The Journal of dermatological treatment最新文献

Purpose: Understanding the treatment goals and preferences of young atopic dermatitis (AD) patients and their caregivers is crucial for enhancing patient-centered care. This study aims to identify these goals and preferences and explore heterogeneity among subgroups.

Materials and methods: A web-based survey was conducted among children (6-11 years), adolescents (12-17 years), and young adults (18-30 years) with AD and caregivers of AD patients. Survey questions included multiple-choice, four-point Likert scale, and open-ended questions. Goals and preferences were stratified by age, gender, disease severity, current treatment, visible lesions, and atopic comorbidity.

Results: A total of 286 respondents were included. Prioritized treatment goals were 'no itch', 'preventing new lesions', and 'no lesions'. Prioritized treatment characteristics were 'high effectiveness' and 'long-term safety'. Young patients (6-30 years) considered convenience of treatment more important than caregivers, while caregivers considered short- and long-term safety more important than young patients. Pediatric patients (6-17 years) considered psychosocial goals more important than young adults. Goals and preferences also differed by disease severity, gender, current treatment, and atopic comorbidity.

Conclusions: Young AD patients and caregivers strive to reduce itch and lesions with effective and safe treatment. Goals and preferences differ within individuals at different stages of life, highlighting the importance of addressing individual needs to improve patient-centered care.

Objectives: To evaluate the efficacy and safety of apremilast, a phosphodiesterase-4 (PDE-4) inhibitor, in treating pityriasis lichenoides et varioliformis acuta (PLEVA) and explore its potential mechanisms.

Methods: We present a 16-year-old male with refractory PLEVA who failed conventional therapies (systemic corticosteroids, acitretin). Treatment with oral apremilast (30 mg twice daily) was initiated.

Results: Significant improvement was observed within 1 week, with near-complete clearance by 8 weeks. No relapse or adverse events occurred during 12-month follow-up.

Conclusions: Apremilast may be a safe and effective option for refractory PLEVA.

Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition with increasing prevalence in infancy. Standard treatments rely heavily on topical corticosteroids, but concerns about long-term side effects and limited efficacy in some cases highlight the need for alternative therapeutic strategies.

Methods: We present a 13-month-old male with moderate AD refractory to moisturizers and hydrocortisone ointments. Sympathetic Nerve Entrapment Point Injection (SNEPI) was administered bilaterally at the T7 paraspinal level using 1 mL of normal saline once weekly for three sessions. Clinical outcomes were monitored during treatment and over a six-year follow-up period.

Results: Pruritus resolved and sleep normalized after the first treatment. By the third session, complete remission of skin lesions was achieved without corticosteroid use, with no recurrence observed during four weeks of follow-up. During a six-year follow-up, the child maintained stable skin with only occasional mild pruritus, suggesting sustained therapeutic benefit.

Conclusions: This case demonstrates the potential of SNEPI as a safe, effective, and steroid-free neuromodulatory treatment for pediatric AD, supporting the role of autonomic modulation in inflammatory skin disorders. Further clinical studies are warranted to evaluate the broader applicability of SNEPI in pediatric dermatology.

Objective: This study explores the effects of a skin management model based on a precision quantitative ointment dispenser on skin symptoms and quality of life in elderly psoriasis patients.

Methods: Elderly psoriasis patients adopted a skin management model based on a precision quantitative ointment dispenser. The Psoriasis Area and Severity Index (PASI) was measured prior to the intervention and at 2, 4, and 6 weeks post-intervention. The Chinese version of the Strategies Used by Patients to Promote Health (C-SUPPH), Symptom Checklist-90 (SCL-90), and Dermatology Life Quality Index (DLQI) were assessed at baseline and after 6 weeks. Patient satisfaction was measured following the 6-week intervention.

Results: Both groups demonstrated reductions in PASI scores at 2, 4, and 6 weeks, with the observation group scoring lower (p < 0.05). After 6 weeks, all dimensions of the C-SUPPH showed improvements in both groups, with the observation group exhibiting greater enhancements; SCL-90 scores for anxiety and phobic anxiety reduced in the observation group; DLQI scores decreased in both groups, but the observation group reported superior outcomes; the observation group recorded a higher satisfaction rate (p < 0.05).

