Max Oscherwitz, Anna Carmichael, Anna Martino, Katie Lovell, Steven R. Feldman
Background
Medication samples are defined by the United States Code of Federal Regulations as small quantities of prescription drugs intended to promote the sale of medications and not permitted to be sold.
Objectives
The use of samples is controversial, particularly in dermatology. We sought out to examine the pros and cons of sampling practices in regard to patient care.
Methods
A PubMed search was conducted using the terms “drug sample” or “medication sample” within the title of articles. Filters used included articles published from “2000–2024”, studies performed on “humans”, and publications in “English”.
Results
Of the 55 papers relevant to the study, none discussed solely the advantages of samples in dermatology, 1/55 (1.8%) discussed solely the disadvantages of samples in dermatology, and 6/55 (10.9%) discussed both the advantages and disadvantages of samples in dermatology.
Conclusions
Several advantages and disadvantages of sampling with specific regard to dermatology were appreciated. To fully understand the implications of sampling in dermatology, further insight is needed.
{"title":"An Economic Perspective on Sampling in Dermatology","authors":"Max Oscherwitz, Anna Carmichael, Anna Martino, Katie Lovell, Steven R. Feldman","doi":"10.1002/jvc2.70047","DOIUrl":"https://doi.org/10.1002/jvc2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medication samples are defined by the United States Code of Federal Regulations as small quantities of prescription drugs intended to promote the sale of medications and not permitted to be sold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The use of samples is controversial, particularly in dermatology. We sought out to examine the pros and cons of sampling practices in regard to patient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PubMed search was conducted using the terms “drug sample” or “medication sample” within the title of articles. Filters used included articles published from “2000–2024”, studies performed on “humans”, and publications in “English”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 55 papers relevant to the study, none discussed solely the advantages of samples in dermatology, 1/55 (1.8%) discussed solely the disadvantages of samples in dermatology, and 6/55 (10.9%) discussed both the advantages and disadvantages of samples in dermatology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several advantages and disadvantages of sampling with specific regard to dermatology were appreciated. To fully understand the implications of sampling in dermatology, further insight is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1122-1126"},"PeriodicalIF":0.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626387","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}
Wen Yang Benjamin Ho, Zi Teng Chai, Haur Yueh Lee, Yen Loo Lim
Acquired haemophilia A (AHA) is a rare condition due to neutralizing antibodies against Factor VIII and can result in severe bleeding manifestations. The association of AHA with bullous pemphigoid (BP) is rare, most frequently observed in the elderly, and has been attributed to cross-reactive antibodies targeting Factor VIII and BPAG2 protein. The diagnosis of AHA requires specific investigations, and treatment involves urgent haemostasis and intensive immunosuppression. Managing both conditions simultaneously is challenging due to the risk of severe bleeding and treatment-related complications including infections. Early diagnosis and treatment are crucial to improve outcomes in these patients.
{"title":"Acquired Haemophilia Occurring in Association With Bullous Pemphigoid","authors":"Wen Yang Benjamin Ho, Zi Teng Chai, Haur Yueh Lee, Yen Loo Lim","doi":"10.1002/jvc2.70117","DOIUrl":"https://doi.org/10.1002/jvc2.70117","url":null,"abstract":"<p>Acquired haemophilia A (AHA) is a rare condition due to neutralizing antibodies against Factor VIII and can result in severe bleeding manifestations. The association of AHA with bullous pemphigoid (BP) is rare, most frequently observed in the elderly, and has been attributed to cross-reactive antibodies targeting Factor VIII and BPAG2 protein. The diagnosis of AHA requires specific investigations, and treatment involves urgent haemostasis and intensive immunosuppression. Managing both conditions simultaneously is challenging due to the risk of severe bleeding and treatment-related complications including infections. Early diagnosis and treatment are crucial to improve outcomes in these patients.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1196-1201"},"PeriodicalIF":0.5,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626510","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>Public awareness of diseases has been shown to increase when celebrities publicly disclose their own [<span>1</span>]. In dermatology, the best example is Australian actor Hugh Jackman that has had multiple basal cell carcinoma and does not hesitate to promote sun protection on social media [<span>2</span>]. We evaluated current trends on various skin conditions, with emphasis on celebrities that disclosed theirs in journals or social media.