Dermatitis Atopic/Contact & Eczema
BMC Dermatology 2013, 13:14
This research was to investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 – 19 years old in 1995 and aged 29 – 32 years, 13 years later, in 2008. They completed a postal questionnaire that included questions regarding one-year prevalence of hand eczema, childhood eczema, asthma, rhino-conjunctivitis and factors considered to affect hand eczema such as hand-washing, washing and cleaning, cooking, taking care of small children and usage of moisturisers. These factors were evaluated with the multinominal logistic regression analysis.
It was found that after 13 years an increased 1-year prevalence of hand eczema was found. The significant risk factors for hand eczema changed over time from endogenous to exogenous factors.
Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema – the prevention of Hand Eczema (PREVEX) Trial (full text link)
BMC Dermatology 2013, 13:16
Background:The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed.
Atopic dermatitis and skin allergies – update and outlook (full text link)
Allergy Vol.68, iss.12 pgs 1509-1519, Dec.2013
A. Wollenberg & K. Feichtner
During the last few years, an impressive amount of experimental studies and clinical trials have dealt with a variety of distinct topics in allergic skin diseases –especially atopic dermatitis. In this update, we discuss selected recent data that provide relevant insights into clinical and pathophysiological aspects of allergic skin diseases or discuss promising targets and strategies for the future treatment of skin allergy. This includes aspects of barrier malfunction and inflammation as well as the interaction of the cutaneous immune system with the skin microbiome
and diagnostic procedures for working up atopic dermatitis patients. Additionally, contact dermatitis, urticaria, and drug reactions are addressed in this review.
This update summarizes novel evidence, highlighting current areas of uncertainties and debates that will stimulate scientific discussions and research activities in the field of atopic dermatitis and skin allergies in the future.
Many patients with moderate-to-severe atopic dermatitis (AD) require systemic immunomodulating treatment to achieve adequate disease control.
We sought to systematically evaluate the efficacy and safety of systemic treatments for moderate-to-severe AD.
Although 12 different interventions for moderate-to-severe AD have been studied in 34 RCTs, strong recommendations are only possible for the short-term use of cyclosporin A. Methodological limitations in the majority of trials prevent evidence-based conclusions. Large head-to-head trials evaluating long-term treatments are required
Journal of Allergy and Clinical Immunology (available on-line 24th Oct, 2013)
Contact Allergy from disperse dyes in textiles-a review (full text link)
(Article first published online: 10 OCT 2012)
Laura Malinauskiene1,2,*, Magnus Bruze2, Kristina Ryberg2,3, Erik Zimerson2, Marléne Isaksson
Several disperse dyes (DDs) are still considered to be themost important allergens in textile dermatitis, but there are sparse data about their current use in textiles. The aim of this review was to evaluate published studies and reports on contact allergy to DDs published in PubMed during the last 22 years (1990–2012). Prevalence data are provided by studyand by dye, aswell as by the described clinical peculiarities of DD dermatitis.We reviewed 54 studies. In total, 26 DDs were tested. The average prevalence in screening studies was >1% for Disperse Blue 106, Disperse Blue 124, and Disperse Orange 3. There is a lack of data on patch testing with Disperse Blue 26, Disperse Blue 102, Disperse Orange 37, Disperse Orange 149, Disperse Yellow 23 and Disperse Yellow 49, which are listed as allergens by the EU commission. It is necessary to check the purity and identity of dyes used for patch testing, confirm the clinical relevance of positive reactions by patch testing with suspected textiles, and, if the results are positive, determine the culprit dye.
