British Journal of Dermatology

Cover image for Vol. 176 Issue 1

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

Editor: Alex Anstey, Bangor, UK

Impact Factor: 4.317

ISI Journal Citation Reports © Ranking: 2015: 5/61 (Dermatology)

Online ISSN: 1365-2133

Associated Title(s): Clinical and Experimental Dermatology

VIEW

  1. 1 - 67
  1. Translational Research

    1. Antimelanoma differentiation-associated protein 5 antibody level is a novel tool for monitoring disease activity in rapidly progressive interstitial lung disease with dermatomyositis

      T. Matsushita, K. Mizumaki, M. Kano, N. Yagi, M. Tennichi, A. Takeuchi, Y. Okamoto, Y. Hamaguchi, A. Murakami, M. Hasegawa, M. Kuwana, M. Fujimoto and K. Takehara

      Version of Record online: 19 JAN 2017 | DOI: 10.1111/bjd.14882

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      What's already known about this topic?

      • Myositis-specific autoantibodies are strongly associated with distinct clinical phenotypes; thus, they can be used to classify patients into groups with more homogeneous clinical features.
      • Antimelanoma differentiation-associated protein (anti-MDA)5 antibodies are specifically expressed in patients with clinically amyopathic dermatomyositis (CADM) or dermatomyositis (DM), and are associated with rapidly progressive interstitial lung disease (RP-ILD).

      What does this study add?

      • Anti-MDA5 antibody levels correlate with disease activity.
      • Relapse is associated with a reincrease in anti-MDA5 antibody levels.

      What is the translational message?

      • Anti-MDA5 antibody levels are a novel parameter for monitoring and a good predictor of RP-ILD relapse in patients with CADM/DM.
  2. Letters to the Editors

    1. You have free access to this content
      Cutis laxa acquisita: novel insights into impaired elastic fibre regeneration

      P. Gkogkolou, K. Hildebrandt, S. Broekaert, D. Metze, G. Sengle and M. Böhm

      Version of Record online: 19 JAN 2017 | DOI: 10.1111/bjd.15196

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  3. Case Reports

    1. Morphological alterations in two siblings with autosomal recessive congenital ichthyosis associated with CYP4F22 mutations

      R. Gruber, G. Rainer, A. Weiss, A. Udvardi, H. Thiele, K.M. Eckl, R. Schupart, P. Nürnberg, J. Zschocke, M. Schmuth, B. Volc-Platzer and H.C. Hennies

      Version of Record online: 17 JAN 2017 | DOI: 10.1111/bjd.14860

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      What's already known about this topic?

      • Autosomal recessive congenital ichthyosis (ARCI) caused by CYP4F22 mutations is very rare.
      • There is evidence that CyP4F22 plays a role in the 12(R)-lipoxygenase pathway and therefore is important for skin-barrier function.

      What does this study add?

      • We report a novel homozygous splice-site mutation c.549+5G>C in CYP4F22 in two sisters with ARCI, presenting with and without a collodion membrane at birth.
      • Transmission electron microscopy reveals epidermal barrier abnormalities in ARCI with CYP4F22 mutations.
  4. Research Letters

    1. Voriconazole exposure regulates distinct cell-cycle and terminal differentiation pathways in primary human keratinocytes

      M. Mansh, L. Ing, M. Dimon, A. Celli, T.M. Mauro and S.T. Arron

      Version of Record online: 17 JAN 2017 | DOI: 10.1111/bjd.14838

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    2. Clinical evaluation of local hyperthermia at 44 °C for molluscum contagiosum: pilot study with 21 patients

      Y.-L. Gao, X.-H. Gao, R.-Q. Qi, J.-L. Xu, W. Huo, J. Tang, Y. Ren, S. Zheng, Y.-X. Hong, B. Song and H.-D. Chen

      Version of Record online: 16 JAN 2017 | DOI: 10.1111/bjd.14849

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  5. Letters to the Editors

    1. Dermatological content of U.K. undergraduate curricula: where are we now?

      A. Yaakub, S.N. Cohen, M. Singh and J.M.R. Goulding

      Version of Record online: 16 JAN 2017 | DOI: 10.1111/bjd.15206

  6. Translational Research

    1. You have full text access to this OnlineOpen article
      Ubiquitin-specific peptidase 2 as a potential link between microRNA-125b and psoriasis

      T. Wei, L. Folkersen, E. Biskup, N. Xu, V. Manfe, O. Niazi and R. Gniadecki

      Version of Record online: 30 DEC 2016 | DOI: 10.1111/bjd.14916

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      What's already known about this topic?

      • MicroRNA (MiR)-125b has previously been shown to be strongly associated with psoriasis.

      What does this study add?

      • This study adds a likely molecular mechanism to the association between miR-125b and psoriasis. Additionally, it provides a possible novel pathway for therapeutic treatment.

      What is the translational message?

      • MiR-125b has previously been shown to be strongly associated with psoriasis.
      • To benefit clinically from this knowledge it is important to understand the underlying mechanism.
      • USP2 was investigated as a potential mechanism mediator.
      • This expanded understanding is a prerequisite if MiR-125b functionality is to be targeted therapeutically.
  7. General Dermatology

    1. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting

      R.C. Lamb, F. Matcham, M.A. Turner, L. Rayner, A. Simpson, M. Hotopf, J.N.W.N. Barker, K. Jackson and C.H. Smith

      Version of Record online: 29 DEC 2016 | DOI: 10.1111/bjd.14833

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      What's already known about this topic?

      • Depression and anxiety have been shown to affect patients with psoriasis.

      What does this study add?

      • Routine use of screening questionnaires will identify new, clinically significant depression and anxiety in people with psoriasis.
      • Risk factors for major depressive disorder and/or generalized anxiety disorder in people with psoriasis include female sex, psoriatic arthritis, psoriasis severity and prior psychiatric morbidity.
      • The quality-of-life screening tool in routine use misses important psychiatric morbidity.
  8. Clinical Trials

    1. Photodynamic therapy using intense pulsed light for treating actinic keratoses and photoaged skin of the dorsal hands: a randomized placebo-controlled study

      E. Kohl, C. Popp, F. Zeman, P. Unger, M. Koller, M. Landthaler, S. Karrer and R.-M. Szeimies

      Version of Record online: 28 DEC 2016 | DOI: 10.1111/bjd.14970

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      What's already known about this topic?

