British Journal of Dermatology

Cover image for Vol. 172 Issue 1

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 - 69
  1. Photobiology

    1. Digital ultraviolet therapy: a novel therapeutic approach for the targeted treatment of psoriasis vulgaris

      T. Werfel, F. Holiangu, K.-H. Niemann, O. Schmerling, F. Lüllau, A. Zedler, H.-D. Sträter and M. Niebuhr

      Article first published online: 30 JAN 2015 | DOI: 10.1111/bjd.13464

      What's already known about this topic?

      • Psoralen–ultraviolet A is effective in the treatment of psoriasis vulgaris, but has long-term carcinogenic risks, especially for squamous cell carcinoma.

      What does this study add?

      • The digital phototherapy device skintrek allows digital ultraviolet therapy of diseased skin while simultaneously sparing the healthy adjacent skin.
      • Therefore skintrek potentially reduces the carcinogenic risk, reduces premature skin ageing and avoids tanning of healthy surrounding skin.
  2. Review Articles

    1. T helper cell 2 immune skewing in pregnancy/early life: chemical exposure and the development of atopic disease and allergy

      J.P. McFadden, J.P. Thyssen, D.A. Basketter, P. Puangpet and I. Kimber

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13497

      What's already known about this topic?

      • Over the last 50 years there has been an epidemic of atopic disease and associated allergy, the environmental causes of which have not been established.

      What does this study add?

      • The physiological T helper (Th) 2 cell skewing of pregnancy and early life, and how accentuation of this Th2 skewing is associated with development of atopic disease and allergy is reviewed and highlighted.
      • We postulate that certain types of exposures to chemicals can accentuate this Th2 skewing.
      • We postulate an alternative explanation, which is independent of the hygiene hypothesis, for the inverse association between birth order and atopic allergy.
  3. Correspondence

  4. Dermatological Surgery and Lasers

    1. Prospective comparison treatment of 595-nm pulsed-dye lasers for virgin port-wine stain

      W. Yu, G. Ma, Y. Qiu, H. Chen, Y. Jin, X. Yang, L. Chang, T. Wang, X. Hu, W. Li and X. Lin

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13356

      What's already known about this topic?

      • Pulsed-dye laser (PDL) was one of the first widespread treatments for port-wine stain (PWS). Significant advances in the technique of PDL and its efficacy and safety for treating PWS have been demonstrated in previous studies.
      • Vbeam® and Cynergy® are both 595-nm PDL systems that have been widely used to treat PWS lesions. No prior study has compared the efficacy of the two pieces of equipment.

      What does this study add?

      • This is the first prospective side-by-side comparison study of 595-nm PDL devices.
      • Our results suggest that Vbeam may have higher efficacy in the treatment of PWS than Cynergy. Despite using supposedly equivalent fluences in 595-nm PDLs, equivalent clinical results cannot be guaranteed.
  5. Correspondence

  6. Review Articles

    1. Onychomadesis: literature review

      J. Hardin and R.M. Haber

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13339

      What's already known about this topic?

      • Onychomadesis is characterized by separation of the nail plate from the matrix with persistent attachment to the nail bed and often but not always, eventual shedding. Onychomadesis has been associated with infection, autoimmune disease, critical illness, and medications.

      What does this study add?

      • To our knowledge a literature review of all associations with onychomadesis has not been completed previously.
  7. Correspondence

    1. Darier disease can be complicated by generalized cutaneous candidiasis: a case report

      L. Weiler, N. Poulalhon, S. Debarbieux and L. Thomas

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13360

    2. Acute systemic sarcoidosis complicating ustekinumab therapy for chronic plaque psoriasis

      J. B. Powell, P. Matthews, R. Rattehalli, F. Woodhead, P. Perkins, G. Powell, W. Szczecinska and J. E. Gach

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13365

    3. Improved psoriasis with weight loss: the role of behavioural factors

      L.F. Sandoval, A. Pierce, S.A. Davis and S.R. Feldman

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13345

  8. Review Articles

    1. Perioperative management of and recommendations for antithrombotic medications in dermatological surgery

      I. Palamaras and K. Semkova

      Article first published online: 28 JAN 2015 | DOI: 10.1111/bjd.13362

      What's already known about this topic?

      • The number of patients on antithrombotic medications undergoing cutaneous surgery is steadily increasing.
      • There are no strict guidelines on perioperative management of these agents and the data on bleeding complications is contradictory.

      What does this study add?

      • This study provides an up-to-date comprehensive approach to the management of antithrombotic medications in patients undergoing cutaneous surgery.
      • The available data on warfarin, aspirin and clopidogrel is sufficient to recommend that these medications be continued throughout cutaneous surgical procedures.
      • The risk of bleeding complications in patients on antithrombotic medications can be minimized by meticulous surgical techniques, elaborate haemostasis, pressure dressings and close postoperative follow-up.
  9. Correspondence

  10. Research Letters

  11. Correspondence

  12. Case Reports

    1. Somatic mosaicism for the COL7A1 mutation p.Gly2034Arg in the unaffected mother of a patient with dystrophic epidermolysis bullosa pruriginosa

      P.C. van den Akker, A.M.G. Pasmooij, R. Meijer, H. Scheffer and M.F. Jonkman

      Article first published online: 22 JAN 2015 | DOI: 10.1111/bjd.13336

      What's already known about this topic?

