1,720,984 research outputs found
Successful Treatment of Recalcitrant Subcorneal Pustular Dermatosis (Sneddon-Wilkinson Diseases) With Apremilast
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Eosinophilic fasciitis and breast cancer: a case report highlighting recurrence signals
No full textEosinophilic fasciitis (EF) poses a diagnostic challenge owing to its uncommon occurrence and aetiology that remains poorly understood. We report a case of a 79-year-old woman with a prolonged history of breast cancer exhibiting EF with concomitant pelvic metastases. This case underscores EF’s potential as an indicator signaling a potential resurgence of cancer, highlighting its significance as a red flag of disease recurrence
Successful treatment of scleromyxedema with daratumumab, lenalidomide and dexamethasone in a patient with multiple myeloma
No full textDupilumab Treatment Efficacy and Impact on Clinical Scores, Serum Biomarkers, and Itch in Adult Patients with Atopic Dermatitis: A Retrospective Analysis
Get PDFPurpose: Dupilumab, a fully human monoclonal antibody that inhibits the signaling pathways of interleukin (IL)-4 and IL-13, has demonstrated remarkable efficacy in the treatment of atopic dermatitis (AD). Dupilumab has been reported to attenuate itch and reduce several serum markers, including blood lactate dehydrogenase (LDH), blood eosinophil count, and serum total immunoglobulin E (IgE). Patients and Methods: The present study investigated retrospectively changes in clinical scores and serum biomarker from 175 adults with moderate-to-severe AD treated with dupilumab. Clinical manifestations were assessed using eczema area and severity index (EASI) and visual analogue scale (VAS) for itch at baseline and subsequently at 16-week intervals up to a duration of 48 weeks. Total IgE, LDH and blood eosinophil count were also collected. Results: The dupilumab treatment significantly improved EASI and VAS scores and decreased serum levels of IgE, LDH, and total eosinophil count. The EASI scores were positively correlated with VAS for itch at all recorded time points, whereas serum biomarkers did not exhibit a strong correlation with EASI scores. Conclusion: These findings highlight the close relationship between the extent and severity of eczema and the intensity of itch experienced by patients and suggest that factors beyond the measured serum biomarkers play a significant role in the clinical manifestations of AD, emphasizing the complex nature of the disease
NEVIGRAV Study: A Case–Control Analysis on Changes in Melanocytic Nevi During Pregnancy
No full textPregnancy can influence modifications and appearance of melanocytic nevi, but studies report inconsistent findings, often lacking standardized methods and comparison groups. This study evaluates dermoscopic changes in nevi and the development of new melanocytic lesions in pregnant women using full-body photography and digital dermoscopy. Nevigrav is an observational case–control study conducted at two university dermatology centers, involving 85 participants (45 pregnant women and 40 controls) with 1614 lesions analyzed. Participants were asked about recent sun exposure or tanning habits. Enrollment was predominantly conducted in autumn and winter months to minimize ultraviolet (UV) exposure as a confounding factor. Total body photography revealed no new lesions in pregnant women when compared to controls. Dimensional growth was observed in the abdomen (p = 0.049) and the back (p < 0.001) between the first and second trimesters, with further abdominal growth in the third trimester (p < 0.001). At the third trimester, pigmentation changes were significant, with phototype III maintaining or increasing pigmentation and phototype II showing a reduction of pigmentation (χ2 = 32.33, p < 0.001). Regional pigmentation differences were noted in the mammary (p = 0.02), abdominal (p = 0.004), and thigh (p = 0.007) areas. No changes in symmetry or dermoscopic nevi patterns, including dots or globules, were observed. Pregnancy does not increase nevi count but may cause size and pigmentation changes, particularly in the abdomen, influenced by phototype and body region. No new dermoscopic patterns or symmetry changes were found
The realistic positioning of UVA1 phototherapy after 25 years of clinical experience and the availability of new biologics and small molecules: a retrospective clinical study
