Psoriasis vulgaris and psoriatic arthritis are common diseases that can lead to considerable impairment of quality of life. The coexistence of alopecia universalis and psoriasis may suppose a therapeutic challenge. We report a 31-year-old female patient with alopecia universalis, psoriasis vulgaris and psoriatic arthritis. The patient exhibited a refractory response of psoriatic arthritis and alopecia universalis to monotherapy with methotrexate (MTX), bimekizumab, deucravacitinib and tofacitinib and to topical therapy with corticoids. A subsequent regimen including tofacitinib and MTX led to marked improvements in both joint pain and hair regrowth. Current evidence supporting the utilisation of tofacitinib and methotrexate for alopecia areata is promising. The strategic implementation of combination therapies that leverage the immunomodulatory properties of MTX alongside the targeted mechanisms of action of tofacitinib may result in enhanced therapeutic outcome. Tofacitinib in combination with MTX is a promising treatment option for patients with severe, refractory alopecia areata and psoriasis.
{"title":"Case Report of a Patient With Psoriasis Vulgaris, Psoriatic Arthritis and Alopecia Universalis Successfully Treated With Tofacitinib and Methotrexate","authors":"Jan Nicolai Wagner, Matthias Augustin, Caroline Gewiss, Carolin Grote, Nesrine Ben-Anaya","doi":"10.1002/jvc2.70068","DOIUrl":"https://doi.org/10.1002/jvc2.70068","url":null,"abstract":"<p>Psoriasis vulgaris and psoriatic arthritis are common diseases that can lead to considerable impairment of quality of life. The coexistence of alopecia universalis and psoriasis may suppose a therapeutic challenge. We report a 31-year-old female patient with alopecia universalis, psoriasis vulgaris and psoriatic arthritis. The patient exhibited a refractory response of psoriatic arthritis and alopecia universalis to monotherapy with methotrexate (MTX), bimekizumab, deucravacitinib and tofacitinib and to topical therapy with corticoids. A subsequent regimen including tofacitinib and MTX led to marked improvements in both joint pain and hair regrowth. Current evidence supporting the utilisation of tofacitinib and methotrexate for alopecia areata is promising. The strategic implementation of combination therapies that leverage the immunomodulatory properties of MTX alongside the targeted mechanisms of action of tofacitinib may result in enhanced therapeutic outcome. Tofacitinib in combination with MTX is a promising treatment option for patients with severe, refractory alopecia areata and psoriasis.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1182-1185"},"PeriodicalIF":0.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cathal O'Connor, Aoife Boyle, Leila Asfour, Bevin Bhoyrul, Laita Bokhari, George Cotsarelis, Chantal Cotter, Brittany Craiglow, Lara Cutlar, Rachita Dhurat, Ncoza Dlova, Isabella Doche, Jeff Donovan, Aaron M. Drucker, Samantha Eisman, Daniel Fernandes Melo, Matthew J. Harries, Maria Hordinsky, Ahmed Kazmi, Brett King, Antonios Kolios, Nekma Meah, Paradi Mirmirani, Arash Mostaghimi, Manabu Ohyama, Yuliya Ovcharenko, Rodrigo Pirmez, Bianca Maria Piraccini, Lidia Rudnicka, David Saceda-Corralo, Jerry Shapiro, Cathryn Sibbald, Rod Sinclair, Blake R. C. Smith, Michela Starace, Sergio Vaño-Galván, Wei Liang Koh, Katherine York, Ian McDonald, Dmitri Wall
Background
Alopecia areata (AA) is a common non-scarring alopecia. Data continue to emerge on associations with autoimmune and other conditions. Janus kinase inhibitors (JAKi) are increasingly used to treat AA.
Objectives
The aim was to assess variation in laboratory testing in patients with AA among hair experts internationally and to compare subspecialized clinical practice to current guidelines.
Methods
Thirty hair experts from 14 countries and six continents contributed to develop a 24-item survey collecting demographic information on respondents; methods of severity assessment; and laboratory testing practices in AA for mimics, contributory factors, associations, and workup for systemic therapy. The survey was distributed to a global network of expert hair specialists.
Results
Of 214 respondents, 79.9% (171/214) had special interest/expertise in hair loss disorders, and 35.5% (n = 76) were based in Europe. Most cared for both adults and children (87.9%, n = 188). For clinical assessment, almost two-thirds (63.6%, n = 136) used the Severity of Alopecia Tool and 38% (n = 84) used the Dermatology Life Quality Index. Only 24.3% (n = 52) typically tested for alternative infectious or inflammatory diagnoses, 39.7% (n = 85) typically tested for contributory conditions such as nutritional deficiencies, and 50.9% (n = 109) typically tested for co-existent autoimmune illnesses. Thyroid function testing was routinely performed in 73.4% (n = 157) and complete blood count (CBC) was checked in 65.9% (n = 141). Compared to conventional systemic therapy, experts were more likely to check lipid levels, creatine kinase, coagulation profiles, thrombophilia screens, tuberculosis blood testing, hepatitis B and C serology before prescribing JAKi.
Conclusions
Real world practice of laboratory testing for AA by hair experts, who may see more severe or complex alopecia, is variable. Most experts routinely perform thyroid function and CBC testing. We discuss evidence for indications for testing for AA mimics, contributory factors, associated autoimmune conditions, and before systemic therapy. Further research is required to characterise the role of laboratory testing in AA.
