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Thalidomide for necrobiotic xanthogranuloma. Clin Exp Dermatol 2021; 47:769-770. [PMID: 34856016 DOI: 10.1111/ced.15047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
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2
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Topical timolol in dermatology: infantile hemangiomas and beyond. Clin Exp Dermatol 2021; 47:819-832. [PMID: 34798680 DOI: 10.1111/ced.15021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/16/2021] [Indexed: 12/01/2022]
Abstract
Timolol, a non-selective β-adrenergic receptor blocker, is well-tolerated and is becoming increasingly popular in dermatology especially after its use in the management of infantile hemangiomas. Its effects are mainly due to vasoconstriction, inhibition of angiogenesis and keratinocyte migration promotion for re-epithelialization and wound healing. We review the evidence behind the use of timolol in several dermatological conditions including infantile hemangiomas, pyogenic granulomas, Kaposi's sarcoma, chronic wound healing, post-surgical wounds, acne vulgaris, rosacea, eczema and red scrotum syndrome.
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3
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Mitigating the risks of surgical smoke: positive pressure rooms and particulate air filters. Clin Exp Dermatol 2021; 47:428. [PMID: 34626434 DOI: 10.1111/ced.14971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
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4
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Novel treatments for keloid scars. Clin Exp Dermatol 2021; 47:457-458. [PMID: 34551142 DOI: 10.1111/ced.14942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/27/2022]
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5
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Delaying dermatological procedural interventions in the context of isotretinoin use: is there a shift in the consensus? Clin Exp Dermatol 2021; 47:240-241. [PMID: 34546575 DOI: 10.1111/ced.14843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
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6
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Exploring the implications of the first COVID-19 lockdown on patients with melanoma: a national survey. Clin Exp Dermatol 2021; 47:114-116. [PMID: 34236708 PMCID: PMC8444712 DOI: 10.1111/ced.14840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
The impact of the COVID‐19 pandemic upon care of malignant melanoma (MM) remains as yet poorly understood. We undertook a UK‐wide national survey, in conjunction with a patient support group (Melanoma UK), to explore patient perceptions of the impact of the pandemic upon treatment and outpatient care of their MM. Our findings suggest that following the onset of COVID‐19, a significant minority of treatments and appointments have been delayed, there has been a shift from face‐to‐face to virtual outpatient consultations and there may be a rise in psychological comorbidities in patients with MM. We would urge clinicians to consider mental health interventions as part of a holistic care package.
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7
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Screen light and the skin. Clin Exp Dermatol 2021; 46:934-935. [PMID: 33547663 DOI: 10.1111/ced.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 11/29/2022]
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Abstract
Systemic photoprotection aims to negate the negative effects of ultraviolet radiation-induced DNA damage. Systemic supplements may be used as a monotherapy or in combination with topical sunscreens. Using the keywords 'carotenoids', 'flavonoids', 'systemic photoprotection', 'polyphenols' and 'polypodium leucotomos extract', we searched the databases MEDLINE and EMBASE to find relevant English-language articles. Few trials have supported the use of any of these supplements as monotherapy, impeding the recommendation of these systemic supplements as an alternative to sunscreen for photoprotection. Nicotinamide has exhibited clinically relevant benefits in reducing nonmelanoma skin cancers in trials and could be recommended as an adjunctive therapy for the most vulnerable indviduals. Further research is required, which needs to be of higher statistical power, using more clinically meaningful outcome measures with comparison to the current gold standard of care (topical photoprotection) to support the use of alternative therapies in clinical practice.
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Mohs micrographic surgery outcomes following virtual consultations during the COVID-19 pandemic. Clin Exp Dermatol 2021; 46:1311-1312. [PMID: 33864397 PMCID: PMC8250692 DOI: 10.1111/ced.14678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
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10
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Utility of immunology, microbiology, and helminth investigations in clinical assessment of severe asthma. J Asthma 2021; 59:541-551. [PMID: 33356678 DOI: 10.1080/02770903.2020.1868496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Systematic assessment of patients with potential severe asthma is key to identification of treatable traits and optimal management. Assessment of antimicrobial immune function is part of that assessment at many centers although there is little evidence-base on its added value in clinical assessment of this patient group. As part of reviewing our local pathway, we have retrospectively reviewed these tests in 327 consecutive referrals to our severe asthma service, in an evaluation to describe the utility of these tests and allow refinement of the local guideline for patient assessment. METHODS AND RESULTS Serum immunoglobulin concentrations were in the normal range in most patients though 12 patients had serum IgG < 5.5 g/L and many had suboptimal anti-Haemophilus (127 of 249 patients tested) and anti-Pneumococcal (111 of 239) immune responses. As expected many patients had evidence of sensitization to Aspergillus although specific IgG was not confined to those with evidence of allergic sensitization/allergic bronchopulmonary aspergillosis (ABPA). Eighteen of 277 patients tested had serological evidence of Strongyloides infection. Bacteria and/or yeast were cultured from the sputum in 76 out of 110 patients productive of sputum, and the most common microbes cultured were Candida sp. (44 patients), Staphylococcus aureus (21 patients), Haemophilus influenzae (18 patients). CONCLUSIONS Many patients had evidence of infection, colonization, or sensitization to potential pathogens relevant to asthma. Strongyloides infection was evident in several patients, which may be a major issue when considering the risk of hyper-infection following immunosuppression and supports our local screening strategy.
