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British Journal of Dermatology

N Van den Berghe, E De Keyser, R Soenen, L Meuleman, S Lanssens, A Gils, J Lambert
BACKGROUND: Cost-effective use of biologicals is becoming increasingly important. Monitoring drug concentrations has emerged as a valuable tool to guide clinical decision-making as drug concentrations have been linked to clinical outcomes. The presence of a concentration-response relationship for ustekinumab at trough is uncertain due to the contradictory results reported. OBJECTIVES: To investigate the relationship between 4-week post injection ustekinumab concentrations and clinical response in psoriasis patients...
April 20, 2019: British Journal of Dermatology
P Gisondi, M Rovaris, S Piaserico, G Girolomoni
BACKGROUND: Secukinumab is administered at the labelled dose of 300 mg at weeks 0, 1, 2, 3, 4 (loading dose) and every 4 weeks thereafter. OBJECTIVE: To investigate the efficacy of secukinumab administered without the initial loading dose in patients with psoriasis. MATERIALS AND METHODS: a retrospective, observational study including adult patients with psoriasis (n=156) treated with secukinumab 300 mg administered either according to the labelled dose (n=75) or without the initial loading dose (n=81)...
April 20, 2019: British Journal of Dermatology
D Ignatova, Y-T Chang, W Hoetzenecker, E Guenova
Ingenol mebutate is a macrocyclic diterpene ester, naturally found in the sap of the Australian plant Euphorbia peplus, which proved efficacious for actinic keratosis. In clinical routine, we observed local improvement of MF upon application of ingenol mebutate in MF patients treated for coincidental actinic keratosis within direct proximity of/overlapping with MF skin lesions. Hence, the objective of this study was to assess the effect of topical ingenol mebutate on MF skin lesions. We offered an individual treatment attempt with ingenol mebutate for one selected MF lesion to three patients with MF stage IA...
April 20, 2019: British Journal of Dermatology
P Delaunay, A L Hérissé, L Hasseine, C Chiaverini, A Tran, C Mary, P Del-Giudice, P Marty, M Akhoundi, T Hubiche
BACKGROUND: Expert visualization of Sarcoptes scabiei remains essential for diagnosing human scabies but access to experts can be difficult. PCR is a very specific tool for the detection and confirmation of Sarcoptes scabiei but this test has a poor sensitivity because of the requirement of previous expertise when collecting appropriate samples to gain a positive result. OBJECTIVE: Evaluate PCR as a diagnostic method for scabies using non expert-dependent standardized sampling...
April 20, 2019: British Journal of Dermatology
S M Lehmann, R E Leube, N Schwarz
BACKGROUND: Epidermal differentiation is a multi-level process in which keratinocytes need to lose their organelles including their mitochondria by autophagy. Disturbed autophagy leads to thickening of the epidermis as it is encountered in Pachyonychia congenita, a rare skin disease caused by mutations in keratins 6, 16, and 17. OBJECTIVES: We therefore asked if mitophagy is disturbed in Pachyonychia congenita and if so at which stage. METHODS: Immortalised keratinocytes derived from Pachyonychia congenita patients were used in fluorescence-based and biochemical assays to dissect the different steps of mitophagy...
April 20, 2019: British Journal of Dermatology
D M Thiboutot, A M Layton, M-M Chren, E A Eady, J Tan
BACKGROUND: Acne ranks second to dermatitis in terms of global burden of skin disease. As such, it is essential that data on treatment efficacy are generated in a way that maximizes the opportunity for comparison among treatments. Interest in developing core outcome sets for use in clinical trials to standardize data collection in skin disease is surging. OBJECTIVES: The goal of this review is to provide an update on the efforts underway, challenges encountered and future directions in the development of an acne core outcome measure set for use in clinical trials...
April 19, 2019: British Journal of Dermatology
V Richer, S AlObaida, P Kharazmi, T Lee, S Kalia, H Lui
Over the last decade new systemic drugs (e.g. biologics, apremilast, alitretinoin) have diversified the options for treating palmoplantar dermatoses such as psoriasis and dermatitis. Topical psoralen-UVA (tPUVA) phototherapy nevertheless remains an important modality for hand and foot dermatoses that may be refractory to topicals, with the advantage of avoiding systemic side effects or drug interactions. Protocols for tPUVA vary greatly in regard to psoralen concentration, vehicle, time interval between application and irradiation, as well as frequency...
