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MULTIPLE ways to correct for MULTIPLE comparisons in MULTIPLE types of studies
L.M. Hollestein,S.N. Lo,J. Leonardi-Bee,S. Rosset,N. Shomron,D.-L. Couturier,S. Gran
doi : 10.1111/bjd.20600
Volume 185, Issue 6 p. 1081-1083
Guidance for providers on the treatment and management of cutaneous lupus erythematosus
B.F. Chong
doi : 10.1111/bjd.20746
Volume 185, Issue 6 p. 1084-1084
Expert consensus guidelines can be helpful in advising clinicians on the diagnosis, management and treatment of diseases. The generation of these guidelines can be achieved via a variety of methods including a Delphi process, which utilizes questionnaires to achieve consensus among experts,1 and other evidence-based methodologies.2 Cutaneous lupus erythematosus (CLE), an autoimmune and photosensitive skin disease, can be complex for patients and their providers because CLE has multiple clinical presentations, does not have curative treatments, and can be challenging to manage due to its waxing and waning nature. Thus, there is high utility for the creation of expert treatment and management guidelines to help patients and providers navigate the complex issues that patients with CLE often face.
Head-to-head trials in psoriasis and psoriatic arthritis: how to conclude?
E. Sbidian,L. Pina-Vegas
doi : 10.1111/bjd.20771
Volume 185, Issue 6 p. 1085-1085
Psoriasis (PsO) and psoriatic arthritis (PsA) are chronic immune-mediated inflammatory disorders that can significantly alter patients’ quality of life.1, 2 Although there is no cure for these two conditions, insights into their pathogenesis have led to the development of cytokine-based therapies that have revolutionized their management. As the interleukin (IL)-23/T-helper (Th)17 immune axis plays a crucial role in the pathogenesis of both PsO and PsA, there has been interest in targeting this pathway for their treatment.3, 4 Once the benefit of a treatment has been established against placebo, only head-to-head trials are helpful in providing physicians with efficacy estimates between the different biologics.
Long-term efficacy: the new gold standard?
S. Gerdes,J. Albrecht
doi : 10.1111/bjd.20715
Volume 185, Issue 6 p. 1086-1087
Risankizumab is the latest of three approved monoclonal anti-interleukin (IL)-23p19 antibodies for the treatment of plaque-type psoriasis. One-year studies demonstrated good efficacy and safety, and further comparative trials showed risankizumab to be more effective than other standard therapies such as fumaric acid esters, adalimumab, ustekinumab and secukinumab.1, 2
Evidence for the long-term efficacy and safety of guselkumab
I. Kotb
doi : 10.1111/bjd.20716
Volume 185, Issue 6 p. 1087-1088
Biological therapy has revolutionized the management of psoriasis and psoriatic arthritis. The decision-making around the choice of biologic, considering efficacy, safety profile, therapeutic longevity, patient satisfaction and comorbidities, has always been a challenge in daily clinical practice. Selective inhibition of the p19 subunit of interleukin (IL)-23 has emerged as a new therapeutic target allowing for maintained high clinical efficacy and improved biological safety by preserving the IL-12 mediated T helper 1 response.1 Guselkumab is a fully human monoclonal antibody against the IL-23p19 subunit. VOYAGE 1 and VOYAGE 2 were the first phase III clinical trials to compare the efficacy and safety of guselkumab to placebo and adalimumab in 1829 patients with moderate-to-severe plaque psoriasis.2-4 Patients were randomized to group 1 (guselkumab 100 mg), group 2 (placebo then crossover to guselkumab at week 16) and group 3 (adalimumab at standard psoriasis dose). All participants received guselkumab every 8 weeks from week 52 to week 252. Results from both studies have shown that guselkumab is superior to placebo at week 16 and adalimumab at week 24. These high efficacy rates were maintained for 4 years, where 82–85% of patients achieved a ? 90% or more reduction in Psoriasis Area and Severity Index (PASI-90) and Investigator Global Assessment (IGA) of 0/1 (clear/minimal).5 Rates of discontinuation of guselkumab due to lack of efficacy in both studies was < 2%. Between 70% and 75% of patients achieved a Dermatology Life Quality Index (DLQI) of 0/1 (no effect of psoriasis on patient life), and this proportion was maintained for over 4 years. A Psoriasis Symptoms and Signs Diary (PSSD) summary score of 0 (symptom-free) was recorded in 35–40%, and 77–83·4% of patients scored < 8 on the Hospital Anxiety and Depression Scale (HADS-A and HADS-D; i.e. no anxiety or depression).
