Atopic dermatitis: a review of evolving targeted therapies.

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory skin condition, affecting a significant number of patients of all ages. As we learn more about the pathogenesis of AD, new targeted treatment options are being developed to better tailor its management. Currently, a variety of biologic agents are utilized to target specific components and regulators of the inflammatory pathways in allergic and inflammatory conditions. These targeted therapies allow for greater efficacy while limiting adverse effects. Areas covered: This review examines the current literature in respect to several different monoclonal antibodies that are being studied toward a personalized approach in the treatment of AD. Expert opinion: Several trials examining the use of biologics for AD have demonstrated mixed success. While some have shown promise for improvement of clinical symptoms, there are several barriers to support consistent use including cost, adverse effects, small sample sizes, conflicting evidence, and lack of demonstrated long-term safety and efficacy. The ultimate goal for future research is to develop biomarkers for different AD phenotypes in order to allow for targeted therapy of AD.

Angiosarcoma with Synchronous Cutaneous and Small Bowel Involvement: A Report of a Rare Presentation.

Angiosarcomas are mesenchymal neoplasms of vascular origin that represent approximately 2% of soft tissue sarcomas. We discuss the case of a 75-year-old female who had presented with a purple nodular rash along the bilateral nasolabial folds. Upon further work-up, she was diagnosed with angiosarcoma, with the confirmed involvement of multi-focal sites. These included biopsy proven sites of the face and duodenum along with the radiographic involvement of the lungs, liver, and osseous tissue. We report this unique presentation of a rare malignancy and the treatment course with radiation, paclitaxel, and bevacizumab. We also discuss the implications of her co-morbid liver cirrhosis and gastric antral vascular ectasia (GAVE) in terms of its influence on the development of the angiosarcoma and treatment response.

Women with type 2 diabetes perceive harder effort during exercise than nondiabetic women.

Regular exercise is a cornerstone of diabetes treatment; however, people with type 2 diabetes (T2D) are commonly sedentary. It is possible that a harder rate of perceived exertion (RPE) during exercise for those with T2D as compared with nondiabetics may be a barrier to physical activity. This study examined RPE (Borg scale, ordinal range 6-20) during submaximal exercise at identical absolute work rates to test the hypothesis that women with T2D demonstrate harder RPE during exercise than nondiabetic controls. In a prespecified analysis of existing data from equivalently sedentary women, RPE during submaximal exercise was compared among women with uncomplicated T2D (n = 13, mean body mass index (BMI) 34.2, mean hemoglobin A1c 9%), overweight controls (OC, n = 13, mean BMI 30.7), and normal-weight controls (NWC, n = 13, mean BMI 23.1). Subjects performed three 7 min, constant-load exercise tests at 20 W and 30 W. Mixed-effects general linear modeling was used to test for differences in mean RPE estimates among groups with and without adjustment for relative work intensity, age, habitual physical activity, or BMI. Subjects with T2D perceived harder effort during bicycling exercise than controls, as measured by RPE at 20 W and 30 W (p < 0.05 for T2D vs. OC and for T2D vs. NWC). Adjusting for relative work intensity eliminated significant group RPE differences at 30 W, but group RPE differences at 20 W remained significant. Harder perceived effort during exercise may be a barrier to physical activity for those with T2D.