90 results on '"L Rudnicka"'
Search Results
2. Transbronchial lung cryobiopsy in sarcoidosis – is single biopsy enough?
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M Gnass, A Filarecka, M Ciesielska, J Soja, D Czyżewski, L Rudnicka, W Zajęcki, A Bartczak, A Ćmiel, A Paluch-Stachowicz, P Gniady, and A Szlubowski
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- 2022
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3. Sisaipho Revisited: Inverse Ophiasis or More than That?
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Katoulis A, Pappa G, Markou E, Kanelleas A, Bozi E, Sgouros D, Rigopoulos D, and Rudnicka L
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Introduction: Alopecia areata exhibits diverse clinical forms, encompassing the less common variant, sisaipho. Clinical observations suggest its unique ability to emulate both male and female pattern hair loss, implying a potential androgenic influence akin to androgenetic alopecia., Case Presentations: Herein, we present 3 cases of alopecia areata in adults exhibiting a male or female pattern distribution or accentuation., Conclusion: To improve diagnosis and differential diagnosis of alopecia, the term "alopecia areata in a male or female pattern distribution" may be introduced as a new clinical subtype of alopecia areata. This new subtype could also integrate sisaipho. By introducing this refined terminology, we seek to improve our comprehension of the condition, enabling more precise diagnoses and tailored treatment approaches., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 S. Karger AG, Basel.)
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- 2025
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4. Efficacy and safety of the oral Janus kinase 3/tyrosine kinase expressed in hepatocellular carcinoma family kinase inhibitor ritlecitinib over 24 months: integrated analysis of the ALLEGRO phase IIb/III and long-term phase III clinical studies in alopecia areata.
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Piliang M, Soung J, King B, Shapiro J, Rudnicka L, Farrant P, Magnolo N, Piraccini BM, Luo X, Wolk R, Woodworth D, Schaefer G, and Lejeune A
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- Humans, Male, Female, Adult, Adolescent, Treatment Outcome, Middle Aged, Young Adult, Child, Administration, Oral, Patient Satisfaction, Pyrimidines, Pyrroles, Alopecia Areata drug therapy, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects
- Abstract
Background: The ALLEGRO phase IIa and IIb/III (NCT02974868 and NCT03732807) studies have demonstrated that ritlecitinib is effective and well tolerated in adults and adolescents with alopecia areata (AA) up to 48 weeks., Objectives: To assess the efficacy of ritlecitinib through month 24 and safety through data cutoff in the ALLEGRO phase IIb/III study and the ongoing long-term open-label phase III ALLEGRO-LT study (NCT04006457)., Methods: Patients aged ≥ 12 years with AA and ≥ 50% scalp hair loss from ALLEGRO IIb/III who rolled over to ALLEGRO-LT after up to 48 weeks were included. Proportions of patients with responses based on clinician-reported Severity of Alopecia Tool (SALT) scores of ≤ 20 and ≤ 10, eyebrow assessment (EBA) and eyelash assessment (ELA), patient global impression of change (PGI-C) and patient satisfaction with hair growth were reported through month 24 for patients who received ritlecitinib 50 mg daily with or without a 200-mg 4-week daily loading dose. Observed and imputed data [last observation carried forward (LOCF)] were reported up to 9 December 2022. Safety was assessed throughout., Results: At month 12, a SALT score ≤ 20 was achieved by 45.1% and 45.9% (observed) and 40.3% and 41.8% (LOCF) of the 191 and 194 patients who received ritlecitinib 50 mg and ritlecitinib 200 mg/50 mg, respectively. At month 24, these proportions increased to 60.8% and 63.1% (observed) and 46.1% and 50.8% (LOCF), respectively. Patients with abnormal EBA or ELA scores at baseline achieved responses at month 24 [EBA observed: 57.6% (50 mg), 61.0% (200/50 mg); EBA LOCF: 46.8% (50 mg), 50.9% (200/50 mg); ELA observed: 51.2% (50 mg), 62.7% (200/50 mg); ELA LOCF: 43.2% (50 mg), 51.7% (200/50 mg)]. PGI-C response was achieved by patients at month 24 [observed: 70.0% (50 mg), 76.4% (200/50 mg); LOCF: 56.6% (50 mg), 65.5% (200/50 mg)]. Safety profiles for both treatment groups were consistent with the known safety profile of ritlecitinib., Conclusions: Ritlecitinib has clinically meaningful and sustained efficacy beyond 1 year with a favourable safety and tolerability profile, supporting its long-term use in patients aged ≥ 12 years with AA., Competing Interests: Conflicts of interest: M.P. has been a consultant and/or investigator for Pfizer, Eli Lilly and Procter & Gamble. J. Soung has been a speaker for Celgene, Regeneron/Sanofi and Ortho Dermatologics; a speaker and investigator for Amgen, AbbVie and Pfizer; a speaker, investigator and advisor for Eli Lilly; an investigator and advisor for LEO Pharma; an investigator, speaker and consultant for Novartis; an investigator for UCB, Janssen, Kyowa Kirin, KoBioLabs and Castel Biosciences; an investigator and consultant for Dermavant; a speaker and consultant for Bristol Myers Squibb; and a speaker, investigator and consultant for Arcutis. B.K. has been an advisory board member, consultant, clinical trial investigator and/or on data monitoring committees for AbbVie, AltruBio, Almirall, AnaptysBio, Arena Pharmaceuticals, Bioniz Therapeutics, Bristol Myers Squibb, Concert Pharmaceuticals, Equillium, Horizon Therapeutics, Eli Lilly, Incyte, Janssen Pharmaceuticals, LEO Pharma, Merck, Otsuka/Visterra, Pfizer, Q32 Bio, Regeneron, Sanofi Genzyme, Sun Pharmaceutical, TWi Biotechnology, Viela Bio and Ventyx Biosciences; and has served on speakers bureau for AbbVie, Incyte, Eli Lilly, Pfizer, Regeneron and Sanofi Genzyme. J. Shapiro has been a consultant for Pfizer and Eli Lilly, and a clinical trial investigator for Pfizer. L.R. has been a speaker for AbbVie, L’Oréal, LEO Pharma, Novartis, Pierre Fabre and Pfizer; and an advisory board member for LEO Pharma, Janssen, L’Oréal, Novartis, Pfizer, Sanofi and UCB. P.F. has been a consultant for Eli Lilly and an advisory board member and investigator for Pfizer. N.M. has received honoraria for participation in advisory boards, speaker and/or consultancy for AbbVie, Almirall, Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Dr. Wolff, Eli Lilly, Janssen, La Roche-Posay, LEO Pharma, Novartis, Pfizer and UCB Pharma. B.M.P. has received honoraria for participation in advisory boards, speaker and/or consultancy for Almirall, Pfizer, Eli Lilly, Pierre Fabre-Ducray, Cantabria-Difa Cooper, Dercos–L’Oréal, ISDIN and Legacy Healthcare. X.L., R.W., D.W., G.S. and A.L. are employees of, and hold stock or stock options in, Pfizer., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.)
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- 2025
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5. Radiotherapy-Induced Alopecia: A Multicenter Retrospective Study of 20 Cases.
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Chequer Cabral GC, Cortez de Almeida RF, Freites-Martinez A, Piraccini BM, Starace M, Rudnicka L, Waśkiel-Burnat A, Alves LD, Müller Ramos P, Dos Santos RLB, Machado CJ, Tortelly V, and Melo DF
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- 2025
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6. Baseline trichoscopic values for afro-textured hair in indigenous South Africans show lower density and unique features.
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Dlova NC, Enechukwu NA, Suleman MH, Maseko JZ, and Rudnicka L
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Background: Afro-textured hair exhibits distinct physicochemical properties with possible variations in measurable hair parameters. Standardized documentation of trichoscopic norms of afro-textured hair in indigenous Africans is notably lacking., Methods: A cross-sectional study involving 122 South Africans of both genders of African ancestry (mean age 20.9 ± 3.3 years) with natural afro-textured hair was performed to establish trichoscopic norms. Standard images, one overview, and five microimages (one 20× and four 50× magnifications) were captured with the FotoFinder Medicam1000V2 videodermoscope. Hair density (HD; N/cm
2 ); hair shaft thickness (HST; μm); the proportion of thin, mid, and thick hairs (%); cumulative hair thickness (mm/cm2 ); and follicular units (FU; N/cm2 ) were assessed., Results: The average HD was 139.1 ± 33.88 hairs/cm2 with significant variations across different scalp areas. The average hair thickness was 62.59 ± 8.45 μm with the frontal scalp showing the greatest HST, the proportion of thick hairs, cumulative hair thickness, and FU densities; the temporal had the greatest proportion of thin hairs, whereas the occipital showed the highest proportion of triple hair FU. Male participants exhibited significantly greater average hair thickness, more thick hairs, and more double and triple FU, whereas females had higher cumulative hair thickness density, more thin and intermediate hairs, and more single follicular units., Conclusion: Baseline trichoscopic values for natural afro-textured hair in indigenous South Africans reveal lower hair densities, variations in shaft diameters, and follicular unit patterns compared to other racial groups. Significant gender-based differences are evident in some of the measured parameters. Tailored reference values are essential for accurate clinical evaluations and hair transplant planning., (© 2025 the International Society of Dermatology.)- Published
- 2025
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7. Lichen Planopilaris in Children: A Systematic Review.