      • Clinical trials have shown that photodynamic therapy (PDT) with intense pulsed light (IPL) is effective in treating actinic keratoses (AK) as well as in improving photoaged facial skin.
      • Yet, AK and particularly the thin skin on the back of the hands are difficult to treat.

      What does this study add?

      • PDT with methyl aminolaevulinate (MAL)-IPL reduced AK on the dorsal hands more effectively than placebo-IPL.
      • The rate of complete AK remission per hand was 54·5% after MAL-IPL and 3·0% after placebo-IPL treatment (P < 0·0001).
      • Both MAL-IPL and placebo-IPL treatment significantly improved photoaged skin of the dorsal hands and induced neocollagenesis. No significant difference was observed between the two treatment modalities.
  9. Translational Research

    1. Exploration of candidate biomarkers for human psoriasis based on gas chromatography-mass spectrometry serum metabolomics

      H. Kang, X. Li, Q. Zhou, C. Quan, F. Xue, J. Zheng and Y. Yu

      Version of Record online: 27 DEC 2016 | DOI: 10.1111/bjd.15008

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      What's already known about this topic?

      • Three significant metabolic pathways have been found to be associated with psoriasis disease severity: arginine and proline; glycine, serine and threonine; and alanine, aspartate and glutamate.
      • Compared with controls, patients with psoriasis have a higher level of alpha ketoglutaric acid but a lower level of asparagine and glutamine.

      What does this study add?

      • Patients with psoriasis showed higher levels of amino acids; lactic acid and urea; add lower levels of crotonic acid, azelaic acid, ethanolamine and cholesterol, compared with healthy controls.
      • Our study shows that ornithine, hypoxanthine, crotonic acid and azelaic acid might be the most significant biomarkers for patients with psoriasis.

      What is the translational message?

      • The metabolites related to glycolysis, protein biosynthesis, redox balance and anabolic activity may be used either for early diagnosis or as a prognosticator for ‘health’, while having a genetic background of psoriasis without clinical manifestation.
    2. Increased global arterial and subcutaneous adipose tissue inflammation in patients with moderate-to-severe psoriasis

      K.F. Hjuler, L.C. Gormsen, M.H. Vendelbo, A. Egeberg, J. Nielsen and L. Iversen

      Version of Record online: 27 DEC 2016 | DOI: 10.1111/bjd.15149

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      What's already known about this topic?

      • Psoriasis is associated with an increased risk of premature occurrence of coronary artery disease and major cardiovascular events.
      • There is evidence of increased soluble inflammatory biomarkers in psoriasis, and imaging studies in patients with psoriasis have shown signs of vascular inflammation.
      • Furthermore, an association between inflammation in fatty tissue in various body regions and arterial inflammation in patients with cardiovascular disease has been shown.

      What does this study add?

      • Both aortic wall inflammation and inflammation in subcutaneous adipose tissue were significantly increased in patients with moderate-to-severe psoriasis compared with controls.
      • These results indicate that global arterial inflammation is increased in patients with moderate-to-severe psoriasis and that subcutaneous adipose tissue inflammation may be a potential link between psoriasis skin inflammation, obesity and vascular inflammation.

      What is the translational message?

      • This study supports the existence of a potential link between skin inflammation, obesity, vascular inflammation, systemic inflammation and cardiovascular comorbidities.
      • The results may be taken into account in cardiovascular disease prevention in patients with psoriasis.
  10. Research Letters

    1. Mucocutaneous toxicity induced by pegylated liposomal doxorubicin: a single-institution, retrospective case series

      M. Vaccaro, M. Santarpia, G. Calapai, C. Mannucci, F. Borgia, G. Altavilla and S.P. Cannavò

      Version of Record online: 27 DEC 2016 | DOI: 10.1111/bjd.14806

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  11. Epidemiology

    1. Identifying people at higher risk of melanoma across the U.K.: a primary-care-based electronic survey

      J.A. Usher-Smith, A.P. Kassianos, J.D. Emery, G.A. Abel, Z. Teoh, S. Hall, R.D. Neal, P. Murchie and F.M. Walter

      Version of Record online: 23 DEC 2016 | DOI: 10.1111/bjd.15181

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      What's already known about this topic?

      • Programmes to identify people at higher risk of melanoma and offer them preventive advice about sun protection, skin awareness, early consultation or surveillance are of increasing interest to healthcare providers in the U.K. and internationally.
      • Numerous models exist for predicting future risk of melanoma, with little difference between models suitable for self-assessment and those requiring a healthcare professional; none has been calibrated for the U.K. population.

      What does this study add?

      • Collecting data on the melanoma risk profile of the general population in U.K. primary care is both feasible and acceptable.
      • This provides an opportunity for new methods of real-time risk assessment in primary care.
      • Using the Williams model produces a distribution of risk in the population attending general practices that allows identification of subgroups at different levels of risk.
      • As regional differences were small, a single approach could be implemented.
  12. Research Letters

    1. You have free access to this content
  13. Letters to the Editors

    1. Microneedle-assisted incubation during aminolaevulinic acid photodynamic therapy of actinic keratoses: a randomized controlled evaluator-blind trial

      H. Lev-Tov, L. Larsen, R. Zackria, H. Chahal, D.B. Eisen and R.K. Sivamani

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.15116

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  14. Medical Dermatology

    1. The reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) among dermatologists, rheumatologists and neurologists

      J. Tiao, R. Feng, S. Bird, J.K. Choi, J. Dunham, M. George, T.C. Gonzalez-Rivera, J.L. Kaufman, N. Khan, J.J. Luo, R. Micheletti, A.S. Payne, R. Price, C. Quinn, A.I. Rubin, A.G. Sreih, P. Thomas, J. Okawa and V.P. Werth

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.15140

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      What's already known about this topic?

      • The Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) is a reliable and valid outcome measure to assess cutaneous disease in adult dermatomyositis (DM) when used by dermatologists

      What does this study add?

