Recent multiple studies have shown that the long-term consequences of atopic dermatitis (AD) include an increased risk of osteoporosis and fracture, especially an increase in hip, pelvic, spinal and wrist fractures. This review summarizes and discusses the risk and mechanisms of osteoporotic fracture in AD, focusing on receptor activator of nuclear factor kappa-B ligand.

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The dermatologist’s guide to beards: a review of structure, function, care and pathology

Boothby-Shoemaker, Wyatt; Comeau, Nicholas; Daveluy, Steven

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad201pmid: 37310915

Facial hair is a commonly desired feature for many individuals. Despite a breadth of dermatology literature covering strategies for removing facial hair, there are no known articles summarizing strategies for facial hair growth or reviewing common facial hair pathologies. Here, we assess Google Trends to describe significant increases in search terms related to facial hair growth and maintenance over the last decade, suggesting an increased public interest in this topic. Next, we review ethnic differences that may affect facial hair distribution, growth, and predisposition to certain facial hair pathologies. Lastly, we review studies on agents used for facial hair growth and review common facial hair pathologies.

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Phage therapy for hidradenitis suppurativa: a unique challenge and possible opportunity for personalized treatment of a complex, inflammatory disease

Bens, Lene; Green, Sabrina I; Jansen, Daan; Hillary, Tom; Vanhoutvin, Tine; Matthijnssens, Jelle; Sabino, João; Vermeire, Séverine; Van Laethem, An; Wagemans, Jeroen; Lavigne, Rob

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad207

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Prevalence and incidence of comorbid diseases and mortality risk associated with lichen planopilaris: a Korean nationwide population-based study

Lim, Sung Ha; Kang, Hyun; Heo, Yeon-Woo; Lee, Won-Soo; Lee, Solam

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad235pmid: 37433080

BackgroundVarious comorbid diseases have been reported in patients with lichen planopilaris (LPP); however, data regarding the risks of incident diseases and mortality are lacking.ObjectivesTo investigate the risks of incident diseases and mortality associated with LPP.MethodsThis was a retrospective nationwide population-based study, using data from the National Health Insurance Service Database of Korea from 2002 to 2019. Patients aged ≥ 18 years with three or more documented medical visits for LPP were included. The adjusted hazard ratios (aHRs) for incident disease outcomes and mortality were compared with 1 : 20 age-, sex-, insurance type- and income-level-matched controls.ResultsIn total, 2026 patients with LPP and 40 520 controls were analysed. The risks of incident systemic lupus erythematosus [aHR 1.91, 95% confidence interval (CI) 1.21–3.03], psoriasis (aHR 3.42, 95% CI 2.83–4.14), rheumatoid arthritis (aHR 1.39, 95% CI 1.19–1.63), lichen planus (aHR, 10.07, 95% CI 7.17–14.15), atopic dermatitis (aHR 2.15, 95% CI 1.90–2.44), allergic rhinitis (aHR 1.29, 95% CI 1.13–1.49), thyroid diseases (hyperthyroidism: aHR 1.42, 95% CI 1.14–1.77, hypothyroidism aHR 1.19 95% CI 1.01–1.41, and thyroiditis: aHR, 1.35, 95% CI 1.08–1.69), nonmelanoma skin cancer (aHR 2.33, 95% CI 1.00–5.44) and vitamin D deficiency (aHR 1.23, 95% CI 1.03–1.47) were higher in patients with LPP. Patients with LPP had a higher mortality rate than controls (aHR 1.30, 95% CI 1.04–1.61), although the risk was not significant after adjusting for comorbidities (aHR 1.08, 95% CI 0.87–1.34).ConclusionsPatients with LPP had a higher risk of various diseases following LPP diagnosis. Close follow-up is needed to optimize comprehensive patient care.

