Heidi Splete

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]

The National Psoriasis Foundation has relaunched its psoriatic arthritis program to aggressively address the disparities in diagnosis and treatment for psoriatic arthritis patients in the United States.

"There are significantly fewer resources for people with psoriatic arthritis than for those with rheumatoid arthritis," despite similar symptoms and prevalence, according to a press release issued by the foundation June 26.

The National Psoriasis Foundation PsA Project states four goals: Reduce the time to diagnosis of PsA; improve clinician understanding of PsA symptoms, treatment options, and the effect of the disease on quality of life; reduce barriers to treatment; and help patients better manage their disease.

Specifically, the foundation aims to reduce from 4 years to 1 year the average time to diagnosis for PsA patients, reduce from 50% to 30% the percentage of patients who report PsA is a problem in their everyday lives; and double the number of PsA patients receiving proper treatment, the number of National Institutes of Health scientists studying psoriatic disease, and the health resources available for PsA patients.

[email protected]

The National Psoriasis Foundation has relaunched its psoriatic arthritis program to aggressively address the disparities in diagnosis and treatment for psoriatic arthritis patients in the United States.

"There are significantly fewer resources for people with psoriatic arthritis than for those with rheumatoid arthritis," despite similar symptoms and prevalence, according to a press release issued by the foundation June 26.

The National Psoriasis Foundation PsA Project states four goals: Reduce the time to diagnosis of PsA; improve clinician understanding of PsA symptoms, treatment options, and the effect of the disease on quality of life; reduce barriers to treatment; and help patients better manage their disease.

Specifically, the foundation aims to reduce from 4 years to 1 year the average time to diagnosis for PsA patients, reduce from 50% to 30% the percentage of patients who report PsA is a problem in their everyday lives; and double the number of PsA patients receiving proper treatment, the number of National Institutes of Health scientists studying psoriatic disease, and the health resources available for PsA patients.

[email protected]

The National Psoriasis Foundation has relaunched its psoriatic arthritis program to aggressively address the disparities in diagnosis and treatment for psoriatic arthritis patients in the United States.

"There are significantly fewer resources for people with psoriatic arthritis than for those with rheumatoid arthritis," despite similar symptoms and prevalence, according to a press release issued by the foundation June 26.

The National Psoriasis Foundation PsA Project states four goals: Reduce the time to diagnosis of PsA; improve clinician understanding of PsA symptoms, treatment options, and the effect of the disease on quality of life; reduce barriers to treatment; and help patients better manage their disease.

Specifically, the foundation aims to reduce from 4 years to 1 year the average time to diagnosis for PsA patients, reduce from 50% to 30% the percentage of patients who report PsA is a problem in their everyday lives; and double the number of PsA patients receiving proper treatment, the number of National Institutes of Health scientists studying psoriatic disease, and the health resources available for PsA patients.

[email protected]

Roughly half of psoriasis patients on adalimumab showed complete resolution in specific body regions after 16 weeks, according to an analysis of the phase III CHAMPION trial reported in the May issue of the Journal of Drugs in Dermatology.

Breaking down the Psoriasis Area Severity Index (PASI) scores by body regions allows for a more clinically relevant assessment of the outcomes, said Dr. Alexander A. Navarini of King’s College, London, and his colleagues.

Adalimumab patients averaged significant improvements in PASI scores from baseline for each body region, compared with scores with methotrexate and placebo. The average improvements for the head were 81%, 57%, and 27% for the adalimumab, methotrexate, and placebo groups, respectively. Improvements for the trunk were 86%, 51%, and 20%, respectively; improvements for the upper extremities were 79%, 53%, and 15%; and improvements for the lower extremities were 78%, 53%, and 15%.

Overall, 50% of adalimumab patients achieved a PASI 100 for the head and trunk regions, compared with 23% of methotrexate patients and 17% of placebo patients (J. Drugs Dermatol. 2014;13:554-62).

The complexity of calculating a PASI score makes it difficult to interpret, said Dr. Navarini and his colleagues.

"The score has difficulty expressing a significant reduction of erythema, scaling, and infiltration of the lesions when no modification of the affected area is observed," they wrote. "Body area is the last parameter to be affected by treatment." In a post-hoc analysis of the CHAMPION study, which showed the safety and effectiveness of adalimumab, compared with methotrexate and placebo, the researchers calculated PASI scores by body regions and by PASI components (J. Drugs Dermatol. 2014;13:554-62).

The study included adults aged 18 years and older with stable, moderate to severe chronic plaque psoriasis. A total of 108 patients were randomized to adalimumab, 110 to methotrexate, and 53 to placebo.

The researchers also reviewed data based on PASI component scores for erythema, induration, desquamation, and surface area.

"For all PASI components, the mean percent improvement in PASI score was significantly greater (P less than .05) for adalimumab-treated patients, compared with methotrexate and placebo-treated patients, at all time points, with the exception of week 1," the researchers wrote.

In addition, improvements in disease quality of life scores correlated with improvements in PASI body region scores and PASI component scores.

The analysis of PASI body region scores and PASI component scores has not been published for other treatments, the researchers noted. However, this strategy "allows for a more thorough evaluation and tracking of a patient’s disease severity as well as response to treatment, no matter how extensive or localized the disease manifestations may be," they added.

[email protected]

Roughly half of psoriasis patients on adalimumab showed complete resolution in specific body regions after 16 weeks, according to an analysis of the phase III CHAMPION trial reported in the May issue of the Journal of Drugs in Dermatology.

Breaking down the Psoriasis Area Severity Index (PASI) scores by body regions allows for a more clinically relevant assessment of the outcomes, said Dr. Alexander A. Navarini of King’s College, London, and his colleagues.