      • Somatic mosaicism reported in epidermolysis bullosa (EB) mainly concerns revertant mosaicism.
      • Forward somatic mosaicism in EB has only been demonstrated for a KRT5 mutation in EB simplex. Parental germline mosaicism was reported for a LAMB3 mutation in Herlitz junctional EB and a dominant COL7A1 mutation in dystrophic EB (DEB).
      • Forward somatic mosaicism exceeding the germ cells has not been reported in DEB.

      What does this study add?

      • We report on forward somatic mosaicism for the COL7A1 mutation p.Gly2034Arg in the unaffected mother of a patient with DDEB pruriginosa.
      • This highlights that forward mosaicism occurs in DEB, which has important implications for genetic counselling in sporadic cases.
      • Our results narrow down the amount of mutant pro-α1(VII) procollagen that is tolerated by the skin to ≥ 10–25% (i.e. 20–50% mutant keratinocytes).
    2. Self-injection of dermal filler: an underdiagnosed entity?

      N. Raoof and S.M. Salvi

      Article first published online: 22 JAN 2015 | DOI: 10.1111/bjd.13327

      What's already known about this topic?

      • Dermal fillers are increasingly used for facial rejuvenation.
      • The use of dermal fillers is currently unregulated.

      What does this study add?

      • Some dermal fillers are easily available on the internet and accessible to patients, with videos available online demonstrating their use.
      • Awareness needs to be raised, with improved legislation, against self-injection of dermal fillers and its complications.
  13. Correspondence

    1. Two cases of severe hidradenitis suppurativa with failure of anakinra therapy

      D. Menis, L. Maroñas-Jiménez, A.M. Delgado-Marquez, C. Postigo-Llorente and F. Vanaclocha-Sebastián

      Article first published online: 22 JAN 2015 | DOI: 10.1111/bjd.13292

  14. Clinical and Laboratory Investigations

    1. CD271 is expressed in melanomas with more aggressive behaviour, with correlation of characteristic morphology by in vivo reflectance confocal microscopy

      F. Beretti, P. Manni, C. Longo, G. Argenziano, F. Farnetani, A.M. Cesinaro, A.M. Witkowski, A. De Pol and G. Pellacani

      Article first published online: 22 JAN 2015 | DOI: 10.1111/bjd.13301

      What's already known about this topic?

      • Human malignant melanoma contains morphologically heterogeneous populations of cells and expresses different markers of stemness.
      • Reflectance confocal microscopy (RCM) represents a new imaging tool for more accurate melanoma detection, which enables the in vivo visualization of cell morphology.

      What does this study add?

      • Melanomas with atypical cells organized in large dermal nests, recognized by RCM, correlate to CD271 positivity and high potential for malignancy.
      • This is probably due to the presence of a cell type intrinsically predisposed to invasion.
  15. Therapeutics

    1. Comparative efficacy of biological treatments for moderate-to-severe psoriasis: a network meta-analysis adjusting for cross-trial differences in reference arm response

      J.E. Signorovitch, K.A. Betts, Y.S. Yan, C. LeReun, M. Sundaram, E.Q. Wu and P. Mulani

      Article first published online: 21 JAN 2015 | DOI: 10.1111/bjd.13437

      What's already known about this topic?

      • Biologics currently indicated for psoriasis include adalimumab, etanercept, infliximab and ustekinumab.
      • There are few randomized clinical trials that directly compare the efficacy of biological treatments for psoriasis.
      • A number of cross-trial comparisons of biological treatment efficacy have been published and used by Health Technology Assessment authorities; however, these comparisons can be confounded by substantial cross-trial variation in reference arm response rates.

      What does this study add?

      • This is the first network meta-analysis of biological therapies for treatment of moderate-to-severe psoriasis that adjusts for reference arm responses.
      • Results of this meta-analysis show that reference arm responses are an important confounder of biological treatment effects in psoriasis trials.
      • A network meta-analysis adjusting for reference arm response provides a significantly better fit to clinical trial data than previously published approaches, and changes the comparative efficacy of available biologics for psoriasis.
  16. Dermatological Surgery and Lasers

    1. The role of the 595-nm pulsed dye laser in treating superficial basal cell carcinoma: outcome of a double-blind randomized placebo-controlled trial

      S. Karsai, H. Friedl, H. Buhck, M. Jünger and M. Podda

      Article first published online: 19 JAN 2015 | DOI: 10.1111/bjd.13266

      What's already known about this topic?

      • Pulsed dye lasers (PDLs) are increasingly used for treating basal cell carcinomas (BCCs).
      • However, so far there have been no sufficiently powered randomized controlled trials (RCTs) in the literature analysing the efficacy and safety of these devices.

      What does this study add?

      • To the best of our knowledge, this is the first RCT that analyses the 595-nm PDL in the treatment of superficial BCC at uncritical anatomical sites (trunk and extremities) with a follow-up of 6 months.
  17. Correspondence

  18. Dermatopathology

    1. The stars within the melanocytic garden: unusual variants of Spitz naevi

      E. Moscarella, S. Al Jalbout, S. Piana, G. Argenziano, A. Lallas, C. Longo, R. Hofmann-Wellenhof and I. Zalaudek

      Article first published online: 18 JAN 2015 | DOI: 10.1111/bjd.13347

      What's already known about this topic?

      • Spitz naevi may present a wide spectrum of morphologies.
      • Clinical and dermoscopic features of unusual variants of Spitz naevi have been reported only rarely.

      What does this study add?

