Pub Date : 2024-12-01Epub Date: 2024-02-22DOI: 10.1080/09546634.2024.2315145
Steven R Feldman, Alson Wai Ming Chan, Alfred Ammoury, Jianzhong Zhang, Akio Tanaka, XingXiang Shi, Amy Cha, Helen Tran
Background: Understanding the patient journey is important to optimize care for patients with atopic dermatitis (AD) and overcome challenges in diagnosis and management.
Objective: To explore patient and caregiver perspectives regarding their experience with AD.
Methods: Patients and caregivers of patients with AD completed a pre-meeting survey and were invited to join an advisory board meeting in their country (China, Hong Kong, Ireland, Japan and Lebanon) to discuss the survey results. Data were analyzed descriptively.
Results: The survey included 31 participants (patients and caregivers) from Hong Kong (n = 7), China (n = 7), Ireland (n = 6), Japan (n = 6) and Lebanon (n = 5). The most challenging factors in the AD journey were management of symptoms before a confirmed diagnosis (68%), sudden recurrence of flares or worsening of symptoms (68%) and lifestyle changes (52%). In terms of overall AD management, 35% of participants indicated that AD was managed well, 23% had a clear treatment plan and 19% were generally satisfied with disease management. A collaborative relationship with healthcare professionals was favored.
Conclusion: A holistic assessment of AD includes understanding patient and caregiver preferences, needs, experiences and disease perceptions. Addressing the identified gaps may improve the management of AD.
{"title":"Patients' and caregivers' perspectives of the atopic dermatitis journey.","authors":"Steven R Feldman, Alson Wai Ming Chan, Alfred Ammoury, Jianzhong Zhang, Akio Tanaka, XingXiang Shi, Amy Cha, Helen Tran","doi":"10.1080/09546634.2024.2315145","DOIUrl":"10.1080/09546634.2024.2315145","url":null,"abstract":"<p><strong>Background: </strong>Understanding the patient journey is important to optimize care for patients with atopic dermatitis (AD) and overcome challenges in diagnosis and management.</p><p><strong>Objective: </strong>To explore patient and caregiver perspectives regarding their experience with AD.</p><p><strong>Methods: </strong>Patients and caregivers of patients with AD completed a pre-meeting survey and were invited to join an advisory board meeting in their country (China, Hong Kong, Ireland, Japan and Lebanon) to discuss the survey results. Data were analyzed descriptively.</p><p><strong>Results: </strong>The survey included 31 participants (patients and caregivers) from Hong Kong (<i>n</i> = 7), China (<i>n</i> = 7), Ireland (<i>n</i> = 6), Japan (<i>n</i> = 6) and Lebanon (<i>n</i> = 5). The most challenging factors in the AD journey were management of symptoms before a confirmed diagnosis (68%), sudden recurrence of flares or worsening of symptoms (68%) and lifestyle changes (52%). In terms of overall AD management, 35% of participants indicated that AD was managed well, 23% had a clear treatment plan and 19% were generally satisfied with disease management. A collaborative relationship with healthcare professionals was favored.</p><p><strong>Conclusion: </strong>A holistic assessment of AD includes understanding patient and caregiver preferences, needs, experiences and disease perceptions. Addressing the identified gaps may improve the management of AD.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-03-26DOI: 10.1080/09546634.2024.2331785
Chunzhi Zheng, Yueqian Yu, Guizhi Zhou, Hong Liu
Aim: This case study aims to report the efficacy and safety of a Janus kinase (JAK) inhibitor in the treatment of generalized eosinophilic pustular folliculitis (EPF).
Methods: We present a case of a 16-year-old Chinese patient who had been suffering from EPF for two years and had shown no response to both topical and systemic glucocorticoids. The patient was subsequently treated with oral tofacitinib at a dosage of 5mg daily.
Results: Significant remission of eruption and pruritus was observed in the patient upon treatment with tofacitinib. However, a relapse occurred upon dose reduction. Subsequent switch to the highly selective JAK1 inhibitor upadacitinib resulted in complete recovery, with the patient achieving a symptom-free status after six months.
Conclusions: JAK inhibitors show promise as a potential treatment option for EPF patients who do not respond to traditional therapies.