Adalimumab patients averaged significant improvements in PASI scores from baseline for each body region, compared with scores with methotrexate and placebo. The average improvements for the head were 81%, 57%, and 27% for the adalimumab, methotrexate, and placebo groups, respectively. Improvements for the trunk were 86%, 51%, and 20%, respectively; improvements for the upper extremities were 79%, 53%, and 15%; and improvements for the lower extremities were 78%, 53%, and 15%.

Overall, 50% of adalimumab patients achieved a PASI 100 for the head and trunk regions, compared with 23% of methotrexate patients and 17% of placebo patients (J. Drugs Dermatol. 2014;13:554-62).

The complexity of calculating a PASI score makes it difficult to interpret, said Dr. Navarini and his colleagues.

"The score has difficulty expressing a significant reduction of erythema, scaling, and infiltration of the lesions when no modification of the affected area is observed," they wrote. "Body area is the last parameter to be affected by treatment." In a post-hoc analysis of the CHAMPION study, which showed the safety and effectiveness of adalimumab, compared with methotrexate and placebo, the researchers calculated PASI scores by body regions and by PASI components (J. Drugs Dermatol. 2014;13:554-62).

The study included adults aged 18 years and older with stable, moderate to severe chronic plaque psoriasis. A total of 108 patients were randomized to adalimumab, 110 to methotrexate, and 53 to placebo.

The researchers also reviewed data based on PASI component scores for erythema, induration, desquamation, and surface area.

"For all PASI components, the mean percent improvement in PASI score was significantly greater (P less than .05) for adalimumab-treated patients, compared with methotrexate and placebo-treated patients, at all time points, with the exception of week 1," the researchers wrote.

In addition, improvements in disease quality of life scores correlated with improvements in PASI body region scores and PASI component scores.

The analysis of PASI body region scores and PASI component scores has not been published for other treatments, the researchers noted. However, this strategy "allows for a more thorough evaluation and tracking of a patient’s disease severity as well as response to treatment, no matter how extensive or localized the disease manifestations may be," they added.

[email protected]

Roughly half of psoriasis patients on adalimumab showed complete resolution in specific body regions after 16 weeks, according to an analysis of the phase III CHAMPION trial reported in the May issue of the Journal of Drugs in Dermatology.

Breaking down the Psoriasis Area Severity Index (PASI) scores by body regions allows for a more clinically relevant assessment of the outcomes, said Dr. Alexander A. Navarini of King’s College, London, and his colleagues.

Adalimumab patients averaged significant improvements in PASI scores from baseline for each body region, compared with scores with methotrexate and placebo. The average improvements for the head were 81%, 57%, and 27% for the adalimumab, methotrexate, and placebo groups, respectively. Improvements for the trunk were 86%, 51%, and 20%, respectively; improvements for the upper extremities were 79%, 53%, and 15%; and improvements for the lower extremities were 78%, 53%, and 15%.

Overall, 50% of adalimumab patients achieved a PASI 100 for the head and trunk regions, compared with 23% of methotrexate patients and 17% of placebo patients (J. Drugs Dermatol. 2014;13:554-62).

The complexity of calculating a PASI score makes it difficult to interpret, said Dr. Navarini and his colleagues.

"The score has difficulty expressing a significant reduction of erythema, scaling, and infiltration of the lesions when no modification of the affected area is observed," they wrote. "Body area is the last parameter to be affected by treatment." In a post-hoc analysis of the CHAMPION study, which showed the safety and effectiveness of adalimumab, compared with methotrexate and placebo, the researchers calculated PASI scores by body regions and by PASI components (J. Drugs Dermatol. 2014;13:554-62).

The study included adults aged 18 years and older with stable, moderate to severe chronic plaque psoriasis. A total of 108 patients were randomized to adalimumab, 110 to methotrexate, and 53 to placebo.

The researchers also reviewed data based on PASI component scores for erythema, induration, desquamation, and surface area.

"For all PASI components, the mean percent improvement in PASI score was significantly greater (P less than .05) for adalimumab-treated patients, compared with methotrexate and placebo-treated patients, at all time points, with the exception of week 1," the researchers wrote.

In addition, improvements in disease quality of life scores correlated with improvements in PASI body region scores and PASI component scores.

The analysis of PASI body region scores and PASI component scores has not been published for other treatments, the researchers noted. However, this strategy "allows for a more thorough evaluation and tracking of a patient’s disease severity as well as response to treatment, no matter how extensive or localized the disease manifestations may be," they added.

[email protected]

The concentration of a protein known to be involved in insulin resistance was significantly higher in serum of both lean and obese psoriasis patients, based on data from 80 adults.

The protein – known as wingless-type MMTV integration site Family, Member 5a (wnt5a) – also is upregulated in psoriatic skin lesions, noted Dr. Sascha Gerdes of the University Medical Center Schleswig-Holstein, Kiel, Germany, and colleagues.

"We investigated whether wnt5a and its counterpart, secreted frizzled-related protein 5, are altered in the circulation of lean and obese patients with psoriasis compared with lean and obese healthy volunteers by measuring serum concentrations of both proteins," they wrote (Experimental Dermatology 2014;23:439-40).

The mean serum concentration of wnt5a was significantly higher in 20 lean psoriasis patients, compared with 20 lean healthy controls (0.096 ng/mL vs. 0.020 ng/mL, respectively, P less than or equal to .01). The difference was even more pronounced in the serum samples from 20 obese psoriasis patients, compared with 20 obese healthy controls (0.177 ng/mL vs. 0.011 ng/mL, respectively, P less than or equal to .001).

