New articles from Acta Dermato-Venereologica http://www.medicaljournals.se/acta/ Acta Dermato-Venereologica is an international peer-review journal for clinical and experimental research in the field of dermatology and venereology. 96:4 2016 - Symmetrical, Hypopigmented Papules and Plaques on the Palms Induced by Contact with Water: A Quiz http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2293
Abstract is missing (Quiz)]]>
2015-11-24 Quiz
96:4 2016 - Urticaria as a Presenting Prodromal Manifestation of Attacks of Hereditary Angioedema http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2350
Abstract is missing (Correspondence)]]>
2016-02-09 Correspondence
96:4 2016 - Comment: Clinical Pathology Correlation: Clinical First, then Pathology, and Lastly Immunochemistry http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2327
Abstract is missing (Correspondence)]]>
2016-01-18 Correspondence
96:4 2016 - CD30-positive Cutaneous Pseudolymphoma Caused by Tocilizumab in a Patient with Rheumatoid Arthritis: Case Report and Literature Review http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2309
Abstract is missing (Short communication)]]>
2015-12-10 Shortcom
96:4 2016 - Cryoglobulinaemia (IgG-κ-type and IgM-γ-type) with Occluding Leukocytoclastic Vasculitis in a Patient with Vitiligo and Demyelinating Polyneuropathy http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2250
Abstract is missing (short communcation)]]>
2016-01-20 Shortcom
96:4 2016 - Non-infectious Panniculitis during Hydroxyurea Therapy in a Patient with Myeloproliferative Disease http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2292
Abstract is missing (Short communication)]]>
2016-01-11 Shortcom
96:4 2016 - Dual CD4/CD8-positive Ichthyosiform Mycosis Fungoides with Lymph Node, Peripheral Blood and Cardiac Involvement: A Case Report http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2305
Abstract is missing (Short communication)]]>
2015-12-14 Shortcom
96:4 2016 - Gonococcal Osteomyelitis Resulting in Permanent Sequelae http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2296
Abstract is missing (Short communication)]]>
2015-12-07 Shortcom
96:4 2016 - A Case of Miliary Tuberculosis Presenting with Whitlow of the Thumb http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2285
Abstract is missing (Short communication)]]>
2015-11-25 Shortcom
96:4 2016 - Erythrokeratoderma Variabilis Caused by p.Gly45Glu in Connexin 31: Importance of the First Extracellular Loop Glycine Residue for Gap Junction Function http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2307
Abstract is missing (Short communication)]]>
2016-01-20 Shortcom
96:4 2016 - Acute Edema Blisters on a Skin Swelling: An Unusual Manifestation of Hereditary Angioedema http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2252
Abstract is missing (Short communcation)]]>
2015-10-22 Shortcom
96:4 2016 - Pain in Hidradenitis Suppurativa: A Pilot Study http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2308
Abstract is missing (Short communication)]]>
2016-01-13 Shortcom
96:4 2016 - The Behavioral Addiction Indoor Tanning Screener (BAITS): An Evaluation of a Brief Measure of Behavioral Addictive Symptoms http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2290
Abstract is missing (Short communication)]]>
2015-12-07 Shortcom
96:4 2016 - Psychological Stress and Skin Symptoms in College Students: Results of a Cross-sectional Web-based Questionnaire Study http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2291
Abstract is missing (Short communication)]]>
2015-11-23 Shortcom
96:4 2016 - Coxsackievirus A6 Polymorphic Exanthem in Israeli Children http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2261
Hand foot and mouth disease (HFMD) is an acute childhood viral exanthem usually associated with coxsackievirus A16 or enterovirus 71. Atypical HFMD associated with coxsackievirus A6 was reported recently. The aim of the current study was to describe coxsackievirus A6-associated atypical HFMD in a series of 8 toddlers who were referred with idiopathic extensive eruptions. Demographic and clinical characteristics, Reverse transcriptase-real-time PCR (RT-PCR) results for enterovirus and phylogenetic analysis for the coxsackievirus A6 strains were recorded. Morphologically polymorphous (vesicular, erosive, papular, desquamative or purpuric) and extensive eruptions were found. One patient had delayed nail shedding. Enterovirus was positive in all patients. Genotype analysis confirmed coxsackievirus A6 in 6 patients and 5 sequences underwent phylogenetic analysis. This is the first such report in Israeli children. In conclusion, coxsackievirus A6 atypical HFMD should be regarded as a novel childhood viral exanthem. We suggest the term “coxsackievirus A6 polymorphic exanthem” due to the extensive and variable nature of this eruption. ]]>
2015-12-03 Clinical