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Papierzewska M, Waśkiel-Burnat A, and Rudnicka L
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- Humans, Child, Adolescent, Male, Female, Child, Preschool, Dermoscopy, Lichen Planus pathology, Lichen Planus drug therapy, Lichen Planus diagnosis, Alopecia pathology, Alopecia drug therapy, Alopecia diagnosis
- Abstract
Background: Lichen planopilaris (LPP) is the most common form of scarring alopecia in adults. The disease may also occur in children and adolescents. The aim of this systematic review is to evaluate clinical, trichoscopic, and histopathologic features of pediatric LPP. Therapeutic management is also discussed., Methods: The systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines by searching PubMed, Scopus, and EBSCO databases with the last search on June 18, 2024., Results: A total of 12 studies including 20 children were analyzed. Male predominance was observed. The typical presentation of LPP in children included scarring, perifollicular erythema, scaling, and plugging; atrophy, and follicular hyperkeratotic papules, located most commonly in the vertex. The most common trichoscopic findings were scaling and blue-gray dots, perifollicular erythema, and the absence of follicular ostia. Histopathological examination revealed perifollicular fibrosis, perifollicular interface lymphocytic inflammation, pigment incontinence, cytoid bodies, and scarring in the dermis. Complete or partial response was observed in children treated with topical, intralesional, and systemic corticosteroids, methotrexate, pioglitazone, and tocilizumab., Conclusions: LPP is a rare cause of scarring alopecia in children. The disease should be taken into consideration in the differential diagnosis of patchy hair loss in children., (© 2024 Wiley Periodicals LLC.)
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- 2025
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8. Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient.
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Szwed C, Gudziewski O, Sar-Pomian M, Olszewska M, Rudnicka L, and Czuwara J
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Background: Lichen planus (LP) is a chronic inflammatory disease that can present with significant morbidity, particularly in children. Erosive lichen planus (ELP), its rare destructive subtype, can be particularly difficult to diagnose and manage. We present a rare pediatric case of ELP with multisite involvement and discuss the differential diagnosis. Case Presentation : A 12-year-old boy presented with painful erosions and ulcers on the lateral tongue and dystrophic nails. His six-year history of tongue and nail lesions prompted several comprehensive examinations. Laboratory tests did not reveal any abnormalities. Histopathological examination of the tongue lesions was representative of ELP. Line-field confocal optical coherence tomography (LC-OCT) examination of the tongue lesions showed features that strongly correlated with histopathology. The patient was later hospitalized due to dysphagia and esophageal food impaction, during which esophageal ELP was confirmed. The patient was initially managed with topical corticosteroids. He was later started on systemic therapy in the form of methotrexate and low-dose naltrexone to address his symptoms and disease presentation. Conclusions: This case highlights the complexities of diagnosis and management of ELP in pediatric patients. A multidisciplinary approach and regular follow-up are necessary to manage symptoms, prevent complications, and improve quality of life.
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- 2024
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9. The Role of Minoxidil in Treatment of Alopecia Areata: A Systematic Review and Meta-Analysis.
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Majewski M, Gardaś K, Waśkiel-Burnat A, Ordak M, and Rudnicka L
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Background/Objectives : Minoxidil, in addition to its vasodilatory effect, has also immunomodulatory properties that may be partially responsible for its efficacy in alopecia areata. The aim of the study was to evaluate the efficacy of monotherapy with topical or oral minoxidil in alopecia areata. Methods : A systematic review and meta-analysis of the efficacy of monotherapy with minoxidil in alopecia areata was conducted following the PRISMA guidelines. Efficacy of minoxidil in alopecia areata was evaluated separately for three groups of the patients: (1) treated with 5% topical minoxidil, (2) less than 5% topical minoxidil, and (3) oral minoxidil. Therapeutic response was defined as any regrowth of terminal hair. Results : Of 244 articles, 13 were considered eligible for the further analysis. The study included 372 patients with alopecia areata (338 using topical minoxidil and 34 taking oral minoxidil). The mean time of treatment ranged from 2 to 60 weeks (mean: 27 weeks). The response rate for 5% topical was 82% (95% CI 0.7-0.93) and 58% (95% Cl 0.5-0.67) for the less than 5% topical minoxidil group. For the group of patients treated orally, the response rate was 82%. Conclusions : Minoxidil, both topical and oral, may be beneficial in monotherapy in patients with alopecia areata. 5% topical minoxidil is characterized by significantly higher efficacy compared to minoxidil at a lower concentration. There are no sufficient data to recommend minoxidil as a first-line therapeutic option for alopecia areata.
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- 2024
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10. The Metaverse: A New Frontier in the Management of Hair Loss and Nail Disorders.
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Goldust M and Rudnicka L
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- 2024
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11. Isotretinoin as a promising option in the treatment of facial papules of frontal fibrosing alopecia.
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Beyzaee AM, Babaei M, Ghoreishi B, Waśkiel-Burnat A, Rudnicka L, Starace M, Tosti A, Patil A, Sinclair R, Goldust M, and Rahmatpour Rokni G
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- Humans, Treatment Outcome, Administration, Oral, Facial Dermatoses drug therapy, Facial Dermatoses pathology, Forehead, Isotretinoin therapeutic use, Isotretinoin administration & dosage, Alopecia drug therapy, Alopecia pathology, Dermatologic Agents therapeutic use, Dermatologic Agents administration & dosage, Fibrosis drug therapy
- Abstract
Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia characterized by hairline recession, pruritus, and facial papules (FP). Various therapies are used to stabilize disease activity and induce remission. However, FP of FFA is resistant to treatment in many cases. In this review, we searched the PubMed and Google Scholar databases to screen the published literature on treatment options for FP in the context of FFA. Overall, 12 studies were included in this review. Available literature suggests a noticeable improvement in resistant-to-treatment FP in FFA patients with oral isotretinoin. The available evidence is limited and is derived from retrospective studies and case reports/series. Systemic isotretinoin can be considered a promising therapeutic regimen for treating resistant-to-treatment FP of FFA patients. However, more extensive, well-designed studies are necessary for confirmatory evidence., (© 2024 the International Society of Dermatology.)
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- 2024
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12. Diffuse pattern of alopecia areata in children: A multicentre retrospective study with 67 patients.
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Buzatto BC, Lemes LR, Cortez de Almeida RF, Machado CJ, Starace M, Piraccini BM, Alessandrini A, Quadrelli F, Marti M, Rudnicka L, Wáskiel Burnat A, Doroshkevich A, Silyuk T, Iorizzo M, Rigatti M, Tosti A, Vincenzi C, Mercau S, Sánchez-Dueñas LE, Asz Sigall D, Dos Santos Lima C, Baptista E, de Carvalho R, Faro GBA, Doche I, and Melo DF
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- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Retrospective Studies, Alopecia Areata
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- 2024
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13. The emerging role of exosomes in the treatment of hair loss.
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Rudnicka L and Olszewska M
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- Humans, Hair Follicle, Exosomes metabolism, Alopecia therapy, Alopecia drug therapy
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- 2024
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14. Differential diagnosis of red scalp: the importance of trichoscopy.
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Waśkiel-Burnat A, Czuwara J, Blicharz L, Olszewska M, and Rudnicka L
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- Humans, Diagnosis, Differential, Dermatitis, Seborrheic diagnosis, Dermatitis, Seborrheic pathology, Rosacea pathology, Rosacea diagnosis, Psoriasis pathology, Psoriasis diagnosis, Dermatomyositis pathology, Dermatomyositis diagnosis, Dermatomyositis diagnostic imaging, Scalp pathology, Dermatitis, Contact pathology, Dermatitis, Contact diagnosis, Erythema pathology, Scalp Dermatoses pathology, Scalp Dermatoses diagnosis, Scalp Dermatoses diagnostic imaging, Dermoscopy methods, Lichen Planus pathology, Lichen Planus diagnosis
- Abstract
Red scalp is a common complaint that may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases to cause diffuse scalp erythema are psoriasis, seborrhoeic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases, the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regularly distributed dotted (glomerular) vessels or twisted red loops, and punctate haemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrhoeic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and polygonal/arborizing vessels. This review also summarizes histological features and therapeutic options for these conditions., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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15. The Usefulness of Line-Field Confocal Optical Coherence Tomography in Monitoring Epidermal Changes in Atopic Dermatitis in Response to Treatment: A Pilot Study.
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Dryżałowska Z, Blicharz L, Michalczyk A, Koscian J, Maj M, Czuwara J, and Rudnicka L
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Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Due to its high prevalence, considerable morbidity, and chronicity, there is a need for the accurate in vivo evaluation of treatment efficacy. Line-field confocal optical coherence tomography (LC-OCT) is a new emerging imaging technique able to perform a non-invasive, real-time examination of the epidermis and the upper dermis. LC-OCT may represent a promising tool in the diagnosis and treatment follow-up of chronic eczematous skin diseases with barrier defects., Objectives: We aimed to investigate the role of LC-OCT in the non-invasive monitoring of the treatment effect on five patients with severe atopic dermatitis during dupilumab treatment., Materials and Methods: LC-OCT imaging was performed on five patients (three women and two men) aged between 14 and 85 years old at the baseline and at 2, 4, and 6 weeks of treatment with dupilumab. The LC-OCT scans were performed at two sites, the lesional skin in the antecubital fossa and the extensor part of the arm, considered a control site on each patient for comparison. The captured images were later evaluated. Descriptive statistics and a t -test were used to compare the analyzed parameters over time and between involved atopic skin and clinically healthy skin., Results: The LC-OCT imaging was able to detect the difference in stratum corneum (SC) thickness and quality and epidermal thickness (ET) and the changes before and after treatment with high accuracy. The main findings include a significant reduction in the epidermal and stratum corneum thickness and decreased epidermal spongiosis and inflammation, with better quality of the stratum corneum indicating restoration of its tightness at both lesional and control sites., Conclusions: This study demonstrates that clinical improvement of affected and unaffected atopic skin under dupilumab treatment correlates with the LC-OCT findings. LC-OCT represents a novel, non-invasive tool examining the in vivo skin barrier and inflammation and can help to monitor the treatment efficacy among patients with atopic dermatitis in daily practice.