      • We describe clinical, dermoscopic and histopathological features of uncommon morphological variants of Spitz naevi, in order to raise awareness among clinicians about their peculiar patterns of presentation.
  19. Clinical and Laboratory Investigations

    1. Abnormal sweating patterns associated with itching, burning and tingling of the skin indicate possible underlying small-fibre neuropathy

      S. Flores, M.D.P. Davis, M.R. Pittelkow, P. Sandroni, A.L. Weaver and R.D. Fealey

      Article first published online: 18 JAN 2015 | DOI: 10.1111/bjd.13576

      What's already known about this topic?

      • Peripheral neuropathies can cause itch and strange sensations in the skin, although reports are limited.
      • Abnormal sweating is a finding in and marker for neuropathies, especially small-fibre neuropathy. Thermoregulatory sweat testing (TST) is an excellent tool to measure whole-body sweating.
      • It is not known whether otherwise unexplained itch and strange sensations in the skin can result from peripheral neuropathy and, if so, how they can be diagnosed.

      What does this study add?

      • Results of TST were abnormal in the majority of patients with itching, burning, numbness and tingling sensations involving the skin, and the areas of anhidrosis on TST corresponded to their symptomatic areas.
      • These results indicate that itching and strange sensations in the skin may be attributable to small-fibre neuropathy.
      • Small-fibre neuropathy may underlie many cutaneous symptoms, and the neuropathy may be estimated using TST.
  20. Correspondence

  21. 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.
  22. Correspondence

  23. Therapeutics

    1. Addition of an oral histamine antagonist to reduce adverse events associated with fumaric acid esters in the treatment of psoriasis: a randomized double-blind placebo-controlled trial

      D.M.W. Balak, S. Fallah-Arani, C.M. Venema, H.A.M. Neumann and H.B. Thio

      Article first published online: 18 JAN 2015 | DOI: 10.1111/bjd.13277

      What's already known about this topic?

      • Frequently occurring adverse events during treatment with fumaric acid esters (FAEs) include gastrointestinal complaints and flushing.
      • A substantial proportion of patients treated with FAEs have to discontinue treatment due to intolerable adverse events.

      What does this study add?

      • Blocking the histamine-1 receptor with cetirizine does not reduce adverse events from FAEs.
      • Histamine does not seem to play a pivotal role in the generation of gastrointestinal complaints and flushing during FAE treatment.
  24. Correspondence

    1. The healing effect of over-the-counter wound healing agents applied under semiocclusive film dressing

      S.C. Davis, J. Gil, R. Treu, J. Valdes, M. Solis, T. Eberlein and W.H. Eaglstein

      Article first published online: 13 JAN 2015 | DOI: 10.1111/bjd.13289

  25. Epidemiology and Health Services Research

    1. Vitiligo Area Scoring Index and Vitiligo European Task Force assessment: reliable and responsive instruments to measure the degree of depigmentation in vitiligo

      L. Komen, V. da Graça, A. Wolkerstorfer, M.A. de Rie, C.B. Terwee and J.P.W. van der Veen

      Article first published online: 8 JAN 2015 | DOI: 10.1111/bjd.13432

      What's already known about this topic?

      • There are no standardized outcome measures to assess the degree of depigmentation in vitiligo.
      • There is limited knowledge on the measurement properties of outcome measures in vitiligo.

      What does this study add?

      • The Vitiligo Area Scoring Index (VASI) and the Vitiligo European Task Force assessment (VETFa) are reliable and responsive instruments to assess the degree of depigmentation in patients with vitiligo.
      • VASI and VETFa are potential measurement instruments to assess the degree of depigmentation in vitiligo research.
  26. Clinical and Laboratory Investigation

    1. Nano-TiO2 modulates the dermal sensitization potency of dinitrochlorobenzene after topical exposure

      S. Smulders, L. Golanski, E. Smolders, J. Vanoirbeek and P.H.M. Hoet

      Article first published online: 7 JAN 2015 | DOI: 10.1111/bjd.13295

      What's already known about this topic?

      • Nanoparticles can exert immunotoxic effects.
      • TiO2 nanoparticles modulate dermal sensitization with dinitrochlorobenzene after subcutaneous injection (worst-case scenario).

      What does this study add?

      • TiO2 nanoparticles modulate chemical-induced dermal sensitization after topical exposure.
      • Nanoparticles incorporated in a paint matrix have no immunomodulatory effects on dermal sensitization after topical exposure.
  27. Therapeutics

    1. Clindamycin phosphate 1·2%–benzoyl peroxide 3·0% fixed-dose combination gel has an effective and acceptable safety and tolerability profile for the treatment of acne vulgaris in Japanese patients: a phase 3, multicentre, randomized, single-blinded, active-controlled, parallel group study

      M. Kawashima, H. Hashimoto, A.B. Alió Sáenz, M. Ono and M. Yamada

      Article first published online: 7 JAN 2015 | DOI: 10.1111/bjd.13265

      What's already known about this topic?

      • Benzoyl peroxide (BPO) can cause a concentration- and frequency-dependent cutaneous irritation. A low concentration of BPO has been associated with improved tolerability.
      • A topical fixed-dose combination gel of clindamycin phosphate 1·2%–BPO 3·0% is an effective treatment for acne in white people.

      What does this study add?