{"title":"COLLAB: A Global Survey of Clinical and Laboratory Assessment in Alopecia Areata by Hair Specialists","authors":"Cathal O'Connor, Aoife Boyle, Leila Asfour, Bevin Bhoyrul, Laita Bokhari, George Cotsarelis, Chantal Cotter, Brittany Craiglow, Lara Cutlar, Rachita Dhurat, Ncoza Dlova, Isabella Doche, Jeff Donovan, Aaron M. Drucker, Samantha Eisman, Daniel Fernandes Melo, Matthew J. Harries, Maria Hordinsky, Ahmed Kazmi, Brett King, Antonios Kolios, Nekma Meah, Paradi Mirmirani, Arash Mostaghimi, Manabu Ohyama, Yuliya Ovcharenko, Rodrigo Pirmez, Bianca Maria Piraccini, Lidia Rudnicka, David Saceda-Corralo, Jerry Shapiro, Cathryn Sibbald, Rod Sinclair, Blake R. C. Smith, Michela Starace, Sergio Vaño-Galván, Wei Liang Koh, Katherine York, Ian McDonald, Dmitri Wall","doi":"10.1002/jvc2.70067","DOIUrl":"https://doi.org/10.1002/jvc2.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alopecia areata (AA) is a common non-scarring alopecia. Data continue to emerge on associations with autoimmune and other conditions. Janus kinase inhibitors (JAKi) are increasingly used to treat AA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim was to assess variation in laboratory testing in patients with AA among hair experts internationally and to compare subspecialized clinical practice to current guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty hair experts from 14 countries and six continents contributed to develop a 24-item survey collecting demographic information on respondents; methods of severity assessment; and laboratory testing practices in AA for mimics, contributory factors, associations, and workup for systemic therapy. The survey was distributed to a global network of expert hair specialists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 214 respondents, 79.9% (171/214) had special interest/expertise in hair loss disorders, and 35.5% (<i>n</i> = 76) were based in Europe. Most cared for both adults and children (87.9%, <i>n</i> = 188). For clinical assessment, almost two-thirds (63.6%, <i>n</i> = 136) used the Severity of Alopecia Tool and 38% (<i>n</i> = 84) used the Dermatology Life Quality Index. Only 24.3% (<i>n</i> = 52) typically tested for alternative infectious or inflammatory diagnoses, 39.7% (<i>n</i> = 85) typically tested for contributory conditions such as nutritional deficiencies, and 50.9% (<i>n</i> = 109) typically tested for co-existent autoimmune illnesses. Thyroid function testing was routinely performed in 73.4% (<i>n</i> = 157) and complete blood count (CBC) was checked in 65.9% (<i>n</i> = 141). Compared to conventional systemic therapy, experts were more likely to check lipid levels, creatine kinase, coagulation profiles, thrombophilia screens, tuberculosis blood testing, hepatitis B and C serology before prescribing JAKi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Real world practice of laboratory testing for AA by hair experts, who may see more severe or complex alopecia, is variable. Most experts routinely perform thyroid function and CBC testing. We discuss evidence for indications for testing for AA mimics, contributory factors, associated autoimmune conditions, and before systemic therapy. Further research is required to characterise the role of laboratory testing in AA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"811-820"},"PeriodicalIF":0.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Al Janahi, Alya Al-Ali, Meera Al Adawi, Yusra S. Al Ali, Harish Bangalore
<p>We present the case of a 2-month-old boy with suspected persistent hyperinsulinemic hypoglycemia of infancy (PHHI), complicated by hypoxic respiratory failure, sepsis, and acute respiratory distress syndrome. Since birth, he had recurrent hypoglycemia, managed with intermittent diazoxide, intravenous (IV) glucagon infusions, and octreotide. Genetic testing confirmed type 3 congenital hyperinsulinism (GCK mutation, p.V91L). He developed waxing and waning lesions on the scalp, face, trunk, upper and lower extremities, and groin, tending to disappear from one location and reappear in another. Clinical examination revealed diffusely scattered, well-demarcated, erythematous desquamative plaques, with disseminated erythematous papules on the trunk, extremities and intertriginous areas (Figure 1A,B). A 4-mm punch biopsy was taken from a lesion on the right thigh (Figure 2A,B).</p><p>The biopsy revealed confluent parakeratosis with subcorneal clefting, loss of the granular layer, and focal pallor of keratinocytes. Zinc levels were unremarkable. Clinicopathologic correlation supported a diagnosis of iatrogenic necrolytic migratory erythema (NME). The glucagon infusion was gradually weaned and eventually discontinued. The eruption improved shortly thereafter. Glucose levels were closely monitored and remained stable. Unfortunately, the patient later developed multiorgan failure and succumbed to sepsis-related complications before a planned pancreatectomy.</p><p>In contrast to our case, NME is classically associated with glucagonoma, an alpha-cell pancreatic tumour in 65%–70% of cases [<span>1</span>]. Glucagonoma syndrome, a paraneoplastic disorder, consists of a triad of diabetes mellitus, NME, and weight loss [<span>2</span>]. Other associations include liver cirrhosis, malabsorption syndromes, Crohn's disease, chronic pancreatitis, or other malignancies such as small cell lung cancer or duodenal neoplasms [<span>1, 2</span>]. In these instances, it can be categorised as ‘pseudoglucagonoma syndrome’ [<span>2</span>]. NME due to glucagon has been reported in neonates with congenital focal hyperinsulinism [<span>3</span>], PHHI [<span>4</span>], and in a 24-year-old female with acute pancreatitis [<span>5</span>]. In all cases, the lesions improved following glucagon cessation. It remains unclear whether the duration of therapy influences the development of lesions. A review found that reported cases ranged from 10 days to 5 months after glucagon initiation [<span>3</span>]. The clinical presentation, management, and outcome of cases of congenital hyperinsulinism treated with glucagon are listed in Table 1.</p><p>Hyperglucagonemia is believed to play a key role in the pathogenesis of NME. The development of skin lesions is thought to be multifactorial, involving nutrient deficiencies, and the activation of inflammatory mediators within the epidermis [<span>2</span>]. A malnutrition model suggested that excess glucagon triggers a catabolic state, disrupt