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- 2024
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16. Dermoscopic Nail Changes in Psoriasis, Lichen Planus, and Lichen Striatus.
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Sar-Pomian M, Starace MVR, Lencastre A, Piraccini BM, Richert B, Rudnicka L, Trakatelli MG, and Iorizzo M
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Background: Onychoscopy is a noninvasive method helpful in diagnosing nail disorders. The aim of the study was to review literature on the usability of onychoscopy in nail psoriasis, nail lichen planus, and nail lichen striatus., Summary: Onychoscopic features of nail psoriasis are pitting, onycholysis with erythematous border, salmon patches, splinter hemorrhages, dotted vessels in lateral and proximal folds, and hyponychium. Onychoscopic features of nail lichen planus are onychorrhexis, onycholysis, longitudinal melanonychia, and red lunula. The literature on the usability of onychoscopy in nail lichen striatus is scarce., Keynotes: Onychoscopy facilitates evaluation of nail abnormalities compared to the clinical examination. Lunular alterations, salmon patches, erythematous border of onycholysis as well as splinter hemorrhages in nail psoriasis are better visualized with onychoscopy compared to the naked eye. Onychoscopy enhances detection of melanonychia, dyschromia, and lunular changes in nail lichen planus. Onychoscopic features are different in fingernails and toenails., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 S. Karger AG, Basel.)
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- 2024
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17. Hair Shaft Abnormalities as a Dermoscopic Feature of Mycosis Fungoides: Pilot Results.
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Jasińska M, Czuwara J, Lortkipanidze N, Michalczyk A, Borkowska B, Gajda-Mróz P, Kurzeja M, Olszewska M, Rudnicka L, and Rakowska A
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Introduction: Diagnosis of persistent erythematous, scaly patches, or plaques can be complex since psoriasis (Ps), eczematous dermatitis (ED), and mycosis fungoides (MF) can be considered. Dermoscopy, which is a noninvasive diagnostic tool, is commonly used to examine blood vessels, scales, and background color; however, research on hair shaft evaluation in inflammatory dermatoses remains scarce. The aim of the study was dermoscopic evaluation of hair shafts in skin lesions localized on the non-scalp skin areas in patients diagnosed with MF, Ps, and ED., Methods: This was a retrospective evaluation of 55 patients diagnosed with MF, Ps, and ED. Photographic and dermoscopic documentation of these patients and detailed medical history were evaluated., Results: A total of 21 patients with MF, 21 patients with Ps, and 13 patients with ED were evaluated. The examination revealed the presence of various abnormalities of hair shafts (e.g., numerous pili torti, single pili torti, 8-shaped hairs, pigtail hairs, broken hairs, hair shafts rapidly tapered over long sections, hair shafts irregular in thickness, angulated hairs, branched hairs, the presence of trichorrhexis nodosa, and monilethrix-like hairs), yellow dots, and black dots. The presence of pili torti was found in 80% of patients with MF, compared with 16% of patients with Ps and 8% of patients with ED (p < 0.005), with multiple pili torti found only in MF patients (67%) (p < 0.005). Statistically significant differences also applied to hair shafts rapidly tapering over long sections and 8-shaped hairs, which occurred only in MF patients (p < 0.005 and p = 0.035, respectively)., Conclusions: The presence of hair shaft abnormalities such as numerous pili torti, 8-shaped hairs, and hair shafts rapidly tapering over long sections is an important criterion that should be considered in the dermoscopic differentiation of the patchy/plaque mycosis fungoides and inflammatory dermatoses, such as psoriasis and eczematous dermatitis localized on the non-scalp skin areas., (© 2024. The Author(s).)
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- 2024
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18. Efficacy and Safety of Rilzabrutinib in Pemphigus: PEGASUS Phase 3 Randomized Study.
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Murrell DF, Caux F, Patsatsi A, Hagino O, Rudnicka L, Vassileva S, Uzun S, Ye J, Yen K, Arora P, Gourlay SG, Joly P, and Werth VP
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- Humans, Middle Aged, Adult, Male, Female, Aged, Treatment Outcome, Aged, 80 and over, Young Adult, Adolescent, Double-Blind Method, Pyrimidines administration & dosage, Pyrimidines adverse effects, Dose-Response Relationship, Drug, Protein Kinase Inhibitors adverse effects, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors therapeutic use, Severity of Illness Index, Remission Induction methods, Pemphigus drug therapy, Agammaglobulinaemia Tyrosine Kinase antagonists & inhibitors
- Abstract
Trial Design: Pemphigus is a rare but life-threatening autoimmune disease requiring long-term treatment that minimizes corticosteroid (CS) exposure while providing consistent disease control. The phase 2 pemphigus study of oral, reversible, covalent Bruton tyrosine kinase inhibitor rilzabrutinib demonstrated rapid and sustained efficacy with well-tolerated safety., Methods: Adults (aged 18-80 years) were randomized 1:1 to 400 mg rilzabrutinib (n = 65) or placebo (n = 66) twice daily (with CS ≤ 0.5 mg/kg/d) for 37 weeks in the phase 3 PEGASUS study in moderate-to-severe pemphigus vulgaris/pemphigus foliaceus., Results: The primary endpoint of complete remission from week 29 to week 37 with the amended endpoint CS dose ≤10 mg/d was not significant for 13 of 54 (24%) rilzabrutinib versus 10 of 55 (18%) placebo patients with PV (P = .45). Secondary endpoints showed numerical but nonsignificant improvements with rilzabrutinib (vs placebo) in reduced CS use, prolonged complete remission duration, and faster time to first complete remission., Conclusions: Overall, rilzabrutinib was well-tolerated, with similar adverse events reported in both groups. Using minimal CS dose ≤10 mg/d and excluding remote observations, the primary efficacy endpoint was not met. However, results from a prespecified sensitivity analysis using CS dose ≤5 mg/d, considering all observations, and including all patients support Bruton tyrosine kinase inhibition as a viable therapeutic approach for pemphigus., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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19. HPV Infections-Classification, Pathogenesis, and Potential New Therapies.
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Mlynarczyk-Bonikowska B and Rudnicka L
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- Humans, Virus Replication drug effects, Papillomavirus Vaccines therapeutic use, Papillomavirus Vaccines immunology, Antiviral Agents therapeutic use, Antiviral Agents pharmacology, Papillomavirus Infections virology, Papillomavirus Infections drug therapy, Papillomaviridae physiology, Papillomaviridae pathogenicity, Papillomaviridae classification, Papillomaviridae genetics
- Abstract
To date, more than 400 types of human papillomavirus (HPV) have been identified. Despite the creation of effective prophylactic vaccines against the most common genital HPVs, the viruses remain among the most prevalent pathogens found in humans. According to WHO data, they are the cause of 5% of all cancers. Even more frequent are persistent and recurrent benign lesions such as genital and common warts. HPVs are resistant to many disinfectants and relatively unsusceptible to external conditions. There is still no drug available to inhibit viral replication, and treatment is based on removing lesions or stimulating the host immune system. This paper presents the systematics of HPV and the differences in HPV structure between different genetic types, lineages, and sublineages, based on the literature and GenBank data. We also present the pathogenesis of diseases caused by HPV, with a special focus on the role played by E6, E7, and other viral proteins in the development of benign and cancerous lesions. We discuss further prospects for the treatment of HPV infections, including, among others, substances that block the entry of HPV into cells, inhibitors of viral early proteins, and some substances of plant origin that inhibit viral replication, as well as new possibilities for therapeutic vaccines.
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- 2024
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20. Correction to: Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program.
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King B, Soung J, Tziotzios C, Rudnicka L, Joly P, Gooderham M, Sinclair R, Mesinkovska NA, Paul C, Gong Y, Anway SD, Tran H, Wolk R, Zwillich SH, and Lejeune A
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- 2024
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21. Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxoedema and scleroedema.
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Knobler R, Geroldinger-Simić M, Kreuter A, Hunzelmann N, Moinzadeh P, Rongioletti F, Denton C, Mouthon L, Cutolo M, Smith V, Gabrielli A, Bagot M, Olesen AB, Foeldvari I, Jalili A, Kähäri VM, Kárpáti S, Kofoed K, Olszewska M, Panelius J, Quaglino P, Seneschal J, Sticherling M, Sunderkötter C, Tanew A, Wolf P, Worm M, Skrok A, Rudnicka L, and Krieg T
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- Humans, Consensus, Diagnosis, Differential, Scleromyxedema diagnosis, Scleromyxedema pathology, Scleromyxedema therapy
- Abstract
The term 'sclerosing diseases of the skin' comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present consensus provides an update to the 2017 European Dermatology Forum Guidelines, focusing on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, updated strategies for the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 2 of this consensus provides clinicians with an overview of the diagnosis and treatment of scleromyxoedema and scleroedema (of Buschke)., (© 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
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- 2024
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22. Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: Localized scleroderma, systemic sclerosis and overlap syndromes.
