North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations.

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 7 special patient populations: (i) pregnancy, (ii) breastfeeding, (iii) pediatrics, (iv) malignancy, (v) tuberculosis infection, (vi) hepatitis B or C infection, and (vii) HIV disease.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies.

Background: New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies.

Objective: To provide evidence-based recommendations related to management of AD in adults using topical treatments.

Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies.

These guidelines update the 2014 recommendations for management of atopic dermatitis in adults with topical therapies. A multidisciplinary workgroup employed best practices for guideline development, including a systematic review of the evidence and application of the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading recommendations. The evidence on atopic dermatitis treatment supported strong recommendations for the use of nonprescription moisturizers, topical calcineurin inhibitors, topical corticosteroids, and topical PDE-4 and JAK inhibitors.

Comorbid diseases of hidradenitis suppurativa: a 15-year population-based study in Olmsted County, Minnesota, USA.

Background: Like other chronic, inflammatory skin disorders, hidradenitis suppurativa (HS) is increasingly recognized to be associated with various medical disorders.

Objective: Using the Rochester Epidemiology Project (REP), we sought to conduct the first American population-based study examining the association between HS and various comorbid conditions.

Methods: From the REP database, we identified patients diagnosed with HS from 2003 through 2018 who were residents of Olmsted County, Minnesota, USA, along with age- and gender-matched controls.

American Academy of Dermatology Guidelines: Awareness of comorbidities associated with atopic dermatitis in adults.

Background: Studies found associations between atopic dermatitis (AD) and various comorbidities.

Objective: To appraise evidence of the association between AD and comorbidities among adults.

Methods: Our multidisciplinary work group conducted a systematic review of the association between AD and selected comorbidities.

Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations.

Background: Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk.

Objective: To provide evidence-based screening recommendations for comorbidities linked to HS.

Methods: Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population.

High-sensitivity C-reactive protein as a biomarker in detecting subclinical atherosclerosis in psoriasis.

Psoriasis is known to be associated with increased risk of cardiovascular diseases. High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and an independent risk factor for atherosclerosis. We aimed to assess the correlation between hs-CRP and subclinical atherosclerosis in psoriatic patients.

Apremilast mechanism of efficacy in systemic-naive patients with moderate plaque psoriasis: Pharmacodynamic results from the UNVEIL study.

Background: Pharmacodynamic (PD) subanalyses of clinical trials in patients with moderate to severe psoriasis demonstrated the efficacy of apremilast correlated with reductions in cytokines involved in the pathogenesis of psoriasis.

Objective: This PD subanalysis of a phase IV, randomized, controlled trial (UNVEIL) in systemic-naive patients with moderate plaque psoriasis (psoriasis-involved body surface area [BSA] 5%-10%; static Physician's Global Assessment [sPGA] = 3) evaluated the relationship between efficacy and changes in inflammatory biomarkers with apremilast 30 mg twice daily (BID) versus placebo.

Methods: Patients were randomized (2:1) to apremilast 30 mg BID or placebo for 16 weeks.

Changing our microbiome: probiotics in dermatology.

Background: Commensal bacteria are a major factor in human health and disease pathogenesis. Interest has recently expanded beyond the gastrointestinal microbiome to include the skin microbiome and its impact on various skin diseases.

Objectives: Here we present current data reviewing the role of the microbiome in dermatology, considering both the gut and skin microflora.

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management.

Hidradenitis suppurativa is a chronic inflammatory disorder affecting hair follicles, with profoundly negative impact on patient quality of life. Evidence informing ideal evaluation and management of patients with hidradenitis suppurativa is still sparse in many areas, but it has grown substantially in the last decade. Part I of this evidence-based guideline is presented to support health care practitioners as they select optimal management strategies, including diagnostic testing, comorbidity screening, and both complementary and procedural treatment options.

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management.

Hidradenitis suppurativa is a severe and debilitating dermatologic disease. Clinical management is challenging and consists of both medical and surgical approaches, which must often be combined for best outcomes. Therapeutic approaches have evolved rapidly in the last decade and include the use of topical therapies, systemic antibiotics, hormonal therapies, and a wide range of immunomodulating medications.

Urticaria: A comprehensive review: Treatment of chronic urticaria, special populations, and disease outcomes.

Second-generation antihistamines are considered first-line agents in the treatment of chronic urticaria because of their safety and efficacy profile. Some patients require higher doses of H antihistamines alone or in combination with other classes of medications, including H antihistamines, leukotriene receptor antagonists, or first-generation H antihistamines. One major therapeutic advance has been omalizumab, a humanized monoclonal anti-immunoglobulin E that was recently approved by the US Food and Drug Administration for the treatment of chronic urticaria that is unresponsive to H antagonists.

Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up.

Urticaria is a common clinical condition presenting with wheals (hives), angioedema, or both. Urticaria has a complex pathogenesis, along with a high disease burden, a significant impact on quality of life, and high health care costs. The first article in this continuing medical education series covers the definition, classification, epidemiology, diagnosis, and work-up of urticaria, taking into account the recent literature and the best available evidence.

Herpes zoster ophthalmicus with associated vasculopathy causing stroke.

Varicella zoster virus (VZV) is an exclusively human, double-stranded DNA virus. Primary infection causes varicella (chickenpox); later the virus becomes dormant in the dorsal root, cranial nerve, and autonomic ganglia along the entire span of the nervous system, retaining the capacity to reactivate and cause a variety of dermal and neurological complications. Recently there has been increasing recognition, both clinically and epidemiologically, of the relationship between VZV and subsequent strokes.

Trimethoprim-Sulfamethoxazole-Induced Drug Eruption With Eosinophilia and Systemic Symptoms (DRESS).

Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe and potentially life threatening adverse drug reaction. To help identify DRESS, several criteria have been established; however, there is still a lack of consensus on diagnosis, and clinical judgment is paramount. Here we describe a 24-year-old female who presented with a cutaneous eruption, fever, lymphadenopathy, eosinophilia, facial edema, and elevated liver enzymes four and a half weeks after a 10-day course of Trimethoprim/sulfamethoxazole (TMP/SMX).

Topical management and wound care approaches for hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects the follicular unit in apocrine glandbearing skin, resulting in deep-seated nodules, sinus tracts, abscesses, and ultimately scarring. HS is a highly distressing condition, and has one of the highest impacts on quality of life compared to other dermatologic diseases. Various topical therapies have been described that may be used alone or in conjunction with systemic or physical modalities for HS.

Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study.

Prior studies have demonstrated that spironolactone is an effective second-line treatment option for postadolescent acne, but has notable side effects. Data are, however, limited. We therefore present a 4-year retrospective study evaluating 291.