J Dermatolog Treat [journal]
- Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 24.:1-30.
Management of alopecia areata and androgenetic alopecia is often challenging as patients may be resistant to currently available modalities of treatment. The use of stem cells may be a novel option for resistant cases.To evaluate the safety and efficacy of the use of autologous bone marrow derived mononuclear cells (including stem cells) as compared to follicular stems cells for the management of resistant cases of alopecia areata and androgenetic alopecia.This study included forty patients (twenty alopecia areata patients and twenty androgenetic alopecia patients), all patients were treated with a single session of intradermal injection of autologous SCs therapy. They were divided into four groups according to the applied modality [either autologous bone marrow derived mononuclear cells (BMMCs or autologous follicular stem cells (FSC)].Six months after stem cell therapy injection, there was a significant improvement, confirmed by immunostaining and digital dermoscopy. The mean improvement in all groups was "very good". There was no significant difference between both methods in either type of alopecia. No serious adverse events were reported.Autologous BMMCs and FSC seem to be a safe tolerable and effective treatment for the management of both resistant alopecia areata and androgenetic alopecia.
- Values and costs in the management of psoriasis. [Journal Article]
- J Dermatolog Treat 2016 Oct; 27(5):393-4.
- The effect of low-carbohydrates calorie-restricted diet on visceral adipose tissue and metabolic status in psoriasis patients receiving TNF-alpha inhibitors: results of an open label controlled, prospective, clinical study. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 23.:1-7.
TNF alpha inhibitors are usually associated with anthropometric changes over the time, however whether and how the visceral adipose tissue (VAT) is involved in this phenomenon, still remains unclear. Aim of the study is to evaluate if the increases in trunk fat percentage (TF%) and VAT are directly involved in anthropometric changes occurring during treatment, and whether and how a calorie restricted diet could prevent these changes.Twenty patients receiving TNF-alpha inhibitors for psoriasis was evaluated at baseline (T0) and after 24 weeks of therapy (T24), and then compared with 25 patients receiving a combined treatment based on TNF alpha inhibitors and low-carbohydrates calorie-restricted diet.TNF-alpha inhibitors do not influence the VAT expression. The combined treatment is associated with a significant decrease in body weight (kg) (p < .0001), BMI (p = .0001), WC (cm) (p < .0001), TF% (p < .0001), VAT (p < .0001), serum levels of triglycerides (mg/dL) (p = .0018) and total cholesterol (mg/dL) (p = .0005).The administration of TNF-alpha inhibitors can induce anthropometric changes after 24 weeks, but it does not cause an increase in VAT. The association between low-carbohydrates calorie-restricted diet and anti-TNF-alpha therapy seems to be able to improve the anthropometric profile of psoriasis patients.
- Predicting therapy response to Mycophenolic acid using UGT1A9 genotyping: Towards personalized medicine in atopic dermatitis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 23.:1-15.
Atopic dermatitis (AD) is a very common chronic inflammatory skin disease requiring long-term treatment. Mycophenolic acid (MPA) is used off-label in treatment of patients with severe AD failing Cyclosporin A treatment, however clinical efficacy is observed in only half of the AD patients. In blood, MPA levels are known to have a large interindividual variability. Low MPA exposure and increased enzyme activity correlates with the presence of UGT1A9 polymorphisms. In this retrospective study, 65 adult AD patients treated with MPA were classified as responder or non-responder to MPA treatment. UGT1A9 polymorphisms were determined using PCR. A significantly higher number of UGT1A9 polymorphisms was found in the group that did not respond to MPA treatment. Of the patients that carried a UGT1A9 polymorphism, 85.7% was non-responder to MPA treatment. This implies that non-responsiveness in AD patients is more likely to occur in carriers of a UGT1A9 polymorphism. In a binary logistic regression analysis the odds ratio was 8.65 (95% confidence interval: 0.93 - 80.17). Our results show that UGT1A9 polymorphisms can be used to identify patients with non-responsiveness to MPA. Patients with UGT1A9 polymorphisms might benefit from higher MPA dosage.
