Real-world Safety and Efficacy of Risankizumab in Psoriatic Patients: A Multicenter, Retrospective, and Not-interventional Study.

BACKGROUND AND OBJECTIVE: Risankizumab - a humanized monoclonal antibody that targets the p19 subunit of IL-23 - has been recently approved to treat moderate-to-severe plaque psoriasis. Real-world data based on a representative pool of patients are currently lacking. OBJECTIVE: To assess the mid- and long-term safety and efficacy profile of risankizumab in patients with moderate-to-severe psoriasis in the routine clinical practice. METHODS: This was a retrospective and multicenter study of consecutive psoriatic patients on risankizumab from April 2020 through November 2022. The primary endpoint was the number of patients who achieved a 100% improvement in their Psoriasis Area and Severity Index (PASI) (PASI100) on week 52. RESULTS: A total of 510 patients, 198 (38.8%) women and 312 (61.2%) men were included in the study. The mean age was 51.7±14.4 years. A total of 227 (44.5%) study participants were obese (body mass index [BMI] >30kg/m2). The mean baseline PASI score was 11.4±7.2, and the rate of patients who achieved PASI100 on week 52, 67.0%. Throughout the study follow-up, 21%, 50.0%, 59.0%, and 66% of the patients achieved PASI100 on weeks 4, 16, 24, and 40, respectively. The number of patients who achieved a PASI ≤2 was greater in the group with a BMI ≤30kg/m2 on weeks 4 (P=.04), 16 (P=.001), and 52 (P=.002). A statistically significantly greater number of patients achieved PASI100 in the treatment-naïve group on weeks 16 and 52 (P=.001 each, respectively). On week 16 a significantly lower number of participants achieved PASI100 in the group with psoriatic arthropathy (P=.04). Among the overall study sample, 22 (4.3%) patients reported some type of adverse event and 20 (3.9%) discontinued treatment. CONCLUSIONS: Risankizumab proved to be a safe and effective therapy for patients with moderate-to-severe psoriasis in the routine clinical practice.

Effectiveness and safety of brodalumab in the treatment of plaque, scalp and palmoplantar psoriasis: A multicentre retrospective study in a Spanish population.

BACKGROUND AND OBJECTIVE: The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0-1/IGA 0 for the special locations at Week 52 of treatment. PATIENTS AND METHODS: Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. RESULTS: A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0-1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. CONCLUSIONS: Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis.

Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study.

BACKGROUND: It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS). OBJECTIVE: To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management. METHODS: Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared. RESULTS: Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra-rater examination was 22.8% (P < 0.01); intra-rater and inter-rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01). LIMITATIONS: The inability to detect lesions that measure ≤0.1 mm or with only epidermal location. CONCLUSION: Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.

Enfermedad de Still del adulto: presentación de cuatro casos / Adult onset Still’s disease: presentation of four cases

La enfermedad de Still del adulto es una enfermedad sistémica, poco frecuente, de etiología desconocida y que suele afectar a adultos jóvenes. Se caracteriza por la asociación de artralgias, fiebre alta en picos y un exantema característico. Las lesiones cutáneas están formadas por máculas eritematosas de color salmón, de aspecto urticariforme y que se distribuyen principalmente en el tronco y la raíz de extremidades. Estas lesiones son asintomáticas y aparecen en forma de erupción característicamente transitoria, de aparición vespertina y resolución posterior fugaz, siguiendo un curso paralelo al de la fiebre. Desde el punto de vista histológico se caracteriza por un infiltrado inflamatorio dérmico perivascular compuesto principalmente de linfocitos y con presencia de neutrófilos. El factor reumatoide y los anticuerpos antinucleares son negativos y en el hemograma se observa leucocitosis con neutrofilia. Otros posibles hallazgos en la enfermedad de Still del adulto son úlceras de garganta, linfadenopatías, esplenomagalia o disfunciónhepática entre otras. Presentamos los casos de cuatro mujeres con enfermedad de Still del adulto y describimos sus lesiones cutáneas, afectación sistémica, características histológicas y su evolución (AU)

