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Histopathologic approach to epidermotropic lymphocytic infiltrates.
Authors: Raghavan SS, Kim J Abstract Mycosis fungoides is the most common and therefore quintessential cutaneous lymphoma and is typically characterized by an epidermotropic infiltrate of atypical monoclonal CD4+ lymphocytes. Classical histopathologic findings include epidermotropism, lymphocytes with convoluted nuclear contours and surrounding perinuclear "halos," and papillary dermal fibrosis. Atypical lymphocytes may occasionally form Pautrier's microabscesses with tagging of lymphocytes along the basal keratinocytes. Unfortunately, a variety of benign inflammatory infiltrates, as well as other cutaneou...
Source: Seminars in Cutaneous Medicine and Surgery - May 4, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Approach to dermal-based lymphoid infiltrates and proliferations.
Authors: Charli-Joseph Y, Toussaint-Claire S, Lome-Maldonado C, Montante-Montes de Oca D, Ortiz-Hidalgo C Abstract The histopathological diagnosis of dermal-based lymphoid infiltrates and proliferations is often challenging due to the vast list of biologically diverse entities that archetypally or occasionally center in the mid-dermis, especially because significant overlap exists in their clinical, histopathologic, and immunophenotypic features. The differential diagnosis includes reactive infiltrates in common and rare inflammatory dermatoses, benign conditions that may mimic lymphoid neoplasms (pseudoly...
Source: Seminars in Cutaneous Medicine and Surgery - May 4, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Maximizing the clinical utility of descriptive lymphoid pathology reporting.
This article explores the use of descriptive (inexact) reporting as it applies to cutaneous lymphoma and its differential diagnosis. A collection of practical descriptive diagnostic categories that will be of use to both dermatologists and dermatopathologists is included. PMID: 29719023 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - May 4, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Molecular advances in cutaneous T-cell lymphoma.
Authors: Bastidas Torres AN, Najidh S, Tensen CP, Vermeer MH Abstract Cutaneous T-cell lymphoma (CTCL) is a group of malignancies derived from skin-homing T cells. Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common CTCL variants. In recent years, the genetic landscape of SS/MF has been characterized using genome-wide nextgeneration sequencing approaches. These studies have revealed that genes subjected to oncogenic mutations take part in cell cycle regulation, chromatin modification, Janus kinase (JAK)-signal transducer and activator of transcription protein (STAT) signaling, T-cell recep...
Source: Seminars in Cutaneous Medicine and Surgery - May 4, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

The Disease Burden of Atopic Dermatitis.
Authors: Eichenfield LF, Stein Gold LF Abstract Recent studies have shed light on the nature of the burden of atopic dermatitis. Analysis of observational data has revealed the effect of atopic dermatitis in diverse areas such as work productivity, physical activity, mood, and risk of comorbidities beyond other atopic conditions. Studies on adults with moderate to severe disease show that the symptoms and consequences of atopic dermatitis affect many aspects of their lives. A clearer understanding of the burden for patients can inform open, sensitive discussions about goals of therapy. Semin Cutan Med Surg...
Source: Seminars in Cutaneous Medicine and Surgery - April 19, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Food Allergy and Atopic Dermatitis: Fellow Travelers or Triggers?
Authors: Tom WL Abstract Many children with atopic dermatitis also have an allergy to one or more foods, but the presence of these two conditions in an individual does not necessarily indicate a causal link between them. Testing and interpretation, sometimes with specialist consultation, may be required to discern whether food allergy is present in a child with atopic dermatitis and-if it is present-whether the food is triggering or exacerbating signs and symptoms of atopic dermatitis. Recent milestone trials have demonstrated that early introduction of peanuts can reduce the development of peanut allergy ...
Source: Seminars in Cutaneous Medicine and Surgery - April 19, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Topical Therapy for Atopic Dermatitis: New and Investigational Agents.
Authors: Stein Gold LF, Eichenfield LF Abstract Recently a new class of topical medications for mild to moderate atopic dermatitis has been introduced with US Food and Drug Administration (FDA) approval of the first new prescription medication for this condition in more than a decade. Crisaborole, the newly approved medication, has relieved pruritus in more than one-third of patients within as little as 48 hours. It also has demonstrated efficacy in patients with skin of color. Topical therapies representing other new approaches to atopic dermatitis, with novel mechanisms of action, have shown promise in c...