96:4 2016 - Hereditary Angioedema in Swedish Adults: Report From the National Cohort http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2274
Hereditary angioedema (HAE) is rare, disabling and sometimes life-threatening. The aim of this study is to describe its prevalence, symptomatology and treatment in Sweden. A total of 146 patients were identified; 110 adults and 36 children with HAE type I (n = 136) or II (n = 10), giving a minimal HAE prevalence of 1.54/100,000. All patients received a written questionnaire followed by a structured telephone interview. This report focuses on the 102 adults who responded. Females reported 19 attacks in the previous year vs. 9 for males (p < 0.01), and females reported 10 days of sick leave vs. 4 days for males (p < 0.05). For all treated acute attacks, plasma-derived C1-inhibitor concentrate (pdC1INH) (used in 27% of patients) had a good effect. For maintenance treatment, 43% used attenuated androgens and 8% used pdC1INH, which reduced their attack rate by more than 50%. In conclusion, the minimal HAE prevalence in Sweden was 1.54/100,000. HAE affected females more severely. Attenuated androgens and pdC1INH had a good effect on preventing attacks.]]>
2015-12-10 Clinical
96:4 2016 - Cutaneous Lymphoma in Korea: A Nationwide Retrospective Study http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2283
The epidemiological and clinicopathological features of cutaneous lymphoma may vary by geographical area. However, only a few large-scale epidemiological studies of cutaneous lymphoma have been performed, mainly in the USA and Europe. This aim of this study was to determine the recent characteristics of cutaneous lymphoma in Korea according to the WHO/EORTC classification. A total of 422 patients with newly diagnosed cutaneous lymphoma from January 2009 to December 2013 comprising 293 cases of mature T-cell and natural killer (NK)-cell lymphoma and 39 cases of mature B-cell lymphoma were retrospectively reviewed. The incidence of mature B-cell lymphoma was lower in Korea than in Europe and the USA. Diffuse large B-cell lymphoma was more prevalent in Korea than in Western countries. The incidence of extranodal NK/T-cell lymphoma, nasal-type was higher in Korea than in Western countries and Japan.]]>
2015-12-10 Clinical
96:4 2016 - Risk of Acute Myocardial Infarction or Stroke in Patients with Mycosis Fungoides and Parapsoriasis http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2294
Mycosis fungoides (MF) and parapsoriasis display increased inflammation, which may be associated with increased risk of arterial cardiovascular events. The aim of this Danish nationwide population-based cohort study was to assess the relative risk (RR) of acute myocardial infarction (AMI) or stroke in patients with MF and parapsoriasis. In patients with MF, the RR of AMI or stroke was 1.0 (95% confidence interval (95% CI) 0.7–1.3). In the second half of the study period, the RR was 1.8 (95% CI 1.1–2.9) during the first 5 years of follow-up. In men with parapsoriasis, the RR of AMI or stroke was 1.7 (95% CI 1.1–2.7) within the first 5 years of follow-up, whereas the RR of AMI during the first 5 years of follow-up was 2.0 (95% CI 1.2–3.4). In conclusion, patients with MF and parapsoriasis have an increased RR of AMI or stroke within the first 5 years of follow-up.]]>
2015-12-01 Clinical
96:4 2016 - Long-term Sequelae of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2295
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions characterized by different extents of epidermal necrosis and mucosal breakdown. A limited number of studies have reported the long-term patterns of SJS and TEN complications in patient populations over long follow-up periods. The aim of this retrospective study was to collect data on long-term sequelae in patients admitted for SJS, SJS/TEN overlap, or TEN between 1998 and 2012. Among all 102 patients eligible for analysis, the 2 most common sequelae were cutaneous and ocular problems, both with incidences of 44.1%. Visceral organ involvement was observed in 2 patients with irreversible deterioration of chronic kidney disease and in one patient with interstitial lung disease. Autoimmune disease was present in 6 patients: Sjögren’s syndrome or Sjögren-like syndrome in 5 patients and concomitant systemic lupus erythematosus and Hashimoto thyroiditis in one patient.]]>
2015-12-01 Clinical
96:4 2016 - Usefulness of Rajka & Langeland Eczema Severity Score in Clinical Practice http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2302
