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The article offers information on the 2018 guidelines for the management of lichen sclerosus published by the British Association of Dermatologists (BAD). The guidelines are prepared for the BAD Clinical Standards Unit and aims to provide up-to-date, evidence-based recommendations for the management of lichen sclerosus.

Summary: Background: Biological therapies are highly effective in psoriasis, but have profound effects on innate and adaptive immune pathways that may negatively impact on cancer immunosurveillance mechanisms. Objectives: To investigate the risk of cancer in patients with psoriasis treated with biological therapy. Methods: We searched MEDLINE, Embase, and the Cochrane Library (up to August 2016) for randomized controlled trials, prospective cohort studies and systematic reviews that reported cancer incidence in people exposed to biological therapy for psoriasis compared with a control population. Results: Eight prospective cohort studies met our inclusion criteria. All the evidence reviewed related to tumour necrosis factor inhibitors (TNFi) with the exception of one study on ustekinumab. An increased risk of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma, was reported with TNFi compared with both a general United States population and a rheumatoid arthritis population treated with TNFi. No evidence for increased risk of cancers (reported as all cancers, lymphoma, melanoma, prostate, colorectal and breast cancer) other than NMSC was identified. Conclusions: There were important limitations to the studies identified including choice of comparator arms, inadequate adjustment for confounding factors and failure to account for latency periods of cancer. There remains a need for ongoing pharmacovigilance in relation to cancer risk and biological therapy; the NMSC signal requires further investigation to determine the risk specifically attributable to biological therapy using prospectively collected data with adjustment for known NMSC risk factors. [ABSTRACT FROM AUTHOR]

The article focuses on the 2018 British Association of Dermatologists' guidelines for management and investigation of generalized pruritus in adults without an underlying dermatosis. Topics discussed include need of enquiring about diet and gastrointestinal symptoms in cases of generalized pruritus without rash (GPWOR), GPWOR presenting symptom of secondary polycythaemia due to kidney disease and association between malignant solid tumours and pruritus.

Summary: Background: Biological therapies are effective treatments for psoriasis and are often prescribed to women of child‐bearing age. Objectives: To evaluate the safety of biological therapy in conception and/or pregnancy. Methods: We performed a systematic review of PubMed, MEDLINE, Embase and Cochrane databases for multivariate‐adjusted studies of women exposed to biologics relevant to the treatment of psoriasis during conception and/or pregnancy. Results: We identified four population‐based cohort studies involving 1300 women exposed to tumour necrosis factor (TNF)‐α inhibitors (TNFi) 3 months prior to or during the first 3 months of pregnancy. These studies showed a trend towards drug‐specific harm with TNFi exposure in women with different inflammatory diseases, with an increased risk of congenital malformations [three studies; odds ratio (OR) range 1·32–1·64] and preterm birth (one study; OR 1·69, 95% confidence interval 1·10–2·60). This trend did not reach statistical significance in all studies; study heterogeneity, variation across comparator cohorts, inadequate adjustment for important confounding variables such as co‐therapy, and an absence of a common constellation of malformations means there is uncertainty about the causal role of TNFi. No studies specifically addressed the effect of TNFi exposure in psoriasis during conception and/or pregnancy, or of interleukin (IL)‐17 and IL‐12/23 antagonists in any indication. Conclusions: When counselling women these findings must be balanced against the potential impact of untreated severe psoriasis on conception and/or pregnancy and maternal wellbeing; ongoing pharmacovigilance via registries remains essential to address this evidence gap. [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Dermatology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: 银屑病是一种可致炎症、发红及鳞状皮肤的皮肤病。生物疗法在治疗银屑病方面疗效显著,但遗憾的是,此类疗法会严重影响免疫系统,进而增加患癌概率。该研究的作者分析了 2016 年 8 月之前的研究,旨在了解接受生物疗法的银屑病患者的患癌概率是否高于其他患者。一些研究表明,某些类型的皮肤癌的发病率增加,如非黑瘤皮肤癌 (NMSC)。在研究中,任何其他类型的癌症的发病率都未增加。但是,作者发现研究中存在多处可能影响结果的薄弱环节。需要开展更多的研究,以了解接受生物治疗是否确实会增加皮肤癌患病风险。参加类似英国皮肤科医师协会生物介入登记 (BADBIR) 这样长期研究的患者将有助于解答这个非常重要的问题。 [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Dermatology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of British Journal of Dermatology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)