British Journal of Dermatology

Cover image for Vol. 172 Issue 4

Early View (Online Version of Record published before inclusion in an issue)

Editor: Alex Anstey, Newport, UK

Impact Factor: 4.1

ISI Journal Citation Reports © Ranking: 2013: 7/61 (Dermatology)

Online ISSN: 1365-2133

Associated Title(s): Clinical and Experimental Dermatology

VIEW

  1. 1 - 85
  1. Photobiology

    1. You have full text access to this OnlineOpen article
      Long-term observational study of afamelanotide in 115 patients with erythropoietic protoporphyria

      G. Biolcati, E. Marchesini, F. Sorge, L. Barbieri, X. Schneider-Yin and E.I. Minder

      Article first published online: 30 APR 2015 | DOI: 10.1111/bjd.13598

      What's already known about this topic?

      • Afamelanotide implants have been studied in two phase II and three phase III studies with significant improvement of outcomes: sun sensitivity and EPP-related pain. However, in absolute values the effects have been small.
      • The afamelanotide-induced tanning causes unblinding, so that a positive bias cannot be excluded.

      What does this study add?

      • This long-term observational study shows that 97% of patients considered afamelanotide to be effective in ameliorating EPP symptoms and 93% adhered to treatment for a prolonged time, if there were no compelling reasons to discontinue, which indicates good clinical effectiveness.
      • This study supports a good safety profile for afamelanotide, as even in long-term usage, only minor adverse effects were observed.
  2. Review Articles

    1. Skin cancer risk in BRCA1/2 mutation carriers

      P.V. Gumaste, L.A. Penn, R.M. Cymerman, T. Kirchhoff, D. Polsky and B. McLellan

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13626

      What's already known about this topic?

      • While BRCA1/2 mutation carriers have a well-documented risk of breast and ovarian cancer, their risk of cancers at other sites is less clear.

      What does this study add?

      • Our review demonstrates there is inconclusive evidence to support a strong link between BRCA1/2 mutations and skin cancer.
      • Increased skin cancer surveillance in BRCA1/2 mutation carriers is not recommended.
  3. Research Letters

  4. Correspondence

    1. Combining biologics with methotrexate in psoriasis: a systematic review

      J.S. van Bezooijen, E.P. Prens, M.S. Pradeepti, R. Atiqi, M.W.J. Schreurs, B.C.P. Koch, T. van Gelder and M.B.A. van Doorn

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13573

  5. Research Letters

    1. Actual practice of melanoma follow-up and treatment in Germany: results of a prospective, longitudinal cohort study

      E. Livingstone, T.K. Eigentler, C. Windemuth-Kieselbach, A. Hauschild, R. Rompel, U. Trefzer, D. Nashan, K. Kilian, D. Debus, K.C. Kähler, A. Mauerer, K. Möllenhoff, E. Dippel and D. Schadendorf

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13612

  6. Correspondence

  7. Research Letters

    1. The prevalence of burning mouth syndrome: a population-based study

      J.J. Kohorst, A.J. Bruce, R.R. Torgerson, L.A. Schenck and M.D.P. Davis

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13613

  8. Case Reports

    1. Primary cutaneous T-cell lymphoma presenting as mycosis fungoides with a T-/null-cell phenotype: report of two cases

      L. Bekel, G. Chaby, C. Lok, A. Dadban, D. Chatelain, S. Ingen-Housz-Oro and N. Ortonne

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13563

      What's already known about this topic?

      • Phenotypic aberrations with loss of some surface antigens are common findings in malignant cutaneous T-cell lymphomas.
      • The almost complete absence of T-cell marker expression in mycosis fungoides has never been reported previously.

      What does this study add?

      • We describe two original observations of cutaneous T-cell lymphoma characterized by an aberrant immunophenotype with loss of pan T-cell antigens including the T-cell receptor β chain.
      • Lymphoma behaviour and evolution does not appear to be modified in these cases.
    2. Segmentally arranged seborrhoeic keratoses with impending atypia and squamous cell carcinoma in an elderly woman

      E. Livingstone, U. Hillen, C. Hafner, S. Piel, L. Groesser, D. Schadendorf and R. Happle

      Article first published online: 29 APR 2015 | DOI: 10.1111/bjd.13562

      What's already known about this topic?

      • Cases of multiple congenital seborrhoeic keratoses being arranged in a segmental pattern appear to be extremely rare.

      What does this study add?

      • In a patient with unilateral congenital seborrhoeic keratoses, multiple precanceroses and one squamous cell carcinoma originating from these lesions were documented.
      • FGFR3 or PIK3CA mutations were found in several lesions, but a causal relationship with premalignant and malignant growth was unlikely.
      • The disorder may be taken as an unusual variant of the presently known keratinocytic naevi, or it may represent a new entity with the proposed name ‘SASKIA naevus’.
  9. Review Articles

    1. Reflectance confocal microscopy in the diagnosis of solitary pink skin tumours: review of diagnostic clues

      C. Longo, E. Moscarella, G. Argenziano, A. Lallas, M. Raucci, G. Pellacani and A. Scope

      Article first published online: 27 APR 2015 | DOI: 10.1111/bjd.13689

      What's already known about this topic?

      • Solitary pink tumours represent a diagnostic challenge for clinicians as they often reveal subtle clinical and dermoscopic features.
      • Reflectance confocal microscopy (RCM) has been shown to improve the accuracy of diagnosis of amelanotic melanoma and basal cell carcinoma.

      What does this study add?

      • This review describes the criteria for RCM diagnosis of neoplasms that present as solitary pink lesions.
      • This descriptive information may facilitate the formulation of prospective studies testing RCM-based diagnosis of amelanotic neoplasms.
  10. Clinical and Laboratory Investigations

    1. Satellite lesions accompanying herpes zoster: a new prognostic sign for high-risk zoster

      L. el Hayderi, S. Bontems, N. Nikkels-Tassoudji, J.E. Arrese, L. Seidel, C. Meex and A.F. Nikkels

      Article first published online: 27 APR 2015 | DOI: 10.1111/bjd.13643

      What's already known about this topic?

      • The clinical relevance of varicella zoster virus satellite lesions occurring during herpes zoster is unclear.

      What does this study add?

