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Li S, Tian A, Wen Y, Gu W, Li W, Qiao X, Zhang C, Luo X. FGD1-related Aarskog-Scott syndrome: Identification of four novel variations and a literature review of clinical and molecular aspects. Eur J Pediatr 2024; 183:2257-2272. [PMID: 38411716 PMCID: PMC11035466 DOI: 10.1007/s00431-024-05484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
Patients with Aarskog-Scott syndrome (AAS) have short stature, facial anomalies, skeletal deformities, and genitourinary malformations. FYVE, RhoGEF, and PH domain-containing 1 (FGD1) is the only known causative gene of AAS. However, the diagnosis of AAS remains difficult, and specific treatments are still absent. Patients suspected with AAS were recruited, and clinical information was collected. Genetic testing and functional analysis were carried out for the diagnosis. By literature review, we summarized the clinical and genetic characteristics of FGD1-related AAS and analyzed the genotype-phenotype correlation. Five patients were recruited, and four novel FGD1 variants were identified. The diagnosis of AAS was confirmed by genetic analysis and functional study. Three patients treated with growth hormone showed improved heights during the follow-up period. By literature review, clinical features of AAS patients with FGD1 variants were summarized. Regarding FGD1 variations, substitutions were the most common form, and among them, missense variants were the most frequent. Moreover, we found patients with drastic variants showed higher incidences of foot and genitourinary malformations. Missense variants in DH domain were related to a lower incidence of cryptorchidism. Conclusion: We reported four novel pathogenic FGD1 variations in AAS patients and confirmed the efficacy and safety of growth hormone treatment in FGD1-related AAS patients with growth hormone deficiency. Additionally, our literature review suggested the crucial role of DH domain in FGD1 function. What is Known: • Aarskog-Scott syndrome is a rare genetic disease, and the only known cause is the variant in FGD1 gene. The typical clinical manifestations of AAS include facial, skeletal, and urogenital deformities and short stature. What is New: • We reported four novel FGD1 variants and reported the treatment of growth hormone in FGD1-related AAS patients. Our genotype-phenotype correlation analysis suggested the crucial role of DH domain in FGD1 function.
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Affiliation(s)
- Sujuan Li
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Anran Tian
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yu Wen
- Department of Pediatrics, The First People's Hospital of Urumqi, Urumqi, 830000, People's Republic of China
| | - Wei Gu
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, People's Republic of China
| | - Wei Li
- Department of Pediatrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, People's Republic of China
| | - Xiaohong Qiao
- Department of Pediatrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, People's Republic of China
| | - Cai Zhang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
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Hu W, Wang Y, Zhang S, Wu X, Lian C. Treatment of severely itchy scalp psoriasis and palmoplantar pustulosis with unsatisfied response to secukinumab, adalimumab or ustekinumab using upadacitinib: A report of two cases. J Dermatol 2024; 51:e151-e153. [PMID: 38031884 DOI: 10.1111/1346-8138.17046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Wenting Hu
- Department of Dermatology and Venereology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Yue Wang
- Department of Dermatology and Venereology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Si Zhang
- Department of Dermatology and Venereology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Xikang Wu
- Department of Pathology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Cuihong Lian
- Department of Dermatology and Venereology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
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Ramos J, Silva AM, António AM, Alves J. Recalcitrant folliculitis decalvans successfully controlled with adalimumab. An Bras Dermatol 2024; 99:480-482. [PMID: 38553282 DOI: 10.1016/j.abd.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 05/01/2024] Open
Affiliation(s)
- José Ramos
- Dermatology and Venereology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
| | | | - Ana Marta António
- Dermatology and Venereology Department, Hospital Garcia de Orta EPE, Almada, Portugal
| | - João Alves
- Dermatology and Venereology Department, Hospital Garcia de Orta EPE, Almada, Portugal
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Wang H, Zhang R. Five percent 5-aminolevulinic acid photodynamic therapy for the treatment of dissecting cellulitis of the scalp. Photodermatol Photoimmunol Photomed 2024; 40:e12954. [PMID: 38361468 DOI: 10.1111/phpp.12954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Huiying Wang
- Department of Dermatology, Changzhou First People's Hospital, Changzhou, China
| | - Ruzhi Zhang
- Department of Dermatology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
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Melgosa Ramos FJ, Berna-Rico E, Suarez-Valle A, Mateu Puchades A, Vañó-Galván S, García-Ruiz R, Saceda Corralo D. Bestimmende Faktoren für die Therapie der dissezierenden Zellulitis der Kopfhaut mit Biologika: Determinant factors of biological therapy for dissecting cellulitis of the scalp. J Dtsch Dermatol Ges 2024; 22:115-117. [PMID: 38212915 DOI: 10.1111/ddg.15271_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/08/2023] [Indexed: 01/13/2024]
Affiliation(s)
| | - Emilio Berna-Rico
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
| | - Ana Suarez-Valle
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
| | | | - Sergio Vañó-Galván
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
- Universität von Alcalá, Alcalá de Henares, Madrid, Spanien
| | - Ramón García-Ruiz
- Abteilung für Dermatologie, Universitätsklinikum Doctor Peset, Valencia, Spanien
| | - David Saceda Corralo
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
- Universität von Alcalá, Alcalá de Henares, Madrid, Spanien
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6
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Melgosa Ramos FJ, Berna-Rico E, Suarez-Valle A, Mateu Puchades A, Vañó-Galván S, García-Ruiz R, Saceda Corralo D. Determinant factors of biological therapy for dissecting cellulitis of the scalp. J Dtsch Dermatol Ges 2024; 22:115-117. [PMID: 38110849 DOI: 10.1111/ddg.15271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/08/2023] [Indexed: 12/20/2023]
Affiliation(s)
| | - Emilio Berna-Rico
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
| | - Ana Suarez-Valle
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
| | | | - Sergio Vañó-Galván
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
- University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ramón García-Ruiz
- Department of Dermatology, University Hospital Doctor Peset, Valencia, Spain
| | - David Saceda Corralo
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
- University of Alcalá, Alcalá de Henares, Madrid, Spain
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Gupta S, Chopra D, Preeyati. Erosive pustular dermatosis of the scalp secondary to Erlotinib: A rare occurrence with trichoscopic perspective. J R Coll Physicians Edinb 2023; 53:255-257. [PMID: 37649190 DOI: 10.1177/14782715231196606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Epidermal growth factor receptor inhibitors are anti-tumour agents that are frequently used for the treatment of neoplastic disorders. In addition to their cutaneous adverse effects, these drugs can rarely lead to erosive pustular dermatosis of the scalp. We report a case of a 67-year-old female who developed erosive pustular dermatosis of the scalp after being started on erlotinib from a trichoscopic perspective, which has been described in literature only once till now.