Adult onset Still’s disease (AOSD) is a rare systemic illness of unknown aetiology and which usually affects young adults. It is characterised by arthralgia,high peaking temperatures and a characteristic exanthema. Cutaneous lesions are salmon coloured erythematous urticariform macula found mainly on the trunk and extremities. These lesions are symptom free and appear as typically transitory evening eruptions with posterior fleeting resolution and follow a parallel course to the high temperature. Histologically, they show a perivascular inflammatory dermic infiltrate with lymphocitic predominance and containing some neutrophils. Rheumatoid factors and antinuclear antibodies are negative and leucocytosis with neutrophilia is seenon blood analysis. Other possible findings in AOSD are sore throat, lymphoadenopathies, splenomegalia or liver dysfunction, among others.AOSD in 4 females is presented describing cutaneous lesions, systemic involvement, histological results and evolution (AU)

Enfermedad de Still del adulto: presentación de cuatro casos / Adult onset Still’s disease: presentation of four cases

La enfermedad de Still del adulto es una enfermedad sistémica, poco frecuente, de etiología desconocida y que suele afectar a adultos jóvenes. Se caracterizapor la asociación de artralgias, fiebre alta en picos y un exantema característico. Las lesiones cutáneas están formadas por máculas eritematosas decolor salmón, de aspecto urticariforme y que se distribuyen principalmente en el tronco y la raíz de extremidades. Estas lesiones son asintomáticas y aparecenen forma de una erupción característicamente transitoria, de aparición vespertina y resolución fugaz, siguiendo un curso paralelo al de la fiebre. Desdeel punto de vista histológico se caracteriza por un infiltrado inflamatorio dérmico perivascular compuesto principalmente de linfocitos y con presencia deneutrófilos. El factor reumatoide y los anticuerpos antinucleares son negativos y en el hemograma se observa leucocitosis con neutrofilia. Otros posibleshallazgos en la enfermedad de Still del adulto son úlceras en la garganta, linfadenopatías, esplenomegalia o disfunción hepática entre otras.Presentamos los casos de cuatro mujeres con enfermedad de Still del adulto y describimos sus lesiones cutáneas, afectación sistémica, característicashistológicas y su evolución (AU)

Adult onset Still’s disease (AOSD) is a rare systemic illness of unknown aetiology and which usually affects young adults. It is characterised by arthralgia,high peaking temperatures and a characteristic exanthema. Cutaneous lesions are salmon coloured erythematous urticariform macula located mainly onthe trunk and extremities. These lesions are symptom free and appear as typically transitory evening eruptions with posterior fleeting resolution and followa parallel course to the fever. Histologically, they show a perivascular inflammatory dermic infiltrate with lymphocitic predominance and containing someneutrophils. Rheumatoid factors and antinuclear antibodies are negative and leucocytosis with neutrophilia is seen on blood analysis. Other possible findingsin AOSD are sore throat, lymphoadenopathies, splenomegalia or liver dysfunction, among others (AU)

Sarna noruega. Tratamiento con ivermectina / Norwegian scabies. Therapy with ivermectine

La sarna noruega es una forma particular de sarna mucho más frecuente en pacientes inmunodeprimidos que en la población general. Se caracteriza por la gran cantidad de parásitos que albergan las lesiones, motivo por el cual es altamente contagiosa y difícil de tratar. Presentamos el caso de una paciente VIH con sarna noruega, que respondió muy bien al tratamiento oral con ivermectina en dosis única, junto con la aplicación tópica de queratolíticos. Describimos las características clínicas de esta forma de sarna, discutimos el uso de ivermectina en el tratamiento de la sarna y destacamos su utilidad en casos de sarna noruega (AU)

Mondor's disease and aesthetic breast surgery: report of case secondary to mastopexy with augmentation.

Although the etiology of Mondor's disease remains obscure, trauma of some form is the most commonly cited cause. Surgical trauma has frequently been quoted, but references in the literature specifically implicating aesthetic breast surgery are scarce. In this article, we report a case of Mondor's disease secondary to mastopexy with concomitant augmentation mammaplasty.