Dermatology
RCT | Vitamin D supplementation shows no significant impact on psoriasis severity
4 Apr, 2023 | 13:51h | UTCSummary: In a randomized, double-blind, placebo-controlled clinical trial involving 122 participants with plaque psoriasis, researchers investigated the effects of vitamin D supplementation on psoriasis severity during winter. Participants received either vitamin D (cholecalciferol, 100,000 IU loading dose followed by 20,000 IU/week) or a placebo for four months. The primary outcome was Psoriasis Area Severity Index (PASI) scores, with secondary outcomes including Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores.
The study found no significant difference in PASI scores or secondary outcomes between the two groups. The results suggest that vitamin D supplementation does not affect psoriasis severity. However, low baseline severity scores and a lower than expected increase in 25-hydroxyvitamin D levels in the intervention group may have influenced the findings, indicating that further research may be needed to account for these factors.
Article: Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels: A Randomized Clinical Trial – JAMA Dermatology (free for a limited period)
Commentary on Twitter
This RCT, performed in North-Norway, found no measurable effect of vitamin D supplementation on psoriasis severity during winter. Low baseline severity, & lower-than-expected rise in 25(OH)D levels in intervention group, may have affected the results. https://t.co/ip17uFQsgM
— JAMA Dermatology (@JAMADerm) March 29, 2023
RCT | Baricitinib + topical corticosteroids effective in kids with moderate-severe atopic dermatitis
4 Apr, 2023 | 13:39h | UTC
S1-guideline cutaneous and subcutaneous leiomyosarcoma
4 Apr, 2023 | 13:37h | UTCS1-guideline cutaneous and subcutaneous leiomyosarcoma – Journal of the German Dermatology Society
Guideline | Merkel cell carcinoma
23 Mar, 2023 | 12:48h | UTC
Suggested guidelines for the treatment of mycosis fungoides in countries with limited resources
21 Mar, 2023 | 13:29h | UTC
Guidelines for the management of people with cutaneous squamous cell carcinoma in situ (Bowen disease)
21 Mar, 2023 | 13:27h | UTC
Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis
21 Mar, 2023 | 13:23h | UTCTwo Phase 3 Trials of Lebrikizumab for Moderate-to-Severe Atopic Dermatitis – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Largest study to date of lebrikizumab supports its use for treatment of atopic dermatitis – George Washington University
Commentary: Lebrikizumab Effective for Adults, Teens With Atopic Dermatitis – HealthDay
FDA issues new information on cases of squamous cell carcinoma and lymphomas around breast implants
16 Mar, 2023 | 13:28h | UTCSummary: The US Food and Drug Administration (FDA) has provided an update on reports of squamous cell carcinoma (SCC) in the scar tissue (capsule) that forms around breast implants. The FDA is aware of 19 cases of SCC in the capsule around the breast implant from published literature, including 3 reports of deaths from the disease.
While the FDA continues to believe that occurrences of SCC in the capsule around the breast implant may be rare, the cause, incidence, and risk factors remain unknown. Health care providers and people who have or are considering breast implants should be aware that cases of SCC and various lymphomas in the capsule around the breast implant have been reported to the FDA and in the literature.
The FDA continues to ask health care providers and people with breast implants to report cases of SCC, lymphomas, or any other cancers around breast implants.