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Clinical features, therapeutic choice and response by phototype in psoriasis: analysis of the French PsoBioTeq cohort

Salle, Romain; Tubach, Florence; Arlegui, Hugo; Curmin, Raphaëlle; Viguier, Manuelle; Beylot-Barry, Marie; Dupuy, Alain; Beneton, Nathalie; Joly, Pascal; De Rycke, Yann; Jullien, Denis; Mahé, Emmanuel; Paul, Carle; Richard, Marie-Aleth; Bachelez, Hervé;

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An effective patient-supporting intervention for topical treatment of psoriasis is also cost-effective

Svendsen, Mathias Tiedemann; Andersen, Klaus Ejner; Feldman, Steven R; Mejldal, Anna; Möller, Sören; Kongstad, Line Planck

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad272pmid: 37585448

This study provides an economic evaluation of a randomized controlled psoriasis trial providing regular long-term support delivered by dermatology nurses. The incremental costs were estimated at £462, with an average increase of 0.08 quality-adjusted life-years (QALYs) per patient for participants receiving the support compared with those receiving standard care. The incremental cost-effectiveness ratio for patients was £5999/QALY. The intervention had an almost 100% probability of being cost-effective at a willingness-to-pay threshold of £30 000 per QALY.

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Skin thermal recovery following cryotherapy: a comparison of liquid nitrogen and liquid nitrous oxide

Erdmann, Sophie A B; Wokes, James

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad224pmid: 37403205

Cryotherapy is a common technique used in the management of superficial skin lesions, with current advice on the correct timing for freeze–thaw cycles based on nonscientific visual skin appearances. We investigated the effect of cryotherapy on thermal thawing times by creating a porcine skin model in a laboratory setting maintained at normal skin temperature and comparing liquid nitrogen and liquid nitrous oxide. Thermal assessment was performed using a thermal camera attached to an iPhone 11Pro® smartphone. Liquid nitrogen reduced skin temperature to –60 °C after 5 s of application, recovering to 0 °C after 70 s. Liquid nitrous oxide reduced skin temperature to –34.8 °C after 5 s but had a faster recovery to 0 °C after only 20 s. Both cryogens required a thawing period of 5 min to recover to normal skin temperature. We therefore suggest that optimum cellular degradation should allow for 5-min freeze–thaw cryotherapy cycles; a slower thawing period than is in current common practice.

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Major improvement of very severe alopecia areata in patients treated with the combination of baricitinib and low doses of corticosteroids: an eight-case series

Hébert, Vivien; Joly, Pascal

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad239pmid: 37467740

Alopecia areata (AA), especially very severe types, causes patients severe psychological and social distress. Although baricitinib alone has been shown to be effective in conferring complete hair regrowth (HR) in severe AA [Severity of Alopecia Tool (SALT) score 50–94], it gave poor therapeutic results in very severe AA (SALT score ≥ 95). Methotrexate alone is similarly ineffective, but in a recent study of patients with areata totalis or universalis, low-dose prednisone with methotrexate gave a 20% rate of HR, and was effective and well tolerated. In our study of baricitinib 4 mg + prednisone 20 mg per day tapered over 3 months to treat eight women with very severe AA, seven of eight achieved complete HR (SALT score 0) and one had partial HR (SALT score 30).

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HLA-C*15:02 and epidermal growth factor receptor inhibitor-induced erosive pustular dermatosis of the scalp

Zhang, Yuan; Grice, Sophie; Wang, Na; Liu, Yongxia; Zhao, Qing; Liu, Tingting; Sun, Lele; Mi, Zihao; Wang, Jianwen; Yu, Gongqi; Zhang, Fan; Meng, Xiaoli; Liu, Hong; Naisbitt, Dean J; Sun, Yonghu; Zhang, Furen

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad282pmid: 37710038

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Tildrakizumab for the treatment of hidradenitis suppurativa in patients previously treated with adalimumab: a 30-month experience

Koszegi, Ben; Wilson, Anna; Stone, Corey; Satgé, Fanny; Cowan, Timothy L; Murrell, Dédée F

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad215pmid: 37434310

Our case series findings indicate that tildrakizumab treatment in patients with hidradenitis suppurativa who previously received adalimumab demonstrated an initial improvement in disease activity within the first 6 months. However, this overall trend was not sustained beyond the 6-month mark. Nevertheless, it is noteworthy that patients who underwent long-term follow-up on tildrakizumab experienced ongoing disease activity but showed a reduction in Dermatology Life Quality Index scores.