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Knobler R, Geroldinger-Simić M, Kreuter A, Hunzelmann N, Moinzadeh P, Rongioletti F, Denton CP, Mouthon L, Cutolo M, Smith V, Gabrielli A, Bagot M, Olesen AB, Foeldvari I, Jalili A, Kähäri V, Kárpáti S, Kofoed K, Olszewska M, Panelius J, Quaglino P, Seneschal J, Sticherling M, Sunderkötter C, Tanew A, Wolf P, Worm M, Skrok A, Rudnicka L, and Krieg T
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- Humans, Diagnosis, Differential, Scleroderma, Systemic diagnosis, Scleroderma, Systemic therapy, Scleroderma, Localized diagnosis, Scleroderma, Localized therapy, Consensus
- Abstract
The term 'sclerosing diseases of the skin' comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present consensus provides an update to the 2017 European Dermatology Forum Guidelines, focusing on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, updated strategies for the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 1 of this consensus provides clinicians with an overview of the diagnosis and treatment of localized scleroderma (morphea), and systemic sclerosis including overlap syndromes., (© 2024 European Academy of Dermatology and Venereology.)
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- 2024
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23. Disease burden, clinical management and unmet treatment need of patients with moderate to severe atopic dermatitis; consensus statements, insights and practices from CERTADE (Central/Eastern EU, Russia, Turkiye AD Experts) Delphi panel.
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Trzeciak M, Rudnicka L, Arenberger P, Engin B, L'vov A, Alper S, Alpsoy E, Benáková N, Bobko S, Borlu M, Czarnecka-Operacz M, Elisyutina O, Ergun T, Ertam I, Fedenko E, Filipovská O, Fomina D, Gadzhigoroeva A, Kojanová M, Lesiak A, Michenko A, Murashkin N, Owczarek W, Özkaya E, Plzáková Z, Reich A, Selerova M, and Gurbuz BA
- Abstract
Background: There is limited insight into the current disease burden and everyday clinical management of moderate-to- severe AD in Poland, Czechia, Russia, and Turkiye. Therefore, this study aimed to get information-driven insights regarding the current disease burden and clinical management of patients with moderate-to-severe AD with common and differentiating aspects of the patient journey and establish a consensus., Methods: In this modified 2-round Delphi panel, 133 questions were asked in total to 27 dermatologists. A consensus was achieved when 70% of the panel members strongly agreed or agreed (or strongly disagreed or disagreed) with an item. Statements with <40% agreement dropped from the Delphi rounds and were not repeated., Results: The results state that AD has a significant impact on the quality of life for both patients and their families with social and economic consequences in these countries. While there were significant dissimilarities regarding the current treatment approach by preference order and treatment duration among participants, there was also a high percentage of consensus on literature and guideline-based statements. Current topical therapies and the immune response modifiers were not found to be sufficient by panelists to cover the therapeutic needs of patients with moderate-to-severe AD. Moreover, panelists highlighted the significant burden of adverse events with the off-label use of currently available immunosuppressants., Conclusions: These results underlined that there is a significant disease burden with an unmet treatment need for patients with moderate-to-severe AD in Poland, Czechia, Russia, and Turkiye., Competing Interests: All panel members/authors received honoraria from Pfizer for their consultancy on answering the questionnaires. DF has acted in advisory board of Novartis, Takeda, GlaxoSmithKline and has received speaker honorarium from Abbvie, Novartis, GlaxoSmithKline, Sanofi, Takeda, CSl Behring, AstraZeneca. MS has acted in advisory board of Novartis, Pfizer, Bristol Byers Squibb and has received speaker honorarium from Abbvie and Pfizer. AL'v has acted in advisory board of Bayer AG, Pfizer, Novartis, Abbvie, and Sanofi and has received speaker honorarium from Pfizer, LEO Pharma, Sanofi, Janssen, Bayer AG, and Sun Pharma. MT has acted in advisory board of Sanofi, Abbvie, and Leopharma, has received speaker honorarium from Abbvie, Bioderma, LEO Pharma, Pierre Fabre, La Roche Possey, Bausch Health, Mead Johnson, Eli Lilly and subinvestigator in clinical trials sponsored by Amge, Novartyis, and Pfizer. MB has acted in advisory board of UCB, Sanofi, Novartis, Pfizer, Lilly, Janssen, Abbvie, and has received speaker honorarium from UCB, Sanofi, Novartis, Pfizer, Lilly, Janssen, and Abbvie. AM has acted in advisory board of Bayer AG and has received honorarium from L'Oreal, Roche, and Novartis. ZP has acted in advisory board of Novartis, Pfizer, and Bristol Byers Squibb and has received speaker honorarium from Pfizer and Abbvie. EA has acted in advisory board of Novartis, Johnson and Johnson, and Abbvie and has received speaker honorarium from Novartis, Johnson and Johnson, and Abbvie. AR has been a consultant or speaker for AbbVie, Bioderma, Bristol-Myers Squibb, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, Pierre-Fabre, Sandoz, and Trevi; and principal investigator or sub investigator in clinical trials sponsored by Abbvie, Argenx, Corbus, Drug Delivery Solutions Ltd., Eli Lilly, Galderma, Genentech, Janssen, Kymab Limited, LEO Pharma, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer, Trevi, and VielaBio. OE has acted in advisory boards of Abbvie, Eli-Lilly, Pfizer, and Sanofi and has received speaker honorarium from Abbvie, Sanofi, Berlin-Chemie/Menarini, and Eli-Lilly. EÖ has acted in advisory boards of Pfizer and Sanofi, and has received speaker honorarium from Pfizer and Sanofi. MK has served as consultant, speaker, or investigator for Abbvie, Amgen, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, and UCB. BE has acted in advisory board of Novartis, Lilly, and Abbvie and has received speaker honorarium from Novartis and Abbvie. EF has acted in advisory board of Novartis, Pfizer, Abbvie, Sanofi, and Eli Lilly and has received speaker honorarium from Novartis, Pfizer, Abbvie, Sanofi, Eli Lilly, and Berlin-Chemie/Menarini. WO has worked as a Consultant or Speaker and participated as Principal Investigator or Subinvestigator in clinical trials sponsored by AbbVie, Alfasigma, Almirall, Bioderma, Bristol-Myers Squibb, Egis, Eli Lilly, Galenica, Galderma, Janssen-Cilag, Leo Pharma, Medac GmbH, Mylan, Novartis, Pfizer, Pierre-Fabre, Roche, Sandoz, Teva Pharmaceuticals, and UCB Pharma. MC-O has acted in the Advisory Board of Novartis and Pfizer. OF has acted in advisory board of Lilly, Novartis, Abbvie, Sanofi, and Janssen and was Principal Investigator in clinical studies of Bristol Myers Squibb, Pfizer, Abbvie, Sanofi, Lilly, Novartis, and Janssen. NM has received research grants from Jansen, Eli Lilly, and Novartis; has acted in advisory board of Galderma, Pierre Fabre, Bayer, LEO Pharma, Pfizer, AbbVie, Amryt Pharma, Zeldis Pharma LLC companies and has received speaker honorarium from LEO Pharma, Abbvie, Novartis, and Viatris. AG has received speaker honorarium from Pfizer, L'Oreal, and Piere Fabre. SB has received speaker honoraria/travel fees from LEO Pharma. ALe has acted in advisory board of Novartis, Abbvie, Leo pharma, Sandoz, Sanofi, and Jansssen Squibb and has received speaker honorarium from Pfizer, Abbvie, Sandoz, Novartis, Leo pharma, Galderma, and Janssen. LR member of advisory boards –Janssen Pharmaceutical Companies, L'Oreal, Leo Pharma, Lilly, Pfizer, Sanofi, Novartis, UCB; invited speaker – Eli Lilly, Leo Pharma, Abbvie, L'Oreal, Lilly, and Pierre Fabre. SA has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer and Abbvie. BG is an employee of Pfizer., (Copyright © 2024 Trzeciak, Rudnicka, Arenberger, Engin, L'vov, Alper, Alpsoy, Benáková, Bobko, Borlu, Czarnecka-Operacz, Elisyutina, Ergun, Ertam, Fedenko, Filipovská, Fomina, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Owczarek, Özkaya, Plzáková, Reich, Selerova and Gurbuz.)
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- 2024
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24. The interplay between dermocosmetics and pharmacotherapy in the management of scalp seborrheic dermatitis.
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Rudnicka L
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- Humans, Middle Aged, Dermatitis, Seborrheic drug therapy, Scalp Dermatoses drug therapy
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- 2024
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25. A ranking of treatment efficacy in alopecia areata is not possible without head-to-head studies.
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Rudnicka L and Olszewska M
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- Humans, Treatment Outcome, Alopecia Areata drug therapy
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- 2024
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26. Hair Evaluation in Orthodontic Patients with Oligodontia.
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Zadurska M, Rakowska A, Czochrowska E, Laskowska M, Perkowski K, Strużycka I, Rudnicka L, and Jurek A
- Abstract
Oligodontia can be isolated or syndromic, associated with other ectodermal abnormalities. The aim of the study was to perform hair examination in orthodontic patients diagnosed with oligodontia with a low clinical expression of symptoms of ectodermal origin. All available orthodontic patients diagnosed with oligodontia in the permanent dentition were enrolled. Hair examination included clinical evaluation of the patients' hair, trichoscopy, trichogram and evaluation of the hair shafts under a polarized light microscope. In total, 25 patients, 18 males and 7 females, aged 6 to 24 years were evaluated for the presence of dental and hair abnormalities. The number of congenitally absent teeth ranged from 6 to 24 teeth and diastemas, microdontia, taurodontism and altered tooth shape were found in 23 patients. Hair disorders were found in 68% of the subjects. Hypotrichosis, the heterogeneity of shaft color and loss of pigment, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa and pseudomoniletrix were observed. Trichoscopy and trichogram are valid non-invasive diagnostic tests which could be used to differentiate between isolated and syndromic oligodontia in patients with a low clinical expression of ectodermal symptoms.