      • The presence of satellite lesions during herpes zoster conveys a statistically significant increased risk for hospitalization of the patient, an immunosuppressive status, the development of systemic signs, and multistage and multidermatomal herpes zoster.
      • Total-body examination for satellite lesions is a rapid, easy and reliable clinical tool for identifying patients with high-risk zoster.
  11. Correspondence

  12. Research Letters

    1. Asthma in patients with psoriasis

      A.S. Lønnberg, L. Skov, A. Skytthe, K.O. Kyvik, O.B. Pedersen, H. Meteran, V. Backer and S.F. Thomsen

      Article first published online: 27 APR 2015 | DOI: 10.1111/bjd.13637

  13. Correspondence

    1. Alpha-1-antitrypsin deficiency panniculitis presenting with severe anasarca, pulmonary embolus and hypogammaglobulinaemia

      A.N. Elsensohn, J.A. Curtis, A.M. Secrest, M. Liaqat, S.R. Florell, K.L. Duffy, K. Edholm and E.M. Summers

      Article first published online: 19 APR 2015 | DOI: 10.1111/bjd.13611

    2. Oral squamous cell carcinoma and hyperkeratotic lesions with BRAF inhibitors

      E. Vigarios, L. Lamant, J.P. Delord, J.C. Fricain, C. Chevreau, B. Barrés, C. Gomez-Roca, M. Boulanger and V. Sibaud

      Article first published online: 19 APR 2015 | DOI: 10.1111/bjd.13610

  14. Case Reports

    1. Treatment of two patients with generalized pustular psoriasis with the interleukin-1β inhibitor gevokizumab

      B. Mansouri, L. Richards and A. Menter

      Article first published online: 19 APR 2015 | DOI: 10.1111/bjd.13614

      What's already known about this topic?

      • Generalized pustular psoriasis (GPP) is a potentially life-threatening, severe inflammatory skin disease for which current therapeutics are limited and frequently inadequate.
      • Interleukin (IL)-1 antagonists have shown promise in treating pustular dermatoses, such as GPP.

      What does this study add?

      • We report two cases of GPP managed with gevokizumab, a humanized monoclonal antibody targeting IL-1β.
      • Both cases have shown noteworthy initial responses to therapy.
  15. Clinical and Laboratory Investigations

    1. Histopathology of drug rash with eosinophilia and systemic symptoms syndrome: a morphological and phenotypical study

      N. Ortonne, L. Valeyrie-Allanore, S. Bastuji-Garin, J. Wechsler, S. de Feraudy, T.-A. Duong, M.-H. Delfau-Larue, O. Chosidow, P. Wolkenstein and J.-C. Roujeau

      Article first published online: 16 APR 2015 | DOI: 10.1111/bjd.13683

      What's already known about this topic?

      • The histological features of drug rash with eosinophilia and systemic symptoms (DRESS) vary from spongiotic dermatitis to an erythema multiforme-like aspect.
      • In DRESS, skin biopsies often show eosinophils and apoptotic bodies.
      • Atypical lymphocytes may be found in skin infiltrates.

      What does this study add?

      • The association of several inflammatory patterns in a single biopsy is suggestive for diagnosis.
      • Cutaneous infiltrates can compromise atypical lymphocytes resembling Sézary cells.
      • DRESS shows a higher density of inflammatory infiltrates, more apoptosis, associated inflammatory patterns and granzyme B+ cells than maculapapular rash.
      • Effector T cells are mainly polyclonal granzyme B+ CD8+ T cells.
  16. Epidemiology and Health Services Research

    1. What the Eczema Area and Severity Index score tells us about the severity of atopic dermatitis: an interpretability study

      Y.A. Leshem, T. Hajar, J.M. Hanifin and E.L. Simpson

      Article first published online: 16 APR 2015 | DOI: 10.1111/bjd.13662

      What's already known about this topic?

      • The Eczema Area and Severity index (EASI) is one of the best validated outcome instruments for atopic dermatitis (AD).

      What does this study add?

      • The severity of AD can now be interpreted from the EASI numerical score.
      • The EASI takes a short time to administer.
      • Our study supports the use of EASI as an outcome tool in clinical trials by providing the first guide for interpreting the score and confirming its ease of use.
  17. Correspondence

    1. Cervical screening uptake in a dermatology cohort on immunosuppressive agents

      J. Clowry, I. Callanan, K. Eustace, P. Collins, B. Kirby and A. Lally

      Article first published online: 16 APR 2015 | DOI: 10.1111/bjd.13609

  18. Dermatopathology

    1. CD68 expression is a discriminative feature of indolent cutaneous CD8-positive lymphoid proliferation and distinguishes this lymphoma subtype from other CD8-positive cutaneous lymphomas

      M. Wobser, S. Roth, T. Reinartz, A. Rosenwald, M. Goebeler and E. Geissinger

      Article first published online: 15 APR 2015 | DOI: 10.1111/bjd.13628

      What's already known about this topic?

      • Indolent cutaneous CD8+ lymphoid proliferation is a variant of cutaneous T-cell lymphomas that typically shows a favourable course.
      • Distinction from aggressive cutaneous CD8+ lymphomas is often difficult on histopathology.

      What does this study add?

      • CD68 is positive in lymphoma cells of indolent cutaneous CD8+ lymphoid proliferation but negative in other cutaneous CD8+ lymphomas.
      • CD68 may represent a new marker to separate indolent CD8+ lymphoid proliferation from other CD8+ cutaneous lymphomas.
  19. Correspondence

  20. Epidemiology and Health Services Research

    1. Lifestyle and youthful looks

      D.A. Gunn, J.L. Dick, D. van Heemst, C.E.M. Griffiths, C.C. Tomlin, P.G. Murray, T.W. Griffiths, S. Ogden, A.E. Mayes, R.G.J. Westendorp, P.E. Slagboom and A.J.M. de Craen

      Article first published online: 15 APR 2015 | DOI: 10.1111/bjd.13646

      What's already known about this topic?

      • Smoking, sun exposure and body mass index have been associated with the perceived age of subjects in passport-type images in a study of north Europeans aged ≥ 70 years.

      What does this study add?

