Search

ABSTRACTBackground: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs).Objective:To describe cutaneous inflammatory eruptions in psoriatic patients treated with an anti IL-17A agent (secukinumab or ixekizumab).Methods: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed.Results: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants.Conclusion: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriatic patients, 3–4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis.

Background:: Terbinafine persists in the nail at effective concentrations for several weeks after discontinuation of treatment. Objective:: Our purpose was to verify whether intermittent terbinafine therapy is effective in dermatophytic onychomycosis and to compare the results of intermittent terbinafine with those of intermittent itraconazole and continuous terbinafine treatment. Methods:: An open, randomized study of 63 patients was performed with three treatment regimens: terbinafine, 250 mg daily (21 patients); terbinafine, 500 mg daily for 1 week every month (21 patients); or itraconazole, 400 mg daily for 1 week every month (21 patients). Treatment was continued for 4 months in toenail infections (60 patients) and 2 months in fingernail infections (3 patients). Results:: At the end of the follow-up period (6 months after discontinuation of treatment) 16 of 17 patients (94.1%) with toenail onychomycosis were mycologically cured in the terbinafine 250 mg group, 16 of 20 (80%) in the terbinafine 500 mg group, and 15 of 20 (75%) in the itraconazole group. Conclusion:: The percentage of patients who were mycologically cured was higher in the continuous terbinafine group than in the intermittent terbinafine and itraconazole groups, but statistical analysis did not reveal any significant difference between these cure rates.

Metastatic Crohn's disease is a rare inflammatory condition characterised by cutaneous granulomatous lesions separated from the affected bowel by normal intact skin. Involvement of the genitalia in Crohn's disease is rare and consists of ulcerated lesions in almost all of the cases reported in the literature. We describe a case of penile involvement in a 27 year old man with a 5 year history of Crohn's disease. Should genital involvement precede the bowel disease, patients may consult the sexually transmitted disease service for this problem and the dermatovenereologists may be the first to formulate the diagnosis. [ABSTRACT FROM PUBLISHER]