      • The study expands the application of the CDASI in adult patients with DM for use by rheumatologists.
      • The study suggests that neurologists are also capable of using the CDASI to assess skin in adult patients with DM, with neurologists achieving moderate interrater reliability.
  15. Letters to the Editor

    1. Attending in-person dermatology teaching meetings: the patients’ experience

      A. Ascott and V.M.L. Jolliffe

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.15176

    2. Hydroxychloroquine prescribing and monitoring practices among Irish dermatologists and rheumatologists

      E. Gilhooley, C. Feighery and S.M. Collins

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.15192

  16. Research Letters

    1. Pigmentary traits and use of indoor tanning beds in a cohort of women

      W.-Q. Li, E. Cho, J. Han, S. Wu and A. A. Qureshi

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14847

  17. Translational Research

    1. Possible mechanisms of the crosstalk between Langerhans cells and regulatory T cells in extramammary Paget disease by receptor activator of nuclear factor kappa B (RANK) ligand/RANK pathways

      T. Fujimura, Y. Kambayashi, S. Furudate, A. Kakizaki, T. Hidaka and S. Aiba

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14864

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      What's already known about this topic?

      • Receptor activator of nuclear factor kappa B (RANK) ligand (RANKL) stimulates RANK on Langerhans cells (LCs), leading to ultraviolet-induced cutaneous immunosuppression.
      • Paget cells express RANKL and matrix metalloproteinase-7, and release soluble (s)RANKL into the tumour microenvironment.
      • About 60% of RANK+ cells in stromal cells in extramammary Paget disease (EMPD) are M2 macrophages, and produce C-C motif chemokine ligand 17 (CCL17) to recruit regulatory T cells (Tregs).
      • Substantial numbers of Foxp3+ Tregs are observed in lesional skin of EMPD.

      What does this study add?

      • The main population of RANK-expressing cells in the epidermis was epidermal LCs. sRANKL stimulation augmented the production of CCL17 from human CD34+ haematopoietic progenitor cell-derived LCs.
      • An immunofluorescence study showed that CD1a+ LCs in EMPD expressed CCL17.
      • Immunohistochemical staining revealed a correlation between the number of LCs and the number of Foxp3+ Tregs in the lesional skin of invasive EMPD.

      What is the translational message?

      • A possible role for RANK/RANKL signalling in induction of the immunosuppressive microenvironment of EMPD suggested that targeting of RANKL with denosumab might be used in conjunction with the therapeutic elimination of primary invasive EMPD to prevent local immunosuppression and metastatic disease.
  18. General Dermatology

    1. You have full text access to this OnlineOpen article
      The validated sun exposure questionnaire: association of objective and subjective measures of sun exposure in a Danish population-based sample

      B. Køster, J. Søndergaard, J.B. Nielsen, M. Allen, A. Olsen and J. Bentzen

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14861

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      What's already known about this topic?

      • Personal ultraviolet radiation (UVR) dosimeters and diaries have previously been applied in studies of UVR.
      • Previous evaluation designs were weakly correlated or less well suited for evaluation.

      What does this study add?

      • Objective and subjective measures of outdoor exposure time are strongly correlated in a week-based evaluation design.
      • The validated sun exposure questionnaire provides a design for reliable short-term evaluation of skin cancer prevention campaigns.
  19. Epidemiology

    1. You have full text access to this OnlineOpen article
      Incidence, prevalence and mortality of patients with psoriasis: a U.K. population-based cohort study

      D.A. Springate, R. Parisi, E. Kontopantelis, D. Reeves, C.E.M. Griffiths and D.M. Ashcroft

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.15021

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      What's already known about this topic?

      • The burden of psoriasis across many world regions is high and there is a need to better understand the epidemiology of this common skin disorder.

      What does this study add?

      • The prevalence of psoriasis in the U.K. is increasing and is higher than suggested from previous studies.
      • A key driver to this increase relates to improvements in life expectancy rather than an increase in incidence of psoriasis over time.
      • Despite improvements in life expectancy, patients with psoriasis remain more likely to die prematurely compared with those without psoriasis with no evidence of change in this premature mortality gap.
  20. Qualitative and Outcomes Research

    1. You have full text access to this OnlineOpen article
      Predictors of perceived stigmatization in patients with psoriasis

      S. van Beugen, H. van Middendorp, M. Ferwerda, J.V. Smit, M.E.J. Zeeuwen-Franssen, E.B.M. Kroft, E.M.G.J. de Jong, A.R.T. Donders, P.C.M. van de Kerkhof and A.W.M. Evers

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14875

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      What's already known about this topic?

      • Perceived stigmatization is common and distressing in patients with psoriasis.
      • Some of its predictors have been examined in small samples.

      What does this study add?

      • This large study of 514 patients with psoriasis examined a combination of potential predictor variables, both previously examined and never before studied.
      • Sociodemographic, disease-related and previously unstudied type D personality variables were found to be predictive of perceived stigmatization.

      What are the clinical implications of this work?

      • These results provide an understanding of which patients may be especially vulnerable to stigmatization-related problems, which may warrant special attention during treatment.
  21. Research Letters

  22. Translational Research

    1. Drug-specific CD4+ T-cell immune responses are responsible for antituberculosis drug-induced maculopapular exanthema and drug reaction with eosinophilia and systemic symptoms syndrome

      Y.-M. Ye, G.-Y. Hur, S.-H. Kim, G.-Y. Ban, Y.-K. Jee, D.J. Naisbitt, H.-S. Park and S.-H. Kim

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14839

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      What's already known about this topic?

      • Antituberculosis drug (ATD) treatment often induces severe adverse drug reactions including hepatotoxicity, drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and maculopapular exanthema.

      What does this study add?

      • This study identified an isoniazid/rifampicin-specific T-cell response in patients with ATD-induced maculopapular exanthema and DRESS.
      • This study describes the nature of isoniazid/rifampicin-specific CD4+ T cells and the mechanism of drug-specific T-cell activation in ATD-induced maculopapular exanthema and DRESS syndrome.

      What is the translational message?