      • A gel combination of clindamycin phosphate 1·2% with BPO 3·0% is effective and maintains an acceptable safety and tolerability profile in Japanese patients with acne, who are perceived to have more sensitive skin than other ethnic groups.
  28. Paediatric Dermatology

    1. Filaggrin loss-of-function mutations are not associated with atopic dermatitis that develops in late childhood or adulthood

      H. Rupnik, M. Rijavec and P. Korošec

      Article first published online: 6 JAN 2015 | DOI: 10.1111/bjd.13477

      What's already known about this topic?

      • Filaggrin gene (FLG) loss-of-function mutations are a major risk factor for atopic dermatitis (AD).
      • It is not clear whether FLG mutations are also important for late childhood or adult onset of AD, which develops in up to 20% of patients.

      What does this study add?

      • The development of AD during late childhood or adulthood is not associated with FLG loss-of-function mutations.
      • Other susceptibility genes and/or other types of dysregulation are likely to be involved in the development of late-onset AD.
  29. Case Reports

    1. Founder mutation in dystonin-e underlying autosomal recessive epidermolysis bullosa simplex in Kuwait

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

      Article first published online: 30 DEC 2014 | DOI: 10.1111/bjd.13294

      What's already known about this topic?

      • The epidermal isoform of dystonin (DST-e), which encodes the 230-kDa bullous pemphigoid antigen (BP230), is a candidate gene for autosomal recessive epidermolysis bullosa simplex (EBS).
      • Only two pedigrees with pathogenic mutations in DST-e have been reported, from Kuwait and Iran.
      • The identified homozygous nonsense mutations led to a lack of BP230 protein at the dermoepidermal junction, poorly formed hemidesmosomal inner plaques and basal keratinocyte fragility.

      What does this study add?

      • We identified four new pedigrees from Kuwait, where seven individuals had recessive EBS due to the same homozygous nonsense mutation, c.3370C>T (p.Gln1124*), in DST-e.
      • Haplotype analysis indicates that all affected individuals share a common ancestral mutant allele, also present in the previously reported Kuwaiti case.
      • Clinically, individuals homozygous for this mutation have lifelong skin fragility. Most heterozygous carriers are asymptomatic.
      • This condition may be more common in Kuwait than is currently appreciated.
    2. Cutaneous Richter syndrome: a better place to transform?

      J. Kluk, M. Moonim, A. Duran, J. Costa Rosa, J. Cabeçadas, R. Alvarez, M. Cravo, S. Whittaker and A. Robson

      Article first published online: 30 DEC 2014 | DOI: 10.1111/bjd.13193

      What's already known about this topic?

      • Richter syndrome (RS) denotes the development of high-grade lymphoma in patients with chronic lymphocytic leukaemia and is associated with a grave prognosis.
      • Skin involvement is exceptionally rare with <20 cases reported in the literature.

      What does this study add?

      • We review the literature and present two further examples of RS arising in the skin.
      • Cutaneous RS may have a more favourable prognosis than more common extracutaneous variants.
  30. Correspondence

    1. Pure ocular mucous membrane pemphigoid reactive with both β4 integrin and the BP180 C-terminal domain

      G. Solano-López, M.J. Concha-Garzón, J. Sánchez-Pérez, Y. Hirako, X. Li, N. Ishii, T. Hashimoto and E. Daudén

      Article first published online: 30 DEC 2014 | DOI: 10.1111/bjd.13290

  31. Research Letters

    1. Influence of interleukin-6 gene polymorphisms in epicardial adipose tissue and coronary artery calcification in patients with psoriasis

      T. Torres, N. Bettencourt, J. Ferreira, C. Carvalho, D. Mendonça, P. Pinho-Costa, C. Vasconcelos, M. Selores and B. Silva

      Article first published online: 30 DEC 2014 | DOI: 10.1111/bjd.13271

  32. Photobiology

    1. Prevalence and trends of sunscreen use and sunburn among Norwegian women

      R. Ghiasvand, E. Lund, K. Edvardsen, E. Weiderpass and M.B. Veierød

      Article first published online: 25 DEC 2014 | DOI: 10.1111/bjd.13434

      What's already known about this topic?

      • Sunscreen is recommended to prevent sunburn and skin cancer.

      What does this study add?

      • The prevalence of sunscreen use is increasing among Norwegian women, but this increase has not been accompanied by a decrease in sunburn.
      • Most Norwegian women use sunscreen, but less than one-third use sunscreen with the recommended sun protection factor (SPF).
      • Using sunscreen with SPF ≥ 15 was not associated with lower risk of recent sunburn.
  33. Epidemiology and Health Services Research

    1. You have full text access to this OnlineOpen article
      Elevated odds of metabolic syndrome in psoriasis: a population-based study of age and sex differences

      K. Danielsen, T. Wilsgaard, A.O. Olsen, A.E. Eggen, K. Olsen, P.A. Cassano and A.-S. Furberg

      Article first published online: 25 DEC 2014 | DOI: 10.1111/bjd.13288

      What's already known about this topic?

      • Evidence suggests an association between psoriasis and the metabolic syndrome.
      • Population-based studies including mild-to-severe cases, age and sex variation, and information on confounding factors are scarce.

      What does this study add?