{"title":"A case of generalized eosinophilic pustular folliculitis: treatment with JAK inhibitor.","authors":"Chunzhi Zheng, Yueqian Yu, Guizhi Zhou, Hong Liu","doi":"10.1080/09546634.2024.2331785","DOIUrl":"10.1080/09546634.2024.2331785","url":null,"abstract":"<p><strong>Aim: </strong>This case study aims to report the efficacy and safety of a Janus kinase (JAK) inhibitor in the treatment of generalized eosinophilic pustular folliculitis (EPF).</p><p><strong>Methods: </strong>We present a case of a 16-year-old Chinese patient who had been suffering from EPF for two years and had shown no response to both topical and systemic glucocorticoids. The patient was subsequently treated with oral tofacitinib at a dosage of 5mg daily.</p><p><strong>Results: </strong>Significant remission of eruption and pruritus was observed in the patient upon treatment with tofacitinib. However, a relapse occurred upon dose reduction. Subsequent switch to the highly selective JAK1 inhibitor upadacitinib resulted in complete recovery, with the patient achieving a symptom-free status after six months.</p><p><strong>Conclusions: </strong>JAK inhibitors show promise as a potential treatment option for EPF patients who do not respond to traditional therapies.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-31DOI: 10.1080/09546634.2024.2308682
Marthe-Lisa Schaarschmidt, Daniel Kromer, Phoebe Wellmann, Wiebke K Peitsch, Christian Kromer
Background: The advent of biologics and janus kinase inhibitors has revolutionized treatment of atopic dermatitis (AD).
Objective: To investigate preferences of patients with AD for attributes of currently approved systemic treatments and assess influencing factors.
Methods: An online discrete choice experiment was conducted in patients with AD throughout Germany to analyze preferences for outcome (probability of (almost) clear skin at week 16, probability of significant itch improvement, time to onset of itch relief and type of side effects) and process attributes (application method and frequency of laboratory tests).
Results: Participants (n = 182, 75.3% female) considered side effects (Relative Importance Score (RIS): 31.2), (almost) clear skin (RIS: 24.2) and probability of itch improvement (RIS: 16.0) most important. Application method (RIS: 14.4), time to onset of itch relief (RIS: 7.4) and frequency of laboratory tests (RIS: 6.8) were less relevant. Preferences were significantly influenced by sex, age, psychiatric comorbidity, current therapy and health-related quality of life according to multivariate regression analysis.
Conclusions: Participants attached great importance to safety and symptom control. However, preferences were also dependent on individual characteristics, underscoring the importance of personal counseling. Conjoined with medical considerations, patients' preferences have fundamental impact on shared decisions for treatment of AD.
{"title":"Patients' preferences for systemic treatment of atopic dermatitis: safety and efficacy count the most.","authors":"Marthe-Lisa Schaarschmidt, Daniel Kromer, Phoebe Wellmann, Wiebke K Peitsch, Christian Kromer","doi":"10.1080/09546634.2024.2308682","DOIUrl":"10.1080/09546634.2024.2308682","url":null,"abstract":"<p><strong>Background: </strong>The advent of biologics and janus kinase inhibitors has revolutionized treatment of atopic dermatitis (AD).</p><p><strong>Objective: </strong>To investigate preferences of patients with AD for attributes of currently approved systemic treatments and assess influencing factors.</p><p><strong>Methods: </strong>An online discrete choice experiment was conducted in patients with AD throughout Germany to analyze preferences for outcome (probability of (almost) clear skin at week 16, probability of significant itch improvement, time to onset of itch relief and type of side effects) and process attributes (application method and frequency of laboratory tests).</p><p><strong>Results: </strong>Participants (<i>n</i> = 182, 75.3% female) considered side effects (Relative Importance Score (RIS): 31.2), (almost) clear skin (RIS: 24.2) and probability of itch improvement (RIS: 16.0) most important. Application method (RIS: 14.4), time to onset of itch relief (RIS: 7.4) and frequency of laboratory tests (RIS: 6.8) were less relevant. Preferences were significantly influenced by sex, age, psychiatric comorbidity, current therapy and health-related quality of life according to multivariate regression analysis.</p><p><strong>Conclusions: </strong>Participants attached great importance to safety and symptom control. However, preferences were also dependent on individual characteristics, underscoring the importance of personal counseling. Conjoined with medical considerations, patients' preferences have fundamental impact on shared decisions for treatment of AD.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-31DOI: 10.1080/09546634.2024.2310633
