1.
Treatment of severe psoriasis in children: recommendations of an Italian expert group.
Fortina, AB, Bardazzi, F, Berti, S, Carnevale, C, Di Lernia, V, El Hachem, M, Neri, I, Gelmetti, CM, Lora, V, Mazzatenta, C, et al
European journal of pediatrics. 2017;(10):1339-1354
Abstract
UNLABELLED This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. CONCLUSION A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up-to-date review of the literature and experts' opinions.
2.
Isotretinoin and mental health in adolescents: Australian consensus.
Rowe, C, Spelman, L, Oziemski, M, Ryan, A, Manoharan, S, Wilson, P, Daubney, M, Scott, J
The Australasian journal of dermatology. 2014;(2):162-7
Abstract
Acne is a common condition among adolescents and has the potential to negatively impact on the psychological well-being of those who suffer from it. In particular, depression and suicidal ideation are more common in adolescents with acne. Successful treatment of acne can improve the quality of life and reduce levels of anxiety and depression in these individuals. The current treatment of choice for severe or refractive acne is isotretinoin, a retinoid. While the possible causal association between isotretinoin and mental illness remains a controversial topic, a recent systematic review has presented evidence to support this relationship. In light of this evidence, a group of dermatologists and psychiatrists have collaborated to develop these recommendations to aid the safe prescribing of isotretinoin in adolescents. These clinical suggestions are aimed at practitioners in both disciplines to increase awareness of the current evidence in support of the association between isotretinoin and adolescent depression.
3.
Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches.
Sidbury, R, Tom, WL, Bergman, JN, Cooper, KD, Silverman, RA, Berger, TG, Chamlin, SL, Cohen, DE, Cordoro, KM, Davis, DM, et al
Journal of the American Academy of Dermatology. 2014;(6):1218-33
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Abstract
Atopic dermatitis is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on use are given based on available evidence.
4.
Native hyaluronic acid in dermatology--results of an expert meeting.
Wiest, L, Kerscher, M
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG. 2008;(3):176-80
Abstract
The glycosaminoglycan hyaluronic acid (HA) is a major component of the extracellular matrix of the skin and plays an important role in the metabolism of the dermis.HA is responsible for hydration,nutrient exchange and protects against free radical damage;via signaling pathways it is also involved in biologic processes like cell differentiation and motility. Native HA has been employed for several years to help the skin to regain elasticity,turgor and moisture. In a clinical study an increase in elasticity and turgor following repeated injections with HA could be demonstrated, but this treatment approach is discussed controversially. An expert conference took place to find a consensus regarding use, aims of treatment, indications and limitations of this therapy. The decisions of the expert meeting are presented in this report.