British Journal of Dermatology

doi: 10.1111/bjd.18276pmid: N/A

SummaryConjunctivitis is a common condition that causes the eye to become red, itchy and oozing. It is common in patients with atopic dermatitis (also called eczema), and in other allergic diseases, including asthma. Apart from allergies, conjunctivitis can also be caused by infections, chemicals, irritants, and other diseases. Dupilumab is a prescription medicine approved in the USA for people 12 years and older with moderate‐to‐severe AD uncontrolled by topical (applied to the skin) prescription medicines or who cannot use topical medicines, for adults in other countries whose AD is uncontrolled with existing therapies, and for people 12 years and older for maintenance treatment of moderate‐to‐severe asthma uncontrolled with their current medicines. Dupilumab blocks activity of specific substances that cause these allergic diseases. In most AD studies, more dupilumab‐treated patients had conjunctivitis than patients on placebo (dummy drug). To investigate this effect, the authors assessed rates, risk factors, severity, and outcomes of conjunctivitis in 11 dupilumab studies in AD, asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), and eosinophilic esophagitis (EoE). In 5 of 6 AD studies, dupilumab‐treated patients were more likely to get conjunctivitis than placebo‐treated patients. No conjunctivitis was confirmed to be caused by infection, and it does not seem to be allergic in nature. Patients who entered these studies with more severe AD or who previously had conjunctivitis were more likely to get conjunctivitis. In asthma and CRSwNP studies, conjunctivitis rates were less frequent for both dupilumab and placebo than in AD studies, and were similar for dupilumab and placebo. In the EoE study, nobody had conjunctivitis. In all studies, conjunctivitis was mostly mild to moderate; most cases recovered during the treatment period. Causes of conjunctivitis in dupilumab‐treated patients require further study.

doi: 10.1111/bjd.18282pmid: N/A

Summary化脓性汗腺炎 (HS) 是一种慢性皮肤病,在皮肤相互接触部位(如腋下和腹股沟)有疼痛性毒疮发作。在全世界,每 1000 人中有约 1 到 40 人受此病影响。当尝试在一项临床试验中测量治疗效果时,会使用所谓的“结局测量量表”。已有一些方法估计存在“多少”疾病。结局测量量表的测量结果应正确且不发生随机变化,显而易见这很重要。之前已证实,HS 试验中使用的结局测量量表缺乏可靠性验证。因此,这项研究旨在明确,在使用 9 种不同的量表时,12 名具有 HS经验的皮肤科医生对 24 名 HS 患者的评分一致性如何。这项研究显示,一种名为 Hurley 分期的量表在评分一致性方面是可接受的量表。但是,Hurley 分期仅适合严重程度分期,以指导各期的最适合治疗。对于指定测量疾病严重程度变化的量表,发现其在评定皮肤科医生之间的一致性低。因此,这些结果引出了以下问题,即基于医生对个体 HS 皮损(受影响斑片)计数的传统量表是否能够最好地测量 HS 身体体征。所以,应当考虑使用如超声等技术的其他 HS 身体体征评估方法。

doi: 10.1111/bjd.18268pmid: 31475338

SummaryHidradenitis suppurativa (HS) is a long‐lasting skin disease with flares of painful boils in areas where skin meets skin, such as the armpits and groins. It affects somewhere between 1 and 40 people out of 1000 worldwide. When trying to measure the effect of a treatment in a clinical trial, so‐called ‘outcome measurement instruments’ are used. These are ways of estimating ‘how much’ disease is present. It is obviously important that outcome measurement instruments measure the right thing and do not vary at random. It has previously been shown that outcome measurement instruments used in HS trials lack proof of their reliability. This study therefore aimed to find out how consistently 12 HS‐experienced dermatologists would score 24 patients with HS, using nine different instruments. The study showed that one called Hurley staging was an acceptable instrument in terms of consistency of scores. However, Hurley staging is suited only for severity staging e.g. to guide the most appropriate treatment in each stage. For instruments designed to measure changes in disease severity, low agreement between the rating dermatologists was found. Therefore, the results question whether HS physical signs are best measured by traditional instruments based on a physician counting individual HS lesions (affected patches). As a result, other assessment methods of physical signs in HS, using technology such as ultrasound, should also be considered.

SummaryThe two most common types of skin cancer (tumour) are called basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). BCC and cSCC have previously been removed from U.K. national cancer statistics, collected by cancer registries, because it was difficult to accurately estimate tumour counts. Improvements to registry data collection of BCC and cSCC since 2013 have resulted in the largest and most complete dataset of BCC and cSCC in the world. Therefore, the aim of this study was to provide better estimates of BCC and cSCC tumour counts using registry data in the U.K. This study confirms that skin cancers are four times more common than any other cancer in the U.K. The authors were able to show that BCCs and cSCCs affected over 210,000 people in the U.K in 2015 with BCCs affecting 3 in 1000 people and cSCCs affecting 1 in 1000 people in 2015 alone. As they most commonly affect elderly people, it is not surprising that incidence rates are increasing by around 5% per year. Although they are less dangerous than melanomas and therefore there is less public awareness of BCC and cSCC, together, they are more than ten times more common than melanomas. This study exposes the previously unreported burden of skin cancers in the U.K. and highlights the importance of skin cancer prevention through protection against excessive ultraviolet radiation through natural (sunshine) or unnatural (tanning booths) exposure.

Summary基底细胞癌 (BCC) 和皮肤鳞状细胞癌 (cSCC) 是两种最常见的皮肤癌(肿瘤)。BCC 和 cSCC 之前已从通过癌症注册研究收集的英国国家癌症统计中删除,因为难以准确估计肿瘤计数。自 2013 年以来对 BCC 注册数据采集的改进带来了世界上最大和最完整的 BCC 和 cSCC 数据集。因此,这项研究的目标是使用英国注册数据提供更好的 BCC 和 cSCC 肿瘤计数估计。这项研究证实,在英国,皮肤癌发生频率比其他癌症高出 4 倍。作者们能够显示,仅在 2015 年,BCC 和 cSCC 就已影响超过 21 万人,且在 2015 年,BCC 影响人数比例为 3/1000,cSCC 为 1/1000。由于它们最常影响老年人,发病率每年增加大约 5% 并不令人惊讶。尽管它们的危险性低于黑色素瘤,因此导致公众对于 BCC 和 cSCC 的认识水平较低,但它们的发生率比黑色素瘤高出超过 10 倍。这项研究暴露了英国之前未报告的皮肤癌负担,强调了通过防止过度自然(日光)或非自然(日晒房)紫外线照射来防止皮肤癌的重要性。