Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Am J Dermatopathol ; 45(10): 718-720, 2023 Oct 01.
Article in English | MEDLINE | ID: mdl-37522571

ABSTRACT

ABSTRACT: Sudden conjunctivitis, lymphopenia, and rash combined with hemodynamic changes (SCoRCH) is a recently described hypersensitivity reaction to trimethoprim-sulfamethoxazole. To date, only 1 case of histologic findings in SCoRCH has been reported, revealing a superficial perivascular dermatitis. In this article, we present a 53-year-old woman with a four-day history of a widespread, confluent, erythematous, and dusky rash after exposure to trimethoprim-sulfamethoxazole. Histologic examination revealed a vacuolar interface dermatitis with several apoptotic keratinocytes at multiple levels of the epidermis, similar to an erythema multiforme-like presentation. As described in SCoRCH, our patient's clinical findings rapidly improved within 48 hours of presentation without treatment. This case adds to the current literature by identifying a newly described histopathological presentation of SCoRCH.


Subject(s)
Conjunctivitis , Dermatitis , Exanthema , Lymphopenia , Thrombocytopenia , Female , Humans , Middle Aged , Trimethoprim, Sulfamethoxazole Drug Combination , Exanthema/chemically induced
2.
Cutis ; 110(2 Suppl): 8-14, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36219602

ABSTRACT

Topical medications have high utility in the treatment of psoriasis because of their localized effect and ability to be used as both monotherapy and adjunctive therapy. The American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) published guidelines in 2020 regarding the management of psoriasis with topical therapies. These guidelines are a framework that assist clinicians treating psoriasis patients with topical agents including steroids, calcineurin inhibitors (CNIs), vitamin D analogues, retinoids (tazarotene), emollients, keratolytics (salicylic acid), anthracenes (anthralin), and keratoplastics (coal tar). This review presents these evidence-based recommendations in a form that dermatologists can readily apply to their clinical practice. The selection of an appropriate topical therapy, effective combination therapies, duration of use, and adverse events are addressed.


Subject(s)
Coal Tar , Dermatologic Agents , Psoriasis , Administration, Topical , Anthralin/therapeutic use , Calcineurin Inhibitors/therapeutic use , Coal Tar/adverse effects , Emollients/therapeutic use , Humans , Psoriasis/chemically induced , Psoriasis/drug therapy , Retinoids/therapeutic use , Salicylic Acid , Steroids/therapeutic use , Vitamin D
3.
Dermatol Online J ; 28(1)2022 Jan 15.
Article in English | MEDLINE | ID: mdl-35499418

ABSTRACT

Fixed drug eruption (FDE) is a cutaneous drug reaction that tends to recur in the same area (fixed location) upon re-exposure to the offending agent. We present a 48-year-old woman with FDE being treated for metastatic breast cancer with atezolizumab. We believe this is the first reported case of FDE secondary to atezolizumab.


Subject(s)
Drug Eruptions , Drug-Related Side Effects and Adverse Reactions , Antibodies, Monoclonal, Humanized , Drug Eruptions/etiology , Drug Eruptions/pathology , Female , Humans , Middle Aged , Neoplasm Recurrence, Local , Skin/pathology
4.
J Dermatolog Treat ; 33(2): 622-625, 2022 Mar.
Article in English | MEDLINE | ID: mdl-32459567

ABSTRACT

BACKGROUND: In late 2019 a viral pneumonia began to spread across the world. The viral disease, COVID-19, is now officially a pandemic, causing concern for the potential risk of systemic therapies for patients with psoriasis. OBJECTIVE: The purpose of this review is to analyze what is currently known about COVID-19 in regard to the safety of systemic treatment, and to provide guidelines for use in psoriasis during this pandemic. METHODS: Review of guidelines from various dermatologic regulatory bodies regarding the use of systemic medications during the COVID-19 pandemic was performed and summarized. RESULTS: The AAD, NPF and IPC are in agreement regarding their recommendation that patients with active COVID-19 infection should discontinue any biologic therapy. CONCLUSION: Patients with active COVID-19 infections should discontinue systemic treatment for psoriasis. Patients with risk factors should discuss continuing treatment on a case by case basis.


Subject(s)
COVID-19 , Pneumonia, Viral , Psoriasis , Humans , Pandemics , Pneumonia, Viral/epidemiology , Psoriasis/complications , Psoriasis/drug therapy , Psoriasis/epidemiology
5.
J Dermatolog Treat ; 33(2): 626-636, 2022 Mar.
Article in English | MEDLINE | ID: mdl-32507066

