Australasian Journal of Dermatology最新文献

Biosimilars offer the potential for substantial cost savings within the Australian healthcare system. This is particularly salient in dermatology, where biologics are used to treat chronic skin diseases and cost savings will be accrued throughout the life of a patient. However, uptake of biosimilars in clinical practice has been hindered by barriers including insufficient clinician education, concerns about safety and efficacy, and negative patient perception. Increased availability of biosimilars promotes long-term sustainability of the Pharmaceutical Benefits Scheme and may help maintain equitable access to healthcare across Australia.

Plume from surgical diathermy systems is recognised as a hazard to healthcare providers but is often ignored during ambulatory care procedures. The development of a squamous cell carcinoma of the larynx in a dermatologist, despite the absence of recognised risk factors, prompted this review and recommendations for change in procedural practices.

Acneiform eruptions have been observed and reported in clinical trials for tyrosine kinase 2 (TYK2) inhibitors. However, data on their occurrence in real-world settings remain limited. This case series describes six patients, who developed acneiform eruptions following the initiation of deucravacitinib for chronic plaque psoriasis. Through this case series, we aim to shed further light into the clinical characteristics and potential risk factors for this side effect. Contrary to clinical trial data, we demonstrate high cessation rates of deucravacitinib following the development of acneiform eruption, due to the significant burden on quality of life. We highlight the need to identify risk factors to improve patient selection and allow adequate counselling or prophylactic treatments for these acneiform eruptions.

Cutaneous arteriovenous haemangioma (AVH) is a rare benign vascular lesion, which typically occurs on the head and neck. Its aetiology is unclear but thrombosis, trauma, infection or endocrine triggers have been proposed. We report the case of a 64-year-old female presenting with acquired AVH of the upper lip following oral herpes simplex virus infection. This is the first documented occurrence of AVH as a post-herpetic isotopic response (PHIR).

Background/objectives: Congenital melanocytic naevi (CMN) are a risk factor for melanoma. Melanoma risk is dependent on the congenital phenotype. Our primary aims were to assess the clinical characteristics of CMN that indicate a high risk of neurocutaneous melanosis (NCM) and melanoma in an Australian paediatric population group; to identify patient characteristics and clinical features of CMN that trigger further investigations; and to determine the rate of malignancy and other complications for CMN.

Methods: We retrospectively reviewed the electronic medical records of all patients under 18 years who were diagnosed with CMN at the Queensland Children's Hospital between 2014 and 2021.

Results: Eighty-eight patients (38 males and 50 females) were included in the analysis. Eighteen patients (20%) had a biopsy to rule out malignancy. Central nervous system magnetic resonance imaging (MRI) was performed in 16 patients (18%). Five patients (5.7%) experienced complications, of which three had NCM and two had transient neurological symptoms with normal MRI. No cases of melanoma, non-melanoma tumours or deaths were recorded.

Conclusions: CMN size, location over the posterior midline axis and multiple numbers of CMN were found to be significantly associated with the development of complications. CMN size, CMN site, presence of satellite naevi and location over the posterior midline axis were all significantly associated with the likelihood of an MRI or biopsy being performed. Large-scale studies, such as a population-based registry, are recommended to accurately assess the true lifetime risk of complications and associated risk factors.

There is paucity of research available regarding the epidemiological characteristics of patients attending dermatology outpatient services in rural Australia. We performed a retrospective cohort study of patients attending a public dermatology clinic established at Dubbo Base Hospital in rural New South Wales. The broad range of dermatological presentations encountered, coupled with the brisk uptake of services by remote patients, highlights the ongoing need for specialist dermatology services in underserved rural communities.

Objectives: This study aimed to evaluate the prevalence of lichen sclerosus (LS) in male patients undergoing circumcision for phimosis, emphasising the significance of a multidisciplinary approach in the early diagnosis and management of this condition.

Methods: A retrospective analysis was performed on 841 male patients who underwent circumcision at a high-volume medical centre between 2001 and 2023. Data were collected on clinical diagnoses made by both dermatologists and urologists, along with the corresponding histological findings. Logistic regression models were utilised to assess diagnostic accuracy and the relationship between clinical suspicion and histological confirmation.

Results: Histological confirmation of LS was identified in 30.6% of the cases. Dermatologists demonstrated a diagnostic accuracy of 81.8%, whereas urologists showed an accuracy of 46.1%. The evaluations conducted by dermatologists exhibited a significant correlation with histological confirmation of LS (odds ratio 4.81; 95% confidence interval: 1.96-11.80; p = 0.001).

Conclusions: This study elucidates the differences in diagnostic accuracy between dermatologists and urologists in identifying LS in patients undergoing circumcision for phimosis, highlighting the necessity of a multidisciplinary approach to improve the diagnostic process. Furthermore, the epidemiological data obtained from this research offer valuable insights into the prevalence of LS and the associated diagnostic challenges within a substantial patient cohort.