Neutrophil-to-Lymphocyte Ratio Predicts Development of Immune-Related Adverse Events and Outcomes from Immune Checkpoint Blockade: A Case-Control Study.

The utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) utility in predicting immune-related adverse events (irAEs) and survival have not been well studied in the context of treatment with immune checkpoint inhibitors (ICIs). We performed a case-control study of cancer patients who received at least one dose of ICI in a tertiary hospital. We examined NLR and PLR in irAE cases and controls. Logistic and Cox regression models were used to identify independent risk factors for irAEs, progression-free survival (PFS), and overall survival (OS). The study included 91 patients with irAEs and 56 controls. Multiple logistic regression showed that NLR < 3 at baseline was associated with higher occurrence of irAEs. Multivariate Cox regression showed that development of irAEs and reduction in NLR from baseline to week 6 were associated with longer PFS. Higher NLR values at baseline and/or week 6 were independently associated with shorter OS. A reduction in NLR from baseline to week 6 was associated with longer OS. In this study of cancer patients treated with ICIs, NLR has a bidirectional relationship with adverse outcomes. Lower NLR was associated with increased occurrence of irAEs while higher NLR values were associated with worse clinical outcomes.

Supportive oncodermatology-a narrative review of its utility and the way forward.

Supportive oncodermatology is an interdisciplinary field, emerging due to increasing dermatological morbidity in patients with cancer and the recognition of the need for greater collaborative and integrated care to improve patient outcomes. These two unique fields (Oncology and Dermatology) may be integrated in various ways, such as through specialised combined clinics, protocols for expedited access, multidisciplinary groups and meetings, and the development of best practices guidelines. This narrative review consolidates the small but growing literature surrounding supportive oncodermatology; discusses the potential benefit and disadvantages, and areas for future research; and suggests a framework for implementation.

An update on pityrosporum folliculitis in Singapore from a single tertiary care dermatological centre.

INTRODUCTION: Pityrosporum folliculitis (PF) is a common skin condition that can be easily misdiagnosed, especially by non-dermatologists. While the initial diagnosis is often made clinically, skin microscopy may help to confirm the same. However, there is scant literature regarding the clinical epidemiology of PF. To our knowledge, in Singapore, only one prior epidemiological study was performed in 1987. Through the present study, we aimed to provide an update regarding the epidemiology, diagnosis and treatment of patients with PF in Singapore. METHODS: We performed a retrospective review of patients with clinical presentations compatible with PF who presented to the dermatology clinic at the National University Hospital, Singapore, between 1 January 2011 and 31 December 2015. The medical records of patients identified as having clinical presentations that resembled PF were reviewed via written and electronic databases. Information regarding the demographics and clinical presentation of the patients was collected. RESULTS: Of the 375 patients identified, 214 (57.1%) were confirmed as having PF based on Gram-stain microscopy. Most (35.0%) of these 214 patients were aged between 21 and 30 years, with a male-to-female ratio of 3:1. The lesions predominantly occurred on the trunk and the back. The majority of patients presented with symptoms that lasted more than one month. 128 (59.8%) patients received oral antifungal treatment, whereas 82 (38.3%) patients were treated with topical antifungal treatment alone. CONCLUSION: A typical Singapore patient with PF is a young man aged 21-30 years, with erythematous follicular papules or pustules over the trunk and the back.