J Drugs Dermatol
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Review Meta Analysis
Progressive multifocal leukoencephalopathy and reversible progressive leukoencephalopathy syndrome in dermatologic therapy.
Progressive multifocal leukoencephalopathy (PML) is a frequently fatal demyelinating disease of the brain caused by activation of the John Cunningham virus. It typically occurs in immunocompromised patients, including transplant recipients on immunosuppressant medications, patients receiving chemotherapy for hematologic malignancies, and patients with human immunodeficiency virus. Unfortunately, there is no effective treatment for PML. ⋯ Symptoms usually resolve over time, or with treatment of the underlying cause. Amid the relatively recent withdrawal of efalizumab from the US market because of its association with PML, and the added warning found on ustekinumab describing RPLS as a possible adverse effect, there has been an increasing level of concern in dermatology that biologics and other systemic medications used in the treatment of psoriasis may be related to an increased risk of specific leukoencephalopathies. In this review, we evaluate the association of prebiologics (eg, cyclosporine, methotrexate, acitretin) and biologics (eg, adalimumab, alefacept, efalizumab, etanercept, infliximab, rituximab, and ustekinumab) with the potential risk of developing PML and RPLS.
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Pyoderma gangrenosum is an inflammatory disease of unknown etiology, commonly mistaken for an infection. Here, we report the case of a 55-year-old woman with an infectious process that was initially misdiagnosed as pyoderma gangrenosum and treated accordingly. We also discuss the criteria and the methods available to diagnose infections and pyoderma gangrenosum correctly.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of ustekinumab in Chinese patients with moderate to severe plaque-type psoriasis: results from a phase 3 clinical trial (LOTUS).
Available biologic agents for the treatment of psoriasis in China are limited. ⋯ Consistent with results previously reported in global phase 3 studies, ustekinumab was highly effective and generally well tolerated in Chinese patients with moderate to severe psoriasis through 36 weeks.