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J Dermatolog Treat [journal]
- Practical Psychodermatology. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 22.:1-4.
- Treatment of vitiligo with NB-UVB: a systematic review. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 8.:1-27.
Abstract Objective: To assess the effect and safety of NB-UVB for vitiligo using an evidence-based approach. Methods: Randomized controlled trials (RCTs) on the treatment of vitiligo with NB-UVB were identified by searching PubMed and the Cochrane Library. The primary outcome was re-pigmentation degree. Results: A total of 7 RCTs involving 232 participants with vitiligo were included in this systematic review. The methodological qualities of included studies were generally moderate. Two trials compared narrow-band ultraviolet B (NB-UVB) with UVA control, showing no significant differences between two methods on the number of patients who achieved >60% re-pigmentation (RR=2.50, 95%CI: 0.11-56.97, P>0.05). Two trials compared NB-UVB with psoralens plus UVA (PUVA) control, and no difference was seen between the two treatments on the number of patients who achieved >50 re-pigmentation (RR=1.16, 95%CI: 0.64-2.11, P>0.05) or >75% re-pigmentation (RR=2.00, 95%CI: 0.89-4.48, P>0.05). Three trials compared NB-UVB with 308-nm excimer light/laser (EL) control, and again no significant difference was found between the two methods (P>0.05). The adverse events of NB-UVB in the included studies were slight and tolerated. Conclusion: NB-UVB showed equivalent efficacies to UVA, PUVA, or 308-nm EL control in the treatment of vitiligo. Side effects of NB-UVB were acceptable. More RCTs were needed to validate the results.
- Open-label exploratory study of acitretin for the treatment of severe chronic hand dermatitis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 8.:1-12.
Abstract Introduction Acitretin is a retinoid approved for the treatment of psoriasis that has good efficacy for palmo-plantar psoriasis. The safety and efficacy of acitretin in severe chronic hand dermatitis (CHD) is unknown. Methods A total of 9 patients with severe CHD were enrolled and treated with acitretin 10 mg once daily which could be increased to 30 mg daily if well tolerated. Patients were treated for up to 24 weeks or 12 weeks if the physician global assessment was clear or almost clear at that time. CHD severity was evaluated using a 5-grade physician global assessment (PGA) scale and the modified total lesion symptom score (mTLSS). Results The proportion of patients achieving PGA of clear or almost clear was 33.3% (95% CI: 9-69%) and the proportion achieving PGA of clear, almost clear or mild was 44% (95% CI:15-77%). The mTLSS decreased by 45% (-6.3±4.7; p=0.02). Three patients did not complete the study: one due to an increase in facial dermatitis, one due to lack of efficacy and one who withdrew consent. Conclusions This pilot study suggests that acitretin could improve severe CHD. Further studies are needed to better assess the efficacy and safety of acitretin in patients with severe CHD.
- Risk of myocardial infarction in psoriasis patients: a retrospective cohort study. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 8.:1-19.
Abstract Background: Psoriasis may or may not be associated with a higher risk for myocardial infarction (MI). We sought to assess differences in MI incidence between control, mild psoriasis, and severe psoriasis patients. Methods: We performed a retrospective cohort study of Kaiser Permanente Southern California members with psoriasis between 1-JAN-04 and 30-JUN-12, assessing the risk and incidence rates of MI. Results: There were 50865 control patients matched to 10173 patients with mild psoriasis and 19205 control patients matched to 3841 patients with severe psoriasis. The MI incidence per 1000 person-years for mild psoriasis controls, mild psoriasis, severe psoriasis controls, and severe psoriasis were 4.9, 6.7, 3.7, and 5.1 respectively. Upon multivariable analysis, mild psoriasis patients had a significantly higher risk of MI compared to matched control patients (hazard ratio (HR) 1.31 [95% CI: 1.14, 1.51]) and severe psoriasis patients had a significantly higher risk of MI compared to matched control patients (HR 1.28 [95% CI: 1.02, 1.60]). Conclusion: Patients with psoriasis are at higher risk for MI compared to control patients.
- Use of Opioid Analgesics in Skin Disorders: Results from a Nationally Representative US Sample. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 4.:1-19.