ABSTRACT

Biologic medications are recent advances that have clinical significance in the treatment of moderate-to-severe AD. A systemic literature review was performed to examine the efficacy and safety of biologic therapies currently in phase II and phase III of clinical trials for moderate-to-severe AD. Our team searched the databases, PubMed, Google Scholar, and ClinicalTrials.gov, on September 2019 for studies pertaining to the use of biologic drugs in AD. Key words included each drug (lebrikizumab, tralokinumab, fezakinumab, etokimab, nemolizumab, tezepelumab, and GBR 830) or 'biologic drugs' or 'immunotherapies' combined with 'atopic dermatitis.' References within retrieved articles were also reviewed to identify potentially missed studies. A total of 19 articles were included in this review. Lebrikizumab, tralokinumab, fezakinumab, nemolizumab, and GBR 830 lead to statistically significant improvements in disease severity and multiple endpoint outcome scores. Tezepelumab and etokimab, however, did not demonstrate statistically significant changes in primary outcome endpoints. Further assessment of tezepelumab and etokimab are needed to assess their safety and efficacy in patients with moderate-to-severe AD. Tralokinumab, lebrikizumab, fezakinumab, nemolizumab, and GBR 830 are effective treatment options for adults with moderate-to-severe AD, but further large-scale studies are needed to confirm their efficacy as monotherapy in children with moderate-to-severe AD.


Subject(s)
Dermatitis, Atopic , Eczema , Adult , Biological Therapy , Child , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Dermatitis, Atopic/drug therapy , Humans , Severity of Illness Index , Treatment Outcome
6.
J Dermatolog Treat ; 33(2): 1166-1167, 2022 Mar.
Article in English | MEDLINE | ID: mdl-32568009

ABSTRACT

Psoriasis is a systemic immune-mediated inflammatory disease that requires consistent treatment and follow-up. Given that COVID-19 will persist in the coming years, dermatologists need to adjust their practices accordingly to care for their patients, particularly psoriasis patients managed with systemic therapies. We provide guidelines for optimizing care for psoriasis patients, including considerations for medication management, lifestyle adjustments, and utilization of telemedicine.


Subject(s)
Biological Products , COVID-19 , Psoriasis , Telemedicine , Biological Products/therapeutic use , Humans , Pandemics , Psoriasis/drug therapy , Psoriasis/epidemiology , SARS-CoV-2
7.
J Clin Aesthet Dermatol ; 14(6): 55-59, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34804357

ABSTRACT

BACKGROUND: Interleukin (IL)-17 inhibitors are a newer class of biologic used to treat patients with moderate-to-severe plaque psoriasis and psoriatic arthritis. OBJECTIVE: We compared evidence-based clinical practice guidelines (CPGs) from leading dermatological organizations for the use of IL-17 inhibitors in psoriasis. METHODS: Guidelines from the Joint American Academy of Dermatology-National Psoriasis Foundation (AAD-NFP) Guidelines, British Association of Dermatologists guidelines (BAD), and European S3 group (ES3) were all reviewed and compared. RESULTS: This analysis revealed significant overlap in the recommendations made by experts from each CPG. However, our review highlights differences in routine laboratory recommendations and the relative and absolute contraindications to use with IL-17 inhibitors. CONCLUSION: IL-17 inhibitors are an effective treatment option for psoriasis. This analysis and review of guidelines for IL-17 inhibitor use highlights the consensus in treatment protocols and areas of disagreement between CPGs.

8.
Cutis ; 108(2S): 7-11, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34662273

ABSTRACT

In April 2019, the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) released a set of guidelines regarding the management of psoriasis with a focus on its extracutaneous manifestations-comorbidities, mental health, psychosocial wellness, and quality of life (QOL). These guidelines provide the most up-to-date evidence on the screening and treatment recommendations for these disease comorbidities. The purpose of this review is to present the recommendations in a form that can be easily applied in clinical practice.


Subject(s)
Psoriasis , Quality of Life , Comorbidity , Humans , Psoriasis/epidemiology , Psoriasis/therapy , United States/epidemiology
10.
Dermatol Ther ; 34(4): e14974, 2021 07.
Article in English | MEDLINE | ID: mdl-33991048

ABSTRACT

The aim of this review is to compare and contrast evidence-based clinical practice guidelines from global dermatological organizations for the use of ustekinumab in psoriasis. Clinical practice guidelines from the American Academy of Dermatology, National Psoriasis Foundation, British Association of Dermatologists, and European S3 were reviewed and compared. Practice guidelines from the three dermatological organizations are similar with regards to treatment dosage and initiation but differ in their recommendations for baseline screening and interval laboratory monitoring, treatment in patients undergoing surgery or receiving live vaccines, and treatment contraindications. Ustekinumab is an effective and well-tolerated systemic treatment for patients with psoriasis and should be considered in the line of therapy that dermatologists discuss with their patients. Consideration should be given to evidence-based practice guidelines of global dermatology organizations to effectively guide treatment decisions in patients with psoriasis.


Subject(s)
Psoriasis , Ustekinumab , Europe , Humans , Psoriasis/diagnosis , Psoriasis/drug therapy , United Kingdom , United States
12.
Cutis ; 107(2): 99-103, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33891841

ABSTRACT

In 2020, the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) released a set of guidelines for the management of psoriasis in adults with systemic nonbiologic therapies, including acitretin, apremilast, cyclosporine, fumaric acid esters, methotrexate, and tofacitinib. This review addresses dosing, efficacy, toxicity, drug-related interactions, and contraindications alongside evidence-based treatment recommendations for each systemic therapy. Important considerations for treatment such as drug selection, initiation of therapy, drug monitoring, and patient management also are discussed. Physicians are encouraged to use these recommendations to guide treatments based on individual patient needs and disease characteristics.