Eric L Simpson, Robert Bissonnette, Zelma C Chiesa Fuxench, Howard Kallender, Daniel Sturm, Haobo Ren, Linda F Stein Gold
Purpose: Ruxolitinib (selective Janus kinase [JAK] 1 and JAK2 inhibitor) cream demonstrated efficacy and safety in patients with atopic dermatitis (AD) in the phase 3 TRuE-AD studies. In TRuE-AD1/TRuE-AD2 (NCT03745638/NCT03745651), adults and adolescents with mild to moderate AD were randomized to apply twice-daily ruxolitinib cream or vehicle for eight weeks. Here, we evaluated the efficacy and tolerability of ruxolitinib cream by anatomic region, focusing on head/neck (HN) lesions that are typically difficult to manage and disproportionately affect quality of life (QoL).Materials and methods: Eczema Area and Severity Index (EASI) responses in anatomic regions were evaluated in the pooled population (N = 1208) and among patients with baseline HN involvement (n = 663). Itch, Investigator's Global Assessment (IGA), QoL, and application site tolerability were also assessed.Results: By Week 2 (earliest assessment), ruxolitinib cream application resulted in significant improvements across all EASI anatomic region subscores and AD signs versus vehicle, with further improvements through Week 8. Significantly more patients with HN involvement who applied ruxolitinib cream versus vehicle achieved clinically meaningful improvements in itch, IGA, and QoL. Application site reactions with ruxolitinib cream were infrequent (<3%), including in patients with HN involvement.Conclusions: These results support the use of ruxolitinib cream for AD treatment across all anatomic regions, including HN.
{"title":"Ruxolitinib cream monotherapy demonstrates rapid improvement in the extent and signs of mild to moderate atopic dermatitis across head and neck and other anatomic regions in adolescents and adults: pooled results from 2 phase 3 studies.","authors":"Eric L Simpson, Robert Bissonnette, Zelma C Chiesa Fuxench, Howard Kallender, Daniel Sturm, Haobo Ren, Linda F Stein Gold","doi":"10.1080/09546634.2024.2310633","DOIUrl":"10.1080/09546634.2024.2310633","url":null,"abstract":"<p><p><b>Purpose:</b> Ruxolitinib (selective Janus kinase [JAK] 1 and JAK2 inhibitor) cream demonstrated efficacy and safety in patients with atopic dermatitis (AD) in the phase 3 TRuE-AD studies. In TRuE-AD1/TRuE-AD2 (NCT03745638/NCT03745651), adults and adolescents with mild to moderate AD were randomized to apply twice-daily ruxolitinib cream or vehicle for eight weeks. Here, we evaluated the efficacy and tolerability of ruxolitinib cream by anatomic region, focusing on head/neck (HN) lesions that are typically difficult to manage and disproportionately affect quality of life (QoL).<b>Materials and methods:</b> Eczema Area and Severity Index (EASI) responses in anatomic regions were evaluated in the pooled population (<i>N</i> = 1208) and among patients with baseline HN involvement (<i>n</i> = 663). Itch, Investigator's Global Assessment (IGA), QoL, and application site tolerability were also assessed.<b>Results:</b> By Week 2 (earliest assessment), ruxolitinib cream application resulted in significant improvements across all EASI anatomic region subscores and AD signs versus vehicle, with further improvements through Week 8. Significantly more patients with HN involvement who applied ruxolitinib cream versus vehicle achieved clinically meaningful improvements in itch, IGA, and QoL. Application site reactions with ruxolitinib cream were infrequent (<3%), including in patients with HN involvement.<b>Conclusions:</b> These results support the use of ruxolitinib cream for AD treatment across all anatomic regions, including HN.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-24DOI: 10.1080/09546634.2024.2365820
Lauren Seigel, Sofia Shoaib, Keshia Maughn, Miran Foster, Shrushti Shah, Lakshmi Batchu, Keith Wittstock, Andrew Alexis
Purpose: Providers who treat patients with psoriasis are unevenly distributed across the United States, with more in urban than rural areas. This retrospective claims analysis characterized disparities in access to care for US patients with psoriasis using data from the STATinMED database.