Systemic antipsoriatic treatment: do women respond better than men and if so, why?
P. Wolf
doi : 10.1111/bjd.20710
Volume 185, Issue 6 p. 1088-1089
Reports on antipsoriatic treatment responses specifically evaluating sex differences are scarce. Maul et al.1 undertook a major effort and now report from a two-country study on data of more than 5300 patients with moderate-to-severe psoriasis extracted from psoriasis registries of Germany (PsoBest) and Switzerland (SDNTT). These registries are fed by data from 880 office-based dermatology practices and academic or hospital-based outpatient clinics in Germany and eight academic dermatology departments in Switzerland. The investigators report slight but statistically significant better response rates throughout the 12-month observation period of the study in women compared with men, who started their treatments with slightly higher Psoriasis Area and Severity Index (PASI) score. After 12 months, 72·3% of women vs. 66·1 of men not only reached PASI75 reduction or an absolute PASI of ? 3 but also in parallel, a significantly higher proportion of women experienced a better quality of life during the observation period, measured by improvement of the Dermatological Quality of Life Index (DLQI) score of ? 4 in 70·7% of women vs. 64·4% men. Of importance to note, the range of percentages of women and men (40·4% vs. 59·6%) in this analysis were similar to that in other registry reports.2, 3 However, at treatment baseline, women not only had a lower PASI score than men (13·1 vs. 14·9), consistent with previous work,4 but also were slightly older (48·3 vs. 47·1 years) and had less body weight (77·5 vs. 90·9 kg), although their body mass index was nearly identical (28·2 vs. 28·5 kg m–2). With regard to treatment allocation, the majority of patients (71·6% of women and 69·4% of men) in this two-country analysis had received nonbiologic agents, i.e. mainly fumaric acid esters and methotrexate although the latter drug was administered less often in women than in men (4·4% vs. 15·8%). The biologics administered to the remaining smaller portion (around 30%) of patients included etanercept, infliximab, adalimumab, ustekinumab and secukinumab.
Epidemiology, comorbidities and mortality of pyoderma gangrenosum: new insights
A.D. Ormerod
doi : 10.1111/bjd.20713
Volume 185, Issue 6 p. 1089-1090
Pyoderma gangrenosum (PG) has a severe impact on patients and their quality of life. It is challenging to treat, and response to therapy is frequently disappointing. It carries significant morbidity and is associated with increased mortality.1 Through anecdotal evidence, limited case series and a previous population-based study, numerous well-known underlying conditions predispose to, or are associated with, PG in about 50% of cases, demanding that clinicians need to always consider which, if any, of these are present and to treat the underlying condition that may be pathogenically driving the underlying inflammatory process. Newer insights point to the genetic association of PG with autoinflammatory syndromes, including hidradenitis and acne, due to abnormalities in PSTPIPI.2
Should we look beyond the interferon signature in chilblain-like lesions associated with COVID-19?
S.M. Pilkington,R.E.B. Watson
doi : 10.1111/bjd.20784
Volume 185, Issue 6 p. 1090-1091
The appearance of chilblain-like lesions (CLL) (‘COVID toes’) during the COVID-19 pandemic has been associated with a type I interferon (IFN) response that is present in asymptomatic and mild cases,1 but not in severe disease.2 The link between IFN signalling and CLL is supported by the occurrence of chilblains in inherited type I interferonopathies.3 Type I IFNs typically participate in the innate immune response to viral pathogens and are powerful inflammatory molecules expressed by both immune and nonimmune cells. The accumulation of double-stranded nucleic acids in the nucleus results in cytotoxic sensing by Toll-like receptors, retinoic acid-inducible gene receptors and NOD-like receptors that initiate a signalling pathway resulting in expression of IFN regulatory factors -7 and -3, inducing IFN-? and IFN-?, respectively. The IFN-? response is greater in infancy and childhood, but decreases with age,4 which may explain why CLL are more prevalent in younger individuals.
