Eur J Dermatol. 2022 Feb 11. doi: 10.1684/ejd.2022.4198. Online ahead of print.

NO ABSTRACT

PMID:35153191 | DOI:10.1684/ejd.2022.4198

Br J Dermatol. 2022 Feb 13. doi: 10.1111/bjd.21047. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical practice guidelines (CPGs) developed with rigorous methods can help optimize clinical care for psoriasis patients.

OBJECTIVES: To conduct an updated systematic review and comprehensive critical appraisal of global psoriasis CPGs.

METHODS: A search of MEDLINE and Embase for psoriasis CPGs published between January 1^st 2015 and March 31^st 2021 was performed. Other guideline repositories were also searched for relevant CPGs. Descriptive analysis was conducted to summarize included guidelines. Three critical appraisal tools were used to assess the quality of included CPGs: the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, Lenzer's red flags, and United States Institute of Medicine's (IOM) criteria of trustworthiness.

RESULTS: We included 33 psoriasis CPGs, with 25 openly accessible. Most CPGs were from high socio-demographic index countries in North America and Europe. 5 CPGs received 'excellent quality' appraisals across all six AGREE II domains. Stakeholder involvement, rigour of development, and applicability were the three domains with the lowest appraisal scores for AGREE II. 22 CPGs raised at least one red flag indicative of potential bias. By IOM's standards, external review of the guideline draft prior to publication and clear updating procedures were most often not addressed by guidelines, and only 3 CPGs were assessed as having higher overall trustworthiness.

CONCLUSIONS: Most psoriasis guidelines were unable to consistently demonstrate high quality across multiple appraisal tools. The EuroGuiDerm guideline on the systemic treatment of psoriasis vulgaris was the only CPG to receive 'excellent quality' across all six AGREE II domains, raise no Lenzer's red flags, and have higher trustworthiness by IOM criteria.

PMID:35152404 | DOI:10.1111/bjd.21047

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00263-8. doi: 10.1016/j.jaad.2022.02.013. Online ahead of print.

NO ABSTRACT

PMID:35151763 | DOI:10.1016/j.jaad.2022.02.013

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00259-6. doi: 10.1016/j.jaad.2022.02.011. Online ahead of print.

NO ABSTRACT

PMID:35151762 | DOI:10.1016/j.jaad.2022.02.011

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00258-4. doi: 10.1016/j.jaad.2022.02.010. Online ahead of print.

NO ABSTRACT

PMID:35151761 | DOI:10.1016/j.jaad.2022.02.010

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00261-4. doi: 10.1016/j.jaad.2022.02.012. Online ahead of print.

NO ABSTRACT

PMID:35151760 | DOI:10.1016/j.jaad.2022.02.012

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00257-2. doi: 10.1016/j.jaad.2022.02.009. Online ahead of print.

NO ABSTRACT

PMID:35151759 | DOI:10.1016/j.jaad.2022.02.009

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00264-X. doi: 10.1016/j.jaad.2022.01.052. Online ahead of print.

NO ABSTRACT

PMID:35151758 | DOI:10.1016/j.jaad.2022.01.052

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00251-1. doi: 10.1016/j.jaad.2022.01.051. Online ahead of print.

ABSTRACT

Disorders of hyperpigmentation are common, and depending on the extent and location of involvement, can affect quality of life and pose a significant psychological burden for patients.^1,2 Given the similarities in presentation of various causes of hyperpigmentation, it is often difficult to elucidate the etiology of these conditions, which is important to guide management.^3,4 Furthermore, certain disorders such as lichen planus pigmentosus and ashy dermatosis have similar clinical and/or histologic presentations, and their classification as distinct entities has been debated, leading to additional confusion.^5-7 In this review, the authors have selected commonly encountered disorders of hyperpigmentation of the skin, subdivided into epidermal, dermal, or mixed epidermal-dermal disorders based on the location of pigment deposition. along with disorders of hyperpigmentation of the mucosa and nails. Melanocytic nevi, genetic disorders, and systemic causes of hyperpigmentation were largely excluded and considered outside the scope of this review. We discuss the pathogenesis of hyperpigmentation, clinical features, and histology of these conditions, along with challenges encountered in diagnosis and classification. The second article in this two-part continuing medical education series focuses on medical and procedural treatments of hyperpigmentation.