Simple, validated eczema severity scores are required for the evaluation of interventions. The Rajka & Langeland (R&L) scale is based on 3 domains (extent, course, and intensity); however, its validity is not yet confirmed. The aim of this study was to investigate the quality aspects of the R&L scale in clinical practice. In the first part of the study, experts and consumers judged the content validity of the scale. The second part of the study was performed with 87 children during a 4-month eczema school. Construct validity, internal consistency, sensitivity to change, time consumption and health-related quality of life variables were investigated. The content of the R&L scale was considered valid by 45 panellists. Inter- and intra-observer reliability was very good. Divergent construct validity was adequate, while convergent construct validity and internal consistency were inadequate. The R&L scale was able to define a significant improvement in eczema during the eczema school. The time required for completing the R&L assessment was significantly shorter than for objective Severity Scoring of Atopic Dermatitis (SCORAD). The R&L scale is a simple, fast, valid, reliable and sensitive tool for scoring of atopic dermatitis in everyday clinical practice.]]>
2016-01-14 Clinical
96:4 2016 - Effects of Apremilast on Pruritus and Skin Discomfort/Pain Correlate With Improvements in Quality of Life in Patients With Moderate to Severe Plaque Psoriasis http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2360
Pruritus and skin discomfort/pain negatively impact health-related quality of life (HRQoL). The effects of apremilast, an oral phosphodiesterase inhibitor, on pruritus, skin discomfort/pain, and patient global assessment of psoriasis disease activity (PgAPDA) were assessed in moderate/severe chronic plaque psoriasis patients in the phase 3 ESTEEM trials. Significant improvements in pruritus and skin discomfort/pain observed at Week 2 with apremilast versus placebo (both studies, p < 0.0001) were sustained through Week 32. Among apremilast-treated patients, improvements in pruritus visual analog scale (VAS) scores correlated with Dermatology Life Quality Index scores (rs = 0.55 [Week 16], rs≥0.51 [Week 32]; both studies, p < 0.001). PgAPDA correlated with improvements in pruritus (rs≥0.56 [Week 16]; rs≥0.53 [Week 32]; both studies, p < 0.001) and skin discomfort/pain (rs ≥0.54 [Week 16]; rs≥0.53 [Week 32]; both studies, p < 0.001) VAS scores. Apremilast provided rapid and sustained improvement in pruritus and skin discomfort/pain, symptoms not typically captured in psoriasis assessments (e.g., PASI) that contribute significantly to patients’ disease severity and HRQoL perceptions.]]>
2016-02-17 Clinical
96:4 2016 - Use of Mycophenolate Mofetil in Patients with Severe Localized Scleroderma Resistant or Intolerant to Methotrexate http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2297
To assess the efficacy and safety of mycophenolate mofetil (MMF) in patients with localized scleroderma (LoS) resistant or intolerant to previous treatment with methotrexate (MTX). A case series of patients with LoS treated with MMF. Outcome was assessed through clinical examination. Adverse events were documented. Seven patients with LoS were treated with MMF. Median age at MMF initiation was 15 years (range 7–74 years). Three patients received MMF due to MTX ineffectiveness and 4 due to MTX intolerance. Disease remission was achieved in 4 patients and maintained in one patient. One patient showed a favourable response, but had to discontinue treatment due to elevated liver enzymes. The remaining patient experienced disease progression. MMF was shown to improve the clinical condition of patients with refractory LoS and may be a relatively safe alternative in patients who are intolerant to MTX.]]>
2015-12-17 Clinical
96:4 2016 - Basal Cell Carcinoma is as Common as the Sum of all Other Cancers: Implications for Treatment Capacity http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2282
Reliable estimates of disease incidence are fundamental to planning future healthcare services. However, in many countries registration of basal cell carcinoma (BCC) is often non-existent. This study examines how many BCC treatments were carried out in Denmark in 2013. The Danish Cancer Registry and the Danish Pathology Registry were used to examine how many BCC treatments were registered, and a test sample was taken from Bispebjerg Hospital to examine the number treated but not registered. The study showed that 21.7% of BCC treatments were performed solely on a clinical diagnosis. Furthermore, some records are inadequate in relation to BCC registration, as BCCs treated are 3 times the number of individuals in the Danish Cancer Registry, and there are nearly as many BCCs as the sum of all other cancers. The increasing BCC incidence will result in difficulties in ensuring treatment capacity.]]>
2016-01-12 Clinical
96:4 2016 - Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2287
The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.]]>
2015-12-08 Investigative
96:4 2016 - Anogenital Human Papillomavirus Prevalence is Unaffected by Therapeutic Tumour Necrosis Factor-alpha Inhibition http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2298
