Dermatology : International Journal for Clinical and Investigative Dermatology

BACKGROUND: Acitretin has been linked to the development of psychiatric disturbance. OBJECTIVES: To assess the psychiatric hazards in patients with psoriasis prescribed acitretin compared with those prescribed disease-modifying antirheumatic drugs (DMARDs). METHODS: This is a nationwide matched cohort study. From Taiwan's National Health Insurance Research Database, Adult patients with psoriasis between 1997 and 2013 were screened. Patients prescribed acitretin for at least 30 days per year on average (acitretin cohort) were matched 1:2 with those prescribed DMARDs for at least 30 days per year on average (reference cohort), by means of age, gender, and psoriasis duration...

BACKGROUND: Pemphigus vulgaris is a life-threatening autoimmune bullous disease characterized by flaccid blister formation. As there has been no macroscopic assessment of epidemiological characteristics, its disease burden in the general population remains unknown. OBJECTIVES: To assess the global incidence rate of pemphigus vulgaris in the general population. METHODS: The search was conducted in databases including Medline, Embase, Web of Science, and The Cochrane Library from inception to May 1st, 2022...

Background While skin cancers are less prevalent in people with skin of color, they are more often diagnosed at later stages and have a poorer prognosis. The use of artificial intelligence (AI) models can potentially improve early detection of skin cancers, however the lack of skin color diversity in training datasets may only widen the pre-existing racial discrepancies in dermatology. Objective To systematically review the technique, quality, accuracy, and implications of studies using AI models trained or tested in populations with skin of color, for classification of pigmented skin lesions...

BACKGROUND: There is growing evidence that patients with alopecia areata (AA) have an increased risk of developing psychiatric comorbidities. However, the relationship between AA and suicidal behaviors remains unclear. OBJECTIVE: To investigate the association between AA and suicidal behaviors Methods: Participants were recruited from the National Health Insurance Research Database in Taiwan, including 10,515 patients with AA and 10,5150 matched controls, to assess the risk of suicide attempts...

UNLABELLED: proportion of patients with psoriasis causing pain and impaired quality of life. Early recognition and treatment are important as PsA may result in structural joint damage with a risk of reduced physical function. OBJECTIVES: The aim of this study was to determine the proportion of psoriasis patients with suspicion of PsA who are diagnosed with PsA or other rheumatologic conditions following referral from a dermatology department. Furthermore, the study aimed to identify clinical and patient-reported variables identifying patients with psoriasis in whom joint discomfort is an expression of PsA...

BACKGROUND: In many fields of medicine, guidelines recommend reduced cancer screening in patients of advanced age and limited life expectancy (LLE). In dermatology, there are currently no guidelines for adjusted evaluation and management practices of keratinocyte cancer (KC) in patients with LLE. Little is known regarding evaluation and management patterns and frequency of biopsies in these patients. OBJECTIVE: We sought to determine if dermatology providers biopsy LLE patients with similar frequency to their age-matched peers and quantify frequency of associated complications...

BACKGROUND: Metformin's effects on non-cancer skin diseases are rarely investigated. OBJECTIVE: To investigate immune-mediated (urticaria, allergic contact dermatitis and psoriasis) and androgen-mediated (acanthosis nigricans, hidradenitis suppurativa and acne) skin diseases associated with metformin use. METHODS: Metformin initiators (n=234,585) and non-metformin initiators (n=125,921) within the initial 12 months of antidiabetic drugs prescription during 1999-2009 were followed up until December 31, 2011...

BACKGROUND: Advanced cutaneous squamous cell carcinoma (aCSCC) represents an area of unmet clinical need, with no standardized treatments until the recent approval of immune checkpoint inhibitors (ICIs). OBJECTIVES: The aim of the study was to describe clinical characteristics and therapeutic strategies of a real-life Italian cohort of aCSCC patients managed at the beginning of cemiplimab approval as compassionate use in Italy. METHODS: A multicenter retrospective study was performed by 10 Italian centers in the period January 1, 2018-May 31, 2020...

BACKGROUND: The Self-Assessment Psoriasis Area Severity Index (SAPASI) is a patient-administered psoriasis assessment tool for which we present a validated translation from English to Swedish. METHODS: Validity was evaluated in this single-centre study using the Psoriasis Area Severity Index (PASI) as the standard. Test-retest reliability was assessed using repeated SAPASI measurements. RESULTS: Significant correlations (P<0.0001) using Spearman's correlation coefficient (r) were found between PASI and SAPASI scores (r=0...

