1,721,413 research outputs found
Public perception of dermatology and dermatologists: a very relevant but untapped issue
No full textDermatology has many faces and encompasses a variety of fields including medical dermatology, skin oncology and surgery, genetic and paediatric skin diseases, sexually transmitted diseases, allergic skin diseases and aesthetic medicine.1 These fields are heterogeneously practiced by hospital-based dermatologists, extra hospital public dermatologists and private practice dermatologists. These differences are brought about by the possibility of performing certain techniques (e.g. surgery, allergy testing), the ability to prescribe expensive drugs (e.g. biologics) and the economical revenue of treating different disorders (e.g. chronic skin disease vs aesthetic problems) among others. Dermatology practice is also affected by the number of dermatologists in each area, and the availability and attitude of primary care physicians (e.g. general practitioners and paediatricians) to treat skin disease
Testing biologics and intracellular signaling inhibitors on pediatric atopic dermatitis: a stairway to modern therapeutic approaches
No full textINTRODUCTION: Atopic dermatitis (AD) is the most common cutaneous inflammatory
disease in adults and children. In the last few years, the pathogenesis of AD has
been profoundly revised and this has led to the identification of novel druggable
targets and the development of new agents targeting specific molecular pathways.
Despite the high prevalence of atopic dermatitis in the pediatric population, the
clinical development of new treatments, either topical or systemic, has been
focused on the adult population in recent years; only a limited number of these
new agents have been tested in pediatric cohorts. Areas covered: In this review,
we describe the pathogenic model of pediatric atopic dermatitis which shows
similarities and substantial differences when compared to adult atopic
dermatitis. The identification of therapeutic targets is highlighted and novel
targeted therapies, both topical and systemic, are discussed. Expert opinion: The
current therapeutic armamentarium for pediatric atopic dermatitis is very limited
and this represents a critical unmet need. The enhancement of clinical research
on pediatric patients is necessary to facilitate an increase in the number of new
targeted therapeutic options being available on the market
Relapse of psoriasis in patients who asked to discontinue etanercept after achieving a stable clinical remission.
No full textIn real-life practice, there are some patients who ask for treatment withdrawal after achieving stable complete remission for a number of reasons including worry regarding adverse events with longterm treatment. The objective of this retrospective study was to investigate psoriasis course (duration of remission and predictors of relapse) in patients who asked to discontinue etanercept after achieving complete and stable remissio
Palisaded neutrophilic granulomatous dermatitis and its associations with autoimmune diseases
No full textPalisaded neutrophilic granulomatous dermatitis and its associations with autoimmune disease
Secukinumab Associated with Acitretin in Generalized Pustular Psoriasis
No full textGeneralized pustular psoriasis, the most severe form of psoriasis, is a rare variant characterized by widespread sterile pustule associated with systemic inflammation. The disease lacks of specific treatment, drugs approved for plaque psoriasis are used in the clinical practice, with variable results. We present the case of a 41-year old woman affected by a severe form of generalized pustular psoriasis, resistant to several therapies included Tumor Necrosis Factor Antagonist; in our patient we decide to use acitretin plus Secukinumab, an IL-17 inhibitor. The association was effective, achieving the complete resolution of pustulation at month-2; the result was maintained for over 14 months of follow up. No adverse events related to therapy were observed. Generalized pustular psoriasis is related to IL-36RN mutations, which lead to upregulation in IL-36 signaling; IL-36 itself could promote IL-17 pathways. Our case demonstrates that targeting IL-17 eventually associated with systemic retinoids could be a valid therapeutic option for these patients
Immune Response to Vaccination in Patients with Psoriasis Treated with Systemic Therapies
No full textPsoriasis is a chronic inflammatory skin disease usually treated with immunomodulatory/ immunosuppressive agents. The use of these agents has been associated with an increased susceptibility to infections. Vaccinationmight represent a critical aspectin themanagement of patients with psoriasis treated with immunomodulatory/immunosuppressive therapies. This narrative review aimed to provide an overview on the immune response to vaccines in subjects treated with systemic agents used to treat patients with moderate to severe psoriasis. Publications appearing in PubMed, Scopus, and ISI–Web of Knowledge database were selected using Medical Subject Headings key terms. Overall, published data confirmed that vaccination with attenuated live vaccines during therapy with immunomodulatory/immunosuppressive therapies should be avoided. For nonlive vaccines, a more favorable safety profile of biologic agents compared to conventional systemic agents is described as the humoral response to vaccines is in general well-preserved. Treatment with cyclosporine and methotrexate is associated with lower antibody titers to vaccines, and thus these agents are better discontinued during vaccination. In contrast, treatment with biological agents is not associated with lower antibody response and can thus be continued safel
An intriguing genital eruption in a traveler returning from Philippines
No full textAn intriguing genital eruption in a traveler returning from Philippine
Segregation analysis revealed hemizygotic causative mutations in a pseudoxanthoma elasticum patient
No full textPseudoxanthoma elasticum (PXE, OMIM 264800) is an autosomal recessive disorder in which elastic fibers of skin, eyes, and cardiovascular system become progressively calcified, causing a spectrum of manifestations with a variable phenotype. The proposed prevalence of PXE is 1/25 000, but this might be an underestimate. PXE is associated with mutations in the ABCC6 (ATP binding cassette subtype C number 6) gene. This article is protected by copyright. All rights reserved
Plasma homocysteine and folate levels in patients with chronic plaque psoriasis.
No full textBackground Hyperhomocysteinaemia is a well-known risk factor for cardiovascular diseases. Patients with severe chronic plaque psoriasis have a higher risk of Death due to arterial and/or venous thrombosis. Objectives To investigate the relationship among plasma homocysteine and folate
levels and severity of chronic plaque psoriasis in a selected cohort of patients with psoriasis without known risk factors for acquired hyperhomocysteinaemia.
Methods We performed a case–control study in 40 patients with chronic plaque
psoriasis and 30 age- and sex-matched healthy controls. Cases and controls were
selected excluding individuals with conditions or diseases associated with
acquired hyperhomocysteinaemia, and were also asked to stop alcohol and coffee
consumption for 1 week before blood sampling. The plasma levels of homocysteine
and folic acid were measured and were correlated with the severity of psoriasis
(Psoriasis Area and Severity Index, PASI).
Results Patients with psoriasis had plasma homocysteine levels higher than controls
(mean ± SD 16Æ0 ± 5Æ6 vs. 10Æ4 ± 4Æ7 lmol L)1; P < 0Æ001). Conversely, folic
acid levels were lower in patients with psoriasis compared with controls
(mean ± SD 3Æ6 ± 1Æ7 vs. 6Æ5 ± 1Æ7 nmol L)1; P < 0Æ001). Plasma homocysteine
levels in patients with psoriasis correlated directly with disease severity (PASI)
and inversely with folic acid levels. Plasma folic acid levels were inversely correlated
with the PASI. No abnormalities of plasma vitamin B6 and B12 were found.
Conclusions Patients with psoriasis may have a tendency to hyperhomocysteinaemia,
which may predispose to higher cardiovascular risk. Dietary modification of this
risk factor appears relevant to the global management of patients with moderate
to severe psoriasis
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