{"title":"Erythematous Papules and Plaques in an Infant Receiving Glucagon Therapy","authors":"Sara Al Janahi, Alya Al-Ali, Meera Al Adawi, Yusra S. Al Ali, Harish Bangalore","doi":"10.1002/jvc2.70044","DOIUrl":"https://doi.org/10.1002/jvc2.70044","url":null,"abstract":"<p>We present the case of a 2-month-old boy with suspected persistent hyperinsulinemic hypoglycemia of infancy (PHHI), complicated by hypoxic respiratory failure, sepsis, and acute respiratory distress syndrome. Since birth, he had recurrent hypoglycemia, managed with intermittent diazoxide, intravenous (IV) glucagon infusions, and octreotide. Genetic testing confirmed type 3 congenital hyperinsulinism (GCK mutation, p.V91L). He developed waxing and waning lesions on the scalp, face, trunk, upper and lower extremities, and groin, tending to disappear from one location and reappear in another. Clinical examination revealed diffusely scattered, well-demarcated, erythematous desquamative plaques, with disseminated erythematous papules on the trunk, extremities and intertriginous areas (Figure 1A,B). A 4-mm punch biopsy was taken from a lesion on the right thigh (Figure 2A,B).</p><p>The biopsy revealed confluent parakeratosis with subcorneal clefting, loss of the granular layer, and focal pallor of keratinocytes. Zinc levels were unremarkable. Clinicopathologic correlation supported a diagnosis of iatrogenic necrolytic migratory erythema (NME). The glucagon infusion was gradually weaned and eventually discontinued. The eruption improved shortly thereafter. Glucose levels were closely monitored and remained stable. Unfortunately, the patient later developed multiorgan failure and succumbed to sepsis-related complications before a planned pancreatectomy.</p><p>In contrast to our case, NME is classically associated with glucagonoma, an alpha-cell pancreatic tumour in 65%–70% of cases [<span>1</span>]. Glucagonoma syndrome, a paraneoplastic disorder, consists of a triad of diabetes mellitus, NME, and weight loss [<span>2</span>]. Other associations include liver cirrhosis, malabsorption syndromes, Crohn's disease, chronic pancreatitis, or other malignancies such as small cell lung cancer or duodenal neoplasms [<span>1, 2</span>]. In these instances, it can be categorised as ‘pseudoglucagonoma syndrome’ [<span>2</span>]. NME due to glucagon has been reported in neonates with congenital focal hyperinsulinism [<span>3</span>], PHHI [<span>4</span>], and in a 24-year-old female with acute pancreatitis [<span>5</span>]. In all cases, the lesions improved following glucagon cessation. It remains unclear whether the duration of therapy influences the development of lesions. A review found that reported cases ranged from 10 days to 5 months after glucagon initiation [<span>3</span>]. The clinical presentation, management, and outcome of cases of congenital hyperinsulinism treated with glucagon are listed in Table 1.</p><p>Hyperglucagonemia is believed to play a key role in the pathogenesis of NME. The development of skin lesions is thought to be multifactorial, involving nutrient deficiencies, and the activation of inflammatory mediators within the epidermis [<span>2</span>]. A malnutrition model suggested that excess glucagon triggers a catabolic state, disrupt","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1263-1266"},"PeriodicalIF":0.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The article by Prieto et al. [<span>1</span>] was an interesting read and brings attention to the disproportionate burden of hidradenitis suppurativa (HS) among patients with skin of colour (SOC), particularly African American and Hispanic populations. However, a significant underrepresentation of Asian population has been noted throughout the review. While the article highlights limited data on Asian populations, a PubMed and Google Scholar search reveals several regional studies from various parts of Asia that contribute valuable insights into the epidemiology and clinical presentation of HS. Though the article [<span>1</span>] appropriately frames HS within the context of skin of colour, it is important to recognise that SOC is not a homogenous category. Asia is a highly heterogeneous region comprising numerous racial and ethnic groups, with the period prevalence of HS reported to be 0.06% [<span>2</span>]. Asian populations—encompassing East Asia (e.g., China, Korea, Japan), Southeast Asia (e.g., Singapore, Malaysia), and South Asia (e.g., India, Pakistan, Bangladesh)—span a broad spectrum of Fitzpatrick skin types (III to VI), each with distinct epidemiological and disease patterns. Central (Kazakhstan, Uzbekistan, Turkmenistan) and Western Asia (Saudi Arabia, UAE) differ in skin phenotype (Fitzpatrick 2–4) and ethnic composition compared to the rest of Asia.