</p><p>We analyzed data generated through Google Trends (GT), for the relative search volumes using keywords [cutaneous disorder] and [celebrity name], together or separately, [worldwide] or restricted to the [country of the celebrity], from a maximum period ranging from January 1, 2004, to May 21, 2023. GT (https://trends.google.com/trends/) provides data on the relative search volume of queries and topics over time and across geographical areas. It allows seasonal and long-term assessment of trends in public interest. It has been previously used in dermatology to compare the burden of various dermatological skin diseases by way of most frequently searched conditions. This study did not require ethical approval by an institutional review board. We reviewed several celebrities namely, Cara Delevingne (psoriasis), Cameron Diaz (acne), Kim Kardashian (psoriasis), Hugh Jackman (skin cancer, basal cell carcinoma), Mickael Jackson (vitiligo), Ewan MacGregor (skin cancer), Jada Smith (alopecia areata), Christ Stein (American musician and songwriter, cofounder and guitarist of the new wave band Blondie, pemphigus), Seal (British musician and songwriter, lupus, discoid lupus) and Winnie Harlow (vitiligo) and a couple of national celebrities from the author's countries: Edouard Philippe (former prime minister of France, alopecia areata, vitiligo) and Tinze (dancer from Finland, atopic dermatitis).</p><p>Acknowledging the well-known limits related to GT use, the impact on disease awareness seems short-lived and narrow when celebrities disclose their skin problems. The magnitude of the impact varies according to the importance of the event, the level of fame of the celebrity and his/her current activity (retired/active) and the skin condition (whether it is visible or not, whether it is a common or a rare disease). Because of the short-lived effect, only repetition could help raising awareness as performed by Hugh Jackman or Cara Delevingne. Public disclosure may have a positive impact on a personal level, for a given patient especially. However, it remains unclear on a global scale. Besides, having a skin condition exposed can lead to negative comments, criticism, and stigmatization on social medias. Anonymous patients, whose psychosocial adjustment is not good, may suffer indirectly of stigmatization by proxy. For instance, former French Prime Minister Édouard Philippe became the target of mockery when he began appearing with a beard and visible scalp vitiligo. By extension, this had a negative impact on anonymous i
{"title":"Impact of Celebrities Disclosing Their Skin Conditions on Public Awareness","authors":"Nicolas Kluger","doi":"10.1002/jvc2.70121","DOIUrl":"https://doi.org/10.1002/jvc2.70121","url":null,"abstract":"<p>Public awareness of diseases has been shown to increase when celebrities publicly disclose their own [<span>1</span>]. In dermatology, the best example is Australian actor Hugh Jackman that has had multiple basal cell carcinoma and does not hesitate to promote sun protection on social media [<span>2</span>]. We evaluated current trends on various skin conditions, with emphasis on celebrities that disclosed theirs in journals or social media.</p><p>We analyzed data generated through Google Trends (GT), for the relative search volumes using keywords [cutaneous disorder] and [celebrity name], together or separately, [worldwide] or restricted to the [country of the celebrity], from a maximum period ranging from January 1, 2004, to May 21, 2023. GT (https://trends.google.com/trends/) provides data on the relative search volume of queries and topics over time and across geographical areas. It allows seasonal and long-term assessment of trends in public interest. It has been previously used in dermatology to compare the burden of various dermatological skin diseases by way of most frequently searched conditions. This study did not require ethical approval by an institutional review board. We reviewed several celebrities namely, Cara Delevingne (psoriasis), Cameron Diaz (acne), Kim Kardashian (psoriasis), Hugh Jackman (skin cancer, basal cell carcinoma), Mickael Jackson (vitiligo), Ewan MacGregor (skin cancer), Jada Smith (alopecia areata), Christ Stein (American musician and songwriter, cofounder and guitarist of the new wave band Blondie, pemphigus), Seal (British musician and songwriter, lupus, discoid lupus) and Winnie Harlow (vitiligo) and a couple of national celebrities from the author's countries: Edouard Philippe (former prime minister of France, alopecia areata, vitiligo) and Tinze (dancer from Finland, atopic dermatitis).