Publications by authors named "Alice Phan"
Article Synopsis
- Diagnosing acral melanocytic lesions, like acral nevi and melanoma, can be difficult, and the BRAAFF checklist was developed to assist in this process but hasn't been validated yet.
- In a study, varying experts diagnosed images of nevi and melanomas using the BRAAFF checklist online, yielding a sensitivity of 92.5% and a specificity of 65.0%, comparable to traditional pattern recognition.
- The checklist showed varying levels of agreement among raters based on experience, and a simplified version achieved similar sensitivity with slightly lower specificity, suggesting that the BRAAFF checklist is a helpful but not superior diagnostic tool.
Management of scabies in children under 15 kg and pregnant or breastfeeding women: recommendations supported by the Centre of Evidence of the French Society of Dermatology.
Br J Dermatol
November 2024
Article Synopsis
- The study explores the effectiveness of one-on-one, nurse-led therapeutic patient education (TPE) for children with moderate-to-severe atopic dermatitis (AD), pitting it against standard care alone.
- A total of 176 children participated, but by week 24, there was no significant difference in disease control (measured by the SCORAD index) between the two groups.
- The only notable improvement from the TPE was a reduction in fear of using topical steroids, although the intervention group displayed consistently lower disease severity throughout the study.
Article Synopsis
- The study aimed to clarify the dermatological features of Costello syndrome (CS) and distinguish them from other similar syndromes like cardiofaciocutaneous syndrome (CFCS) and types of Noonan syndrome (NS).
- A ten-year multi-center study involving 31 patients found common skin and hair anomalies in CS, such as excessive eyebrows and various types of skin growths, which can help differentiate CS from CFCS and NS.
- The findings propose multiple melanocytic naevi as a potential marker for a milder form of CS and suggest that acitretin could be beneficial for treating certain skin conditions, although no clear genotype-phenotype link was identified.
H syndrome is a rare autosomal recessive genetic disorder characterized by the following clinical features: cutaneous hyperpigmentation, hypertrichosis, hepatosplenomegaly, heart anomalies, hearing loss, hypogonadism, short stature, hallux valgus, hyperglycemia, fixed flexion contractures of the toe joints, and the proximal interphalangeal joints. In rare cases, autoinflammatory and lymphoproliferative manifestations have also been reported. This disorder is due to loss-of-function mutations in gene, which encode the equilibrative nucleoside transporter ENT3.
View Article and Find Full Text PDFArticle Synopsis
- The PIK3CA-related overgrowth spectrum (PROS) includes conditions caused by mosaic variants in the PIK3CA gene, which can also lead to various cancers, including an increased risk of Wilms tumor (WT).
- A study of 267 PROS patients found a low overall cancer development rate of 2.2%, with an estimated 5.6% probability of cancer by age 45, suggesting the risk of WT in these patients is relatively low.
- The findings indicate that routine abdominal ultrasound for cancer detection in PROS might not be necessary, and more long-term studies are needed to better understand the risks of different cancers and their connection to PIK3CA variants.
Article Synopsis
- This study focuses on the effectiveness of biologic therapies for children with palmoplantar plaque psoriasis, assessing data from 170 patients in the BiPe cohorts.
- Results show that children with palmoplantar psoriasis tended to be male, had an earlier onset of psoriasis, and experienced more nail involvement compared to those with generalized plaque psoriasis.
- After three months of treatment, those with palmoplantar psoriasis had higher mean PGA scores and were more likely to discontinue treatment due to inefficacy, suggesting that adalimumab may be the most effective option, but more research is needed for better management guidelines.
Biologics combined with conventional systemic agents for the treatment of children with severe psoriasis. Real-life data from the BiPe cohorts and a practice survey among French and Italian pediatric dermatologists.
Dermatol Ther
November 2022
Article Synopsis
- - Combined therapies in treating childhood psoriasis involve using multiple drugs to enhance effectiveness and minimize side effects, with a study evaluating their use in 170 children across France and Italy.
- - Out of the participants, 13% received various combinations of conventional and biologic medications, achieving significant improvements in psoriasis scores, despite reporting a few serious adverse events with positive outcomes.
- - A survey of 61 dermatologists revealed that 64% have used or intend to use these combined therapies, primarily to boost the effectiveness of biologic treatments when initial results are insufficient.
Background/objectives: We observed isolated cases of perialar intertrigo in children and teenagers that did not appear to correspond to any known clinical entity. The objective of this study was to describe the clinical features of this dermatosis and the clinical characteristics of the patients.
