Real-life, long-term data on efficacy, safety, response and discontinuation patterns of omalizumab in a Greek population with chronic spontaneous urticaria.

BACKGROUND: Omalizumab is approved for the treatment of chronic spontaneous urticaria (CSU) not responding to antihistamines. Data on omalizumab use in real-world settings and in different populations are lacking. OBJECTIVES: To record our five-year experience of omalizumab use in patients with refractory CSU in a real-world setting. MATERIALS & METHODS: A retrospective analysis of medical records of 80 patients with refractory CSU was performed. Demographic, and clinical characteristics, patterns of response, discontinuation strategies and rate of recurrence were analysed. RESULTS: Eighty individuals were included. UAS7 and DLQI significantly decreased from baseline. Complete response was achieved in 86.3%. Late response was observed at 27.5% of the patients. After discontinuation, 21.7% of patients reinitiated omalizumab due to relapse. The mean number of omalizumab administrations up to first discontinuation was 6.8 (based on an approach to shorten the treatment interval). Only 15.0% of patients experienced adverse events during treatment. CONCLUSION: Omalizumab, with long-term management, was highly effective and safe in achieving control of refractory CSU, with more favourable responses compared to Phase III clinical trials.

An Unusual Presentation of Lupus Vulgaris and the Practical Usefulness of Dermatoscopy.

We report a case report of lupus vulgaris (LV) presented on the extremities of an 80-year-old man. He was misdiagnosed as having psoriasis and referred to our department for a second-opinion evaluation. The discrepancy between the clinical manifestation which was misleading and the dermatoscopic findings raised the suspicion of an underlying granulomatous disease and we proceeded to skin biopsy. The histopathologic examination set the diagnosis of LV.

Successful treatment of hypertrophic lichen planus with betamethasone under occlusion and TCA-peelings.

Hypertrophic lichen planus (HLP) is a variant of lichen planus characterized by marked epidermal hyperplasia and severe pruritus. We present a case of a female patient with HLP and concomitant primary biliary cirrhosis, which responded to topical therapy with betamethasone under occlusion and TCA-peelings.

A case of atrophoderma vermiculatum responding to systemic isotretinoin.

BACKGROUND: Atrophoderma vermiculatum is a rare, benign follicular disorder that primarily affects children. It is characterized by symmetric reticular or honeycomb atrophy of the cheeks that may extend to the ears and forehead. The defect is believed to be due to abnormal keratinization in the pilosebaceous follicle. Management of atrophoderma vermiculatum is challenging. MAIN OBSERVATIONS: We report the case of a 10-year-old boy, diagnosed as atrophoderma vermiculatum. The boy underwent two 6-month treatment courses with isotretinoin at a dose of 0.50mg/kg/day, which resulted in partial remission of the lesions. Even though the disease did not completely regressed, isotretinoin stopped atrophy progression and improved cosmetic appearance of the skin. CONCLUSIONS: In this case of a child with atrophoderma vermiculatum isotretinoin stopped atrophy progression and improved cosmetic appearance of the skin. No adverse events were observed. However, always, when applying isotretinoin in children, it has to be considered that, apart from possible common adverse events, this treatment may promote premature epiphyseal plate closure and may stop normal growth in some children.