PMID:35151757 | DOI:10.1016/j.jaad.2022.01.051

J Am Acad Dermatol. 2022 Feb 10:S0190-9622(22)00256-0. doi: 10.1016/j.jaad.2022.02.008. Online ahead of print.

NO ABSTRACT

PMID:35151756 | DOI:10.1016/j.jaad.2022.02.008

J Am Acad Dermatol. 2022 Feb 9:S0190-9622(22)00253-5. doi: 10.1016/j.jaad.2022.02.005. Online ahead of print.

NO ABSTRACT

PMID:35150759 | DOI:10.1016/j.jaad.2022.02.005

J Am Acad Dermatol. 2022 Feb 9:S0190-9622(22)00254-7. doi: 10.1016/j.jaad.2022.02.006. Online ahead of print.

NO ABSTRACT

PMID:35150758 | DOI:10.1016/j.jaad.2022.02.006

J Am Acad Dermatol. 2022 Feb 9:S0190-9622(22)00249-3. doi: 10.1016/j.jaad.2022.02.004. Online ahead of print.

NO ABSTRACT

PMID:35150757 | DOI:10.1016/j.jaad.2022.02.004

J Am Acad Dermatol. 2022 Feb 9:S0190-9622(22)00208-0. doi: 10.1016/j.jaad.2022.01.050. Online ahead of print.

ABSTRACT

Quality improvement (QI) in medicine is reliant on a team-based approach and an understanding of core QI principles. Part two of this series outlines the steps of performing a quality improvement project, from identifying QI opportunities to carrying out successive Plan-Do-Study-Act (PDSA) cycles to hard-wiring improvements into the system. QI Frameworks will be explored, and readers will understand how to interpret basic QI data.

PMID:35150756 | DOI:10.1016/j.jaad.2022.01.050

J Am Acad Dermatol. 2022 Feb 8:S0190-9622(22)00248-1. doi: 10.1016/j.jaad.2022.02.003. Online ahead of print.

NO ABSTRACT

PMID:35149150 | DOI:10.1016/j.jaad.2022.02.003

J Am Acad Dermatol. 2022 Feb 8:S0190-9622(22)00202-X. doi: 10.1016/j.jaad.2021.12.063. Online ahead of print.

ABSTRACT

Tuberculosis is an ancient disease that continues to affect an estimated 10 million people per year and is responsible for 1.4 million deaths per year. Additionally, the HIV epidemic and multi-drug resistance present challenges to disease control. Cutaneous tuberculosis is an uncommon, often indolent, manifestation of Mycobacterial infection that has a varied presentation. Diagnosis is challenging as lesions mimic other more common conditions and microbiological confirmation is often not possible. Cutaneous tuberculosis can be broadly categorized into multibacillary and paucibacillary forms. About one-third of skin tuberculosis is associated with systemic involvement. By early recognition of cutaneous tuberculosis, dermatologists can play an important role in disease control. The first article in this 2-part continuing medical education series describes the latest epidemiology, microbiology, and pathogenesis of tuberculosis. Furthermore, we review the classification, clinical manifestations, common clinical differentials, and systemic involvement that occurs in cutaneous tuberculosis.

PMID:35149149 | DOI:10.1016/j.jaad.2021.12.063

J Am Acad Dermatol. 2022 Feb 8:S0190-9622(22)00203-1. doi: 10.1016/j.jaad.2021.12.064. Online ahead of print.