      • As the first-line treatment for tuberculosis is a combination regimen, the culprit drug is frequently not identified.
      • A lymphocyte transformation test for ATDs would be beneficial to assess the risk of drug hypersensitivity reaction.
  23. Research Letters

    1. Syndromic inherited poikiloderma due to a de novo mutation in FAM111B

      T. Takeichi, A. Nanda, H.-S. Yang, C.-K. Hsu, J.Y.-Y. Lee, H. Al-Ajmi, M. Akiyama, M.A. Simpson and J.A. McGrath

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14845

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    2. Comparing survival of patients with single or multiple primary melanoma in the Netherlands: 1994–2009

      L.M. Pardo, R.J.T. van der Leest, E. de Vries, I. Soerjomataram, T. Nijsten and L.M. Hollestein

      Version of Record online: 22 DEC 2016 | DOI: 10.1111/bjd.14846

  24. Case Reports

    1. Pulmonary sarcoid-like granulomatosis induced by nivolumab

      H. Montaudié, J. Pradelli, T. Passeron, J.-P. Lacour and S. Leroy

      Version of Record online: 19 DEC 2016 | DOI: 10.1111/bjd.14808

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      What's already known about this topic?

      • Antiprogrammed death (anti-PD)1 antibodies such as nivolumab have dramatically changed the landscape of melanoma treatment.

      • Nivolumab is also indicated in advanced squamous cell nonsmall-cell lung cancer.

      • Sarcoid-like reaction may occur during melanoma treatment, but it has never been reported with anti-PD1 therapy.

      What does this study add?

      • Pulmonary sarcoid-like reaction can occur during nivolumab therapy.

      • With the increasing use of PD1 inhibitors for the treatment of cancers, clinicians should be familiar with this associated adverse event.

  25. Research Letters

  26. Qualitative Research

    1. You have full text access to this OnlineOpen article
      Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis

      R.J. Thorneloe, C. Bundy, C.E.M. Griffiths, D.M. Ashcroft and L. Cordingley

      Version of Record online: 17 DEC 2016 | DOI: 10.1111/bjd.15086

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      What's already known about this topic?

      • Although common, little is known about factors contributing to nonadherence to therapies used in psoriasis.

      What does this study add?

      • Illness and medication beliefs and associated mood influence medication nonadherence.
      • Attempts to adhere can undermine people's ability to manage their emotional distress.
      • For some patients, following prescribed medication regimens adds to rather than relieves psoriasis-associated distress.

      What are the clinical implications of this work?

      • Some occurrences of nonadherence to medication in psoriasis should be recognized as a strategic decision by the patient to reduce distress and to gain control.
      • Assessing patients’ beliefs and mood, and identifying potentially conflicting health goals may help to support medication adherence.
  27. General Dermatology

    1. Acute skin and hair symptoms followed by severe, delayed eye complications in subjects using the synthetic opioid MT-45

      A. Helander, M. Bradley, A. Hasselblad, L. Norlén, I. Vassilaki, M. Bäckberg and J. Lapins

      Version of Record online: 14 DEC 2016 | DOI: 10.1111/bjd.15174

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      What's already known about this topic?

      • The use of new psychoactive substances (NPS) distributed through open online sale, also referred to as ‘legal highs’ or ‘Internet drugs’, has increased much in recent years.
      • Intake of NPS has been reported to result in numerous severe adverse events and fatalities, due to unintended overdose or unknown toxic side-effects.

      What does this study add?

      • This study describes a new complex adverse drug reaction with symptoms involving the hair, skin, nails and eyes, seemingly linked to the intake of the NPS opioid MT-45.
      • The study expands the understanding of health hazards associated with the use of novel, untested recreational drugs.
      • This paper further highlights the importance for health professionals to consider NPS as a potential cause of unusual and otherwise unrecognized clinical signs and symptoms.
  28. Translational Research

    1. Reducing Flightless I expression decreases severity of psoriasis in an imiquimod-induced murine model of psoriasiform dermatitis

      H.T. Chong, G.N. Yang, S. Sidhu, J. Ibbetson, Z. Kopecki and A.J. Cowin

      Version of Record online: 10 DEC 2016 | DOI: 10.1111/bjd.14842

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      What's already known about this topic?

      • The pathogenic mechanisms of the inflammatory pathways underpinning psoriasis are being uncovered, leading to design of novel therapeutic options.
      • Conventional therapies for psoriasis often have unfavourable safety profiles and are not ideal for long-term use.
      • New means of treating psoriasis are needed.

      What does this study add?

      This study describes the novel role of Flightless I (Flii) in psoriasis.

      • Flii is increased in psoriatic patient skin and reducing its levels in the imiquimod-induced murine model of psoriasis leads to better outcomes.
      • Reducing cutaneous Flii could be a potential new approach for treating psoriasis when conventional approaches are no longer beneficial.

      What is the translational message?

      Higher levels of Flii correlate with the higher disease severity underpinning the inflammatory pathways involved in psoriasis.

      • These data identify Flii as a therapeutic target for psoriasis and provide clear evidence that reducing Flii levels in psoriasis may have clinical benefits.
  29. Research Letters

    1. Association of nonmelanoma skin cancer with second noncutaneous malignancy in the Women's Health Initiative

      K.J. Ransohoff, M.L. Stefanick, S. Li, A.W. Kurian, H. Wakelee, A. Wang, E. Paskett, J. Han and J.Y. Tang

      Version of Record online: 9 DEC 2016 | DOI: 10.1111/bjd.14766

  30. General Dermatology

    1. Superantigens and adhesins of infant gut commensal Staphylococcus aureus strains and association with subsequent development of atopic eczema

      F.L. Nowrouzian, G. Lina, E. Hodille, E. Lindberg, B. Hesselmar, R. Saalman, I. Adlerberth and A.E. Wold

      Version of Record online: 9 DEC 2016 | DOI: 10.1111/bjd.15138

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      What's already known about this topic?

      • Insufficient immune activation by microbes increases the risk of allergy development.
      • Staphylococcus aureus produces a variety of T-cell-activating enterotoxins, called superantigens.
      • The association of superantigens with development of atopic eczema has not previously been investigated.

