Clinical features are indicators of activity in common vitiligo
This was a 1-year prospective observational study. Fifty patients were included. Lesions were classified as hypomelanotic with poorly defined borders (HPDB, 29 cases) or amelanotic with sharply demarcated borders (ASDB, 21 cases). One year after biopsy, of the 48 patients still in the study, 20 had lesions that were considered to be stable and 28 active. Correlations were found between clinical aspects, histological findings and vitiligo activity. ASDB lesions indicated stability of a lesion, while inflammatory vitiligo, trichrome vitiligo and HPDB lesions were considered as markers of activity. The authors conclude that a simple clinical examination including a Wood's lamp may allow reliable and efficient evaluation of the stability of vitiligo lesions.
Benzekri L, Gauthier Y, Hamada S, Hassam B. Clinical features and histological findings are potential indicators of activity in lesions of common vitiligo. Br J Dermatol 2013; 168: 265–271.
Effect of FLG mutations and AD on the risk of ICD
Visser et al. investigated the relative contribution and interaction of filaggrin gene (FLG) mutations and atopic dermatitis (AD) in 634 patients with occupational irritant contact dermatitis (ICD) and 393 controls. FLG mutations were found in 15·9% of the patients with ICD and 8·3% of the controls, with a crude odds ratio (OR) of 2·09 [95% confidence interval (CI) 1·33–3·28] for the combined genotype (R501X, 2282del4, R2447X and S3247X). The adjusted OR for FLG mutations, corrected for AD, was 1·62 (95% CI 1·01–2·58). Subjects with AD were at approximately three times higher risk of developing ICD than controls. There was no evidence of an interaction between these two risk factors. Individuals with concurrent FLG mutations and AD are at the highest risk of developing ICD.
Visser MJ, Landeck L, Campbell LE et al. Impact of atopic dermatitis and loss-of – function −mutations in the filaggrin gene on the development of occupational irritant −contact dermatitis. Br J Dermatol 2013; 168: 326–332.
Secukinumab in the treatment of moderate-to-severe plaque psoriasis
The efficacy and safety of different doses of secukinumab, a fully human anti-interleukin (IL)-17A IgG1κ monoclonal antibody, in patients with moderate-to-severe plaque psoriasis were investigated. After 12 weeks of treatment, secukinumab 3 × 150 and 3 × 75 mg resulted in significantly higher Psoriasis Area and Severity Index 75% response rates vs. placebo (82% and 57% vs. 9%; P < 0·001 and P = 0·002, respectively). Two cases of neutropenia (≤ grade 2) were reported in the 3 × 150 mg cohort.
Papp KA, Langley RG, Sigurgeirsson B et al. Efficacy and safety of secukinumab in the treatment of moderate-to-severe plaque psoriasis: a randomized, double-blind, placebo-controlled phase II dose-ranging study. Br J Dermatol 2013; 168: 412–421.
Systemic immunosuppressive therapy and retinoids for HS
Blok et al. report a systematic review of systemic retinoids and immunosuppressants in adults with hidradenitis suppurativa (HS). A total of 87 papers were included, comprising 518 patients with HS who were treated with systemic retinoids, biologic agents or other immunosuppressive agents, including colchicine, ciclosporin, dapsone or methotrexate. Overall, the quality of evidence was low and differed between the agents, making direct comparisons difficult. Infliximab, adalimumab and acitretin were the most effective systemic agents, although the quality of evidence for acitretin was lower than that for infliximab and adalimumab. Randomized controlled trials are needed to identify the most effective treatment targets and the most effective therapy for HS.
Blok JL, van Hattem S, Jonkman MF, Horváth B. Systemic therapy with immunosuppressive agents and retinoids in hidradenitis suppurativa: a systematic review. Br J Dermatol 2013; 168: 243–252.