ABSTRACT

Despite the availability of effective treatment regimens for cutaneous tuberculosis, delayed diagnosis, infection with multi-drug resistant Mycobacterial strains, and co-infection with HIV present challenges to disease control. A delay in diagnosis can be mitigated by adequate sensitization of dermatologists to the clinical signs and symptoms, and incorporation of appropriate tests for diagnosis. All cases of cutaneous tuberculosis should be confirmed with histopathology, culture with or without molecular testing. Additionally, in each case, a thorough evaluation for systemic involvement is necessary. Mycobacteria may not be isolated from cutaneous tuberculosis lesions and therefore, a trial of antituberculosis treatment may be required to confirm the diagnosis. The second article in this 2-part continuing medical education series describes the sequelae, histopathology, and treatment of tuberculosis.

PMID:35149148 | DOI:10.1016/j.jaad.2021.12.064

J Eur Acad Dermatol Venereol. 2022 Feb 11. doi: 10.1111/jdv.18000. Online ahead of print.

NO ABSTRACT

PMID:35148453 | DOI:10.1111/jdv.18000

J Eur Acad Dermatol Venereol. 2022 Feb 11. doi: 10.1111/jdv.18001. Online ahead of print.

NO ABSTRACT

PMID:35148438 | DOI:10.1111/jdv.18001

J Eur Acad Dermatol Venereol. 2022 Jan 24. doi: 10.1111/jdv.17954. Online ahead of print.

NO ABSTRACT

PMID:35147995 | DOI:10.1111/jdv.17954

J Am Acad Dermatol. 2022 Feb 7:S0190-9622(22)00195-5. doi: 10.1016/j.jaad.2021.12.062. Online ahead of print.

ABSTRACT

Racial and ethnic disparities in dermatology negatively affect outcomes such as mortality and quality of life. Dermatologists and dermatologic surgeons should be familiar with disease-specific inequities that may influence their practice. The second article in this two-part continuing medical education series highlights gaps in frequency, clinical presentation, management, and outcomes by race and ethnicity. We review cutaneous malignancies including basal cell carcinoma, squamous cell carcinoma, melanoma, Merkel cell carcinoma, dermatofibrosarcoma protuberans, and cutaneous T cell lymphoma, and inflammatory disorders including atopic dermatitis, psoriasis, hidradenitis suppurativa, acne vulgaris, and rosacea.

PMID:35143915 | DOI:10.1016/j.jaad.2021.12.062

J Am Acad Dermatol. 2022 Feb 7:S0190-9622(22)00194-3. doi: 10.1016/j.jaad.2021.12.061. Online ahead of print.

ABSTRACT

Racial or ethnic disparities are prevalent in the field of dermatology. Part 1 of this continuing medical education series aims to elucidate contributors to racial and ethnic disparities within dermatology and highlight potential actionable steps to combat these disparities. We review access to care, workforce diversity, cultural competency, implicit bias, dermatologic education material, patient education, and clinical research. Part 2 of the continuing medical education series will address disease-specific inequities that influence the clinical practice of dermatology.

PMID:35143914 | DOI:10.1016/j.jaad.2021.12.061

J Am Acad Dermatol. 2022 Feb 7:S0190-9622(22)00193-1. doi: 10.1016/j.jaad.2022.01.045. Online ahead of print.

ABSTRACT

INTRODUCTION: Dermatologic phenotypes in PTEN hamartoma tumor syndrome (PHTS) are heterogeneous and poorly documented.

OBJECTIVE: To characterize dermatologic findings among PHTS and conduct an analysis of genotype-dermatologic phenotype associations.

METHODS: Mucocutaneous findings were reviewed in a multi-center cohort study of PHTS. Genotype-dermatologic phenotype associations were tested using multivariable regression.

RESULTS: A total of 201 patients were included. Children were significantly less likely than adults to have oral papillomas, vascular malformations, benign follicular neoplasms, and acral keratoses. There were no cases of skin cancer among children. Basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma developed in 5%, 2%, and 1% of white adults, respectively. After adjusting for age, missense mutations were associated with 60% lower odds of developing cutaneous papillomatous papules (Odds Ratio: 0.4; 95% Confidence Interval: [0.2, 0.7]), oral papillomas (0.4; [0.2, 0.9]), and vascular malformations (0.4; [0.2, 0.8]).