</p><p>Acknowledging the well-known limits related to GT use, the impact on disease awareness seems short-lived and narrow when celebrities disclose their skin problems. The magnitude of the impact varies according to the importance of the event, the level of fame of the celebrity and his/her current activity (retired/active) and the skin condition (whether it is visible or not, whether it is a common or a rare disease). Because of the short-lived effect, only repetition could help raising awareness as performed by Hugh Jackman or Cara Delevingne. Public disclosure may have a positive impact on a personal level, for a given patient especially. However, it remains unclear on a global scale. Besides, having a skin condition exposed can lead to negative comments, criticism, and stigmatization on social medias. Anonymous patients, whose psychosocial adjustment is not good, may suffer indirectly of stigmatization by proxy. For instance, former French Prime Minister Édouard Philippe became the target of mockery when he began appearing with a beard and visible scalp vitiligo. By extension, this had a negative impact on anonymous i","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1228-1230"},"PeriodicalIF":0.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626061","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}
Lorena Alexandra Mija, Elio Kechichian, Carolina Lucena Fernandes
A 66-year-old woman with a history of metastatic colon adenocarcinoma and sarcoidosis presented with a 4-month history of widespread ulcerated, hyperkeratotic, verrucous plaques with violaceous borders on the face, trunk and limbs, measuring up to 5 cm (Figure 1a). She had recently undergone home renovations due to water damage. She reported no systemic symptoms. Skin biopsy and culture revealed broad-based budding yeast forms consistent with Blastomyces dermatitidis (Figure 1b), confirming disseminated cutaneous blastomycosis. Chest X-ray showed no pulmonary involvement. Oral itraconazole was initiated, leading to significant clinical improvement.
Blastomycosis is a systemic fungal infection endemic to parts of North America. This case highlights the importance of including blastomycosis in the differential diagnosis of verrucous nodules or ulcers, particularly in patients with relevant travel or environmental exposure in endemic regions such as Southern Quebec, where incidence has been rising.
Lorena Alexandra Mija: writing – original draft preparation. Elio Kechichian and Carolina Lucena Fernandes: conceptualisation, methodology, supervision.
All patients in this manuscript have given written informed consent for participation in the study and the use of their deidentified, anonymized, aggregated data and their case details (including photographs) for publication. Ethical Approval: not applicable.
{"title":"Disseminated Cutaneous Blastomycosis","authors":"Lorena Alexandra Mija, Elio Kechichian, Carolina Lucena Fernandes","doi":"10.1002/jvc2.70133","DOIUrl":"https://doi.org/10.1002/jvc2.70133","url":null,"abstract":"<p>A 66-year-old woman with a history of metastatic colon adenocarcinoma and sarcoidosis presented with a 4-month history of widespread ulcerated, hyperkeratotic, verrucous plaques with violaceous borders on the face, trunk and limbs, measuring up to 5 cm (Figure 1a). She had recently undergone home renovations due to water damage. She reported no systemic symptoms. Skin biopsy and culture revealed broad-based budding yeast forms consistent with <i>Blastomyces dermatitidis</i> (Figure 1b), confirming disseminated cutaneous blastomycosis. Chest X-ray showed no pulmonary involvement. Oral itraconazole was initiated, leading to significant clinical improvement.</p><p>Blastomycosis is a systemic fungal infection endemic to parts of North America. This case highlights the importance of including blastomycosis in the differential diagnosis of verrucous nodules or ulcers, particularly in patients with relevant travel or environmental exposure in endemic regions such as Southern Quebec, where incidence has been rising.</p><p><b>Lorena Alexandra Mija:</b> writing – original draft preparation. <b>Elio Kechichian and Carolina Lucena Fernandes:</b> conceptualisation, methodology, supervision.</p><p>All patients in this manuscript have given written informed consent for participation in the study and the use of their deidentified, anonymized, aggregated data and their case details (including photographs) for publication. Ethical Approval: not applicable.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1258-1259"},"PeriodicalIF":0.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625862","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}
Dimitra Kiritsi, Aikaterini Bakirtzi, Ioannis Athanasiou, Giovanni Damiani, Grzegorz Stanislawski, Hans Bayer
Background
Laser tattoo removal traditionally employs q-switched and picosecond lasers, which require multiple sessions. Besides the selective photothermolysis that laser devices offer, the photoacoustic effect by acoustic pulse devices may provide further benefits.