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- 2024
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27. Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel.
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Rudnicka L, Trzeciak M, Alpsoy E, Arenberger P, Alper S, Benáková N, Bobko S, Borlu M, Czarnecka Operacz M, Engin B, Ergun T, Sağduyu IE, Filipovská O, Gadzhigoroeva A, Kojanová M, Lesiak A, Michenko A, Murashkin N, Onsun N, Owczarek W, Plzakova Z, Reich A, Selerová M, and Gürbüz BA
- Abstract
Objectives: This study aims to update the understanding of Alopecia Areata (AA) in Poland, Czechia, Russia, and Türkiye, focusing on the disease burden, clinical management, and patient journey. It seeks to establish a consensus on optimal management strategies for AA in these regions., Methods: A modified 2-round Delphi panel was conveyed with 23 Dermatologists (Russia; 4, Türkiye; 7, Poland; 6, and Czechia; 6). The Delphi questionnaire consisted of 61 statements and 43 questions designed to obtain an overall understanding of the perception and acceptance of available information regarding the care of patients with alopecia areata., Results: The study revealed that moderate-to-severe AA significantly impacts patients' and their families' QoL, consistent with previous studies. AA was found to cause more substantial impairment when additional lesions appeared in visible areas besides the scalp. Work and productivity impairment were notably higher in adults with moderate-to-severe AA. Diagnostic consensus highlighted the importance of skin biopsies and trichoscopy, while the need for more practical severity scoring systems was emphasized. Current treatments, including topical therapies, corticosteroids, and systemic immune modifiers, were deemed insufficient, highlighting the unmet medical need., Conclusion: The Delphi study underscores a significant disease burden and unmet medical needs in patients with moderate-to-severe AA. It highlights the necessity of access to novel treatments and further research to develop more effective therapies with a tolerable safety profile. The findings align with global research, emphasizing the psychosocial impact of AA and the need for standardized, effective treatment protocols., Competing Interests: PA has acted in advisory board of AbbVie, Bristol Myers Squibb, Merck Sharp Dohme, Novartis, Pfizer Pharmaceuticals, and has received speaker honorarium from Pfizer, Abbvie. MK has served as consultant, speaker, or investigator for Abbvie, Almirall, Amgen, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, Sanofi and UCB. MC has acted on the advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received a speaker honorarium from Pfizer, Abbvie, OF has acted in advisory board of Novartis, Lilly, LeoPharma, Almirall and in clinical studies Pfizer, Janssen, Lilly, Amgen, Abbvie, Novartis, Regeneron. AM has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from L’Oreal, La Roche Posay. MT has been a speaker and/or consultant an/or investigator and/or participant of Advisory Board of Abbvie, BauschHealth, Bioderma, Eli Lilly, La Roche, Leo pharma, Novartis, Pfizer, Pierre-Fabre, Sanofi Genzyme. ZP has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. IS has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. WO received honorarium for lectures and clinical research from AbbVie, Aflofarm Farmacja, Alfasigma, Almirall, Amgen, Apotex Polska Astellas Pharma, AstraZeneca, Bausch Health Poland, Berlin Chemie Menarini, Boehringer Ingelheim, Bristol Myers Squibb, EGIS, Eli Lilly, Galderma, Janssen-Cilag, LEO Pharma, Medac GmbH, Merck, Mylan Healthcare, Novartis, Pfizer, Pierre Fabre Medicamente, TZF Polfa S.A., Roche Diagnostics, Sandoz, Sanofi-Aventis, SUN-FARM, Teva Pharmaceuticals, UCB Pharma. AL has acted in advisory board of Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Janssen, Almiral and has received speaker honorarium from Pfizer, Abbvie, Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Almiral, UCB. AG has received speaker honorarium from Pfizer. NM reports grants and personal fees from Jansen, grants from Eli Lilly, grants and personal fees from Novartis, personal fees from Galderma, personal fees from Pierre Fabre, personal fees from Bayer, personal fees from Leofarma, grants and personal fees from Pfizer, grants and personal fees from AbbVie, grants from Amryt Pharma, personal fees and non-financial support from Viatris, outside the submitted work. NB declare to have acted as member of Advisory Board of Pfizer Pharmaceuticals and has received speaker honorarium from Pfizer. SB has received speaker honorarium from Pfizer, LEO PHARMAEB has acted in advisory board of Novartis and Pfizer Pharmaceuticals has received speaker honorarium from Pfizer, Abbvie. SA has acted in advisory board of Novartis, Pfizer and Bristol Myers Squibb, and has received honorarium from Pfizer and Abbvie. AR has worked as a consultant or speaker for AbbVie, Bioderma, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, Pierre-Fabre, Sandoz and Trevi and has participated as principal investigator in clinical trials sponsored by AbbVie, Almirall, Amgen, Anaptys, Argenx, Biogen, Biothera, BMS, Celltrion, Dermira, Dice, Evelo, Galderma, Genentech, Horizon Therapeutics, Incyte, Janssen, Kymab Ltd., Leo Pharma, Eli Lilly, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer, Regeneron, Sanofi, Takeda, Trevi, and UCB. BG is an employee of Pfizer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Rudnicka, Trzeciak, Alpsoy, Arenberger, Alper, Benáková, Bobko, Borlu, Czarnecka Operacz, Engin, Ergun, Sağduyu, Filipovská, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Onsun, Owczarek, Plzakova, Reich, Selerová and Gürbüz.)
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- 2024
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28. European expert consensus statement on the systemic treatment of alopecia areata.
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Rudnicka L, Arenbergerova M, Grimalt R, Ioannides D, Katoulis AC, Lazaridou E, Olszewska M, Ovcharenko YS, Piraccini BM, Prohic A, Rakowska A, Reygagne P, Richard MA, Soares RO, Starace M, Vañó-Galvan S, and Waskiel-Burnat A
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- Adult, Adolescent, Child, Humans, Quality of Life, Alopecia drug therapy, Minoxidil therapeutic use, Azathioprine therapeutic use, Alopecia Areata drug therapy, Janus Kinase Inhibitors therapeutic use
- Abstract
Alopecia areata is an autoimmune form of non-scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA-approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA-approved for patients with severe alopecia areata. Other systemic medications used off-label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy., (© 2024 European Academy of Dermatology and Venereology.)
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- 2024
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29. Androgenetic Alopecia in Children and Adolescents: From Trichoscopy to Therapy.
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Losoya-Jaquez MR, Lopez Yañez-Blanco A, Armendariz-Barragan Y, Aguilar-Figueroa NG, Rudnicka L, and Sanchez-Dueñas LE
- Abstract
Introduction: Pediatric androgenetic alopecia is a product of hormonal and genetic factors. The diagnosis depends on recognizing the hair loss pattern in the context of a positive family history and a typical trichoscopy., Methods: A multicenter retrospective study assessing medical data from January 2008 to January 2023 of two reference centers - one public and one private in west Mexico. Patients under 18 years old were included. The clinical features, trichoscopic findings, associated conditions, and treatment received were documented and analyzed., Results: We found 145 patients, with a mean age of 16.08 ± 1.30 years, predominantly comprising males (72%). Trichoscopy was performed on 33 patients. The main trichoscopic findings were hair shaft thickness variability in 100% of the cases, vellus hair in 85%, and single-hair units in 79%. Vitamin D deficiency was found in 84% of the cases with laboratory determination, insulin resistance in 33%, and hyperandrogenemia in 12.5%. Topical minoxidil emerged as the main treatment modality in 24% of cases, demonstrating both efficacy and tolerability., Conclusion: Pediatric androgenetic alopecia could be more prevalent than commonly perceived, potentially explained by the lower level of suspicion among medical practitioners. Distinctive trichoscopic findings offer valuable guidance for therapeutic strategies and ongoing management., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 S. Karger AG, Basel.)
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- 2024
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30. The road to publication: Advice from journal editors.
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Navarrete-Dechent C, Ashique KT, Ingram JR, Rudnicka L, Gilaberte Y, Ring J, Murrell DF, Elston D, and Thiers BH
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- Humans, Publishing, Peer Review, Research
- Abstract
Competing Interests: Conflicts of interest None disclosed.
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- 2024
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31. Trichoscopy of Androgenetic Alopecia: A Systematic Review.
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Kuczara A, Waśkiel-Burnat A, Rakowska A, Olszewska M, and Rudnicka L
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Background : Androgenetic alopecia, the most common cause of non-scarring hair loss, is a consequence of the gradual miniaturization of the hair follicles. In the majority of male androgenetic alopecia cases, a patient's history and clinical evaluation may be sufficient to establish the diagnosis, while for women, they should be supplemented with trichoscopy. Methods : The PubMed and Scopus databases were used to collate published studies and to analyze the most typical trichoscopic findings in patients diagnosed with androgenetic alopecia. A total of 34 articles were retrieved after exclusion. Results : The most common features identified using trichoscopy included hair diameter variability (94.07% of patients), vellus hairs (66.45%) and the peripilar sign (43.27%). Others, such as the honeycomb pattern, yellow and white dots, were less relevant. Conclusions : We concluded that hair diameter variability, vellus hairs and the peripilar sign represented valuable indicators for the diagnosis of androgenetic alopecia.