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Affiliation(s)
- Sharang Gupta
- Department of Dermatology, Government Medical College, Patiala, India
| | - Dimple Chopra
- Department of Dermatology, Government Medical College, Patiala, India
| | - Preeyati
- Government Medical College, Patiala, India
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Lim DZJ, Lim FC, Tey HL. Clinical efficacy of a gentle anti-dandruff itch-relieving shampoo formulation. Int J Cosmet Sci 2023; 45:769-774. [PMID: 37539788 DOI: 10.1111/ics.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
Dandruff is a common scalp condition affecting almost half of the world's population. Despite its high prevalence, the exact pathophysiology is not well established and is understood to be multifactorial, with factors such as fungal colonization, sebaceous gland activity and individual factors being implicated. There is a need for an effective and safe shampoo that can target the above factors. Hence, we have developed a shampoo formulation with properties of oil control, moisturizing, non-irritative, anti-fungal, anti-microbial and itch-relieving. In this interventional, open-label study, we evaluated the efficacy and safety of this shampoo in reducing the clinical signs of dandruff and pruritus in patients with pre-existing mild-to-moderate dandruff over a course of 21-day treatment duration through self-assessment and objective clinical evaluations. After continued use of the shampoo, there was a significant decrease in the adherent and loose scalp flaking scores. Mean pruritus scores also decreased significantly across the 21-day time points. There were also no adverse events or skin intolerances reported. This study showed that our shampoo formulation has led to a significant reduction in both adherent and loose scalp flaking and pruritus when used in individuals suffering from mild to moderate dandruff. As such, it is an ideal shampoo, which can be used to effectively control dandruff.
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Affiliation(s)
| | | | - Hong Liang Tey
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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9
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Yu C, Yu N, Jiang X, Gao X, Lv S, Wang G. Efficacy and safety of supramolecular active zinc in the treatment of scalp psoriasis: a multicentre, randomized, observed-blind, parallel-group, placebo- and active-controlled noninferiority trial. Clin Exp Dermatol 2023; 48:1138-1144. [PMID: 37140426 DOI: 10.1093/ced/llad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Controlling the relapses of scalp psoriasis is a clinical issue. OBJECTIVES To evaluate the efficacy and safety of a supramolecular active zinc antidandruff hair conditioner in managing scalp psoriasis (SP). METHODS This multicentre randomized, observed-blind, parallel-group, placebo- and active-controlled noninferiority trial enrolled 211 patients with SP between October 2018 and June 2019. The participants were randomized 1 : 1 : 1 to the experimental (supramolecular active zinc antidandruff hair conditioner), placebo (supramolecular hydrogel) or positive control (calcipotriol ointment) group. The primary efficacy endpoint was the disease control rate at the end of the fourth week of treatment, measured using the Investigator's Global Assessment score. RESULTS This study included 70, 70 and 71 participants in the experiment, control and placebo groups, respectively. The disease control rates of SP at the end of week 4 of treatment in the full-analysis set (FAS) were 39%, 25% and 37% in the experimental, placebo and control groups. The margin of superiority between the experimental and placebo groups was > 0 [96% confidence interval (CI) 13.22% (0.43% to ∞)] in the FAS. The experimental group was superior to the placebo group. The noninferiority margin between the experiment and control groups was > -15% [96% CI -1.43% (-14.91% to ∞)] in the FAS. The experimental group was not inferior to the control group. CONCLUSIONS Supramolecular active zinc antidandruff hair conditioner was helpful for the treatment of SP, and it has good clinical efficacy in maintaining therapeutic effect and assisting in preventing the recurrence of psoriasis.
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Affiliation(s)
- Chen Yu
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi' an, China
| | - Nan Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinghua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Shichao Lv
- Department of Dermatology, Strategic Support Force Specialty Medical Center (306 Hospital of PLA), Beijing, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi' an, China
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Misitzis A, Bhargava S, Cunha PR, Kroumpouzos G. Aminolevulinic Acid-Photodynamic Therapy for Erosive Pustular Dermatosis of the Scalp: Comparison of Two Treatment Protocols and Participant Satisfaction. Skinmed 2022; 20:107-112. [PMID: 35532762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Treatment of erosive pustular dermatosis of the scalp (EPDS) is challenging. Topical and systemic medications have achieved limited success, and destructive modalities have been associated with EPDS recurrence because of the tendency of the condition to recur after any treatment that induces trauma to the skin. Our group has have recently reported two series of EPDS treated with aminolevulinic acid-photodynamic therapy (ALA-PDT). Here, we aimed at comparing the protocols utilized in those series regarding efficacy, cost, and patient satisfaction. The first protocol included one visit for curettage of the hyperkeratosis and a second one for ALA-PDT. The revised (second) protocol included all procedures (curettage and ALA-PDT) in one visit. A novel silicone gel was applied immediately after completion of PDT, and patients were instructed to apply it twice daily over the treated areas until their follow-up visit. Both protocols were efficacious and provided similar length of remission. The second protocol was less costly. Patients treated using the second protocol were more satisfied due to the ease of treatment completion in one visit and better postoperative healing. (SKINmed. 2022;20:107-112).
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Affiliation(s)
- Angelica Misitzis
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | - Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College, Ujjain, India
| | - Paulo R Cunha
- Department of Dermatology, Medical School of Jundiaí, Jundiaí, São Paulo, Brazil
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
- Department of Dermatology, Medical School of Jundiaí, Jundiaí, São Paulo, Brazil
- GK Dermatology, PC, South Weymouth, MA;
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Fechine COC, Valente NYS, Romiti R. Lichen planopilaris and frontal fibrosing alopecia: review and update of diagnostic and therapeutic features. An Bras Dermatol 2022; 97:348-357. [PMID: 35379508 PMCID: PMC9133245 DOI: 10.1016/j.abd.2021.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/06/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
Lichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities.