FDA Safety Communication: Reports of Squamous Cell Carcinoma (SCC) in the Capsule Around Breast Implants – FDA Safety Communication – U.S. Food & Drug Administration
Related:
FDA Report: 660 Cases of Breast Implant-Associated Anaplastic Large Cell Lymphoma
Study: Long-term Outcomes of Silicone Breast Implants
SR | Therapeutics for treating mpox in humans – still no evidence from randomized trials
15 Mar, 2023 | 15:20h | UTCTherapeutics for treating mpox in humans – Cochrane Library
Summary: Therapeutics for treating mpox – Cochrane Library
RCT | Nirogacestat for desmoid tumors
15 Mar, 2023 | 14:57h | UTCNirogacestat, a γ-Secretase Inhibitor for Desmoid Tumors – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Nirogacestat Improves Outcomes for Patients With Desmoid Tumors – Memorial Sloan Kettering Cancer Center
Commentary on Twitter
In a randomized, placebo-controlled trial, oral nirogacestat twice daily led to 41% of patients having a tumor response, and 2-year progression-free survival was 76%. Most adverse events were low grade. https://t.co/wtt7solTHW pic.twitter.com/qkRchfnXU2
— NEJM (@NEJM) March 10, 2023
Review | Pathogenesis, epidemiology and control of Group A Streptococcus infection
14 Mar, 2023 | 13:38h | UTC
Commentary on Twitter
NEW📢🎉Pathogenesis, epidemiology and control of Group A Streptococcus infectionhttps://t.co/XFSKQrTe1P
Brouwer & co. summarize the epidemiological and clinical features of Group A Streptococcus infection, and the molecular mechanisms of GAS virulence and drug resistance. pic.twitter.com/qm23YgnKlg
— Nature Reviews Microbiology (@NatureRevMicro) March 10, 2023
RCT | Efficacy of methotrexate alone vs. methotrexate plus low-dose prednisone in patients with alopecia areata
13 Mar, 2023 | 14:34h | UTCEfficacy of Methotrexate Alone vs Methotrexate Plus Low-Dose Prednisone in Patients With Alopecia Areata Totalis or Universalis: A 2-Step Double-Blind Randomized Clinical Trial – JAMA Dermatology (link to abstract – $ for full-text)
Commentary: Low-Cost Treatment Option for Alopecia Universalis, Totalis Identified in Clinical Trial – HCP Live
Commentary on Twitter
Methotrexate combined with low-dose prednisone may be an inexpensive and effective therapeutic option in patients with chronic and recalcitrant alopecia areata totalis or universalis. https://t.co/k1QWHJQjfP
— JAMA Dermatology (@JAMADerm) March 8, 2023
Cohort Study | Clinical associations and classification of immune checkpoint inhibitor‐induced cutaneous toxicities
10 Mar, 2023 | 14:09h | UTC
CDC Study | Estimates of serial interval and incubation period for mpox virus infection in the US
8 Mar, 2023 | 14:34h | UTCSummary:
Monkeypox cases have been reported globally since May 2022, with most transmission occurring through close physical contact associated with sexual activities among men who have sex with men.
This study presented the estimated mean serial interval and incubation period for monkeypox virus infection based on data collected from 12 US health departments. The serial interval is the time between symptom onset in a primary case-patient and symptom onset in the secondary case-patient. It is critical for estimating the effective reproduction number and forecasting incidence, both of which are important for understanding the course of an outbreak and the effect of interventions.
The results indicate that the mean estimated serial interval for symptom onset is 8.5 days, while the mean estimated incubation period is 5.6 days.
Commentary: 8.5 days elapse between successive mpox cases, study estimates – CIDRAP
CDC Interim Guidance | Treatment considerations for severe manifestations of Mpox
7 Mar, 2023 | 13:08h | UTCCommentary: CDC recommendations and clinical considerations for the treatment of severe Mpox – News Medical
Phase 2 RCT | Neoadjuvant–adjuvant pembrolizumab improves event-free survival vs. adjuvant-only therapy in advanced melanoma
6 Mar, 2023 | 14:11h | UTCSummary:
This phase 2 clinical trial evaluated whether giving pembrolizumab before and after surgery (neoadjuvant-adjuvant therapy) would increase event-free survival in patients with resectable stage III or IV melanoma, compared to adjuvant therapy alone. The trial involved 313 patients, with 154 in the neoadjuvant-adjuvant group and 159 in the adjuvant-only group.
