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Distinguishing between pyoderma gangrenosum (PG) and necrotising fasciitis (NF) can be challenging in certain cases because the treatments are very different (1). We report a case that led us to consider the differential diagnosis of both conditions, and also their association. A 43-year-old woman developed, in the early hours following excision of an inguinal epidermal cyst, a necrotic inflammatory ulceration with fever, general weakness and signs of septic shock. This article is protected by copyright. Al...
Vulvar melanoma (VM) accounts for 1-3% of all melanoma arising in women with poor long-term clinical outcome. VM can be uni- or multifocal. Multifocality is defined as multiple foci of melanoma separated by intact epithelium, or arising on follow-up, outside the vicinity of the surgical scar. This article is protected by copyright. All rights reserved.
Indoor and outdoor airborne pollutants modify our environment and represent a growing threat to human health worldwide. Airborne pollution effects on respiratory and cardiac health and diseases have been well established, but its impact on skin remains poorly described. Nonetheless, the skin is one of the main targets of pollutants, which reach the superficial and deeper skin layers by transcutaneous and systemic routes. In this review, we report the outcomes of basic and clinical research studies monitorin...
Having the ability to discriminate visual cues and use them to communicate with others is called visual literacy; a requisite competency in dermatology which can take years to master through experiential learning. Following our pilot of art-based training for dermatology trainees in the UK, we enrolled ten trainees from the Manchester Dermatology Training Programme (n=6 first year; n=4 second year trainees) on a visual literacy training course in order to interrogate the hypothesis: visual literacy training...
We would like to respond to the recent letter by Wüthrich and colleagues.. As Wüthrich et al. have used silk garments within their hospital clinic for many decades it is unsurprising they so strongly believe in the value of these products. Unfortunately, the extent of their investment has seemingly left them unable to countenance information that does not accord with their own experience. This article is protected by copyright. All rights reserved.
Prurigo nodularis (PN) is a common and debilitating skin condition with an unmet therapeutic need since there are no currently approved therapies and off-label treatments have limited efficacy. We describe a case of generalized PN refractory to multimodal treatment regimens, effectively treated with dupilumab, an interleukin (IL)-4 receptor antagonist approved for the treatment of asthma and atopic dermatitis in adults. This article is protected by copyright. All rights reserved.
The distribution of atopic dermatitis (AD) lesions and its impact on quality of life (QOL) is not well-established in the US adult population.
Vitiligo, a disease characterized by a progressive loss of melanocytes can be classified into three major forms, non-segmental (NSV), segmental, and mixed. NSV can be divided in subtypes, including generalized, acrofacial, and universalis. In acrofacial, the involved sites are located to face, hands, and feet but generally the presence palmo plantar (PP) lesions is not evaluated. After a personal communication of Prof. Alain Taïeb reporting some cases of PP vitiligo, we have analyzed the incidence of PP vi...
Three biotherapies - etanercept, adalimumab, and ustekinumab - are licensed in childhood psoriasis. The few data available on their efficacy and tolerance are mainly derived from industry trials. However, biological drug survival impacts long-term performance in real-life settings.
Incidence of anal carcinoma is increased in people living with HIV (PLWH). Due to the improved life expectancy in PLWH, identifying appropriate prevention strategies for non-AIDS defining cancer types such as anal carcinoma has become a priority in managing PLWH today.
Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term including lichen planus pigmentosus, erythema dyschromicum perstans and pigmented contact/cosmetic dermatitis.
Kovacs and Podda present a case series of Hurley Stage 3 Hidradenitis Suppurativa patients responsive to Guselkumab (a monoclonal IL-23 antagonist) over a 12-week period as measured by the IHS4 outcome measure. A phase 2 trial of Guselkumab in HS is currently underway, utilizing the HiSCR outcome measure in line with the PIONEER studies. Both outcome measures have been appropriately validated both psychometrically and clinically. HiSCR is defined as a 50% reduction in inflammatory abscess and nodule count f...
Dupilumab is an interleukin (IL)-4 receptor alpha antagonist that was approved by the US Food and Drug Administration in April 2017 for the treatment of adult patients with moderate-to-severe atopic dermatitis (AD) not adequately controlled with topical therapies. Dupilumab is a fully human monoclonal antibody that binds to the alpha subunit of the IL-4 receptor and inhibits downstream signaling of IL-4 and IL-13, thus inhibiting the helper T cell, type 2 (TH2) pathway activation and cytokines that play a k...
