Real life data on the biopsychosocial effects of Adalimumab in the management of hidradenitis suppurativa: A multicenter cross sectional analysis and consideration of a multisystem monitoring approach to follow up.

Hidradenitis suppurativa (HS) is a chronic relapsing, remitting disease which results in the formation of inflammatory nodules and pustules in intertriginous areas. HS is a complex disease with known psychosocial impact. Adalimumab is a biologic, used for treatment resistant HS, which working by inactivating TNF-alpha. Our primary objective was to determine the effects of adalimumab on HS-PGA and DLQI scores in patients with HS that had been on the treatment for at least 6 months. Our secondary objective was to note and assess the significance of adverse effects and impacts on wider health, namely occupational and social. A retrospective cross-sectional study was performed using clinic notes from routine follow ups in biologic clinics in three specialist HS centers. About 77% (n = 78/101) patients demonstrated improvements in their HS-PGA scores. Significant improvements in the DLQI scores of the patient cohort (P = .0001, 95% CI -12.8 to -5.9) have also been demonstrated. A total of 31.7% (32/101) patients experienced adverse effects spanning multiple organ systems, with 27.7% (28/101) requiring treatment cessation. Three of these patients stopped due to the worsening of preexisting mental health symptoms. Adalimumab is effective in reducing HS-PGA and DLQI scores, but patients still complain of systemic effects necessitating drug cessation in some instances. A holistic and multisystemic approach to follow up is required, and there is scope for further studies examining temporal causality in the context of adalimumab and its multisystemic physical and psychological effects.

A randomised, controlled trial of a 4% cutaneous emulsion of sodium cromoglicate in treatment of atopic dermatitis in children.

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory skin disease. Sodium cromoglicate (SCG) is a chromone with anti-inflammatory, anti-itch and anti-allergic activity. This trial is a 12-week comparison (RCT) of a 4% SCG cutaneous emulsion with its vehicle in AD. MATERIALS AND METHODS: 208 children aged 2-12 years participated, 104 in each group. The primary endpoint was change in SCORAD score. Secondary endpoints included SASSAD score, topical steroid usage and global assessments. RESULTS: SCORAD was reduced by 28% (SCG group) and by 19% (vehicle): difference was statistically significant (p = 0.03) after 8 weeks and nearly significant (p = 0.09) after 12. A similar result occurred in SASSAD (p = 0.001 at 8 weeks). In subjects without major protocol deviations (SCG-64, vehicle-63), difference in SCORAD remained significant at 12 weeks (p = 0.04). Weight of topical steroids reduced in both groups: -0.60 ± 1.3 g/day (35%), SCG and -0.05 ± 1.1 g/day vehicle (p = 0.04). Treatment success, defined as investigator global opinion graded very or moderately effective, was significantly more frequent in SCG group (p = 0.025). Application site discomfort reported by 12.5% of subjects in SCG group and 16.5% in vehicle group. CONCLUSIONS: SCG 4% cutaneous emulsion provides an effective, well-tolerated, steroid-sparing treatment for AD in children.

The effect of pulsed dye laser on the dermatology life quality index in erythematotelangiectatic rosacea patients: an assessment.

BACKGROUND: Erythematotelangiectatic rosacea is a common cutaneous disorder. It has a major psychosocial impact on a patient's life. OBJECTIVE: This study aims to investigate the impact of pulsed dye laser on the quality of life of affected patients as measured by the Dermatology Life Quality Index. METHODS: The authors report a prospective study of 20 patients (in a wide range of skin phototypes) attending a laser clinic. All patients completed the Dermatology Life Quality Index questionnaires before and after three sessions of laser treatment. RESULTS: The mean Dermatology Life Quality Index scores pre- and post-laser treatment were 17.3 and 4.3, respectively. All patients experienced a statistically significant improvement in their quality of life (p<0.0001, paired t test). CONCLUSION: The Dermatology Life Quality Index questionnaire (pre- and post-laser treatment) is an important tool for monitoring the efficacy of therapy and patient satisfaction.

Hairy intraoral flap--an unusual indication for laser epilation: a series of 5 cases and review of the literature.

A variety of the flaps used to reconstruct defects of the head and neck region following surgery for malignant disease contain hair follicles that may result in unwanted hair growth. This can cause significant distress to the patients in a variety of ways. We report 5 cases of significant intraoral hair growth of which 4 cases were successfully managed with long-pulsed alexandrite laser. One patient was not treated due to technical difficulties. We review the literature on the management of hair growth on intraoral flaps.