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11
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Vitiligo: an update on systemic treatments. Clin Exp Dermatol 2020; 46:248-258. [PMID: 33350506 DOI: 10.1111/ced.14435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022]
Abstract
Vitiligo is an autoimmune skin condition characterized by depigmented macules and patches, and has a huge psychosocial impact on patients. Treatment of vitiligo aims to prevent the spread of disease and facilitate repigmentation of affected lesions. The mainstay of treatment for unstable vitiligo has been topical agents (corticosteroids, calcineurin inhibitors) and phototherapy. However, systemic treatments are increasingly being shown to have a significant impact on the course of the disease as monotherapy or adjunctive therapy. Of note, oral mini-pulsed corticosteroid therapy, methotrexate, minocycline, ciclosporin, Janus kinase inhibitors and certain supplements have been used in the systemic treatment of vitiligo. We review the underlying evidence supporting the use of each of these systemic treatments.
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12
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Visible light and hyperpigmentation: the invisible culprit. Clin Exp Dermatol 2020; 46:995-997. [PMID: 33340156 DOI: 10.1111/ced.14437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/09/2020] [Indexed: 11/29/2022]
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13
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Hydroquinone: myths and reality. Clin Exp Dermatol 2020; 46:636-640. [PMID: 33159818 DOI: 10.1111/ced.14480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 11/28/2022]
Abstract
Hydroquinone has pharmacological uses in disorders of pigmentation because of its ability to competitively inhibit the enzyme tyrosinase. Our contemporary review presents the strongest evidence supporting the use of hydroquinone with the most effective and tolerable formulations combining hydroquinone, retinoid and corticosteroid (modified Kligman formula or 'triple combination cream'). The risk of exogenous ochronosis is low if prescribed concentrations of ≤ 5 for a limited period with regular monitoring. Dermatologists should reassure patients that with controlled use, hydroquinone can be well-tolerated and safe for a range of hyperpigmentary conditions.
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14
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The advent of artificial intelligence for the identification of skin lesions. Clin Exp Dermatol 2020; 46:413-415. [PMID: 33145783 DOI: 10.1111/ced.14405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/28/2022]
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15
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Refining the management of hyperpigmentary disorders. Clin Exp Dermatol 2020; 45:1063. [PMID: 32356613 DOI: 10.1111/ced.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
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16
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Patient perceptions of Mohs micrographic surgery during the COVID-19 pandemic and lessons for the next outbreak. Clin Exp Dermatol 2020; 46:179-180. [PMID: 32803789 PMCID: PMC7460918 DOI: 10.1111/ced.14423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
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17
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Spironolactone in dermatology: uses in acne and beyond. Clin Exp Dermatol 2020; 45:986-993. [PMID: 32844462 DOI: 10.1111/ced.14340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2020] [Indexed: 11/28/2022]
Abstract
Spironolactone is a synthetic aldosterone receptor antagonist, with a role off-label in various dermatological conditions. Its antiandrogenic properties make it suitable for diseases in which excess androgen production results in unwanted and psychologically distressing manifestations in susceptible females. Treatment with spironolactone aims to attenuate androgen-mediated conditions including acne, hidradenitis suppurativa, female pattern hair loss and hirsutism. We discuss the emerging utility of spironolactone in dermatology, its potential adverse effects and considerations for monitoring.