      • Sunbed use and oral care were also found to associate significantly with a higher perceived facial age in 45–75-year-old north European men and women.
      • Significant lifestyle factors accounted for around 10 years of perceived facial age, illustrating the strong relationship between lifestyle and perceived age.
  21. Research Letters

  22. Correspondence

    1. Capsaicin 8% cutaneous patch: a promising treatment for brachioradial pruritus?

      C. Zeidler, H. Lüling, A. Dieckhöfer, N. Osada, F. Schedel, S. Steinke, M. Augustin and S. Ständer

      Article first published online: 13 APR 2015 | DOI: 10.1111/bjd.13501

  23. Cutaneous Biology

    1. Elevations in T-helper-2-initiating cytokines (interleukin-33, interleukin-25 and thymic stromal lymphopoietin) in lesional skin from chronic spontaneous (‘idiopathic’) urticaria

      A.B. Kay, P. Clark, M. Maurer and S. Ying

      Article first published online: 12 APR 2015 | DOI: 10.1111/bjd.13621

      What's already known about this topic?

      • Increased expression of T-helper (Th)2 [interleukin (IL)-4 and IL-5] cytokines was previously demonstrated in skin biopsies from chronic spontaneous urticaria (CSU).

      What does this study add?

      • The Th2-initiating cytokines (IL-33, IL-25 and thymic stromal lymphopoietin) are also expressed in CSU, but in lesional, not unaffected, skin.
      • This suggests that innate pathways may play a role in the mechanism of wealing.
      • IL-33 colocalized to endothelial cells, fibroblasts, macrophages and mast cells; IL-25 was expressed by epithelial cells, mast cells and eosinophils.
  24. Review Articles

    1. Patient-reported outcome measures in psoriasis: the good, the bad and the missing!

      H. Kitchen, L. Cordingley, H. Young, C.E.M. Griffiths and C. Bundy

      Article first published online: 12 APR 2015 | DOI: 10.1111/bjd.13691

      What's already known about this topic?

      • Psoriasis has a significant impact on the lives of patients and is associated with psychological comorbidity, suboptimal coping and low levels of well-being.
      • Patient-reported outcome (PRO) measures can facilitate the assessment of physical and psychological functioning and identify suboptimal coping strategies.
      • The Dermatology Life Quality Index is widely used in psoriasis research. No psoriasis-specific PRO measure is consistently used in the current management of psoriasis in the U.K.

      What does this study add?

      • To date, no study has systematically reviewed the development and validation of psoriasis PRO measures in accordance with published guidelines and theory in order to explore which measures are appropriate for the comprehensive clinical management of psoriasis.
      • This study indicates that no single PRO measure demonstrates adequate evidence of validity, reliability and sensitivity to change in capturing the emotional well-being and coping strategies of patients with psoriasis.
    2. Typing of Propionibacterium acnes: a review of methods and comparative analysis

      Y. Yu, J. Champer, H. Garbán and J. Kim

      Article first published online: 9 APR 2015 | DOI: 10.1111/bjd.13667

      What's already known about this topic?

      • Several methods exist to type different strains of Propionibacterium acnes.
      • Types of P. acnes appear to be associated with different diseases.
      • P. acnes types display several phenotypic differences.

      What does this study add?

      • Several methods of typing are reviewed and compared.
      • Differences between P. acnes types are assessed and correlated with their disease associations.
      • Future studies regarding P. acnes types are proposed.
  25. Epidemiology and Health Services Research

    1. Health-related quality of life in morphoea

      N.K. Klimas, A.D. Shedd, I.H. Bernstein and H. Jacobe

      Article first published online: 8 APR 2015 | DOI: 10.1111/bjd.13572

      What's already known about this topic?

      • Little is known about health-related quality of life (HRQoL) in morphoea.
      • Existing studies indicate that morphoea has a modest effect on quality of life in children, while studies in adults generally report greater negative impact on quality of life and emotional distress.

      What does this study add?

      • Disease severity and symptoms, such as pain and itch, are linked with HRQoL. Pruritus reflects disease activity. Individuals with morphoea worry about the impact and progression of their condition.
      • HRQoL issues in morphoea should be addressed. Physicians have the opportunity to intervene with education about the disease and its prognosis.
  26. Review Articles

    1. You have full text access to this OnlineOpen article
      Fatigue in psoriasis: a phenomenon to be explored

      I.M. Skoie, T. Ternowitz, G. Jonsson, K. Norheim and R. Omdal

      Article first published online: 8 APR 2015 | DOI: 10.1111/bjd.13647

      What's already known about this topic?

      • Fatigue is prevalent in patients with chronic inflammatory diseases, cancer and some neurological diseases.
      • Depression, sleep disorders and pain influence fatigue.
      • Genes and molecular signalling pathways are increasingly recognized as important contributors to fatigue.

      What does this study add?

      • The relationship of fatigue with psoriasis disease activity is unclear.
      • Biological drugs have a beneficial effect on fatigue in patients with psoriasis.
      • More knowledge regarding the prevalence, severity and impact of fatigue in patients with psoriasis is needed.
      • Future therapeutic studies should include fatigue as an outcome variable.
  27. Clinical and Laboratory Investigations

    1. Skin reaction and regeneration after single sodium lauryl sulfate exposure stratified by filaggrin genotype and atopic dermatitis phenotype

      J. Bandier, B.C. Carlsen, M.A. Rasmussen, L.J. Petersen and J.D. Johansen

      Article first published online: 2 APR 2015 | DOI: 10.1111/bjd.13651

      What's already known about this topic?

      • Subjects with atopic dermatitis (AD) have barrier defects and increased susceptibility to irritants.
      • Studies have suggested that filaggrin mutations facilitate penetration of irritants, which could explain the increased risk of irritant contact dermatitis among patients with AD and filaggrin mutations.

      What does this study add?

      • Skin response and regeneration after sodium lauryl sulfate barrier disruption are more dependent on AD than on filaggrin genotype.
      • Those with both mutations and AD have higher inflammatory alertness, with a more rapid inflammatory response.
  28. Therapeutics

    1. Tofacitinib withdrawal and retreatment in moderate-to-severe chronic plaque psoriasis: a randomized controlled trial

      R. Bissonnette, L. Iversen, H. Sofen, C.E.M. Griffiths, P. Foley, R. Romiti, M. Bachinsky, S.T. Rottinghaus, H. Tan, J. Proulx, H. Valdez, P. Gupta, L. Mallbris and R. Wolk

      Article first published online: 2 APR 2015 | DOI: 10.1111/bjd.13551

      What's already known about this topic?