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Affiliation(s)
| | | | - Ricardo Romiti
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
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Babalola F, Chima M, Jobarteh R, Gottlieb A. Refractory Dissecting Cellulitis of the Scalp Treated With Risankizumab. J Drugs Dermatol 2022; 21:313-314. [PMID: 35254754 DOI: 10.36849/jdd.6699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Perifolliculitis capitis abscedens et suffodiens or dissecting cellulitis (DC) is a rare and chronic disease with a predilection for the occipital, vertex, and parietal scalp. DC is characterized by multinodular lesions with purulent drainage and sinus tract formation. It is classically seen in middle-aged males of African descent. The etiology of the disease is unknown; however, leading theories suggest that stasis associated with follicular occlusion begets bacterial infection and follicular destruction with a subsequent granulomatous and neutrophilic response.1 This is supported by the suppurative nature of the disease and its association with acne conglobota, pilonidal cysts, and hidradenitis suppurativa. These conditions are thought to have a shared etiology and are also widely accepted as being due to follicular occlusion.1 The approach to treatment of DC is varied as there is no current consensus on management. We present the case of risankizumab, an IL-23 inhibitor, used to successfully treat DC. J Drugs Dermatol. 2022;21(3): doi:10.36849/JDD.6699.
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Madray VM, Kent SM, Davis LS. Aminolevulinic Acid Photodynamic Therapy-Induced Erosive Pustular Dermatosis of the Scalp. Dermatol Surg 2021; 47:1140-1142. [PMID: 33731561 DOI: 10.1097/dss.0000000000002988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- V M Madray
- Medical College of Georgia at Augusta University, Augusta, Georgia
| | - S M Kent
- Department of Dermatology at Augusta University, Augusta, Georgia
| | - L S Davis
- Department of Dermatology at Augusta University, Augusta, Georgia
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Kempers S, DuBois J, Forman S, Poon A, Cutler E, Wang H, Cutler D, Fang J, Kwan R. Tirbanibulin Ointment 1% as a Novel Treatment for Actinic Keratosis: Phase 1 and 2 Results. J Drugs Dermatol 2021; 19:1093-1100. [PMID: 33196758 DOI: 10.36849/jdd.2020.5576] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Current field-directed treatments of actinic keratosis (AK), a pre-malignant condition, are often limited by severe local reactions and/or complex treatment. Tirbanibulin, a novel potent anti-proliferative synthetic agent that inhibits tubulin polymerization and Src kinase signalling, is being developed as a convenient, safe, and effective field treatment of actinic keratosis. HYPOTHESIS A short course of tirbanibulin ointment 1% safely reduces AK lesions. METHODS In the Phase 1 study, 4 treatment cohorts with forearm lesions received tirbanibulin ointment 1% over 25 or 100 cm2 once daily for 3 or 5 days and were evaluated through day 45. In the Phase 2 study, 2 treatment cohorts with face or scalp lesions received tirbanibulin ointment 1% once daily for 3 or 5 days over 25 cm2 and were evaluated through day 57. Lesion reductions, clearance rates, safety, and pharmacokinetics were assessed. RESULTS Forearm AK lesions were reduced by day 45 in all Phase 1 cohorts (N=30). Complete AK clearance at day 57 for face/scalp AK lesions in Phase 2 cohorts (N=168) was demonstrated in 43% and 32% of participants of the 5-day and 3-day cohorts, respectively. Adverse reactions were mainly transient mild local erythema and flaking/scaling, pruritus, and pain. Tirbanibulin plasma concentrations were low or undetectable. CONCLUSION Tirbanibulin ointment 1% was well tolerated and active in AK reduction. Based on activity, the 5-day regimen was selected for Phase 3 development. Clinicaltrials.gov: NCT02337205; NCT02838628 J Drugs Dermatol. 2020;19(11):1093-1100. doi:10.36849/JDD.2020.5576THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
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Reschke R, Grunewald S, Paasch U, Averbeck M, Simon JC, Wetzig T. Erosive Pustular Dermatosis of the Scalp: Clinicopathological Correlation Leading to a Definition of Diagnostic Criteria. Wounds 2021; 33:143-146. [PMID: 33872195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Erosive pustular dermatosis of the scalp (EPDS) is frequently misdiagnosed as epithelial tumor or trauma. To the authors’ knowledge, no international guidelines or consistent recommendations for treatment of EPDS exist, and histological findings often are labeled as nonspecific. OBJECTIVE This study aimed to identify clinical and histological characteristics unique to EPDS to aid diagnosis. MATERIALS AND METHODS The biopsies of 21 patients (age range, 73–90 years) with EPDS and who were diagnosed and treated at the Department of Dermatology at University of Leipzig Medical Center and the Asklepios Medical Center, Weißenfels, Germany, were reevaluated by dermatopathologists. Results were correlated with the clinical findings and course. RESULTS Erosive pustular dermatosis of the scalp was observed in elderly patients with androgenetic alopecia and field cancerization of the capillitium; most patients had multiple comorbidities. Therapy used to treat actinic keratosis lesions (eg, imiquimod, ingenol mebutate), photodynamic therapy, cryotherapy, trauma, and surgery all were found to have predisposed for or led to EPDS. Erosive pustular dermatosis of the scalp presented clinically as exophytic crusts and pus overlying shiny granulation tissue. Histopathological findings demonstrated an ulcerated epidermis and dermal infiltrates dominated by lymphocytes together with a multitude of plasma cells. Plasma cells were found in all 21 biopsies and represented a common criterion for the correct diagnosis. The erosive lesions healed well within weeks after therapy with topical steroids. CONCLUSIONS Chronic, poorly healing lesions with crusts and pus over shiny granulation tissue on the scalp are suggestive of EPDS, which should be confirmed by biopsy. Histological clues to a diagnosis of EPDS include dermal infiltrates of plasma cells and lymphocytes. The topical application of high-potency steroids showed great effectiveness in the present study.