- A new topical panthenol-containing emollient: skin-moisturizing effect following single and prolonged usage in healthy adults, and tolerability in healthy infants. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 22.:1-7.
Two studies were conducted with a new topical panthenol-containing emollient (NTP-CE) to investigate the skin-moisturizing effect in healthy adults and tolerability in healthy infants.In Study 1 (N = 44), a single skin application of NTP-CE was performed followed by a 4-week twice-daily application. Skin hydration and stratum corneum (SC) water content change (using Raman spectroscopy) were measured. In the 4-week Study 2 (N = 65, aged 3-25 months), NTP-CE tolerability was assessed using a 5-point scoring system; skin hydration was determined in a subset (N = 21).In Study 1, mean AUC0 - 24 h for skin capacitance change from baseline was 302.03 i.u. with NTP-CE and -15.90 i.u. in control areas (p < .001). With NTP-CE (at 4 h), the water content within the upper SC part was reduced (-45.10 vs. -13.39 g/cm(2), p = .013) and the water gradient increased (0.51 vs. 0.11 g/cm(4), p = .036), indicating relocation of water into deeper layers. In Study 2, there was no statistically significant change from baseline in mean cutaneous tolerability scores. At days 7, 14, and 28, skin hydration had increased by 42%, 54%, and 49%, respectively (all p < .001).Single and prolonged NTP-CE usage is associated with sustained and deep skin moisturization. NTP-CE is well tolerated by healthy infants.
- Assessing the overall benefit of a medication: cumulative benefit of secukinumab over time in patients with moderate-to-severe plaque psoriasis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 19.:1-6.
Conventional measurements for assessing psoriasis treatment effects capture improvements at fixed, pre-specified timepoints, failing to account for cumulative clinical benefit over time.Explore the innovative concept of "cumulative clinical benefit" by examining the effect of secukinumab over 52 weeks in moderate-to-severe psoriasis patients.Cumulative clinical benefit was determined as the area-under-the-curve of the percentage of responders over 52 weeks (AUC0-52 wks), using pooled data from two phase III trials for patients receiving secukinumab (300 or 150 mg) or etanercept.Normalized cumulative benefit with secukinumab 300 mg, secukinumab 150 mg, and etanercept was 74.2%, 63.2%, and 50.5%, respectively, for PASI 75; 58.0%, 42.5%, and 29.5%, respectively, for PASI 90; 32.3%, 18.8%, and 8.7%, respectively, for PASI 100; and 58.3%, 47.9%, and 38.3%, respectively, for DLQI 0/1. 52-week PASI 75 clinical benefit ratios for secukinumab 300 and 150 mg versus etanercept were 1.47 and 1.25, respectively; the ratio of the two secukinumab doses was 1.17, favoring 300 mg.Post hoc analysis.Cumulative clinical benefit estimated by AUC0-52 wks is a novel measure for comparing psoriasis treatments. Secukinumab 300 mg provides greater cumulative clinical benefit than secukinumab 150 mg; both provide greater cumulative benefit than etanercept.
- Early clinical response to tofacitinib treatment as a predictor of subsequent efficacy: Results from two phase 3 studies of patients with moderate-to-severe plaque psoriasis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 18.:1-5.
The ability to predict response to psoriasis treatments has important implications. Tofacitinib is an oral JAK inhibitor being investigated for psoriasis.The objective of this study is to identify and validate the clinical predictors of responses in psoriasis patients treated with tofacitinib.Selected baseline characteristics or early improvement in Psoriasis Area and Severity Index (PASI) in the phase 3 tofacitinib study OPT 1 (NCT01276639) were evaluated as predictors for a clinical response (75% improvement in PASI [PASI75]) at week 16. Predictive ability was assessed by the area-under-the-receiver operating characteristic curve (AUC-ROC). The predictive ability of the identified variables was validated with study OPT 2 (NCT01309737).PASI improvement at weeks 8 and 12 demonstrated good discriminatory abilities to predict PASI75 response at week 16 (AUC-ROC ≥86% and 94%, respectively) in OPT 1. Validation with PASI50 response at week 8 in OPT 2 to predict PASI75 response at week 16 showed that the sensitivity, specificity, PPV, and NPV were 88%, 69%, 80%, and 81%, respectively, in tofacitinib-treated subjects.Achieving a PASI50 response after 8 weeks of treatment with tofacitinib in psoriasis patients appears to be a reliable predictor of achieving a PASI75 response at week 16.clinicaltrials.gov: NCT01276639 and NCT01309737.