LIMITATIONS: Partly retrospective data CONCLUSION: Children are less likely than adults to have certain dermatologic findings, likely due to age-related penetrance. The risk of pediatric melanoma and the life-time risk of non-melanoma skin cancer in PHTS may not be elevated. Missense variants may be associated with the development of fewer dermatologic findings but future validation is required.

PMID:35143913 | DOI:10.1016/j.jaad.2022.01.045

J Am Acad Dermatol. 2022 Feb 7:S0190-9622(22)00207-9. doi: 10.1016/j.jaad.2022.01.049. Online ahead of print.

ABSTRACT

Patient safety (PS) and quality improvement (QI) have gained momentum over the last decade and are becoming more integrated into medical training, physician reimbursement, maintenance of certification and practice improvement initiatives. While PS and QI are often lumped together, they differ in that PS is focused on preventing adverse events while QI is focused on continuous improvements to improve outcomes. The pillars of healthcare as defined by the 1999 Institute of Medicine (IOM) report "To Err is Human: Building a Safer Health System" are safety, timeliness, effectiveness, efficiency, equity, and patient-centered care. Implementing a safety culture is dependent on all levels of the health care system. Part one of this CME will provide dermatologists with an overview of how PS fits into our current healthcare system and will include a focus on basic QI/PS terminology, principles, and processes. This article also outlines systems for the reporting of medical errors and sentinel events and the steps involved in a root cause analysis.

PMID:35143912 | DOI:10.1016/j.jaad.2022.01.049

J Am Acad Dermatol. 2022 Feb 7:S0190-9622(22)00205-5. doi: 10.1016/j.jaad.2022.02.001. Online ahead of print.

NO ABSTRACT

PMID:35143911 | DOI:10.1016/j.jaad.2022.02.001

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17997. Online ahead of print.

NO ABSTRACT

PMID:35143086 | DOI:10.1111/jdv.17997

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17993. Online ahead of print.

NO ABSTRACT

PMID:35143084 | DOI:10.1111/jdv.17993

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17994. Online ahead of print.

NO ABSTRACT

PMID:35143082 | DOI:10.1111/jdv.17994

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17996. Online ahead of print.

NO ABSTRACT

PMID:35143081 | DOI:10.1111/jdv.17996

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17995. Online ahead of print.

NO ABSTRACT

PMID:35143080 | DOI:10.1111/jdv.17995

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17999. Online ahead of print.

NO ABSTRACT

PMID:35143077 | DOI:10.1111/jdv.17999

J Eur Acad Dermatol Venereol. 2022 Feb 10. doi: 10.1111/jdv.17998. Online ahead of print.

NO ABSTRACT

PMID:35143073 | DOI:10.1111/jdv.17998

J Eur Acad Dermatol Venereol. 2022 Feb 9. doi: 10.1111/jdv.17969. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the widespread use of optical coherence tomography (OCT) for imaging of keratinocyte carcinoma, we lack an expert consensus on the characteristic OCT features of basal cell carcinoma (BCC), an internationally vetted set of OCT terms to describe various BCC subtypes, and an educational needs assessment.

OBJECTIVES: To identify relevant BCC features in OCT images, propose terminology based on inputs from an expert panel and identify content for a BCC-specific curriculum for OCT trainees.

METHODS: Over three rounds, we conducted a Delphi consensus study on BCC features and terminology between March and September 2020. In the first round, experts were asked to propose BCC subtypes discriminable by OCT, provide OCT image features for each proposed BCC subtypes and suggest content for a BCC-specific OCT training curriculum. If agreement on a BCC-OCT feature exceeded 67%, the feature was accepted and included in a final review. In the second round, experts had to re-evaluate features with less than 67% agreement and rank the ten most relevant BCC OCT image features for superficial BCC, nodular BCC and infiltrative and morpheaphorm BCC subtypes. In the final round, experts received the OCT-BCC consensus list for a final review, comments and confirmation.