Acne and Rosacea
Women’s experiences with isotretonoin risk reduction counselling (link to abstract and full text)
JAMA Dermatol. Published online November 20, 2013
Carly A. Werner, BA1; Melissa J. Papic, BS2; Laura K. Ferris, MD, PhD3; Jessica K. Lee, MD4; Sonya Borrero, MD2,5; Noel Prevost, PA3; Eleanor Bimla Schwarz, MD, MS2,4,5
Objective:To explore women’s experiences with counseling about isotretinoin risk
Conclusions and Relevance: Since few clinicians provide women information on highly
effective (ie, intrauterine or subdermal) contraceptives, the iPLEDGE program increases
anxiety about isotretinoin more than it helps women feel protected from the teratogenic risks
Analysis of Facial Skin-Resident Microbiota in Japanese Acne Patients (link to abstract only)
Numata S.a· Akamatsu H.b· Akaza N.a, c· Yagami A.a· Nakata S.c· Matsunaga K.a
Mirvaso Gains CHMP Support for Rosacea Erythema Treatment (Medscape article..may require registration; it is free)
The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has recommended marketing of brimonidine tartrate 3 mg/g topical gel (Mirvaso, Galderma) for the symptomatic treatment of facial erythema of rosacea in adult patients
On-line Dec 7th BJD
JAMA Dermatol. Published online December 4th,2013 (in press, corrected proof)
Background:Lymphoblastic lymphoma (LBL) is a rare neoplasm of precursor lymphocytes, and cutaneous involvement is present in less than 20% of cases.
Objective:We sought to describe the clinical and histopathological features of cutaneous LBL.
Conclusion:This study compared the clinical features of T-LBL and B-LBL, in particular the affected sites and number of skin lesions. Cutaneous T-LBL is likely to be accompanied by disseminated disease and has a relatively poor prognosis compared with B-LBL.
(Lancet oncology on-line Dec.2013)
Prof Hywel C Williams,
Tumor Volume as a Prognostic Factor in Resectable Malignant Melanoma (link to full text)
Dermatology (published on-line 06.12.2013)
Voss B. · Wilop S. · Jonas S. · El-Komy M.H.M. · Schaller J. · von Felbert V. · Megahed M.
Background: Vertical tumor thickness according to Breslow and histological ulceration are still the most powerful predictors for the clinical outcome of resectable cutaneous malignant melanoma (MM) without lymph node infiltration. It has been proposed that tumor volume in MM may also be of prognostic relevance.
Methods: We retrospectively analyzed the prognostic impact of tumor volume and other established risk factors in 122 MM patients with a median follow-up period of 39.7 months.
Results: We found the logarithmic tumor volume to be a better prognostic factor compared to Breslow tumor thickness in multivariate analysis. MM with a tumor volume below a threshold of 140 mm3 had a significantly higher relapse-free survival after 5 years of 98% compared to 47% in larger MMs (p < 0.0001).
Conclusion: In some melanomas with a low tumor thickness, a higher tumor volume appeared to be linked to a higher risk of disease recurrence. Inclusion of tumor volume into the risk assessment of resectable MM may be of benefit in the future.
(link to full text)
Kasper Fjellhaugen Hjuler a, b Henrik Frank Lorentzen a
Background:Unlicensed use of melanotan-II
(MT-II) to promote skin pigmentation has become
prevalent amongst young people attending
fitness centres. We present a case where the melanocyte stimulation of MT-II in combination with the use of sun tanning beds coincided with cutaneous melanoma.
Observation: A 20-year-old woman with
Fitzpatrick skin type II was referred to a dermatology
clinic. Clinical examination revealed a suspicious black melanocytic lesion in her left gluteal region. Furthermore, her skin was universally intensely pigmented. The melanocytic lesion was excised, and histology confirmed the diagnosis of melanoma.
Three months prior to the excision the patient had conducted a 3- to 4-week courseof self-injections with MT-II, intending an augmentation of sunbed tanning.
Conclusionsand Relevance:This observation
brings attention to the potential risks related to the use of the cyclic α-melanocytestimulating hormone analogue MT-II. There are several hazardous aspects of the possible widespread use of MT-II. As the drug is unlicensed and incompletely tested, the extent and types of adverse effects are unknown.
Case Reports in Dermatology( published on-line 24.12.2013)
Kenichiro Mae Yukihiko Kato Kae Usui Namiko Abe Ryoji Tsuboi
Malignant peripheral nerve sheath tumors (MPNST) constitute a rare variety of soft tissue sarcomas thought to originate from Schwann cells or pluripotent cells of the neural crest. Malignant triton tumor (MTT), a very rare, highly aggressive soft tissue tumor, is a subgroup of MPNST and is comprised of malignant Schwann cells coexisting with malignant rhabdo-myoblasts. We herein report the case of a 24-year-old man who presented a subcutaneous mass in his right thigh. The mass was removed surgically in its entirety and radiation therapy was applied locally to prevent tumor regrowth. Nonetheless, the patient died 10 months after surgery from metastases to the lung and brain. He presented neither cafe-au-lait spots nor cutaneous neurofibromas. The histopathology showed a transition from a neurofibroma to an MTT, making this the second report of an MTT arising from a neurofibroma without neurofibromatosis type 1, an autosomal dominant disorder with which 50–70% of tumors reported in previous studies were associated. A histopathological examination using immunostaining with desmin confirmed this diagnosis. MTT has a poorer prognosis than MPNST and should therefore be regarded as a distinct clinical entity.