      • In this population-based study individuals reporting psoriasis displayed elevated prevalence of metabolic syndrome.
      • The strongest association was present in young women, where those with psoriasis had up to fourfold increased odds of metabolic syndrome, independent of lifestyle risk factors.
      • The results support a possible benefit from targeted screening for metabolic risk factors in all patients with psoriasis, irrespective of age and disease severity.
  34. Review Articles

    1. Blistering time as a parameter for the strength of dermoepidermal adhesion: a systematic review and meta-analysis

      L.K. Hatje, C. Richter, U. Blume-Peytavi and J. Kottner

      Article first published online: 25 DEC 2014 | DOI: 10.1111/bjd.13298

      What's already known about this topic?

      • Structural and functional changes during skin ageing increase the risk for developing skin injuries.
      • The artificial induction of suction blisters in humans is an established dermatological method.

      What does this study add?

      • Increased skin temperature and age are major predictors for reduced suction blistering times in healthy humans in comparison with suction pressure.
      • Blistering time is an important and clinically relevant outcome parameter measuring the mechanical integrity of the dermoepidermal junction.
  35. Clinical and Laboratory Investigations

    1. Most individuals with either segmental or nonsegmental vitiligo display evidence of bilateral cochlear dysfunction

      T.S. Anbar, M.M. El-Badry, J.A. McGrath and E.S. Abdel-Azim

      Article first published online: 25 DEC 2014 | DOI: 10.1111/bjd.13276

      What's already known about this topic?

      • Melanocytes, the targeted cells in vitiligo skin, are also present in the inner ear and are critical for normal cochlear function.
      • Clinical studies revealed that 12·5–18·9% of patients with vitiligo had sensorineural hearing loss.
      • No studies have correlated the cochlear function and vitiligo subtype.

      What does this study add?

      • We compared cochlear function, measured by distortion product otoacoustic emissions, in patients with segmental vitiligo and nonsegmental vitiligo.
      • Bilateral cochlear dysfunction is common in both types.
    2. Immunofluorescence mapping in inherited epidermolysis bullosa: a study of 86 cases from India

      R. Hiremagalore, A. Kubba, S. Bansel and H. Jerajani

      Article first published online: 23 DEC 2014 | DOI: 10.1111/bjd.13305

      What's already known about this topic?

      • Immunofluorescence mapping, an important diagnostic tool, helps in classifying epidermolysis bullosa (EB) and identifies the gene to be targeted for mutational analysis.

      What does this study add?

      • Specific immunofluorescence patterns were observed in cases of EB simplex and Kindler syndrome, which have not been described to date.
      • There is greater discordance between clinical diagnosis and antigen mapping findings in the neonatal period.
      • Performing antigen mapping during this period is critical for predicting prognosis and for genetic counselling.
  36. Epidemiology and Health Services Research

    1. Impact of smoking on response to systemic treatment in patients with psoriasis: a retrospective case–control study

      C.E. Kinahan, S. Mazloom and A.P. Fernandez

      Article first published online: 23 DEC 2014 | DOI: 10.1111/bjd.13359

      What's already known about this topic?

      • Smoking is a well-established risk factor for developing psoriasis and is associated with more severe disease.
      • Smoking cessation does not appear to result in clinical improvement of psoriasis.
      • Whether smoking in patients with psoriasis impacts response to systemic therapy is unknown.

      What does this study add?

      • In our retrospective psoriatic cohort smoking did not affect response to systemic treatments.
      • A prospective study examining the complex relationship between smoking, psoriasis and response to systemic therapy is warranted.
  37. Cutaneous Biology

    1. Topical application of delphinidin reduces psoriasiform lesions in the flaky skin mouse model by inducing epidermal differentiation and inhibiting inflammation

      H.C. Pal, J.C. Chamcheu, V.M. Adhami, G.S. Wood, C.A. Elmets, H. Mukhtar and F. Afaq

      Article first published online: 23 DEC 2014 | DOI: 10.1111/bjd.13513

      What's already known about this topic?

      • Psoriasis is a chronic inflammatory skin disease characterized by increased epidermal hyperproliferation, aberrant keratinocyte differentiation, impaired barrier function and infiltration of inflammatory cells.

      What does this study add?

      • Topical application of delphinidin, an anthocyanidin present in pigmented fruits and vegetables, reduced psoriasiform lesions and was associated with induction of epidermal differentiation, a reduction in keratinocyte proliferation, and modulation in the expression of tight junction proteins.
      • Delphinidin treatment inhibited proinflammatory cytokines, infiltration of inflammatory macrophages and neutrophils, and increased the expression of activator protein-1 proteins.
  38. Research Letters

    1. Clinical features of Old World cutaneous leishmaniasis in elderly patients

      M.J. Yazdanpanah, M. Banihashemi, S.M. Mohammadi, Z. Hatami, F. Livani, H. Esmaili and V. Mashayekhi-Goyonlo

      Article first published online: 18 DEC 2014 | DOI: 10.1111/bjd.13431

  39. Correspondence

    1. Intractable erosive lichen planus treated successfully with rituximab

      K. Heelan, M.A. McAleer, L. Roche, C. McCreary and M. Murphy

      Article first published online: 17 DEC 2014 | DOI: 10.1111/bjd.13537

    2. Reducing the strain of dermatological surgery

      R. Urwin and W. Hussain

      Article first published online: 17 DEC 2014 | DOI: 10.1111/bjd.13212

    3. Human papillomavirus evaluation of vemurafenib-induced skin epithelial tumors: a case series

      E. Dika, A. Patrizi, S. Venturoli, P.A. Fanti, D. Barbieri, R. Strammiello, B. Melotti and M. La Placa

      Article first published online: 16 DEC 2014 | DOI: 10.1111/bjd.13275

  40. Clinical and Laboratory Investigations

    1. γδ T-cell-rich variants of pityriasis lichenoides and lymphomatoid papulosis: benign cutaneous disorders to be distinguished from aggressive cutaneous γδ T-cell lymphomas

      M. E. Martinez-Escala, M. Sidiropoulos, J. Deonizio, P. Gerami, M.E. Kadin and J. Guitart

      Article first published online: 15 DEC 2014 | DOI: 10.1111/bjd.13364

      What's already known about this topic?