Objectives
To assess the efficacy of combined use of a radial shock acoustic wave (SAW) device and a picosecond laser in quicker clearance of tattoos.
Methods
A split-lesion study was performed in 32 adult patients with Fitzpatrick skin type I–III. Overall, 26 tattoos were evaluated until the end of the study. One side of each tattoo received only the picosecond laser treatment, and the other side, a sequential combination of picosecond and SAW. The sessions were repeated at 4–6 weeks intervals for a total of four sittings. Outcome assessment was carried out by two blinded assessors using standardized photography. An assessment of physician improvement score, side-effects score and patient satisfaction score (Visual Analogue Scale of Pain [VAS] and 5-point Likert scale) was taken during and at the end of the study.
Results
The blinded assessment showed a statistically significant improvement on the SAW+picosecond laser treatment side (p = 0.14; OR: 5.44; 95% CI: 1.41–21.05). Scores in VAS for pain decreased through the sessions, with the combination side exhibiting a more pain-tolerant profile. Regarding the outcome of patient satisfaction, at Visit 4, the mean value for the SAW-treated side was 3.9 (more clear difference), whereas only 3/26 participants stated that the only laser-treated side was marginally better. No serious side effects were reported.
Conclusions
The addition of a radial shock acoustic wave device to the state-of-the-art picosecond laser treatment seems to offer a more effective and well-tolerated approach for tattoo removal.
{"title":"Evaluation of Combined Treatment With Picosecond Laser and Acoustic Shock Wave Therapy for Tattoo Removal: A Prospective Randomized Controlled Trial","authors":"Dimitra Kiritsi, Aikaterini Bakirtzi, Ioannis Athanasiou, Giovanni Damiani, Grzegorz Stanislawski, Hans Bayer","doi":"10.1002/jvc2.70042","DOIUrl":"https://doi.org/10.1002/jvc2.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laser tattoo removal traditionally employs q-switched and picosecond lasers, which require multiple sessions. Besides the selective photothermolysis that laser devices offer, the photoacoustic effect by acoustic pulse devices may provide further benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the efficacy of combined use of a radial shock acoustic wave (SAW) device and a picosecond laser in quicker clearance of tattoos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A split-lesion study was performed in 32 adult patients with Fitzpatrick skin type I–III. Overall, 26 tattoos were evaluated until the end of the study. One side of each tattoo received only the picosecond laser treatment, and the other side, a sequential combination of picosecond and SAW. The sessions were repeated at 4–6 weeks intervals for a total of four sittings. Outcome assessment was carried out by two blinded assessors using standardized photography. An assessment of physician improvement score, side-effects score and patient satisfaction score (Visual Analogue Scale of Pain [VAS] and 5-point Likert scale) was taken during and at the end of the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The blinded assessment showed a statistically significant improvement on the SAW+picosecond laser treatment side (<i>p</i> = 0.14; OR: 5.44; 95% CI: 1.41–21.05). Scores in VAS for pain decreased through the sessions, with the combination side exhibiting a more pain-tolerant profile. Regarding the outcome of patient satisfaction, at Visit 4, the mean value for the SAW-treated side was 3.9 (more clear difference), whereas only 3/26 participants stated that the only laser-treated side was marginally better. No serious side effects were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The addition of a radial shock acoustic wave device to the state-of-the-art picosecond laser treatment seems to offer a more effective and well-tolerated approach for tattoo removal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1020-1024"},"PeriodicalIF":0.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625865","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}
Elena Ippoliti, Niccolò Gori, Benedetta Ambrosio, Giulia Coscarella, Maria Vittoria Cannizzaro, Ketty Peris
The treatment landscape for moderate-to-severe atopic dermatitis (AD) has evolved significantly with the introduction of novel targeted therapies addressing specific pathogenic mechanisms of the disease. Despite this therapeutic revolution, a proportion of patients experience intolerance and/or inadequate response to multiple lines of treatment, highlighting the need for new therapeutic options. Lebrikizumab, a monoclonal IgG4 humanized antibody that selectively targets interleukin (IL)−13, has been recently approved for AD treatment. We present two case reports of multimorbid, difficult-to-treat patients who achieved successful disease control with lebrikizumab treatment.
