The Journal of dermatology
-
Randomized Controlled Trial Multicenter Study
Efficacy and safety of brodalumab in the Korean population for the treatment of moderate to severe plaque psoriasis: A randomized, phase III, double-blind, placebo-controlled study.
Psoriasis, a chronic inflammatory skin disease, negatively impacts patients' quality of life (QoL). This randomized, phase III, double-blind, placebo-controlled, multicenter study evaluated the efficacy and safety of brodalumab, a human anti-interleukin-17 receptor A monoclonal antibody, in Korean patients with moderate to severe plaque psoriasis. Coprimary end-points were the percentage of patients with 75% or more improvement in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment (sPGA) success (score 0/1) at week 12. ⋯ Brodalumab treatment rapidly improved DLQI scores. The most common treatment-emergent adverse events were nasopharyngitis, upper respiratory tract infections, tinea pedis, and urticaria. Overall, treatment with brodalumab 210 mg Q2W resulted in a rapid and significant clinical benefit and was well tolerated in patients with moderate to severe plaque psoriasis in Korea.
-
In the dermoscopic diagnosis of skin tumors, it remains unclear whether a deep neural network (DNN) trained with images from fair-skinned-predominant archives is helpful when applied for patients with darker skin. This study compared the performance of 30 Japanese dermatologists with that of a DNN for the dermoscopic diagnosis of International Skin Imaging Collaboration (ISIC) and Shinshu (Japanese only) datasets to classify malignant melanoma, melanocytic nevus, basal cell carcinoma and benign keratosis on the non-volar skin. The DNN was trained using 12 254 images from the ISIC set and 594 images from the Shinshu set. ⋯ The specificity of the DNN at the dermatologists' mean sensitivity value was 0.962 for the Shinshu set and 1.00 for the ISIC set and significantly higher than that for the human readers (both P < 0.001). The dermoscopic diagnostic performance of dermatologists for skin tumors tended to be less accurate for patients of non-local populations, particularly in relation to the dominant skin type. A DNN may help close this gap in the clinical setting.
-
Randomized Controlled Trial
Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double-blind, placebo-controlled trial.
Effective therapies for adult female acne (AFA) are limited. Oral spironolactone (SPL), 100-200 mg/day, is currently used off-label to treat AFA. However, high-dose SPL results in clinically significant side-effects which prevent widespread use in clinical practice. ⋯ A small number of participants in SPL25 and SPL50 reported mild and temporary TRAE, such as menstrual irregularities, breast tenderness and dizziness. The combination of SPL 50 mg/day and topical BP proved effective in improving moderate AFA in Thai women, with an acceptable side-effect profile. We propose this regimen as an option for treating moderate AFA.
-
Enfortumab vedotin (EV) is a novel, fully humanized monoclonal antibody-drug conjugate composed of an anti-Nectin-4 antibody joined to monomethyl auristatin E. In this report, we described a case of a severe eczematoid and lichenoid eruption with full-thickness epidermal necrosis developing in patients with metastatic urothelial cancer treated with EV. Because phase II and phase III clinical studies are ongoing, in the future, substantial amounts of EV are expected to be used for the treatment of metastatic urothelial cancer. Therefore, understanding the mechanisms of drug eruption caused by EV is important for oncologists as well as dermatologists.