Understanding the paradoxical proinflammatory effects of an immunosuppressant
R.F.L. O’Shaughnessy
doi : 10.1111/bjd.20778
Volume 185, Issue 6 p. 1091-1092
Glucocorticoids are frequently used as immunosuppressive treatment in skin disease and asthma. Glucocorticoids bind to a protein called the glucocorticoid receptor in the cytoplasm of cells, which then translocates to the nucleus and binds DNA, activating transcription.1 From an epidermal standpoint glucocorticoid treatment can accelerate epidermal barrier formation,2, 3 suggesting a still not fully understood link between innate immunity and epidermal barrier function. There is also a paradoxical side-effect of glucocorticoid treatment, in that it can induce a rosacea-like disease.4 Why is it that treatment with an immunosuppressive drug can induce an immune response in the skin? This is the question that Wang et al. address in this issue of the BJD.5
Refining the diagnosis and assessment methodology in frontal fibrosing alopecia
Misaki Kinoshita-Ise
doi : 10.1111/bjd.20711
Volume 185, Issue 6 p. 1092-1093
Guidelines that clearly define a disease entity and provide details of the methods with which to assess disease severity/activity and treatment outcomes are indispensable to clinical trials/studies.
Bullous pemphigoid: towards personalized care
H.Y. Lee
doi : 10.1111/bjd.20753
Volume 185, Issue 6 p. 1093-1094
Bullous pemphigoid (BP) is the most common subepidermal autoimmune blistering disease. Its incidence is increasing and the contemporary incidence of BP is estimated to be between 20 and 40 cases per million.1, 2 BP affects older people, and these patients are typically multimorbid with poor functional status.2, 3 The global crude 1-year death rate is 22% and the 1-year standardized mortality rate is 2·9.4 Common causes of death include infections and cardiovascular events.4, 5 Risk factors for death include age, poor function, hypoalbuminaemia, high doses of oral corticosteroids and neurological comorbidities. Death occurs predominantly within the first year of diagnosis, suggesting that both disease factors and treatment modalities may impact long-term outcomes.4 These patients are also prone to metabolic complications such as osteoporosis and hyperglycaemia.6
The role of interferons in melanoma resistance to immune checkpoint blockade: mechanisms of escape and therapeutic implications
K. M. Hargadon
doi : 10.1111/bjd.20608
Volume 185, Issue 6 p. 1095-1104
WNT10A, dermatology and dentistry
B. J. Doolan,A. Onoufriadis,P. Kantaputra,J. A. McGrath
doi : 10.1111/bjd.20601
Volume 185, Issue 6 p. 1105-1111
British Association of Dermatologists guidelines for the management of people with cutaneous lupus erythematosus 2021
D. O’Kane,C. McCourt,S. Meggitt,D.P. D’Cruz,C.H. Orteu,E. Benton,S. Wahie,S. Utton,M. Hashme,M.F. Mohd Mustapa,L.S. Exton,the British Association of Dermatologists’ Clinical Standards Unit
doi : 10.1111/bjd.20597
Volume 185, Issue 6 p. 1112-1123
The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of cutaneous lupus erythematosus (CLE) in the presence or absence of systemic lupus erythematosus (SLE) in adults, young people and children. The document aims to:
Efficacy of secukinumab and adalimumab in patients with psoriatic arthritis and concomitant moderate-to-severe plaque psoriasis: results from EXCEED, a randomized, double-blind head-to-head monotherapy study