{"title":"Successful Lebrikizumab Therapy in Two Patients With Atopic Dermatitis Resistant to Multiple Therapies","authors":"Elena Ippoliti, Niccolò Gori, Benedetta Ambrosio, Giulia Coscarella, Maria Vittoria Cannizzaro, Ketty Peris","doi":"10.1002/jvc2.70103","DOIUrl":"https://doi.org/10.1002/jvc2.70103","url":null,"abstract":"<p>The treatment landscape for moderate-to-severe atopic dermatitis (AD) has evolved significantly with the introduction of novel targeted therapies addressing specific pathogenic mechanisms of the disease. Despite this therapeutic revolution, a proportion of patients experience intolerance and/or inadequate response to multiple lines of treatment, highlighting the need for new therapeutic options. Lebrikizumab, a monoclonal IgG4 humanized antibody that selectively targets interleukin (IL)−13, has been recently approved for AD treatment. We present two case reports of multimorbid, difficult-to-treat patients who achieved successful disease control with lebrikizumab treatment.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1193-1195"},"PeriodicalIF":0.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625760","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}
Robert Stephens, Chris D. Anderson, Rolf B. Saager, Antony Johnston, Dariush Adybeik
Background
Conventional photodynamic treatment (cPDT) of thin basal cell carcinomas (BCCs) has uncomfortably high rates of incomplete clearance. Incomplete clearance/recurrence rates for superficial BCCs are as high as 40% and even higher for tumours treated on the head and neck. Our experience has been that flushing is more pronounced on the head and neck during cPDT photoactivation. We postulated that haemoglobin, although delivering oxygen, may be acting as a competing chromophore.
Objectives
To determine whether a 2-phased photoactivation protocol, in which blood is removed before the second phase intense pulsed light (IPL) activation, improves clearance rates.
Methods
Retrospective observational study of 206 treatment-naïve BCCs ≤ 1 mm thickness treated over a 7-year period with a 2-phased photoactivation protocol (‘biphasic PDT’). The first phase consists of conventional red-light activation (20−37 Jcm−2). Second phase photoactivation uses IPL (30−45 Jcm−2) delivered with sufficient mechanical pressure in the handpiece to blanch the skin.
Optical coherence tomography (OCT) has been used to aid in lesion diagnosis, to establish suitability of tumour for treatment and to improve verification of treatment outcomes.
Results
In the final group of 175 tumours, of which most were located on the head and neck and over 40% were nodular, there were only four incomplete treatments over a 2-year median follow-up period (up to 7 years). The few incomplete clearances were easily managed.
Conclusions
One or two biphasic photodynamic treatments are highly effective (98% clearance) in thin, treatment-naïve BCCs (≤ 1 mm in thickness) selected on clinical and OCT assessment.