RESULTS: The Delphi included six key opinion leaders and 22 experts. Consensus was found on terminology for three OCT BCC image features: (i) hyporeflective areas, (ii) hyperreflective areas and (iii) ovoid structures. Further, the participants ranked the ten most relevant image features for nodular, superficial, infiltrative and morpheaform BCC. The target group and the key components for a curriculum for OCT imaging of BCC have been defined.

CONCLUSION: We have established a set of OCT image features for BCC and preferred terminology. A comprehensive curriculum based on the expert suggestions will help implement OCT imaging of BCC in clinical and research settings.

PMID:35141952 | DOI:10.1111/jdv.17969

Br J Dermatol. 2022 Feb 10. doi: 10.1111/bjd.21050. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic reduced the number of skin cancer diagnoses, potentially causing a progression to unfavorable tumor stages.

OBJECTIVE: To identify the impact of delayed diagnostics on primary invasive melanoma and cutaneous squamous cell carcinoma (cSCC) by comparing tumor (pT) stage, Breslow thickness and invasion depth from pre to post the first and second lockdown periods.

METHODS: In this population-based cohort study, histopathology reports registered between 01-01-2018 and 22-7-2021 were obtained from the nationwide histopathology registry in the Netherlands. The Breslow thickness of melanomas, invasion depth of cSCCs, and pT-stage for both tumor types were compared across five time periods: (i) pre-COVID, (ii) first lockdown, (iii) between first and second lockdown, (iv) second lockdown, and (v) after second lockdown. Breslow thickness was compared using an independent t-test. pT-stage groups were compared using a χ² -test. Outcomes were corrected for multiple testing using the false discovery rate.

RESULTS: In total, 20,434 primary invasive melanomas and 68,832 cSCCs were included in this study. The mean primary melanoma Breslow thickness of pre-pandemic era (i) and the following time periods (ii-v) showed no significant difference. A small shift was found towards unfavorable pT-stages during the first lockdown compared to the pre-COVID period: pT1 52.3% vs. 58.6%; pT2 18.9% vs. 17.8%; pT3 13.2% vs. 11.0%; pT4 9.1% vs. 7.3% (p=0.001). No relevant changes were seen in subsequent periods. No significant change in pT-stage distribution was observed between the pre-COVID (i) and COVID-affected periods (ii-v) for cSCCs.

CONCLUSION: Until now, the diagnostic delay by COVID-19 did not result in relatively more unfavorable primary tumor characteristics of melanoma or cSCC. Follow-up studies in the coming years are needed to identify a potential impact on staging distribution and survival in the long term.

PMID:35141890 | DOI:10.1111/bjd.21050

Br J Dermatol. 2022 Feb 10. doi: 10.1111/bjd.21048. Online ahead of print.

NO ABSTRACT

PMID:35141879 | DOI:10.1111/bjd.21048

Br J Dermatol. 2022 Feb 10. doi: 10.1111/bjd.21046. Online ahead of print.

ABSTRACT

BACKGROUND: The use of indoor tanning devices causes melanoma and other skin cancers with resulting morbidity, mortality and increased healthcare costs. Policy-makers require robust economic evidence to inform decisions about a possible ban of such devices to mitigate these burdens.

OBJECTIVES: To assess the health costs and consequences of introducing a policy-based intervention across England to ban commercial indoor tanning with an accompanying public information campaign.

METHODS: A cost-effectiveness analysis, adopting a healthcare system perspective, was conducted using a decision-model to track a national cohort of 18-year-olds over a lifetime time horizon. A nationwide ban on commercial indoor tanning combined with a public information campaign (the policy-based intervention) was compared with the status quo of availability of commercial indoor tanning. The expected costs (currency: GBP, price year: 2019) and Quality Adjusted Life Years (QALYs) were calculated. Net Monetary Benefit (NMB; net benefit measured in cost compared to an accepted threshold) and Net Health Benefit (NHB; net gain in QALYs compared to an accepted threshold) of implementation were calculated. A probabilistic sensitivity analysis was used to calculate the probability the intervention was cost-effective.

