Journal of the European Academy of Dermatology and Venereology : JEADV
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Sarcoidosis is a systemic granulomatous disease that affects numerous organs, commonly manifesting at the lungs and skin. While corticosteroids remain the first line of treatment, tumour necrosis factor alpha (TNF-α) inhibitors have been investigated as one potential steroid sparing treatment for sarcoidosis. ⋯ Paradoxically, in some patients treated with biologic TNF-α inhibitors for other diseases, treatment can induce the development of sarcoidosis. In the light of this complexity, we discuss the role of TNF-α in granuloma formation, the therapeutic role of TNF-α inhibition and immunologic abnormalities following treatment with these TNF-α inhibitors including drug-specific alterations involving interferon-γ, lymphotoxin-α, TNF receptor 2 (TNFR2) and T-regulatory cells.
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J Eur Acad Dermatol Venereol · Nov 2015
Is an online skin cancer toolkit an effective way to educate primary care physicians about skin cancer diagnosis and referral?
Skin disorders account for over 20% of GP consultations. Half of dermatology referrals to secondary care are for skin lesions, but only 12% of urgent skin cancer referrals are deemed appropriate. Suitably designed online learning resources may positively impact GP confidence in the recognition of skin cancer and improve patient outcomes. ⋯ The skin cancer toolkit is an accessible online learning resource for improving confidence with skin cancer referral amongst GPs. Although we were unable to identify any immediate changes in skin cancer diagnoses or appropriate referral behaviours, research is required to evaluate its longer term effects on outcomes.
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J Eur Acad Dermatol Venereol · Nov 2015
Frequency of undiagnosed psoriatic arthritis among psoriasis patients in Australian dermatology practice.
Psoriatic arthritis commonly develops in psoriasis patients and, if undiagnosed, can lead to potentially avoidable joint damage and an increased risk of comorbidity and mortality. Increased awareness of PsA symptoms among dermatologists provides an opportunity for earlier diagnosis, more timely therapy and prevention of disability. ⋯ In this study, the frequency of undiagnosed PsA in Australian dermatology practice was 9% among plaque psoriasis patients with no prior PsA diagnosis. Compared with psoriasis alone, the impact of undiagnosed PsA on health-related quality of life of psoriasis patients is substantial.
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J Eur Acad Dermatol Venereol · Nov 2015
Dermoscopy of tumours arising in naevus sebaceous: a morphological study of 58 cases.
Naevus sebaceous is a congenital hamartoma commonly associated with the development of secondary neoplasms. There are sparse data relating to the dermoscopy of tumours arising in naevus sebaceous. ⋯ Benign adnexal tumours associated with naevus sebaceous are dermoscopic mimickers of basal cell carcinomas. A pigmented nodule arising in a naevus sebaceous with a total blue large ovoid nest on dermoscopy could be a trichoblastoma, basal cell carcinoma, hidrocystoma or hidradenoma. Dermoscopy can be a useful diagnostic tool which generates a more accurate preoperative diagnosis.
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J Eur Acad Dermatol Venereol · Oct 2015
Physician perspectives in the management of psoriasis and psoriatic arthritis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis survey.
Available literature on psoriasis and psoriatic arthritis (PsA) demonstrates a tremendous burden of disease and suggests underdiagnosis and undertreatment. ⋯ Physicians in North America and Europe caring for patients with psoriasis and PsA acknowledge unmet treatment needs, largely concerning long-term safety/tolerability and efficacy of currently available therapies; evidence suggests underdiagnosis of PsA and undertreatment of psoriasis among dermatologists.