There was no significant difference in the mean serum concentration of secreted frizzled-related protein 5 (sFRP5) in lean psoriasis patients, compared with lean controls. However, obese psoriasis patients had significantly higher concentrations of sFRP5, compared with obese controls (14.358 ng/mL vs. 6.389 ng/mL, respectively).

A second set of experiments on the serum samples of 50 psoriasis patients ranging from lean to obese showed that wnt5a levels increased as body mass index increased and was statistically significant in patients with a body mass index between 35 and less than 40 kg/m², compared with lean patients who had a BMI between 20 and less than 25 kg/m² (0.337 ng/mL vs. 0.125 ng/mL, respectively).

"We hypothesize that the expression of wnt5a in psoriatic lesions subsequently leads to an increase in wnt5a in the circulation, which could partly explain why metabolic comorbidity such as insulin resistance and diabetes mellitus type 2 develops in psoriasis patients with and without obesity," the researchers noted.

Although the findings suggest a role for wnt5a in the interaction of psoriasis and metabolic comorbidities, additional studies are needed to determine how psoriasis treatment and/or weight management might impact both wnt5a and sFRP5 in psoriasis patients, they added.

The researchers had no financial conflicts to disclose.

[email protected]

The concentration of a protein known to be involved in insulin resistance was significantly higher in serum of both lean and obese psoriasis patients, based on data from 80 adults.

The protein – known as wingless-type MMTV integration site Family, Member 5a (wnt5a) – also is upregulated in psoriatic skin lesions, noted Dr. Sascha Gerdes of the University Medical Center Schleswig-Holstein, Kiel, Germany, and colleagues.

"We investigated whether wnt5a and its counterpart, secreted frizzled-related protein 5, are altered in the circulation of lean and obese patients with psoriasis compared with lean and obese healthy volunteers by measuring serum concentrations of both proteins," they wrote (Experimental Dermatology 2014;23:439-40).

The mean serum concentration of wnt5a was significantly higher in 20 lean psoriasis patients, compared with 20 lean healthy controls (0.096 ng/mL vs. 0.020 ng/mL, respectively, P less than or equal to .01). The difference was even more pronounced in the serum samples from 20 obese psoriasis patients, compared with 20 obese healthy controls (0.177 ng/mL vs. 0.011 ng/mL, respectively, P less than or equal to .001).

There was no significant difference in the mean serum concentration of secreted frizzled-related protein 5 (sFRP5) in lean psoriasis patients, compared with lean controls. However, obese psoriasis patients had significantly higher concentrations of sFRP5, compared with obese controls (14.358 ng/mL vs. 6.389 ng/mL, respectively).

A second set of experiments on the serum samples of 50 psoriasis patients ranging from lean to obese showed that wnt5a levels increased as body mass index increased and was statistically significant in patients with a body mass index between 35 and less than 40 kg/m², compared with lean patients who had a BMI between 20 and less than 25 kg/m² (0.337 ng/mL vs. 0.125 ng/mL, respectively).

"We hypothesize that the expression of wnt5a in psoriatic lesions subsequently leads to an increase in wnt5a in the circulation, which could partly explain why metabolic comorbidity such as insulin resistance and diabetes mellitus type 2 develops in psoriasis patients with and without obesity," the researchers noted.

Although the findings suggest a role for wnt5a in the interaction of psoriasis and metabolic comorbidities, additional studies are needed to determine how psoriasis treatment and/or weight management might impact both wnt5a and sFRP5 in psoriasis patients, they added.

The researchers had no financial conflicts to disclose.

[email protected]

The concentration of a protein known to be involved in insulin resistance was significantly higher in serum of both lean and obese psoriasis patients, based on data from 80 adults.

The protein – known as wingless-type MMTV integration site Family, Member 5a (wnt5a) – also is upregulated in psoriatic skin lesions, noted Dr. Sascha Gerdes of the University Medical Center Schleswig-Holstein, Kiel, Germany, and colleagues.

"We investigated whether wnt5a and its counterpart, secreted frizzled-related protein 5, are altered in the circulation of lean and obese patients with psoriasis compared with lean and obese healthy volunteers by measuring serum concentrations of both proteins," they wrote (Experimental Dermatology 2014;23:439-40).

The mean serum concentration of wnt5a was significantly higher in 20 lean psoriasis patients, compared with 20 lean healthy controls (0.096 ng/mL vs. 0.020 ng/mL, respectively, P less than or equal to .01). The difference was even more pronounced in the serum samples from 20 obese psoriasis patients, compared with 20 obese healthy controls (0.177 ng/mL vs. 0.011 ng/mL, respectively, P less than or equal to .001).

There was no significant difference in the mean serum concentration of secreted frizzled-related protein 5 (sFRP5) in lean psoriasis patients, compared with lean controls. However, obese psoriasis patients had significantly higher concentrations of sFRP5, compared with obese controls (14.358 ng/mL vs. 6.389 ng/mL, respectively).

A second set of experiments on the serum samples of 50 psoriasis patients ranging from lean to obese showed that wnt5a levels increased as body mass index increased and was statistically significant in patients with a body mass index between 35 and less than 40 kg/m², compared with lean patients who had a BMI between 20 and less than 25 kg/m² (0.337 ng/mL vs. 0.125 ng/mL, respectively).

"We hypothesize that the expression of wnt5a in psoriatic lesions subsequently leads to an increase in wnt5a in the circulation, which could partly explain why metabolic comorbidity such as insulin resistance and diabetes mellitus type 2 develops in psoriasis patients with and without obesity," the researchers noted.