</p><p>Among the Southeast Asian cohorts from Singapore and Malaysia, Indian patients appear disproportionately affected by HS while Chinese patients are underrepresented relative to national census data [<span>2</span>]. A recent systematic review and meta-analysis of 30,125 patients from East and Southeast Asia highlights distinct demographic and clinical patterns, revealing a male predominance (66%), lesion distribution favoring the axilla and gluteal area, and a notably low rate of familial HS (5%) compared to Western cohorts (30%). The male predominance in Asian HS populations has been attributed, in part, to significantly higher smoking rates among Asian men, in contrast to Western cohorts where smoking prevalence is balanced between males and females [<span>3</span>]. Lesional distribution in HS shows some overlap between East Asia and Western countries, though the commonly involved sites differ. In East Asian cohorts like Korea and Japan, gluteal involvement is more common especially among males, whereas axillary involvement dominates among females. In contrast, Southeast Asian studies from Singapore and Malaysia consistently report the axilla as the most affected site, possibly due to climatic factors like higher humidity and sweat-induced follicular occlusion [<span>2</span>]. Only around 5% of Asian HS patients report a positive family history, compared to approximately 30% in Western populations—a difference that may be influenced by rising obesity rates in Asia unmasking sporadic cases, and the predominance of Caucasian participants in Western studies, where familial HS i
{"title":"The Understudied Landscape of Hidradenitis Suppurativa in Asian Skin of Colour Populations","authors":"Anju George","doi":"10.1002/jvc2.70065","DOIUrl":"https://doi.org/10.1002/jvc2.70065","url":null,"abstract":"<p>The article by Prieto et al. [<span>1</span>] was an interesting read and brings attention to the disproportionate burden of hidradenitis suppurativa (HS) among patients with skin of colour (SOC), particularly African American and Hispanic populations. However, a significant underrepresentation of Asian population has been noted throughout the review. While the article highlights limited data on Asian populations, a PubMed and Google Scholar search reveals several regional studies from various parts of Asia that contribute valuable insights into the epidemiology and clinical presentation of HS. Though the article [<span>1</span>] appropriately frames HS within the context of skin of colour, it is important to recognise that SOC is not a homogenous category. Asia is a highly heterogeneous region comprising numerous racial and ethnic groups, with the period prevalence of HS reported to be 0.06% [<span>2</span>]. Asian populations—encompassing East Asia (e.g., China, Korea, Japan), Southeast Asia (e.g., Singapore, Malaysia), and South Asia (e.g., India, Pakistan, Bangladesh)—span a broad spectrum of Fitzpatrick skin types (III to VI), each with distinct epidemiological and disease patterns. Central (Kazakhstan, Uzbekistan, Turkmenistan) and Western Asia (Saudi Arabia, UAE) differ in skin phenotype (Fitzpatrick 2–4) and ethnic composition compared to the rest of Asia.</p><p>Among the Southeast Asian cohorts from Singapore and Malaysia, Indian patients appear disproportionately affected by HS while Chinese patients are underrepresented relative to national census data [<span>2</span>]. A recent systematic review and meta-analysis of 30,125 patients from East and Southeast Asia highlights distinct demographic and clinical patterns, revealing a male predominance (66%), lesion distribution favoring the axilla and gluteal area, and a notably low rate of familial HS (5%) compared to Western cohorts (30%). The male predominance in Asian HS populations has been attributed, in part, to significantly higher smoking rates among Asian men, in contrast to Western cohorts where smoking prevalence is balanced between males and females [<span>3</span>]. Lesional distribution in HS shows some overlap between East Asia and Western countries, though the commonly involved sites differ. In East Asian cohorts like Korea and Japan, gluteal involvement is more common especially among males, whereas axillary involvement dominates among females. In contrast, Southeast Asian studies from Singapore and Malaysia consistently report the axilla as the most affected site, possibly due to climatic factors like higher humidity and sweat-induced follicular occlusion [<span>2</span>]. Only around 5% of Asian HS patients report a positive family history, compared to approximately 30% in Western populations—a difference that may be influenced by rising obesity rates in Asia unmasking sporadic cases, and the predominance of Caucasian participants in Western studies, where familial HS i","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"902-904"},"PeriodicalIF":0.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feleke Tilahun Zewdu, Saba Maria Lambert, Michael Marks, Yematawork Kebede Aragaw, Derese Bekele Daba, Kassahun Alemu, Endalamaw Gadisa, Stephen L. Walker
Background
Cutaneous leishmaniasis (CL) is a public health problem in Ethiopia. Diagnosis is often delayed, and treatment options are limited. Liquid nitrogen cryotherapy is a recommended treatment but not widely available. Carbon dioxide (CO2) cryotherapy is used for the prevention of cervical cancer and is widely available in Ethiopia and might be a suitable therapy for treating localized CL.
Objectives
The aim of this short report is to assess the effectiveness of carbon dioxide cryotherapy for the treatment of CL in CL treatment centre, Ethiopia.
Methods
We performed a prospective study assessing the effectiveness of CO2 cryotherapy for the treatment of localized CL between September 2022 and June 2023 at an established CL treatment centre.
Results
Seventeen individuals with 24 CL lesions were enrolled. Twelve (70.6%) were confirmed using a skin slit smear and five by histopathology (29.4%). Nine (52.9%) individuals received a single session of CO2 cryotherapy, five received two (29.4%) and three (17.65%) received three sessions of cryotherapy. At Day 90, 16 participants were assessed and 14 (82.4%) had healed.
Conclusions
CO2 cryotherapy shows promise as a potential treatment strategy for CL. Formal evaluations are required.