A.B. Gottlieb,J.F. Merola,K. Reich,F. Behrens,P. Nash,C.E.M. Griffiths,W. Bao,P. Pellet,L. Pricop,I.B. McInnes
doi : 10.1111/bjd.20413
Volume 185, Issue 6 p. 1124-1134
Long-term efficacy and safety of risankizumab for the treatment of moderate-to-severe plaque psoriasis: interim analysis of the LIMMitless open-label extension trial beyond 3 years of follow-up
K.A. Papp,M.G. Lebwohl,L. Puig,M. Ohtsuki,S. Beissert,J. Zeng,S. Rubant,R. Sinvhal,Y. Zhao,A.M. Soliman,G. Alperovich,C. Leonardi
doi : 10.1111/bjd.20595
Volume 185, Issue 6 p. 1135-1145
Five-year maintenance of clinical response and health-related quality of life improvements in patients with moderate-to-severe psoriasis treated with guselkumab: results from VOYAGE 1 and VOYAGE 2*
K. Reich,K. B. Gordon,B. E. Strober,A. W. Armstrong,M. Miller,Y. K. Shen,Y. You,C. Han,Y. W. Yang,P. Foley,C. E. M. Griffiths
doi : 10.1111/bjd.20568
Volume 185, Issue 6 p. 1146-1159
Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study*
J.-T. Maul,M. Augustin,C. Sorbe,C. Conrad,F. Anzengruber,U. Mrowietz,K. Reich,L.E. French,M. Radtke,P. Häusermann,L.V. Maul,W.-H. Boehncke,D. Thaçi,A.A. Navarini
doi : 10.1111/bjd.20387
Volume 185, Issue 6 p. 1160-1168
Comorbidities, mortality and survival in patients with pyoderma gangrenosum: a Danish nationwide registry-nested case–control study*
H. Ben Abdallah,R. Bech,K. Fogh,A.B. Olesen,C. Vestergaard
doi : 10.1111/bjd.20474
Volume 185, Issue 6 p. 1169-1175
Type I interferon response and vascular alteration in chilblain-like lesions during the COVID-19 outbreak*
L. Frumholtz,J.-D. Bouaziz,M. Battistella,J. Hadjadj,R. Chocron,D. Bengoufa,H. Le Buanec,L. Barnabei,S. Meynier,O. Schwartz,L. Grzelak,N. Smith,B. Charbit,D. Duffy,N. Yatim,A. Calugareanu,A. Philippe,C.L. Guerin,B. Joly,V. Siguret,L. Jaume,H. Bachelez,M. Bagot,F. Rieux-Laucat,S. Maylin,J. Legoff,C. Delaugerre,N. Gendron,D.M. Smadja,C. Cassius,on behalf of Saint-Louis CORE (COvid REsearch)
doi : 10.1111/bjd.20707
Volume 185, Issue 6 p. 1176-1185
High tumour mutational burden and EGFR/MAPK pathway activation are therapeutic targets in metastatic porocarcinoma*
D. Westphal,M. Garzarolli,M. Sergon,P. Horak,B. Hutter,J.C. Becker,M. Wiegel,E. Maczey,S. Blum,S. Grosche-Schlee,A. Rütten,S. Ugurel,A. Stenzinger,H. Glimm,D. Aust,G. Baretton,S. Beissert,S. Fröhling,S. Redler,H. Surowy,F. Meier
doi : 10.1111/bjd.20604
Volume 185, Issue 6 p. 1186-1199
Glucocorticoids promote CCL20 expression in keratinocytes
L. Wang,M. Yang,X. Wang,B. Cheng,Q. Ju,D.Z. Eichenfield,B.K. Sun
doi : 10.1111/bjd.20594
Volume 185, Issue 6 p. 1200-1208
Lesional activation of Tc17 cells in Behçet disease and psoriasis supports HLA class I-mediated autoimmune responses*
S. Vural,K. Kerl,P. Ertop Do?an,S. Vollmer,U. Puchta,M. He,Y. Arakawa,A.O. Heper,A. Karal-Öktem,D. Hartmann,A. Boyvat,J.C. Prinz,A. Arakawa
doi : 10.1111/bjd.20643
Volume 185, Issue 6 p. 1209-1220
Guidelines for clinical trials of frontal fibrosing alopecia: consensus recommendations from the International FFA Cooperative Group (IFFACG)*