      What does this study add?

      • The superantigen genes selm and seln were significantly more prevalent in S. aureus strains that colonized the guts of infants who remained noneczematous for 18 months than in strains that colonized infants who subsequently developed atopic eczema.
      • We found no significant negative association between S. aureus colonization and later development of eczema.
      • The putative protective effect of S. aureus strains appears to be linked to a specific combination of superantigens and adhesins.
  31. Case Reports

    1. Childhood epidermolysis bullosa acquisita during squaric acid dibutyl ester immunotherapy for alopecia areata

      L. Guerra, V. Pacifico, V. Calabresi, N. De Luca, D. Castiglia, C. Angelo, G. Zambruno and G. Di Zenzo

      Version of Record online: 8 DEC 2016 | DOI: 10.1111/bjd.14764

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      What's already known about this topic?

      • Epidermolysis bullosa acquisita (EBA) is an autoimmune bullous disease characterized by autoantibodies against type VII collagen.
      • EBA manifests more frequently in adults.

      What does this study add?

      • We describe the first case of childhood EBA presenting during squaric acid dibutyl ester (SADBE) immunotherapy for alopecia areata.
      • The temporal relationship between EBA development and SADBE initiation and the rapid response to therapy combined with SADBE withdrawal suggest the implication of SADBE in EBA induction.
  32. Paediatric Dermatology

    1. Validation of the Simplified Psoriasis Index in Dutch children and adolescents with plaque psoriasis

      M.J. van Geel, M.E. Otero, E.M.G.J. de Jong, P.C.M. van de Kerkhof and M.M.B. Seyger

      Version of Record online: 8 DEC 2016 | DOI: 10.1111/bjd.15120

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      What's already known about this topic?

      • Validated severity measures do not exist for psoriasis in children and adolescents.
      • The Simplified Psoriasis Index (SPI) is a summary measure of psoriasis, with separate domains for current severity and psychosocial impact.
      • Its validity and reliability has been demonstrated in adults in professionally assessed (proSPI) and patient self-assessment (saSPI) versions.

      What does this study add?

      • Both the proSPI and saSPI are valid for use in children and can be readily introduced into routine practice.
  33. Research Letters

    1. You have full text access to this OnlineOpen article
    2. Complement in bullous pemphigoid: results from a large observational study

      T.R. Romeijn, M.F. Jonkman, C. Knoppers, H.H. Pas and G.F.H. Diercks

      Version of Record online: 7 DEC 2016 | DOI: 10.1111/bjd.14822

  34. Case Reports

    1. Successful treatment of systemic juvenile xanthogranulomatosis with cytarabine and 2-chlorodeoxyadenosine: case report and review of the literature

      L. Maintz, J. Wenzel, M. Irnich, H. Reinhard and T. Bieber

      Version of Record online: 2 DEC 2016 | DOI: 10.1111/bjd.14813

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      What's already known about this topic?

      • The non-Langerhans cell histiocytosis juvenile xanthogranulomatosis (JXG) is usually a benign disease limited to the skin.
      • Only a few cases of often fatal systemic disease with at least two affected organs have been reported.
      • Treatment is controversial and no standard protocol is available.

      What does this study add?

      • The successful treatment of a case of JXG with involvement of the skin, central nervous system, liver and spleen with cytarabine and 2-chlorodeoxyadenosine.
  35. Review Articles

    1. Topical herbal medicines for atopic eczema: a systematic review of randomized controlled trials

      Y. Thandar, A. Gray, J. Botha and A. Mosam

      Version of Record online: 30 NOV 2016 | DOI: 10.1111/bjd.14840

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      What's already known about this topic?

      • Patients use topical complementary or alternative medicines to manage atopic eczema.
      • Objective evidence of efficacy and safety is lacking and is essential for clinicians and patients to make informed choices.

      What does this study add?

      • Of six studies that displayed superiority of treatment over placebo, only two studies, of liquorice gel and Hypericum perforatum, were considered to have a low risk of bias across all domains.
      • The promising effect of these two therapies for atopic eczema warrants continued research in well-designed studies.
  36. Scholarly Reviews

    1. Are neutrophilic dermatoses autoinflammatory disorders?

      T.K. Satoh, M. Mellett, E. Contassot and L.E. French

      Version of Record online: 30 NOV 2016 | DOI: 10.1111/bjd.15105

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      What's already known about this topic?

      • Many inherited autoinflammatory diseases have characteristic skin manifestations composed of a neutrophil-rich cutaneous inflammatory infiltrate.

      • Neutrophilic dermatoses have similar clinical skin manifestations to inherited autoinflammatory diseases caused by overproduction of certain cytokines of the interleukin-1 family.

      What does this study add?

      • Certain unifying features of these disorders suggest that they are a cutaneous consequence of autoinflammation and may be considered as autoinflammatory diseases.

      • Some of these neutrophilic dermatoses may lack IL-1 as a triggering cytokine, but can still benefit from IL-1-targeted therapy.

  37. Letters to the Editor

    1. Linagliptin-associated bullous pemphigoid that was most likely caused by IgG autoantibodies against the midportion of BP180

      A. Sakai, Y. Shimomura, O. Ansai, Y. Saito, K. Tomii, Y. Tsuchida, H. Iwata, H. Ujiie, H. Shimizu and R. Abe

      Version of Record online: 29 NOV 2016 | DOI: 10.1111/bjd.15111

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  38. Medical Dermatology

    1. Long-term adherence to topical psoriasis treatment can be abysmal: a 1-year randomized intervention study using objective electronic adherence monitoring

      H. Alinia, S. Moradi Tuchayi, J.A. Smith, I.M. Richardson, N. Bahrami, S.C. Jaros, L.F. Sandoval, M.E. Farhangian, K.L. Anderson, K.E. Huang and S.R. Feldman

      Version of Record online: 29 NOV 2016 | DOI: 10.1111/bjd.15085

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      What's already known about this topic?

      • We already know that short-term adherence to topical medication is poor, but there is too little information about patients’ long-term use of treatment.
      • Understanding long-term adherence to topical treatment of chronic skin diseases is essential.

      What does this study add?