Although the findings suggest a role for wnt5a in the interaction of psoriasis and metabolic comorbidities, additional studies are needed to determine how psoriasis treatment and/or weight management might impact both wnt5a and sFRP5 in psoriasis patients, they added.

The researchers had no financial conflicts to disclose.

[email protected]

Patients who survived Stevens-Johnson syndrome or toxic epidermal necrolysis had a 7% incidence of recurrence, based on data from a 10-year population study of more than 500 Canadian patients.

The findings were published June 4 in a research letter in JAMA.

Overall, 42 of 581 patients (7%) were hospitalized for a recurrent episode of either Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), with a median time to first recurrence of 315 days. Eight patients (1%) had multiple recurrences (JAMA 2014;311:2231-2).

Given the rare incidence of SJS and TEN in the general population (fewer than 8 cases per million people per year), "the observed recurrence risk in our population (greater than 7%) is several thousand–fold higher than would be expected if subsequent episodes were probabilistically independent of the first SJS or TEN episode," wrote Dr. Yaron Finkelstein of the Hospital for Sick Children, Toronto, and colleagues.

"We speculate that this increased risk reflects individual susceptibility," they added. "Genetic predisposition has been identified for several medications in association with specific genotypes," and recurrence also has been reported after exposure to medications, including carbamazepine and zonisamide, they said.

The study included 708 patients hospitalized for an initial episode of SJS or TEN; 127 died following the initial episode. The researchers followed the remaining patients for approximately 10 years, which yielded data for 2,621 person-years.

Approximately 18% of the patients with an initial episode were younger than 18 years, but 21% of the patients who had a recurrence were younger than 18 years (9 of 42 patients). Adult patients who developed recurrence were significantly younger at the time of the first episode than those who didn’t have recurrences, the researchers noted. Other factors significantly associated with recurrence of SJS or TEN included male gender, rural residence, and treatment of the first episode at an academic hospital.

The results were limited by the lack of access to patient data about medication exposures, the researchers noted. But the findings confirm the need to review the pros and cons of drug therapy in patients with a history of SJS or TEN, keeping in mind the risk of drug-induced recurrence, they added.

The study was funded by a grant from the Canadian Institutes of Health Research, the Canadian Drug Safety and Effectiveness Research Network, and the Institute for Clinical Evaluative Sciences. The researchers had no financial conflicts to disclose.

[email protected]

Patients who survived Stevens-Johnson syndrome or toxic epidermal necrolysis had a 7% incidence of recurrence, based on data from a 10-year population study of more than 500 Canadian patients.

The findings were published June 4 in a research letter in JAMA.

Overall, 42 of 581 patients (7%) were hospitalized for a recurrent episode of either Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), with a median time to first recurrence of 315 days. Eight patients (1%) had multiple recurrences (JAMA 2014;311:2231-2).

Given the rare incidence of SJS and TEN in the general population (fewer than 8 cases per million people per year), "the observed recurrence risk in our population (greater than 7%) is several thousand–fold higher than would be expected if subsequent episodes were probabilistically independent of the first SJS or TEN episode," wrote Dr. Yaron Finkelstein of the Hospital for Sick Children, Toronto, and colleagues.

"We speculate that this increased risk reflects individual susceptibility," they added. "Genetic predisposition has been identified for several medications in association with specific genotypes," and recurrence also has been reported after exposure to medications, including carbamazepine and zonisamide, they said.

The study included 708 patients hospitalized for an initial episode of SJS or TEN; 127 died following the initial episode. The researchers followed the remaining patients for approximately 10 years, which yielded data for 2,621 person-years.

Approximately 18% of the patients with an initial episode were younger than 18 years, but 21% of the patients who had a recurrence were younger than 18 years (9 of 42 patients). Adult patients who developed recurrence were significantly younger at the time of the first episode than those who didn’t have recurrences, the researchers noted. Other factors significantly associated with recurrence of SJS or TEN included male gender, rural residence, and treatment of the first episode at an academic hospital.

The results were limited by the lack of access to patient data about medication exposures, the researchers noted. But the findings confirm the need to review the pros and cons of drug therapy in patients with a history of SJS or TEN, keeping in mind the risk of drug-induced recurrence, they added.

The study was funded by a grant from the Canadian Institutes of Health Research, the Canadian Drug Safety and Effectiveness Research Network, and the Institute for Clinical Evaluative Sciences. The researchers had no financial conflicts to disclose.

[email protected]

Patients who survived Stevens-Johnson syndrome or toxic epidermal necrolysis had a 7% incidence of recurrence, based on data from a 10-year population study of more than 500 Canadian patients.

The findings were published June 4 in a research letter in JAMA.

Overall, 42 of 581 patients (7%) were hospitalized for a recurrent episode of either Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), with a median time to first recurrence of 315 days. Eight patients (1%) had multiple recurrences (JAMA 2014;311:2231-2).

Given the rare incidence of SJS and TEN in the general population (fewer than 8 cases per million people per year), "the observed recurrence risk in our population (greater than 7%) is several thousand–fold higher than would be expected if subsequent episodes were probabilistically independent of the first SJS or TEN episode," wrote Dr. Yaron Finkelstein of the Hospital for Sick Children, Toronto, and colleagues.

"We speculate that this increased risk reflects individual susceptibility," they added. "Genetic predisposition has been identified for several medications in association with specific genotypes," and recurrence also has been reported after exposure to medications, including carbamazepine and zonisamide, they said.

The study included 708 patients hospitalized for an initial episode of SJS or TEN; 127 died following the initial episode. The researchers followed the remaining patients for approximately 10 years, which yielded data for 2,621 person-years.