{"title":"Effectiveness of Carbon Dioxide Cryotherapy for the Treatment of Localized Cutaneous Leishmaniasis in Ethiopia","authors":"Feleke Tilahun Zewdu, Saba Maria Lambert, Michael Marks, Yematawork Kebede Aragaw, Derese Bekele Daba, Kassahun Alemu, Endalamaw Gadisa, Stephen L. Walker","doi":"10.1002/jvc2.70061","DOIUrl":"https://doi.org/10.1002/jvc2.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cutaneous leishmaniasis (CL) is a public health problem in Ethiopia. Diagnosis is often delayed, and treatment options are limited. Liquid nitrogen cryotherapy is a recommended treatment but not widely available. Carbon dioxide (CO<sub>2</sub>) cryotherapy is used for the prevention of cervical cancer and is widely available in Ethiopia and might be a suitable therapy for treating localized CL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this short report is to assess the effectiveness of carbon dioxide cryotherapy for the treatment of CL in CL treatment centre, Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a prospective study assessing the effectiveness of CO<sub>2</sub> cryotherapy for the treatment of localized CL between September 2022 and June 2023 at an established CL treatment centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen individuals with 24 CL lesions were enrolled. Twelve (70.6%) were confirmed using a skin slit smear and five by histopathology (29.4%). Nine (52.9%) individuals received a single session of CO<sub>2</sub> cryotherapy, five received two (29.4%) and three (17.65%) received three sessions of cryotherapy. At Day 90, 16 participants were assessed and 14 (82.4%) had healed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CO<sub>2</sub> cryotherapy shows promise as a potential treatment strategy for CL. Formal evaluations are required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"830-835"},"PeriodicalIF":0.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ariana Ramírez-Zumbado, Daniel Barquero-Orias, Wendy Vindas-Calderón, Paula Forsythe-Rodríguez
<p>A 22-year-old female patient, known with epilepsy under treatment with chlorpromazine and sodium valproate, with no history of allergies or addictions, presents with a history of 8 months of evolution of a painful, persistent lesion on the sole of the left foot, which had increased in size. Physical examination revealed a deep nodular lesion on the skin of the sole of the left foot with an irregular surface with areas of increased elevation (Figure 1).</p><p>As part of the differential diagnosis, sarcoma versus vascular lesion was initially suggested. Laboratory investigations, blood count, and biochemical profile were performed and reported to be within a normal range. The diagnostic approach began with an imaging study by soft tissue ultrasound, which was reported as possibly a vascular malformation, however, a sarcomatous lesion could be ruled out. Therefore, it was decided to perform an incisional skin biopsy of the lesion.</p><p>The patient was lost for follow-up and could only be re-evaluated 1 year later. Clinically, the lesion persisted and increased in size (Figure 1B). A second skin biopsy and culture for fungi and bacteria were performed (Figure 2).</p><p>Cutaneous botryomycosis is a rare chronic granulomatous infection caused by bacteria. The most frequently implicated germ is <i>S. aureus</i>, however, it can be caused by gram-positive cocci (<i>Streptococci</i> and coagulase-negative <i>Staphylococci</i>), gram-negative bacteria (<i>Pseudomonas aeruginosa</i>, <i>Escherichia coli, Proteus</i> spp, and <i>Serratia</i> spp) and anaerobic bacteria (<i>Peptostreptococci</i> spp and <i>Actinobacilli</i> spp) [<span>1</span>].</p><p>Previous trauma from surgery, burns, disruption of the protective barrier of the skin by microtrauma is often documented. Other identifiable factors are immunocompromise, HIV infection, diabetes mellitus and alcoholism [<span>2, 3</span>]. Botryomycosis can be classified into the cutaneous and the more frequent visceral form. Cutaneous botryomycosis frequently involves exposed parts of the skin, such as the hands, head, and neck or areas of constant trauma such as the feet [<span>2</span>].</p><p>Cutaneous botryomycosis presents characteristically as subcutaneous nodules, ulceration that does not heal with fistulas or verrucous lesions. They are mostly localised lesions, however, deep structures such as bones, muscles, and tendons may be involved by continuity [<span>1, 4</span>]. In addition, any visceral organ [<span>5</span>]. The differential diagnosis of cutaneous botryomycosis includes mycetoma, tuberculosis, actinomycosis, sporotrichosis, and abscesses [<span>6</span>]. The diagnosis is based on culture and histopathology [<span>7</span>]. When botryomycosis is suspected, the bacterial agent must be isolated. Purulent secretions draining from fistulas are useful: Other aetiologic agents can be ruled out using methods such as 10% KOH, polarised light, and different stains such as Ziehl-Neelsen, Fite,
{"title":"Plantar Nodular Lesion in A 22-Year-Old Immunocompetent Female Patient","authors":"Ariana Ramírez-Zumbado, Daniel Barquero-Orias, Wendy Vindas-Calderón, Paula Forsythe-Rodríguez","doi":"10.1002/jvc2.70056","DOIUrl":"https://doi.org/10.1002/jvc2.70056","url":null,"abstract":"<p>A 22-year-old female patient, known with epilepsy under treatment with chlorpromazine and sodium valproate, with no history of allergies or addictions, presents with a history of 8 months of evolution of a painful, persistent lesion on the sole of the left foot, which had increased in size. Physical examination revealed a deep nodular lesion on the skin of the sole of the left foot with an irregular surface with areas of increased elevation (Figure 1).</p><p>As part of the differential diagnosis, sarcoma versus vascular lesion was initially suggested. Laboratory investigations, blood count, and biochemical profile were performed and reported to be within a normal range. The diagnostic approach began with an imaging study by soft tissue ultrasound, which was reported as possibly a vascular malformation, however, a sarcomatous lesion could be ruled out. Therefore, it was decided to perform an incisional skin biopsy of the lesion.</p><p>The patient was lost for follow-up and could only be re-evaluated 1 year later. Clinically, the lesion persisted and increased in size (Figure 1B). A second skin biopsy and culture for fungi and bacteria were performed (Figure 2).</p><p>Cutaneous botryomycosis is a rare chronic granulomatous infection caused by bacteria. The most frequently implicated germ is <i>S. aureus</i>, however, it can be caused by gram-positive cocci (<i>Streptococci</i> and coagulase-negative <i>Staphylococci</i>), gram-negative bacteria (<i>Pseudomonas aeruginosa</i>, <i>Escherichia coli, Proteus</i> spp, and <i>Serratia</i> spp) and anaerobic bacteria (<i>Peptostreptococci</i> spp and <i>Actinobacilli</i> spp) [<span>1</span>].</p><p>Previous trauma from surgery, burns, disruption of the protective barrier of the skin by microtrauma is often documented. Other identifiable factors are immunocompromise, HIV infection, diabetes mellitus and alcoholism [<span>2, 3</span>]. Botryomycosis can be classified into the cutaneous and the more frequent visceral form. Cutaneous botryomycosis frequently involves exposed parts of the skin, such as the hands, head, and neck or areas of constant trauma such as the feet [<span>2</span>].</p><p>Cutaneous botryomycosis presents characteristically as subcutaneous nodules, ulceration that does not heal with fistulas or verrucous lesions. They are mostly localised lesions, however, deep structures such as bones, muscles, and tendons may be involved by continuity [<span>1, 4</span>]. In addition, any visceral organ [<span>5</span>]. The differential diagnosis of cutaneous botryomycosis includes mycetoma, tuberculosis, actinomycosis, sporotrichosis, and abscesses [<span>6</span>]. The diagnosis is based on culture and histopathology [<span>7</span>]. When botryomycosis is suspected, the bacterial agent must be isolated. Purulent secretions draining from fistulas are useful: Other aetiologic agents can be ruled out using methods such as 10% KOH, polarised light, and different stains such as Ziehl-Neelsen, Fite, ","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1267-1269"},"PeriodicalIF":0.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreas Pinter, Jose Luis López Estebaranz, Anthony Bewley, Jordi Galván, Siva Narayanan, Volker Koscielny, Ismail Kasujee
Background
Effective management of scalp psoriasis needs treatment with high patient preference and treatment satisfaction. Clinical trials show promising results for calcipotriene and betamethasone dipropionate cream based on polyaphron dispersion (PAD) technology (CAL/BDP PAD-cream). However, real-world data are scarce.
