Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations.

A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).

Adalimumab Originator vs. Biosimilar in Hidradenitis Suppurativa: A Multicentric Retrospective Study.

This study aimed to compare adalimumab originator vs. biosimilar in HS patients, and to evaluate the effect of a switch to a biosimilar, or a switch back to the originator, in terms of treatment ineffectiveness. Patients with a diagnosis of HS were enrolled from 14 Italian sites. Treatment ineffectiveness was measured using Hurley score. The major analyses were 1) comparison between the two treatment groups (non-switcher analysis), and 2) the cross-over trend of Hurley score between treatment switchers (switcher analysis). Cox and Poisson regression models were used to compare the treatment ineffectiveness between groups. A total of 326 patients were divided into four groups: 171 (52.5%) taking originator; 61 (18.7%) patients taking biosimilar; 66 (20.2%) switchers; 28 (8.6%) switchers from originator to biosimilar and switched. A greater loss of efficacy was observed in the group allocated to the biosimilar than the originator group. The switcher analysis showed an effectiveness loss in the biosimilar compared to the originator. These results seem to indicate that a switch from one drug to the other may lead to a greater risk of inefficacy. A return to the previous treatment also does not ensure efficaciousness.

AISI: A New Disease Severity Assessment Tool for Hidradenitis Suppurativa.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic, disabling, skin disorder. Because of renewed scientific interest in HS, different aspects of the condition, such as disease severity assessment, are being investigated and better defined. The aim of this study is to provide a novel tool for the assessment of disease severity. METHODS AND MATERIALS: An HS-tailored, composite, dynamic score, named the Acne Inversa Severity Index (AISI) was designed to include a physician-rated assessment that considers the type of lesions occurring and the affected body sites. Additionally, a 0-10 visual analog scale (VAS), named Illness-VAS, was created to assess a patient's pain, discomfort, and disability due to HS. The authors compared AISI with other validated measurements, namely the Hurley staging classification, modified Sartorius score, and the Dermatology Life Quality Index (DLQI). RESULTS: The AISI was tested in 46 patients with HS, demonstrating a significant correlation with Hurley staging (r: 0.70856; P = 0.0021), modified Sartorius score (r: 0.9730; P = less than 0.00001), and DLQI (r: 0.8257; P = 0.0221). According to AISI cut-offs, HS may be defined as mild (AISI less than 10), moderate (AISI 10 > 18), and severe (AISI > 18). Additionally, comparing the 2 dynamic scores, AISI and Sartorius, AISI proved significantly faster than the Sartorius score (46.44 ± 19.24 seconds vs 83.2 ± 19.04 seconds; P =1.31 x 10-6). CONCLUSIONS: Being simple, fast, dynamic, and accurate, the AISI could represent the ideal measurement for HS severity in both real-life and clinical trial settings.