BACKGROUND: Vulvar lichen sclerosus (VLS) is a chronic, relapsing, inflammatory dermatosis that has significant impact on patients' quality of life (QoL). While disease severity and associated QoL impact have been studied, factors associated with treatment adherence and their relation to QoL in VLS remain unexplored. OBJECTIVE: To describe demographics, clinical characteristics and skin-related QoL in VLS patients, and to assess the relationship between QoL and treatment adherence...

BACKGROUND: Ten-year survival and retention rate data on biologics are extremely limited, and there is a need to evaluate these metrics based on real-world data as well as on the results of clinical studies. OBJECTIVE: To assess the long-term survival rates of adalimumab and infliximab in real-life practice. METHODS: This study is based on data from the Turkish Psoriasis Registry and the digital records of the Medical School of Bezmialem Vakif University...

BACKGROUND: Melanoma patients have a higher risk of developing additional melanomas. Predisposing factors of a second primary melanoma in patients without any genetic predisposition are not well established. OBJECTIVES: To identify risk factors related to the development of a second primary melanoma in order to know which patients should be followed up closely. METHODS: A longitudinal study was performed at Hospital Gregorio Marañón (Madrid, Spain), based on follow-up data of patients diagnosed with cutaneous melanoma from 1998 to 2020...

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating disorder of the pilosebaceous unit. Dermal tunnels, sinus tracts, or fistulas are unique features of HS. One may hypothesize that HS tunnels remain active and may contribute to inflammation and disease severity. SUMMARY: Increased inflammatory infiltrate with an increased number and densities of immune cells was reported in HS tunnels. Moreover, significantly higher levels of IL-36, Il-17A, IL-17C, IL-17F, and CXCL8 mRNA compared to non-tunnel HS skin were found...

BACKGROUND: Generalized pustular psoriasis (GPP) is a rare, neutrophilic skin disease that can become life-threatening if flares are untreated. There are limited data describing the characteristics and clinical course of GPP disease flares with current treatment options. OBJECTIVE: To describe the characteristics and outcomes of GPP flares using historical medical information from patients enrolled in the Effisayil™ 1 trial. METHODS: Investigators collected retrospective medical data characterizing patients' GPP flares prior to clinical trial enrollment...

BACKGROUND: The knowledge about the location and kinetics of tattoo pigments in human skin after application and during the recovery is restricted due to the limitation of in vivo methods for visualizing pigments. Here, the localization and distribution of tattoo ink pigments in freshly and old tattooed human skin during the regeneration of the epidermis and dermis were investigated in vivo. METHODS: Two-photon excited fluorescence lifetime imaging (TPE-FLIM) was used to identify tattoo ink pigments in human skin in vivo down to the reticular dermis...

There is a need to revise current healthcare organization due to the ever-rising costs and variation in quality of delivered care. Over the past decades there have been several strategic frameworks attempting to tackle this problem. Value-based healthcare (VBHC) is one those frameworks which has gained increasing popularity the last years. The framework is formulated on the premise that the healthcare sector should deliver integrated care, using integrated practice units (IPUs), and strive to maximize the value created...

BACKGROUND: Prevention campaigns for skin cancers have focused primarily on melanoma, and over time there has been increasing awareness of the need to select the population to be screened to maximize program effectiveness. OBJECTIVES: To report the results of a free dermatological initiative, as part of an awareness campaign dedicated to keratinocyte cancers, targeting individuals pre-selected through a short questionnaire. METHODS: One day of dermatological consultations was held at 15 dermato-oncology referral centers during May 22-June 30, 2021...

BACKGROUND AND OBJECTIVES: Solid organ transplant recipients (SOTRs) are at increased risk of skin cancer and suffer from greater disease-specific morbidity and mortality. To risk stratify the expanding SOTR population for more targeted skin cancer screening, a detailed understanding of risk factors is needed. Using combined clinical and pathological data to capture prevalence of actinic keratosis (AK) and skin cancer, this study aimed to identify risk factors of skin cancer development in a Danish SOTR cohort...

BACKGROUND: The similar visual appearance of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) may cause confusion for diagnosis. OBJECTIVE: To investigate the value of ultra-high frequency ultrasound (uHFUS) in differentiating sBCC from BD. MATERIALS AND METHODS: This prospective study included a pilot cohort of 110 patients (73 BDs and 37 sBCCs) from November 2016 to October 2020 and a validation cohort of 42 patients (30 BDs and 12 sBCCs) from July 2021 to December 2021...

BACKROUND: The histopathologic presence of basal cell carcinoma (BCC) cells at one or more margins of the specimen after surgical excision is considered suggestive of incomplete tumor clearance. The management of incompletely excised BCC might vary in different clinical scenarios from re-excision to application of other treatmenents or even watchful waiting. OBJECTIVE: Τo report the real-life management of incompletely excised BCC in a tertiary referral center and compare the recurrence rates according to the selected management modality...