Objectives
To evaluate patient- and clinician-reported outcomes and impact of adherence on treatment outcomes of CAL/BDP PAD-cream in adults with mild-to-moderate scalp psoriasis in real-world settings in Europe.
Methods
PRO-SCALP is an ongoing observational, multicentre cohort study, collecting data primarily at baseline and Week 8 (end of the study, EOS). Patient self-assessments included Treatment Satisfaction Questionnaire for Medication Version 9 (TSQM-9), Scalpdex questionnaire, Worst Itch-Numerical Rating Scale (WI-NRS), sleep patterns, personal preferences and adherence to CAL/BDP PAD-cream using a visual analogue scale (VAS). Clinicians' assessments included physician global assessment of scalp (scalp-PGA) and S-mPASI.
Results
Of 152 patients included in this interim analysis, 134 patients (mean age: 48.4 years; 69.4% females) had evaluable outcome data. At EOS, mean (SD) patient satisfaction scores (TSQM-9) were—effectiveness: 76.0 (23.9), convenience of use: 70.2 (21.3), global satisfaction: 76.1 (22.5). At Week 8, 79.0% of patients attained a scalp-PGA score of 0 (clear) or 1 (almost clear), and 71.0% attained scalp-PGA success, defined as a scalp PGA score of 0/1 and ≥ 2-points improvement in scalp-PGA score change from baseline (CFB). CFB of S-mPASI scores, patient-reported symptoms, emotions, functioning and overall Scalpdex scores as well as WI-NRS scores improved significantly (p < 0.0001) at EOS, within both low-adherence (VAS < 80) and high-adherence (VAS: 80−100) groups. Across key outcome measures, CFB of treatment outcomes was found to be better in patients with higher adherence.
Conclusions
Findings of the study indicate high treatment satisfaction, significant improvement in clinical outcomes and patients' quality of life associated with CAL/BDP PAD-cream, especially in patients with higher adherence.
{"title":"Patient and Clinician-Reported Outcomes and Adherence to Calcipotriene/Betamethasone Dipropionate PAD-Cream in Treatment of Scalp Psoriasis in Adults: An Interim Analysis of the PRO-SCALP Study","authors":"Andreas Pinter, Jose Luis López Estebaranz, Anthony Bewley, Jordi Galván, Siva Narayanan, Volker Koscielny, Ismail Kasujee","doi":"10.1002/jvc2.70058","DOIUrl":"https://doi.org/10.1002/jvc2.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective management of scalp psoriasis needs treatment with high patient preference and treatment satisfaction. Clinical trials show promising results for calcipotriene and betamethasone dipropionate cream based on polyaphron dispersion (PAD) technology (CAL/BDP PAD-cream). However, real-world data are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate patient- and clinician-reported outcomes and impact of adherence on treatment outcomes of CAL/BDP PAD-cream in adults with mild-to-moderate scalp psoriasis in real-world settings in Europe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PRO-SCALP is an ongoing observational, multicentre cohort study, collecting data primarily at baseline and Week 8 (end of the study, EOS). Patient self-assessments included Treatment Satisfaction Questionnaire for Medication Version 9 (TSQM-9), Scalpdex questionnaire, Worst Itch-Numerical Rating Scale (WI-NRS), sleep patterns, personal preferences and adherence to CAL/BDP PAD-cream using a visual analogue scale (VAS). Clinicians' assessments included physician global assessment of scalp (scalp-PGA) and S-mPASI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 152 patients included in this interim analysis, 134 patients (mean age: 48.4 years; 69.4% females) had evaluable outcome data. At EOS, mean (SD) patient satisfaction scores (TSQM-9) were—effectiveness: 76.0 (23.9), convenience of use: 70.2 (21.3), global satisfaction: 76.1 (22.5). At Week 8, 79.0% of patients attained a scalp-PGA score of 0 (clear) or 1 (almost clear), and 71.0% attained scalp-PGA success, defined as a scalp PGA score of 0/1 and ≥ 2-points improvement in scalp-PGA score change from baseline (CFB). CFB of S-mPASI scores, patient-reported symptoms, emotions, functioning and overall Scalpdex scores as well as WI-NRS scores improved significantly (<i>p</i> < 0.0001) at EOS, within both low-adherence (VAS < 80) and high-adherence (VAS: 80−100) groups. Across key outcome measures, CFB of treatment outcomes was found to be better in patients with higher adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings of the study indicate high treatment satisfaction, significant improvement in clinical outcomes and patients' quality of life associated with CAL/BDP PAD-cream, especially in patients with higher adherence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"791-802"},"PeriodicalIF":0.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Fung Yong, Michael O'Connell, Alana Durack, Lyndsey Paul
Background
Synchronous melanoma (SM) is defined as ≥ 2 melanomas diagnosed at the same time, or within 3 months of diagnosing the first melanoma, and occurs rarely.
