1,721,106 research outputs found

    Polymorphic light eruption: What's new in pathogenesis and management

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    Polymorphic light eruption is the commonest photosensitive disorder, characterized by an intermittent eruption of non-scarring erythematous papules, vesicles or plaques that develop within hours of ultraviolet radiation exposure of patient skin. Together with the lesions, a terrible itch starts and increases with the spreading of the disease, sometimes aggravated by a sort of burning sensation. Clinical picture and symptoms can improve during the rest of the summer with further solar exposures. In the last years many advances have been performed in the knowledge of its pathogenesis and some news have been proposed as preventive, as well as therapeutic options. All this has been discussed in the current mini review

    Atopic dermatitis: Epidemiology and clinical phenotypes

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    Atopic dermatitis (AD) is a chronic, lifelong, relapsing condition. The wide spectrum of the possible clinical presentations, depending on patient' s age, age of onset of disease, topography and morphology of dermatitis, limits the epidemiologic information on its prevalence and incidence. A clear definition of the different clinical AD phenotypes and epidemiology is essential for an appropriate patient's treatment and management, in particular for adults. This review summarizes the most recent epidemiologic data from the 21st century, on AD prevalence and incidence rates either in children or adults, with a special focus on their trends in Europe. Moreover, an effort to categorize diverse AD clinical expressions, has been made, aiming to facilitate differential diagnosis and speed up the start of the correct therapy

    Efficacy, tolerability and safety of switching from etanercept to infliximab for the treatment of moderate-to-severe psoriasis: A multicenter, open-label trial (TANGO)

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    Biologic anti-tumor necrosis factor-α (anti-TNF-α) therapies have revolutionized the management of psoriasis. However, despite similar mechanisms of action, inter-patient variability in the clinical responses to therapy remain unexplained. Possible differences between agents include stability or bioavailability and anti-drug antibody development, and patient factors such as compliance may play a role. As a result, it is not uncommon for physicians to switch a patient from one anti-TNF-α agent to another when initial response is inadequate. This multicenter, single-arm, observational, Phase IV study assessed the efficacy and safety of infliximab therapy in patients with moderate-to-severe psoriasis who had not responded to 24 weeks' etanercept treatment. Drug efficacy was assessed using specific psoriasis indexes; health-related quality of life (HRQoL) was measured using the Dermatology Life Quality Index and the Skindex-29. A total of 48 patients were screened, 38 were treated with infliximab and 31 completed the study. Of these, 71% achieved Psoriasis Area and Severity Index 75 after 10 weeks, and improvement in HRQoL was documented. The results of this study showed that patients with moderate-to-severe psoriasis could be successfully switched from etanercept to infliximab, with improvements in both clinical parameter and HRQoL

    Oral Diseases During Systemic Psoriatic Drugs: A Review of the Literature and Case Series

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    Introduction: The oral health of psoriatic patients seems to be compromised compared to that of control individuals: many published studies have investigated the relationship between psoriatic disease and gingivitis, periodontitis, and missing teeth. However, data from these studies are not consistent nor exhaustive. Moreover, no study has considered the possible specific effects of conventional and biological systemic psoriatic treatments. Objective: We report a narrative review of the literature about the possible link between anti- psoriatic drugs and oral disease onset and present case series of patients that have experienced oral disease during systemic therapy for psoriasis. Methods: This is a narrative review. The literature search was performed using the MEDLINE database. From the selected articles, additional references were identified by a manual search among the cited literature. Results: Oral adverse events during psoriatic therapies can be found in sporadic cases. The specific mechanisms of interplay between oral anatomic structures and the pathway targeted by the systemic agents will be investigated in depth. Conclusion: All psoriatic patients who are candidates for conventional or biological systemic therapy should have regular oral health check-ups with a dentist and a dermatologist to prevent oral complications. Dermatologists and oral medicine specialists should be ready to recognize and manage this increasing number of oral adverse drug reactions during systemic treatments for psoriatic disease so as to provide patients with sufficient information about this risk and to stress the fundamental importance of regular dental assessments and good oral hygiene

    PDE4 Inhibition Reduced Osteoclast Differentiation in Psoriatic Patients

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    Background: Psoriatic skin inflammation has been linked to joint inflammation and bone structural alterations, contributing to a "pro-osteoclastogenic march." Osteoclasts (OCs), responsible for bone resorption, originate from monocytes/macrophages and are regulated by the RANKL-RANK signaling pathway. The cyclic AMP (cAMP) pathway plays a crucial role in OC maturation, and phosphodiesterases (PDEs) control its intracellular levels. Apremilast, a selective PDE4 inhibitor used for psoriasis (Pso) and psoriatic arthritis (PsA) treatment, may modulate osteoclastogenesis. Methods: Seventeen patients with moderate-to-severe psoriasis without arthritis, eligible for systemic apremilast therapy, were enrolled. Blood samples were collected at baseline and after 52 weeks of treatment to evaluate in vitro osteoclastogenesis from peripheral blood monocytes/macrophages and to measure serum RANKL levels. Results: After 52 weeks of apremilast treatment, OC and RANKL levels were significantly reduced in psoriatic patients compared to baseline. A sub-analysis was performed on two age- and sex-matched subgroups: a biona & iuml;ve group and a bioexperienced group. Bioexperienced patients exhibited lower OCP counts and reduced plasma RANKL levels compared to biona & iuml;ve patients. Conclusions: Our findings highlight the role of PDE4 in the pro-osteoclastogenic process in psoriasis and suggest that apremilast may counteract bone resorption by modulating RANKL levels and osteoclast differentiation, with potential clinical implications

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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