up were included in the study. Patients' clinical and demographic features, baseline QFT results and latest QFT results (if any), and TB infection status were noted from the past medical records.
Results
A total of 717 patients, of whom 333 (46.4%) were female, were included in the study. The cumulative exposure time to an anti-IL-17 agent was 14,147 patient-months, 9743 patient-months for SEC and 4404 patient-months for IXE. Also, 459 (SEC = 305/IXE = 154) patients used an anti-IL-17 agent for ≥ 12 months. Of these, 125 had positive baseline QFT results. In all, 334 had negative baseline QFT results. The latest QFT result of 309 was also negative (persistent seronegative group). During follow-up, the QFT results of 10 patients changed from negative to positive (positive seroconversion group). Seven of them were using SEC and three were using IXE, respectively. No case of active TB infection was detected.
Conclusion
In our study, the positive seroconversion rate of 10/334 seems high, but this did not translate to active disease. However, closer monitoring may be required, especially in patients with advanced age, the presence of PsA, long disease duration and long anti-IL-17 treatment duration.
{"title":"Evaluation of serial QuantiFERON-TB Gold in tube test results and tuberculosis infection status in patients with psoriasis receiving anti-IL-17 treatment (secukinumab and ixekizumab): Real-world data from a tuberculosis-endemic country","authors":"Ece Erbağcı MD, Sema Koç Yıldırım MD, Fatma Aslı Hapa MD","doi":"10.1111/ajd.14340","DOIUrl":"10.1111/ajd.14340","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In comparison with TNF-α inhibitors, anti-IL-17A agents are considered to have a lower risk of active tuberculosis (TB) or latent TB infection (LTBI) reactivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we aimed to evaluate the TB infection status and serial QuantiFERON-TB-Gold in tube test (QFT) results of psoriasis patients using IL-17 inhibitors (secukinumab [SEC] and ixekizumab [IXE]) in a real-world setting from a tuberculosis-endemic country. Patients who used an anti-IL-17 agent for at least 3 months in our follow-up were included in the study. Patients' clinical and demographic features, baseline QFT results and latest QFT results (if any), and TB infection status were noted from the past medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 717 patients, of whom 333 (46.4%) were female, were included in the study. The cumulative exposure time to an anti-IL-17 agent was 14,147 patient-months, 9743 patient-months for SEC and 4404 patient-months for IXE. Also, 459 (SEC = 305/IXE = 154) patients used an anti-IL-17 agent for ≥ 12 months. Of these, 125 had positive baseline QFT results. In all, 334 had negative baseline QFT results. The latest QFT result of 309 was also negative (persistent seronegative group). During follow-up, the QFT results of 10 patients changed from negative to positive (positive seroconversion group). Seven of them were using SEC and three were using IXE, respectively. No case of active TB infection was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our study, the positive seroconversion rate of 10/334 seems high, but this did not translate to active disease. However, closer monitoring may be required, especially in patients with advanced age, the presence of PsA, long disease duration and long anti-IL-17 treatment duration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"567-575"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465880","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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