At a median follow-up of 14.7 months, the neoadjuvant-adjuvant group had significantly longer event-free survival than the adjuvant-only group, with similar rates of adverse events between groups, suggesting that pembrolizumab given both before and after surgery may be an effective treatment option for these patients.
Article: Neoadjuvant–Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Neoadjuvant immunotherapy improves outlook in high-risk melanoma – MD Anderson Cancer Center
Commentary on Twitter
Patients who received 3 doses of pembrolizumab before surgery and 15 doses after surgery had significantly longer event-free survival than those who received adjuvant-only therapy with 18 doses after surgery. https://t.co/qmMPV4gvSj#SkinCancer pic.twitter.com/69TDuyPAg7
— NEJM (@NEJM) March 4, 2023
RCT | Oral nicotinamide does not reduce skin cancer incidence in organ-transplant recipients
6 Mar, 2023 | 14:07h | UTCSummary:
This article discusses a phase 3 clinical trial investigating whether oral nicotinamide (vitamin B3) effectively prevents skin cancer in organ transplant recipients.
The study enrolled 158 participants who had at least two keratinocyte cancers in the past five years, with 79 assigned to the nicotinamide group and 79 to the placebo group.
After 12 months, the two groups had no significant differences in the number of squamous-cell and basal-cell carcinomas, or actinic keratoses. Adverse events and changes in blood or urine laboratory variables were also similar in the two groups.
Article: Nicotinamide for Skin-Cancer Chemoprevention in Transplant Recipients – New England Journal of Medicine (link to abstract – $ for full-text)
Related Study: A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention – New England Journal of Medicine
Drug allergy | A 2022 practice parameter update
3 Mar, 2023 | 13:59h | UTCDrug allergy: A 2022 practice parameter update – The Journal of Allergy and Clinical Immunology
RCTs | Secukinumab in moderate-to-severe hidradenitis suppurativa
3 Mar, 2023 | 13:30h | UTCSecukinumab in moderate-to-severe hidradenitis suppurativa (SUNSHINE and SUNRISE): week 16 and week 52 results of two identical, multicentre, randomised, placebo-controlled, double-blind phase 3 trials – The Lancet (link to abstract – $ for full-text)
M-A | Prevalence and odds of depressive and anxiety disorders and symptoms in children and adults with alopecia areata
2 Mar, 2023 | 12:59h | UTCPrevalence and Odds of Depressive and Anxiety Disorders and Symptoms in Children and Adults With Alopecia Areata: A Systematic Review and Meta-analysis – JAMA Dermatology (link to abstract – $ for full-text)
Commentary: Anxiety, Depressive Disorder Prevalence Greater Among Alopecia Areata Patients – HCP Live
Mpox outbreak in advanced HIV cases | Global case series reveals higher mortality and clinical complications
23 Feb, 2023 | 13:44h | UTCSummary: This article discusses a case series investigating monkeypox (mpox) in people with HIV and low CD4 cell counts. The mpox outbreak in 2022 has affected a significant percentage of people living with HIV, and data suggest worse clinical outcomes and higher mortality in those with more advanced HIV. The case series includes data from 382 confirmed mpox cases in people living with HIV from 19 countries. The individuals included were predominantly cisgender men, with a median age of 35. Most individuals were adherent to antiretroviral therapy, and the median CD4 count was 211 cells per mm3. Severe complications were more common in those with lower CD4 cell counts, including necrotizing skin lesions, lung involvement, secondary infections, and sepsis. Approximately 28% of individuals were hospitalized, and 25% of those hospitalized died. All deaths occurred in people with CD4 counts of less than 200 cells per mm3. The study reinforces the importance of HIV and CD4 testing in mpox cases, prioritization of preventive mpox vaccination in people with HIV and a CD4 cell count of less than 200 cells per mm3, and the use of potential mpox antivirals where available. The authors suggest that a severe, disseminated, and necrotizing form of mpox should be considered an AIDS-defining condition in CDC and WHO HIV disease classifications. Clinicians should also be aware that starting antiretroviral therapy in people with advanced HIV and mpox could contribute to deterioration and possible death, possibly as part of an immune reconstitution syndrome.