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Affiliation(s)
- Robin Reschke
- Department of Dermatology, University of Leipzig Medical Center, Germany
| | - Sonja Grunewald
- Department of Dermatology, University of Leipzig Medical Center, Germany
| | - Uwe Paasch
- Department of Dermatology, University of Leipzig Medical Center, Germany
| | - Marco Averbeck
- Department of Dermatology, University of Leipzig Medical Center, Germany
| | - Jan C Simon
- Department of Dermatology, University of Leipzig Medical Center, Germany
| | - Tino Wetzig
- Department of Dermatology, Dermatosurgery and Allergology, Asklepios Medical Center, Weißenfels, Germany
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Espitia O, Agard C. Scalp Necrosis in Giant Cell Arteritis. Mayo Clin Proc 2021; 96:987-988. [PMID: 33814093 DOI: 10.1016/j.mayocp.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 10/21/2022]
Affiliation(s)
- Olivier Espitia
- Department of Internal Medicine, CHU Nantes, Nantes, France.
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Subramanyam C, Wu H, Puri P, Chambers CJ, Sivamani RK. Lichen planopilaris with significant post-inflammatory pigmentary alteration. Dermatol Online J 2021; 27:13030/qt5j609387. [PMID: 33560796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023] Open
Abstract
Lichen planopilaris is an uncommon dermatological manifestation of lichen planus of the scalp and results in cicatricial alopecia. We present a patient with lichen planopilaris and significant post-inflammatory pigmentary alteration, confirmed by histopathology. The patient's case represents a clinically important variation from an expected typical pattern of dyschromia at periphery of alopecic zones in lichen planopilaris.
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Affiliation(s)
| | | | | | | | - Raja K Sivamani
- California Northstate University, Elk Grove, CA Pacific Skin Institute, Sacramento, CA, Zen Dermatology, Sacramento, CA Department of Dermatology, University of California Davis, Sacramento, CA.
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Wen Y, Yang S, Wang Y. Enlarging Alopecic Plaque on the Scalp: A Quiz. Acta Derm Venereol 2021; 101:adv00361. [PMID: 33241422 PMCID: PMC9309841 DOI: 10.2340/00015555-3706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Yujie Wen
- Department of Dermatology and Venereology, Peking University First Hospital, 100034 Beijing, China
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20
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Guo W, Zhu C, Stevens G, Silverstein D. Analyzing the Efficacy of Isotretinoin in Treating Dissecting Cellulitis: A Literature Review and Meta-Analysis. Drugs R D 2021; 21:29-37. [PMID: 33387328 PMCID: PMC7937584 DOI: 10.1007/s40268-020-00335-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Dissecting cellulitis of the scalp is a primary scarring alopecia. Isotretinoin is commonly referenced in the literature as a treatment for dissecting cellulitis. The objective of this article was to conduct a review and meta-analysis to assess the efficacy of isotretinoin for treating dissecting cellulitis of the scalp. METHODS The following databases were searched for articles prior to 23 June, 2019: PubMed, Embase, Cochrane Central, CINAHL, and Web of Science. Multi-patient studies (more than three) that reported on the administration of isotretinoin for dissecting cellulitis were included. A pooled meta-analysis for improvement of disease burden after isotretinoin administration in patients with dissecting cellulitis of the scalp was performed. A fixed-effects model was used. RESULTS Five articles were ultimately used for the quantitative meta-analysis. The overall efficacy rate of isotretinoin in treating dissecting cellulitis of the scalp was estimated to be 0.9 with a 95% confidence interval (0.81-0.97). The sensitivity analysis suggested that the overall efficacy is still very high, with a range of 0.83-0.94. Recurrence was seen in 24% (6/25) of patients. Common associated diseases amongst patients with dissecting cellulitis of the scalp were acne conglobata 20% (30/151) and hidradenitis suppurativa 19% (11/72). CONCLUSIONS Isotretinoin is an effective treatment for improving symptoms of dissecting cellulitis of the scalp. Disease recurrence is a common finding for those who undergo successful treatment.
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Affiliation(s)
- William Guo
- Renaissance School of Medicine at Stony Brook University, 1320 Stony Brook Rd., Building F, Suite 200, Stony Brook, NY, 11790, USA.
| | - Chencan Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Gregg Stevens
- Health Sciences Library at Stony Brook University, Stony Brook, NY, USA
| | - David Silverstein
- Department of Dermatology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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21
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Henkel E, Buch C, Bambekova P, Usatine RP. Itchy scalp with scale. J Fam Pract 2020; 69:523-525. [PMID: 33348349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The patient had a history of treatment for head lice, but a dermatoscopic exam revealed that lice weren't to blame for his itchy scalp.
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Affiliation(s)
- Emily Henkel
- Dell Medical School, University of Texas at Austin, USA
| | - Chirag Buch
- University of Texas Health at San Antonio, USA
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22
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Belmontesi M. Sequential Treatment of Actinic Keratosis and Photoaging by Daylight PDT and Injectable NASHA Gel as Skin Booster. J Drugs Dermatol 2020; 19:1065-1068. [PMID: 33196754 DOI: 10.36849/jdd.2020.2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Actinic keratosis (AK) is a common intraepithelial atypical proliferation of keratinocytes that might progress into invasive squamous cell carcinoma. METHOD We have tested the treatment using sequential sessions of photodynamic therapy in daylight and injectable non-animal hyaluronic acid gel skin boosters (NSBs) on 4 patients with AK on head and neck. Two further sessions of NSBs were scheduled, 30 and 60 days after the first injection, to improve the overall skin quality. RESULTS All patients showed a clinically significant improvement of the overall face skin quality, photoaging signs, and fine wrinkles; all patients were satisfied of the treatment outcome. None of the patients reported any side effect related to the treatment. DISCUSSION The combination of two minimally invasive treatments showed to be effective giving the almost complete resolution of AK and a clear improvement of skin texture, with noticeable reduction of the clinical signs of skin photoaging, meeting patient’s expectations. J Drugs Dermatol. 2020;19(11): doi:10.36849/JDD.2020.2229.