E. A. Olsen,M. Harries,A. Tosti,W. Bergfeld,U. Blume-Peytavi,V. Callender,V. Chasapi,O. Correia,G. Cotsarelis,R. Dhurat,N. Dlova,I. Doche,N. Enechukwu,R. Grimalt,S. Itami,M. Hordinsky,K. Khobzei,W. -S. Lee,S. Malakar,A. Messenger,A. McMichael,P. Mirmirani,Y. Ovcharenko,S. Papanikou,G. M. Pinto,B. M. Piraccini,R. Pirmez,P. Reygagne,J. Roberts,L. Rudnicka,D. Saceda-Corralo,J. Shapiro,T. Silyuk,R. Sinclair,R. O. Soares,A. Souissi,A. Vogt,K. Washenik,A. Zlotogorski,D. Canfield,S. Vano-Galvan
doi : 10.1111/bjd.20567
Volume 185, Issue 6 p. 1221-1231
International multicentre observational study to assess the efficacy and safety of a 0·5 mg kg?1 per day starting dose of oral corticosteroids to treat bullous pemphigoid
V. Hébert,S. Bastos,K. Drenovska,J. Meijer,S. Ingen-Housz-Oro,C. Bedane,L. Lunardon,S. Debarbieux,H. Jedlickova,F. Caux,G. Chaby,M. D’Incan,C. Feliciani,C. Boulard,N. Schumacher,E. Schmidt,A. Roussel,M.A. Richard,J. Gottlieb,V. Ferranti,O. Guérin,J. Bénichou,P. Joly,for the French study group on autoimmune bullous skin diseases, and the autoimmune bullous skin disease task force of the European Academy of Dermatology and Venereology
doi : 10.1111/bjd.20593
Volume 185, Issue 6 p. 1232-1239
Why we should abandon the misused descriptor ‘erythema’
A.Y. Finlay,T.W. Griffiths,S. Belmo,M.M.U. Chowdhury
doi : 10.1111/bjd.20660
Volume 185, Issue 6 p. 1240-1241
Analysis of T-cell responses directed against the spike and/or membrane and/or nucleocapsid proteins in patients with chilblain-like lesions during the COVID-19 pandemic
C. Cassius,M. Merandet,L. Frumholtz,D. Bergerat,A. Samri,C. Grolleau,L. Grzelak,O. Schwartz,N. Yatim,P. Moghadam,L. Jaume,M. Bagot,J. Legoff,C. Delaugerre,J.-D. Bouaziz,H. Le Buanec, on behalf of Saint-Louis CORE (COvid REsearch)
doi : 10.1111/bjd.20647
Volume 185, Issue 6 p. 1242-1244
Dear Editor, A range of cutaneous manifestations have been described in association with SARS-CoV-2 infection during the COVID-19 pandemic.1 Among them, chilblain-like lesions (CLL) occurred more frequently than expected. A direct link was demonstrated thanks to the visualization of viral particles in the skin endothelial cells by electron microscopy,2 which however was further questioned.3 An indirect link was highlighted with high prevalence of seropositivity in patients with CLL compared with the general population.4 However, numerous publications still question the link between CLL and SARS-CoV-2·5 Herein, we assessed this association in a cohort of 50 patients with CLL. The patients were aged 32 years (interquartile range 27–43), 29 (58%) had suggestive extracutaneous COVID-19 symptoms and 20 (40%) had been in close contact with people with confirmed COVID-19. We performed SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) for direct viral assessment, SARS-CoV-2 serology for humoral response, and interferon (IFN)-? release assay for cellular T-cell response.
Teledermoscopy: a helpful detection tool for amelanotic and hypomelanotic melanoma
A. Altayeb,S. Dawood,A. Atwan,C. Mills
doi : 10.1111/bjd.20609
Volume 185, Issue 6 p. 1244-1245
Advanced care planning, code status and end-of-life care in patients with bullous pemphigoid
L.L. Thompson,J. Yoon,M.S. Chang,N.J. Polyakov,C.X. Pan,S.T. Chen,E.X. Wei,A.P. Charrow
doi : 10.1111/bjd.20606
Volume 185, Issue 6 p. 1246-1247
Mosaic NEK9 mutation, fibrous dysplasia and premature puberty in naevus comedonicus syndrome
V. Carmignac,G. Salomon,M. Severino-Freire,Y. Duffourd,M. Chevarin,P. Vabres,J. Mazereeuw-Hautier
