Dermatology : International Journal for Clinical and Investigative Dermatology

BACKGROUND: Value-based healthcare (VBHC) is an increasingly employed strategy to transform healthcare organizations into economically sustainable systems that deliver high-value care. In dermatology, the need for VBHC is evident as chronic skin diseases require long-term, often expensive treatments. This narrative review aims to introduce dermatologists to the principles and implementation of VBHC. SUMMARY: VBHC emphasizes maximizing outcomes that are directly relevant to patients...

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INTRODUCTION: Keloid is an abnormal proliferation of scar tissue that grows beyond the original margins of the injury. Even after complete resection, recurrences are common and pose a poorly understood challenge in dermatology. There is lack of large prospective clinical trials, thus treatment recommendations are based on retrospective analyses and small cohort studies. Superficial radiotherapy is recommended in recurrent keloids; however, the successful treatment rates vary greatly. The aim of this study is to evaluate the keloid recurrence rate after post excision soft x-ray radiotherapy and the associated factors...

INTRODUCTION: Night shift work disrupts circadian rhythms and has been associated with immune system alterations and various health conditions. However, there is limited data regarding its impact on psoriasis. The aim of our study was to compare psoriasis severity and the hormonal and immunological profile in patients with a night shift work to those with a daytime occupation. METHODS: In this case-control study, we enrolled psoriatic patients aged >18 years engaged in night shift work and a control group of psoriatic patients with a daytime occupation...

INTRODUCTION: Psoriasis is a chronic inflammatory skin disease with variable clinical presentation, multifactorial etiology and an immunogenetic basis. Several studies demonstrate that it results from a dysregulated interaction between skin keratinocytes, immune cells and the environment that leads to a persistent inflammatory process modulated by cytokines and T cells.The development of new treatment options requires increased understanding of pathogenesis. However, the successful implementation of effective drugs requires well-characterized and highly available preclinical models that allow researchers to quickly and reproducibly determine their safety and efficacy...

INTRODUCTION: Despite numerous treatment options for Nail lichen planus (NLP), a validated method for measuring the severity of NLP and therapeutic response in clinical trials is absent. To develop and validate a measurement instrument (tNLPSI - typical nail lichen planus severity index) for typical nail lichen planus that could be used in clinical trials. METHODS: 48 patients with typical NLP diagnosed pathologically and 5 dermatologists participated. The physicians were trained to use the tNLPSI activity scale and Physician's Global Assessment (PGA)...

INTRODUCTION: Neutrophilic dermatoses (NDs) often occur secondary to inflammatory conditions, medication exposure, and hematologic malignancy. While malignancy-associated NDs (MA-NDs) have been well-reported among those with hematologic cancers, little is known about drug-induced NDs (DI-NDs) within this population. The objective of this study is to compare the presentations and outcomes of patients with hematologic malignancies who developed MA-NDs and DI-NDs. METHODS: Cases of neutrophilic dermatosis (ND) occurring between 2013 and 2023 among those with hematologic malignancies were identified from the electronic medical records of our institution...

Background Atopic dermatitis (AD) is a common chronic skin disease with an inflammatory pathophysiology that includes the activation of the innate and adaptive immune systems. Objectives We aimed to investigate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR) and eosinophil-to-neutrophil ratio (ENR) in AD patients, according to age and disease severity. Methods This is a retrospective, population-based cohort study conducted between the years 2005 and 2020, comparing hematological markers of AD patients and sex-age-ethnicity matched controls...

Introduction With the aging of the population in China, the prevalence of atopic dermatitis (AD) is high in the elderly patients. These patients usually have more comorbidities and they need more effective and safer treatments. Dupilumab is an anti-interleukin-4 (IL-4) receptor monoclonal antibody which was approved for the treatment of moderate to severe AD. Objective To investigate the efficacy and safety of dupilumab in elderly patients with moderate to severe AD. Methods A real world retrospective study was conducted...

Introduction MEK inhibitors are in use for several indications for adults and children. Cutaneous toxicities are among the most common adverse effects. We aimed to describe the spectrum of cutaneous adverse events, its frequency and severity in a cohort of pediatric patients. Methods We reviewed all records of patients in our tertiary treatment center treated with MEK inhibitors between January 2016 and January 2023 for all indications. Results Among 33 patients, 76% reported cutaneous adverse effects. The highest prevalence was in the group of patients treated with trametinib (90%), followed by the group treated with selumetinib (50%) and the group treated with combination of trametinib and BRAF inhibitor (dabrafenib, 34%)...