Statin use is not associated with reduced risk of skin cancer: A meta-analysis (link to abstract only)
British Journal of Cancer, 12/26/2013 Clinical Article
Li X, et al. –
There is contradictory evidence about the association between statin and skin cancer. The meta–analysis does not support a potential role of statin use in the prevention of skin cancer
· Literature search in PubMed and Web of Science was undertaken up to June 2013.
· Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated.
· A total of 21 articles with 29 studies were identified.
· No association was found between statin and skin cancer among neither melanoma (RR, 0.94; 95% CI, 0.85–1.04) nor non–melanoma skin cancer (RR, 1.03; 95% CI, 0.90–1.19).skin cancer.
An Infant With Atrophic and Wrinkled Abdominal Skin (link to first page preview only)
Mahwish Irfan, MD1; Kate Lowenthal, MD2; Thomas Helm, MD2; Zdenka Safar, MD3; Ilene Rothman, MD2
JAMA Dermatology 04.12.2013
Congenital erosive and vesicular dermatosis with reticulated supple scarring: Unifying clinical features (link to abstract only, full text available to read in Bell Library)
JAAD, vol.69,iss.6, pgs.909-15
New approaches to the prevention of childhood atopic dermatitis (full text link)
C. Flohr, J. Mann
There has been a steep rise in the burden of atopic dermatitis (AD), and up to20% of children in developed countries now suffer of the disease. At present,treatment at best achieves symptom control rather than cure, and there is astrong need to identify new methods of disease prevention. While earlierapproaches focused on allergen avoidance strategies, there has been a clear shifttowards attempts to induce tolerance and enhancement of skin barrier function,as skin barrier breakdown plays an important role in AD development. This articlereviews the latest developments in the prevention of AD
JAMA DermatologyPublished online November 27, 2013.
Megan Brown, MD1; Angela Hernández-Martín, MD2; Ana Clement, MD3; Isabel Colmenero, MD4; Antonio Torrelo, MD2
JAAD on-line 24.12.2013
Ella A.M. van der Voort, MDa, Edith M. Koehler, MDEmmilia A. Dowlatshahi, MDa, Albert Hofman, MD,PhDc, Bruno H. Stricker, MB, PhDc, d, Harry L.A. Janssen,PhDb, Jeoffrey N.L. Schouten, MD, PhDb,Tamar Nijsten, MD, PhDa, ,
Objective:We sought to compare the prevalence of NAFLD in people with psoriasis and those without psoriasis.
Conclusion:Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.
Ann Rheum Dis 2014; 73; 149-153
The objective of this study was
to examine the risk of mortality in patients with PsA
compared with matched controls, patients with psoriasis and those with rheumatoid arthritis (RA).
Conclusions Patients with RA and psoriasis have
increased mortality compared with the general
population but patients with PsA do not have a significantly increased risk of mortality.
JAMA Derm Published on-line 18.12.2013
This study reported that in patients who switched TNF-alfa therapy (n=105) 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks.