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Surgical plume in dermatology: an insidious and often overlooked hazard. Clin Exp Dermatol 2020; 45:841-847. [PMID: 32780880 PMCID: PMC7436401 DOI: 10.1111/ced.14350] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/05/2020] [Indexed: 02/06/2023]
Abstract
Dermatologists performing surgical procedures face occupational and health hazards when exposed to surgical plume released during electrosurgical and ablative laser procedures. These hazardous fumes have toxic, infectious and carcinogenic effects. Understanding this risk is of particular importance during the COVID-19 pandemic as the understanding of the transmissibility and infectious nature of the virus is still evolving rapidly. In this article, we present the hazards from laser and surgical plumes, and discuss possible preventative measures aimed at reducing these risks.
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Impact of COVID-19 on Mohs micrographic surgery: UK-wide survey and recommendations for practice. Clin Exp Dermatol 2020; 45:901-902. [PMID: 32593224 PMCID: PMC7361858 DOI: 10.1111/ced.14356] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 11/29/2022]
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20
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Dermatological insights from Google Trends: what does the public think is important during COVID-19 lockdown? Clin Exp Dermatol 2020; 45:898-900. [PMID: 32491254 PMCID: PMC7300990 DOI: 10.1111/ced.14319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2020] [Indexed: 11/30/2022]
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21
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Comparison of efficacy of field treatments for actinic keratoses. Clin Exp Dermatol 2020; 45:938-940. [PMID: 32588913 DOI: 10.1111/ced.14316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
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22
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Identification of factors affecting the outcome of General Anaesthetic Allergy Testing. Clin Exp Allergy 2020; 50:977-980. [PMID: 32484979 DOI: 10.1111/cea.13674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/06/2020] [Accepted: 05/17/2020] [Indexed: 11/26/2022]
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23
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Secure communication conduits during COVID-19 lockdown. Clin Exp Dermatol 2020; 45:748-749. [PMID: 32302418 PMCID: PMC7264547 DOI: 10.1111/ced.14244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 11/26/2022]
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24
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How dermatology will change in the post-COVID-19 ('POST-CORONA') era. Clin Exp Dermatol 2020; 45:764-765. [PMID: 32394512 PMCID: PMC9213899 DOI: 10.1111/ced.14280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/01/2022]
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26
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Allergen Immunotherapy in the Era of SARS-CoV-2. J Investig Allergol Clin Immunol 2020; 30:459-461. [PMID: 32394897 DOI: 10.18176/jiaci.0568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The emerging importance of tranexamic acid in dermatology. Clin Exp Dermatol 2019; 45:445-449. [PMID: 31663643 DOI: 10.1111/ced.14115] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 01/19/2023]
Abstract
Tranexamic acid (TA) is an antifibrinolytic agent, increasingly recognized as being of utility for a wide variety of skin diseases. We review the evidence supporting the use of TA for a range of dermatological indications, including (among others) melasma, postinflammatory hyperpigmentation, urticaria, angio-oedema and haemostasis, in addition to practical considerations of its use by dermatologists.
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Oral tranexamic acid for the treatment of melasma. Clin Exp Dermatol 2018; 44:347-349. [PMID: 30484898 DOI: 10.1111/ced.13831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2018] [Indexed: 01/19/2023]
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29
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Intravenous immunoglobulins in dermatology. Part 1: biological mechanisms and methods of administration. Clin Exp Dermatol 2018; 43:513-517. [PMID: 29774583 DOI: 10.1111/ced.13553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2017] [Indexed: 11/30/2022]
Abstract
Intravenous immunoglobulin (IVIg) is a solution of human IgG, salt, sugars and solvents, which is used to treat a multitude of diseases. Although IVIg has been known to treat many diseases safely and successfully, there are relatively few supporting randomized controlled trials. In this article, we review the biological mechanisms of IVIg in dermatological disorders and the practicalities of its use, including its mechanism of action, dosing, availability, costs and adverse effects.
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Intravenous immunoglobulins in dermatology. Part 2: clinical indications and outcomes. Clin Exp Dermatol 2018; 43:659-666. [PMID: 29774587 DOI: 10.1111/ced.13552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 11/29/2022]
Abstract
Intravenous immunoglobulin (IVIg) is a solution of human IgG, salt, sugars and solvents used to treat a multitude of diseases. Although IVIg has been known to treat many diseases safely and successfully, there are relatively few supporting randomized controlled trials. In part two of this review, we assess the clinical indications of IVIg in dermatological disorders and the outcomes of its use.