Article: Mpox in people with advanced HIV infection: a global case series – The Lancet (free registration required)
News Release: Clinicians identify severe form of mpox with high mortality in people with advanced HIV – Queen Mary University of London
Commentaries:
Mpox: Clinicians identify severe form with high mortality in advanced HIV patients – The BMJ
Commentary from the author on Twitter (thread – click for more)
📣 📣 Our global case series on MPOX in people with advanced HIV infection is at #CROI2023 and in @TheLancet today: 382 cases of human MPOX infection in PLWH with CD4 counts <350 cells/mm3 in 19 countries
**We found MPOX is an opportunistic pathogen** /1https://t.co/WodDN4Ujoj pic.twitter.com/IlK7viABmy— @profchloeorkin.bsky.social (@profchloeorkin) February 21, 2023
WHO Report | Global trends in the 2022-23 Mpox (Monkeypox) outbreak
23 Feb, 2023 | 13:43h | UTCSummary: The report provides an overview of the 2022-23 monkeypox (mpox) outbreak worldwide as reported to WHO as of February 18, 2023. The report focuses on laboratory-confirmed cases and mentions that 86,019 cases and 1,389 probable cases, including 96 deaths, have been reported to WHO from 110 Member States across all 6 WHO regions, including some countries without previously documented mpox transmission. The outbreak primarily affects men who have sex with men, and no signal suggests sustained transmission beyond these networks. The WHO Director-General has determined that this outbreak continues to constitute a public health emergency of international concern and issued revised temporary recommendations in relation to the outbreak.
Report: 2022-23 Mpox (Monkeypox) Outbreak: Global Trends – World Health Organization
Commentary on Twitter
With over 86,000 total cases & 96 related deaths, #mpox outbreak has slowed down but is still ongoing in several countries.
Maintained surveillance & enhanced access to diagnostics, vaccines and treatments are key to stop the disease transmission globally https://t.co/mLHsVoWKBY pic.twitter.com/PcLFQjjrz7
— World Health Organization (WHO) (@WHO) February 21, 2023
M-A | Oral manifestation of the monkeypox virus
23 Feb, 2023 | 13:42h | UTCOral manifestation of the monkeypox virus: a systematic review and meta-analysis – eClinicalMedicine
RCT | Laser treatment does not improve sexual dysfunction in survivors of breast cancer
16 Feb, 2023 | 15:19h | UTCInvited commentary: Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy – JAMA Network Open
Related:
RCT | Laser no better than sham treatment for genitourinary syndrome of menopause
M-A | Carbon dioxide laser vs. vaginal estrogen for genitourinary syndrome of menopause.
Perspective: From vaginal laser treatment to spa breaks – it’s the great menopause gold rush.
Commentary on Twitter
The LIGHT Trial RCT: Vaginal laser therapy does not improve sexual dysfunction/genitourinary syndrome of menopause in breast cancer survivors receiving aromatase inhibitors when added to first line therapy based on moisturizers and vibrator stimulation. https://t.co/jdVDgHe9HC
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
M-A | Worldwide prevalence of antibiotic-associated Stevens-Johnson syndrome and toxic epidermal necrolysis
16 Feb, 2023 | 15:04h | UTCSummary: The article examined the prevalence Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) associated with antibiotics worldwide. The analysis included 38 studies involving 2,917 patients, which showed that 28% of SJS/TEN cases were associated with antibiotics. Among antibiotic-associated SJS/TEN, the sulfonamide class was associated with 32% of cases, followed by penicillins, cephalosporins, fluoroquinolones, and macrolides.
Article: Worldwide Prevalence of Antibiotic-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis – JAMA Dermatology (free for a limited period)
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.