Publications by authors named "Alavi Afsaneh"
Background: Hidradenitis suppurativa (HS) affects different patient populations that require unique considerations in their management. However, no HS guidelines for these populations exist.
Objective: To provide evidence-based consensus recommendations for patients with HS in seven special patient populations: i) pregnancy, ii) breastfeeding, iii) pediatrics, iv) malignancy, v) tuberculosis infection, vi) hepatitis B or C infection, and vii) HIV disease.
Long-term efficacy and safety of secukinumab in patients with moderate-to-severe hidradenitis suppurativa: Week 104 results from the SUNSHINE and SUNRISE extension trial.
Br J Dermatol
November 2024
Background: SUNSHINE and SUNRISE demonstrated sustained clinical efficacy of secukinumab in patients with moderate-to-severe hidradenitis suppurativa (HS) through 52 weeks. Patients completing the core trials could enter a 4-year extension trial.
Objectives: To evaluate the long-term efficacy, safety/tolerability, and maintenance of clinical response of secukinumab through Week 104 in the extension trial.
Background: There is a known association between common variable immunodeficiency (CVID) and granulomas in multiple organ systems, including the skin, lung, liver, and spleen. Rubella virus has also been detected within cutaneous granulomas in both immunocompetent and immunocompromised hosts. We present a retrospective case series of patients with CVID and granulomatous skin disease and describe the spectrum of clinical and histopathologic features, including the status of rubella virus in the cutaneous granulomas.
View Article and Find Full Text PDFIntroduction: Squamous metaplasia of lactiferous duct (SMOLD), also known as Zuska's disease, is an uncommon, recurrent inflammatory fistulizing disease of the breast that strongly correlates with smoking in premenopausal patients. Clinical and imaging findings may overlap with other breast conditions. SMOLD is well recognized by breast pathologists; however, the dermatology literature on this condition remains scarce.
View Article and Find Full Text PDFObjective: The aim of this study was to characterize the phenotype and genotype of patients with Yao syndrome (YAOS), with focus on comparing to prior cohorts, identifying novel features, and describing treatment observations.
Methods: A retrospective medical records review of patients with YAOS seen at Mayo Clinic was conducted to characterize clinical features, genotypes, and therapeutic trials and responses.
Results: Twenty-two patients diagnosed with YAOS were included.
Introduction: The International Hidradenitis Suppurativa Severity Score System (IHS4) is a validated tool that measures inflammatory lesions, including draining tunnels, in hidradenitis suppurativa (HS).
Objective: To evaluate secukinumab efficacy using IHS4 in patients with moderate to severe HS.
Methods: Data from the SUNSHINE and SUNRISE trials, which assessed subcutaneous secukinumab 300 mg every 2 (SECQ2W) and 4 (SECQ4W) weeks in adults with moderate to severe HS, were analyzed.
Article Synopsis
- The study focuses on differentiating perianal issues caused by hidradenitis suppurativa (HS) and perianal fistulizing inflammatory bowel disease (IBD), as they often present similar symptoms.
- A retrospective review of patient data at the Mayo Clinic identified 15 key clinical features using machine learning to help distinguish between HS and IBD cases.
- Findings revealed significant differences in symptoms, with HS patients showing more skin-related issues and IBD patients experiencing additional gastrointestinal symptoms, which may lead to better diagnosis and treatment strategies.
Article Synopsis
- Immune checkpoint inhibitors (ICIs) are revolutionizing cancer treatment but pose risks for severe skin reactions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which need more study.
- This systematic review examined 158 cases to analyze factors related to SJS/TEN in ICI patients to improve risk assessment and clinical management.
- Findings show that SJS/TEN typically occurs in older males, often linked to PD-1 inhibitors, and highlights significant morbidity and mortality risks, though limitations exist in the data reporting and consistency.
Pregnancy is a conjectured risk factor for pyoderma gangrenosum (PG), an autoinflammatory neutrophilic dermatosis characterized by painful ulcers. Even so, there are no available treatment guidelines for those with PG who are pregnant or breastfeeding. To describe existing treatment options, we systematically reviewed the literature on PG treatment in pregnant or breastfeeding patients.