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23
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Marsh RL, Spohn GP, Kaffenberger JA. Erosive pustular dermatosis of the scalp. Dermatol Online J 2020; 26:13030/qt8ks9j8sv. [PMID: 32941728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023] Open
Abstract
Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition commonly associated with antecedent iatrogenic insult. EPDS may be diagnostically challenging owing to a lack of pathognomonic histologic findings and cutaneous manifestations that overlap with alternative dermatologic conditions. Therefore, EPDS may be more common than previously recognized. We present a 60-year-old woman with a four-year history of non-healing scalp erosions, progressive skin atrophy, and scarring alopecia despite intravenous antibiotics and intraoperative debridement who improved with systemic glucocorticoids. Our report emphasizes the importance of early recognition of EPDS when delayed wound healing and erosive disease occur in the setting of iatrogenic injury to the scalp. Timely treatment with systemic anti-inflammatory agents is paramount to prevent cicatricial alopecia and mitigate further scalp insult in EPDS.
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Affiliation(s)
| | | | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
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24
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Petersen B, Lebwohl M. Treating Scalp Psoriasis with Calcipotriene/Betamethasone Dipropionate Fixed-dose Combination Cutaneous Foam: Review of Phase 2 Data. J Drugs Dermatol 2020. [PMID: 32820879 DOI: 10.36849/jdd.2020.5168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Two Phase 2 studies investigated the effect of a fixed-dose combination foam containing calcipotriene monohydrate (Cal) and betamethasone dipropionate (BD) on scalp psoriasis in adult and adolescent patients. Patients had psoriasis classified as at least 'mild' per PGA. NCT01536938 enrolled adult patients (≥18 years) randomized 1:1:1 to once-daily (QD) Cal/BD foam (Cal 0.005%, BD 0.064%), Cal foam (0.005%) or BD foam (0.064%). NCT02387853 enrolled adolescent patients (12- <17 years) to Cal/BD foam QD (dose as previously). Treatment success was based on improvement in PGA classification at week 4. Additional efficacy endpoints included mPASI in adults and effect on extent of scalp surface area (SSA) in adolescents. Safety was also assessed. Overall, 302 adults (n=100 Cal/BD foam; n=101 Cal foam; n=101 BD foam) and 106 adolescents received treatment. Treatment success in adults was significantly higher with Cal/BD vs Cal foam (53.0% vs 35.6%, P=0.021) and numerically higher than with BD foam (47.5%, P=0.45). Mean percentage changes in mPASI were -80.0%, -57.8% and -71.2%, for Cal/BD, Cal and BD foam, respectively. In adolescents, 73.6% of patients treated with Cal/BD foam achieved treatment success and mean SSA fell from 50.6% at baseline to 12.5% at week 4. All treatment-related AEs were considered mild-to-moderate across both studies, except one severe AE (hypersensitivity reaction with urticaria) in the adult Cal/BD foam group, which led to withdrawal from the study. In these studies, treatment of scalp psoriasis with Cal/BD foam provided good efficacy for adults and adolescents and was generally well tolerated. J Drugs Dermatol. 2020;19(8): doi:10.36849/JDD.2020.5168.
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25
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Friedman AJ, Momeni K, Kogan M. Topical Cannabinoids for the Management of Psoriasis Vulgaris: Report of a Case and Review of the Literature. J Drugs Dermatol 2020; 19:795. [PMID: 32845594 DOI: 10.36849/jdd.2020.5229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Wright TA. Spinosad: A Low-Risk, Effective Treatment for Lice. Am Fam Physician 2019; 100:601. [PMID: 31730321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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27
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Affiliation(s)
- Gloria Orlando
- Unit of Dermatology, Department of Medicine - DIMED, University of Padova, Via Gallucci 4, IT-35121 Padova, Italy.
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28
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Steadman L, Hrynewycz K, Grove DC, Haggstrom A. Seborrhea herpeticum: cutaneous herpes simplex virus infection within infantile seborrheic dermatitis. Cutis 2019; 104:295-296. [PMID: 31886781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Eczema herpeticum has been well described in the setting of atopic dermatitis (AD) and other dermatoses. We present the case of a 2-month-old infant boy with cutaneous herpes simplex virus (HSV) infection within existing diffuse infantile seborrheic dermatitis. Providers should be aware that cutaneous HSV can be confined to a seborrheic distribution and may represent underlying epidermal dysfunction secondary to seborrheic dermatitis.
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Affiliation(s)
| | - Katherine Hrynewycz
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
| | - Daniel C Grove
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
| | - Anita Haggstrom
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
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Tortelly VD, De Mattos T, Fernandes LSDA, Nunes BEM, Melo DF. Low-dose naltrexone: a novel adjunctive treatment in symptomatic alopecias? Dermatol Online J 2019; 25:13030/qt6j45h81f. [PMID: 31553867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023] Open
Abstract
Naltrexone is a competitive antagonist of μ, κ and γ opioid receptors, used for treatment of alcoholism and opioid addiction. Low-dose naltrexone (LDN) is defined as daily doses ranging from 1mg to 5mg. This is purported to have a paradoxical effect that leads to an increase in endogenous opioids, including beta-endorphins, which have anti-inflammatory properties. Theses mechanisms may also justify their possible role in the treatment of inflammatory conditions. The aim of this article is to discuss the use of LDN as an adjuvant therapeutic option in symptomatic alopecias presenting with trichodynia. Trichodynia is defined as scalp discomfort of variable intensity presenting as diffuse or localized dysesthesia and may be described by patients as pain, pruritus, or burning. These are common symptoms in patients with hair loss that negatively impacts quality of life. Scalp discomfort may be refractory to conventional therapies and does not yet have a specific therapeutic guideline. For these cases, LDN would be a possible alternative to be added to the therapeutic arsenal owing to its anti-inflammatory properties, analgesic potential, low cost, and few adverse effects described. Further studies are needed to standardize dosing, better understand its mechanism of action, and evaluate its potential therapeutic indications.
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Affiliation(s)
- Violeta Duarte Tortelly
- Departament of Dermatology, Marcilio Dias Naval Hospital Rio de Janeiro - Rio de Janeiro Departament of Dermatology, Pedro Ernesto Universitary Hospital, University of the State of Rio de Janeiro - UERJ Rio de Janeiro - Rio de Janeiro.