Approximately 18% of the patients with an initial episode were younger than 18 years, but 21% of the patients who had a recurrence were younger than 18 years (9 of 42 patients). Adult patients who developed recurrence were significantly younger at the time of the first episode than those who didn’t have recurrences, the researchers noted. Other factors significantly associated with recurrence of SJS or TEN included male gender, rural residence, and treatment of the first episode at an academic hospital.

The results were limited by the lack of access to patient data about medication exposures, the researchers noted. But the findings confirm the need to review the pros and cons of drug therapy in patients with a history of SJS or TEN, keeping in mind the risk of drug-induced recurrence, they added.

The study was funded by a grant from the Canadian Institutes of Health Research, the Canadian Drug Safety and Effectiveness Research Network, and the Institute for Clinical Evaluative Sciences. The researchers had no financial conflicts to disclose.

[email protected]

Melanoma risk increased by 80% among women who had five or more severe sunburns as teenagers, based on a review of data from more than 100,000 white women.

The findings were published online May 29 in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

©garth11/thinkstockphotos.com

"We investigated the relationship between a number of potential risk factors, including chronic sun exposure over long durations in adulthood and sun exposure in early life, and risk of different types of skin cancer," wrote Dr. Shaowei Wu of Brigham and Women’s Hospital, Boston, and colleagues.

Diagnoses of 6,955 basal cell carcinomas (BCCs), 880 squamous cell carcinomas (SCCs), and 779 melanomas were identified during 2.05 million person-years of follow-up. The relative risk of skin cancer was 68% higher for both BCC and SCC, and 80% higher for melanoma in women who reported five or more blistering sunburns between ages 15 and 25 years, compared with those who reported no such sunburns (Cancer Epidemiol. Biomarkers Prev. 2014;23:1080-9).

The study included 101,916 nurses participating in the Nurses’ Health Study II. The women enrolled between the ages of 25 and 42 years, and were followed for 20 years between 1989 and 2009. The eligible participants had no baseline history of any cancer and were diagnosed with incident BCC, SCC, or melanoma between baseline and the last follow-up.

Cumulative ultraviolet radiation exposure in adulthood, measured over long durations using a composite estimate called UV flux, also was associated with an increased risk of BCC and SCC, but not with melanoma. This suggests that "melanoma may have a more complicated relationship with sun exposure than SCC and BCC," the researchers said.

The study was limited by the approximate estimates of UV radiation exposure, incomplete information about personal behaviors such as sunscreen use, and the fact that BCC cases were not independently validated as SCC and melanoma. However, the findings "support heterogenous associations between sun exposure, other potential risk factors, and risk of different types of skin cancer, and thus may have potential implications for the prevention of skin cancers," the researchers noted.

Also, "our participants consisted entirely of white women, and thus the generalizability of the results to men and other ethnicities may be limited," they said.

The study was supported by the department of dermatology at Brigham and Women’s Hospital, and by a grant from the National Institutes of Health. Corresponding author Dr. Abrar A. Qureshi has served as a consultant and/or advisory board member for multiple pharmaceutical companies. The other authors had no financial conflicts to disclose.

[email protected]

Melanoma risk increased by 80% among women who had five or more severe sunburns as teenagers, based on a review of data from more than 100,000 white women.

The findings were published online May 29 in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

©garth11/thinkstockphotos.com

"We investigated the relationship between a number of potential risk factors, including chronic sun exposure over long durations in adulthood and sun exposure in early life, and risk of different types of skin cancer," wrote Dr. Shaowei Wu of Brigham and Women’s Hospital, Boston, and colleagues.

Diagnoses of 6,955 basal cell carcinomas (BCCs), 880 squamous cell carcinomas (SCCs), and 779 melanomas were identified during 2.05 million person-years of follow-up. The relative risk of skin cancer was 68% higher for both BCC and SCC, and 80% higher for melanoma in women who reported five or more blistering sunburns between ages 15 and 25 years, compared with those who reported no such sunburns (Cancer Epidemiol. Biomarkers Prev. 2014;23:1080-9).

The study included 101,916 nurses participating in the Nurses’ Health Study II. The women enrolled between the ages of 25 and 42 years, and were followed for 20 years between 1989 and 2009. The eligible participants had no baseline history of any cancer and were diagnosed with incident BCC, SCC, or melanoma between baseline and the last follow-up.

Cumulative ultraviolet radiation exposure in adulthood, measured over long durations using a composite estimate called UV flux, also was associated with an increased risk of BCC and SCC, but not with melanoma. This suggests that "melanoma may have a more complicated relationship with sun exposure than SCC and BCC," the researchers said.

The study was limited by the approximate estimates of UV radiation exposure, incomplete information about personal behaviors such as sunscreen use, and the fact that BCC cases were not independently validated as SCC and melanoma. However, the findings "support heterogenous associations between sun exposure, other potential risk factors, and risk of different types of skin cancer, and thus may have potential implications for the prevention of skin cancers," the researchers noted.

Also, "our participants consisted entirely of white women, and thus the generalizability of the results to men and other ethnicities may be limited," they said.

The study was supported by the department of dermatology at Brigham and Women’s Hospital, and by a grant from the National Institutes of Health. Corresponding author Dr. Abrar A. Qureshi has served as a consultant and/or advisory board member for multiple pharmaceutical companies. The other authors had no financial conflicts to disclose.

[email protected]

Melanoma risk increased by 80% among women who had five or more severe sunburns as teenagers, based on a review of data from more than 100,000 white women.