Abstract Introduction: Increasing and inappropriate use of opioid analgesics (OA) have been declared a public health concern in the US. There are no epidemiologic studies of OA use in skin disorders. We examined OA use in a nationally representative sample of US patient visits with only physician-diagnosed skin disorders. Methods: Retrospective cross-sectional study of 56,751 patient visits from 1995-2010 (ICD9-CM codes 680-709 denoting 'Diseases of the Skin and Subcutaneous Tissue';172,173, 216 and 232 denoting malignant and benign skin neoplasms). Results: An estimated 3.1% ± 0.2% of skin disorders visits were associated with OA use; 52.7% ± 5.4% were Schedule III opioids; 11.4% ± 1.4% of OA visits involved skin neoplasms, and 45.4% ± 2.3% cellulitis and abscess. OA use increased from 1995-2010 (adjusted OR=1.82, 95% CI 1.49-2.22), even after controlling for increase in the frequency of skin infections from 1995-2010. Discussion: The most frequent use OA for cellulitis and abscess is entirely consistent with their FDA-approved indications for pain management. The almost two-fold increase in OA use in skin disorders from 1995-2010 may suggest that OA are being considered for pain management earlier in therapy. Conclusions: Only a minority of patient visits with OA had primary dermatologic disease. OA are being used in dermatology primarily for FDA-approved indications.
- Acneiform Eruptions in Dermatology: A Differential Diagnosis. Joshua A. Zeichner. Springer- Verlag New York Inc. New York, NY. 2013. 480 pages, $209. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 1.:1-4.
Abstract N/A- book review.
- Total skin clearance results in improvements in health-related quality of life and reduced symptom severity among patients with moderate to severe psoriasis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Jul 31.:1-5.
Abstract Background: Newer therapies provide high levels of skin clearance in patients with moderate to severe psoriasis. However, insufficient evidence exists on the impact of total skin clearance from the patient's perspective. Objectives: To examine effects of total skin clearance on health-related quality of life (HRQoL) and psoriasis symptom severity in subjects with moderate to severe psoriasis. Methods: Pooled data from a phase 2 dose-ranging trial in psoriasis using brodalumab (antibody to interleukin-17 receptor A) were used to compare subjects with static physician global assessment (sPGA) 1 versus sPGA 0 and subjects with Psoriasis Area and Severity Index (PASI) 75 to <100 versus PASI 100 at week 12 based on no impairment in Dermatology Life Quality Index (DLQI = 0) and no psoriasis symptoms (Psoriasis Symptom Inventory = 0). Results: Of subjects with sPGA 0 (clear) and 1 (almost clear), 61.4% and 45.7% had a DLQI = 0 (p = 0.15), and 65.5% and 32.6% had a Psoriasis Symptom Inventory = 0 (p = 0.001), respectively. Significantly more subjects with sPGA 1 continued to report itching, redness, scaling, and flaking compared to subjects with sPGA 0. Similar results were observed based on PASI score. Conclusions: A higher proportion of subjects with total skin clearance reported no impairment in HRQoL and no psoriasis symptoms than those who were almost clear.
- Saudi practical guidelines on biologic treatment of psoriasis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Aug 7.:1-7.
Abstract The current treatment of psoriasis patients with biologic agents in the Kingdom of Saudi Arabia (KSA) is mainly based on clinical experience. Although there are published international guidelines for treatment with biologics, such as the European S3 guidelines (a joint project of the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the International Psoriasis Council), many nations have found it beneficial to develop country-based guidelines that incorporate specific regional aspects of therapy (legal and practical). With the expanded role of biologic agents in the treatment of psoriasis in Saudi Arabia, a need for local Saudi guidelines has become evident. Here we present a practical approach to the evidence-based clinical administration of biologics for professionals who treat patients with psoriasis.
- Do you make the correct management strategy on CO2 laser in treating divided nevus of the eyelid? [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Jul 31.:1.
- Autologus Bone Marrow Stem Cells in Atrophic Acne Scars; A Pilot Study. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Jul 21.:1-26.
Abstract Acne scar is a very distressing and difficult problem for physicians and patients. Management of cutaneous scarring from acne can be challenging and confusing. The available modalities may be effective, having considerable morbidity and long down time. Besides, they may not have the same efficacy in different skin types or acne scar types. Objective: To evaluate the short-term safety and efficacy of autologous bone marrow stem cells in treating atrophic acne scars. Methods: 14 patients with moderate to severe atrophic acne scars were included. All patients were subjected to single session of autologous bone marrow stem cells therapy. Each patient received 5 microgram/kg/day granulocyte-colony stimulating factor (G-CSF) as a single subcutaneous dose for two successive days before bone marrow aspiration. The stem cells containing solution was injected under each scar intradermally. The scars of the patients were clinically assessed both qualitatively and quantitatively before and after 6 months. The Patients were given a preformed questionnaire CADI (Cardiff acne disability index) before and after treatment. Results: After six months of the injection, there was significant improvement in the qualitative grading, quantitative grading and CADI scores. All types of scars showed significant improvement. No significant adverse effects were reported in any patient. Conclusion: Autologous bone marrow stem cells seem to be safe and effective treatment option for the management of all types of atrophic facial acne scars.