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Treatment of keloid scars using light-, laser- and energy-based devices: a contemporary review of the literature. Lasers Med Sci 2017; 32:2145-2154. [PMID: 29047002 DOI: 10.1007/s10103-017-2332-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 09/19/2017] [Indexed: 01/28/2023]
Abstract
Keloid scars are common and have a predilection for young, ethnic skin often with a family history. Keloids can be painful and pruritic and cause significant emotional distress when particularly visible or prominent. In this article, we review the evidence underlying the use of laser- and energy-based devices for treatment of keloid scars, either as monotherapy or in conjunction with other therapies such as corticosteroids, surgery and silicone gel in the treatment of keloid scars.
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32
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Integration of reflectance confocal microscopy into clinical practice for the management of lentigo maligna. Clin Exp Dermatol 2017; 42:593-595. [PMID: 28556434 DOI: 10.1111/ced.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 11/30/2022]
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33
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Patient satisfaction and the waiting room in Mohs surgery: appropriate prewarning may abrogate boredom. J Eur Acad Dermatol Venereol 2017; 31:e337-e338. [PMID: 28107578 DOI: 10.1111/jdv.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Nicotinamide (niacinamide) is the water-soluble, amide form of vitamin B3. We review the evidence underlying the use of nicotinamide for various dermatological indications, including nonmelanoma cancer prophylaxis, blistering disorders, acne vulgaris and cosmetic indications, and speculate upon its future role in dermatological practice.
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M8 Asthma management in an inner-city teaching hospital emergency department: real-life after national review of asthma deaths (NRAD). Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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Paradoxical exacerbation of chronic plaque psoriasis by sorafenib. Clin Exp Dermatol 2015; 41:407-9. [PMID: 26667599 DOI: 10.1111/ced.12788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2015] [Indexed: 11/27/2022]
Abstract
Vascular endothelial growth factor (VEGF) antagonists have been investigated as a potential treatment for psoriasis, but there have been reports of VEGF antagonists triggering and/or exacerbating pre-existing psoriasis. We present the case of a 61-year old-man with exacerbation of pre-existing psoriasis after treatment with sorafenib, a small molecule inhibitor of the tyrosine kinase domain of the VEGF receptor, and we review the literature for other published cases of sorafenib-induced or sorafenib-exacerbated psoriasis. Clinicians, including both dermatologists and oncologists, should be aware of this potential side-effect of sorafenib in addition to the other cutaneous side effects reported for this drug.
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No age-related decline in efficacy of photodynamic therapy for treatment of basal cell carcinoma. Br J Dermatol 2015; 173:1564-5. [PMID: 26286806 DOI: 10.1111/bjd.14080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Facial angiolymphoid hyperplasia with eosinophilia: sustained remission following treatment with carbon dioxide laser. Clin Exp Dermatol 2015; 41:96-8. [PMID: 25917269 DOI: 10.1111/ced.12648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2014] [Indexed: 11/29/2022]
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39
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Facial spicules and pink papules in a renal transplant recipient. Clin Exp Dermatol 2015; 40:816-8. [PMID: 25753909 DOI: 10.1111/ced.12615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2014] [Indexed: 11/29/2022]
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40
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Giant condylomata acuminata of Buschke and Lowenstein: A peristomal variant. Int J Surg Case Rep 2014; 5:1014-7. [PMID: 25460461 PMCID: PMC4275778 DOI: 10.1016/j.ijscr.2014.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Giant condylomata acuminata (GCA) is a rare, locally invasive tumour that may undergo malignant transformation. It was first described a HPV-induced penile tumour which clinically resembled both a squamous cell carcinoma and condyloma acuminatum, often arising from a pre-existing warty lesion. We describe a case of peri-stomal GCA transformation into invasive squamous cell carcinoma (SCC), which is, to our knowledge, the first report of this in the literature. PRESENTATION OF CASE A 74 year old gentleman developed an acuminate, papillomatous peristomal eruption around a fifty year old ileostomy, with biopsies of the eruption showing reactive changes. Two years later, he developed ulcerating plaques affecting the previously papillomatous areas and an erythematous nodular lesion involving the superior part of the ileostomy and adjacent skin. Histological examination of the ileostomy lesion showed focal small islands of atypical squamous epithelium, and moderately differentiated invasive squamous cell carcinoma was shown in the excised tissue subsequently. Human papillomavirus (HPV type 16), p16 and p53 tumour suppressors were positive in the peri-stomal skin sample. DISCUSSION AND CONCLUSIONS Recurring, changing papillomatous lesions in the peristomal area should be reviewed with a high index of suspicion in relation to GCA tumours as they can progress to invasive squamous cell carcinomas.