The findings were published online May 29 in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

©garth11/thinkstockphotos.com

"We investigated the relationship between a number of potential risk factors, including chronic sun exposure over long durations in adulthood and sun exposure in early life, and risk of different types of skin cancer," wrote Dr. Shaowei Wu of Brigham and Women’s Hospital, Boston, and colleagues.

Diagnoses of 6,955 basal cell carcinomas (BCCs), 880 squamous cell carcinomas (SCCs), and 779 melanomas were identified during 2.05 million person-years of follow-up. The relative risk of skin cancer was 68% higher for both BCC and SCC, and 80% higher for melanoma in women who reported five or more blistering sunburns between ages 15 and 25 years, compared with those who reported no such sunburns (Cancer Epidemiol. Biomarkers Prev. 2014;23:1080-9).

The study included 101,916 nurses participating in the Nurses’ Health Study II. The women enrolled between the ages of 25 and 42 years, and were followed for 20 years between 1989 and 2009. The eligible participants had no baseline history of any cancer and were diagnosed with incident BCC, SCC, or melanoma between baseline and the last follow-up.

Cumulative ultraviolet radiation exposure in adulthood, measured over long durations using a composite estimate called UV flux, also was associated with an increased risk of BCC and SCC, but not with melanoma. This suggests that "melanoma may have a more complicated relationship with sun exposure than SCC and BCC," the researchers said.

The study was limited by the approximate estimates of UV radiation exposure, incomplete information about personal behaviors such as sunscreen use, and the fact that BCC cases were not independently validated as SCC and melanoma. However, the findings "support heterogenous associations between sun exposure, other potential risk factors, and risk of different types of skin cancer, and thus may have potential implications for the prevention of skin cancers," the researchers noted.

Also, "our participants consisted entirely of white women, and thus the generalizability of the results to men and other ethnicities may be limited," they said.

The study was supported by the department of dermatology at Brigham and Women’s Hospital, and by a grant from the National Institutes of Health. Corresponding author Dr. Abrar A. Qureshi has served as a consultant and/or advisory board member for multiple pharmaceutical companies. The other authors had no financial conflicts to disclose.

[email protected]

Teledermatologic consults via mobile phones invalidated, clarified, or enlarged an emergency physician’s diagnosis and management in 68% of 110 cases seen in the emergency department, based on data from an observational study published online May 7 in JAMA Dermatology.

"Easy access to a dermatologist helped ED physicians manage their skin problems," wrote Dr. Tu Anh Duong, who conducted the study while at the Hôpital Henri Mondor, Créteil, France, and her associates.

Management concordance between emergency physicians and dermatologists was high for diagnostic and specialist consultations within 24 hours, moderate for immediate hospitalization, and poor for patient discharge, the researchers noted (JAMA Dermatol. 2014 May 7 [doi:10.1001/jamadermatol.2013.7792]).

The study included 110 adults aged 18 years and older seen consecutively for dermatologic conditions at four French hospitals. The majority of the conditions were skin infections (28%) or eczema/urticaria (24%). In each case, an ED physician sent digital images and possible diagnoses to a dermatologist, and both physicians recorded their diagnoses and management choices. For 83 cases, the physicians participated in a videoconference, which improved diagnostic performance in 57 cases (69%) and invalidated photographic diagnoses in 8 cases (10%).

The findings confirm the convenience and effectiveness of using mobile devices for teledermatology services in the ED and suggest that that such devices be used for real-time communication between physicians after images are sent, the researchers said. However, "the use of mobile devices requires a functional high-speed telecommunication network, a secure protocol for image transfer, a reliable storage system, and some minimal organization," they added.

The study was funded by a research grant from the Société Française de Dermatologie. Mobile phones and communication costs were provided by the Société Française du Radiotéléphonie. Dr. Duong disclosed receiving a grant from Basilea Pharmaceutica for the first year of her PhD program.

[email protected]

On Twitter @hsplete

Teledermatologic consults via mobile phones invalidated, clarified, or enlarged an emergency physician’s diagnosis and management in 68% of 110 cases seen in the emergency department, based on data from an observational study published online May 7 in JAMA Dermatology.

"Easy access to a dermatologist helped ED physicians manage their skin problems," wrote Dr. Tu Anh Duong, who conducted the study while at the Hôpital Henri Mondor, Créteil, France, and her associates.

Management concordance between emergency physicians and dermatologists was high for diagnostic and specialist consultations within 24 hours, moderate for immediate hospitalization, and poor for patient discharge, the researchers noted (JAMA Dermatol. 2014 May 7 [doi:10.1001/jamadermatol.2013.7792]).

The study included 110 adults aged 18 years and older seen consecutively for dermatologic conditions at four French hospitals. The majority of the conditions were skin infections (28%) or eczema/urticaria (24%). In each case, an ED physician sent digital images and possible diagnoses to a dermatologist, and both physicians recorded their diagnoses and management choices. For 83 cases, the physicians participated in a videoconference, which improved diagnostic performance in 57 cases (69%) and invalidated photographic diagnoses in 8 cases (10%).

The findings confirm the convenience and effectiveness of using mobile devices for teledermatology services in the ED and suggest that that such devices be used for real-time communication between physicians after images are sent, the researchers said. However, "the use of mobile devices requires a functional high-speed telecommunication network, a secure protocol for image transfer, a reliable storage system, and some minimal organization," they added.

The study was funded by a research grant from the Société Française de Dermatologie. Mobile phones and communication costs were provided by the Société Française du Radiotéléphonie. Dr. Duong disclosed receiving a grant from Basilea Pharmaceutica for the first year of her PhD program.

[email protected]

On Twitter @hsplete

Teledermatologic consults via mobile phones invalidated, clarified, or enlarged an emergency physician’s diagnosis and management in 68% of 110 cases seen in the emergency department, based on data from an observational study published online May 7 in JAMA Dermatology.