View Article and Find Full Text PDFHidradenitis suppurativa (HS) is a chronic inflammatory disease manifesting as painful dermal nodules, abscesses, and tunnels. Activation of the IL-1R/toll-like receptor pathway is strongly implicated in the pathogenesis of HS; thus, the role of a key signaling node, IRAK4, was investigated in a noninterventional study (NCT04440410) that enrolled 30 patients with HS. IRAK4 expression was evaluated in blood and lesional, perilesional, and nonlesional skin biopsies.
View Article and Find Full Text PDFInpatient hospitalization of individuals with hidradenitis suppurativa (HS) has increased. Inpatient services may not be familiar enough with this disease to understand how to manage severe HS and/or HS flares. It would be beneficial to the inpatient medical community to establish consensus recommendations on holistic inpatient care of patients with HS.
View Article and Find Full Text PDFThe use of cannabis and cannabis-related products among patients with hidradenitis suppurativa (HS) is increasing globally. Given the potential anti-inflammatory, therapeutic, and pain management benefits of cannabis-related products, we reviewed primary literature to evaluate the prevalence and possible purpose for cannabis use among patients with HS and to provide recommendations to patients and physicians. A narrative review of original studies was conducted using Embase and Ovid Medline databases.
View Article and Find Full Text PDFArticle Synopsis
- - The goal of the educational activity is to enhance understanding of how pseudoporphyria manifests in patients.
- - It's aimed at healthcare professionals like doctors and nurses who focus on skin and wound care.
- - Participants will learn to recognize pseudoporphyria's symptoms, differentiate it from other conditions that cause blistering, and understand treatment options.
Article Synopsis
- Yao syndrome (YAOS) is a newly identified autoinflammatory disease associated with the NOD2 gene, causing symptoms like fevers, GI issues, arthritis, and skin problems.
- A review revealed that 85.7% of YAOS patients experienced skin symptoms, commonly presenting as red patches and plaques on various body parts.
- Prednisone is recommended as the first-line treatment, with sulfasalazine and other drugs as secondary options; YAOS should be considered when diagnosing patients with skin rashes alongside joint pain, fever, and GI symptoms.
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by ulcerative painful lesions with violaceous undermined borders. Up to 75% of PG cases develop in association with an underlying systemic disease. Monoclonal gammopathy is reportedly a concomitant condition with PG, with studies indicating immunoglobulin (Ig) A gammopathy as the most common.
View Article and Find Full Text PDFArticle Synopsis
- - Atypical wounds are becoming more common globally, creating challenges for accurate diagnosis and treatment, which are crucial skills for dermatologists
- - Successfully managing atypical wounds requires identifying their underlying causes, combined with effective pain management and active patient involvement
- - Ongoing advancements in treatment methods, along with more research and clinical training, are vital to effectively dealing with the rising number of atypical wounds
Article Synopsis
- * The symptoms of angiosarcoma can vary widely, presenting as anything from bleeding spots to larger masses, which may eventually lead to serious complications like ulceration.
- * Treatment requires a comprehensive approach involving surgery, radiation, and chemotherapy, and there is currently limited research on lower limb cases, prompting the need for healthcare providers to consider angiosarcoma in patients with lymphedema-related symptoms.
Discrepancies in hidradenitis suppurativa lesion characterization by providers and patients.
J Eur Acad Dermatol Venereol
January 2025
Article Synopsis
- - The study examines inconsistencies in how healthcare providers and patients identify and count lesions associated with hidradenitis suppurativa (HS), highlighting potential issues in the existing clinical response measurement tool, HiSCR, and the impact of rater training on trial outcomes.
- - An online survey of 47 members from the HISTORIC collaboration revealed significant variability in lesion classification, with many providers differing on whether lesions should be treated as single or multiple entities based on their morphology.
- - Findings suggest a need for standardized, consensus-driven guidelines for rater training in HS clinical trials to improve consistency in lesion characterization and potentially enhance trial results.
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a considerable disease burden. Existing treatment options are limited and often suboptimal; a high unmet need exists for effective targeted therapies.
Objectives: To explore the effects of spesolimab treatment in patients with HS.