Concurrent Uveodermatological (Vogt-Koyanagi-Harada-Like) Syndrome and Polymyositis in a Jack Russell Terrier
Kerstin BaikerE. ScurrellT WagnerDavid WalkerLaia Solano‐GallegoB. A. SummersB. SmythSandra Schöniger
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Acne vulgaris is one of the most common dermatological disease which may present with disturbed epidermal barrier function, exacerbated by drugs used to treat acne, both general and local. The instructing patients with acne in the selection of appropriate cosmetic products, significantly improves their quality of life. The aim of the study was to gain the knowledge of acne patients about the skin care principles. The study involved 80 patients suffering from acne vulgaris and showed the need to conduct education in the field of proper care of the acne skin.
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Dupilumab inhibits the interleukin-4 receptor subunit α and is FDA approved for treatment of moderate-to-severe atopic dermatitis. It is a relatively new drug, and whether it is efficacious for other diseases in dermatology is an area of increasing interest. We searched the literature and ClinicalTrials.gov database for uses of dupilumab beyond atopic dermatitis in dermatology and for ongoing studies on new uses for dupilumab. Off-label reports identified described use of dupilumab for several different dermatologic conditions, including allergic contact dermatitis, hand dermatitis, chronic spontaneous urticaria, prurigo nodularis, and alopecia areata. Overall, there is limited but promising data for dupilumab use beyond atopic dermatitis in dermatology. The relatively safe adverse effect profile of dupilumab may make it an option for certain recalcitrant diseases in dermatology, but further studies will be needed to assess its efficacy and determine its best possible use. J Drugs Dermatol. 2019;18(10):1053-1055.
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Abstract Introduction Acne vulgaris commonly affects adolescents. But recent reports suggest a rising prevalence of post‐adolescence acne. While there are few reports on post‐adolescence acne, there are even fewer reports comparing adolescence acne and post‐adolescence. Methods Epidemiological data of adolescence (<25 years) and post‐adolescence (≥25 years) acne patients diagnosed between 2004 and 2013 in a tertiary dermatology referral centre was analysed. From the pool of patients seen in 2010, 80 adolescence and 84 post‐adolescence acne patients’ epidemiological characteristics and treatment responses were analysed. Results During the 10‐year study period, there was an increase in the number and proportion of acne cases. In 2004, 4447 (5.77%) of all new diagnoses made were of acne vulgaris. The proportion rose to 5723 (8.13%) in 2013. There were consistently more female than male acne patients. The proportion of post‐adolescent cases remained constant at about 30% of all acne patients seen. Mean age of acne vulgaris patients decreased from 23.1 years in 2004 to 22.6 years in 2013. In the subgroup analysis, there were more males than females with adolescence acne (61.3% vs. 38.8%, P < 0.01) and more females with post‐adolescence acne (69.0% vs. 31.0%, P < 0.01). Thirty‐four (40.5%) post‐adolescence acne patients had acne from adolescence persisting into adulthood. Comedonal acne was more prevalent in the adolescence acne patients (58.8% vs. 40.5%, P = 0.019), whereas cystic acne was more prevalent in post‐adolescence patients (18.1% vs. 7.5%, P = 0.044). Systemic retinoids were more often used for treatment in the adolescence acne patients than post‐adolescence acne patients (23.8% vs. 10.7%, P = 0.027). Conclusion Acne predominantly affects adolescents but post‐adolescence acne is not uncommon. For post‐adolescence acne, females predominate over males. Inflammatory and cystic acne tends to be more predominant in post‐adolescence acne patients, whereas comedonal acne is more often seen in adolescence acne patients.
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Acne in the adult female often presents as a chronic condition that can have a considerable negative psychological, social and emotional impact on the affected individual. Estimated prevalence rates of adult female acne vary widely according to study type. Case reports and clinical examinations estimate the prevalence of clinical acne at 10-12%, while survey estimates of physiological disease states are as high as 54%. Two subtypes of adult female acne may be defined according to time of onset: 'persistent' and 'late-onset', accounting for approximately 80 and 20% of cases, respectively. Postadolescent acne is generally mild-to-moderate in severity and presents with more inflammatory lesions and fewer comedones compared to adolescent acne. Furthermore, the impact of acne on the quality of life is often greater in adult females than in younger individuals. Despite these important differences, the key principles of acne treatment in the adult female do not differ significantly from those of other age groups. However, specific characteristics relating to the adult female should be considered when selecting a treatment regimen.
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Background: Human-associated bacterial communities on the skin, skin microbiome, likely play a central role in development of immunity and protection from pathogens. In atopic patients, the skin bacterial diversity is smaller than in healthy subjects. Objective: To review treatment strategies for atopic dermatitis in Canada, taking the skin microbiome concept into account. Methods: An expert panel of 8 Canadian dermatologists explored the role of skin microbiome in clinical dermatology, specifically looking at atopic dermatitis. Results: The panel reached consensus on the following: (1) In atopic patients, the skin microbiome of lesional atopic skin is different from nonlesional skin in adjacent areas. (2) Worsening atopic dermatitis and smaller bacterial diversity are strongly associated. (3) Application of emollients containing antioxidant and antibacterial components may increase microbiome diversity in atopic skin. Conclusion: The skin microbiome may be the next frontier in preventive health and may impact the approach to atopic dermatitis treatment.
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The aim of this study was to investigate the early-life development of the skin microbiome in atopic dermatitis. Nineteen infants with atopic dermatitis and 19 healthy infants were evaluated 3 times, at 3 months intervals, within the first 30 months of life. Tape-strips were collected from volar forearms, cheeks, and eczema lesions, and the skin microbiome was assessed by 16S rRNA sequencing. Both the community structure and richness of the skin microbiome of infants with atopic dermatitis differed significantly from that of healthy infants, with greater richness in healthy infants. For infants with atopic dermatitis, the community composition was not dominated by Staphylococci. For healthy infants, community composition and richness correlated significantly with age, while such a pattern was not revealed in infants with atopic dermatitis. This suggests a slower maturation of the skin microbiome in atopic dermatitis, which precedes the staphylococcal predominance observed in older children and adults.
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