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30
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Gameiro L, Tovo LFR, Sanches Júnior JA, Aprahamian I. Treatment of actinic keratoses and cancerization field of the face and scalp with 0.015% ingenol mebutate gel in Brazilian individuals: safety, tolerability and patients' perspectives. An Bras Dermatol 2019; 94:313-319. [PMID: 31365660 PMCID: PMC6668952 DOI: 10.1590/abd1806-4841.20197938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/25/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Actinic keratosis (AK) represents a risk of progression to squamous cell carcinoma. Ingenol mebutate gel is a novel therapeutic option for field-directed treatment. OBJECTIVES To evaluate the safety, tolerability and patients' perspectives, related to the therapeutic success of managing AKs on the face and scalp with ingenol mebutate gel in Brazilian individuals. METHODS This was an observational, retrospective and descriptive study of 68 areas of actinic keratosis on the face and scalp treated with Ingenol mebutate gel involving a total of 37 patients. The drug was applied for three consecutive days on an area of of 25 cm2 and documentation was performed on baseline and days 4, 8, 15, 60 and 180. On day 4, the composite local skin reaction score was calculated. At the end, a questionnaire was applied to evaluate patients' perspectives about the treatment. RESULTS Adherence was 100%, no serious adverse events were recorded and the mean composite local skin reaction score (standard deviation) was 8.61±4.22. The treatment was considered optimum by 75.68% of the patients. STUDY LIMITATIONS Calculation of composite local skin reaction score performed only on the fourth day. CONCLUSIONS Treatment with ingenol mebutate gel was considered safe and tolerable in Brazilian subjects. Patients had a maximum adherence rate and a great improvement in self-esteem. The results of this research reproduce the findings of the literature.
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Affiliation(s)
- Luiz Gameiro
- Department of Internal Medicine, Faculdade de Medicina de
Jundiaí, Jundiaí (SP), Brazil
| | | | | | - Ivan Aprahamian
- Department of Internal Medicine, Faculdade de Medicina de
Jundiaí, Jundiaí (SP), Brazil
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31
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Nagata M, Kamata M, Ohtsuki M, Sato S, Tada Y. Scalp psoriasis in a haemodialysis patient successfully treated with a half-dose of apremilast. Eur J Dermatol 2019; 29:341-342. [PMID: 31389793 DOI: 10.1684/ejd.2019.3588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mayumi Nagata
- Department of Dermatology, Teikyo University School of Medicine, Tokyo,, Department of Dermatology, Sanno Hospital, Tokyo
| | - Masahiro Kamata
- Department of Dermatology, Teikyo University School of Medicine, Tokyo
| | - Mamitaro Ohtsuki
- Department of Dermatology, Sanno Hospital, Tokyo,, Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Sayuri Sato
- Department of Dermatology, Sanno Hospital, Tokyo
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo
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Faccini-Martínez ÁA, Echazarreta S, Fernández M, Cortés T, de Mayorga Muñoz ED, Orduna T. Scalp eschar and neck lymphadenopathy after tick bite in Argentina. Infez Med 2019; 27:183-186. [PMID: 31205043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Scalp eschar and neck lymphadenopathy after a tick bite (SENLAT) is an emerging non-pathogen-specific syndrome characterized by scalp eschar and occipital and/or cervical lymph node enlargement following a tick bite. We report a case of SENLAT syndrome in an Argentinian patient after exposure to ticks during outdoor work in the Paraná River Delta region.
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Affiliation(s)
- Álvaro A Faccini-Martínez
- Postgraduate Program in Infectious Diseases, Health Science Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil; Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología, Bogotá, Colombia
| | - Sofía Echazarreta
- Argentinian Municipal Center of Regional Pathology and Tropical Medicine (CEMPRA-MT), Hospital F. J. Muñiz, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Marisa Fernández
- Argentinian Municipal Center of Regional Pathology and Tropical Medicine (CEMPRA-MT), Hospital F. J. Muñiz, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Tatiana Cortés
- Hospital F. J. Muñiz, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | | | - Tomás Orduna
- Argentinian Municipal Center of Regional Pathology and Tropical Medicine (CEMPRA-MT), Hospital F. J. Muñiz, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
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Jansen MHE, Kessels JPHM, Nelemans PJ, Kouloubis N, Arits AHMM, van Pelt HPA, Quaedvlieg PJF, Essers BAB, Steijlen PM, Kelleners-Smeets NWJ, Mosterd K. Randomized Trial of Four Treatment Approaches for Actinic Keratosis. N Engl J Med 2019; 380:935-946. [PMID: 30855743 DOI: 10.1056/nejmoa1811850] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Actinic keratosis is the most frequent premalignant skin disease in the white population. In current guidelines, no clear recommendations are made about which treatment is preferred. METHODS We investigated the effectiveness of four frequently used field-directed treatments (for multiple lesions in a continuous area). Patients with a clinical diagnosis of five or more actinic keratosis lesions on the head, involving one continuous area of 25 to 100 cm2, were enrolled at four Dutch hospitals. Patients were randomly assigned to treatment with 5% fluorouracil cream, 5% imiquimod cream, methyl aminolevulinate photodynamic therapy (MAL-PDT), or 0.015% ingenol mebutate gel. The primary outcome was the proportion of patients with a reduction of 75% or more in the number of actinic keratosis lesions from baseline to 12 months after the end of treatment. Both a modified intention-to-treat analysis and a per-protocol analysis were performed. RESULTS A total of 624 patients were included from November 2014 through March 2017. At 12 months after the end of treatment, the cumulative probability of remaining free from treatment failure was significantly higher among patients who received fluorouracil (74.7%; 95% confidence interval [CI], 66.8 to 81.0) than among those who received imiquimod (53.9%; 95% CI, 45.4 to 61.6), MAL-PDT (37.7%; 95% CI, 30.0 to 45.3), or ingenol mebutate (28.9%; 95% CI, 21.8 to 36.3). As compared with fluorouracil, the hazard ratio for treatment failure was 2.03 (95% CI, 1.36 to 3.04) with imiquimod, 2.73 (95% CI, 1.87 to 3.99) with MAL-PDT, and 3.33 (95% CI, 2.29 to 4.85) with ingenol mebutate (P≤0.001 for all comparisons). No unexpected toxic effects were documented. CONCLUSIONS At 12 months after the end of treatment in patients with multiple actinic keratosis lesions on the head, 5% fluorouracil cream was the most effective of four field-directed treatments. (Funded by the Netherlands Organization for Health Research and Development; ClinicalTrials.gov number, NCT02281682.).