RESULTS: Compared to the current situation, a ban on commercial indoor tanning combined with a public information campaign would result in 1,206 avoided cases of melanoma, 207 fewer melanoma deaths, and 3,987 averted cases of keratinocyte cancers over the lifetime of all 18-year-olds (n=618,873) living in England in 2019. An additional 497 QALYs would be realised along with healthcare cost-savings of £697,858. This intervention would result in an NMB of £10.6m and a NHB of 530 QALYS. Multiple sensitivity analyses confirmed the robustness of findings. At a cost-effectiveness threshold of £20,000, there is a 99% likelihood of this policy-based intervention being cost-effective.

CONCLUSIONS: The implementation of a ban on commercial indoor tanning across England with an accompanying public information campaign would be an effective use of healthcare resources.

PMID:35141876 | DOI:10.1111/bjd.21046

J Eur Acad Dermatol Venereol. 2022 Feb 9. doi: 10.1111/jdv.17991. Online ahead of print.

NO ABSTRACT

PMID:35138657 | DOI:10.1111/jdv.17991

J Eur Acad Dermatol Venereol. 2022 Feb 9. doi: 10.1111/jdv.17992. Online ahead of print.

NO ABSTRACT

PMID:35138650 | DOI:10.1111/jdv.17992

J Eur Acad Dermatol Venereol. 2022 Feb 8. doi: 10.1111/jdv.17989. Online ahead of print.

NO ABSTRACT

PMID:35133676 | DOI:10.1111/jdv.17989

J Eur Acad Dermatol Venereol. 2022 Feb 8. doi: 10.1111/jdv.17988. Online ahead of print.

NO ABSTRACT

PMID:35133674 | DOI:10.1111/jdv.17988

J Eur Acad Dermatol Venereol. 2022 Feb 8. doi: 10.1111/jdv.17990. Online ahead of print.

NO ABSTRACT

PMID:35133654 | DOI:10.1111/jdv.17990

J Am Acad Dermatol. 2022 Feb 4:S0190-9622(22)00197-9. doi: 10.1016/j.jaad.2022.01.046. Online ahead of print.

NO ABSTRACT

PMID:35131403 | DOI:10.1016/j.jaad.2022.01.046

J Am Acad Dermatol. 2022 Feb 4:S0190-9622(22)00190-6. doi: 10.1016/j.jaad.2021.10.065. Online ahead of print.

ABSTRACT

Systemic sclerosis (SSc; also referred to as systemic scleroderma or scleroderma), is a rare, complex immune-mediated connective tissue disease (CTD) characterized by progressive skin fibrosis and other clinically heterogenous features. The etiopathogenesis of SSc involves vasculopathy and immune system dysregulation occurring on a permissive genetic and epigenetic background, ultimately leading to fibrosis. Recent developments in our understanding of disease specific autoantibodies and bioinformatic analyses has led to reconsideration of the purely clinical classification of diffuse and limited cutaneous SSc subgroups. Autoantibody profiles are predictive of skin and internal organ involvement and disease course. Early diagnosis of SSc, with commencement of disease modifying treatment, has the potential to improve patient outcomes. Many early presenting clinical manifestations, signs of disease progression and activity in SSc are cutaneous, meaning dermatologists can and should play a key role in the diagnosis and management of this significant condition. The first article in this continuing medical education (CME) series discusses the epidemiology, clinical characteristics and pathogenesis of SSc in adults, with an emphasis on skin manifestations, the important role of dermatologists in recognising these, and their correlation with systemic features and disease course.

PMID:35131402 | DOI:10.1016/j.jaad.2021.10.065

J Am Acad Dermatol. 2022 Feb 4:S0190-9622(22)00191-8. doi: 10.1016/j.jaad.2021.10.066. Online ahead of print.