      • Tofacitinib inhibits Janus kinase (JAK)1/JAK3 implicated in psoriasis pathogenesis. Oral tofacitinib was effective in treating psoriasis in a phase 2b study.
      • Patients may need to stop treatment temporarily.

      What does this study add?

      • Continuous tofacitinib treatment was most effective in psoriasis, but if treatment had been interrupted, retreatment was possible.
      • Up to 50% of patients recaptured a ≥ 75% improvement in Psoriasis Area Severity Index score upon retreatment.
      • Tofacitinib is well tolerated. No patients experienced psoriasis rebound during treatment withdrawal.
  29. Systematic Reviews

    1. Evaluation of skin ageing: a systematic review of clinical scales

      G. Dobos, A. Lichterfeld, U. Blume-Peytavi and J. Kottner

      Article first published online: 2 APR 2015 | DOI: 10.1111/bjd.13509

      What's already known about this topic?

      • Clinical scales are widely used in dermatological research and practice.
      • Skin ageing is a complex phenomenon with numerous visible signs.
      • Skin ageing scales need to be valid and reliable.

      What does this study add?

      • Currently there are more than 100 different scales available.
      • Evidence supporting the validity and reliability of the majority of scales is poor.
      • The development of new skin ageing scales must be justified and accompanied by adequate methodology.
  30. Epidemiology and Health Services Research

    1. ‘We're all carrying a burden that we're not sharing’: a qualitative study of the impact of cutaneous T-cell lymphoma on the family

      L.E. Selman, T. Beynon, E. Radcliffe, S. Whittaker, D. Orlowska, F. Child and R. Harding

      Article first published online: 1 APR 2015 | DOI: 10.1111/bjd.13583

      What's already known about this topic?

      • Cutaneous T-cell lymphoma (CTCL) is a rare, progressive cancer that can be life limiting and highly disfiguring.
      • CTCL has a negative impact on patients' quality of life.

      What does this study add?

      • Family caregivers of patients with CTCL experience multiple demands from the disease and the burden of caregiving.
      • CTCL has a profound impact on family dynamics and relationships.
      • Support services for families are needed that provide tailored information and understand family adjustment processes.
  31. Correspondence

    1. Persistent alopecia induced by vismodegib

      S. Alkeraye, C. Maire, E. Desmedt, C. Templier and L. Mortier

      Article first published online: 1 APR 2015 | DOI: 10.1111/bjd.13630

    2. Clinical characteristics of postherpetic pruritus: assessment using a questionnaire, von Frey filaments and Neurometer

      H.-J. Lee, G.-W. Kim, W.-J. Kim, J.-H. Mun, M. Song, H.-S. Kim, H.-C. Ko, M.-B. Kim and B.-S. Kim

      Article first published online: 1 APR 2015 | DOI: 10.1111/bjd.13569

  32. Dermatopathology

    1. Secondary cutaneous lymphoma: comparative clinical features and survival outcome analysis of 106 cases according to lymphoma cell lineage

      W.J. Lee, K.H. Won, C.H. Won, S.E. Chang, J.H. Choi, K.C. Moon, C.-S. Park, J. Huh, C. Suh and M.W. Lee

      Article first published online: 1 APR 2015 | DOI: 10.1111/bjd.13582

      What's already known about this topic?

      • Lymphoma is a diverse group of malignancies that includes many different categories.

      What does this study add?

      • The characteristics of skin lesions in secondary cutaneous lymphoma are different depending on the lymphoma cell lineages.
      • Skin lesion characteristics such as time point of appearance and extent affect the survival of secondary cutaneous lymphoma.
  33. Clinical and Laboratory Investigations

    1. Dermoscopy structures as predictors of sentinel lymph node positivity in cutaneous melanoma

      T. González-Álvarez, C. Carrera, A. Bennassar, A. Vilalta, R. Rull, L. Alos, J. Palou, S. Vidal-Sicart, J. Malvehy and S. Puig

      Article first published online: 1 APR 2015 | DOI: 10.1111/bjd.13552

      What's already known about this topic?

      • There is a good correlation between some dermoscopic criteria and histopathology in melanoma.
      • Dermoscopy is a method proposed for the preoperative evaluation of melanoma thickness.

      What does this study add?

      • Dermoscopy can reduce sentinel lymph node biopsy procedures by 41·5%.
      • The presence of an atypical pigmented network correlates with a negative sentinel lymph node.
      • Dermoscopic ulceration and the presence of blotch correlated strongly with a positive sentinel lymph node.
  34. Dermatopathology

    1. Reflectance confocal microscopy correlates of dermoscopic patterns of facial lesions help to discriminate lentigo maligna from pigmented nonmelanocytic macules

      N. de Carvalho, F. Farnetani, S. Ciardo, C. Ruini, A.M. Witkowski, C. Longo, G. Argenziano and G. Pellacani

      Article first published online: 31 MAR 2015 | DOI: 10.1111/bjd.13546

      What's already known about this topic?

      • The clinical diagnosis of facial pigmented lesions can be challenging because of the overlapping features of benign and malignant entities.
      • Dermoscopy and reflectance confocal microscopy (RCM) can assist in the diagnostic process.

      What does this study add?

      • This article provides an original perspective regarding the role of dermoscopy and RCM in the diagnosis of facial malignant lesions.
      • RCM can be used to assess appropriate treatment options and follow-up protocols for facial lesions.
  35. Research Letters

    1. Rituximab therapy in pemphigus foliaceus: report of 12 cases and review of recent literature

      L. de Sena Nogueira Maehara, J. Huizinga and M.F. Jonkman

      Article first published online: 31 MAR 2015 | DOI: 10.1111/bjd.13586

  36. Correspondence

  37. Research Letters

    1. Clinical consequences of sesquiterpene lactone mix contact allergy in Denmark

      R.M. Andersen, L. Skov, T. Menné and J.D. Johansen

      Article first published online: 27 MAR 2015 | DOI: 10.1111/bjd.13584

  38. Correspondence

    1. Cutaneous paraneoplastic granulomatous eruptions secondary to metastatic carcinoid tumour

      J.M. Cohen, V.E. Nambudiri, M.H. Kulke, D.J. Todd, G.F. Murphy and N.R. LeBoeuf

      Article first published online: 27 MAR 2015 | DOI: 10.1111/bjd.13516

  39. Research Letters

  40. Therapeutics

    1. You have full text access to this OnlineOpen article
      Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-to-severe psoriasis: results from the PHOENIX 2 study through 5 years of follow-up

      R.G. Langley, M. Lebwohl, G.G. Krueger, P.O. Szapary, Y. Wasfi, D. Chan, M.C. Hsu, Y. You, Y. Poulin, N. Korman, J.C. Prinz, K. Reich and on behalf of the PHOENIX 2 Investigators

      Article first published online: 22 MAR 2015 | DOI: 10.1111/bjd.13469

      What's already known about this topic?