Subject(s)
Psoriasis , Acitretin , Adult , Cyclosporine , Humans , Methotrexate , Psoriasis/drug therapy , United States
16.
J Dermatolog Treat ; 32(5): 492-494, 2021 Aug.
Article in English | MEDLINE | ID: mdl-31697211

ABSTRACT

BACKGROUND: Generalized pustular psoriasis (GPP) is an uncommon variant of psoriasis that is characterized clinically by sterile pustule formation superimposed over inflamed, erythematous skin. METHODS: In June 2019, we conducted a systematic search of the PubMed Medline database using the keywords 'pustular psoriasis' and 'treatment'. RESULTS: First-line treatment for the condition consists of established therapies, such as acitretin, cyclosporine, methotrexate, and infliximab. Several medications targeting IL-17 or IL-23 have also emerged recently with drugs such as ixekizumab, secukinumab, brodalumab, guselkumab, and ustekinumab having shown some efficacy. CONCLUSIONS: This review highlights the research in support of common treatments of GPP, including classically used medications and newer monoclonal antibodies, and addresses the continued need for high quality studies regarding treatments for this condition.


Subject(s)
Dermatologic Agents/administration & dosage , Psoriasis/drug therapy , Antibodies, Monoclonal/therapeutic use , Humans , Interleukin-17/immunology , Skin Diseases, Vesiculobullous/drug therapy
18.
J Drugs Dermatol ; 19(10): 956-959, 2020 10 01.
Article in English | MEDLINE | ID: mdl-33026767

ABSTRACT

Mild to moderate atopic dermatitis (AD) occurs frequently in children and adults and is usually managed through the use of pharmacologic treatments, such as topical corticosteroids (TCS) and topical calcineurin inhibitors (TCIs), and good skin care practices. As chronic TCS or TCI can lead to the development of adverse effects, there is a need for safe, alternative treatments for patients with resistant AD. A systemic literature review was performed to examine the safety and efficacy of topical agents currently in phase II and phase III clinical trials for AD. Our team searched the databases, PubMed, Google Scholar, and ClinicalTrials.gov, on March 2020 for studies pertaining to the use of topical agents in AD. Key words included each drug (tapinarof, crisaborole, ARQ-151 cream, ruxolitinib) or "topical agents"; combined with "atopic dermatitis"; Articles published within the last 5 years were included as references. References within retrieved articles were also reviewed to identify potentially missed studies. A total of 24 articles were included in this review. Tapinarof, crisaborole, and ruxolitinib lead to statistically significant improvements in multiple disease severity scores. ARQ-151 cream achieved statistical significance in secondary endpoints, including vIGA-AD and EASI-75, but not in the primary endpoint of the study. All topical agents were well-tolerated by study participants. The findings demonstrate that tapinarof, crisaborole, ARQ-151 cream, and ruxolitinib are safe, effective treatment options for patients with mild to moderate AD. J Drugs Dermatol. 2020;19(10):956-959. doi: 10.36849/JDD.2020.5214.


Subject(s)
Dermatitis, Atopic/drug therapy , Dermatologic Agents/administration & dosage , Skin Cream/administration & dosage , Administration, Cutaneous , Aminopyridines/administration & dosage , Aminopyridines/adverse effects , Benzamides/administration & dosage , Benzamides/adverse effects , Boron Compounds/administration & dosage , Boron Compounds/adverse effects , Bridged Bicyclo Compounds, Heterocyclic/administration & dosage , Bridged Bicyclo Compounds, Heterocyclic/adverse effects , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Cyclopropanes/administration & dosage , Cyclopropanes/adverse effects , Dermatitis, Atopic/diagnosis , Dermatologic Agents/adverse effects , Humans , Nitriles , Pyrazoles/administration & dosage , Pyrazoles/adverse effects , Pyrimidines , Resorcinols/administration & dosage , Resorcinols/adverse effects , Severity of Illness Index , Skin Cream/adverse effects , Stilbenes/administration & dosage , Stilbenes/adverse effects , Treatment Outcome
19.
Cutis ; 106(2): 82-86, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32941553

ABSTRACT

In July 2019, the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) released an updated set of guidelines regarding the use of phototherapy to manage adult patients with psoriasis. Treatment with light of various wavelengths is reviewed, with a focus on modalities utilizing UV light. These guidelines provide the most up-to-date evidence regarding dosing, indications, contraindications, and adverse effects of phototherapy alone and in combination with other treatments for psoriasis. This review aims to present the recommendations in a form that is readily translatable to clinical practice.


Subject(s)
Phototherapy/methods , Practice Guidelines as Topic , Psoriasis/therapy , Adult , Humans , Phototherapy/adverse effects , United States
SELECTION OF CITATIONS
SEARCH DETAIL
...