Materials and methods: Patients (≥18 years) had ≥1 claim with a psoriasis diagnosis and ≥1 claim for advanced psoriasis therapy (apremilast or biologics) between January 2015 and December 2019. Access to psoriasis care was determined using the proportion of patients with 0, 1-2, 3-4, or ≥5 providers in their local area.
Results: Overall, 179,688 patients were included in the analysis, 80.0% in urban areas. The access ratio was highest for internal medicine physicians (97.1 per 1000 patients) and lowest for dermatologists (4.4 per 1000 patients) and family practice physicians (3.9 per 1000 patients). In urban areas, 41% of patients had access to ≥5 dermatologists versus 7% in rural areas. Whereas 2% of patients in urban areas sought care outside of their local area, 75% in rural areas did so. Use of advanced therapies was low in all states (<17%).
Conclusion: Access to psoriasis-treating providers varied widely. Regardless of access, utilization of advanced treatments was low, suggesting the need for effective, easy-to-administer therapy.
{"title":"Health disparities in psoriasis: geographic barriers to access in the United States.","authors":"Lauren Seigel, Sofia Shoaib, Keshia Maughn, Miran Foster, Shrushti Shah, Lakshmi Batchu, Keith Wittstock, Andrew Alexis","doi":"10.1080/09546634.2024.2365820","DOIUrl":"https://doi.org/10.1080/09546634.2024.2365820","url":null,"abstract":"<p><strong>Purpose: </strong>Providers who treat patients with psoriasis are unevenly distributed across the United States, with more in urban than rural areas. This retrospective claims analysis characterized disparities in access to care for US patients with psoriasis using data from the STATinMED database.</p><p><strong>Materials and methods: </strong>Patients (≥18 years) had ≥1 claim with a psoriasis diagnosis and ≥1 claim for advanced psoriasis therapy (apremilast or biologics) between January 2015 and December 2019. Access to psoriasis care was determined using the proportion of patients with 0, 1-2, 3-4, or ≥5 providers in their local area.</p><p><strong>Results: </strong>Overall, 179,688 patients were included in the analysis, 80.0% in urban areas. The access ratio was highest for internal medicine physicians (97.1 per 1000 patients) and lowest for dermatologists (4.4 per 1000 patients) and family practice physicians (3.9 per 1000 patients). In urban areas, 41% of patients had access to ≥5 dermatologists versus 7% in rural areas. Whereas 2% of patients in urban areas sought care outside of their local area, 75% in rural areas did so. Use of advanced therapies was low in all states (<17%).</p><p><strong>Conclusion: </strong>Access to psoriasis-treating providers varied widely. Regardless of access, utilization of advanced treatments was low, suggesting the need for effective, easy-to-administer therapy.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-05-15DOI: 10.1080/09546634.2024.2349658
Maryia Zhdanava, Timothy Fitzgerald, Dominic Pilon, Rachel E Teneralli, Aditi Shah, Lilian Diaz, Patrick Lefebvre, Steven R Feldman
Purpose: Real-world data comparing long-term performance of interleukin (IL)-23 and IL-17 inhibitors in psoriasis are limited. This study compared treatment persistence and remission among patients initiating guselkumab versus IL-17 inhibitors.
Methods: Adults with psoriasis initiating guselkumab, secukinumab, or ixekizumab treatment (index date) were identified from Merative™ MarketScan® Research Databases (01/01/2016-10/31/2021). Persistence was defined as no index biologic supply gaps of twice the labeled maintenance dosing interval. Remission was defined using an exploratory approach as index biologic discontinuation for ≥6 months without psoriasis-related inpatient admissions and treatments.
Results: There were 3516 and 6066 patients in the guselkumab versus secukinumab comparison, and 3805 and 4674 patients in guselkumab versus ixekizumab comparison. At 18 months, the guselkumab cohort demonstrated about twice the persistence rate as secukinumab (hazard ratio [HR] = 2.15; p < 0.001) and ixekizumab cohorts (HR = 1.77; p < 0.001). At 6 months after index biologic discontinuation, the guselkumab cohort was 31% and 40% more likely to achieve remission than secukinumab (rate ratio [RR] = 1.31; p < 0.001) and ixekizumab cohorts (RR = 1.40; p < 0.001).