      • Data regarding dosing adjustment from PHOENIX 1 are limited. Protocol-defined dose-interval adjustment was permitted only early in the study based on clinical response.

      What does this study add?

      • PHOENIX 2 evaluated both protocol-defined and investigator-initiated dose and/or dose-interval adjustment.
      • Improved response was generally demonstrated following dosing adjustments; further investigations are required to quantify the actual incremental benefits.
      • Some patients may desire treatment goals beyond 75% improvement in Psoriasis Area and Severity Index.
  41. Epidemiology and Health Services Research

    1. Psoriasis and obesity in French children: a case–control, multicentre study

      E. Mahé, A. Beauchet, C. Bodemer, A. Phan, A.-C. Bursztejn, F. Boralevi, A.-L. Souillet, C. Chiaverini, E. Bourrat, J. Miquel, P. Vabres, S. Barbarot, D. Bessis, C. Eschard, S. Hadj-Rabia and for the Groupe de Recherche de la Société Française de Dermatologie Pédiatrique

      Article first published online: 22 MAR 2015 | DOI: 10.1111/bjd.13507

      What's already known about this topic?

      • The frequency and severity of psoriasis are associated with a high prevalence of obesity in adults.
      • Obesity is associated with severe plaque psoriasis in children.

      What does this study add?

      • Childhood psoriasis is associated with overweight with abdominal obesity, or obesity per se irrespective of the type of psoriasis and its severity.
      • There is no difference in the determinants for obesity in children with psoriasis and controls.
      • The main determinants for overweight in children with psoriasis are female sex and having a parent who is overweight.
  42. Cutaneous Biology

    1. Differential expression and functionality of ATP-binding cassette transporters in the human hair follicle

      I.S. Haslam, C. El-Chami, H. Faruqi, A. Shahmalak, C.A. O'Neill and R. Paus

      Article first published online: 19 MAR 2015 | DOI: 10.1111/bjd.13549

      What's already known about this topic?

      • ATP-binding cassette (ABC) transporters are expressed in the epidermis and cutaneous immune cells (Langerhans cells).
      • ABCB1 and ABCG2 may enhance the transepidermal movement of substrate drugs.
      • ABCC1 is present in the hair follicle.

      What does this study add?

      • A detailed expression and localization map for numerous well-characterized xenobiotic and lipid-transporting ABC proteins in the human hair follicle.
      • The first functional data indicating that ABCB1 and ABCG2 actively reduce the accumulation of substrates within the hair follicle.
  43. Systematic Reviews

    1. The value of in vivo reflectance confocal microscopy in the diagnosis and monitoring of inflammatory and infectious skin diseases: a systematic review

      L. Hoogedoorn, M. Peppelman, P.C.M. van de Kerkhof, P.E.J. van Erp and M.J.P. Gerritsen

      Article first published online: 19 MAR 2015 | DOI: 10.1111/bjd.13499

      What's already known about this topic?

      • Many inflammatory and infectious skin diseases have been imaged by in vivo reflectance confocal microscopy (RCM).

      What does this study add?

      • This systematic review provides an overview and accuracy assessment of RCM features and diagnoses.
      • This review facilitates further implementation of RCM in dermatological practice.
  44. Case Reports

    1. Epidermal barrier abnormalities in exfoliative ichthyosis with a novel homozygous loss-of-function mutation in CSTA

      V. Moosbrugger-Martinz, A. Jalili, A.S. Schossig, K. Jahn-Bassler, J. Zschocke, M. Schmuth, G. Stingl, K.M. Eckl, H.C. Hennies and R. Gruber

      Article first published online: 18 MAR 2015 | DOI: 10.1111/bjd.13545

      What's already known about this topic?

      • Recently, loss-of-function mutations in CSTA, encoding cysteine protease inhibitor A, were reported to cause autosomal recessive exfoliative ichthyosis (AREI).

      • There is evidence for a key role of cysteine protease inhibitor A in desmosome-mediated cell–cell adhesion within the basal and spinous layers of the human epidermis.

      What does this study add?

      • We report a novel homozygous loss-of-function mutation in CSTA.
      • Transmission electron microscopy revealed epidermal barrier abnormalities in AREI.
      • We compare the morphological characteristics between AREI and Netherton syndrome (also caused by a protease inhibitor deficiency).
  45. Correspondence

    1. Arthritis possibly induced and exacerbated by a tumour necrosis factor antagonist in a patient with psoriasis vulgaris

      T. Takahashi, Y. Asano, S. Shibata, K. Nakamura, M. Nakao, R. Shida, A. Mitsui, M. Araki, R. Watanabe, H. Fujita, Y. Tada and S. Sato

      Article first published online: 18 MAR 2015 | DOI: 10.1111/bjd.13587

  46. Research Letters

    1. The global burden of disease associated with alopecia areata

      C. Karimkhani, L.N. Boyers, M. Naghavi, L.E. Coffeng, J.P. Lott, S. Wulf, R. Hay, H.C. Williams, M.A. Weinstock, S.A. Norton, A.W. Armstrong, C.A. Dunnick, D.A. Norris and R.P. Dellavalle

      Article first published online: 18 MAR 2015 | DOI: 10.1111/bjd.13559

  47. Review Articles

    1. Phototherapy, photodynamic therapy and photophoresis in the treatment of connective-tissue diseases: a review

      E.A. Gordon Spratt, L.V. Gorcey, N.A. Soter and J.A. Brauer

      Article first published online: 18 MAR 2015 | DOI: 10.1111/bjd.13544

      What's already known about this topic?

      • Connective-tissue diseases, including lupus erythematosus, morphoea/scleroderma and dermatomyositis, occur in patients who are medically complex and have unique cutaneous manifestations that may be recalcitrant to conventional therapies.
      • Given the association of connective-tissue diseases and photosensitivity, the use of light-based therapeutic modalities for these conditions is controversial.