      • Most lymphoid-rich inflammatory skin conditions are composed of T cells expressing αβ T-cell receptors (TCRs) and, in general, TCR γδ T-cell infiltrates of the skin are associated with aggressive cutaneous lymphomas.

      What does this study add?

      • Regardless of the presence or absence of lymphoid atypia, a subset of γδ T-cell-rich cutaneous lymphoid infiltrates are self-limited and indolent. Pityriasis lichenoides and lymphomatoid papulosis may present as a predominant γδ T-cell infiltrate.
  41. Photobiology

    1. Combination of ablative fractional laser and daylight-mediated photodynamic therapy for actinic keratosis in organ transplant recipients – a randomized controlled trial

      K. Togsverd-Bo, U. Lei, A.M. Erlendsson, E.H. Taudorf, P.A. Philipsen, H.C. Wulf, L. Skov and M. Hædersdal

      Article first published online: 15 DEC 2014 | DOI: 10.1111/bjd.13222

      What's already known about this topic?

      • Daylight-mediated photodynamic therapy (dPDT) with methyl aminolaevulinate (MAL) significantly reduces pain intensities compared with conventional PDT for treatment of actinic keratoses (AK) in field-cancerized skin.
      • Ablative fractional laser (AFL) resurfacing creates vertical channels that facilitate uptake of MAL and thereby increases the efficacy of PDT.

      What does this study add?

      • This study demonstrates that AFL pretreatment combined with dPDT has high tolerability and increased efficacy compared with conventional and dPDT for difficult-to-treat AK in organ transplant recipients.
  42. Paediatric Dermatology

    1. Hypotrichosis associated with capillary malformation–arteriovenous malformation syndrome

      A. Martín-Santiago, N. Knöpfel, J. del Pozo, J. Escalas, B. Bartolomé, V. Janer, M. Pascual, C. Nieto and J.A. Hervás

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13287

      What's already known about this topic?

      • Capillary malformation–arteriovenous malformation (CM-AVM) syndrome is characterized by multifocal small CMs and a risk for fast-flow malformations.
      • The disease is caused by mutations in the RASA1 gene, implicated in vascular development.

      What does this study add?

      • Red punctate spots with pale halos are a frequent finding, as recently described.
      • We report hypotrichosis associated with the CMs of CM-AVM syndrome, suggesting that RASA1 gene mutations could be involved in hair follicle proliferation and the cell cycle.
  43. Dermatological Surgery and Lasers

    1. Topical axitinib suppresses angiogenesis pathways induced by pulsed dye laser

      L. Gao, D.M. Nadora, S. Phan, M. Chernova, V. Sun, S.M.O. Preciado, W. Jia, G. Wang, M.C. Mihm Jr, J.S. Nelson and W. Tan

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13439

      What's already known about this topic?

      • The regeneration of blood vessels in port-wine stain (PWS) after pulsed dye laser treatment is a critical barrier that must be overcome to achieve an adequate therapeutic outcome.
      • Activation of angiogenesis pathways induced by PDL contributes to PWS blood vessel recurrence.

      What does this study add?

      • Topical application of 0·5% axitinib can systematically suppress PDL-induced angiogenesis.
      • We propose a potentially new therapeutic strategy using PDL + axitinib for the clinical management of patients with PWS.
  44. Dermatopathology

    1. iSlide: a ‘big picture’ interactive teledermatopathology e-learning system

      P. Lee, C.-F. Chen, H.-T. Wan, W.-S. Jian, M.-H. Hsu, S. Syed-Abdul, C.-W. Huang, Y.-C. Huang, Y.-T. Lin, T.-J. Chen, Y.-H. Wu and Y.-C. Li

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13274

      What's already known about this topic?

      • Teledermatopathology is the application of telemedicine to dermatopathology.
      • Teledermatopathology is potentially similar to face-to-face interaction in dermatopathology.
      • Through the effective use of health information technology, telemedicine makes it possible for health care to be universally and pervasively accessible to all.

      What does this study add?

      • The iSlide system utilizes digital slides to improve training efficiency and reduces education and training costs in dermatopathology.
      • The iSlide e-learning platform can integrate with social network applications such as Facebook to further enhance interactive discussions.
  45. Cutaneous Biology

    1. Propionibacterium species and follicular keratinocyte activation in acneic and normal skin

      A.C. Jahns, H. Eilers, R. Ganceviciene and O.A. Alexeyev

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13436

      What's already known about this topic?

      • Acne vulgaris is a multifactorial inflammatory disease.
      • Hyperproliferation of keratinocytes is believed to be a major contributing factor to acne vulgaris.
      • Follicular hyperkeratinization and increased sebum production favour the colonization of Propionibacterium acnes.

      What does this study add?