Conclusions: Guselkumab was associated with greater persistence and likelihood of remission than IL-17 inhibitors, indicating greater disease control and modification potential.
{"title":"Comparative analysis of persistence and remission with guselkumab <i>versus</i> secukinumab and ixekizumab in the United States.","authors":"Maryia Zhdanava, Timothy Fitzgerald, Dominic Pilon, Rachel E Teneralli, Aditi Shah, Lilian Diaz, Patrick Lefebvre, Steven R Feldman","doi":"10.1080/09546634.2024.2349658","DOIUrl":"https://doi.org/10.1080/09546634.2024.2349658","url":null,"abstract":"<p><p><b>Purpose:</b> Real-world data comparing long-term performance of interleukin (IL)-23 and IL-17 inhibitors in psoriasis are limited. This study compared treatment persistence and remission among patients initiating guselkumab <i>versus</i> IL-17 inhibitors.</p><p><p><b>Methods:</b> Adults with psoriasis initiating guselkumab, secukinumab, or ixekizumab treatment (index date) were identified from Merative™ MarketScan<sup>®</sup> Research Databases (01/01/2016-10/31/2021). Persistence was defined as no index biologic supply gaps of twice the labeled maintenance dosing interval. Remission was defined using an exploratory approach as index biologic discontinuation for ≥6 months without psoriasis-related inpatient admissions and treatments.</p><p><p><b>Results:</b> There were 3516 and 6066 patients in the guselkumab <i>versus</i> secukinumab comparison, and 3805 and 4674 patients in guselkumab <i>versus</i> ixekizumab comparison. At 18 months, the guselkumab cohort demonstrated about twice the persistence rate as secukinumab (hazard ratio [HR] = 2.15; <i>p</i> < 0.001) and ixekizumab cohorts (HR = 1.77; <i>p</i> < 0.001). At 6 months after index biologic discontinuation, the guselkumab cohort was 31% and 40% more likely to achieve remission than secukinumab (rate ratio [RR] = 1.31; <i>p</i> < 0.001) and ixekizumab cohorts (RR = 1.40; <i>p</i> < 0.001).</p><p><p><b>Conclusions:</b> Guselkumab was associated with greater persistence and likelihood of remission than IL-17 inhibitors, indicating greater disease control and modification potential.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-27DOI: 10.1080/09546634.2024.2391445
Xin Huang, Guiying Zhang, Shuaihantian Luo
Purpose: Amyopathic dermatomyositis (ADM) is a rare, idiopathic, connective tissue disease and melanoma differentiation-associated protein 5 (MDA5) antibody-positive ADM is more treatment-resistant, especially in patients with interstitial lung disease (ILD). The purpose of this article is to report a case of anti-MDA5-positive ADM successfully treated with JAK inhibitor Upadacitinib.
Materials and methods: A 35-year-old Chinese woman presented with recurrent itchy erythema on her face and scalp for 4 years. Upon examination, there were heliotrope erythema and eyelid edema, reddish rash on neck and scalp. Biopsy of the lesions was consistent with DM and a line blot assay confirmed the presence of anti-MDA5 antibodies. This patient was treated with oral Upadacitinib at a dosage of 30 mg daily.
Results: After 6 weeks of treatment, she achieved complete clinical remission with no reported side effects or instances of relapse. The antibody titer of anti-MDA5 was also decreased.
Conclusions: Upadacitinib may be a potential drug candidate in patients with treatment-resistant ADM, especially in cases with refractory cutaneous conditions.