      What does this study add?

      • This review is the first report to examine the evidence available in the literature for the treatment of lupus, morphoea, scleroderma and dermatomyositis with phototherapy, photodynamic therapy and photopheresis.
      • Cutaneous manifestations of some of these connective-tissue disorders may be effectively and safely treated with light-based modalities despite associations with photosensitivity.
  48. Research Letters

    1. New immune system genetic polymorphisms associated with moderate-to-severe plaque psoriasis: a case–control study

      R. Prieto-Pérez, G. Solano-López, T. Cabaleiro, M. Román, D. Ochoa, M. Talegón, O. Baniandrés, J.L.L. Estebaranz, P. de la Cueva, E. Daudén and F. Abad-Santos

      Article first published online: 18 MAR 2015 | DOI: 10.1111/bjd.13585

  49. Therapeutics

    1. Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry

      P. Gisondi, S. Cazzaniga, S. Chimenti, M. Maccarone, M. Picardo, G. Girolomoni, L. Naldi and the Psocare Study Group

      Article first published online: 17 MAR 2015 | DOI: 10.1111/bjd.13539

      What's already known about this topic?

      • Screening for latent tuberculosis infection (LTBI) is mandatory in patients with psoriasis candidate to biological therapy.
      • The risk of developing active tuberculosis in patients treated with tumour necrosis factor-α inhibitors is significantly higher than in subjects not exposed to biologics.

      What does this study add?

      • The nationwide prevalence of LTBI in patients with psoriasis enrolled in the Psocare registry is 8·3%.
      • Independent factors associated with LTBI were male sex, age over 55 years and being entered into a conventional treatment.
  50. Photodermatology

    1. Efficacy of ablative fractional laser-assisted photodynamic therapy for the treatment of actinic cheilitis: 12-month follow-up results of a prospective, randomized, comparative trial

      S.H. Choi, K.H. Kim and K.-H. Song

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13542

      What's already known about this topic?

      • Photodynamic therapy (PDT) is less efficient for actinic cheilitis (AC) than for actinic keratosis.
      • Use of an erbium:yttrium–aluminium–garnet ablative fractional laser (Er:YAG AFL) improves the methyl aminolaevulinate (MAL) penetration into deeper portions of lesions.

      What does this study add?

      • The present study showed Er:YAG AFL-assisted MAL-PDT is better for the treatment of AC and requires fewer sessions than conventional MAL-PDT.
  51. Scholarly Reviews

    1. Approach to chronic wound infections

      D. Leaper, O. Assadian and C.E. Edmiston

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13677

      What's already known about this topic?

      • Infection is the most likely cause of stalled healing in chronic wounds.
      • Infection in chronic wounds is a clinical decision-making process; a diagnostic would be useful for practitioners.
      • Presence of biofilm cannot be detected clinically and a diagnostic is needed.

      What does this study add?

      • Presence of biofilm is the likely cause of persistent infection and requires maintenance debridement at dressing changes, as well as topical antiseptic intervention.
      • Use of antibiotics to treat infections in chronic wounds requires strict antibiotic stewardship.
  52. Correspondence

    1. Successful switch to dabrafenib after vemurafenib-induced toxic epidermal necrolysis

      G. Jeudy, S. Dalac-Rat, B. Bonniaud, A. Hervieu, T. Petrella, E. Collet and P. Vabres

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13522

    2. Acute generalized exanthematous pustulosis: a retrospective audit of practice between 1994 and 2011 at a single centre

      S. Ingen-Housz-Oro, C. Hotz, L. Valeyrie-Allanore, E. Sbidian, F. Hemery, O. Chosidow and P. Wolkenstein

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13540

  53. Case Reports

    1. Chromium-induced diffuse dermatitis with lymph node involvement resulting from Langerhans cell histiocytosis after metal-on-metal hip resurfacing

      N. Bizzotto, A. Sandri, G. Trivellin, B. Magnan, G.M. Micheloni, A. Zamò, P. Bernardi, A. Sbarbati and D. Regis

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13517

      What's already known about this topic?

      • Metal-on-metal (MOM) hip resurfacing (HR) is frequently associated with metallic corrosion, the release of wear debris and high levels of metal ions in the blood.
      • Systemic and local signs of prolonged exposure to metal ions include hypersensitivity, possible carcinogenicity and pseudotumour formation.
      • Metal-related dermatitis and lymphadenopathy after orthopaedic joint prostheses are well known.

      What does this study add?

      • Combined diffuse dermatitis with lymph node involvement resulting from Langerhans cell histiocytosis induced by chromium after MOM-HR has not been previously reported.
      • Prolonged release of metal ions and high serum levels may cause sensitization and type IV hypersensitivity reaction to chromium. Lymphadenopathy with diagnosis of special Langerhans cell histiocytosis may be due to prolonged activation of the type IV immune response.
      • Replacing the prosthesis using alternative coupling surfaces is the only approach that can resolve these symptoms.
  54. Correspondence

    1. Comparison of reflectance confocal microscopy and standardized skin surface biopsy for three different lesions in a pityriasis folliculorum patient

      C. Yuan, X.-M. Wang, A. Guichard, T. Lihoreau, S. Mac-Mary, L. Khyat, M. Ardigò and P. Humbert

      Article first published online: 15 MAR 2015 | DOI: 10.1111/bjd.13506

  55. Research Letters

  56. Correspondence

    1. Mutations in GJB6 causing phenotype resembling pachyonychia congenita

      G.I. Hale, N.J. Wilson, F.J.D. Smith, G. Wylie, M.E. Schwartz and M. Zamiri

      Article first published online: 13 MAR 2015 | DOI: 10.1111/bjd.13520

  57. Research Letters

  58. Correspondence

    1. Myopathy in hereditary leiomyomatosis and renal cell cancer in an extended family

      A. España, E. Ornilla, R. Zarate, I. Gil-Bazo and P. Briones

      Article first published online: 11 MAR 2015 | DOI: 10.1111/bjd.13504

  59. Dermatological Surgery and Lasers

    1. Mohs micrographic surgery in dermatofibrosarcoma protuberans allows tumour clearance with smaller margins and greater preservation of healthy tissue compared with conventional surgery: a study of 74 primary cases

      C. Serra-Guillén, B. Llombart, E. Nagore, C. Guillén, C. Requena, V. Traves, S. Kindem, R. Alcalá, N. Rivas and O. Sanmartín

      Article first published online: 9 MAR 2015 | DOI: 10.1111/bjd.13417

      What's already known about this topic?

