Skinmed最新文献

A 79-year-old woman with psoriasis presented to the emergency department with new-onset eruptions on the trunk, extremities, and oral mucosa for 8-9 days. For psoriasis, she had been taking 15 mg of methotrexate weekly for over 18 years, and had discontinued folic acid a few months prior to this.

64-year-old woman with a history of esophageal strictures presented in 2015 for evaluation of progressive depigmented patches that developed over the preceding year. She was prescribed topical steroids with no improvement. Narrow-band ultraviolet B (NB-UVB) and topical tacrolimus were eventually added to the topical steroids accompanying an oral steroid taper. The patient discontinued topical tacrolimus because of irritation. The patient was lost to follow-up for the next 3 years, during which she did not take any treatment and her vitiligo had worsened (Figure 1). At her visit 3 years later, she repeated an oral prednisone taper and restarted mid-potency topical steroid. In January 2020, the patient was approved for and started oral tofacitinib 5 mg twice daily. Consistent improvement was observed on the subsequent visits in March 2020 and November 2020. The only adverse reaction reported by the patient was an increase in furuncles on her pelvis and thighs.

Genodermatoses are inherited skin disorders associated with manifestations pertaining to both cutaneous and systemic involvement. Most of these disorders are associated with systemic conditions leading to mortality and morbidity. Only few studies have been reported from India. Since there is predominance of consanguineous marriage in northern part of India, very rare disorders are seen but have been under-reported. The present study was done to evaluate the different types of genodermatoses present in population of Kashmir valley, India. The study included total 154 cases of genodermatoses seen over a period of 3 years. Prevalence of genodermatoses was 0.96 per 1000 new OPD cases. Male to female ratio was 1.26:1. Age ranged from 2 days to 56 years with Median age of 7 years. The disorders of keratinisation constituted major group with 67 (42.4%) cases. Mechano-bullous disorder was second most common group seen. Consanguinity in parents was found in 83 (53.8%) of cases while 71 (46.1%) had non-consanguineous marriage in parents. Positive family history was noted in 61 (39.6%) number of cases while as 93 (60.3%) had no positive family history. Recessively inherited disorders were more than dominantly inherited disorders. Predominant or only cutaneous manifestations were seen in 124 (80.5%) cases while 30 (19.4%) patients had extracutaneous associations. In conclusion, a wide spectrum of disorders were seen in our study. Though consanguinity attributes to the presence of recessively inherited disorders but dominant disorders are seen in significant proportion. In absence of genetic testing, proper history and clinical evaluation help in establishment of diagnosis and mode of inheritance in majority of cases.

Vitiligo is an acquired chronic loss of skin pigmentation characterized by white and frequent symmetric patches, for which corticosteroids are the mainstay of treatment. Regular intake of steroids for prolonged periods is frequently associated with severe and sometimes irreversible adverse events. This study was designed to compare the effectiveness and safety profiles of azathioprine versus psoralen+ultraviolet light A (PUVA)-solar light (SOL; sunlight) to determine which agent reduces the length and adverse effects of vitiligo therapy in a better manner. This single-center, randomized, open-label, prospective case-control study recruited 100 patients. Oral mini-pulse (OMP) corticosteroid therapy was administered to all patients during the first month of the study. The first group of patients (group A) continued with azathioprine 50-mg tablet twice a day (BID), and the second group (group B) was given PUVA-SOL for 2 months with concurrent OMP. Disease activity was monitored. At the end of the study period, 58% (group A) and 50% (group B) of patients had their improved vitiligo area severity index (VASI) scores by 25%-50%. Similarly, 36% (group A) and 50% (group B) of patients improved their VASI score by more than 50%. On the global physician assessment scale, 42% (group A) and 54% (group B) patients had a good to excellent response. Based on these findings, both azathioprine and PUVA-SOL were considered as good steroid-sparing agents, primarily if used with an initial phase of concomitant oral corticosteroids.

Anti-tumor necrosis factor alpha (anti-TNF-α) comprises a group of drugs that inhibit the action of cytokine TNF-α, and are used to treat diseases mainly caused by this cytokine. An increase in cutaneous adverse events has been observed with similar anti-TNF biologic treatments frequently used in clinical practice.

Two monozygotic twins (Fitzpatrick skin type II 56-year-old women) with significant photoaging and mild to moderate global fine lines based on the modified Griffiths 10-point scale were enrolled in the study. The past medical etymology and laboratory evaluation were unremarkable. Each subject followed a standardized skin care regimen with topical platelet renewosomes^TM (human platelet extract [HPE]) daily for a 12-week duration.^1-4 In order to evaluate aesthetic outcomes/changes subjectively, three blinded board-certified plastic surgeons (Yael Halaas, K. Kay Durairaj, and Michael Somenek) compared photographs between baseline and 12-week follow-up (Figure 1). This evaluation was completed using the Global Aesthetic Improvement Scale (GAIS) and the modified Griffiths 10-point scale.^5,6.