Objectives
The objective of this study was to review all the cases of SM discussed at the melanoma MDT meeting in our cancer centre over the last 5 years.
Methods
Melanoma MDT lists, histopathology and clinical records were reviewed from July 2018 to July 2023 inclusive, for new SMs. This study includes invasive malignant melanoma (MM), lentigo maligna (LM) and melanoma in situ (MIS).
Results
1082 patients were diagnosed with cutaneous melanomas over the 5-year period. Of these patients, 33 patients (3.05%) with SMs were identified in 21 males and 12 females. Ages ranged from 44 to 93 years. Twenty-four patients (72.7%) had SMs diagnosed at the same time and nine (27.3%) had subsequent melanoma diagnosed within a 3-month period. Risk factors noted included family history of melanoma (6.06%, n = 2), history of immunosuppression (12.1%, n = 4), and history of previous non-melanoma skin cancer (6.06%, n = 2). Of the total number of SMs (n = 68), 26.5% (n = 18) were invasive, 20.6% (n = 14) were LMs and 52.9% (n = 36) were MIS. Most lesions (33.9%, n = 21) were located on the trunk, with 13 (62%) on the back. Sixteen (48.5%) patients had both synchronous in situ lesions, 16 patients had LM/MIS with an invasive melanoma (pathological stage 1a to 4b) and 1 (2.4%) patient had stage 1a with stage 1b melanoma.
Conclusions
To the best of our knowledge, this is the largest retrospective study to date of SM. It highlights the importance of a full skin check especially once a melanoma has been identified, to ensure further melanomas are not missed.
{"title":"Synchronous Melanoma: A Single-Centre 5-Year Retrospective Study","authors":"Ji Fung Yong, Michael O'Connell, Alana Durack, Lyndsey Paul","doi":"10.1002/jvc2.70064","DOIUrl":"https://doi.org/10.1002/jvc2.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Synchronous melanoma (SM) is defined as ≥ 2 melanomas diagnosed at the same time, or within 3 months of diagnosing the first melanoma, and occurs rarely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to review all the cases of SM discussed at the melanoma MDT meeting in our cancer centre over the last 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Melanoma MDT lists, histopathology and clinical records were reviewed from July 2018 to July 2023 inclusive, for new SMs. This study includes invasive malignant melanoma (MM), lentigo maligna (LM) and melanoma in situ (MIS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>1082 patients were diagnosed with cutaneous melanomas over the 5-year period. Of these patients, 33 patients (3.05%) with SMs were identified in 21 males and 12 females. Ages ranged from 44 to 93 years. Twenty-four patients (72.7%) had SMs diagnosed at the same time and nine (27.3%) had subsequent melanoma diagnosed within a 3-month period. Risk factors noted included family history of melanoma (6.06%, <i>n</i> = 2), history of immunosuppression (12.1%, <i>n</i> = 4), and history of previous non-melanoma skin cancer (6.06%, <i>n</i> = 2). Of the total number of SMs (<i>n</i> = 68), 26.5% (<i>n</i> = 18) were invasive, 20.6% (<i>n</i> = 14) were LMs and 52.9% (<i>n</i> = 36) were MIS. Most lesions (33.9%, <i>n</i> = 21) were located on the trunk, with 13 (62%) on the back. Sixteen (48.5%) patients had both synchronous in situ lesions, 16 patients had LM/MIS with an invasive melanoma (pathological stage 1a to 4b) and 1 (2.4%) patient had stage 1a with stage 1b melanoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To the best of our knowledge, this is the largest retrospective study to date of SM. It highlights the importance of a full skin check especially once a melanoma has been identified, to ensure further melanomas are not missed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"840-844"},"PeriodicalIF":0.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariana de la Vega, María Antonieta Domínguez Gómez, Martha Alejandra Morales-Sánchez
Background
Mycosis fungoides (MF) is the most common type of cutaneous T cell lymphoma, and less than 5% of cases occur in paediatric patients. No treatment standardized guidelines exist for paediatric population, and evidence comes from small retrospective studies. No studies in Mexican children were identified.
Objectives
To describe epidemiological data, to determine treatment response and factors associated with remission or relapse, and to examine the impact of diagnosis delay in complete remission.
Methods
We retrospectively analysed records of all patients aged 0−18 years diagnosed with MF who were treated in Centro Dermatológico Pascua, between January 2007 and July 2023.
Results
One hundred and twenty-three patients were included. The median age at diagnosis was 12 years. All patients presented with early clinical stages (IA/IB). Hypopigmented phenotype was present in 70.7%. Phototherapy was the most frequently indicated treatment (89.4%). Complete remission was achieved by 35.8% in a median of 16.54 ± 14.74 months. Involved body surface area (BSA), duration of disease and phototherapy were inversely associated with complete remission. The median time to follow-up was 19 months (range 40 months), with an overall survival of 100%, and no disease progression. Relapse was present in 15.44%, and associated predictors were skin phototype and clinical variants different from hypopigmented. BSA and the duration of the disease were negatively associated. Institutional diagnosis delay had a median of 3 months (range 0.8−10.7 months), with no statistically significant impact in complete remission.
Conclusions
To our knowledge, this study represents the largest paediatric cohort worldwide, and the first to examine the Mexican population. Phototherapy is the most prescribed treatment modality in our centre, with acceptable remission rates. Our study confirms a favourable prognosis of MF in children. Prospective studies are needed to better characterize the epidemiology and clinical course of the disease, to determine treatment efficacy and to identify prognostic factors.