      • Dermatofibrosarcoma protuberans (DFSP) is a malignant tumour with unpredictable subclinical extension in the form of asymmetric tentacle-like projections.
      • Conventional surgical excision with wide margins usually removes a large amount of healthy skin and does not always completely remove the tumour.
      • Mohs micrographic surgery (MMS) achieves tumour clearance with smaller margins than conventional surgery, but the amount of tissue spared has never been quantified.

      What does this study add?

      • It is impossible to recommend an optimal margin for the conventional excision of DFSP, as each tumour has a unique subclinical extension.
      • MMS should be the treatment of choice in DFSP because it is associated with high cure rates and avoids unnecessarily large surgical defects.
      • The mean percentages of skin spared using MMS rather than conventional surgery with 2- and 3-cm margins are 49·4% and 67·9%, respectively.
  60. Epidemiology and Health Services Research

    1. Relations between the characteristics and psychological comorbidities of chronic pruritus differ between men and women: women are more anxious than men

      A. Stumpf, S. Ständer, B. Warlich, F. Fritz, P. Bruland, B. Pfleiderer, G. Heuft and G. Schneider

      Article first published online: 9 MAR 2015 | DOI: 10.1111/bjd.13492

      What's already known about this topic?

      • Chronic pruritus (CP) is a symptom with a negative impact on quality of life and is known to be associated with anxiety and depression.
      • To our knowledge, no study has investigated sex-specific differences in this context.

      What does this study add?

      • We found sex-specific differences in anxiety levels and distinct pruritus characteristics and clinical features in relation to anxiety and depression. We believe that these findings are of importance to clinicians and basic researchers.
  61. Dermatological Surgery and Lasers

    1. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation

      A. Lallas, J. Pyne, A. Kyrgidis, S. Andreani, G. Argenziano, A. Cavaller, J. Giacomel, C. Longo, A. Malvestiti, E. Moscarella, S. Piana, F. Specchio, R. Hofmann-Wellenhof and I. Zalaudek

      Article first published online: 9 MAR 2015 | DOI: 10.1111/bjd.13510

      What's already known about this topic?

      • While the dermoscopic criteria of squamous cell carcinoma (SCC) have been well described, little is currently known about the variability of these criteria with respect to the histopathological grade of differentiation in SCC.

      What does this study add?

      • Poorly differentiated SCC is dermoscopically typified by a predominantly red colour, attributed to the presence of bleeding and/or dense vascularity.
      • Identifying poorly differentiated tumours in vivo may enhance their appropriate management.
  62. Cutaneous Biology

    1. Phenotypic modulation of smooth muscle cells in lymphoedema

      F. Ogata, K. Fujiu, I. Koshima, R. Nagai and I. Manabe

      Article first published online: 9 MAR 2015 | DOI: 10.1111/bjd.13482

      What's already known about this topic?

      • Lymphoedema is a debilitating progressive condition that is frequently observed following cancer surgery and severely restricts quality of life.
      • Although it is known that lymphatic dysfunction and obstruction underlie lymphoedema, the pathogenic mechanism is poorly understood.

      What does this study add?

      • Lymphatic smooth muscle cells play a key role in the development of lymphoedema.
  63. Research Letters

    1. Livedo-like dermatitis and necrotic lesions after high-dose buprenorphine injections: a national French survey

      L. Wainstein, C. Bernier, M. Gérardin, R. Bouquié, O. Espitia, J.M. Mussini, P. Jolliet and C. Victorri-Vigneau

      Article first published online: 9 MAR 2015 | DOI: 10.1111/bjd.13503

  64. Correspondence

  65. Case Reports

    1. Whole-exome sequencing diagnosis of two autosomal recessive disorders in one family

      T. Takeichi, A. Nanda, S. Aristodemou, J.R. McMillan, J. Lee, M. Akiyama, H. Al-Ajmi, M.A. Simpson and J.A. McGrath

      Article first published online: 7 MAR 2015 | DOI: 10.1111/bjd.13473

      What's already known about this topic?

      • Mutations in the suppression of tumorigenicity 14 gene (ST14), encoding matriptase, underlie autosomal recessive congenital ichthyosis type 11 (ARCI11). To date, only four pathogenic mutations in ST14 have been reported.
      • Walker–Warburg syndrome (WWS) is a rare autosomal recessive disorder with developmental malformations, resulting from mutations in POMT1, which encodes O-mannosyltransferase.
      • Next-generation sequencing has the potential to reveal both anticipated and incidental mutations.

      What does this study add?

      • Using whole-exome sequencing, we identified a new homozygous splice-site mutation in ST14 in a 4-year-old Bedouin girl with ARCI11.
      • Bioinformatics analysis of the exome dataset revealed that this girl was also heterozygous for a mutation in POMT1, providing insight into WWS affecting two other siblings in this family.
      • Whole-exome sequencing can provide both molecular diagnostics for known disorders, and data that can improve clinical diagnosis and genetic counselling.
  66. Correspondence

    1. Distinctive clinical and dermoscopic features of BRAF V600K mutated melanomas

      G. Ponti, M. Manfredini, A. Tomasi and G. Pellacani

      Article first published online: 7 MAR 2015 | DOI: 10.1111/bjd.13484

  67. Therapeutics

    1. You have full text access to this OnlineOpen article
      Long-term safety and efficacy of bimatoprost solution 0·03% application to the eyelid margin for the treatment of idiopathic and chemotherapy-induced eyelash hypotrichosis: a randomized controlled trial

      D.A. Glaser, P. Hossain, W. Perkins, T. Griffiths, G. Ahluwalia, E. Weng and F.C. Beddingfield

      Article first published online: 7 MAR 2015 | DOI: 10.1111/bjd.13443

      What's already known about this topic?

      • The safety and efficacy of bimatoprost ophthalmic solution 0·03% have been previously established for idiopathic hypotrichosis in studies lasting up to 4 months.

      What does this study add?