"Easy access to a dermatologist helped ED physicians manage their skin problems," wrote Dr. Tu Anh Duong, who conducted the study while at the Hôpital Henri Mondor, Créteil, France, and her associates.

Management concordance between emergency physicians and dermatologists was high for diagnostic and specialist consultations within 24 hours, moderate for immediate hospitalization, and poor for patient discharge, the researchers noted (JAMA Dermatol. 2014 May 7 [doi:10.1001/jamadermatol.2013.7792]).

The study included 110 adults aged 18 years and older seen consecutively for dermatologic conditions at four French hospitals. The majority of the conditions were skin infections (28%) or eczema/urticaria (24%). In each case, an ED physician sent digital images and possible diagnoses to a dermatologist, and both physicians recorded their diagnoses and management choices. For 83 cases, the physicians participated in a videoconference, which improved diagnostic performance in 57 cases (69%) and invalidated photographic diagnoses in 8 cases (10%).

The findings confirm the convenience and effectiveness of using mobile devices for teledermatology services in the ED and suggest that that such devices be used for real-time communication between physicians after images are sent, the researchers said. However, "the use of mobile devices requires a functional high-speed telecommunication network, a secure protocol for image transfer, a reliable storage system, and some minimal organization," they added.

The study was funded by a research grant from the Société Française de Dermatologie. Mobile phones and communication costs were provided by the Société Française du Radiotéléphonie. Dr. Duong disclosed receiving a grant from Basilea Pharmaceutica for the first year of her PhD program.

[email protected]

On Twitter @hsplete

A trio of up-and-coming dermatologists received the La Roche-Posay North American Foundation’s 2014 Research Awards, presented at the annual meeting of the American Academy of Dermatology in Denver.

The awards were given to candidates with promising projects in clinical, biological, and pharmacological research linked to dermatology.

Dr. Thomas Strub of the Icahn School of Medicine at Mount Sinai, New York, received the first-place grant of $10,000 for his study "Epigenetic Mechanisms Underlying Drug Resistance of Malignant Melanoma."

"It is a privilege for me to be chosen by the La Roche-Posay North American Foundation for supporting my research goals," Dr. Strub said in a statement. "Melanoma therapies remain limited, and drug resistance invariably occurs, with patients ultimately relapsing. I hope my research will shed light onto the epigenome of resistant melanoma tumors and insight on the elements involved in melanoma, which will ultimately improve patient outcomes."

Dr. Shadmehr Demehri of Washington University, St. Louis, received the second prize of $5,000 for his study "The Role of Calcipotriol in Treatment of Pre-cancerous Skin Lesions."

"It’s a great honor to be a recipient of the La Roche-Posay North American Foundation’s research award," Dr. Demehri said in a statement. "My research focuses on determining the role of immune activation in cancer therapy. Specifically, I aim to understand the effects of epithelial cytokine expression on induction of antitumor immunity. Considering the rising prevalence of skin cancer in our population, the outcomes of our investigation can have significant impact on care for patients with skin and other types of cancers."

Dr. Emily Newsom of Wayne State University, Detroit, received the third prize award of $5,000 for her study "Mapping Cytogenetic Abnormalities in Cutaneous T-cell Lymphoma using FISH."

"I appreciate the La Roche-Posay North American Foundation’s commitment to furthering research in dermatology. This award will allow me to advance my career and research in cutaneous lymphoma," Dr. Newsom said in a statement.

The winners were selected by the La Roche-Posay North American Scientific Committee.

For additional information about La Roche-Posay, visit www.laroche-posay.us and "like" the La Roche-Posay Facebook page at www.facebook.com/LaRochePosayusa.

[email protected]

A trio of up-and-coming dermatologists received the La Roche-Posay North American Foundation’s 2014 Research Awards, presented at the annual meeting of the American Academy of Dermatology in Denver.

The awards were given to candidates with promising projects in clinical, biological, and pharmacological research linked to dermatology.

Dr. Thomas Strub of the Icahn School of Medicine at Mount Sinai, New York, received the first-place grant of $10,000 for his study "Epigenetic Mechanisms Underlying Drug Resistance of Malignant Melanoma."

"It is a privilege for me to be chosen by the La Roche-Posay North American Foundation for supporting my research goals," Dr. Strub said in a statement. "Melanoma therapies remain limited, and drug resistance invariably occurs, with patients ultimately relapsing. I hope my research will shed light onto the epigenome of resistant melanoma tumors and insight on the elements involved in melanoma, which will ultimately improve patient outcomes."

Dr. Shadmehr Demehri of Washington University, St. Louis, received the second prize of $5,000 for his study "The Role of Calcipotriol in Treatment of Pre-cancerous Skin Lesions."

"It’s a great honor to be a recipient of the La Roche-Posay North American Foundation’s research award," Dr. Demehri said in a statement. "My research focuses on determining the role of immune activation in cancer therapy. Specifically, I aim to understand the effects of epithelial cytokine expression on induction of antitumor immunity. Considering the rising prevalence of skin cancer in our population, the outcomes of our investigation can have significant impact on care for patients with skin and other types of cancers."

Dr. Emily Newsom of Wayne State University, Detroit, received the third prize award of $5,000 for her study "Mapping Cytogenetic Abnormalities in Cutaneous T-cell Lymphoma using FISH."

"I appreciate the La Roche-Posay North American Foundation’s commitment to furthering research in dermatology. This award will allow me to advance my career and research in cutaneous lymphoma," Dr. Newsom said in a statement.