Extent and Consequences of Antibody Formation Against Adalimumab in Patients With Psoriasis(link to abstract only)
JAMA Derm On-line first 18.12.2013
Stef P. Menting, MD1; Paula P. M. van Lümig, MD2; Anna-Christa Q. de Vries, MD1; Juul M. P. A. van den Reek, MD2; Desiree van der Kleij, PhD3; Elke M. G. J. de Jong, MD, PhD2; Phyllis I. Spuls, MD, PhD1; Lidian L. A. Lecluse, MD, PhD1
In this multicentre cohort study of patients receiving adalimumab therapy for plaque-type psoriasis (n=80), antidrug antibody formation was seen in 49% (by 24 weeks in most cases). It was strongly correlated with adalimumab concentration, and influenced clinical responseAffiliationsDermatology Unit, Department of Medicine, University of Padua, Padua, Italy
JAMA Derm On-line first 04.12.2013
Lancet On-line first 06.12.2013
Dr Susan R Kahn, MDa, Stan Shapiro, PhDa, b, Philip S Wells, MDc, d, Marc A Rodger, MDd, e, Michael J Kovacs, MDf, David R Anderson, MDg, h, Vicky Tagalakis, MDa, Adrielle H Houweling, MSca, Thierry Ducruet, MSca, Christina Holcroft, ScDi, j, Mira Johri, PhDk, l, Susan Solymoss, MDn, o, Marie-José Miron, MDq, Erik Yeo, MDr, Reginald Smith, PharmDs, Sam Schulman, MDt, u, v, Jeannine Kassis, MDw, Clive Kearon, MBt, Isabelle Chagnon, MDm, Turnly Wong, MDx, Christine Demers, MDy, Rajendar Hanmiah, MDz, Scott Kaatz, DOaa,Rita Selby, MBBSab, Suman Rathbun, MDac, Sylvie Desmarais, MDad, Lucie Opatrny, MDp, Thomas L Ortel, MDae, Jeffrey S Ginsberg, MDt,
Diagnostic Pathology2013, 8:185
Abstract:We report a case of recurrent cutaneous necrotizing eosinophilic vasculitis (RCNEV) in a 57-year-old male. The patient presented with papules and pruritus of the lower limbs of more than 1 month duration, and with angioedema and intensively pruritic, necrotizing lesions of the bilateral anterior tibias and feet for 2 weeks. Treatment with systemic corticosteroids was administered for 1 month, and resulted in a significant improvement. We also present a review of the pertinent literature and discuss the clinical features, histopathological features, and differentiation of RCNEV.
New and Updated Cochrane Reviews
(new published on-line 20.12.2013)
(new published on-line 19.12.2013)
(new published on-line 10.01.2014)
(new published on-line 09.12.2013)
(new published on-line 19.12.2013)
(new published on-line 19.11.2013)
(updated published on-line 10.01.2014)
(updated published on-line 09.12.2013)
(updated published on-line 16.12.2013)
(updated published on-line 07.01.2014)
New England Journal of Medicine
Images in Clinical Medicine
Evolution of a diabetic foot infection (Dec.5th)
Cutaneous and Gastrointestinal purpura (Nov.7th)
N Engl J Med 2013; 369:2362-2363
In this case report, ivacaftor was used as therapy and as an indicator to show that aquagenic wrinkling of the palms in a patient with the G551D cystic fibrosis mutation is related to the presence of this cysticfibrosis transmembrane conductance regulator variant.
To the Editor: Cystic fibrosis is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which encodes for a protein involved in transepithelial ion transport. Aquagenic wrinkling of the palms, a transient phenomenon of the skin…
December 18, 2013
van Bon L., Affandi A.J., Broen J., et al.
Systemic sclerosis (also called scleroderma) is a complex heterogeneous fibrosing autoimmune disorder with an unknown pathogenesis. The way in which its three major pathologic hallmarks — extensive fibrosis, vasculopathy, and immune dysfunction — are interconnected is unknown. Mechanistic…
(full text available to read in Bell Library)
December 19th, 2013. 369: 2438-2449
Roh E.K.Vleugels R.A.Hoang M.P.
Presentation of Case. Dr. Amir Aboutalebi (Dermatology): A 57-year-old woman was admitted to this hospital because of recurrent painful bullous and erosive skin lesions. Approximately 19 months before admission, 1 week after the patient had begun taking citalopram, the development of oral erosions,…
Prosthetic Reconstruction of Complicated Auricular Defects : Use of a Hybrid Prosthetic Fabrication Technique (link to first page preview)
JAMA Facial Plast Surg. Published online December 05, 2013
Levi G.Â Ledgerwood,Â MD1; JanetÂ Chao,Â MS2; Travis T.Â Tollefson,Â MD, MPH1
A multidisciplinary rehabilitative approach to patients treated for head and neck malignant neoplasms aims to address both the surgical defects and functional deficits. Free tissue transfer for reconstruction of large facial defects is considered the gold standard for many defects.1 Prosthetic facial restoration can be useful when surgical reconstruction is precluded by medical comorbidities, defect size or location, or patient preference.2
Pruritus in the Older Patient (link to abstract only, full text available to read in Bell Library)
Timothy G. Berger, MD1; Melissa Shive, MD, MPH2; G. Michael Harper, MD3
Using a patient case as an example, this clinical review discusses the aetiology, diagnosis, and treatment of pruritus in the elderly. It is intended to provide generalist physicians with an evidence-based treatment approach for this patient group.