doi : 10.1111/bjd.20603
Volume 185, Issue 6 p. 1247-1249
To see or not to see: a cross-sectional study suggesting lack of bias towards authors in the peer-review process
H. Daou,L. Gu,S.R. Lipner
doi : 10.1111/bjd.20607
Volume 185, Issue 6 p. 1249-1251
Complete clearance of severe plaque psoriasis with 24 weeks of oral roflumilast therapy
A. Egeberg,H. Meteran,M. Gyldenløve,C. Zachariae
doi : 10.1111/bjd.20602
Volume 185, Issue 6 p. 1251-1252
Insurance coverage gap for treatment of melasma compared with rosacea: it pays to be light
H. Sun,J.S. Lim,C.F. Silva,S.A. Maczuga,L.C. Hollins
doi : 10.1111/bjd.20641
Volume 185, Issue 6 p. 1252-1254
Histopathologically-confirmed lichenoid eruptions from immune checkpoint inhibitor therapy: a retrospective cohort analysis
T.V. Jacoby,M.S. Chang,L.L. Thompson,R.K. Foreman,K.L. Reynolds,S.T. Chen
doi : 10.1111/bjd.20698
Volume 185, Issue 6 p. 1254-1256
Risk of psoriasis among survivors of adult-onset cancer: a nationwide population-based cohort study
M. Kim,H.E. Park,K. Han,J. Lee
doi : 10.1111/bjd.20610
Volume 185, Issue 6 p. 1256-1258
Patients with nodular prurigo commonly have pre-existing psychological disease that requires treatment concomitant with cutaneous therapies
P. Pathmarajah,M. A. Gkini,H. Fox,V. Muralidharan,R. E. Taylor,A. Bewley
doi : 10.1111/bjd.20627
Volume 185, Issue 6 p. 1258-1259
Primary cutaneous anaplastic large-cell lymphoma with marked spontaneous regression of organ manifestation after SARS-CoV-2 vaccination
T. Gambichler,S. Boms,S. Hessam,I. Tischoff,A. Tannapfel,T. Lüttringhaus,J. Beckman,R. Stranzenbach
doi : 10.1111/bjd.20630
Volume 185, Issue 6 p. 1259-1262
Can artificial intelligence be used for accurate remote scoring of the Psoriasis Area and Severity Index in adult patients with plaque psoriasis?
M. de Brito,B. R. Stevens,Z. Z. N. Yiu
doi : 10.1111/bjd.20663
Volume 185, Issue 6 p. 1262-1264
Decreased quality of life in people with psoriasis and psoriatic arthritis vs. people with psoriasis alone: data from a national US survey
G.C. Gondo,J.F. Merola,S.J. Bell,A. Blauvelt
doi : 10.1111/bjd.20657
Volume 185, Issue 6 p. 1264-1265
Menopausal hormone therapy and risk of melanoma: a population-based cohort study
N. C. Støer,E. Botteri,M. Busund,R. Ghiasvand,S. Vangen,E. Lund,E. Weiderpass,M.B. Veierød
doi : 10.1111/bjd.20640
Volume 185, Issue 6 p. 1266-1267
A retrospective study evaluating the outcomes of high-dose methylprednisolone pulse therapy for 483 patients with moderate-to-severe alopecia areata
M. Wada-Irimada,M. Mizuashi,T. Takahashi,G. Tojo,K. Onami,K. Shido,E. Otake,S. Yusa,K. Tanita,E. Yamazaki,S. Aiba,K. Yamasaki
doi : 10.1111/bjd.20644
Volume 185, Issue 6 p. 1267-1269
Efficacy of short-term intravenous clindamycin prior to oral clindamycin–rifampicin treatment in hidradenitis suppurativa: a retrospective case series
G. Nikolakis,A. Kristandt,M. Hauptmann,M. Becker,C.C. Zouboulis
doi : 10.1111/bjd.20645
Volume 185, Issue 6 p. 1270-1272
Dear Editor, Antibiotics are the first-line treatment for hidradenitis suppurativa (HS), although HS is not an infectious disease.1 Certain, prolonged antibiotic courses exhibit an anti-inflammatory effect, which can be utilized to treat follicular/inflammatory skin diseases, e.g. acne and rosacea.
