1,720,977 research outputs found
Parapsoriasis during dupilumab treatment in three patients with a long-lasting history of atopic dermatitis
Assessment of the efficacy, skin acceptability and cosmetic quality of an adjuvant cream based on 40% urea and amino-inositol in the treatment of mild psoriasis
Background: Psoriasis is a chronic inflammatory disease with a multifactorial genesis. Structural changes are encountered in psoriasis and skin barrier function is impaired. Tight junctions (TJs) play a key role in skin barrier dysfunction. Loss of profilaggrin or filaggrin leads to changes in the stratum corneum and consequent loss of water and the development of xerosis. Methods: We carried out an observational study to evaluate the efficacy, skin acceptability and cosmetic qualities of a cream formulation, based on 40% urea and amino-inositol, in the treatment of mild psoriasis in the absence of other associated cosmetic/pharmacological treatments. All parameters were evaluated before (T0) and after 4 weeks (T4). Efficacy assessment was based on both clinical evaluation and photographic documentation. Results: The results showed significant clinical improvement (-64.18% PASI, -57.11% BSA, -61.84% Plaque Score, -41.86% PGA and -76.34% VAS -77.5 DLQI) in 4 weeks of treatment. No significant side effects were reported. Similarly, the degree of satisfaction with the product and adherence to its use were particularly satisfactory among patients. Conclusions: The tested product was found to be a promising, effective adjuvant treatment in patients with mild psoriasis, and was also useful in reducing itchy symptoms, the impact on quality of life, as well as significantly reducing the clinical signs of psoriasis
Real-life efficacy and safety of upadacitinib in adolescents with moderate-to-severe atopic dermatitis unresponsive to dupilumab: A case series
Injection site reactions resulting from the use of biological therapy in the treatment of moderate-to-severe plaque psoriasis
Introduction: Biological medications have significantly improved the prognosis of psoriasis patients. All biological drugs (except infliximab) for psoriasis require subcutaneous (SC) administration. Adverse events of biologic drug treatment include injection site reactions. ISRs are a local phenomenon characterized by swelling, erythema, pruritus, and pain around the injection site. Areas covered: We conducted a review to analyze the differences between the ISRs of various biologics approved for psoriasis. Specifically, the review focused on anti-TNF-α, anti-IL12/23, anti-IL-17 and anti-IL-23 drugs. Expert opinion: Etanercept and adalimumab have reported ISR rates of 37% and 20%, respectively, with erythema, pruritus, pain, and irritation being the most common. Citrate free (CF) solution and thinner needles have reduced ISR associated with adalimumab. Ustekinumab showed a low risk of ISR. Regarding secukinumab and ixekizumab, pain was found to be the most common ISR. The introduction of CF ixekizumab formulation has shown promise in reducing ISRs associated with ixekizumab. The risk of ISR appears insignificant with bimekizumab, brodalumab, and anti-IL23 drugs, with ISR rates ranging from less than 1% to 7.1%. The choice of biologic agent should consider ISR risk. Education on injection techniques and the use of single-dose autoinjectors/pens can mitigate ISR risk
Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature
The outbreak of coronavirus disease 2019 (COVID-19) represented a new worldwide challenge, strongly impacting on the global economy, overall health and lifestyle. Since then, several strategies have been adopted to contain the widespread of infection. Among these, vaccination is currently the most important measure to fight against the pandemic. However, several concerns such as slower-than-hoped-for rollout, the hurried approval with limited data, the mechanism of action (in particular mRNA-based), and the uncertain duration of protection they afforded were initially raised. Moreover, even if cutaneous reactions have been rarely reported in clinical trials, global mass vaccination showed several dermatologic reactions not initially recognized, leaving dermatologists to decide how to diagnose and treat them. In this scenario, dermatologists should be ready to promptly recognize these clinical manifestations. Thus, the aim of this manuscript is to review current literature on cutaneous reactions following COVID-19 vaccination, particularly inflammatory dermatological diseases, in order to help clinicians to better understand these dermatological conditions and to provide an extensive overview of all the vaccine-related skin manifestations
The Past, the Present and the Future of Teledermatology: A Narrative Review
: Teledermatology may be defined as the application of telemedicine to dermatology. According to published data, teledermatology is more widespread in Europe and North America, probably where resources for health care are greater than in other areas of the world. Indeed, teledermatology requires advanced technology to be efficient, as high image quality is necessary to allow the dermatologist to make correct diagnoses. Thanks to the recent advances in this field, teledermatology is become routinary in daily clinical practice. However, its use has been improved over time, overcoming several challenges. The aim of this narrative review is to retrace the almost 30-year history of teledermatology, to address the new challenges posed by advancing technologies such as artificial intelligence and the implications it may have on healthcare
Injections Site Reactions and Biologics for Psoriasis: A Questionnaire Based Real Life Study
Background: Biologic selection for psoriasis treatment should take into account numerous factors including injection site reactions (ISRs) such as swelling at the injection site, pain, burning, erythema, all possibly reducing patient adherence. Methods: A 6-months observational real life study was performed involving psoriasis patients. Inclusion criteria were age ≥ 18 years, moderate-to-severe psoriasis diagnosis since at least 1 year, patients being on biologic treatment for psoriasis ≥ 6 months. A 14-item questionnaire was administered to all patients enrolled to assess whether the patient ever experienced ISRs after the injection of the biologic drug. Results: 234 patients were included: 32.5% received an anti-TNF-alpha drug, 9.4% received anti-IL12/23, 32.5% received an anti-IL17, 25.6% received an anti-IL23. 51.2% of study population reported at least one symptom related to ISR. 35.9% of patients experienced pain, 31.6% swelling, 28.2% burning sensation and 17.9% erythema. 3.4% of the surveyed population experienced anxiety or fear of the biologic injection due to ISRs symptoms. The greater incidence of pain was registered in anti-TNF-alpha and anti-IL17 groups (47.4% and 42.1%, p<0.01). Ixekizumab proved to be the drug with the highest rate of patients experiencing pain (72.2%), burning (77.7%) and swelling (83.3%). No patients reported biologics discontinuation or delay for ISRs symptoms. Conclusion: Our study highlighted that each different class of biologics for psoriasis was linked to ISRs. These events are more frequently reported with anti-TNF-alpha and anti-IL17
Monkeypox: a dermatologist perspective
: Monkeypox (MPX) is a human zoonotic disease due to Monkeypox virus. Morbidity and mortality are lower than in other Orthopox virus diseases, in particular smallpox. MPX is an endemic disease of Western and Central Africa. However, a multi-country outbreak is currently taking place in many non-endemic countries. The clinical and epidemiological characteristics of this epidemic appear peculiar, with significant differences compared to those of the endemic areas. In particular, it predominantly affects males having sex with males, and the route of sexual transmission appears to be particularly frequent. This has led to considerable media interest and concern among the population. Dermatologists are likely to be consulted frequently during the outbreak, especially for the differential diagnosis. Indeed, although MPX can affect various organs, the skin is constantly involved. Since the skin rash have different stages of development, MPX should be differentiate from several, common skin diseases, also because the systemic symptoms can be variable and of different severity. Therefore, dermatologists must be aware of the clinical characteristics of the disease and its management
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