      • Long-term adherence to topical treatment is abysmal and measures that physicians can take to improve adherence have the potential to provide major improvements in patients’ treatment outcomes.
      • A reporting intervention can have large effects on short-term adherence, but effects on long-term adherence attenuate over time.
    2. Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, exhibits minimal immunogenicity in patients with moderate-to-severe plaque psoriasis

      K. Reich, A. Blauvelt, A. Armstrong, R.G. Langley, T. Fox, J. Huang, C. Papavassilis, E. Liang, P. Lloyd and G. Bruin

      Version of Record online: 22 NOV 2016 | DOI: 10.1111/bjd.14965

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      What's already known about this topic?

      • The proinflammatory cytokine interleukin (IL)-17A plays a pivotal role in psoriasis pathogenesis.
      • Secukinumab is a therapeutic fully human monoclonal antibody that selectively targets IL-17A.
      • Secukinumab has demonstrated efficacy in phase III clinical trials of patients with moderate-to-severe psoriasis.
      • Biologics can be immunogenic, and the resulting antidrug antibodies can compromise efficacy.

      What does this study add?

      • Secukinumab demonstrated low immunogenicity, and the antidrug antibodies that were detected were of no clinical concern.
  39. Clinical Trials

    1. You have full text access to this OnlineOpen article
      Efficacy and safety of LAS41008 (dimethyl fumarate) in adults with moderate-to-severe chronic plaque psoriasis: a randomized, double-blind, Fumaderm®- and placebo-controlled trial (BRIDGE)

      U. Mrowietz, J.C. Szepietowski, R. Loewe, P. van de Kerkhof, R. Lamarca, W.G. Ocker, V.M. Tebbs and I. Pau-Charles

      Version of Record online: 15 NOV 2016 | DOI: 10.1111/bjd.14947

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      What's already known about this topic?

      • A combination of fumaric acid esters (FAEs), including dimethyl fumarate (DMF), is approved for the treatment of moderate-to-severe psoriasis in Germany, with a positive risk–benefit profile for long-term use.
      • Despite being recommended in international treatment guidelines, FAEs are not available in most European countries.

      What does this study add?

      • This international, randomized, double-blind trial demonstrates the efficacy and safety of LAS41008 (DMF) for the treatment of adults with moderate-to-severe chronic plaque psoriasis.
  40. Research Letters

    1. Vitiligo-like depigmentations as the first sign of melanoma: a retrospective case series from a tertiary vitiligo centre

      H.E. Teulings, J.E. Lommerts, A. Wolkerstorfer, L. Nieuweboer-Krobotova, R.M. Luiten, M.W. Bekkenk and J.P.W. van der Veen

      Version of Record online: 11 NOV 2016 | DOI: 10.1111/bjd.14790

  41. Case Reports

    1. Severe recalcitrant cutaneous manifestations in systemic lupus erythematosus successfully treated with fumaric acid esters

      A.M. Saracino and C.H. Orteu

      Version of Record online: 6 NOV 2016 | DOI: 10.1111/bjd.14698

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      What's already known about this topic?

      • Fumaric acid esters (FAEs) exert a variety of immunomodulatory, anti-inflammatory and antioxidant effects.
      • FAEs are an effective treatment for moderate-to-severe psoriasis and have been reported to be effective in treating other inflammatory and granulomatous skin diseases.

      What does this study add?

      • We report the efficacious and well-tolerated use of FAEs in the treatment of severe, extensive and recalcitrant cutaneous manifestations of systemic lupus erythematosus (SLE), previously treated unsuccessfully with several monotherapies and combination therapies.
      • These cases demonstrate the safe use of FAEs with concurrent immunomodulatory and immunosuppressive therapies in the context of treating SLE.
      • We report the first cases of chilblain lupus erythematosus treated with FAEs.
    2. Multiple apocrine hidrocystomas successfully treated with botulinum toxin A

      J.R. Bordelon, N. Tang, D. Elston, G. Niedt and T. Lazic Strugar

      Version of Record online: 26 OCT 2016 | DOI: 10.1111/bjd.14753

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      What's already known about this topic?

      • Current treatments for solitary hidrocystomas, both eccrine and apocrine, are numerous and usually efficacious.
      • Treatments for multiple hidrocystomas are more challenging and often limited due to surface area and location.
      • Recently, botulinum toxin A (BTX-A) has been successfully used for the treatment of multiple eccrine hidrocystomas; the possible mechanism may be denervation of the cholinergic eccrine glands.

      What does this study add?

      • There are some data to suggest that apocrine glands are innervated similarly to eccrine glands, and we therefore propose treating apocrine hidrocystomas with BTX-A via the same mechanism.
      • This case portrays the successful use of BTX-A in the treatment of multiple facial apocrine hidrocystomas, leading to lesion resolution.
  42. Research Letters

  43. Review Articles

    1. Topical treatments for scalp psoriasis: summary of a Cochrane Systematic Review

      J.G. Schlager, S. Rosumeck, R.N. Werner, A. Jacobs, J. Schmitt, C. Schlager and A. Nast

      Version of Record online: 19 OCT 2016 | DOI: 10.1111/bjd.14811

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      What's already known about this topic?

      • Patients with chronic plaque psoriasis often have lesions of the scalp that are difficult to treat.
      • There are various effective topical treatment options such as corticosteroids (e.g. betamethasone dipropionate), vitamin D (e.g. calcipotriol) and their combination.
      • Detailed Grading of Recommendations Assessment, Development and Evaluation Working Group assessment of the effect of these treatments has not been done so far.

      What does this study add?