No full textBackgroundSince the early 1990s, Ultraviolet (UV) A1 phototherapy has been described as an effective and safe treatment of a multitude of skin disorders. However, after 30 years, its use has remained limited to few dermatological centers.ObjectiveTo analyze the changes over the years and the current position of UVA1 phototherapy through a Real-World Evidence (RWE) study at a single tertiary referral center.MethodsWe reviewed the medical files of 740 patients treated between 1998 and 2022. Treatment results were collected, efficacy was assessed by a grading scale and acute adverse effects were registered.ResultsWe treated patients with 26 different diseases. We registered marked improvement (MI) or complete remission (CR) in 42.8% of patients with morphea, 50% with Urticaria Pigmentosa, 40.7% with Granuloma annulare and 85.7% with skin sarcoidosis. Good results were obtained also in the treatment of chronic Graft Versus Host Disease (GVHD), Eosinophilic Fasciitis, Sclero-atrophic Lichen, skin manifestations of systemic lupus erythematosus and psoriasis of HIV+ patients. Systemic Sclerosis, Romberg's Syndrome, Bushke's Scleredema, Nephrogenic Fibrosing Dermopathy, REM Syndrome, Follicular Mucinosis, Pretibial Myxedema, Scleromyxedema, pemphigus foliaceus, chronic cutaneous lupus erythematosus, erythroderma of Netherton Syndrome and Necrobiosis Lipoidica were no or poorly responsive. In clinical indications where UVA1 was used as a second line phototherapy after narrow-band (NB)-UVB, we saw good MI or CR rates in Mycosis Fungoides (57% of patients), Atopic Dermatitis (33.9%), Pitiryasis Lichenoides chronica (50%), Pityriasis Lichenoides et varioliformis acute (75%) and Lymphomatod Papulosis (62.5%). Short-term adverse events were uncommon and mild.ConclusionOver the past decade, the annual number of treated patients has progressively declined for several reasons. Firstly, UVA1 phototherapy has taken a backseat to the cheaper and more practical NB-UVB phototherapy, which has proven effective for common indications. Secondly, the emergence of new, safe, and effective drugs for conditions such as atopic dermatitis, GVHD, and connective tissue disorders. Finally, our research has shown that UVA1 therapy is often ineffective or minimally effective for some rare diseases, contrary to previous case reports and small case series. Nonetheless, UVA1 continues to be a valuable treatment option for patients with specific skin disorders
Impact of Pemphigus on Sleep Quality: A Prospective Observational Single-Center Case-Control Study
Full text linkIntroduction: Pemphigus, an autoimmune disorder, significantly impacts the quality of life for those affected. Objective: This study examined the sleep quality in patients with pemphigus, a domain for which the existing literature provides limited data without a focused analysis. Methods: A total of 156 individuals, 52 in the case and 104 in the control group, completed several questionnaires (Pittsburgh Sleep Quality Index [PSQI], General Health Questionnaire-12 [GHQ-12], and ABQOL [Autoimmune Bullous Disease Quality of Life]). Disease severity was evaluated using the Pemphigus disease area index (PDAI index). Results: The case group exhibited significantly higher levels of psychological distress, reflected in GHQ- 12 scores (P = 0.00), and notably poorer sleep quality compared to controls across various parameters (sleep latency [SL], disturbances [SDi], medication [SM], daytime sleep dysfunction [DSD]), and the global PSQI score (GS)] (P = 0.00)). Significant correlations were observed between PDAI scores and sleep duration (SDu) (P = 0.01), SM (P=0.03), SL (P =0.03), and GS (P=0.00). An association was found between the equivalent steroid intake and SDu (P=0.00) as well as GS (P=0.02). No statistically significant correlation emerged between disease duration and PSQI scores. Our findings indicated a correlation between poor sleep quality and cutaneous rather than mucosal manifestations (p=0.01). Pemphigus affects sleep quality. Severe disease showed heightened SDi, correlating with higher steroid doses, and in the chronic phase, the impact seems to have been more influenced by the pro-inflammatory stage of the disease. Patients with cutaneous pemphigus exhibited reduced sleep quality compared to those with oral pemphigus. Conclusion: Understanding that pemphigus worsens sleep quality can be beneficial for the holistic management of individuals with this condition
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