Hypersensitivity reactions in sporotrichosis: a retrospective cohort of 325 patients from a reference hospital in Rio de Janeiro, Brazil (2005–2018)
A.C. Procópio-Azevedo,V.B.S. Rabello,M.M. Muniz,M.H.G. Figueiredo-Carvalho,R. Almeida-Paes,R.M. Zancopé-Oliveira,J.C.A.L. Silva,P.M. de Macedo,A.C.F. Valle,M.C. Gutierrez-Galhardo,D.F.S. Freitas
doi : 10.1111/bjd.20646
Volume 185, Issue 6 p. 1272-1274
Dear Editor, Sporotrichosis is a subcutaneous mycosis that occurs worldwide and is caused by thermally dimorphic fungi of the genus Sporothrix. In 1998, sporotrichosis emerged in Rio de Janeiro, Brazil with a zoonotic profile, and since then has extended to neighbouring states and countries. Nowadays, it is considered a Neglected Tropical Disease by the World Health Organization. The Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ) is the main reference for the diagnosis and treatment of sporotrichosis. Lymphocutaneous, fixed cutaneous, disseminated cutaneous and extracutaneous/disseminated forms have been observed.1 Sporotrichosis-associated cutaneous hypersensitivity reactions (CHRs), such as erythema nodosum (EN), erythema multiforme (EM) and Sweet syndrome (SS), have been reported only in zoonotic transmission of the disease.2-5 Hypersensitivity lesions are sometimes mistaken for sporotrichosis lesions, which can compromise appropriate treatment.1, 6 Moreover, EN is associated with faster healing of the sporotrichosis lesions.1 We aimed to test this association in a larger sample, verify possible associations with clinical presentations, and perform molecular identification of available isolates.
Image: Atypical chondrodermatitis nodularis due to in-ear headphones
C. Huffman,M.A. Cardis
doi : 10.1111/bjd.20702
Volume 185, Issue 6 p. e199-e199
Dear Editor, A man in his 20s presented with a painful papule in his left medial concha that began 6 months prior (a). He noted that recently it was difficult to insert his earbuds (in-ear headphones), which he used many hours daily since transitioning to the virtual workspace (a, inset). A biopsy confirmed chondrodermatitis nodularis (b), which typically affects patients over age 40 years and involves protuberant portions of the helix or antihelix due to repeated pressure injury while sleeping.1 Given the increasing use of in-ear headphones for occupational and social engagements, chondrodermatitis nodularis may present in younger patients and in unusual locations.2
Do anti-psoriatic drugs work better in women than men?
doi : 10.1111/bjd.20787
Volume 185, Issue 6 p. e200-e200
Psoriasis is a chronic, scaly skin condition affecting about 2·5% of the population. It has a negative impact on people’s quality of life, more so in women. It is usually treated with creams but is sometimes severe enough to need strong medicines, which are not always effective. This study examines differences between men and women in their responses to treatment.
The role of T cells and interleukin-17A in Behçet disease
doi : 10.1111/bjd.20788
Volume 185, Issue 6 p. e201-e201
Behçet disease (BD) is a severe chronic inflammatory disease. It damages blood vessels and can affect all organs, including the skin, eyes and brain. This can lead to blindness or even death. BD is common along the historical ‘Silk Road’, extending from Europe to the Far East, especially in Turkey. To find out what causes the disease, researchers from Turkey, Germany and Japan investigated skin lesions from patients with BD.
Mortality and associated diseases in patients with pyoderma gangrenosum: a Danish nationwide study
doi : 10.1111/bjd.20789
Volume 185, Issue 6 p. e202-e202
Pyoderma gangrenosum (PG) is a rare ulcerative skin disease associated with certain other diseases (comorbidities) such as inflammatory bowel and rheumatic diseases. There is little information available on this topic.
Clinical response and improvements in health-related quality of life in patients with moderate-to-severe psoriasis treated with guselkumab over 5 years: results from VOYAGE 1 and VOYAGE 2
doi : 10.1111/bjd.20790
Volume 185, Issue 6 p. e203-e203
Psoriasis is a chronic skin disease that needs long-term therapy to manage its symptoms (itch, tightness, burning, stinging and pain) and signs (dryness, cracking, scaling, flaking, redness and bleeding). Besides causing physical effects, psoriasis affects the quality of life of each patient (including at home/school and in relationships). Specific molecules called cytokines cause psoriasis, and certain treatments improve psoriasis by blocking these cytokines. One of these treatments, named guselkumab, blocks a cytokine called interleukin-23. Guselkumab treatment for psoriasis was studied for 5 years in two large clinical trials (VOYAGE 1 and VOYAGE 2) with over 1800 patients in a large number of countries. Some patients received guselkumab from the beginning. Other patients switched to guselkumab after receiving another treatment – adalimumab (which blocks a different cytokine) – or placebo (which looks like the drug being tested but does not contain any medicine). Standard measures were used to determine if guselkumab would clear or nearly clear the psoriasis over 5 years.