We completely agree with Dr. Frew's comment that comparing results of clinical trials requires consistent outcome measures. HiSCR has been used as a primary endpoint outcome measure in multiple RCTs. We would recommend to continue to use HiSCR in future trials to preserve comparability, despite its known weaknesses well outlined in the comment. This article is protected by copyright. All rights reserved.
Palmoplantar keratoderma (PPK) constitutes a heterogenous group of disorders that may be further subdivided into hereditary and acquired forms, characterized by hyperkeratosis of the palm and sole skin [1,2]. In recent years, the exponentially increasing use of next-generation sequencing technologies has led to the identification of several novel disease genes, substantially contributing to better comprehend PPK's molecular basis. PPK involvement may severely limit normal activities and lead to palmar retra...
Previous studies have identified causative factors of striae distensae (SD), which are: family history, pregnancy, sudden weight gain, adolescent growth spurt and hormonal disturbances. Genetic factors are also known to play a role in SD aetiology. Skin samples with SD show decreased levels of collagen, elastin, and fibronectin gene expression compared to healthy skin. The study on European population conducted by Tung et al. (2013) suggested contribution of the following polymorphisms in SD aetiology: ELN...
Melanoma, a malignant neoplasm of melanocytic origin, is now considered a "health emergency" as it represents 4% of skin cancers and it is responsible for 80% of skin cancer deaths, corresponding to approximately 1%-2% of all cancer deaths. It is characterized by complex and heterogeneous etiopathogenesis in which are involved constitutional and environmental risk factors. Among these, an important role is played by air pollution. We examined all the cases of melanoma of the U.O.C. of Dermatology and STD of...
Chronic Pruritus (CP) is a highly impairing symptom, often of multifactorial origin, with a certain percentage of psychosomatic/psychiatric (PP) comorbidity. Up to now it has not been investigated in large samples of CP patients how psychiatric comorbidity may interact with symptom presentation and treatment of CP. This was the objective of our study. We analyzed data from the database of the Center for Chronic Pruritus (CCP) of the University Hospital Münster including sociodemographic and clinical data, ...
Basal cell carcinoma (BCC) represents one of the best indications for the use of in-vivo reflectance confocal microscopy (RCM). High levels of diagnostic accuracy is reached with the combined use of dermoscopy and RCM for BCC diagnosis that is based on a set of distinct confocal features. Furthermore, new handled devices allowed to speed-up the confocal examination at patient's bedside, making easier and faster the systematic use of RCM for atypical skin lesions. This article is protected by copyright. All ...
Subungual metastases (SM) represent a very rare event, in which malignant cells spread from a primary tumor to the nail unit, ie specifically the nail plate and the tissue around it. They account for 1% of acral metastases and usually occur in well-known cancer patient, signalling a progression of the disease. They may rarely be the presenting sign of an undiagnosed tumor. Due to the variable clinical presentation, SM are frequently misdiagnosed as infectious or inflammatory nail diseases, even in patients ...
The Sinebrychoff art museum located in Helsinki includes paintings by old European masters to be found in Finland from the 1300s up to the mid-1800s. While browsing the museum's permanent exhibition, the portrait of Anna van Schoonhoven by Netherlandish painter Jan Cornelisz Verspronck (1597-1662) in 1645 is more likely to attract the dermatologist's eye. The portrait depicts a notable sitting from aside, half-turned towards the viewer, her hands on her lap (Figure 1). Anna von Schoonhoven was the wife of a...
To the editor: We recently read with interest the results published by Maccari et al. in "Crossed looks on the dermatologist's position and the patient's preoccupations as to psoriasis and pregnancy: preliminary results of the PREGNAN-PSO study." This study sheds light on knowledge gaps in a cohort of dermatologists' understanding on treatment of psoriasis in pregnancy. We echo their concerns about the lack of existing safety data on systemic treatments, particularly in regards to biologics, used for psori...
The most characteristic skin manifestation of systemic lupus erythematosus (LE) is malar rash characterized by an erythematous congestive sometimes secondarily squamous eruption over the cheeks and nasal bridge, that typically spares nasolabial folds. This rash is referred to as "acute cutaneous lupus erythematosus" (ACLE) (1). Recently, 2 SLE patients with remarkable skin involvement of seborrheic area (SA) came to our attention. This article is protected by copyright. All rights reserved.
The public perception of dermatologists, highly relevant for implementing strategies to improve dermatological care, has been scarcely investigated in France, in regards to the background where the number of active dermatologists is continuously decreasing.
The occurrence of sexual dysfunction side effects associated with finasteride use in men with androgenetic alopecia (AGA) is thought to be less prevalent than is publicized. There is a need to investigate sexual dysfunction among finasteride users with population-based controls.