      • Overall moderate-quality evidence that the two-compound combination is only of small benefit over the corticosteroid alone, and that both therapies are similarly safe (short-term therapy).
      • Overall moderate-quality evidence that the two-compound combination and corticosteroid monotherapy are more effective and safer than vitamin D alone (short-term therapy).
      • Firm conclusions for other topical treatments cannot be drawn due to limited data.
  44. Research Letters

    1. Anti-programmed cell death-1 therapy in nonmelanoma skin cancer

      J.K. Winkler, R. Schneiderbauer, C. Bender, O. Sedlaczek, S. Fröhling, R. Penzel, A. Enk and J.C. Hassel

      Version of Record online: 17 OCT 2016 | DOI: 10.1111/bjd.14664

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  45. Translational Research

    1. Immune cells from patients with psoriasis are defective in inducing indoleamine 2,3-dioxygenase expression in response to inflammatory stimuli

      M. Llamas-Velasco, P. Bonay, M. José Concha-Garzón, L. Corvo-Villén, A. Vara, D. Cibrián, A. Sanguino-Pascual, F. Sánchez-Madrid, H. de la Fuente and E. Daudén

      Version of Record online: 17 OCT 2016 | DOI: 10.1111/bjd.14779

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      What's already known about this topic?

      • Data regarding indoleamine 2,3-dioxygenase (IDO) regulation in human autoimmune diseases are limited.
      • In psoriasis, IDO expression has been studied only in lesional skin.

      What does this study add?

      • This study demonstrates that in patients with psoriasis, IDO activity in serum samples is reduced as the disease severity increases.
      • Peripheral myeloid dendritic cells from patients with psoriasis fail to induce IDO in response to inflammatory stimuli.
      • Induction of CD4+ regulatory T-cell differentiation by immature monocyte-derived dendritic cells from patients with psoriasis is reduced and is associated with a lower expression of IDO.

      What is the translational message?

      • IDO activity measured in serum samples, as well as its expression induced by proinflammatory stimuli, is associated with higher Psoriasis Area and Severity Index.
      • A lower expression of IDO is also associated with a defective differentiation of regulatory T cells.
      • These data provided a better understanding of the exacerbated inflammatory response characteristic of this condition, and suggest that IDO may be a therapeutic target for psoriasis.
  46. Research Letters

    1. Possible paradoxical occurrence of inflammatory arthritis in patients with psoriasis treated with biologics: findings in the Biobadaderm cohort

      D. Ruiz-Genao, B. Perez-Zafrilla, J.L. Lopez-Estebaranz, I. Belinchón-Romero, J.M. Carrascosa, M. Ferrán, F. Vanaclocha, E. Herrera-Ceballos, I. García-Doval and The Biobadaderm Study Group

      Version of Record online: 17 OCT 2016 | DOI: 10.1111/bjd.14690

  47. Systematic Reviews

    1. Short-term efficacy and safety of new biological agents targeting the interleukin-23–T helper 17 pathway for moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis

      F. Gómez-García, D. Epstein, B. Isla-Tejera, A. Lorente, A. Vélez García-Nieto and J. Ruano

      Version of Record online: 13 OCT 2016 | DOI: 10.1111/bjd.14814

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      What's already known about this topic?

      • Old antitumour necrosis factor-α agents and recently licensed drugs blocking the interleukin-23–T helper 17 pathway are more efficacious than placebo for the treatment of moderate-to-severe plaque psoriasis.
      • Traditionally, meta-analyses have usually compared only two interventions at a time, but the need to summarize a comprehensive and coherent set of comparisons based on all of the available evidence has led more recently to synthetic methods that address multiple interventions.

      What does this study add?

      • To the best of our knowledge, this is the first network meta-analysis to study the comparative short-term efficacy and safety of these agents using the new 2015 PRISMA statement for network meta-analyses.
      • Infliximab and secukinumab ranked as the most efficacious drugs, but with the highest risk for any adverse event and associated infections, respectively.
      • Ustekinumab was the agent with the best efficacy–safety profile.
    2. A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis

      F.M. Ali, A.C. Cueva, J. Vyas, A.A. Atwan, M.S. Salek, A.Y. Finlay and V. Piguet

      Version of Record online: 12 OCT 2016 | DOI: 10.1111/bjd.14788

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      What's already known about this topic?

      • Psoriasis significantly impacts quality of life (QoL) in patients.
      • Generic, skin-specific and disease-specific instruments are used in psoriasis interventional studies.
      • In psoriasis randomized controlled trials (RCTs), biologics are the most researched interventions for which QoL is reported.

      What does this study add?

      • The most commonly used QoL instruments in psoriasis RCTs are the Dermatology Life Quality Index, 36-Item Short Form Survey and EuroQol-5D.
      • There is an increasing use of QoL instruments in RCTs in psoriasis.
      • The minimal clinically important difference of QoL measure scores is under-reported.
      • There is inconsistent reporting of QoL data and a need for guidelines when reporting.
  48. Epidemiology

    1. Increased overall drug utilization in patients with psoriasis: a case–control study based on Dutch general practitioner data

      E.A. Dowlatshahi, L.M. Hollestein, R.M.C. Herings, T. Nijsten and M. Wakkee

      Version of Record online: 12 OCT 2016 | DOI: 10.1111/bjd.14754

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      What's already known about this topic?

      • Patients with psoriasis use more health resources than people without psoriasis.
      • Medication use in psoriasis has been studied mostly in the context of psoriasis comorbidities.

      What does this study add?

      • This is the first large population-based study to give an overview of the entire spectrum of drug use in patients with psoriasis compared with controls, during a long follow-up period.
      • The findings suggest increased healthcare utilization among patients with psoriasis.
  49. General Dermatology

    1. Frequency and predictors of a high clinical response in patients with psoriasis on biological therapy in daily practice: results from the prospective, multicenter BioCAPTURE cohort

      J. Zweegers, B. Roosenboom, P.C.M. van de Kerkhof, J.M.P.A. van den Reek, M.E. Otero, S. Atalay, A.L.A. Kuijpers, M.I.A. Koetsier, W.P. Arnold, M.A. Berends, L. Weppner-Parren, M. Bijen, M.D. Njoo, J.M. Mommers, P.P.M. van Lümig, R.J.B. Driessen, W. Kievit and E.M.G.J. de Jong

      Version of Record online: 7 OCT 2016 | DOI: 10.1111/bjd.14888

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      What's already known about this topic?

      • A high clinical response in patients with psoriasis is shifting towards a 90% improvement compared with baseline Psoriasis Area and Severity Index (PASI 90).
      • To date, no studies have assessed which patients with psoriasis are more likely to achieve a high clinical response at week 24 of biological treatment.

