JOURNAL OF CUTANEOUS MEDICINE AND SURGERY

Pulmonary, Ocular, and Cardiac Involvement in Patients With Cutaneous Sarcoidosis of the Face and Head
Badash A, Whittington K, Ene A, Zorra I, Rubinstein I, Tsoukas M and Sweiss NJ
Photodynamic Therapy in Acne Vulgaris: A Systematic Review
Qureshi S, Rehan Z, Ao A and Mukovozov I
Acne is a multifactorial disorder of the pilosebaceous unit. Photodynamic therapy (PDT) is an energy-based treatment shown to be safe in acne vulgaris, although the mechanism of action of PDT in acne is incompletely understood. This review summarizes the clinical features of and treatment efficacy in acne patients treated with PDT. A systematic review of Medline, Embase, and the Cochrane Database of Systematic Reviews was conducted. Title, abstract, full-text screening, and data extraction were completed using Covidence. Studies reporting the use of PDT in patients with acne were included while clinical features and treatment responses were extracted. Treatment outcomes were scored as complete response, partial response, and no response. After screening a total of 1122 studies, 82 studies met the inclusion criteria, representing 56 prospective studies, 25 randomized controlled trials, and 1 retrospective study. Results representing 4340 patients with acne (mean age 24.4 years; 52% females) treated with PDT are summarized. Overall, 2154 (50%) participants underwent aminolevulinic acid PDT, 452 (10%) participants underwent methyl aminolevulinate PDT, 28 (<1%) participants underwent daylight PDT, and 1706 (39%) underwent other modalities of PDT. The average follow-up period after study completion was 3 months, ranging from 2 weeks to 13 months. A partial response was observed in treated patients with outcome measures including clinical response, lesion count, pain, recurrence, and patient satisfaction. This systematic review provides preliminary data summarizing the clinical features and treatment efficacy in patients with acne treated with PDT. Our results suggest a partial clinical response when using PDT to manage acne. Future studies should focus on standardizing study protocols and drawing direct comparisons between PDT and other modalities for acne treatment.
Hidradenitis Suppurativa from a Multi-Omic Scope
Garbayo-Salmons P, Saus E, Exposito-Serrano V, Moreno M, Sàbat M and Calvet J
Hidradenitis suppurativa (HS) is recognized as a systemic immune-mediated disease (IMID), sharing genetic and environmental risk factors with other IMIDs such as inflammatory bowel disease and psoriasis. Over time, correlating clinical findings with genetic, proteomic, and metabolomic results has been challenging due to diverse sampling methods, analysis techniques, and the use of variable clinical phenotype descriptions across studies. This review aims to summarize the results from various omics fields to explore the etiopathology of HS. Genetic studies highlight defects in Notch and γ-secretase signaling and inflammasome function. Syndromic HS involves specific mutations in autoinflammatory syndromes such as pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) and pyoderma gangrenosum, acne, and HS (PASH). Proteomic analyses reveal key inflammatory pathways indicating activation of both innate and adaptive immunity. Additionally, microbiome studies show an increased presence of anaerobes like in HS lesions and a decreased presence of commensals such as . Gut microbiota dysbiosis, particularly involving and , is associated with HS. Moreover, metabolomic profiling indicates dysregulated tryptophan catabolism and lipid metabolism, with increased 5-lipoxygenase-derived metabolites and odd-chain fatty acids suggesting bacterial involvement. In summary, despite advances, robust associations between genetics, proteomics, microbiome, and metabolomics in HS are still lacking. Integrating these datasets could identify new clinical phenotypes, genetic predispositions, microbial signatures, and therapeutic targets, enhancing personalized treatment strategies and biomarker discovery for HS classification, prognosis, and treatment response.
Teledermatology and Virtual Visits for Acne Management: A Review
Mehta S, Metko D, Maazi M, Wang OJE and Li MK
Acne vulgaris is a common dermatological condition requiring individualized management. Teledermatology provides convenience and accessibility that is highly suitable for this dermatological condition. Herein, our review aimed to describe the current state of teledermatology in the context of acne management and to assess patient satisfaction, adherence to virtual care, and the experiences of health care providers in delivering remote dermatological services. A systematic search for articles was conducted in Medline, Embase, and PubMed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Title, abstract, full-text screening, and data abstraction were carried out in duplicate. One thousand one hundred three nonduplicate articles were screened based on title and abstract review. A total of 21 studies were included in the review. It was found that teledermatology is well-suited to the effective management of acne vulgaris. When compared to in-person care, teledermatology resulted in similar outcomes on several acne-grading scales. Additionally, patient satisfaction was comparable, with a large proportion of patients preferring virtual care to traditional in-person visits. However, compliance was found to be lower for virtual care. There are several secondary benefits to telemedicine, including time savings and greater accessibility to care for rural patients. Teledermatology is an evolving, promising medium for acne management for both clinicians and patients. Future research comparing the effectiveness of different teledermatology platforms, its limitations and pitfalls, and integration of patient and physician preferences to improve treatment outcomes is warranted.