{"title":"A case of refractory anti-MDA5-positive amyopathic dermatomyositis successfully treated with upadacitinib.","authors":"Xin Huang, Guiying Zhang, Shuaihantian Luo","doi":"10.1080/09546634.2024.2391445","DOIUrl":"https://doi.org/10.1080/09546634.2024.2391445","url":null,"abstract":"<p><p><b>Purpose:</b> Amyopathic dermatomyositis (ADM) is a rare, idiopathic, connective tissue disease and melanoma differentiation-associated protein 5 (MDA5) antibody-positive ADM is more treatment-resistant, especially in patients with interstitial lung disease (ILD). The purpose of this article is to report a case of anti-MDA5-positive ADM successfully treated with JAK inhibitor Upadacitinib.</p><p><p><b>Materials and methods:</b> A 35-year-old Chinese woman presented with recurrent itchy erythema on her face and scalp for 4 years. Upon examination, there were heliotrope erythema and eyelid edema, reddish rash on neck and scalp. Biopsy of the lesions was consistent with DM and a line blot assay confirmed the presence of anti-MDA5 antibodies. This patient was treated with oral Upadacitinib at a dosage of 30 mg daily.</p><p><p><b>Results:</b> After 6 weeks of treatment, she achieved complete clinical remission with no reported side effects or instances of relapse. The antibody titer of anti-MDA5 was also decreased.</p><p><p><b>Conclusions:</b> Upadacitinib may be a potential drug candidate in patients with treatment-resistant ADM, especially in cases with refractory cutaneous conditions.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-05DOI: 10.1080/09546634.2024.2333016
Nan Dang, Huiwen Zheng, Yunqing Ren
Dupilumab is a novel treatment agent for moderate to severe atopic dermatitis (AD) with few adverse effects. Drug-induced psoriasiform lesions are rare.
We report a 4-year-old boy with AD who developed pustular psoriasis during treatment with dupilumab.
Pustular psoriasis appeared within 1 week of treatment and worsened in the second week. After stopping dupilumab administration, topical corticosteroids (desonide and mometasone furoate creams) and oral desloratadine without relief. Pustular psoriasis was confirmed by pathological examination, and thiamphenicol was administered. After 2 weeks of treatment, the lesions nearly resolved without recurrence in 1-year follow-up.
Dupilumab-induced pustular psoriasis is rare in children.
{"title":"A pediatric case of dupilumab-induced pustular psoriasis.","authors":"Nan Dang, Huiwen Zheng, Yunqing Ren","doi":"10.1080/09546634.2024.2333016","DOIUrl":"10.1080/09546634.2024.2333016","url":null,"abstract":"<p><p>Dupilumab is a novel treatment agent for moderate to severe atopic dermatitis (AD) with few adverse effects. Drug-induced psoriasiform lesions are rare.</p><p><p>We report a 4-year-old boy with AD who developed pustular psoriasis during treatment with dupilumab.</p><p><p>Pustular psoriasis appeared within 1 week of treatment and worsened in the second week. After stopping dupilumab administration, topical corticosteroids (desonide and mometasone furoate creams) and oral desloratadine without relief. Pustular psoriasis was confirmed by pathological examination, and thiamphenicol was administered. After 2 weeks of treatment, the lesions nearly resolved without recurrence in 1-year follow-up.</p><p><p>Dupilumab-induced pustular psoriasis is rare in children.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Alopecia areata (AA) is a common autoimmune skin disease. Our study aimed to systematically evaluate the efficacy and safety of compound glycyrrhizin (CG) combined with topical minoxidil therapy in treating AA.
Methods: We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on CG combined with topical minoxidil therapy compared with topical minoxidil therapy alone for AA were included. The Cochrane Collaborative Network Tool was used to assess the risk of bias. Statistical analysis was completed using RevMan5.3 software and Stata 15.0 software. The GRADE system was used to evaluate the quality of evidence for outcomes.
Result: 11 RCTs and 1189 patients were included. Compared with topical minoxidil therapy alone, CG combined with topical minoxidil therapy was more effective at improving the clinical efficacy (RR = 1.36, 95% CI [1.27, 1.45], p < 0.00001). The SALT score (MD = -10.09, 95% CI [-12.89, -7.30], p < 0.00001), serum TNF-α levels (MD = -0.99, 95% CI [-1.19, -0.39], p < 0.00001), serum IL-12 levels (MD = -8.84, 95% CI [-11.20, -6.47], p < 0.00001) and serum IFN-γ levels (MD = -7.44, 95% CI [-11.51, -3.37], p = 0.0003) were reduced, and the serum TGF-β1 levels (MD = 2.40, 95% CI [1.24, 3.57], p < 0.0001) were increased. There were no significant differences in reported adverse events, including irritant contact dermatitis (RR = 0.51, 95% CI [0.25, 1.01], p = 0.05),' gastrointestinal reactions (RR = 2.47, 95% CI [0.49, 12.55], p = 0.28), lower limb edema (RR = 2.60, 95% CI [0.61, 11.06], p = 0.20), facial edema (RR = 2.33, 95% CI [0.61, 8.93], p = 0.22), or localized itching (RR = 0.56, 95% CI [0.18, 1.75], p = 0.32), between the two groups.