April 18, 2019: British Journal of Dermatology
M Papini, F Cusano, M Romanelli, M Burlando, G Stinco, G Girolomoni, K Peris, C Potenza, A Offidani, M Bartezaghi, E Aloisi, A Costanzo
Recent studies have shown that biological drugs approved for treating psoriasis and psoriatic arthritis are not effective in all patients, and that variations in the genome have been associated with different clinical responses or side effects. HLA-Cw6 gene is associated with more severe and early-onset psoriasis. Recent reports have shown that HLA-Cw6 status predicts efficacy of some biologic treatments in psoriasis patients. The Phase 3b SUPREME study (NCT02394561) demonstrated the efficacy of secukinumab in patients with moderate-to-severe plaque-type psoriasis, irrespective of HLA-Cw6 status at week 24...
April 18, 2019: British Journal of Dermatology
E A Langan, A Künstner, M Miodovnik, D Zillikens, D Thaçi, J F Baines, S M Ibrahim, W Solbach, J K Knobloch
BACKGROUND: The treatment of psoriasis has been revolutionised by the development of biologic therapies. However, the pathogenesis of psoriasis, in particular the role of the cutaneous microbiome, remains incompletely understood. Moreover, skin microbiome studies have heavily relied on 16S rRNA sequencing data in the absence of bacterial culture. OBJECTIVES: To characterise and compare the cutaneous microbiome in 20 healthy controls and 23 patients with psoriasis using metagenomic analyses and to determine changes in the microbiome during treatment...
April 15, 2019: British Journal of Dermatology
K A Bain, E McDonald, F Moffat, M Tutino, M Castelino, A Barton, J Cavanagh, U Z Ijaz, S Siebert, I B McInnes, A Astrand, S Holmes, S W F Milling
BACKGROUND: Alopecia areata (AA) is a common autoimmune disease, causing patchy hair loss that can progress to involve the entire scalp (totalis) or body (universalis). CD8+ NKG2D+ T cells dominate hair follicle pathogenesis, but the specific mechanisms driving hair loss are not fully understood. OBJECTIVES: To provide a detailed insight into the systemic cytokine signature associated with AA, and assess the association between cytokines and depression. METHODS: Multiplex analysis of plasma cytokines from AA patients, psoriatic arthritis (PsA) patients and healthy controls...
April 13, 2019: British Journal of Dermatology
J Gottlieb, M Madrange, C Gardair, E Sbidian, A Frazier, P Wolkenstein, G Hickman, P Schneider, C Baudry, P Claudepierre, P Bertheau, P Richette, A Smahi, H Bachelez
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of skin appendages, commonly associating with other conditions including spondyloarthritis, and is a major component of severe cutaneo-articular autoinflammatory syndromes (AIS), called PAPASH (Pyogenic Arthritis, pyoderma gangrenosum/PG, Acne, HS), PsAPASH (Psoriatic Arthritis, PG, Acne, HS) and PASS (Ankylosing Spondylitis, Acne, PG and HS). The clinical phenotypes of these AIS are ill-defined and unlike PASH or PAPA syndromes, still lack any biological or genetic marker...
April 13, 2019: British Journal of Dermatology
A F Klassen, S Lipner, M O'Malley, N M Longmire, S J Cano, T Breitkopf, C Rae, Y L Zhang, A L Pusic
BACKGROUND: Psychosocial concerns represent important outcomes in studies of treatments for acne and acne scarring. Also, important, but largely overlooked, is the concept of appearance. OBJECTIVES: To design an acne-specific patient-reported outcome measure for acne and acne scarring. METHODS: We used a mixed methods approach. Phase 1 involved 21 patient interviews that were audio-recorded, transcribed and coded. Concepts were identified and developed into scales that were refined through 10 cognitive interviews and input from 16 clinical experts...
April 12, 2019: British Journal of Dermatology
C Manaspon, S Thaweesapphithak, T Osathanon, K Suphapeetiporn, T Porntaveetus, V Shotelersuk
ectodermal dysplasia (ED) is a group of hereditary disorders affecting the development of ectodermal organs. There are more than 200 types of ED caused by the mutations in approximately 50 genes.1, 2 Nonetheless, the mutations in some genes have been found in only one family affected with ED. Identification of more families with mutations in the same gene would confirm their etiologic roles. This article is protected by copyright. All rights reserved.