Patients receiving tumour necrosis factor alpha (TNF-α) inhibitors are at increased risk of exacerbation of (myco-)bacterial and some viral infections. However, information on anogenital human papillomavirus (HPV) infection in these patients is sparse or conflicting. In this study 222 patients with psoriasis or inflammatory bowel disease (IBD), who received either anti-TNF-α inhibitors or alternatives (purine-, folic acid analogues, phototherapy, fumaric ester, mesalazine) continuously for at least 6 months, were evaluated for the presence of anogenital HPV-induced lesions, mucosal HPV DNA, and serological status of mucosal low-risk HPV6 and high-risk HPV16/HPV18. Hallmarks of anogenital HPV infection were more frequently detected in patients with psoriasis than in those with IBD. HPV-induced lesions, viral DNA, and seroprevalence were not elevated in participants with psoriasis or IBD, who received TNF-α inhibitors for a mean duration of 31.4 months (range 6–96 months) compared with recipients of alternative or no treatment. TNF-α blockade for a mean period of 31.4 months does not increase detectable anogenital HPV infection or disease.]]>
2015-12-07 Investigative
96:4 2016 - Narrowband Ultraviolet B Exposures Maintain Vitamin D Levels During Winter: A Randomized Controlled Trial http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2269
Exposure to solar ultraviolet B radiation during the summer months is the main source of vitamin D (VD) for people living in northern latitudes. The aim of this study was to determine whether artificial narrowband ultraviolet B (NB-UVB) whole-body exposures could maintain VD levels in winter. The intervention group received 2 standard erythema doses (SEDs) of NB-UVB exposures every second week from October 2013 to April 2014. In October 2013 serum 25-hydroxyvitamin D concentrations were 78.3 nmol/l in the intervention group (n = 16) and 76.8 nmol/l in the control group (n = 18). By April 2014 the concentrations had increased by 11.7 nmol/l (p = 0.029) in the intervention group and decreased by 11.1 nmol/l (p = 0.022) in the control group. The baseline VD concentration showed a negative correlation (p = 0.012) with body mass index (BMI). In conclusion, a suberythemal NB-UVB dose of 2 SED every second week maintains and even increases serum VD concentrations during the winter. A high BMI seems to predispose subjects to low levels of VD. ]]>
2015-12-07 Investigative
96:4 2016 - Up-regulation of Proinflammatory Genes and Cytokines Induced by S100A8 in CD8+ T Cells in Lichen Planus http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2306
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. The inflammatory status of LP may be related to S100A8 (myeloid-related protein 8; MRP8) activation of cytotoxic cells. The aims of this study were to evaluate S100A8 expression in skin lesions and the in vitro effects of S100A8 on CD8+ T cells and natural killer (NK) cells in LP. Increased levels of S100A8/S100A9 were detected in the skin lesions as well as in the sera of subjects with LP. S100A8 expression induced an increased cytotoxic response by peripheral blood CD8+CD107a+ T cells as well as by NK CD56bright cells in patients with LP. Increased expression of interleukin (IL)-1?, tumour necrosis factor (TNF) and IL-6 in the CD8+ T cells of patients with LP was induced by S100A8, in contrast to the control group that produced IL- 10 and interferon type I genes. These data suggest that, in individuals with LP, S100A8 may exert distinct immunomodulatory and cytotoxicity functions.]]>
2015-12-14 Investigative
96:4 2016 - Epidemiology of Melanocytic Naevi in Children from Lleida, Catalonia, Spain: Protective Role of Sunscreen in the Development of Acquired Moles http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2277
The worldwide incidence of malignant melanoma is increasing. The number of pigmented naevi and amount of solar exposure are important risk factors. The aim of this study was to characterize a paediatric population (from Lleida, Catalonia, Spain) in terms of phenotype, sun behaviour and naevi prevalence. Data on the numbers and distributions of acquired naevi in 369 children, aged 4, 8 and 14 years, were collected and correlated with age, sex, skin phototype and environmental factors (annual/lifetime intermittent and chronic sun exposure, sunburns and sunscreen use). The density of naevi increased with age. Boys had more naevi on the trunk and girls had more naevi on the legs. Children with light skin phototype had more naevi. A higher level of accumulated sun exposure correlated with a higher number of naevi in children with non-adequate sunscreen use. In conclusion, several risk factors associated with naevi density and distribution were found, as previously reported by others. Multivariate analysis confirmed a protective role of sunscreen in the development of acquired melanocytic naevi.]]>
2015-11-17 Investigative
96:4 2016 - Expanding the Clinical and Genetic Spectrum of KRT1, KRT2 and KRT10 Mutations in Keratinopathic Ichthyosis http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2299