      • Acne and control samples show a comparable keratinocyte proliferation status.
      • There is no link between bacterial colonization and follicular keratinocyte proliferation.
      • P. acnes and P. granulosum occur as distinct populations within the same follicle.
  46. Correspondence

    1. Steroid treatment can improve the impaired quality of life of patients with acquired idiopathic generalized anhidrosis

      A. Fukunaga, M. Hatakeyama, M. Tsujimoto, Y. Oda, K. Washio and C. Nishigori

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13285

  47. Epidemiology and Health Services Research

    1. Hypochromic vitiligo: delineation of a new entity

      K. Ezzedine, A. Mahé, N. van Geel, N. Cardot-Leccia, Y. Gauthier, V. Descamps, A. Al Issa, F. Ly, O. Chosidow, A. Taïeb and T. Passeron

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13423

      What's already known about this topic?

      • The classification of vitiligo has important implications.
      • Few observations of vitiligo minor/hypochromic vitiligo, a rare entity affecting mainly individuals with dark skin types, have been reported.

      What does this study add?

      • We herein delineate a new entity that we called ‘hypochromic vitiligo’ through a case series of 24 patients with typical clinical presentation.
  48. Therapeutics

    1. Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE)

      A. Blauvelt, J.C. Prinz, A.B. Gottlieb, K. Kingo, H. Sofen, M. Ruer-Mulard, V. Singh, R. Pathan, C. Papavassilis, S. Cooper and for the FEATURE Study Group

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13348

      What's already known about this topic?

      • Secukinumab is a fully human antibody targeting interleukin-17A.

      What does this study add?

      • Use of the secukinumab PFS was associated with high usability as determined by successful, hazard-free, subject-accepted self-injection.
      • Self-administration of secukinumab via PFS allows the delivery of its clinical benefits with improved convenience in disease management.
      • This phase 3 study in moderate-to-severe plaque psoriasis showed that secukinumab administration via pre-filled syringe (PFS) demonstrated significant clinical efficacy vs. placebo, with an acceptable safety profile.
  49. Clinical and Laboratory Investigations

    1. Stevens–Johnson syndrome and toxic epidermal necrolysis: follow-up of pulmonary function after remission

      T.A. Duong, N. de Prost, S. Ingen-Housz-Oro, A.-S. Carrié, F. Zerah, L. Valeyrie-Allanore, M. Bagot, O. Chosidow, J.-C. Roujeau, P. Wolkenstein and B. Maitre

      Article first published online: 11 DEC 2014 | DOI: 10.1111/bjd.13505

      What's already known about this topic?

      • Specific bronchial epithelial detachment may occur during the acute phase of Stevens–Johnson syndrome/toxic epidermal necrolysis.
      • Assessment of residual pulmonary dysfunction has not previously been described following remission.

      What does this study add?

      • Most of the patients were asymptomatic. Pulmonary function tests displayed a mild restrictive syndrome in five patients but no obstructive syndrome.
      • Instead, alveolar diffusion was impaired, likely reflecting alveolar–capillary barrier damage, when high initial skin detachment was observed.
  50. Cutaneous Biology

    1. Aldara®-induced skin inflammation: studies of patients with psoriasis

      H. Vinter, L. Iversen, T. Steiniche, K. Kragballe and C. Johansen

      Article first published online: 10 DEC 2014 | DOI: 10.1111/bjd.13236

      What's already known about this topic?

      • The Aldara®-induced mouse model of psoriasis is now a frequently used model of psoriasis.
      • The phenotype of the treated mouse skin shows many similarities with human psoriasis including the dependence of the cytokine pathways on the interleukin-23/17 axis.

      What does this study add?

      • The application of Aldara on human nonlesional psoriatic skin induced psoriasis-like skin inflammation, although typical psoriasis did not develop.
  51. Case Reports

    1. An unusual case of bilateral pyoderma gangrenosum with Achilles tendon rupture

      G.A. Fremlin, C. Rawlings, J.A. Livingstone and A.P.J.J. Bray

      Article first published online: 10 DEC 2014 | DOI: 10.1111/bjd.13264

      What's already known about this topic?

      • Pyoderma gangrenosum (PG) is a rare, noninfectious, inflammatory ulcerating skin disorder that can affect deep muscle and tissue.
      • The diagnosis is often difficult. Many case reports document patients initially being treated for cellulitis or having undergone surgical intervention, which has subsequently led to worsening of the disease (pathergy).
      • PG rapidly responds to immunosuppression, and any surgical intervention should be postponed until the disease has been stabilized.

      What does this study add?

      • This is the first report of PG causing destruction of a tendon, highlighting its aggressive nature.
      • We illustrate the importance of multidisciplinary team input in diagnosis and management, including the final reconstruction.
  52. Cutaneous Biology

    1. 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.
  53. Clinical and Laboratory Investigations

    1. When is onychomycosis onychomycosis? A cross-sectional study of fungi in normal-appearing nails

      A. Shemer, A.K. Gupta, R. Farhi, D. Daigle and B. Amichai

      Article first published online: 10 DEC 2014 | DOI: 10.1111/bjd.13389

      What's already known about this topic?

      • Fungi are present in onycholytic nails and in normal-appearing nails of individuals with dermatophytosis of other bodily sites.

      What does this study add?

      • Fungal organisms were found in the normal-appearing nails and feet of individuals without evidence of clinical pathology of the nails and feet.
      • Although fungi may exist on the host in passive form, it is hypothesized that the presence of these organisms represents a preliminary stage of infection.
  54. Photobiology

    1. Phototoxicity of narrowband ultraviolet (UV) B (311 nm) compared with broadband UVB in the photo hen's egg test

      P.R. Bafteh, M. Siegesmund, V. Kuerten and N.J. Neumann

      Article first published online: 8 DEC 2014 | DOI: 10.1111/bjd.13221

      What's already known about this topic?