Conclusion: The current evidence indicates that CG combined with topical minoxidil therapy is effective and safe for AA. However, owing to the suboptimal quality of the included studies, more high-quality and large-scale RCTs are needed for comprehensive analysis and further validation.
简介斑秃(AA)是一种常见的自身免疫性皮肤病。我们的研究旨在系统评估复方甘草酸苷(CG)联合米诺地尔外用治疗 AA 的有效性和安全性:我们检索了 PubMed、EMBASE、Cochrane Library、Web of Science、CNKI、万方和 VIP 数据库。方法:我们检索了 PubMase、EMBASE、Cochrane Library、Web Science、CNKI、Wanfang 和 VIP 数据库,纳入了关于 CG 联合局部米诺地尔疗法与单用局部米诺地尔疗法治疗 AA 的随机对照试验(RCT)。采用 Cochrane 协作网络工具评估偏倚风险。统计分析使用 RevMan5.3 软件和 Stata 15.0 软件完成。结果:共纳入 11 项 RCT 和 1189 名患者。与单纯外用米诺地尔治疗相比,CG联合外用米诺地尔治疗能更有效地改善临床疗效(RR = 1.36,95% CI [1.27,1.45],P P P = 0.0003),降低血清TGF-β1水平(MD = 2.40,95% CI [1.24,3.57],P P = 0.05)、'胃肠道反应(RR = 2.47,95% CI [0.49,12.55],P = 0.28)、下肢水肿(RR = 2.60,95% CI [0.61,11.06],P = 0.20)、面部水肿(RR = 2.33,95% CI [0.61,8.93],P = 0.22)或局部瘙痒(RR = 0.56,95% CI [0.18,1.75],P = 0.32):目前的证据表明,CG 联合米诺地尔局部治疗对 AA 有效且安全。结论:目前的证据表明,CG 联合局部米诺地尔疗法对 AA 有效且安全,但由于纳入的研究质量不佳,因此需要更多高质量和大规模的 RCT 进行全面分析和进一步验证。
{"title":"Efficacy and safety of compound glycyrrhizin combined with topical minoxidil for alopecia areata: a systematic review and meta-analysis of randomized controlled trials.","authors":"Chenqi Guo, Xiangru Gu, Junchen Li, Yingdong Wang, Xiaoya Liu, Guojing Yang, Min Zhang, Yu Zhang","doi":"10.1080/09546634.2024.2381766","DOIUrl":"https://doi.org/10.1080/09546634.2024.2381766","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is a common autoimmune skin disease. Our study aimed to systematically evaluate the efficacy and safety of compound glycyrrhizin (CG) combined with topical minoxidil therapy in treating AA.</p><p><strong>Methods: </strong>We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on CG combined with topical minoxidil therapy compared with topical minoxidil therapy alone for AA were included. The Cochrane Collaborative Network Tool was used to assess the risk of bias. Statistical analysis was completed using RevMan5.3 software and Stata 15.0 software. The GRADE system was used to evaluate the quality of evidence for outcomes.</p><p><strong>Result: </strong>11 RCTs and 1189 patients were included. Compared with topical minoxidil therapy alone, CG combined with topical minoxidil therapy was more effective at improving the clinical efficacy (RR = 1.36, 95% CI [1.27, 1.45], <i>p</i> < 0.00001). The SALT score (MD = -10.09, 95% CI [-12.89, -7.30], <i>p</i> < 0.00001), serum TNF-α levels (MD = -0.99, 95% CI [-1.19, -0.39], <i>p</i> < 0.00001), serum IL-12 levels (MD = -8.84, 95% CI [-11.20, -6.47], <i>p</i> < 0.00001) and serum IFN-γ levels (MD = -7.44, 95% CI [-11.51, -3.37], <i>p</i> = 0.0003) were reduced, and the serum TGF-β1 levels (MD = 2.40, 95% CI [1.24, 3.57], <i>p</i> < 0.0001) were increased. There were no significant differences in reported adverse events, including irritant contact dermatitis (RR = 0.51, 95% CI [0.25, 1.01], <i>p</i> = 0.05),' gastrointestinal reactions (RR = 2.47, 95% CI [0.49, 12.55], <i>p</i> = 0.28), lower limb edema (RR = 2.60, 95% CI [0.61, 11.06], <i>p</i> = 0.20), facial edema (RR = 2.33, 95% CI [0.61, 8.93], <i>p</i> = 0.22), or localized itching (RR = 0.56, 95% CI [0.18, 1.75], <i>p</i> = 0.32), between the two groups.</p><p><strong>Conclusion: </strong>The current evidence indicates that CG combined with topical minoxidil therapy is effective and safe for AA. However, owing to the suboptimal quality of the included studies, more high-quality and large-scale RCTs are needed for comprehensive analysis and further validation.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-30DOI: 10.1080/09546634.2024.2307488