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National survey of patients with Gorlin syndrome highlights poor awareness, multiple treatments and profound psychosocial impact of disease. J Eur Acad Dermatol Venereol 2014; 30:371-3. [PMID: 25351930 DOI: 10.1111/jdv.12796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guttate psoriasis is associated with an intermediate phenotype of impaired Langerhans cell migration. Br J Dermatol 2014; 171:409-11. [PMID: 24628096 DOI: 10.1111/bjd.12960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND An episode of guttate psoriasis can be an isolated event, can recur as guttate episodes, or develop into chronic plaque psoriasis (CPP). A previous study revealed that early-onset (before age 40 years) CPP is associated with inhibition of epidermal Langerhans cell (LC) migration. OBJECTIVES To determine whether guttate psoriasis is also associated with abnormal LC mobilization. METHODS Three groups of patients were recruited: current guttate episode (n = 5); guttate psoriasis progressed to CPP (n = 6); and resolved guttate psoriasis (n = 2). Biopsies were taken from uninvolved skin and LC migration was measured ex vivo using an epidermal explant model. RESULTS Patients with a current episode of guttate psoriasis displayed epidermal LC migration, although the extent was significantly lower than in skin from healthy controls (P < 0·05). In contrast, in those patients in whom guttate psoriasis developed into CPP there was no mobilization of LC. Finally, in patients in whom guttate psoriasis had resolved, LC migration was normal. CONCLUSIONS We have shown that guttate psoriasis is associated with an abnormality of LC mobilization, but a less marked inhibition compared with that seen in CPP. In resolved guttate psoriasis LC function returns to normal. These data provide further evidence that the pathogenesis of psoriasis is characterized by significant changes in epidermal LC function.
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Lack of awareness of skin cancer among immunocompromised patients with antineutrophil cytoplasmic antibody-associated vasculitis: a questionnaire survey. Br J Dermatol 2014; 171:193-5. [PMID: 24484377 DOI: 10.1111/bjd.12861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Systemic treatments for basal cell carcinoma (BCC): the advent of dermato-oncology in BCC. Br J Dermatol 2014; 169:53-7. [PMID: 23488543 DOI: 10.1111/bjd.12311] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2013] [Indexed: 11/28/2022]
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the U.K. and its incidence is increasing. Vismodegib, a hedgehog pathway inhibitor, has recently been licensed by the U.S. Food and Drug Administration for treatment of advanced BCC. Phase 2 trials have demonstrated efficacy in cases of locally advanced and metastatic BCC, as well as cases of hereditary basal cell naevus (Gorlin) syndrome. Side-effects are frequent and considerable and include myalgia, taste disturbance, alopecia, weight loss and fatigue. Further research is needed to investigate means of circumventing these side-effects, and longitudinal data are required to assess the long-term benefits of, and the nature of resistance to, this novel class of agents. Alternative hedgehog inhibitors are currently in clinical development. We review the current data pertaining to this novel treatment modality and discuss its likely future role in the management of BCC.
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Abstract
The T-cell component of the antigen-specific immune response is the target of various novel interventions to modify chronic immunologic disorders, such as allergic diseases. Recent clinical trials have evaluated the safety and efficacy of therapeutic vaccines consisting of short, synthetic, allergen-derived peptides, corresponding to T-cell epitopes from the eliciting antigen. The main advantage of such an approach is the reduction in systemic, immunoglobulin E-mediated adverse events compared with existing whole allergen immunotherapy, often referred to as 'allergy shots'. T-cell peptide epitopes, although capable of inducing immunologic tolerance, are short linear structures that have reduced ability to cross-link mast cell- and basophil-bound immunoglobulin E. The precise mechanism of tolerance induction remains incompletely defined. However, recent data indicate that peptide therapy induces/expands a population of antigen-specific regulatory T-cells. A novel form of treatment combining efficacy with a substantially decreased occurrence of adverse events is likely to have a major impact on the management and prevalence of allergic diseases. Furthermore, the principles of epitope-specific therapy hold promise for the development of therapeutic vaccines for the treatment of autoimmune diseases.
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Anaphylaxis. Br J Hosp Med (Lond) 2013; 74:C55-9. [PMID: 23571315 DOI: 10.12968/hmed.2013.74.sup4.c55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Skin surveillance and reduction of immunosuppression after failure of renal transplant. Clin Exp Dermatol 2013; 38:428-9. [PMID: 23495758 DOI: 10.1111/j.1365-2230.2012.04474.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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