The winners were selected by the La Roche-Posay North American Scientific Committee.

For additional information about La Roche-Posay, visit www.laroche-posay.us and "like" the La Roche-Posay Facebook page at www.facebook.com/LaRochePosayusa.

[email protected]

A trio of up-and-coming dermatologists received the La Roche-Posay North American Foundation’s 2014 Research Awards, presented at the annual meeting of the American Academy of Dermatology in Denver.

The awards were given to candidates with promising projects in clinical, biological, and pharmacological research linked to dermatology.

Dr. Thomas Strub of the Icahn School of Medicine at Mount Sinai, New York, received the first-place grant of $10,000 for his study "Epigenetic Mechanisms Underlying Drug Resistance of Malignant Melanoma."

"It is a privilege for me to be chosen by the La Roche-Posay North American Foundation for supporting my research goals," Dr. Strub said in a statement. "Melanoma therapies remain limited, and drug resistance invariably occurs, with patients ultimately relapsing. I hope my research will shed light onto the epigenome of resistant melanoma tumors and insight on the elements involved in melanoma, which will ultimately improve patient outcomes."

Dr. Shadmehr Demehri of Washington University, St. Louis, received the second prize of $5,000 for his study "The Role of Calcipotriol in Treatment of Pre-cancerous Skin Lesions."

"It’s a great honor to be a recipient of the La Roche-Posay North American Foundation’s research award," Dr. Demehri said in a statement. "My research focuses on determining the role of immune activation in cancer therapy. Specifically, I aim to understand the effects of epithelial cytokine expression on induction of antitumor immunity. Considering the rising prevalence of skin cancer in our population, the outcomes of our investigation can have significant impact on care for patients with skin and other types of cancers."

Dr. Emily Newsom of Wayne State University, Detroit, received the third prize award of $5,000 for her study "Mapping Cytogenetic Abnormalities in Cutaneous T-cell Lymphoma using FISH."

"I appreciate the La Roche-Posay North American Foundation’s commitment to furthering research in dermatology. This award will allow me to advance my career and research in cutaneous lymphoma," Dr. Newsom said in a statement.

The winners were selected by the La Roche-Posay North American Scientific Committee.

For additional information about La Roche-Posay, visit www.laroche-posay.us and "like" the La Roche-Posay Facebook page at www.facebook.com/LaRochePosayusa.

[email protected]

Social media take center stage at this year’s American Academy of Dermatology annual meeting, as the AAD offers its first Twitter "selfie" photo contest. The winner will receive a $50 Starbucks gift card; how’s that for an incentive?

To enter, you (or a friend) need to have a Twitter account. Send your best selfie (it can be one person, two people, or a group shot) of you and your friends enjoying the meeting. Note: Photos may be taken in or around the convention center, or out and about in Denver, but no photos may be taken from inside the meeting session rooms.

Once you’re on Twitter, tweet your best selfie to @AADMtgs, and be sure to use the hashtag #aad14.

The contest kicks off on Friday, March 21, at noon (Mountain Standard Time), and ends on Tuesday, March 25, at noon (MST). A panel will review the photos, and the winner will be notified by noon on Friday, March 28 (Central Standard Time). Gift cards will be mailed or e-mailed. More information is available at the AAD’s website, aad.org.

While you’re tweeting your selfies, keep up with the latest news and development from the meeting by following @sknews, as well as our intrepid reporter, Naseem Miller (@naseemmiller).

[email protected]

On Twitter @hsplete

Social media take center stage at this year’s American Academy of Dermatology annual meeting, as the AAD offers its first Twitter "selfie" photo contest. The winner will receive a $50 Starbucks gift card; how’s that for an incentive?

To enter, you (or a friend) need to have a Twitter account. Send your best selfie (it can be one person, two people, or a group shot) of you and your friends enjoying the meeting. Note: Photos may be taken in or around the convention center, or out and about in Denver, but no photos may be taken from inside the meeting session rooms.

Once you’re on Twitter, tweet your best selfie to @AADMtgs, and be sure to use the hashtag #aad14.

The contest kicks off on Friday, March 21, at noon (Mountain Standard Time), and ends on Tuesday, March 25, at noon (MST). A panel will review the photos, and the winner will be notified by noon on Friday, March 28 (Central Standard Time). Gift cards will be mailed or e-mailed. More information is available at the AAD’s website, aad.org.

While you’re tweeting your selfies, keep up with the latest news and development from the meeting by following @sknews, as well as our intrepid reporter, Naseem Miller (@naseemmiller).

[email protected]

On Twitter @hsplete

Social media take center stage at this year’s American Academy of Dermatology annual meeting, as the AAD offers its first Twitter "selfie" photo contest. The winner will receive a $50 Starbucks gift card; how’s that for an incentive?

To enter, you (or a friend) need to have a Twitter account. Send your best selfie (it can be one person, two people, or a group shot) of you and your friends enjoying the meeting. Note: Photos may be taken in or around the convention center, or out and about in Denver, but no photos may be taken from inside the meeting session rooms.

Once you’re on Twitter, tweet your best selfie to @AADMtgs, and be sure to use the hashtag #aad14.

The contest kicks off on Friday, March 21, at noon (Mountain Standard Time), and ends on Tuesday, March 25, at noon (MST). A panel will review the photos, and the winner will be notified by noon on Friday, March 28 (Central Standard Time). Gift cards will be mailed or e-mailed. More information is available at the AAD’s website, aad.org.

While you’re tweeting your selfies, keep up with the latest news and development from the meeting by following @sknews, as well as our intrepid reporter, Naseem Miller (@naseemmiller).

[email protected]

On Twitter @hsplete