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Affiliation(s)
- Maud H E Jansen
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Janneke P H M Kessels
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Patty J Nelemans
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Nina Kouloubis
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Aimee H M M Arits
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Han P A van Pelt
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Patricia J F Quaedvlieg
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Brigitte A B Essers
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Peter M Steijlen
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Nicole W J Kelleners-Smeets
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
| | - Klara Mosterd
- From the Departments of Dermatology (M.H.E.J., J.P.H.M.K., N.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and Clinical Epidemiology and Medical Technology Assessment (B.A.B.E.), Maastricht University Medical Center, and the GROW School for Oncology and Developmental Biology (M.H.E.J., J.P.H.M.K., A.H.M.M.A., P.M.S., N.W.J.K.-S., K.M.) and the Department of Epidemiology (P.J.N.), Maastricht University, Maastricht, the Department of Dermatology, Zuyderland Medical Center, Heerlen (J.P.H.M.K., P.J.F.Q.), the Department of Dermatology, Catharina Hospital, Eindhoven (A.H.M.M.A., P.M.S.), and the Department of Dermatology, VieCuri Medical Center, Venlo (H.P.A.P.) - all in the Netherlands
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Sjerobabski Masnec I, Franceschi N. Perifolliculitis Capitis Abscedens et Suffodiens Treated with Anti-tumor Necrosis Factor-alpha - Possible New Treatment Option. Acta Dermatovenerol Croat 2018; 26:255-289. [PMID: 30390728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The case of a 26-year-old male patient with perifolliculitis capitis abscedens et suffodiens (PCAS) who later developed hidradenitis suppurativa (HS) and exacerbation of acne is presented. The patient did not respond well to conventional treatment including isotretinoin and oral antibiotics. Quality of life was significantly impaired. After introduction of anti-tumor necrosis factor-alpha (TNF-α) treatment, the patient's clinical picture improved dramatically and quality of life increased. The treatment has been well tolerated by the patient for 15 months at time of writing this report.
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Affiliation(s)
- Ines Sjerobabski Masnec
- Ines Sjerobabski Masnec, MD, Department of Dermatology and Venereology, Sestre milosrdnice University Hospital Center , Vinogradska 29, 10000 Zagreb , Croatia;
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Mattessich S, Aubert P, Rees A. Bilateral brown plaques behind the ears. Cutis 2018; 102:E1-E3. [PMID: 30489562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Sarah Mattessich
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Pamela Aubert
- Department of Dermatology, Kaiser Permanente Panorama City Medical Center, California, USA
| | - Adam Rees
- Department of Dermatology, Kaiser Permanente Panorama City Medical Center, California, USA
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Veraldi S, Pontini P, Nazzaro G. Phthirus pubis Infestation of the Scalp: A Case Report and Review of The Literature. Korean J Parasitol 2018; 56:487-489. [PMID: 30419734 PMCID: PMC6243192 DOI: 10.3347/kjp.2018.56.5.487] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/27/2018] [Accepted: 10/02/2018] [Indexed: 12/18/2022]
Abstract
Phthirus pubis usually infests the pubis, groin, buttocks and perianal region. It can sometimes infest the thighs, abdomen, chest, axillae and beard. Eyelashes and eyebrows may be involved in children. The involvement of the scalp is very rare. We describe a case of P. pubis infestation located exclusively on the scalp in an adult woman. Neither lice/nits nor skin lesions were observed elsewhere, including eyebrows, eyelashes, axillae, pubis, buttocks and perianal region (the patient was hairless in the axillae and pubis). A review of the literature is enclosed.
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Affiliation(s)
- Stefano Veraldi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Pontini
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Din RS, Tsiaras WG, Mostaghimi A. Two Cases of Severe Erosive Pustular Dermatosis Mimicking Infection. Wounds 2018; 30:E84-E86. [PMID: 30212368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Erosive pustular dermatosis of the scalp (EPDS) is a noninfectious inflammatory disorder characterized by pustules, erosions, ulcerations, and crusted erythematous plaques that is often associated with mechanical or chemical trauma. While its appearance may mimic infection, its etiology is thought to have an autoimmune component based on responsiveness to immunomodulators. CASE REPORT Herein, the authors present 2 cases of EPDS that were initially treated as primary infections. In both cases, the wounds did not respond to antimicrobial treatment and led to severe ulceration, exposing cranial bone. Both wounds improved with topical corticosteroid therapy. CONCLUSIONS These cases represent the importance of considering topical steroid treatment and a diagnosis of EPDS after debridement for purulent scalp ulcers.
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Affiliation(s)
- Ryan S Din
- Brigham and Women's Hospital, Boston, MA
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38
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Shah VV, Lee EB, Reddy SP, Wu JJ. Scalp psoriasis with increased hair density. Cutis 2018; 102:63-64. [PMID: 30138498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Psoriasis is a chronic autoimmune skin disease that commonly affects the scalp. Psoriatic lesions on the scalp typically result in alopecia, possibly due to a higher proportion of hairs in the catagen and telogen stages. Involvement of the scalp in psoriasis can be problematic for the patient's quality of life as well as the clinician treating the condition. Here, we present an unusual case of scalp psoriasis presenting with increased hair density in the involved area that was resistant to topical steroids.