- Chinese herbal medicine for atopic eczema: an overview of clinical evidence. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 18.:1-5.
Atopic eczema (AE), or atopic dermatitis, is a common inflammatory skin disease. As conventional medicines for moderate and severe AE patients have been reported to be associated with unwanted side effects, many patients with AE have sought other therapies. Chinese herbal medicine (CHM) is one of the most commonly used complementary therapies with a long history of being applied for the treatment of AE. Clinical evidence for CHM for AE in systematic reviews and randomised controlled trials (RCTs) published from 2013 to 2016 was reviewed. Findings from the Cochrane systematic review suggested that oral use of a CHM formulation may improve health-related quality of life (HRQoL) of children with moderate or severe AE. The benefit on improvement of AE requires further high-quality clinical studies.
- Efficacy of tip cryotherapy in the treatment of idiopathic guttate hypomelanosis (IGH): a randomized, controlled, evaluator-blinded study. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Aug 23.:1-5.
Idiopathic guttate hypomelanosis (IGH) is a common hypopigmentation affecting a large amount of older population. However, there is no standard treatment. Cryotherapy has been reported as an alternative therapy for years; nevertheless, there is no randomized controlled study to determine its efficacy.To evaluate the efficacy and side effects of tip cryotherapy in IGH treatment.Total 101 lesions were included. Forty-three lesions were treated with cryotherapy and 58 lesions were assigned as control. A single session of tip cryotherapy was delivered and remained for 5 s. Colorimeter was used to measure lesional luminosity at baseline and then monthly until 4 months. Digital photographs were evaluated by two blinded dermatologists. In addition, patients' assessments and side effects were assessed.Mean luminosity scale gradually decreased from baseline. Also, the score of the treated lesions has been significantly lower than that of the control lesions since week 8 (p = .005). At the fourth month, dermatologists' assessment revealed that 82.3% of the treated lesions comparing to only 2% of the control showed more than 75% improvement (p < .001). Burning sensation was the most common side effect.Tip cryotherapy appears to be an effective therapy with minimal adverse effect for IGH.
- Patch-test Results Using Korean Standard Series: A 5-year Retrospective Review. [JOURNAL ARTICLE]
- J Dermatolog Treat 2016 Jul 28.:1-23.
There have been few studies regarding the results of the Korean standard patch test.The purpose of this study was to analyze the type and frequency of common contact allergens in Korea and to compare the results with those of previous reports.From June 2009 to June 2014, 330 patients with suspected allergic contact dermatitis who visited our clinic were tested using the Korean standard patch test.The highest sensitization rate was found for nickel sulfate (47.58%). There was a significant gender difference in the prevalence of sensitization to nickel sulfate (OR = 2.41, P = 0.0004) and wool alcohol (OR = 2.85, P = 0.0358). Higher sensitization to nickel sulfate (OR = 1.18, P = 0.0159), 4-phenylenediamine (OR = 1.23, P= 0.003), and tixocortol-21-pivalte (OR 1.48, P = 0.0212) and lower sensitization to thimerosal (OR = 0.77, P = 0.0023) were associated with increasing age. Patients with allergic contact dermatitis on the scalp had a significantly higher risk of sensitization to 4-phenylenediamine (OR = 3.07, P = 0.0013). Patients with allergic contact dermatitis on the hands had significantly higher risks of sensitization to wool alcohol (OR = 3.44, P = 0.0083), formaldehyde (OR = 2.52, P = 0.0178), and colophony (OR = 2.05, P = 0.0499).These results demonstrate trends in patch test results in Korea and the basis for the presumption of the route of allergen exposure.