RESUMO
Psoriasis is a chronic skin condition that is associated with several comorbidities and co-manifestations that reduce patient quality of life. Psoriatic arthritis (PsA) is a form of spondyloarthritis that is associated with psoriasis and typically involves peripheral disease, axial disease, enthesitis, dactylitis, and skin and nail lesions. Psoriatic arthritis is associated with a substantial psychosocial and functional burden and can lead to irreversible joint damage if left untreated. Early and accurate diagnosis of PsA is critical. The symptoms of PsA span the fields of dermatology and rheumatology, and professional societies recommend co-management between rheumatologists and dermatologists to optimally treat the condition. Dermatologists must be familiar with the hallmarks of PsA, while rheumatologists should understand the impact that cutaneous manifestations of PsA can have on quality of life. Current models of co-management include combined clinics and virtual clinics, which have had success in case reports. Co-management of PsA has been associated with more use of biologics, better preventive care, and higher patient satisfaction.
Assuntos
Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Dermatologistas , Gerenciamento Clínico , Equipe de Assistência ao Paciente , Reumatologistas , Antirreumáticos/uso terapêutico , Medicamentos Biossimilares/uso terapêutico , Comorbidade , Efeitos Psicossociais da Doença , Humanos , Imunossupressores/uso terapêutico , Interleucina-17/antagonistas & inibidores , Inibidores da Fosfodiesterase 4/uso terapêutico , Guias de Prática Clínica como Assunto , Inibidores de Proteínas Quinases/uso terapêutico , Psoríase/diagnóstico , Psoríase/terapia , Qualidade de Vida , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
There are numerous proposed but contested components involved in the pathophysiology of rosacea, including inflammatory mediators, reactive oxygen species (ROS) released by neutrophils, and microbial components. Ideal comprehensive rosacea management should address these components. Azelaic acid (AzA), a naturally occurring substance, has many proposed mechanisms of action--antimicrobial, anti-inflammatory/antioxidant, and keratinolytic--that address the proposed components of rosacea pathophysiology and has demonstrated efficacy in subtype 2 rosacea. In a roundtable discussion, information leaders discussed the pathophysiology of rosacea and other issues of importance to successful rosacea management, such as skin care regimens, quality of life (QOL), and compliance.
Assuntos
Fármacos Dermatológicos/uso terapêutico , Ácidos Dicarboxílicos/uso terapêutico , Rosácea/terapia , Fármacos Dermatológicos/farmacologia , Ácidos Dicarboxílicos/farmacologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Emolientes/uso terapêutico , Géis , Humanos , Metronidazol/uso terapêutico , Higiene da Pele , Sabões/uso terapêutico , Protetores Solares/uso terapêuticoRESUMO
UNLABELLED: When treating patients with extensive dermatitis, total body surface area affected must be considered when prescribing topical medication. Halcinonide 0.1% cream, a class 2 topical corticosteroid, is now available in a 216g jar. This large size is convenient and cost effective for patients with large-area dermatoses. OBJECTIVES: The objectives of this study were to determine the efficacy and patient acceptance of halcinonide in 216g jars for the treatment of large-area dermatoses. DESIGN: This study was an open-label, noncomparator trial evaluating the clinical outcomes and acceptability of halcinonide in 216g jars. Halcinonide was prescribed twice daily for up to 28 days. MEASUREMENT: Severity of dermatoses was based on investigator observations at the baseline visit and again after 28 days. Patient satisfaction was evaluated based on a questionnaire completed at the conclusion of the study. RESULTS: Total enrollment was 40 patients. Dermatoses affected an average of 12 percent body surface area. At baseline, all patients exhibited dermatoses rated as severe or moderate. Nearly half of patients were completely cleared or almost cleared by 28 days, with all patients noting at least some improvement. Most patients agreed that they liked the way the product spread on the skin (94.7%), and more than 80 percent found that it was neither sticky nor greasy. In more than 90 percent of cases, the investigator reported that halcinonide provided a shorter duration of therapy versus triamcinolone one-pound jars. CONCLUSION: Halcinonide 0.1% cream in 216g jars is effective and convenient for patients with large-area dermatoses.
RESUMO
Rosacea is a common inflammatory facial dermatosis seen in adults that exhibits considerable variety in clinical presentation. Multiple medical therapeutic options are available including topical and oral treatments. Optimal medical management of rosacea includes assessment of subtype and disease severity and use of appropriate skin care to reduce epidermal barrier dysfunction. This article provides an overall discussion of the medical management of rosacea and reviews interim results from a study evaluating the role of designated skin care in rosacea treatment.