Methods: We conducted a prospective, multicenter cohort study in France from August 2017 to November 2019.
Background: Congenital nail matrix nevi (NMN) are difficult to diagnose because they feature clinical characteristics suggestive of adult subungual melanoma. Nail matrix biopsy is difficult to perform, especially in children.
Objective: To describe the initial clinical and dermatoscopic features of NMN appearing at birth (congenital) or after birth but before the age of 5 years (congenital-type).
Article Synopsis
- The study aimed to analyze the clinical practice and safety of switching biologics among pediatric psoriasis patients in the BiPe cohort, which included 134 patients.
- Out of the patients, 29 switched biologics mainly due to loss of efficacy, with most transitions occurring from etanercept to adalimumab or ustekinumab.
- The research found no significant differences in drug survival rates based on whether the biologics were used as first-line or second-line treatments, indicating a need for more data to guide switching in clinical practice.
Background: Teledermoscopy (TDS) improves diagnostic accuracy and decreases the number of unnecessary consultations.
Objectives: To determine the diagnostic concordance in tertiary (dermatologist-to-experts) TDS with histopathology/follow-up-based diagnosis.
Methods: A descriptive retrospective cohort study including 290 requests.
Topical sirolimus 0.1% for treating cutaneous microcystic lymphatic malformations in children and adults (TOPICAL): protocol for a multicenter phase 2, within-person, randomized, double-blind, vehicle-controlled clinical trial.
Trials
December 2019
Background: Cutaneous microcystic lymphatic malformations (CMLMs) are rare conditions in children and adults. They present as clusters of vesicles full of lymph and blood to various extents, inducing maceration, esthetic impairment, pain, and impaired quality of life. The treatment is challenging.
View Article and Find Full Text PDFBackground: Phase III clinical trials of biotherapies for childhood psoriasis are designed for a selected population, which can differ from real-life patients.
Objective: Our objective was to assess the proportion of children with psoriasis that received biotherapy in the biological treatments for pediatric psoriasis (BiPe) cohort that would be excluded from phase III clinical trials of these treatments.
Methods: Data concerning initiation of the first biotherapy from all patients included in the BiPe cohort were analyzed.
Background: Atopic dermatitis is a highly prevalent, chronic, relapsing disease in both adults and children. On the severity spectrum, lower-end patients benefit from small amounts of topical anti-inflammatory treatments (TAT), whereas higher-end patients need systemic immunosuppressants; in-between patients are treated with TAT and phototherapy. The major therapeutic challenge in this population is the long-term control of disease activity, and the current TAT-based pro-active strategy does not meet all their needs.
View Article and Find Full Text PDFMethotrexate has demonstrated its efficiency for the treatment of juvenile localized scleroderma but some patients may be resistant. The aim of our study was to define the profile of such patients. We performed an observational retrospective multicenter study between 2007 and 2016 and included all children seen in the French Paediatric Dermatology and Rheumatology departments with active localized scleroderma treated by methotrexate for a minimum of 4 months.
View Article and Find Full Text PDFPurpose: PIK3CA-related overgrowth spectrum (PROS) encompasses a range of debilitating conditions defined by asymmetric overgrowth caused by mosaic activating PIK3CA variants. PIK3CA encodes the p110α catalytic subunit of phosphatidylinositol-3-kinase (PI3K), a critical transducer of growth factor signaling. As mTOR mediates the growth-promoting actions of PI3K, we hypothesized that the mTOR inhibitor sirolimus would slow pathological overgrowth.
View Article and Find Full Text PDFBackground: Psoriasis affects 2-4% of the population, with the most common clinical type being plaque psoriasis. The linear form of psoriasis is very rare. The literature on linear psoriasis (LP) consists of only case reports, and data are few.
View Article and Find Full Text PDFIntroduction: To assess the prevalence of nail involvement in children <16 years old with a confirmed diagnosis of scabies.
Study Design: Observational, prospective study in 7 French dermatology departments between June 2015 and January 2017. Children were included if they had scabies confirmed by dermoscopy and/or microscopy and if nails could be sampled.
Psoriasis affects 0.5-2% of children. Severe forms required use of systemic treatments.
View Article and Find Full Text PDFBackground: Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse, and this may in part contribute to delay in detection and thicker tumors.
Objective: To analyze the clinicodermoscopic characteristics of PM.
Methods: Retrospective study of 52 melanomas diagnosed in patients before the age of 20 years.