      What does this study add?

      • We focused on high responders, defined as achieving PASI 100, PASI 90 or PASI ≤ 5.
      • Frequency of reaching high clinical responses at 24 weeks of biological treatment was assessed, as were predictors that could identify patients with the ability to respond well to biological treatment.
      • In only a limited number of treatment episodes are PASI 90 (15%) or PASI 100 (3%) achieved.
      • Lower baseline body mass index is a predictor for achieving PASI ≤ 5.
  50. Epidemiology

    1. Should tumour necrosis factor antagonist safety information be applied from patients with rheumatoid arthritis to psoriasis? Rates of serious adverse events in the prospective rheumatoid arthritis BIOBADASER and psoriasis BIOBADADERM cohorts

      I. García-Doval, M.V. Hernández, F. Vanaclocha, A. Sellas, P. de la Cueva, D. Montero and the BIOBADADERM and BIOBADASER study groups

      Version of Record online: 3 OCT 2016 | DOI: 10.1111/bjd.14776

      What's already known about this topic?

      • Safety results from the use of biologics in some immune-mediated inflammatory diseases, such as rheumatoid arthritis, are frequently applied to others, such as psoriasis.

      What does this study add?

      • Safety results from studies of rheumatoid arthritis patients are not fully applicable to psoriasis patients, as the rate of serious adverse events in rheumatoid arthritis patients is almost double, and the pattern of adverse events is different.
  51. Letters to the Editor

  52. Medical Dermatology

    1. You have full text access to this OnlineOpen article
      Efficacy and safety of brodalumab in patients with generalized pustular psoriasis and psoriatic erythroderma: results from a 52-week, open-label study

      K. Yamasaki, H. Nakagawa, Y. Kubo, K. Ootaki and the Japanese Brodalumab Study Group

      Version of Record online: 2 OCT 2016 | DOI: 10.1111/bjd.14702

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      What's already known about this topic?

      • The pathological roles of interleukin (IL)-17 cascades in severe types of psoriasis including generalized pustular psoriasis (GPP) and psoriatic erythroderma (PsE) have not been well established.

      What does this study add?

      • Brodalumab significantly improved the symptoms of patients with GPP and PsE throughout the 52 weeks and demonstrated favourable safety profiles without any new safety signals.
      • Brodalumab is expected to be a promising new treatment option for patients with GPP and PsE by blocking IL-17-receptor A-mediated signalling.
  53. General Dermatology

    1. Comparing preferences for outcomes of psoriasis treatments among patients and dermatologists in the U.K.: results from a discrete-choice experiment

      J.M. Gonzalez, F.R. Johnson, H. McAteer, J. Posner and F. Mughal

      Version of Record online: 24 SEP 2016 | DOI: 10.1111/bjd.14798

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      What's already known about this topic?

      • Plaque psoriasis is associated with a number of comorbidities and can have a significant negative effect on patients’ quality of life.
      • Systemic nonbiological and biological treatments for psoriasis can result in serious toxicities, including risks of serious infections and malignancies or lymphoma.

      What does this study add?

      • This study uses a discrete-choice experiment to elicit and contrast stated preferences for outcomes of psoriasis treatments from the perspective of patients with psoriasis and the dermatologists who treat them using a common instrument.
  54. Letters to the Editor

    1. The cross-talk between renal function, inflammation and psoriasis vulgaris

      S. Coimbra, H. Oliveira, P. Rocha-Pereira, A. Figueiredo and A. Santos-Silva

      Version of Record online: 21 SEP 2016 | DOI: 10.1111/bjd.14913

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  55. Scholarly Reviews

    1. Treatment of clinically amyopathic dermatomyositis in adults: a systematic review

      J. Callander, Y. Robson, J. Ingram and V. Piguet

      Version of Record online: 30 AUG 2016 | DOI: 10.1111/bjd.14726

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      What's already known about this topic?

      • Clinically amyopathic dermatomyositis (CADM) is defined as the presence of cutaneous signs of dermatomyositis with no clinical evidence of muscle weakness for ≥ 6 months.
      • CADM affects 5–20% of patients with dermatomyositis and has a significant impact on quality of life.
      • There is no current consensus on the treatment of CADM and no previous systematic reviews have assessed this.

      What does this study add?

      • This systematic review has established that there are no randomized controlled trials or robust observational studies for treatment of CADM.
      • From the compilation of case series and reports, hydroxychloroquine is the most commonly prescribed treatment for CADM.
      • A proportion of patients have treatment-resistant disease.
      • In comparison with other treatments, intravenous immunoglobulin led to improvement or remission in the highest proportion of patients included in our review.
    2. Current perspective on actinic keratosis: a review

      J.A. Siegel, K. Korgavkar and M.A. Weinstock

      Version of Record online: 8 AUG 2016 | DOI: 10.1111/bjd.14852

      What's already known about this topic?

      • Actinic keratoses (AKs) are a major public health concern because of their high prevalence, substantial cost and potential for progression to keratinocyte carcinoma, particularly squamous cell carcinoma.

      What does this study add?

      • Improved agreement among healthcare practitioners on AK definition and classification is needed to improve management.
      • More head-to-head comparisons of alternative treatment strategies for AK are needed to determine the best treatment.
    3. Pyoderma gangrenosum and Sweet syndrome: the prototypic neutrophilic dermatoses

      D. Wallach and M.-D. Vignon-Pennamen

      Version of Record online: 22 JUL 2015 | DOI: 10.1111/bjd.13955

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      What's already known about this topic?

      • Pyoderma gangrenosum and Sweet syndrome are the prototypic conditions of the vast group of the neutrophilic dermatoses, characterized by an aseptic infiltration of the skin by polymorphonuclear leucocytes.
      • A similar infiltration may also occur in internal organs, defining the neutrophilic disease.
      • The principles of the management of patients with a neutrophilic disease have been properly described.

      What does this study add?

      • The genetic and molecular mechanisms of neutrophilic inflammation are currently poorly understood.
      • They may be similar to the mechanisms of the monogenic autoinflammatory diseases, which are among the rare causes of neutrophilic dermatoses.

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