Conclusion: The precision quantitative ointment dispenser-based skin management model improves skin symptoms and quality of life in elderly psoriasis patients.

Purpose: Hailey-Hailey disease (HHD), a rare autosomal dominant blistering disorder predominantly affecting intertriginous areas, is characterized by chronic relapsing courses that cause substantial morbidity. Despite multiple available therapeutic modalities, management of refractory cases remains challenging.

Materials and methods: This case report details a 67-year-old male with severe erythroderma-like HHD, whose genetic analysis revealed a heterozygous nonsense mutation (c.1774C > T) in the ATP2C1 gene. Following conventional therapies, the patient developed treatment-related complications. Therefore, oral tofacitinib was administered as an alternative treatment.

Results: The patient achieved marked clinical improvement post-tofacitinib administration, with no treatment-emergent adverse events.

Conclusions: This case indicates that tofacitinib may serve as a promising therapeutic option for refractory erythroderma-like HHD, particularly in cases linked to ATP2C1 mutations.

Objectives: Upadacitinib, a selective JAK1 inhibitor, is approved for the treatment of atopic dermatitis but is increasingly used off-label in dermatology. This study aimed to summarize the existing evidence on such off-label use to clarify its potential value and safety in dermatological practice.

Methods: We identified 113 papers (n = 638) on the off-label use of upadacitinib for dermatological conditions via PubMed.

Results: Our findings indicate that upadacitinib demonstrated potential efficacy in alopecia areata, vitiligo, lupus erythematosus, and other dermatoses. The most common upadacitinib dose is 15 mg/day. Common adverse events included elevated creatine kinase levels, infections, and acne.

Conclusions: While preliminary data show promising results, the evidence is limited to case reports and case series. Future randomized trials are needed to validate efficacy and safety.

Objectives: Chronic spontaneous urticaria (CSU) is a debilitating disease that impacts patients' wellbeing. Herein, we report the burden of CSU on the health-related quality of life (HRQoL), unmet needs, treatment patterns, and expectations of Italian patients with CSU from the Urticaria Voices study.

Methods: Urticaria Voices, a multi-national, cross-sectional, survey study, was conducted in adult patients with CSU. Patients completed an online survey on the impact of CSU on patients' HRQoL, unmet needs, and treatments. Data were analyzed descriptively.

Results: Overall, 64 Italian patients with CSU participated in the Urticaria Voices study (mean age: 42.4 years; 70% women). The average time since diagnosis was 7.8 years. Patients rated CSU's negative impact as 6.3/10, with the top impact being reduced confidence (28.1%). The main unmet need was treatments with fewer side effects (39.1%). Most patients (82.8%) used antihistamine, with 77.4% of them being switched to another antihistamine and 43.4% being updosed. Patients reported freedom from itch and hives as the top treatment expectation (7.69/10).

Conclusion: CSU imparts a substantial disease burden that negatively impacts the HRQoL of Italian patients. More effective treatments for CSU emerged as an important unmet need. Raising disease awareness and improving access to new treatments can facilitate enhanced CSU care.

Background: Facial wrinkles, caused by aging and repetitive muscle contractions, are commonly treated with botulinum neurotoxin type A (BoNT-A). However, excessive toxin diffusion can cause side-effects like muscle weakness.

Objectives: This study aimed to compare the diffusion, efficacy, and safety of letibotulinum toxin A with two other BoNT-A products for treating forehead wrinkles.

Methods: In a double-blind, randomized, split-face controlled trial, 20 participants with moderate-to-severe horizontal forehead wrinkles received letibotulinum toxin A on one side and prabotulinum or onabotulinum toxin A on the other. The primary outcome was diffusion profile assessed via anhidrosis area (iodine-starch test at 2 weeks); secondary outcomes included wrinkle reduction, assessed by photographic analysis, and safety.

Results: Results show that letibotulinum toxin A exhibited diffusion patterns and wrinkle-reduction efficacy comparable to the control products. No statistically significant differences were observed be-tween the groups for the primary or secondary outcomes.

Conclusion: Letibotulinum toxin A is a safe, effective alternative for wrinkle treatment, potentially minimizing excessive diffusion risks and related side effects, making it a valuable addition to available treatment options.