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Dermatology International Journal of Dermatology European Journal of Dermatology JDDG - Journal of the German Society of Dermatology Journal of Dermatological Treatment Journal of Cosmetic Dermatology BMC Dermatology Dermatology Research and Practice Case Reports in Dermatology International Journal of Women's Dermatology

pmid:

37315154

Phage therapy is an emerging antimicrobial treatment for critical multidrug-resistant pathogens. In this review, the specific potential and challenges of phage therapy for patients with hidradenitis suppurativa (HS) are discussed. This represents a unique challenge as HS is a chronic inflammatory disease, but presenting with acute exacerbations, which have an enormous negative impact on patient’s quality of life. The therapeutic arsenal for HS has expanded in the past decade, for example, with adalimumab and several other biologicals that are currently under investigation. However, treatment of HS remains challenging for dermatologists because there are individuals who do not respond to any classes of the current treatment options when used for a first or second time. Furthermore, after several courses of treatment, a patient may lose their response to therapy, meaning long-term use is not always an option. Culturing studies and 16S ribosomal RNA profiling highlight the complex polymicrobial nature of HS lesions. Despite the detection of various bacterial species in lesion samples, several key pathogens, including Staphylococcus, Corynebacterium and Streptococcus, may be potential targets for phage therapy. Using phage therapy for the treatment of a chronic inflammatory disease could potentially provide new insights into the role of bacteria and the immune system in HS development. In addition, it is possible more details on the immunomodulatory effects of phages may come to light.

Zago, Marilyn;

Chosidow, Olivier;

Sbidian, Émilie;

2023 Clinical and Experimental Dermatology

doi: 10.1093/ced/llad233pmid: 37409606

BackgroundLittle is known about phototype and the response to systemic treatment in psoriasis.ObjectivesTo assess the characteristics of psoriasis, the therapeutic choice and its efficacy according to phototype.MethodsWe included patients from the PsoBioTeq cohort initiating a first biologic. Patients were classified according to their phototype. The evaluation included disease characteristics, choice of the initial biologic and therapeutic response at 12 months based on 90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) and Dermatology Life Quality Index (DLQI) 0/1.ResultsOf the 1400 patients included, 423 (30.2%), 904 (64.6%) and 73 (5.2%) were in the phototype I–II, III–IV and V–VI groups, respectively. The V–VI group had a higher initial DLQI, and more frequently initiated ustekinumab. Patients in the V–VI group maintained the initial biologic prescribed as did the other phototype groups, even though the proportion of patients reaching PASI 90 and DLQI 0/1 at 12 months was lower in this group than the other groups.ConclusionsPatient phototype seems associated with quality of life and choice of the initial biologic in psoriasis. The phototype V–VI group less frequently switched treatments than did the other groups when the response was not efficient.

Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity, mostly presenting as acneiform eruptions, paronychia and xerosis. Erosive pustular dermatosis of the scalp (EPDS) is a rare cutaneous adverse reaction that develops during treatment with EGFRIs. The pathogenesis of EGFRI-induced EPDS is poorly understood. Here we present three cases of EPDS induced by EGFRIs. The proteins LTA4H (leukotriene A-4 hydrolase), METAP1 (methionine aminopeptidase 1), BID (BH3-interacting domain death agonist), SMAD1 (mothers against decapentaplegic homologue), PRKRA (interferon-inducible double-stranded RNA-dependent protein kinase activator A), YES1 (tyrosine-protein kinase Yes) and EGFL7 (epidermal growth factor-like protein 7) were significantly upregulated in EGFRI-stimulated peripheral blood mononuclear cell cultures, and validated in the lesions. All of the proteins colocalized with CD4+ and CD8+ T-cell expression. Next-generation-based human leucocyte antigen (HLA) typing showed all patients carried HLA-C*15:02, and modelling studies showed that afatinib and erlotinib bound well within the E/F binding pockets of HLA-C*15:02. Moreover, T cells were preferentially activated by EGFRIs in individuals carrying HLA-C*15:02. The case series revealed that EGFRI-induced EPDS may be mediated by drug-specific T cells.