April 12, 2019: British Journal of Dermatology
G Gasparini, N Madjlessi, J Delyon, L Carmisciano, N Brahimi, N Basset-Seguin, M Oren, M Battistella, C Lebbé, F Herms, B Baroudjian
Dermoscopy was proven more accurate than naked-eye examination and sequential digital dermoscopy imaging (SDDI) superior to dermoscopy alone for melanoma detection2 . SDDI combined with total-body photography (TBP)3 namely the "two-step method" of digital follow-up (DFU), seems at present the best surveillance strategy for high risk patients. With the aim to endorse its usefulness, we retrospectively studied 148 at high risk patients included in DFU at the Dermato-oncology Unit of Hôpital Saint-Louis between 2014 and 2018...
April 12, 2019: British Journal of Dermatology
F Rongioletti
Primary cutaneous mucinoses are a heterogeneous group of diseases characterized by the abnormal deposition of glycosamminoglycans (mucin) in the skin as the main histopathological clue resulting in distinctive clinical presentations. They are usually diseases of adult age and are uncommon in children in whom the diagnosis and the management are a difficult task. In particular, the classification of primary cutaneous mucinoses occurring in childhood is a difficult and confusing challenge because of the very limited number of described cases and overlaps in their clinicopathological features in the absence of reports of homogeneous case series...
April 12, 2019: British Journal of Dermatology
E Chasseuil, J A McGrath, A Seo, X Balguerie, N Bodak, H Chasseuil, M Denis-Musquer, A Goldenberg, R Goussot, A D Irvine, N P Khumalo, M C King, S Küry, D Lipsker, S Mallet, B M Mayosi, A Nanda, E Puzenat, E Salort-Campana, R Sidbury, A Shimamura, S Bézieau, S Mercier, S Barbarot
Dear Editor, Hereditary Fibrosing Poikiloderma with Tendon Contractures, Myopathy and Pulmonary Fibrosis (POIKTMP [MIM 615704]) is a recently described autosomal dominant disorder due to missense mutations in the FAM111B gene. Key features are early-onset poikiloderma, muscle contractures in particular of the triceps surae, diffuse progressive fatty myopathy, pulmonary fibrosis in adulthood and exocrine pancreatic insufficiency. Dermatological manifestations seem to be constant and early however, a precise description is lacking...
April 10, 2019: British Journal of Dermatology
M Augustin, D Thaci, K Eyerich, A Pinter, M Radtke, F Lauffer, U Mrowietz, S Gerdes, D Pariser, M Lebwohl, C Sieder, N Melzer, K Reich
BACKGROUND: Conventional analyses present aggregate data, masking late responders and efficacy reductions. Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, shows sustained efficacy in moderate to severe psoriasis. OBJECTIVE: To determine stability of response to secukinumab, changes in efficacy were assessed in individual patients. METHODS: This is a post hoc analysis of two Phase 3 RCTs, FIXTURE [NCT01358578] and CLEAR [NCT02074982]...
April 10, 2019: British Journal of Dermatology
E Burden-Teh, K S Thomas, S Gran, R Murphy
Psoriasis in children can be a challenging diagnosis: the clinical presentation is often more subtle, may occur in covered sites and can be an unexpected diagnosis as psoriasis if often thought to occur at older ages. Poor recognition and delayed diagnosis of psoriasis in children can lead to inadequate treatment and lack of monitoring for comorbidities including juvenile psoriatic arthritis. Diagnostic criteria would help both clinical practice and clinical research, but to date none are available. This article is protected by copyright...
April 10, 2019: British Journal of Dermatology
L Morrison, C Chen, J S Torres, M Wehner, A Junn, E Linos
Facebook and other social media platforms have been used to influence public opinion, political behavior, and retail. However, Facebook can also be used as an opportunity for public health promotion. Indoor tanning is a known carcinogen, with a direct dose-response relationship to melanoma. The risk of melanoma is higher when initial exposure occurs at a young age (<35 years). According to the 2015 National Health Interview Survey, 3.5% of US adults, and 20.4% of non-Hispanic white women, report using indoor tanning beds in the past year...
April 10, 2019: British Journal of Dermatology
J I Silverberg, D J Margolis, M Boguniewicz, L Fonacier, M H Grayson, P Y Ong, Z C Fuxench, E L Simpson
BACKGROUND: Structured patient-reported outcomes of AD severity are not standardized in clinical practice. We sought to determine the construct validity, internal consistency, cross-cultural validity, floor or ceiling effects of multiple AD severity assessments. METHODS: A cross-sectional, population-based study of 2893 adults, including 602 adults that met a modified UK Diagnostic Criteria for AD. AD severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD) and its objective and subjective components, and numerical rating scale (NRS)-itch...
April 10, 2019: British Journal of Dermatology
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