{"title":"Photodynamic Treatment of 206 Thin (≤ 1 mm) Basal Cell Carcinomas Using a Biphasic Activation Protocol: The Outcomes Over a 7-Year Period and the Rationale Behind the Treatment","authors":"Robert Stephens, Chris D. Anderson, Rolf B. Saager, Antony Johnston, Dariush Adybeik","doi":"10.1002/jvc2.70115","DOIUrl":"https://doi.org/10.1002/jvc2.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conventional photodynamic treatment (cPDT) of thin basal cell carcinomas (BCCs) has uncomfortably high rates of incomplete clearance. Incomplete clearance/recurrence rates for superficial BCCs are as high as 40% and even higher for tumours treated on the head and neck. Our experience has been that flushing is more pronounced on the head and neck during cPDT photoactivation. We postulated that haemoglobin, although delivering oxygen, may be acting as a competing chromophore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine whether a 2-phased photoactivation protocol, in which blood is removed before the second phase intense pulsed light (IPL) activation, improves clearance rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective observational study of 206 treatment-naïve BCCs ≤ 1 mm thickness treated over a 7-year period with a 2-phased photoactivation protocol (‘biphasic PDT’). The first phase consists of conventional red-light activation (20−37 Jcm<sup>−2</sup>). Second phase photoactivation uses IPL (30−45 Jcm<sup>−2</sup>) delivered with sufficient mechanical pressure in the handpiece to blanch the skin.</p>\u0000 \u0000 <p>Optical coherence tomography (OCT) has been used to aid in lesion diagnosis, to establish suitability of tumour for treatment and to improve verification of treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the final group of 175 tumours, of which most were located on the head and neck and over 40% were nodular, there were only four incomplete treatments over a 2-year median follow-up period (up to 7 years). The few incomplete clearances were easily managed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One or two biphasic photodynamic treatments are highly effective (98% clearance) in thin, treatment-naïve BCCs (≤ 1 mm in thickness) selected on clinical and OCT assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1082-1089"},"PeriodicalIF":0.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625688","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}
A. Fernández-Galván, M. Aparicio, P. Muñoz, J. Fulgencio-Barbarín, N. D. Zurita, D. Arroyo-Sánchez, O. Cabrera-Marante, L. M. Allende, M. Llamas-Velasco
Transporter associated with antigen presentation (TAP) deficiency syndrome (TDS) is a rare primary immunodeficiency (PID) characterised by a broad spectrum of clinical manifestations, with noninfectious cutaneous granulomas (CG) being a common feature. We present a case of TDS caused by a novel TAP1 mutation, diagnosed after nearly three decades of follow-up, based on the identification of distinctive skin lesions. Notably, this case is associated with cutaneous rubella virus (RV) replication, a finding previously reported in other PIDs, but only once in TDS, making this the second documented instance of its kind. Moreover, this is the first documented case of CG transforming into invasive squamous cell carcinoma (iSCC) and progressing to Epstein-Barr virus (EBV)-associated lymphoproliferative disease (EBV-LPD), ultimately leading to the patient's death.
{"title":"Cutaneous Granulomas Associated With Rubella Replication in TAP Deficiency Syndrome: A Fatal Case Report Evolving Into Cutaneous Squamous Cell Carcinoma and EBV-Associated Lymphoproliferative Syndrome","authors":"A. Fernández-Galván, M. Aparicio, P. Muñoz, J. Fulgencio-Barbarín, N. D. Zurita, D. Arroyo-Sánchez, O. Cabrera-Marante, L. M. Allende, M. Llamas-Velasco","doi":"10.1002/jvc2.70002","DOIUrl":"https://doi.org/10.1002/jvc2.70002","url":null,"abstract":"<p>Transporter associated with antigen presentation (TAP) deficiency syndrome (TDS) is a rare primary immunodeficiency (PID) characterised by a broad spectrum of clinical manifestations, with noninfectious cutaneous granulomas (CG) being a common feature. We present a case of TDS caused by a novel TAP1 mutation, diagnosed after nearly three decades of follow-up, based on the identification of distinctive skin lesions. Notably, this case is associated with cutaneous rubella virus (RV) replication, a finding previously reported in other PIDs, but only once in TDS, making this the second documented instance of its kind. Moreover, this is the first documented case of CG transforming into invasive squamous cell carcinoma (iSCC) and progressing to Epstein-Barr virus (EBV)-associated lymphoproliferative disease (EBV-LPD), ultimately leading to the patient's death.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1167-1170"},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625810","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>Topical retinoids influence a range of cellular processes, including growth, differentiation and immune modulation [<span>1</span>]. Retinol, a widely accessible over-the-counter retinoid, is increasingly relevant due to impending European Union regulations limiting concentrations to 0.05% in body lotions and 0.3% in face and hand products [<span>2</span>]. Although non-prescription retinol products are less potent than prescription formulations, they are not without risks, including skin irritation and, in rare cases, hypervitaminosis A [<span>3</span>]. Despite these potential harms, retinol is often used without medical supervision. Social media platforms are becoming prominent sources of dermatologic information, particularly among adolescents [<span>4</span>]. We hypothesised that youth audiences are frequently exposed to and influenced by retinol-related content