      • Broadband ultraviolet B (BB-UVB) has been further replaced by narrowband UVB 311 nm (NB-UVB), especially in the therapy of psoriasis, atopic eczema and vitiligo.
      • Several studies have indicated a better therapeutic response for almost all indications compared with BB-UVB.

      What does this study add?

      • This study shows the phototoxic effects of NB-UVB in comparison with BB-UVB in an in vivo setting.
      • Furthermore, it shows that the photo hen's egg test is a valid model for examining phototoxicity.
  55. Paediatric Dermatology

    1. Safety profile of a divided dose of propranolol for heart rate in children with infantile haemangioma during 16 weeks of treatment

      H. Song, H. Shi, X. Zhang, J. Wang, Y. Yu, W. Chen and H. Zhou

      Article first published online: 7 DEC 2014 | DOI: 10.1111/bjd.13250

      What's already known about this topic?

      • Heart rates are thought to decrease during propranolol treatment for infantile haemangioma (IH).

      What does this study add?

      • Our study describes the careful and close monitoring of heart rate during 16 weeks of propranolol treatment in subjects with IH.
      • We found that all heart rates were within the normal range and that a three-times-daily dosing regimen had no significant effects on heart rates in patients with IH.
      • Our results reassure the safety of using propranolol at 2 mg kg−1 per day with respect to heart rates for up to 16 weeks of therapy.
  56. Clinical and Laboratory Investigations

    1. Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy

      I. Stanganelli, C. Longo, L. Mazzoni, S. Magi, M. Medri, G. Lanzanova, F. Farnetani and G. Pellacani

      Article first published online: 30 NOV 2014 | DOI: 10.1111/bjd.13373

      What's already known about this topic?

      • Short-term and long-term sequential digital dermoscopy is useful for monitoring atypical melanocytic lesions for diagnosing featureless melanoma.
      • Reflectance confocal microscopy (RCM) provides a real-time noninvasive optical method and improves the diagnostic accuracy of melanoma, thus reducing unnecessary excisions.

      What does this study add?

      • Combining sequential dermoscopy imaging with RCM may help to reduce the burden of unnecessary excisions of lesions (false-positive) revealing minor dermoscopic changes at follow-up and RCM-negative score.
  57. Photobiology

    1. Photodynamic therapy vs. topical imiquimod for treatment of superficial basal cell carcinoma: a subgroup analysis within a noninferiority randomized controlled trial

      M.H. Roozeboom, P.J. Nelemans, K. Mosterd, P.M. Steijlen, A.H.M.M. Arits and N.W.J. Kelleners-Smeets

      Article first published online: 30 NOV 2014 | DOI: 10.1111/bjd.13299

      What's already known about this topic?

      • Imiquimod is superior to photodynamic therapy in the treatment of superficial basal cell carcinoma (sBCC).
      • There are only a few noncomparative studies on possible patient and tumour characteristics that influence noninvasive treatment response.

      What does this study add?

      • Higher probability of treatment success for imiquimod vs. methylaminolevulinate photodynamic therapy (MAL-PDT) was found in most subgroups.
      • Imiquimod was superior in females, large tumours and sBCC on the trunk.
      • In patients > 60 years with an sBCC on the lower extremities MAL-PDT was more effective than imiquimod.
  58. Cutaneous Biology

    1. Lack of association of ALOX12 and ALOX15B polymorphisms with psoriasis despite altered urinary excretion of 12(S)-hydroxyeicosatetraenoic acid

      M. Setkowicz, L. Mastalerz, A. Gielicz, A. Wojas-Pelc and M. Sanak

      Article first published online: 30 NOV 2014 | DOI: 10.1111/bjd.13225

      What's already known about this topic?

      • Inflammatory and proliferative abnormalities of psoriatic lesions are accompanied by alterations in the 12- and 15-lipoxygenase pathways.

      What does this study add?

      • We investigated systemic production of 12(S)-hydroxyeicosatetraenoic acid (HETE) and its eicosanoid metabolites tetranor-12(S)-HETE, 12-oxo-eicosatetraenoic acid and 15(S)-HETE in a case–control study.
      • Urinary excretion of lipoxygenases products was measured and candidate gene polymorphisms ascertained. No genetic association was found between psoriasis and the ALOX12 rs1126667 or ALOX15 rs11568070 variants.
      • In patients with psoriasis, a significantly altered metabolism of 12(S)-HETE was found, manifested by its enhanced breakdown to tetranor-12(S)-HETE.
    2. Possible patterns of epidermal melanocyte disappearance in nonsegmental vitiligo: a clinicopathological study

      L. Benzekri, I. Hmamouchi and Y. Gauthier

      Article first published online: 12 NOV 2014 | DOI: 10.1111/bjd.13160

      What's already known about this topic?

      • Vitiliginous skin shows a complete loss of melanin pigment and a marked reduction or absence of melanocytes along the basal layer of melanocytes.
      • Histopathological findings in vitiligo skin are discordant according to the type of depigmented lesions.

      What does this study add?

      • For the first time, two possible patterns of melanocyte disappearance that are correlated with histopathological findings and clinical features are proposed for nonsegmental vitiligo.

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