Twenty-six families with keratinopathic ichthyoses (epidermolytic ichthyosis, superficial epidermolytic ichthyosis or congenital reticular ichthyosiform erythroderma) were studied. Epidermolytic ichthyosis is caused by mutations in the genes KRT1 or KRT10, mutations in the gene KRT2 lead to superficial epidermolytic ichthyosis, and congenital reticular ichthyosiform erythroderma is caused by frameshift mutations in the genes KRT10 or KRT1, which lead to the phenomenon of revertant mosaicism. In this study mutations were found in KRT1, KRT2 and KRT10, including 7 mutations that are novel pathogenic variants. Novel clinical features found in patients with congenital reticular ichthyosiform erythroderma are described, such as mental retardation, spasticity, facial dysmorphisms, symblepharon and malposition of the 4th toe. ]]>
2016-01-19 Investigative
96:4 2016 - Eight Novel Mutations Confirm the Role of AAGAB in Punctate Palmoplantar Keratoderma Type 1 (Buschke-Fischer-Brauer) and Show Broad Phenotypic Variability http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2304
Punctate palmoplantar keratoderma (PPKP1; Buschke-Fischer-Brauer) is a rare autosomal dominant inherited skin disease characterized by multiple hyperkeratotic papules involving the palms and soles. Mutations have been found at 2 loci, on chromosomes 15q22–15q24 and 8q24.13–8q24.21. We recently identified mutations in 3 families, in the AAGAB gene on 15q, which encodes the alpha- and gamma-adaptin-binding protein p34. The current study examined 14 additional families, comprising a total of 26 affected individuals and identified 8 novel mutations in 9 families. In one family a mutation that was present only in the affected individuals was found, and in 4 other families, previously reported mutations were found (1, 2). These results confirm the role of AAGAB in PPKP1. Our findings suggest that there is no correlation with age, but with mechanical factors. No additional obvious genotype–phenotype correlation was observed, even when comparing different types of mutations. Rather, identical genotypes presented a very broad interfamilial and intrafamilial variability of phenotypes.]]>
2016-01-11 Investigative
96:4 2016 - Expression of CD164 on Malignant T cells in Sézary Syndrome http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2264
Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by pruritic erythroderma, peripheral lymphadenopathy and the presence of malignant T cells in the blood. Unequivocal detection of malignant cells in patients with Sézary syndrome is of important diagnostic, prognostic and therapeutic value. However, no single Sézary syndrome specific cell surface marker has been identified. In a cohort of patients with Sézary syndrome, CD164 expression on total CD4+ lymphocytes was significantly upregulated compared with healthy controls. CD164 expression was in most cases limited to CD4+CD26– malignant T lymphocytes, unequivocally identified using flow-cytometry by the expression of a specific Vβ clone for each patient. Increased expression of CD164 may be a promising diagnostic parameter and a potential target for a CD164-linked therapeutic approach in Sézary syndrome.]]>
2015-12-15 Investigative
96:4 2016 - Association of a Single Nucleotide Polymorphism in a Late Cornified Envelope-like Proline-rich 1 Gene (LELP1) with Atopic Dermatitis http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2301
There is some evidence that genes involved in the pathogenesis of atopic dermatitis, in addition to the filaggrin (FLG) gene, may be located at chromosome region 1q21. The aim of this study was to examine the association of single nucleotide polymorphisms in the region of the late cornified envelope-like proline-rich 1 (LELP1), hornerin (HRNR) and FLG genes with the course and risk of atopic dermatitis. Single nucleotide polymorphisms and mutations were genotyped by PCR restriction fragment length polymorphism and real-time PCR in a group of 152 patients with atopic dermatitis and 104 healthy volunteers. CC genotype and C-allele of LELP1 rs7534334 were found in patients with atopic dermatitis and were associated with elevated levels of serum immunoglobulin E, severity of atopic dermatitis and concomitant asthma. LELP1 rs7534334 enhanced the risk of atopic dermatitis nearly 2.5-fold. This pilot study suggests that rs7534334 SNP, located in the LELP1 region, may be a potential genetic marker for the risk and course of atopic dermatitis.]]>
2015-12-11 Investigative
96:4 2016 - Effectiveness of Biologic and Conventional Systemic Therapies in Adults with Chronic Plaque Psoriasis in Daily Practice: A Systematic Review http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2276