BACKGROUND: Surgical excision of extramammary Paget disease (EMPD) is associated with a high local recurrence rate. OBJECTIVES: This study aimed to assess the local recurrence rate of EMPD after preoperative mapping biopsy (PMB) with local excision. METHODS: This retrospective study included patients with EMPD who were treated at our dermatosurgery clinic between January 2016 through May 2022. In addition, we retrieved individual patient data of EMPD cases from articles published in PubMed, Cochrane, Embase, and Scopus to compare recurrence rates between patients with or without PMB using Cox's proportional hazard model...

INTRODUCTION: According to the common disease/rare variant (CDRV) hypothesis, it is important to study the role of rare variants in complex diseases. The association of rare variants with psoriasis has been demonstrated, but the association between rare variants and specific clinical subtypes of psoriasis has not been investigated. METHODS: Gene-based and gene-level meta-analyses were performed on data extracted from our previous study data sets(2,483 patients with guttate psoriasis and 8,292 patients with non-guttate psoriasis) for genotyping...

INTRODUCTION: Super bioavailable itraconazole (SB ITZ) overcomes the limitations of conventional itraconazole (CITZ) such as inter-individual variability and reduced bioavailability. It has been approved for systemic mycoses in Australia and Europe as 50mg and the United States as 65mg and in India as 50mg, 65mg, 100mg, and 130mg. However, data on the ideal dose and duration of SB ITZ treatment in managing dermatophytosis is insufficient. This consensus discusses the suitability, dosage, duration of treatment, and relevance of using SB ITZ in managing dermatophytosis in different clinical scenarios...

INTRODUCTION: According to the DLQI user manual, the patients´ answers 'not relevant' (NR) and 'not at all' (affected in this aspect of life by the skin problem) are treated equally and interpreted as no impairment in health related quality of life (HRQoL). The aim of this study was to gain more insights about 'not relevant' responders with atopic dermatitis (AD). METHODS: 3,353 patients with AD, recruited from dermatological offices and a patient organisation, were surveyed in three cross-sectional studies...

BACKGROUND: Topical corticosteroid (TCS) phobia may negatively impact treatment adherence. Currently, there are few studies exploring trust and knowledge of TCS use among pharmacy staff. OBJECTIVE: To examine TCS knowledge and possible phobia among Danish pharmacy staff. METHODS: A questionnaire, based on Topical Corticosteroid Phobia (TOPICOP©) questionnaire, was developed and rephrased to fit pharmacy staff. The questions were Likert scales and numerical rating scales (NRS) (0-10)...

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BACKGROUND: novel oncologic therapies, including epidermal growth factor receptor inhibitors (EGFR-Is) and immune checkpoint inhibitors (ICIs), are associated with a new spectrum of adverse reactions, with prominent cutaneous toxicities. The impact of cutaneous adverse events (cAEs) on patients' quality of life (QoL) represents an unmet clinical need. OBJECTIVES: 1) to assess whether cutaneous toxicities directed therapies are effective in reducing the QoL burden via the submission of two patient reported outcome measures (PROMs); 2) to investigate whether class of oncologic therapy, type of cAE and toxicity severity differently impact on patients' QoL...

Introduction Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, characterized by painful and recurrent lesions in apocrine gland-bearing skin areas. It is a heterogeneous disease, which makes assessment and data collection difficult. Questionnaires with detailed items, such as the Belgian European Registry for Hidradenitis Suppurativa (ERHS-Be), are useful to study HS and its associated comorbidities. The aim of this registry is to uncover new factors associated with HS, understand HS patients' clinical profiles and efficacy of treatments...

No abstract text is available yet for this article.

INTRODUCTION: Ultraviolet radiation (UVR) is the primary risk factor for keratinocyte carcinomas (KC). Oral supplementation with nicotinamide (NAM; NAM-mono) is reported to reduce the formation of new KCs. NAM's photoprotection is mediated by enhanced DNA repair. We wanted to explore whether NAM in combination with anti-proliferative (Metformin; Met) or antioxidant (Phloroglucinol; PG) compounds could potentially enhance its photoprotective effects. METHODS: Hairless mice (C3...