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Janus kinase (JAK) inhibitors are novel molecules increasingly prescribed for various dermatologic conditions. However, the Food and Drug Administration recently reported increased risks of malignancy in patients taking this class of medication. To shed more light on this potential adverse effect, we present a patient with cutaneous T-cell lymphoma possibly associated with his treatment with a JAK inhibitor for atopic dermatitis. To our knowledge, there are no reported cases of cutaneous T-cell lymphoma in association with JAK inhibitors in the literature. We highlight the importance of remaining cautious when prescribing this new class of medication, especially in patients with risk factors for malignancy. Moreover, when faced with atypical presentations of atopic dermatitis, we stress the need for a biopsy to make the correct diagnosis prior to treatment. Lastly, we encourage further studies to better characterize the malignancy risk associated with JAK inhibitors.
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This article was migrated. The article was marked as recommended. Introduction Continuous Professional Development (CPD) is an important part of a physician's professional life. Yet, providing effective in-service training solutions is a persistent challenge for CPD planners. Methods Primary care physicians are frequently confronted with skin lesionsthey feel ill-prepared to manage. A dermatology Learning-by-concordance (LbC) online activity was developed and offered to family physicians for CPD credit. We were interested in finding out whether this online tool was suitable for CPD. Following a pilot phase, the on-line activity was launched and 45 geographically dispersed primary care physicians completed it. They participated in a telephone conference a week later with an expert to discuss outstanding questions. Evaluation was carried out by a survey that was available immediately after the last case. Results Participants found the on-line training tool user friendly and should be implemented on a larger scale. Participants found the dermatology concepts discussed allowed them to increase their knowledge and apply it to their practice. Discussion Among the strengths of LbC is that the learning task resemble those of a primary physician's daily practice. Finally, our study reveals that LbC is easily integrated in busy work schedules and thus is an effective learning solution for CPD.
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BACKGROUND: Bullous pemphigoid (BP) is an autoimmune bullous disease requiring immunosuppressive therapy. Kaposi sarcoma (KS) is an angioproliferative tumor associated with the opportunistic viral infection human herpes virus 8 (HHV-8). It is a well-known condition associated with longstanding human immunodeficiency virus infection, but it may also occur in the context of iatrogenic immunosuppression. OBJECTIVE: Although a rare complication, all dermatologists dealing with immunosuppressors must be aware and have a high index of suspicion when a patient presents with rapidly progressive violaceous papules. METHODS AND RESULTS: We describe an Italian male patient treated for bullous pemphigoid with topical and systemic corticosteroids and mycophenolate mofetil (MMF) who developed multifocal cutaneous KS after a few months of therapy. CONCLUSION: To our knowledge, KS onset associated with MMF and corticosteroids intake for BP treatment has not been reported previously. KS associated with iatrogenic immunosuppression can have an aggressive course, and it must be promptly recognised since cessation of immunosuppression therapy can lead to complete resolution. Immune restoration is the key to control this viral infection.