ABSTRACT

The management of systemic sclerosis (SSc) is complex, evolving and requires a multidisciplinary approach. At diagnosis and throughout the disease course, clinical assessment and monitoring of skin involvement via the modified Rodnan Skin Score, patient reported outcomes and new global composite scores (such as the CRISS, which also considers lung function), is vital. Immunomodulation is the mainstay of skin fibrosis treatment, with mycophenolate mofetil considered first line. Meanwhile vasculopathy related manifestations (Raynaud's phenomenon, digital ulcers) and calcinosis, require general measures combined with specific pharmacological (calcium channel blockers, phosphodiesterase type 5 inhibitors and prostanoids) and non-pharmacological (digital sympathectomy and botulinum toxin injections), and often multifaceted, management approaches. Patients should be specifically screened for systemic manifestations at the time of diagnosis, and regularly thereafter and treated accordingly. Numerous targeted therapeutic options for SSc, including skin fibrosis, are emerging and include B-cell depletion, anti-IL-6, JAK and TGF-β inhibition. The second article in this continuing medical education (CME) series discusses these key aspects of SSc assessment and treatment, with particular focus on skin involvement. It is vital that dermatologists play a key role in the multidisciplinary approach to SSc management.

PMID:35131401 | DOI:10.1016/j.jaad.2021.10.066

J Am Acad Dermatol. 2022 Feb 4:S0190-9622(22)00200-6. doi: 10.1016/j.jaad.2022.01.048. Online ahead of print.

NO ABSTRACT

PMID:35131400 | PMC:PMC8815194 | DOI:10.1016/j.jaad.2022.01.048

J Am Acad Dermatol. 2022 Feb 4:S0190-9622(22)00198-0. doi: 10.1016/j.jaad.2022.01.047. Online ahead of print.

NO ABSTRACT

PMID:35131399 | DOI:10.1016/j.jaad.2022.01.047

Br J Dermatol. 2022 Feb 6. doi: 10.1111/bjd.20951. Online ahead of print.

NO ABSTRACT

PMID:35128631 | DOI:10.1111/bjd.20951

Br J Dermatol. 2022 Feb 6. doi: 10.1111/bjd.20946. Online ahead of print.

NO ABSTRACT

PMID:35128630 | DOI:10.1111/bjd.20946

J Eur Acad Dermatol Venereol. 2022 Feb 5. doi: 10.1111/jdv.17983. Online ahead of print.

ABSTRACT

Cutaneous mucinoses are a heterogeneous group of conditions, characterized by the deposition of glycosaminoglycans (mucin) in the dermis, follicles, or in the epidermis. Major cutaneous mucinoses include lichen myxedematosus, scleredema, mucinoses associated with thyroid disease, reticular erythematous mucinosis, papulonodular mucinosis associated with connective tissue diseases, cutaneous focal mucinosis. The aim of this review is to provide an update of what has currently been reported in the last 30-year literature about several new or emerging conditions of acquired cutaneous mucinoses in adults. Two new clinical-pathologic entities have been described: 1) Obesity associated lymphedematous mucinosis and pretibial stasis mucinosis; (OACM) 2) Nodular mucinosis of the breast (NMB). Two relatively new disease categories encompassing cutaneous mucinoses with a common pathogenetic mechanism have been identified: 1) Cutaneous mucinoses associated with drug exposure including biologic therapy, anti-colony-stimulating factor 1 receptor (CSF1R) and subcutaneous intralesional interferons (toxic dermal mucinoses); 2) Cutaneous mucinosis following physical agents including mechanical traumas and after knee replacement.

PMID:35124832 | DOI:10.1111/jdv.17983

J Am Acad Dermatol. 2022 Feb 3:S0190-9622(22)00188-8. doi: 10.1016/j.jaad.2022.01.043. Online ahead of print.

NO ABSTRACT

PMID:35124110 | DOI:10.1016/j.jaad.2022.01.043