ABSTRACT
Chanarin-Dorfman syndrome (CDS) is a rare, autosomal recessive disorder of impaired triacylglycerol catabolism leading to cytoplasmic deposition of triglycerides in various cell types. We describe the case of an 8-month-old boy with cataracts, strabismus, motor delays, and an ichthyosiform rash since birth. Genetic testing revealed a pathogenic variant of the ABHD5 gene, suggestive of CDS, and further workup demonstrated hepatic steatosis and myopathy. His ichthyosis improved with initiation of a diet low in very long-chain fatty acids and medium-chain fatty acid supplementation.
Subject(s)
Cataract , Ichthyosiform Erythroderma, Congenital , Ichthyosis, Lamellar , Ichthyosis , Lipid Metabolism, Inborn Errors , Muscular Diseases , Male , Humans , Infant , Ichthyosiform Erythroderma, Congenital/diagnosis , Ichthyosiform Erythroderma, Congenital/genetics , Ichthyosis, Lamellar/diagnosis , Ichthyosis, Lamellar/genetics , Ichthyosis/diagnosis , Ichthyosis/genetics , Muscular Diseases/diagnosis , Muscular Diseases/genetics , Muscular Diseases/pathology , Lipid Metabolism, Inborn Errors/diagnosis , Lipid Metabolism, Inborn Errors/genetics , Lipid Metabolism, Inborn Errors/pathology , Cataract/diagnosis , 1-Acylglycerol-3-Phosphate O-Acyltransferase/geneticsABSTRACT
Introduction: Many tumor necrosis factor (TNF)-alpha 'biosimilar' agents have been approved for the treatment of psoriasis and other autoinflammatory conditions. These biosimilars have the same structure as the originator biologic and have been shown to be equivalent in terms of safety and efficacy. However, given the method by which biosimilars are manufactured, they are not exact replicas of the originator, unlike generic forms of non-biologic medications. Therefore, there is controversy regarding whether these agents should be considered interchangeable with their originator biologics.Areas covered: The objective of this review is to summarize the safety data for each of the approved TNF-alpha biosimilars to determine whether or not these agents have appropriate safety profiles to replace their originator biologics.Expert opinion: Based on extrapolation of phase III investigations in patients with rheumatologic diseases, each of the approved anti-TNF agents have comparable efficacy, tolerability, and safety profiles to their originators. Studies in patients with psoriasis are more limited. Transitioning from a biologic to its biosimilar has also been shown to be similarly safe and immunogenetic compared to maintenance therapy with the originator. More post-marketing studies are needed to demonstrate the long-term safety in patients with psoriasis.
Subject(s)
Biological Products/adverse effects , Biosimilar Pharmaceuticals/adverse effects , Psoriasis/drug therapy , Biological Products/administration & dosage , Biological Therapy/methods , Biosimilar Pharmaceuticals/administration & dosage , Dermatologic Agents/administration & dosage , Dermatologic Agents/adverse effects , Drug Approval , Drug Substitution , Humans , Psoriasis/pathology , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
YouTube is increasingly utilized by patients for health information. We aimed to assess the educational quality of YouTube videos about phototherapy and excimer laser for psoriasis. A cross-sectional analysis of YouTube videos was conducted using the search terms psoriasis phototherapy and psoriasis laser. Of the 200 videos screened, 124 met inclusion criteria. Sixty-eight (54.8%) were generated by device manufacturers advertising their product, 35 (28.2%) by healthcare professionals, and 8 (6.5%) by patients delivering testimonials from experiences receiving therapy. Fourteen (11.2%) contained high-quality patient education content, 28 (22.5%) were fair quality, and 82 (66.1%) were low quality. Compared to videos generated by advertisers, those created by healthcare providers were of higher educational quality and more likely to be patient-directed. Neither the number of views nor interaction differed significantly among videos of varying educational quality, between videos presenting evidence-based versus non-evidence-based claims about psoriasis, and between videos conveying positive versus negative messages regarding medical consultation. Overall, the majority of YouTube videos about phototherapy and excimer laser advertise devices are of fair-to-low educational quality and are not patient-centric. The addition of more videos that accurately and holistically discuss patient-relevant aspects of these therapies may transform YouTube into a more effective resource for informing patient choices.
Subject(s)
Consumer Health Information , Lasers, Excimer/therapeutic use , Patient Education as Topic , Phototherapy , Psoriasis/therapy , Social Media , Video Recording , Cross-Sectional Studies , HumansABSTRACT
Development of lentigines in areas of resolving psoriatic plaques is a rare phenomenon that has been reported following various treatment modalities including phototherapy, topical therapies, and biologics. Although the exact mechanism is unknown, evidence suggests that the cause may be multifactorial, with factors such as skin type, sun exposure, inflammation, and immunologic cytokines all playing a potential role. Herein, we present the first reported case of a patient developing multiple lentigines following treatment of psoriasis with the IL-23 inhibitor guselkumab.