The efficacy of biologic or conventional systemic therapies for psoriasis has been shown in randomized controlled trials. Effectiveness, however, has been studied in daily practice cohorts, and no aggregation of effectiveness data is available. This systematic review searched PubMed and EMBASE and summarized the real-world evidence on effectiveness of biologics (adalimumab, etanercept, infliximab and ustekinumab) and conventional systemic therapies (acitretin, cyclosporine, fumarates and methotrexate) for the treatment of plaque psoriasis in adults. Thirty-two studies were included. Few data were available on infliximab, ustekinumab and conventional systemics. Results show that biologics and conventional systemics were effective in real-life treatment of psoriasis, with large ranges in the percentage of patients reaching 75% improvement in psoriasis area and severity index score compared with baseline, especially for etanercept and adalimumab treatment. Combination therapies of biologics with conventional systemics, and dose adjustments of biologics were frequently applied strategies and may explain the large range in improvements between cohorts.]]>
2015-12-01 Special
96:4 2016 - Efficacy and Safety of Mammalian Target of Rapamycin Inhibitors in Vascular Anomalies: A Systematic Review http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2300
Mammalian target of rapamycin (mTOR) inhibitors are a promising new treatment in vascular anomalies, but no published randomized controlled trials are available. The aim of this systematic review of all reported cases was to assess the efficacy and safety of mTOR inhibitors in all vascular anomalies, except cancers, in children and adults. In November 2014 MEDLINE, CENTRAL, LILACS and EMBASE were searched for studies of mTOR inhibitors in any vascular condition, except for malignant lesions, in humans. Fourteen publications and 9 posters, with data on 25 and 59 patients, respectively, all < 18 years old were included. Of these patients, 35.7% (n = 30) had vascular tumours, and 64.3% (n = 54) had malformations. Sirolimus was the most frequent mTOR inhibitor used (98.8%, n = 83). It was efficient in all cases, at a median time of 2 weeks (95% confidence interval 1–10 weeks). Sirolimus was well tolerated, the main side-effect being mouth sores, which led to treatment withdrawal in one case. The dosage of sirolimus was heterogeneous, the most common being 1.6 mg/m2/day.]]>
2015-12-17 Special
96:4 2016 - Post-transplant Merkel Cell Carcinoma http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2284
Malignant tumours are the foremost complications of immunosuppressive treatment. They are a major challenge for organ transplant recipients and their treating physicians. This paper reviews the aetiology and current treatment of an unusual neuroendocrine skin cancer, Merkel cell carcinoma (MCC), caused by a Merkel cell polyomavirus infection. MCC occurs more frequently than expected in immunosuppressed subjects, especially in organ transplant recipients. The current literature comprises reports of 79 organ transplant recipients with MCC. The risk of MCC in organ transplant recipients is increased up to 66–182-fold compared with the general population. In addition to the increased risk of developing MCC, immunosuppressed individuals have poorer MCC-specific survival. The aim of this review article is to familiarize organ transplant doctors with this unique and clinically challenging skin cancer, and to provide recent data on the diagnosis and current treatment recommendations for an immunosuppressed population.]]>
2015-12-01 Review
96:4 2016 - Psoriasis and Psoriatic Arthritis: Flip Sides of the Coin? http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2385
Presence (current or past) of psoriasis of the skin is a major criterion to establish the diagnosis of psoriatic arthritis. However, in individual patients, the course of psoriasis and psoriatic arthritis do not seem to correlate. This raises the issue of whether psoriasis and psoriatic arthritis are distinct entities, or parts of the spectrum of a “psoriatic disease”. Arguments in favour of both concepts, derived from clinical observations, animal experiments, genetic approaches, and therapeutic studies are reviewed, and the implications for scientists and practicing dermatologists highlighted. ]]>
2016-03-30 Review
96:4 2016 - Farewell and Welcome! http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2361
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2015-04-10 Editorial
96:3 2016 - ERRATUM: "New Topical Treatment Options for Actinic Keratosis: A Systematic Review" http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2361
Abstract is missing (Erratum)]]>
2016-02-23 Erratum
96:3 2016 - Violaceous and Petechial Persistent Plantar Plaques: A Quiz http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2242
Abstract is missing (Quiz)]]>
2015-10-01 Quiz
96:3 2016 - Keratotic Nodule on The Heel: A Quiz http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2237
Abstract is missing (Quiz)]]>
2015-09-30 Quiz