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- 2024
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32. Dermoscopic characteristics of cutaneous larva migrans in dark skin: a study from Banjul, The Gambia.
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Enechukwu NA, Ogun GO, Malachy DE, Errichetti E, and Rudnicka L
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- Animals, Humans, Gambia, Epidermis, Ancylostoma, Black People, Larva Migrans diagnosis
- Abstract
Cutaneous larva migrans (CLM) results from hookworm larvae infestation, mainly Ancylostoma braziliense or Ancylostoma caninum. It is common in Sub-Saharan Africa, often acquired through soil contact, especially in sandy beaches, manifesting as serpiginous, erythematous and intensely pruritic tracts within the epidermis, and presenting with diverse clinical appearances. Diagnosis is mostly clinical; however, dermoscopy can enhance diagnostic accuracy and distinction from mimics. The current body of literature is deficient in its representation of dermoscopic data for CLM in Black patients. This study explores dermoscopy in nine dark-skinned patients with 16 CLM lesions. Distinctive serpiginous structureless areas displaying a range of colours, peripheral scales surrounding brown areas and brown dots were predominant features, whereas vascular characteristics were less evident. This article highlights the presence of distinct reaction patterns, including brown dots, scales, and accentuated, often disrupted brown reticular lines in addition to the characteristic winding tracts in darker skin., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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33. Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program.
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King B, Soung J, Tziotzios C, Rudnicka L, Joly P, Gooderham M, Sinclair R, Mesinkovska NA, Paul C, Gong Y, Anway SD, Tran H, Wolk R, Zwillich SH, and Lejeune A
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- Humans, Carbazoles, Janus Kinase 3, Protein Kinase Inhibitors adverse effects, SARS-CoV-2, Treatment Outcome, Alopecia Areata drug therapy, Alopecia Areata epidemiology, Antineoplastic Agents, Tryptamines
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Background: The ALLEGRO phase 2a and 2b/3 studies demonstrated that ritlecitinib, an oral JAK3/TEC family kinase inhibitor, is efficacious at doses of ≥ 30 mg in patients aged ≥ 12 years with alopecia areata (AA)., Objective: The objective of this study was to evaluate the safety of ritlecitinib in an integrated analysis of four studies in AA., Methods: Two cohorts were analyzed: a placebo-controlled and an all-exposure cohort. Proportions and study size-adjusted incidence rates (IRs) of adverse events (AEs) of interest and laboratory abnormalities are reported., Results: In the placebo-controlled cohort (n = 881; median exposure: 169 days), the proportion of ritlecitinib-treated patients with AEs was 70.2-75.4% across doses versus 69.5% in the placebo group; serious AEs occurred in 0-3.2% versus 1.9% for the placebo. A total of 19 patients permanently discontinued due to AEs (5 while receiving the placebo). In the all-exposure cohort (n = 1294), median ritlecitinib exposure was 624 days [2091.7 total patient-years (PY)]. AEs were reported in 1094 patients (84.5%) and serious AEs in 57 (4.4%); 78 (6.0%) permanently discontinued due to AEs. The most common AEs were headache (17.7%; 11.9/100 PY), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (15.5%; 9.8/100 PY), and nasopharyngitis (12.4%; 8.2/100 PY). There were two deaths (breast cancer and acute respiratory failure/cardiorespiratory arrest). Proportions (IRs) were < 0.1% (0.05/100 PY) for opportunistic infections, 1.5% (0.9/100 PY) for herpes zoster, 0.5% (0.3/100 PY) for malignancies (excluding nonmelanoma skin cancer), and 0.2% (0.1/100 PY) for major adverse cardiovascular events., Conclusions: Ritlecitinib is well tolerated with an acceptable safety profile up to 24 months in patients aged ≥ 12 years with AA (video abstract and graphical plain language summary available)., Trial Registries: ClinicalTrials.gov: NCT02974868 (date of registration: 11/29/2016), NCT04517864 (08/18/2020), NCT03732807 (11/07/2018), and NCT04006457 (07/05/2019)., (© 2024. The Author(s).)
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- 2024
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34. The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results From a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity.
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Moussa A, Bennett M, Wall D, Meah N, York K, Bokhari L, Asfour L, Rees H, Abraham LS, Asz-Sigall D, Basmanav FB, Bergfeld W, Betz RC, Bhoyrul B, Blume-Peytavi U, Callender V, Chitreddy V, Combalia A, Cotsarelis G, Craiglow B, Dhurat R, Donovan J, Doroshkevich A, Eisman S, Farrant P, Ferrando J, Gadzhigoroeva A, Green J, Grimalt R, Harries M, Hordinsky M, Irvine A, Jolliffe V, Kaiumov S, King B, Lee J, Lee WS, Li J, Lortkipanidze N, McMichael A, Mesinkovska NA, Messenger A, Mirmirani P, Olsen E, Orlow SJ, Ovcharenko Y, Piraccini BM, Pirmez R, Rakowska A, Reygagne P, Rudnicka L, Corralo DS, Senna M, Shapiro J, Sharma P, Siliuk T, Starace M, Suchonwanit P, Takwale A, Tosti A, Vañó-Galván S, Visser WI, Vogt A, Wade M, Yip L, Zhou C, and Sinclair R
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- Humans, Alopecia diagnosis, Consensus, Morbidity, Quality of Life, Alopecia Areata diagnosis
- Abstract
Importance: Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact., Objective: To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI)., Evidence Review: A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022., Findings: Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss., Conclusions and Relevance: This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity.
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- 2024
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35. Line-field confocal optical coherence tomography-A new diagnostic method in hair loss associated with folliculitis decalvans.
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Kurzeja M, Warszawik-Hendzel O, Rakowska A, Graczyk A, Waskiel-Burnat A, Czuwara J, Olszewska M, and Rudnicka L
- Subjects
- Humans, Alopecia diagnostic imaging, Tomography, Optical Coherence, Folliculitis
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- 2024
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36. Trichoscopy - a valuable tool for identifying conditions mimicking androgenetic alopecia.
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Khutsishvili N, Rudnicka L, Ovcharenko Y, Starace M, Buchukuri I, Pataraia S, and Lortkipanidze N
- Subjects
- Male, Adolescent, Humans, Female, Dermoscopy, Learning, Alopecia diagnosis, Hair diagnostic imaging
- Abstract
Androgenetic alopecia (AGA) is the most prevalent type of hair loss in women and men. Recently, a European consensus group published guidelines for the diagnostic evaluation of AGA in men, women, and adolescents. This S1 guideline presents expert opinion-based recommendations for gender-dependent steps in the diagnostic procedure, which can easily be implemented in the daily clinical routine. For diagnosing AGA, detailed anamnesis and objective learning are not enough because there are several conditions mimicking this disease. Trichoscopy can be considered an important, non-invasive tool for diagnosing hair and scalp disorders that may have similar clinical signs to AGA., (© 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)
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- 2024
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37. Correlation between 18-FDG standardized uptake value and tumor grade in patients with resectable non-small cell lung cancer.
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Kużdżał B, Moszczyński K, Żanowska K, Hauer J, Popovchenko S, Bryndza M, Warmus J, Trybalski Ł, Rudnicka L, and Kocoń P
- Abstract
Background: Positron-emission tomography (PET) is widely used for staging lung cancer. Although a correlation between the fluorodeoxyglucose standardized uptake value (SUV) and the histologic grade of the tumor has been shown in several studies, little is known about the impact of different clinical variables on this correlation. This study aimed to evaluate the correlation between tumor SUV and tumor grade in a large cohort of patients and to analyse the impact of clinical factors on this correlation., Methods: This retrospective cohort study including patients with non-small cell lung cancer age 18-90 years, with clinical stage I-IVA, who underwent curative-intent lung resection., Results: Data from 726 patients was included in this study. There was a strong correlation between SUV and primary tumor grade in the whole cohort (P<0.001), which was significant in both sexes (P<0.001) and in all selected age groups (P<0.001-0.03). There was a significant SUV-grade correlation for the right upper and left lower lobes, as well as for the central location in the right lung (P<0.001, P=0.005 and P=0.04, respectively). Moreover, a significant SUV-grade correlation was found for squamous cell cancer and adenocarcinoma (P<0.001 and P=0.01, respectively), and for T1-T3 factors (P<0.001, P=0.006, P=0.005 respectively)., Conclusions: In patients with resectable lung cancer, a significant correlation was observed between the SUV of the primary tumor and its grade. This correlation was maintained for both sexes, age groups, most common histological types and T factors T1-T3., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-23-798/coif). All authors report that this study was supported by a statutory grant of the Jagiellonian University. The authors have no other conflicts of interest to declare., (2023 Translational Cancer Research. All rights reserved.)
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- 2023
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38. Autoinflammatory Keratinization Diseases-The Concept, Pathophysiology, and Clinical Implications.