Clinical Study on the Induction of Psoriasis Flare-Ups by PM2.5 Air Pollutants via Immune Barrier Dysfunction
Wang X, Wang S and Luo X
This study explores the clinical correlation between the air pollutant PM2.5 and the induction of psoriasis flare-ups through the disruption of the immune barrier.
Efficacy and Safety of Carbapenem Antibiotics in Hidradenitis Suppurativa: A Systematic Review
Aw K, Huang R, McMullen E, Piguet V and Croitoru D
National Trends in Healthcare Expenditures for the Management of Skin Cancer in the United States
Ma B, James MT, Chan AW and Mydlarski PR
Malignant melanoma and keratinocyte carcinomas account for a substantial proportion of healthcare expenditures in the United States.
Trends in Cutaneous Melanoma in Nova Scotia With a Focus on 2007 to 2019
Dorey RA, Walsh G, Dewar R and Hull PR
Melanoma represents a significant public health challenge in Canada, contributing to the deaths of over 1000 individuals each year. Prince Edward Island and Nova Scotia were previously noted to have the highest incidence rates of melanoma in Canada.
Toe Web Erythrasma
Zhao L and Liu ZH
Association Between Lichen Planus and Atherosclerosis: A Systematic Review and Meta-Analysis
Chuang KW, Huang SW and Chang HC
Dupilumab Therapy for Keloids and Hypertrophic Scars: A Systematic Review
Huang RS, McMullen EP, Metko D and Piguet V
Economic Burden and Cost-Effectiveness of Oral Lichen Planus Interventions and Complications: A Systematic Review
Sriranganathan A, Li HO and Kirchhof MG
Off-Label Use of Tildrakizumab in Patients with Hidradenitis Suppurativa
Maazi M, Toy J, Gui XY and Piguet V
Systemic Treatment Options for Inflammatory Linear Verrucous Epidermal Nevi: An Evidence-Based Review
Sood S, Bestavros S, Yilmaz O, Maliyar K, Sachdeva M, Abduelmula A, Hanna E, Mufti A and Yeung J
Biologic Therapy in Psoriasis Patients with Renal Disease: A Systematic Review
Geng RSQ, Sood S, Waked J, Merchant N, Abduelmula A, Yeung J and Mufti A
Retrospective Review of Morphea in Paediatric Patients with Skin of Colour
Mohsen ST, Park M, Pope E, Laxer RM and Sibbald CJ
Efficacy of Treatments in Reducing Facial Erythema in Rosacea: A Systematic Review
Hua NJ, Chen J, Geng RSQ, Sibbald RG and Sibbald C
Rosacea is a chronic inflammatory skin condition that affects over 5% of individuals worldwide. Its clinical presentation is characterized by an array of features, including erythema, papules and pustules, phymatous changes, telangiectasia, and ocular manifestations. Specifically, the multifaceted manifestation of erythema varies widely in intensity and distribution. Factors contributing to pathogenesis include neurovascular dysregulation, increased levels of pro-inflammatory mediators, and aberrant vasodilation. Erythema management plays an important role in reducing the psychosocial burden associated with rosacea and improving overall quality of life. Cochrane CENTRAL, Medline, and Embase databases were searched from inception to September 2023 and included 33 clinical trials reporting on a total of 7411 rosacea patients (74.1% female) and 21 different topical or systemic treatments. The mean age was 48.8 years (range, 18-83 years), and the mean time to outcome assessment was 8.1 weeks (standard deviation, 4.1 weeks). Treatment efficacy was assessed by outcome measures including percent improvement from baseline on 4- and 5-point scales, clinician erythema assessment (CEA) success (improvement ≥1 point), and CEA and patient self-assessment success (improvement ≥1 point). Pooled effect sizes for each treatment were calculated as a weighted average based on the number of patients in each study. The most effective topical treatments for reducing erythema include sodium sulphacetamide and sulphur, praziquantel, metronidazole, and B244 spray (). The most effective systemic treatment was paroxetine. Our findings highlight the varying efficacy of treatments in addressing the erythema in rosacea, recognizing the nuances of clinical presentations.
Tocilizumab for the Treatment of Refractory Morphea: A Systematic Review
Metko D, Mehta S, Geng R, Mufti A and Yeung J
Drug-Induced Pityriasis Rosea: A Systematic Review
Devoy C, Lee A, Geng RSQ, Rijal H, Han JY, Wilken B, Chen J, Bouadi N and Sibbald C
Real-World Effectiveness and Safety of Tildrakizumab for Moderate-to-Severe Plaque Psoriasis in Adult Patients: A 52-Week Multicenter Retrospective Study
Yeung J and Sood S
Ocular Adverse Events Associated with Biologics Approved for Psoriasis: An FDA Adverse Event Reporting Database Study
Katsiaunis A and Lipner SR