RESUMO
Alopecia areata (AA) is a chronic inflammatory disease characterized by nonscarring alopecia. In contrast to adult onset AA, the epidemiology, clinical characteristics, and therapy of childhood AA are less explored. This study aims at providing recommendations for the management of childhood AA. The special interest group (SIG) in pediatric dermatology under the Indian Association of Dermatology, Venereology and Leprosy (IADVL) conducted online meetings from February 2021 to September 2021, intending to identify the critical aspects in the diagnosis and treatment of AA. The classification, diagnosis, and tools for assessment of disease activity of childhood AA have been described in this study, along with recommendations for topical and systemic therapy, including newer therapeutic options.
RESUMO
The nation-wide lockdowns imposed in India during March--May 2020 (in four phases) to curb the spread of the novel Corona virus, greatly enhanced the near-surface air-quality due to lowering of industrial, transport and human activities. The present study focuses on the changes in the vertical structure of aerosol concentration and how those changes impacted radiation balance, the planetary boundary layer (PBL) height and surface meteorological parameters. Instrumented tower and Ceilometer measurements made at Gadanki (13.45°N, 79.18°E), located in a rural environment, coupled with satellite-derived Aerosol Optical Depth (AOD) data have been used to understand the changes in lockdown period. Significant reduction in backscatter density during the lockdown compared to 2019 indicates that aerosol reduction during the lockdown is not only limited to the surface, rather observed in the entire PBL. Except for the fourth phase of lockdown during which several relaxations have been given for vehicular movement and other anthropogenic activities, the reduction in backscatter density is seen in all phases of lockdown. However, the reduction is prominently seen in the second and third phases. The AOD also reduced by 40% around Gadanki, comparable to that of in urban regions. Due to the reduction in aerosols during the lockdown period, the insolation increases by 60 Wm-2, which is expected to increase the temperature. However, the increased loss of long-wave radiation (due to reduction in trapping gases) and more rain events during the lockdown period decreased the temperature by ~1 °C. Measurements also suggest that the most of net radiation is partitioned into the latent heat flux increasing the humidity and lowering the PBL height (due to reduced strength of thermals and sensible heat flux).
RESUMO
BACKGROUND: Itolizumab, a humanized monoclonal antibody to CD6, is a novel therapeutic agent evaluated in chronic plaque psoriasis. OBJECTIVE: We sought to assess the safety and efficacy of itolizumab in moderate to severe chronic plaque psoriasis. METHODS: A total of 225 patients were randomized (2:2:1) to 2 different itolizumab arms (A or B; A = 4-week loading dose of 0.4 mg/kg/wk followed by 1.6 mg/kg every 2 weeks; B = 1.6/mg every 2 weeks) or placebo. At week 12, the placebo arm was switched to 1.6 mg/kg itolizumab every 2 weeks. The primary end point was the proportion of patients with at least 75% improvement in Psoriasis Area and Severity Index score at week 12. RESULTS: At week 12, 27.0% in arm A (P = .0172 vs placebo), 36.4% in B (P = .0043 vs placebo), and 2.3% in the placebo arm had at least 75% improvement in Psoriasis Area and Severity Index score. At week 28, the proportion with at least 75% improvement in Psoriasis Area and Severity Index score was comparable: 46.1%, 45.5%, and 41.9% for A, B, and placebo, respectively. In weeks 1 to 12, the incidence of all adverse events was comparable across arms (A, 43%; B, 38%; placebo, 47%) and the incidence of infections was not greater than placebo (11.1%, 8.9%, and 18.6% for A, B, and placebo). LIMITATIONS: No active comparator is a limitation. CONCLUSIONS: Itolizumab is an effective and well-tolerated novel biological therapy in moderate to severe psoriasis.