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Blicharz L, Czuwara J, Rudnicka L, and Torrelo A
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- Humans, Inflammation genetics, Mutation, Immunity, Innate, Guanylate Cyclase genetics, Membrane Proteins, CARD Signaling Adaptor Proteins genetics, Interleukins genetics, Psoriasis genetics, Psoriasis pathology, Keratosis
- Abstract
Recent advances in medical genetics elucidated the background of diseases characterized by superficial dermal and epidermal inflammation with resultant aberrant keratosis. This led to introducing the term autoinflammatory keratinization diseases encompassing entities in which monogenic mutations cause spontaneous activation of the innate immunity and subsequent disruption of the keratinization process. Originally, autoinflammatory keratinization diseases were attributed to pathogenic variants of CARD14 (generalized pustular psoriasis with concomitant psoriasis vulgaris, palmoplantar pustulosis, type V pityriasis rubra pilaris), IL36RN (generalized pustular psoriasis without concomitant psoriasis vulgaris, impetigo herpetiformis, acrodermatitis continua of Hallopeau), NLRP1 (familial forms of keratosis lichenoides chronica), and genes of the mevalonate pathway, i.e., MVK, PMVK, MVD, and FDPS (porokeratosis). Since then, endotypes underlying novel entities matching the concept of autoinflammatory keratinization diseases have been discovered (mutations of JAK1, POMP, and EGFR). This review describes the concept and pathophysiology of autoinflammatory keratinization diseases and outlines the characteristic clinical features of the associated entities. Furthermore, a novel term for NLRP1-associated autoinflammatory disease with epithelial dyskeratosis (NADED) describing the spectrum of autoinflammatory keratinization diseases secondary to NLRP1 mutations is proposed., (© 2023. The Author(s).)
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- 2023
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39. Multilocus-sequence typing reveals clonality of Staphylococcus aureus in atopic dermatitis.
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Blicharz L, Szymanek-Majchrzak K, Młynarczyk G, Czuwara J, Waśkiel-Burnat A, Goldust M, Samochocki Z, and Rudnicka L
- Subjects
- Humans, Staphylococcus aureus genetics, Multilocus Sequence Typing, Skin, Dermatitis, Atopic, Staphylococcal Skin Infections, Staphylococcal Infections
- Abstract
Background: Atopic dermatitis (AD) is exacerbated by Staphylococcus aureus, which is capable of displacing not only the physiological microbiota, but also other strains of its own species. Analyses of the molecular characteristics and relationships of S. aureus strains present in different microniches are lacking., Objectives: To determine, using multilocus sequence typing (MLST), the relationship of S. aureus isolates from the lesional and nonlesional skin and anterior nares of patients with AD, and to review the characteristics of the dominant clones., Methods: Sixty-three individuals with active AD were enrolled. Ten patients with moderate-to-severe AD (SCoring of Atopic Dermatitis score ≥ 25) colonized by S. aureus in all analysed locations were included in the MLST analysis., Results: The most prevalent sequence types were 7 (10/30 strains; 33.3%), 15 and 97 (both 5/30 strains; 16.7%) all of which were associated with the expression of adhesins and toxins promoting chronic microbial dysbiosis, skin barrier damage and inflammation. Six patients (60%) were carriers of clonal S. aureus strains at all analysed locations, three (30%) carriers in lesional and nonlesional skin, and one (10%) was a carrier in nonlesional skin and the anterior nares., Conclusions: The results imply that the identified S. aureus lineages are better adapted to dominate the microbiota in AD. Decontaminating the identified reservoirs of S. aureus (i.e. anterior nares and nonlesional skin) could reduce the severity of AD., Competing Interests: Conflicts of interest The authors state no conflict of interest related to the present work., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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40. Line-field confocal optical coherence tomography: A new diagnostic method of lichen planopilaris.
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Kurzeja M, Warszawik-Hendzel O, Rakowska A, Graczyk A, Fedorczuk D, Czuwara J, Olszewska M, and Rudnicka L
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- Humans, Tomography, Optical Coherence, Lichen Planus diagnostic imaging
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- 2023
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41. Dermoscopy as a Noninvasive Diagnostic Tool for Hailey-Hailey Disease and Darier Disease.
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Kurzeja M, Rakowska A, Jasinska M, Warszawik-Hendzel O, Olszewska M, and Rudnicka L
- Abstract
Introduction: Hailey-Hailey disease (HHD) and Darier disease (DD) are rare genetic disorders for which differential diagnosis, especially in less obvious cases, can be difficult. The diagnosis is based on the clinical picture and family history, and is confirmed by histopathologic examination. Dermoscopy is a noninvasive technique that is primarily used at the present time to diagnose skin cancers. However, in the past few years this technique has also been increasingly used as a noninvasive diagnostic tool of inflammatory skin diseases. The aim of the study was to evaluate whether dermoscopy is a useful noninvasive diagnostic tool for HHD and DD., Methods: We performed an observational retrospective case series study involving 13 patients with HHD (n = 8) and DD (n = 5). The presence or absence of standardized dermoscopic features of inflammatory diseases (according to International Dermoscopy Society [IDS] guidelines) was assessed in these patients., Results: The most distinctive feature of HHD was white clouds separated by pink furrows, visible in all cases (8/8; 100.0%). Another distinctive clue of HHD was the crumbled fabric pattern seen in six patients with HHD (6/8; 75.0%). These dermoscopic findings were not present in patients with DD. The most typical features of DD in the dermoscopic examination was star-like or oval-shaped yellow areas surrounded by whitish halo, visible in all patients (5/5; 100.0%). Another distinctive dermoscopic clue of DD was pinkish homogeneous structureless background, which was present in all patients (5/5, 100.0%). These latter two features were not observed in patients with HHD., Conclusion: Dermoscopy reveals distinctive features of HHD and DD, respectively. Therefore, we conclude that dermoscopy can be an excellent complementary noninvasive tool in the diagnostic process of patients with HHD and DD., (© 2023. The Author(s).)
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- 2023
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42. The profile of adipokines associated with fibrosis and impaired microcirculation in systemic sclerosis.
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Niemczyk A, Waśkiel-Burnat A, Zaremba M, Czuwara J, and Rudnicka L
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- Humans, Adipokines metabolism, Complement Factor D metabolism, Apelin metabolism, Nicotinamide Phosphoribosyltransferase metabolism, Microcirculation, Fibrosis, Retinol-Binding Proteins, Pulmonary Arterial Hypertension, Scleroderma, Systemic, Vascular Diseases
- Abstract
Purpose: Adipokines belong to a group of molecules mostly produced by adipose tissue. Abnormalities in the secretion of several adipokines have already implicated to play a pathogenic role in systemic sclerosis (SSc). However, the possible role of numerous molecules still needs to be clarified. The aim of the study was to determine whether the altered level of selected circulating adipokines might correlate with the intensity of fibrosis and vasculopathy in the course of SSc., Materials and Methods: Serum concentrations of chemerin, adipsin, retinol-binding protein 4, apelin, visfatin, omentin-1, and vaspin were determined with ELISA in the sera of patients with SSc (n = 55) and healthy controls (n = 25)., Results: The serum concentration of adipsin (p = 0.03) and visfatin (p = 0.04) was significantly increased and the level of retinol-binding protein 4 (p = 0.03) was decreased in diffuse compared to limited cutaneous SSc. Moreover, serum adipsin level correlated positively with the intensity of skin fibrosis measured with the modified Rodnan skin score (r = 0.31, p = 0.02) and was significantly higher in patients with pulmonary arterial hypertension than in those without the condition (p = 0.03). The concentrations of adipsin (p = 0.01) and visfatin (p = 0.04) were significantly increased and the level of apelin (p = 0.02) was decreased in patients with active digital ulcerations compared to individuals without this complication., Conclusion: Adipsin may be considered a pivotal protein in the development of both fibrosis and impaired microcirculation. Its abnormal concentration reflects the intensity of skin thickening and the presence of pulmonary arterial hypertension. Adipsin, visfatin, and apelin are adipose tissue-derived molecules associated with digital vasculopathy., Competing Interests: Declaration of competing interest The authors declare no conflict of interests., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2023
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43. EGFR inhibitor-induced folliculitis decalvans: a case series and management guidelines.
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Nowaczyk J, Fret K, Kaminska-Winciorek G, Rudnicka L, and Czuwara J
- Subjects
- Humans, Female, Quality of Life, ErbB Receptors, Alopecia chemically induced, Alopecia drug therapy, Folliculitis chemically induced, Folliculitis complications, Folliculitis drug therapy, Carcinoma, Non-Small-Cell Lung drug therapy, Lung Neoplasms drug therapy, Lung Neoplasms complications
- Abstract
Epidermal growth factor receptor (EGFR) is one of therapeutic targets in oncology for solid tumors originating from epithelial tissue, such as non-small-cell lung carcinoma (NSCLC) and breast cancer. EGFR inhibitors used in cancer treatment may cause a broad spectrum of dose-dependent cutaneous adverse events, including acneiform papulopustular rash, nail and hair disturbances, xerosis, and mucositis. The pathogenesis of the EGFR inhibitor-induced adverse reactions originates from disturbances in keratinocyte differentiation, cytokine secretion, and neutrophil chemotaxis. One of the rare, yet distressing adverse events may be folliculitis decalvans, a progressive neutrophil-driven scarring alopecia with hair tufts formation resembling doll's hair. Early diagnosis and introduction of treatment are crucial for disease prognosis since a long course of the disease leads to decreased quality of life. Here, we review the literature cases of EGFR inhibitor-induced folliculitis decalvans and provide guidance on management and prevention of this condition in oncologic patients. Furthermore, we report the first afatinib-associated folliculitis decalvans in three female patients with NSCLC., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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44. Hair loss is a symptom of many complex medical and psychological problems.