How can we assess severity and treatments in frontal fibrosing alopecia?
doi : 10.1111/bjd.20791
Volume 185, Issue 6 p. e204-e204
Frontal fibrosing alopecia (FFA) is one of the most common causes of permanent or scarring hair loss. This distressing condition may affect both sexes and all races, although it is most common in post-menopausal white women. The cause of this hair loss condition is unknown, although there may be a genetic susceptibility and hormonal factors may be important. The associated inflammation in the scalp occurs at the level of where the hair follicle stem cells reside, leading to permanent loss of the follicle and the hair shaft that it produces. Classically there is slowly progressive hair loss affecting the front of the scalp and the temples often with redness and scaling around the follicle openings. Some patients notice itching or burning at the involved sites. Eyebrow hair loss occurs in almost 90% of individuals and can precede the scalp hair loss. To date, treatment is usually with antinflammatory topical and systemic agents and anti-androgens but clinical trials assessing the effectiveness of each treatment are currently lacking.
Investigating new treatment strategies for eccrine porocarcinoma
doi : 10.1111/bjd.20792
Volume 185, Issue 6 p. e205-e205
Eccrine porocarcinoma is a rare skin cancer of the sweat gland. It affects 0·004% of people worldwide. Unfortunately, there are no effective treatment options available for patients with eccrine porocarcinoma that has spread throughout the body. To identify new treatment strategies it is important to first understand the underlying mechanisms of how this tumour develops and progresses within the body.
Chilblain-like lesions during the COVID-19 outbreak
doi : 10.1111/bjd.20793
Volume 185, Issue 6 p. e206-e206
Chilblains are skin lesions that affect the hands and feet, and usually appear in winter. They are frequent, non-cancerous, mostly of unknown cause/spontaneous (idiopathic), sometimes painful and generally develop into flare-ups. They affect young people worldwide. Usually, there is no need for treatment.
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doi : 10.1111/bjd.20794
Volume 185, Issue 6 p. e207-e207
????????????????, ? 2·5% ???????????????????????, ??????????????????, ???????????????, ??????????????????????????????
T ??????-17A ????????
doi : 10.1111/bjd.20795
Volume 185, Issue 6 p. e208-e208
??? (BD) ????????????????????, ?????????, ?????????????????????????BD ?????“????”???????, ????????, ???????????????????, ??????????????????? BD ????????
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doi : 10.1111/bjd.20796
Volume 185, Issue 6 p. e209-e209
?????? (PG) ????????????, ??????? (???) ??, ????????????????????????
?? Guselkumab ?????????????? 5 ??????????????????: VOYAGE 1 ? VOYAGE 2 ???
doi : 10.1111/bjd.20797
Volume 185, Issue 6 p. e210-e210
???????????, ???????????? (???????????????) ??? (?????????????????) ???????????, ???????????????? (????/???????) ??????????????????, ????????????????????????????? Guselkumab, ??????????-23 ??????????????? (VOYAGE 1 ? VOYAGE 2) ???? Guselkumab ???? 1800 ?????? 5 ???????????????? Guselkumab?????????????——????? (?????????) ???????? Guselkumab????????? Guselkumab ???? 5 ????????????????????, ??????????? (> 50%), ??????????? (> 80%)???, ? Guselkumab ???? 5 ??, ?? 40% ??????????????, ?? 30% ??????????????????????????????, ?? 70% ???? VOYAGE 1 ? VOYAGE 2 ????????????????????? Guselkumab ???????????????? Guselkumab ????, ????????????????????, ?? Guselkumab ???? 5 ???????????????????????????????
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doi : 10.1111/bjd.20798
Volume 185, Issue 6 p. e211-e211
???????? (FFA) ?????????????????????????????????????, ???????????????????????????, ????????????????, ???????????????????????????????????, ??????????????, ?????????????????, ??????????????????????????????????? 90% ??????????, ???????????????, ??????????????????????, ????????????????????
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doi : 10.1111/bjd.20799
Volume 185, Issue 6 p. e212-e212
?????????????????????? 0·004% ?????????????, ?????????????????????????????????????, ??????????????????????????
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doi : 10.1111/bjd.20800
Volume 185, Issue 6 p. e213-e213
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