Breast Infection (full text link)
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f3291 (Published 16 December 2013)
J Michael Dixon
· Breast infection during breastfeeding is less common than it used to be
· Early prescription of appropriate antibiotics in infection limits abscess formation
· Delay in referral to breast clinics of patients with lactating infection that does not settle rapidly with antibiotics continues to be a problem
· Breast abscesses can be aspirated or drained through a very small skin incision
· Breast cancer should be excluded in patients with inflammatory changes that do not settle rapidly on appropriate therapy
Diagnosis and management of hyperhidrosis (full text link)
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6800 (Published 25 November 2013)
· The prevalence of hyperhidrosis is estimated at 1%, but it is probably much higher owing to low levels of reporting to primary care
· Onset tends to be at puberty, when axillary apocrine glands start to function, making axillary hyperhidrosis the most common type
· Although prevalence is equal among the sexes, women are more likely to present to primary practice
· Initial treatment in primary care should include lifestyle and behavioural advice and topical agents
· If this approach does not work, refer to a dermatologist
· Sympathectomy is reserved for people in whom conservative measures are ineffective or poorly tolerated, and who accept the risk of compensatory hyperhidrosis
Pruritus in the Older Patient (link to abstract only, full text available to read in Bell Library)
A Clinical Review
Timothy G. Berger, MD1; Melissa Shive, MD, MPH2; G. Michael Harper, MD3
Behind the Headlines…Fatty acids in marine algae could treat skin problems
The study was carried out by two researchers from the School of Natural Sciences at the University of Stirling in Scotland and was published in the peer-reviewed open access scientific journal Marine Drugs. The study can be read free on-line or downloaded as a PDF (link)
Mobile Applications in Dermatology (link to abstract only)
Ann Chang Brewer, MD1; Dawnielle C. Endly, DO2; Jill Henley, DO2; Mahsa Amir, MD3; Blake P. Sampson, MD4; Jacqueline F. Moreau, MS5; Robert P. Dellavalle, MD, PhD, MSPH3,6,7
It’s right there in your hand-underuse of mobile applications in dermatology (link to abstract and first page preview)
Ashish C. Bhatia, MD1
June K. Robinson, MD1; Ashish C. Bhatia, MD1; Jeffrey P. Callen, MD2
Case Rep Dermatol 2013;5:363–367
Naoko Matsunoa Makoto Kunisadaa Haruhisa Kankia Yutaka Simomurab Chikako Nishigoria
JAAD Volume 70, Issue 2, February 2014, Pages 243–251
Spontaneous Cutaneous Endometriosis of the Umbilicus (link to full text)
Case Rep Dermatol 2013;5:368-372Gin T.J.a· Gin A.D.a· Gin D.b· Pham A.c· Cahill J.b
Stem Cell Reports j Vol. 2 j 1–8 j January 14, 2014
Laura De Rosa,1,5 Sonia Carulli,1,5 Fabienne Cocchiarella,1 Daniela Quaglino,2 Elena Enzo,1
Eleonora Franchini,1 Alberto Giannetti,3 Giorgio De Santis,4 Alessandra Recchia,1 Graziella Pellegrini,1
and Michele De Luca1,*
Dermatology Research and Practice
Volume 2013 (2013), Article ID 379725, 10 pages
This work is licensed under the Creative CommonsAttribution-NonCommercial-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
The following sources have been searched for evidence
- Annals of the Rheumatic Diseases
- BMC Dermatology
- British Journal of Cancer
- British Medical Journal
- Case Reports in Dermatology
- Contact Dermatitis
- Dermatology Research and Practice
- Diagnostic Pathology
- Journal of Allergy and Clinical Immunology
- Journal of the American Academy of Dermatology
- Lancet + Lancet Oncology
- JAMA Dermatology
- NHS Headlines