on social media. To evaluate the quality of this information, we conducted a cross-sectional qualitative analysis of the most popular retinol-related videos across TikTok, Instagram, and Facebook. On 2 February 2025, we identified the 50 most-liked or most-viewed retinol-related videos on each platform. Table 1 demonstrates a summary of our qualitative analysis findings. Videos were independently assessed using the validated 16-item DISCERN tool, which evaluates the quality of consumer health information, generating scores from 1 (very poor) to 5 (excellent). On TikTok, the top 50 videos received over 10.3 million likes and 66,850 comments. The mean DISCERN score was 2.18. Only 30% (15/50) were created by board-certified dermatologists, while 62% (31/50) were user-generated testimonials, often showing ‘before-and-after’ footage. Merely 18% (9/50) of videos addressed potential side effects such as irritation or interactions, and only 12% (6/50) mentioned correct application techniques. Instagram content was identified using the hashtag #retinol, which yielded approximately 1.2 million posts. Among the top 50 posts, 18% were authored by consultant dermatologists, 4% by plastic surgeons, 6% by aesthetic practitioners and smaller proportions by general practitioners and pharmacists. These posts collectively represented 11.6 million followers. The mean DISCERN score was 2.02, with significantly higher scores for content created by medical professionals (<i>p</i> = 0.03). On Facebook, the top 50 most-watched clips had a cumulative viewership of 247 million. Of these, 22% were produced by dermatologists and 4% by plastic surgeons. The remaining 58% (29/50) were user-generated videos documenting personal use. The mean DISCERN score was 2.20. While 66% (33/50) of videos mentioned side effects, only 10 included advice on proper application. None of the reviewed content addressed risks such as photosensitivity or emphasised that products should not be used without medical oversight, especially by adolescents. Across all platforms, the mean DISCERN score was 2.13, representing ‘poor’ informa
{"title":"Retinol Misinformation Is ‘Topical’ on Social Media: A Qualitative Analysis","authors":"Brian Nolan, Lisa Murphy, Lyndsey Paul","doi":"10.1002/jvc2.70124","DOIUrl":"https://doi.org/10.1002/jvc2.70124","url":null,"abstract":"<p>Topical retinoids influence a range of cellular processes, including growth, differentiation and immune modulation [<span>1</span>]. Retinol, a widely accessible over-the-counter retinoid, is increasingly relevant due to impending European Union regulations limiting concentrations to 0.05% in body lotions and 0.3% in face and hand products [<span>2</span>]. Although non-prescription retinol products are less potent than prescription formulations, they are not without risks, including skin irritation and, in rare cases, hypervitaminosis A [<span>3</span>]. Despite these potential harms, retinol is often used without medical supervision. Social media platforms are becoming prominent sources of dermatologic information, particularly among adolescents [<span>4</span>]. We hypothesised that youth audiences are frequently exposed to and influenced by retinol-related content on social media. To evaluate the quality of this information, we conducted a cross-sectional qualitative analysis of the most popular retinol-related videos across TikTok, Instagram, and Facebook. On 2 February 2025, we identified the 50 most-liked or most-viewed retinol-related videos on each platform. Table 1 demonstrates a summary of our qualitative analysis findings. Videos were independently assessed using the validated 16-item DISCERN tool, which evaluates the quality of consumer health information, generating scores from 1 (very poor) to 5 (excellent). On TikTok, the top 50 videos received over 10.3 million likes and 66,850 comments. The mean DISCERN score was 2.18. Only 30% (15/50) were created by board-certified dermatologists, while 62% (31/50) were user-generated testimonials, often showing ‘before-and-after’ footage. Merely 18% (9/50) of videos addressed potential side effects such as irritation or interactions, and only 12% (6/50) mentioned correct application techniques. Instagram content was identified using the hashtag #retinol, which yielded approximately 1.2 million posts. Among the top 50 posts, 18% were authored by consultant dermatologists, 4% by plastic surgeons, 6% by aesthetic practitioners and smaller proportions by general practitioners and pharmacists. These posts collectively represented 11.6 million followers. The mean DISCERN score was 2.02, with significantly higher scores for content created by medical professionals (<i>p</i> = 0.03). On Facebook, the top 50 most-watched clips had a cumulative viewership of 247 million. Of these, 22% were produced by dermatologists and 4% by plastic surgeons. The remaining 58% (29/50) were user-generated videos documenting personal use. The mean DISCERN score was 2.20. While 66% (33/50) of videos mentioned side effects, only 10 included advice on proper application. None of the reviewed content addressed risks such as photosensitivity or emphasised that products should not be used without medical oversight, especially by adolescents. Across all platforms, the mean DISCERN score was 2.13, representing ‘poor’ informa","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1231-1233"},"PeriodicalIF":0.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625636","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}
Genital pustular psoriasis is a rare and often underdiagnosed condition that can severely affect physical comfort, quality of life and psychological well-being. It can be particularly challenging to manage, often requiring systemic therapies due to its potential unresponsiveness to conventional topical treatment.