Jenni Korhonen, Hanna Siiskonen, Salla Haimakainen, Rauno J Harvima, Ilkka T Harvima
Purpose: Mast cells, their serine proteinase tryptase, and immunoglobulin E (IgE) can be involved in cutaneous carcinogenesis.Materials and methods: To study the association of tryptase+ and IgE+ cells with photodamage and skin cancers 385 adult patients (201 males, 184 females, 75 with immunosuppression) at risk of any type of skin cancer were examined. Skin biopsies were taken from the sun-protected medial arm and from the photodamaged dorsal forearm skin followed by immunohistochemical staining for tryptase and IgE.Results: The results show that tryptase+ and IgE+ cells are significantly higher in number in the photodamaged than sun-protected skin, both in immunocompetent and -compromised subjects, and there is a strong correlation between tryptase+ and IgE+ cells. The numbers of forearm tryptase+ and especially IgE+ cells associated significantly with the forearm photodamage severity. In the logistic regression analysis, the forearm to upper arm ratio of IgE+ cells produced a univariate odds ratio of 1.521 (p = .010) and a multivariate one of 3.875 (p = .047) for the history of squamous cell carcinoma. The serum level of total IgE correlated significantly to the IgE to tryptase ratio in both skin sites.Conclusions: Therefore, IgE+ mast cells participate in photodamage and carcinogenesis, though it is unclear whether they are tumor-protective or -causative.
{"title":"Expression of mast cell tryptase and immunoglobulin E is increased in cutaneous photodamage: implications for carcinogenesis.","authors":"Jenni Korhonen, Hanna Siiskonen, Salla Haimakainen, Rauno J Harvima, Ilkka T Harvima","doi":"10.1080/09546634.2024.2307488","DOIUrl":"10.1080/09546634.2024.2307488","url":null,"abstract":"<p><p><b>Purpose:</b> Mast cells, their serine proteinase tryptase, and immunoglobulin E (IgE) can be involved in cutaneous carcinogenesis.<b>Materials and methods:</b> To study the association of tryptase<sup>+</sup> and IgE<sup>+</sup> cells with photodamage and skin cancers 385 adult patients (201 males, 184 females, 75 with immunosuppression) at risk of any type of skin cancer were examined. Skin biopsies were taken from the sun-protected medial arm and from the photodamaged dorsal forearm skin followed by immunohistochemical staining for tryptase and IgE.<b>Results:</b> The results show that tryptase<sup>+</sup> and IgE<sup>+</sup> cells are significantly higher in number in the photodamaged than sun-protected skin, both in immunocompetent and -compromised subjects, and there is a strong correlation between tryptase<sup>+</sup> and IgE<sup>+</sup> cells. The numbers of forearm tryptase<sup>+</sup> and especially IgE<sup>+</sup> cells associated significantly with the forearm photodamage severity. In the logistic regression analysis, the forearm to upper arm ratio of IgE<sup>+</sup> cells produced a univariate odds ratio of 1.521 (<i>p</i> = .010) and a multivariate one of 3.875 (<i>p</i> = .047) for the history of squamous cell carcinoma. The serum level of total IgE correlated significantly to the IgE to tryptase ratio in both skin sites.<b>Conclusions:</b> Therefore, IgE<sup>+</sup> mast cells participate in photodamage and carcinogenesis, though it is unclear whether they are tumor-protective or -causative.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}