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1.
Arch Dermatol Res ; 316(7): 487, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39042295

RESUMO

Alopecia areata (AA) is nonscarring hair loss characterized by Th1 and concomitant Th2 skewing, particularly in atopic patients. Despite novel developments for adult AA, safe and effective treatments for pediatric patients remain limited. Dupilumab, with a well-studied safety profile, may have therapeutic potential for atopic pediatric AA. To evaluate the ability of dupilumab to regrow hair in pediatric AA patients. We conducted a single-center, retrospective, observational study to evaluate hair regrowth [using Severity of Alopecia Tool (SALT)] with dupilumab in 20 children with both AD and AA (age range 5-16 years, mean 10.8 years; baseline SALT range 3-100, mean 54.4). Patient demographics, atopic history, IgE and SALT scores were collected at 12wk follow-up visits, up to > 72wks, to evaluate hair regrowth. Spearman correlations with clinical data were performed. Patients showed clinical improvement over the follow-up period (range 24 to > 72wks, mean 67.6wks) with significant mean(± SD) reduction in SALT at 48wks versus baseline [20.4(± 35.1) vs 54.4(± 37.6), respectively; p < 0.01] and continued improvement up to > 72wks [2.2(± 4.9), p < 0.01]. Baseline SALT positively correlated with disease duration (r = 0.54, p < 0.01), and negatively correlated with improvement in SALT at weeks 24, 36, and 48 (|r|≥ 0.65, p < 0.01 for all comparisons). Baseline IgE positively correlated with improvement in SALT at week 36 (r > 0.60, p < 0.05). Dupilumab was well-tolerated, with no new safety concerns. These real-world data support the utility of dupilumab to safely treat pediatric AA patients, corroborating the role of Th2 skewing in children with AA and associated atopy, warranting larger clinical trials.


Assuntos
Alopecia em Áreas , Anticorpos Monoclonais Humanizados , Cabelo , Humanos , Alopecia em Áreas/tratamento farmacológico , Alopecia em Áreas/imunologia , Criança , Adolescente , Feminino , Masculino , Estudos Retrospectivos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem , Pré-Escolar , Cabelo/crescimento & desenvolvimento , Cabelo/efeitos dos fármacos , Resultado do Tratamento , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/imunologia , Índice de Gravidade de Doença , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Seguimentos
5.
J Invest Dermatol ; 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38888524

RESUMO

Skin barrier function (SBF) disorders are a class of pathologies that affect a significant portion of the world population. These disorders cause skin lesions with intense itch, impacting patients' physical and psychological well-being as well as their social functioning. It is in the interest of patients that their disorder be monitored closely while under treatment to evaluate the effectiveness of the ongoing therapy and any potential adverse reactions. Symptom-based assessment techniques are widely used by clinicians; however, they carry some limitations. Techniques to assess skin barrier impairment are critical for understanding the nature of the disease and for helping personalize treatment. This review recalls the anatomy of the skin barrier and describes an atomic-force microscopy approach to quantitatively monitor its disorders and their response to treatment. We review a panel of studies that show that this technique is highly relevant for SBF disorder research, and we aim to motivate its adoption into clinical settings.

7.
Artigo em Inglês | MEDLINE | ID: mdl-38821440

RESUMO

Contact dermatitis (CD) is a common and burdensome condition divided into irritant contact dermatitis and allergic contact dermatitis. Treatment relies on accurate diagnosis and identification of the trigger, because definitive treatment is irritant or allergen avoidance. However, avoidance is not always possible, such as when the patient is reacting to a necessary medical device, when the trigger is integral to the patient's occupation, and when avoidance is practically untenable. In these cases, treatment is particularly challenging, especially because the literature on treatments in this clinical scenario is limited. In addition, CD has a complex pathophysiology that varies according to the trigger type, leading to variable treatment efficacy. This article reviews the current literature on treatments for CD with a focus on treatments when trigger avoidance is not feasible.

11.
J Dermatolog Treat ; 35(1): 2355976, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38797745

RESUMO

PURPOSE: Based on a potential shared pathophysiology tied to mast cell activity and neurogenic inflammation that may link pruritus and chronic cough (CC), this study, leveraging the All of Us database, examines the association between the two conditions. MATERIALS AND METHODS: A nested case-control comparison was used to examine the association, identifying cases with SNOMED codes 418363000 (pruritus) and 68154008 (CC). Matching was performed on a 1:4 ratio by age, sex, and ethnicity using the MatchIt package in R, followed by maximum likelihood method to estimate odds ratios (ORs) and 95% confidence intervals from 2x2 contingency tables. RESULTS: CC patients (n = 2,388) were more than twice as likely to be diagnosed with pruritus (OR: 2.65) and pruritus patients (n = 22,496) were more than twice as likely to be diagnosed with CC (OR: 2.57), than respective matched controls. CONCLUSIONS: These results highlight the potential bidirectional relationship between CC and pruritus, suggesting possible shared immune and neural pathways. Treatments like difelikefalin and nalbuphine that modulate these pathways, alongside P2X3 targeting agents, are emerging as potential therapeutic approaches for itch and chronic cough given the possible interconnected pathophysiology. This study's insights into the associations between pruritus and CC may pave the way for targeted therapeutic strategies that address their shared mechanisms.


Assuntos
Tosse , Prurido , Humanos , Masculino , Feminino , Prurido/etiologia , Estudos de Casos e Controles , Doença Crônica , Tosse/etiologia , Tosse/fisiopatologia , Pessoa de Meia-Idade , Estados Unidos , Adulto , Bases de Dados Factuais , Idoso , Adulto Jovem , Adolescente , Tosse Crônica
18.
JAMA Dermatol ; 160(2): 226-229, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38117528

RESUMO

This cross-sectional study characterizes the frequency and degree of innovation of new dermatologic drugs approved by the US Food and Drug Administration (FDA) from 2012 to 2022.


Assuntos
Aprovação de Drogas , Estados Unidos , Humanos , United States Food and Drug Administration , Fatores de Tempo
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