Objectives
To evaluate the effectiveness of apremilast in treating male patients with refractory genital psoriasis with pustular features, a rare subtype that can be mistaken for other conditions, including infections and Reiter's syndrome.
Methods
A retrospective case series of six male patients, aged 21−47 years, presenting with recurrent circinate balanitis or balanoposthitis and histological features suggestive of pustular psoriasis (intraepidermal neutrophilic aggregates without frank pustules). These patients had previously failed multiple treatments, including topical corticosteroids, calcineurin inhibitors, acitretin, ciclosporin and methotrexate. Apremilast was initiated with a 6-day titration protocol, and patients were followed for 1–3 months.
Results
All six patients showed complete remission within 1−3 months of starting apremilast, with no major side effects reported. Diagnostic work-up, including viral, bacterial, mycological swabs and syphilis serology, was negative for all patients, and no extragenital symptoms typically associated with Reiter's syndrome were observed.
Conclusions
Apremilast appears to be an effective and well-tolerated treatment for refractory genital psoriasis with pustular features, providing a promising therapeutic option for patients with this challenging condition. Further studies with larger cohorts and randomized trials are needed to confirm its long-term efficacy and safety.
{"title":"Efficacy of Apremilast in Refractory Genital Psoriasis: A Retrospective Case Series","authors":"Jonathan Krygier, Ursula Sass, Bertrand Richert","doi":"10.1002/jvc2.70120","DOIUrl":"https://doi.org/10.1002/jvc2.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Genital pustular psoriasis is a rare and often underdiagnosed condition that can severely affect physical comfort, quality of life and psychological well-being. It can be particularly challenging to manage, often requiring systemic therapies due to its potential unresponsiveness to conventional topical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effectiveness of apremilast in treating male patients with refractory genital psoriasis with pustular features, a rare subtype that can be mistaken for other conditions, including infections and Reiter's syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective case series of six male patients, aged 21−47 years, presenting with recurrent circinate balanitis or balanoposthitis and histological features suggestive of pustular psoriasis (intraepidermal neutrophilic aggregates without frank pustules). These patients had previously failed multiple treatments, including topical corticosteroids, calcineurin inhibitors, acitretin, ciclosporin and methotrexate. Apremilast was initiated with a 6-day titration protocol, and patients were followed for 1–3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All six patients showed complete remission within 1−3 months of starting apremilast, with no major side effects reported. Diagnostic work-up, including viral, bacterial, mycological swabs and syphilis serology, was negative for all patients, and no extragenital symptoms typically associated with Reiter's syndrome were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Apremilast appears to be an effective and well-tolerated treatment for refractory genital psoriasis with pustular features, providing a promising therapeutic option for patients with this challenging condition. Further studies with larger cohorts and randomized trials are needed to confirm its long-term efficacy and safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 5","pages":"1150-1156"},"PeriodicalIF":0.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625644","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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