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Affiliation(s)
- Vidhi V Shah
- University of Missouri-Kansas City School of Medicine, USA
| | - Erica B Lee
- John A. Burns School of Medicine, University of Hawaii, Honolulu, USA
| | - Shivani P Reddy
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, California, USA
| | - Jashin J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, California, USA
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Kosumi H, Izumi K, Natsuga K, Yamaguchi Y, Itami A, Shimizu H. Cutis Verticis Gyrata Fluctuation with Atopic Dermatitis Disease Activity. Acta Derm Venereol 2017; 97:1245-1246. [PMID: 28681061 DOI: 10.2340/00015555-2750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hideyuki Kosumi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan
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Strazzulla LC, Avila L, Lo Sicco K, Shapiro J. Novel Treatment Using Low-Dose Naltrexone for Lichen Planopilaris. J Drugs Dermatol 2017; 16:1140-1142. [PMID: 29141063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
<p>Lichen planopilaris (LPP) is a variant of lichen planus that affects the scalp causing scarring hair loss. Patients also frequently experience symptoms of scalp itch, pain, and burning. To date, there are no long-term remittive nor curative therapies available. Low-dose naltrexone has anti-inflammatory properties and has recently been described in the context of treating autoimmune conditions. This retrospective medical record review describes four LPP patients treated with low-dose (3 milligrams per day) naltrexone. This medication provided benefit in these four patients including reduction in symptoms of pruritus, clinical evidence of inflammation of the scalp, and disease progression. All patients tolerated naltrexone without adverse effects. This is the first case series demonstrating the beneficial effects of low-dose naltrexone for patients with LPP. This medication was well-tolerated by the patients and is cost-effective.</p> <p><em>J Drugs Dermatol. 2017;16(11):1140-1142.</em></p>.
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41
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Cizenski JD, Farah RS. Atypical fibroxanthoma arising within erosive pustular dermatosis of the scalp. Cutis 2017; 100:E14-E16. [PMID: 29121139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We describe a painful atypical fibroxanthoma (AFX) arising in a setting of erosive pustular dermatosis of the scalp. Complete excision was curative and also was associated with resolution of pain and clearance of the erosive pustular dermatosis of the scalp. We review the diagnosis and management of AFX and discuss the role of actinic damage in this process.
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Affiliation(s)
- Jeffrey D Cizenski
- Department of Dermatology, Upstate Medical University, Syracuse, New York, USA
| | - Ramsay S Farah
- Department of Dermatology, Upstate Medical University, Syracuse, New York, USA
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Schaarschmidt ML, Schlich M, Staub J, Schmieder A, Goerdt S, Peitsch WK. Lupus Miliaris Disseminatus Faciei: Not Only a Facial Dermatosis. Acta Derm Venereol 2017; 97:655-656. [PMID: 28119995 DOI: 10.2340/00015555-2616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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López Estebaranz JL, Pampín Franco A, Gamo Villegas R, Floristán U. Monitoring Ingenol Mebutate Gel Treatment of Actinic Keratoses by Reflectance Confocal Microscopy. Acta Derm Venereol 2017; 97:646-648. [PMID: 28093603 DOI: 10.2340/00015555-2607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nau JY. [Not Available]. Rev Med Suisse 2017; 13:874-875. [PMID: 28727348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Affiliation(s)
- Su-Kyung Park
- Department of Dermatology, Chonbuk National University Medical School, 20, Geonji-ro(Geumam-dong), Deokjin-gu, Jeonju, 54907, Korea
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Al-Raddadi R, Frances C, Moguelet P, Bachmeyer C, Guégan S. Ustekinumab as Effective Treatment for Refractory Amicrobial Pustulosis of the Folds Associated with Crohn's Disease. Acta Derm Venereol 2017; 97:389-390. [PMID: 27722763 DOI: 10.2340/00015555-2544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Reem Al-Raddadi
- Service de dermatologie-allergologie, Hôpital Tenon, AP-HP, 4, rue de la Chine, FR-75020 Paris, France
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Yanes DA, Kaffenberger JA, Carr DR. Erythema multiforme as a reaction to imiquimod 5% cream. Dermatol Online J 2017; 23:13030/qt0r2992mq. [PMID: 28329504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023] Open
Abstract
We describe a patient with erythema multiformefollowing a local site reaction after the use of topicalimiquimod 5% cream and review the literature forprevious reports of this cutaneous adverse effect.
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Affiliation(s)
- Daniel A Yanes
- College of Medicine, The Ohio State University, Columbus
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48
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Shokeen D. Update on new drugs in dermatology. Cutis 2016; 98:E26-E27. [PMID: 28040823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Medications in dermatology are used in a variety of different methods and dosages and for numerous different diseases entities that are not approved by the US Food and Drug Administration (FDA); however, there are medications that have only recently hit the market that require our attention, as they are either FDA approved for the intended dermatologic use or could be effective in treating conditions that previously have been poorly managed.
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Affiliation(s)
- Divya Shokeen
- Department of Dermatology, University of Florida, Gainesville, USA
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49
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Zargari O, Aghazadeh N, Moeineddin F. Clinical applications of topical ivermectin in dermatology. Dermatol Online J 2016; 22:13030/qt1kq4p7pp. [PMID: 28329606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023] Open
Abstract
Ivermectin (IVM) is a broad-spectrum anti-parasitic drug with significant anti-inflammatory properties. The emergence of treatment resistance to lindane, permethrin, and possibly malathion complicates the global strategy for management of common parasitic skin diseases such as scabies and head lice. In this regard. IVM has been safely and effectively used in the treatment of these common human infestations. In addition, IVM may be useful in inflammatory cutaneous disorders such as papulopustular rosacea where demodex may play a role in pathogenesis. Herein, we review the current applications of topical IVM in dermatology.
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Affiliation(s)
| | - Nessa Aghazadeh
- Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran.
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50
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Fan W, Zhang Q, Song L. An unusual case of folliculitis spinulosa decalvans. Cutis 2016; 98:175-178. [PMID: 27814407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report the case of a 24-year-old man who presented with pustules, atrophic scars, and alopecia on the scalp, along with follicular keratotic papules on the cheeks, chest, abdomen, back, lateral upper arms, thighs, and axillae, of 6 years' duration. A diagnosis of folliculitis spinulosa decalvans (FSD) was made based on the clinical manifestation and histopathological findings. Dental examination also revealed dental anomalies and a fissured tongue, which are not known to be related to FSD. We provide an overview of the characteristic findings of FSD as well as a review of previously reported cases.
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Affiliation(s)
- Wenge Fan
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, Jiangsu Province, People's Republic of China
| | - Qingsong Zhang
- Department of Dermatology, Traditional Chinese Medical Hospital of Changshu City, China
| | - Linyi Song
- Department of Dermatology, The First Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China
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