Source: Seminars in Cutaneous Medicine and Surgery - April 19, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Systemic Therapy of Atopic Dermatitis: Welcome to the Revolution.
Authors: Eichenfield LF, Stein Gold LF Abstract Until recently, systemic therapy of atopic dermatitis was limited to off-label use of immunomodulators, which can pose significant safety concerns, and treatment with systemic corticosteroids, not recommended in the most recent guidelines. The introduction of dupilumab in 2017 marked a major advance in systemic therapy for atopic dermatitis. It has demonstrated long-term efficacy in adults with moderate to severe disease, and is being studied in children. Several other biologic agents and "small molecules" with varying mechanisms of action are in phase 2 or 3...
Source: Seminars in Cutaneous Medicine and Surgery - April 19, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Improving Outcomes Through Therapeutic Patient Education.
Authors: Stein Gold LF, Eichenfield LF Abstract Therapeutic patient education is a nascent movement in the care of atopic dermatitis, offering patients-and, for children, their caregivers-knowledge, skills, support, and coping strategies for managing what for many is a relapsing/ remitting chronic disease that severely compromises quality of life. Interventions range from a written treatment plan provided in the office to a 6-week education program. Studies indicate that this approach yields benefits for patients and their caregivers. Most of these studies involved children and their parents or other careg...
Source: Seminars in Cutaneous Medicine and Surgery - April 19, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Introduction.
Authors: Eichenfield LF PMID: 29659641 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - April 18, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Introduction.
Authors: Menter AM PMID: 29614135 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - April 5, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

The Evolving Landscape of Psoriasis Treatment.
Authors: Armstrong AW, Gordon KB, Menter MA, Wu JJ Abstract The process of discovering new drugs for plaque psoriasis has revealed much about the multisystemic nature of the disease. Current and emerging biologic agents may reliably achieve a Psoriasis Area and Severity Index (PASI 75) up to 90. Initially, clinicians select therapies based on the severity of the psoriasis. Although mild disease can be treated with topical agents, for patients with moderate to severe disease, concurrent therapy with oral systemic agents, biologics, and/ or phototherapy needs to be considered. In some instances, clinicians m...
Source: Seminars in Cutaneous Medicine and Surgery - April 5, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Treating to Target-A Realistic Goal in Psoriasis?
Authors: Gordon KB, Armstrong AW, Menter MA, Wu JJ Abstract For many patients, the new biologic therapies for psoriasis can improve Psoriasis Area and Severity Index (PASI) scores in a relatively short time. But when results are less than optimal, patients often become frustrated. By providing effective medical treatment using a treat-to-target strategy, clinicians can relieve symptoms and halt disease progression. Although body surface area (BSA) and PASI scores are appropriate for analyzing results of clinical trials, clinicians need to use more patient-centered assessments of patients' progress such as ...
Source: Seminars in Cutaneous Medicine and Surgery - April 5, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Common and Not-So-Common Comorbidities of Psoriasis.
Authors: Menter MA, Armstrong AW, Gordon KB, Wu JJ Abstract Plaque psoriasis is increasingly recognized as a multisystemic disease whose most common comorbidities include psoriatic arthritis, cardiovascular disease, metabolic syndrome, overweight/obesity, inflammatory bowel disease, and depression. The presence of such comorbidities affects the therapeutic choices for clinicians. Patients often visit dermatologists more frequently than they do other clinicians, so it is incumbent upon dermatologists to recognize and address early signs of psoriatic comorbidities to prevent further deterioration and improve...
Source: Seminars in Cutaneous Medicine and Surgery - April 5, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Practical Strategies for Optimizing Management of Psoriasis.
Authors: Wu JJ, Armstrong AW, Gordon KB, Menter MA Abstract Approximately 30% of patients with moderate plaque psoriasis and 20% of those with severe psoriasis have inadequate disease control with their current therapeutic regimens. Among the factors that affect treatment efficacy are drug selection and lack of patient adherence to treatment, which is often due to patient frustration that psoriasis is a chronic, multisystemic, and incurable disease. By forming a strong therapeutic alliance with patients and by asking them about their expectations for treatment, clinicians have a better chance of providing ...
Source: Seminars in Cutaneous Medicine and Surgery - April 5, 2018 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research