      • Very little has been reported on eyelash loss and regrowth after chemotherapy, and there is currently no standard prevention or treatment for chemotherapy-induced hypotrichosis of the eyelashes.
      • We provide long-term (up to 12 months) safety and efficacy data for treatment with bimatoprost ophthalmic solution 0·03% in chemotherapy-induced and idiopathic hypotrichosis.
  68. Review Articles

    1. The genetics of pyoderma gangrenosum and implications for treatment: a systematic review

      E.M. DeFilippis, S.R. Feldman and W.W. Huang

      Article first published online: 27 FEB 2015 | DOI: 10.1111/bjd.13493

      What's already known about this topic?

      • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful skin ulcerations for which treatment can be challenging.

      What does this study add?

      • This study reviews over 823 cases of PG and its associated gene mutations and syndromes.
      • The various treatments of PG, depending on the underlying disease association, are discussed.
  69. Paediatric Dermatology

    1. Henoch–Schönlein purpura and systemic disease in children: retrospective study of clinical findings, histopathology and direct immunofluorescence in 34 paediatric patients

      E.F. Johnson, J.S. Lehman, D.A. Wetter, C.M. Lohse and M.M. Tollefson

      Article first published online: 25 FEB 2015 | DOI: 10.1111/bjd.13472

      What's already known about this topic?

      • Henoch–Schönlein purpura (HSP) is commonly associated with systemic involvement.

      What does this study add?

      • Lesions above the waist and clinically evident oedema are associated with gastrointestinal involvement.
      • Renal involvement is associated with perivascular C3 on direct immunofluorescence and with microscopic dermal oedema.
      • Clinical and microscopic findings may help predict systemic involvement in HSP in children.
  70. Photobiology

    1. Cutaneous leishmaniasis responds to daylight-activated photodynamic therapy: proof of concept for a novel self-administered therapeutic modality

      C.D. Enk, A. Nasereddin, R. Alper, M. Dan-Goor, C.L. Jaffe and H.C. Wulf

      Article first published online: 25 FEB 2015 | DOI: 10.1111/bjd.13490

      What's already known about this topic?

      • Photodynamic therapy (PDT) is effective for cutaneous leishmaniasis, but requires special equipment.
      • Daylight-activated PDT abolishes the need for artificial light sources and has proven effective for the treatment of actinic keratoses.

      What does this study add?

      • Daylight-activated PDT is effective against cutaneous leishmaniasis caused by both Leishmania major and Leishmania tropica.
      • Daylight-activated PDT is a self-administered regimen that can be performed without professional assistance.
  71. Correspondence

    1. Two Spanish cases of atypical melanosis of the foot, an early stage of acral lentiginous melanoma in situ

      D. Menis, L. Maroñas-Jiménez, J. Rodríguez-Peralto, R. Martin-Llamas and F. Vanaclocha-Sebastián

      Article first published online: 15 FEB 2015 | DOI: 10.1111/bjd.13485

  72. Epidemiology and Health Services Research

    1. Use of health care services by patients with psoriasis: a population-based study

      L.-T. Kao, K.-H. Wang, H.-C. Lin, H.-C. Li, S. Yang and S.-D. Chung

      Article first published online: 15 FEB 2015 | DOI: 10.1111/bjd.13442

      What's already known about this topic?

      • Although there are reports in the literature on the economic burden of psoriasis, few studies have compared differences in health care services use between patients with psoriasis and those without it.
      • Only one study has previously reported that patients with psoriasis incur greater health care costs than a general group of patients.

      What does this study add?

      • With regard to both dermatology and nondermatology services, patients with psoriasis had significantly more outpatient visits, and greater outpatient and total costs than those without it.
      • The total cost for all health services was about 1·4-fold greater for patients with psoriasis than those without it.
    2. Personal history of gallstones and risk of incident psoriasis and psoriatic arthritis in U.S. women

      L.X. Tong, S. Wu, T. Li, A.A. Qureshi, E.L. Giovannucci and E. Cho

      Article first published online: 15 FEB 2015 | DOI: 10.1111/bjd.13463

      What's already known about this topic?

      • Psoriasis, a debilitating chronic disease, may share some common risk factors, and thus aetiological pathways, with gallstones.
      • To date, the association between gallstones and psoriasis has not been investigated.

      What does this study add?

      • A history of cholecystectomy-confirmed gallstones was associated with a higher relative risk of developing both psoriasis and psoriatic arthritis (PsA).
      • A history of gallstones was associated with increased risk of developing concomitant PsA, especially in patients with a body mass index < 30 kg m−2.
  73. Cutaneous Biology

    1. Intravenous transplantation of bone marrow mesenchymal stem cells could effectively promote vascularization and skin regeneration in mechanically stretched skin

      S.B. Zhou, C.A. Chiang, K. Liu and Q.F. Li

      Article first published online: 18 JAN 2015 | DOI: 10.1111/bjd.13251

      What's already known about this topic?

      • Skin expansion can provide clinical reconstruction with regenerated skin but the outcome is strictly limited by the skin's instinctive regenerative capacity.
      • Recent reports have indicated that intradermal injection of bone marrow mesenchymal stem cells (MSCs) have contributed to expanded skin regeneration.
      • Few studies have addressed the influence of intravenous MSC transplantation on skin regeneration induced by mechanical stretch.

      What does this study add?

      • This study reported that intravenously transplanted MSCs could be recruited to expanded skin areas and engrafted in expanded skin.
      • Migrated MSCs could effectively improve skin vascularization and promote skin regeneration.
    2. Similar response patterns to topical minoxidil foam 5% in frontal and vertex scalp of men with androgenetic alopecia: a microarray analysis

      P. Mirmirani, M. Consolo, P. Oyetakin-White, E. Baron, P. Leahy and P. Karnik

      Article first published online: 10 DEC 2014 | DOI: 10.1111/bjd.13399

      What's already known about this topic?

      • There are regional variations in the scalp hair miniaturization seen in androgenetic alopecia (AGA).
      • Use of topical minoxidil can lead to reversal of miniaturization in the vertex scalp.

      What does this study add?

      • Frontal scalp of patients with AGA is responsive to minoxidil treatment in a manner similar to vertex scalp.
      • The hair-growth properties of minoxidil topical foam may be mediated through increased production of hair keratin-associated proteins and decreased epidermal differentiation complex and inflammatory gene expression.

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