- Author
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Rudnicka L
- Subjects
- Humans, Alopecia diagnosis, Alopecia etiology
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- 2023
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45. Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about?
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Waśkiel-Burnat A, Rakowska A, Zaremba M, Maciejewska M, Blicharz L, Starace M, Iorizzo M, Piraccini BM, Olszewska M, and Rudnicka L
- Abstract
Background: Numerous studies have indicated that alopecia areata is associated with a chronic systemic inflammation, which is considered as a risk factor for venous thromboembolism. The aim of the study was to evaluate the following markers of venous thromboembolism risk: soluble fibrin monomer complex (SFMC), thrombin-antithrombin complex (TATC), and prothrombin fragment 1 + 2 (F1 + 2) in patients with alopecia areata and compare them with healthy controls., Methods: In total, 51 patients with alopecia areata [35 women and 16 men; mean age: 38 (19-54) years] and 26 controls [18 women and 8 men; mean age: 37 (29-51) years] were enrolled in the study. The serum concentrations of thromboembolism markers were measured using an enzyme-linked immunosorbent assay (ELISA) kit., Results: An increased level of SFMC was detected in patients with alopecia areata compared with the controls [25.66 (20-34.86) versus 21.46 (15.38-29.48) µg/ml; p < 0.05)]. In addition, a higher level of F1 + 2 was observed in patients with alopecia areata in comparison with the control group [70150 (43720-86070) versus 38620 (31550-58840) pg/ml; p < 0.001]. No significant correlation was detected among SFMC or F1 + 2 and the Severity of Alopecia Tool (SALT) score, disease duration, or the number of the hair loss episodes., Conclusion: Alopecia areata may be associated with an increased risk of venous thromboembolism. Regular screening and preventive management of venous thromboembolism may be beneficial in patients with alopecia areata, especially before and during systemic Janus kinase (JAK) inhibitors or glucocorticoid therapy., (© 2023. The Author(s).)
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- 2023
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46. Topical proactive therapy in dermatology. A scoping review.
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Makowska K, Nowaczyk J, Samochocki Z, Blicharz L, and Rudnicka L
- Abstract
The term 'proactive therapy' refers to a long-term management of clinically intact skin in previously disease-affected areas. This method was initially implemented in atopic dermatitis to maintain the remission and decrease the risk of exacerbations. Proactive therapy aims to limit the need for reactive treatment and improve the patients' quality of life. A proactive approach is likely to be adopted for other relapsing and inflammatory skin conditions in the future. This scoping review aims to identify dermatological conditions to be treated with the proactive approach, evaluate the available evidence for its efficacy and safety, as well as highlight the research gaps., Competing Interests: KM and JN declare no conflict of interest. LB: invited speaker – AbbVie, Sanofi. LR: member of advisory boards – Janssen Pharmaceutical Companies, L’Oréal, Leo, Lilly, Pfizer, Sanofi, Novartis, UCB, Timber Pharma; invited speaker – Leo, AbbVie, L’Oréal, Lilly, Pierre Fabre. Registration: OSF Registration number (DOI): 10.17605/OSF.IO/WX5J7., (Copyright: © 2023 Termedia Sp. z o. o.)
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- 2023
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47. Dermatoscopy of Cutaneous Lichen Planus - Attempt to Translate Metaphoric Terminology Into Descriptive Terminology.
- Author
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Szykut-Badaczewska A, Sikora M, Rudnicka L, and Kittler H
- Abstract
Introduction: Dermatoscopy is gaining appreciation in assisting the diagnosis of inflammatory dermatoses (inflammoscopy). Lichen planus (LP) is a common inflammatory skin disease with characteristic dermatoscopic features. Over the last few years, numerous articles were published on the dermatoscopy of LP and a high number of terms have been used to describe the dermatoscopic features of this disease., Objectives: The objective of this study was to review the literature on the dermatoscopy of LP and to re-evaluate the published descriptions in the light of the 2019 expert consensus on the terminology of dermatoscopy for non-neoplastic skin diseases., Methods: We searched the PubMed database using the keywords 'lichen planus and dermatoscopy', 'lichen planus and dermoscopy', 'lichen planus and epiluminescence microscopy', and 'lichen planus and inflammoscopy'., Results: Of 408 articles retrieved, we selected 67 articles for full-text review, and finally included 58 articles, mostly case reports or small case series, comprising 572 patients with LP. We identified 118 different terms or short descriptions that were used to characterize the dermatoscopy of LP and redescribed them according to International Dermoscopy Society consensus paper. Frequently, authors applied various terms or descriptions to variants of the same feature. Although reported under different designations, Wickham striae were the most consistent dermatoscopic feature of LP. Other characteristics of LP, such as vascular patterns, pigmented structures and follicular findings were less consistent or depended on skin type, anatomic site, disease stage and applied treatment., Conclusions: While Wickham striae are the single most important clue for the diagnosis, other dermatoscopic characteristics of LP are less consistent. Based on the descriptions published in the literature we established a dictionary of useful terms for the description of LP that is consistent with the terminology suggested by the recent consensus conference.
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- 2023
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48. Ocular involvement in autoimmune bullous diseases.
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Kurzeja M, Olszewska M, Grzybowski A, and Rudnicka L
- Subjects
- Humans, Pemphigus drug therapy, Autoimmune Diseases diagnosis, Skin Diseases, Vesiculobullous complications, Skin Diseases, Vesiculobullous diagnosis, Pemphigoid, Benign Mucous Membrane complications, Pemphigoid, Benign Mucous Membrane diagnosis, Pemphigoid, Benign Mucous Membrane drug therapy, Conjunctivitis
- Abstract
Autoimmune bullous diseases represent a heterogenous group of disorders caused by autoantibodies against adhesion molecules; the location of the target protein determines the level of cleft formation. The spectrum of ocular lesions in autoimmune bullous diseases can range from mild symptoms to severe involvement with sight impairment and even, in some cases, blindness. In pemphigus vulgaris, the prevalence of ocular involvement has been reported to be between 7% and 26%. The most common clinical sign of ocular pemphigus vulgaris is bilateral conjunctivitis with hyperemia. Ocular involvement also occurs in 41% to 70% of patients with paraneoplastic pemphigus. The main ocular manifestations are bilateral cicatrizing conjunctivitis with symblepharon formation, and shortening of the fornices. In mucous membrane pemphigoid, ocular involvement is seen in 61% to 70% of patients; the most frequent ocular finding is cicatricial conjunctivitis. Patients with autoimmune bullous diseases having common ocular involvement should be assessed by an ophthalmologist to avoid serious complications. Diagnostic procedures and treatment require multidisciplinary care based on the close cooperation between dermatologists and ophthalmologists., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)
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- 2023
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49. Clinical benefit and tolerance profile of a keratolytic and hydrating shampoo in subjects with mild to moderate psoriasis. Results from a double-blind, randomized, vehicle-controlled study.
- Author
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Massiot P, Pinto PC, Leclerc-Mercier S, Rasmont V, Piraccini BM, Rudnicka L, Reygagne P, Melo DF, Vano-Galvan S, Wu WY, and Kerob D
- Subjects
- Adult, Humans, Quality of Life, Treatment Outcome, Keratolytic Agents adverse effects, Double-Blind Method, Excipients, Inflammation, Immunoglobulin A therapeutic use, Scalp Dermatoses diagnosis, Scalp Dermatoses drug therapy, Dermatologic Agents therapeutic use, Psoriasis diagnosis, Psoriasis drug therapy, Hair Preparations adverse effects
- Abstract
Introduction: Scalp psoriasis frequently goes with other disease location and may lead to a significant burden and impairment of quality of life (QoL). Adherence to local treatments is a frequent problem. A keratolytic and hydrating shampoo containing 2% salicylic acid, 5% urea, and 1% glycerin (active shampoo) has been developed for psoriasis-prone scalp., Objective: To assess the efficacy and tolerability of an active shampoo in subjects with mild to moderate scalp psoriasis., Materials and Methods: A single-center, randomized, double-blind, vehicle-controlled study was conducted on 67 adults with mild to moderate psoriasis. The active shampoo or its vehicle were applied daily for 14 days and 3 times/week for another 14 days. Assessments included the Psoriasis Scalp Severity Index (PSSI), Investigator Global Assessment (IGA), calculated total surface affected hair, scalp greasiness, irritation, and assessed scalp dermatitis-specific quality-of-life issues using SCALPDEX and product acceptability., Results: The active shampoo significantly (p < 0.05) reduced the PSSI by 39.0%, 37.2%, 63.0%, and 69.0% immediately after washing compared to a 22.8%, 5.5%, 19.6%, and 13.0% with the vehicle at Days 1, 8, 15, and 30, respectively. SCALPDEX items, IGA, and irritation significantly (p < 0.05) reduced with the active shampoo. Hair and scalp greasiness improved continuously with both products until Day 21. Subject-reported symptom scores paralleled the positive evolution of clinical signs. The active shampoo was well tolerated, subjects were highly satisfied and had an improved QoL., Conclusion: The active shampoo significantly improved clinical signs, symptoms, and QoL of mild-to-moderate scalp psoriasis compared to the vehicle. It was very well tolerated and highly appreciated by the subjects., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
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- 2023
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50. Persistent Chemotherapy-Induced Alopecia Treated With Low Dose Oral Minoxidil: A Multicenter Retrospective Case Series of 15 Patients.
- Author
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Iorizzo M, Waśkiel-Burnat A, Anedda J, Piraccini BM, Apalla Z, Rudnicka L, and Starace M
- Published
- 2023
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