{"title":"Mycosis Fungoides in Paediatric Patients: A Real-Life Retrospective Study","authors":"Mariana de la Vega, María Antonieta Domínguez Gómez, Martha Alejandra Morales-Sánchez","doi":"10.1002/jvc2.70059","DOIUrl":"https://doi.org/10.1002/jvc2.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mycosis fungoides (MF) is the most common type of cutaneous T cell lymphoma, and less than 5% of cases occur in paediatric patients. No treatment standardized guidelines exist for paediatric population, and evidence comes from small retrospective studies. No studies in Mexican children were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe epidemiological data, to determine treatment response and factors associated with remission or relapse, and to examine the impact of diagnosis delay in complete remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analysed records of all patients aged 0−18 years diagnosed with MF who were treated in Centro Dermatológico Pascua, between January 2007 and July 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and twenty-three patients were included. The median age at diagnosis was 12 years. All patients presented with early clinical stages (IA/IB). Hypopigmented phenotype was present in 70.7%. Phototherapy was the most frequently indicated treatment (89.4%). Complete remission was achieved by 35.8% in a median of 16.54 ± 14.74 months. Involved body surface area (BSA), duration of disease and phototherapy were inversely associated with complete remission. The median time to follow-up was 19 months (range 40 months), with an overall survival of 100%, and no disease progression. Relapse was present in 15.44%, and associated predictors were skin phototype and clinical variants different from hypopigmented. BSA and the duration of the disease were negatively associated. Institutional diagnosis delay had a median of 3 months (range 0.8−10.7 months), with no statistically significant impact in complete remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this study represents the largest paediatric cohort worldwide, and the first to examine the Mexican population. Phototherapy is the most prescribed treatment modality in our centre, with acceptable remission rates. Our study confirms a favourable prognosis of MF in children. Prospective studies are needed to better characterize the epidemiology and clinical course of the disease, to determine treatment efficacy and to identify prognostic factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"783-790"},"PeriodicalIF":0.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Cather, Melodie Young, Muriel Boreham, Shehla Admani, Tina Bhutani, Erin Foster, Richard Fried, Melinda Gooderham, Jeannette Jakus, Sandra Johnson, Ryoichi Kamide, John Koo, Tiffany Mayo, Michael Payette, Caitriona Ryan, Lucinda Whitney, Krista Bohnert, Melissa Seal, Patrick Burnett, Diane Hanna
Background
Psoriasis occurring on the skin of the genital and perigenital regions, including the inguinal creases, vulva, penis, scrotum, perianal area, and the intergluteal cleft, has specific diagnostic and treatment requirements due to the sensitivity and private nature of these areas.
Objectives
A multidisciplinary group of 13 US-based clinicians who are experts in the management of genital psoriasis, the Genital Psoriasis Wellness Consortium, convened to discuss the impact of genital psoriasis on patients focusing on three main domains: (1) physical diagnosis and patient conversations, (2) impact on patient quality of life/interpersonal relationships, and (3) treatment decisions.
Methods
A PubMed literature search was conducted, and the Consortium members used the results to formulate their consensus statements using a modified Delphi process, including a nominal group technique. The process included two rounds of virtual subcommittee meetings based on the three domains, followed by surveys to obtain anonymous feedback, and concluded with a final meeting to discuss and finalize the language of the consensus recommendations across all three domains. Three additional psoriasis experts provided feedback on these consensus statements from Canadian, European, and Asian perspectives.
Results
Herein, we report our 14 consensus statements and a summary of the supporting data.
Conclusions
These consensus statements are meant as a practical resource for clinicians to ensure that symptoms of genital psoriasis are not overlooked. We hope to continue to add to these statements as additional clinical data become available.
{"title":"Genital Psoriasis: Shining Light on This Hidden Disease","authors":"Jennifer Cather, Melodie Young, Muriel Boreham, Shehla Admani, Tina Bhutani, Erin Foster, Richard Fried, Melinda Gooderham, Jeannette Jakus, Sandra Johnson, Ryoichi Kamide, John Koo, Tiffany Mayo, Michael Payette, Caitriona Ryan, Lucinda Whitney, Krista Bohnert, Melissa Seal, Patrick Burnett, Diane Hanna","doi":"10.1002/jvc2.70043","DOIUrl":"https://doi.org/10.1002/jvc2.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psoriasis occurring on the skin of the genital and perigenital regions, including the inguinal creases, vulva, penis, scrotum, perianal area, and the intergluteal cleft, has specific diagnostic and treatment requirements due to the sensitivity and private nature of these areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A multidisciplinary group of 13 US-based clinicians who are experts in the management of genital psoriasis, the Genital Psoriasis Wellness Consortium, convened to discuss the impact of genital psoriasis on patients focusing on three main domains: (1) physical diagnosis and patient conversations, (2) impact on patient quality of life/interpersonal relationships, and (3) treatment decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PubMed literature search was conducted, and the Consortium members used the results to formulate their consensus statements using a modified Delphi process, including a nominal group technique. The process included two rounds of virtual subcommittee meetings based on the three domains, followed by surveys to obtain anonymous feedback, and concluded with a final meeting to discuss and finalize the language of the consensus recommendations across all three domains. Three additional psoriasis experts provided feedback on these consensus statements from Canadian, European, and Asian perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Herein, we report our 14 consensus statements and a summary of the supporting data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These consensus statements are meant as a practical resource for clinicians to ensure that symptoms of genital psoriasis are not overlooked. We hope to continue to add to these statements as additional clinical data become available.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 4","pages":"719-731"},"PeriodicalIF":0.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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