Search

Introduction: After the introduction of dupilumab as systemic treatment for atopic dermatitis, an increasing number of patients have been successfully treated. However, reports of patients developing psoriasis as a secondary skin condition have been accumulating. The most likely reason is assumed to be an immune shift from Th2- to Th1-mediated auto-inflammatory processes. Case Presentation: Our patient is a 38-year-old male suffering from head-neck type atopic dermatitis since childhood. As one of the first patients in Switzerland, he received dupilumab in 2018 leading to a significant improvement of his skin lesions. One year later he developed progressing circular erythematous-squamous plaques which correlated histologically with psoriasis. In 2021, 3 years after initiating dupilumab, we switched systemic therapy to baricitinib. Three months after initiation, his psoriatic lesions were completely healed, while the atopic lesions remained stable with low inflammatory activity. Conclusion: In patients treated with dupilumab for atopic dermatitis immune shift needs to be considered in case of newly appearing skin lesions. With a growing number of described cases, we conclude that baricitinib is a good alternative treatment for atopic dermatitis in patients suffering from biologic-induced psoriasis. [ABSTRACT FROM AUTHOR]

Itch is the commonest skin‐related symptom, associated with a high psychosocial and economic burden. While the main focus of itch research lies on a few chronic skin diseases, only little is known about the perception of itch, itch‐aggravating/‐relieving factors and treatment preferences in patients with acute and chronic itch of various etiology. In this cross‐sectional study, we assessed these aspects in 126 patients (mean age 61.7 ± 18.4 years, 67 females, median itch duration 3.9 years) using a 78‐item questionnaire. The diseases were categorized into 11 diagnostic groups for descriptive analysis; the three most frequent groups ("atopic dermatitis," "nonatopic eczema," "inflammatory dermatoses") were statistically compared. Itch was most often perceived as localized 42.9%, burning (40.5%), and worrying (39.7%) with worsening in the evening (49.2%), due to warmth (42.1%) and sweating (26.2%). While itch perception, itch‐aggravating factors and treatment preferences differed broadly among patients, the itch‐relieving personal strategies were more uniform ("scratching by hand 70.6%, applying topicals 57.9%). Also, 69.8% of patients suffered from itch‐related sleep disturbance, consequently affecting their relatives in 30.0%. Subgroup comparisons revealed significant differences regarding itch‐aggravating factors (P =.0012) and itch duration (P =.0082). Patients rated the antipruritic effectiveness of phototherapy, "complementary and alternative medicine" and "other tablets" as high, but oral antihistamines, "cortisone tablets" and any topical as only moderately efficacious. The preferred administration of an ideal itch treatment was "creams/ointments" (51.6%) or "tablets" (35.7%), only few patients preferred "injections" or "patches." Consideration of such differences and similarities in itch characteristics and treatment preferences could help to better tailor treatment in itch patients. [ABSTRACT FROM AUTHOR]

In this work we investigate the thermodynamics conditions at which neutrinos decouple from matter in neutron star merger remnants by post-processing results of merger simulations. We find that the matter density and the neutrino energies are the most relevant quantities in determining the decoupling surface location. For mean energy neutrinos (∼ 9, 15 and 24 MeV for ν e , ν ¯ e and ν μ , τ , respectively) the transition between diffusion and free-streaming conditions occurs around 10 11 g cm - 3 for all neutrino species. Weak and thermal equilibrium freeze-out occurs deeper (several 10 12 g cm - 3 ) for heavy-flavor neutrinos than for ν ¯ e and ν e ( ≳ 10 11 g cm - 3 ). Decoupling temperatures are broadly in agreement with the average neutrino energies, with softer equations of state characterized by ∼ 1 MeV larger decoupling temperatures. Neutrinos streaming at infinity with different energies come from different remnant parts. While low-energy neutrinos ( ∼ 3 MeV ) decouple at ρ ∼ 10 13 g cm - 3 , T ∼ 10 MeV and Y e ≲ 0.1 close to weak equilibrium, high-energy ones ( ∼ 50 MeV ) decouple from the disk at ρ ∼ 10 9 g cm - 3 , T ∼ 2 MeV and Y e ≳ 0.25 . The presence of a massive NS or a BH influences the neutrino thermalization. While in the former case decoupling surfaces are present for all relevant energies, the lower maximum density ( ≲ 10 12 g cm - 3 ) in BH-torus systems does not allow softer neutrinos to thermalize and diffuse. [ABSTRACT FROM AUTHOR]