Impact of Parallel Topical Treatment with Nadifloxacin and Adapalene on Acne Vulgaris Severity and Quality of Life: A Prospective, Uncontrolled, Multicentric, Noninterventional Study

<b><i>Introduction:</i></b> Daily parallel application of adapalene and nadifloxacin has been determined to be effective and well tolerated in patients with acne vulgaris in randomized, controlled clinical studies. Here, the authors report the results from a large, prospective, uncontrolled, multicentric, noninterventional study under real-life conditions in Germany. The effect of treatment on acne severity, safety, and, for the first time, health-related quality of life (HRQoL) was investigated. <b><i>Methods:</i></b> Of the 292 patients (safety collective: 231 adults, 61 adolescents) who had at least grade 4 acne vulgaris on the face as per the Leeds Revised Acne Grading (LRAG), 273 (efficacy collective: 213 adults, 60 adolescents) were treated with adapalene 0.1% cream or gel and nadifloxacin 1% cream for the defined minimum of 28 days. Patients were evaluated for acne severity, acne-related facial symptoms, HRQoL, overall assessment of therapy, and safety. <b><i>Results:</i></b> After the median treatment duration of 37 and 38 days (adults and adolescents, respectively), 93.4% and 85.0% of adults and adolescents, respectively, exhibited a sustained decrease in acne severity. The LRAG decreased by at least 3 scores in 29.1% and 24.6% of female and male adults, respectively. HRQoL improved in 67.9% and 63.5% of adults and adolescents, respectively (median improvement in the Dermatology Life Quality Index scores per patient of 3.0 [female adults], 1.0 [male adults], and 2.0 for all adolescents in the Children’s Dermatology Life Quality Index). Female adults were more impaired in terms of HRQoL compared to male adults. The 2 best overall efficacy ratings were provided by physicians in 79.3% and 69.5% and by patients in 68.5% and 58.3% of adult and adolescent cases, respectively. The treatment was well tolerated, as reflected in the low number of 9 mild adverse events (AEs), all of which resolved without treatment. However, 4 patients terminated the study prematurely due to AEs. <b><i>Conclusion:</i></b> In this study, the parallel use of adapalene and nadifloxacin for at least 5 weeks resulted in a rapid improvement in acne severity, an increase in HRQoL, and a good safety profile. Therefore, it represents a promising treatment option that offers the possibility of flexible therapy adjustment.

Therapeutic Impact and Management of Persistent Head and Neck Atopic Dermatitis in Dupilumab-Treated Patients

<b><i>Background:</i></b> Localization of atopic dermatitis (AD) in exposed areas such as the hands, head, and neck has been considered as a negative factor impacting on dupilumab response, although a comparison of exposed versus unexposed areas is not currently available. <b><i>Objectives:</i></b> The aim of this study is to evaluate the clinical response to dupilumab depending on the presence or persistency of AD skin manifestations in specific body areas. <b><i>Methods:</i></b> The study retrospectively collected clinical and demographic data of adult patients affected by moderate to severe AD. Based on the anatomical sites involved, 5 subcohorts of patients were identified. <b><i>Results:</i></b> A total of 41 patients were included in the study. Disease amelioration was detected during the study period, although baseline head/neck and hand localization was associated with a significantly lower likelihood of achieving an Eczema Area Severity Index (EASI) ≤1. In addition, patients with head/neck persistency showed a significantly lower response when compared to patients without persistency of head/neck AD in terms of both mean EASI and Dermatology Life Quality Index (DLQI) reduction. <b><i>Conclusion:</i></b> AD localization in exposed areas at the baseline and AD persistency at the head/neck may have a negative impact on certain treatment response parameters to dupilumab therapy.

Pustulosis palmoplantaris: Langfriste Kontrolle im Blick

Im Rahmen der sog. 2PRECISE-Studie, einer multizentrischen, randomisierten, doppelblinden Phase 3b Parallel-Studie, wurden Patienten mit mittelschwerer bis schwerer PPP (palmoplantarer Psoriasis Area and Severity Index (PPPASI) ≥12 und Dermatology Life Quality Index (DLQI) ≥10) über 52 Wochen mit Secukinumab bzw. Placebo behandelt. Der primäre Endpunkt der Studie war die Bestimmung der Rate der Patienten mit einem ppPASI75 unter Therapie mit Secukinumab in Woche 16 gegenüber Placebo. Es wurde ein Signifikanzlevel von 2,5% zugrunde gelegt. 79 Patienten erhielten Secukinumab in einer Dosierung von 300mg und 80 Patienten wurden mittels Secukinumab 150mg behandelt. 78 Patienten wurden der Placebo-Gruppe zugeordnet. Ab Woche 16 erhielten 27 Patienten aus der Placebo-Gruppe 150mg Secukinumab und 28 Patienten 300mg Secukinumab. 10 Patienten hatten auf Placebo angesprochen. In Woche 16 erreichten 26,6% der mit 300mg Secukinumab behandelten Patienten und 17,5% der Patienten unter 150mg Secukinumab einen ppPASI75 im Vergleich zu 14,1% der mit Placebo behandelten Patienten (P = 0,0411). Der primäre Endpunkt wurde nicht erreicht, jedoch ergab sich eine Odds Ratio (OR) von 2,62 (95% Konfidenzintervall, 1,04–6,60) zugunsten von 300mg Secukinumab gegenüber Placebo. In Woche 52 wiesen 41,8% der mit 300mg Secukinumab behandelten Patienten und 35,0% der Patienten unter Secukinumab 150mg einen ppPASI75 auf. Das klinische Ansprechen der Patienten, die auch unter einer Plaque Psoriasis litten, war besser als das der Patienten mit einer reinen PPP. Die Lebensqualitätsverbesserung gemessen mit dem DLQI war unter 300mg Secukinumab deutlich besser als unter Placebo. In Woche 16 erreichten 13% der Patienten unter Secukinumab 300mg einen DLQI von 0 oder 1, während es unter Placebo nur 4,3% der Patienten waren. Es wurden in der Studie keine unerwarteten unerwünschten Ereignisse beobachtet.

The impact of superficial dermatophytosis on quality of life: A cross-sectional observational study

: The Indian dermatologists are witnessing an epidemic of sorts when it comes to superficial dermatophytosis cases in the last decade. At the receiving end of this epidemic are the patients who are suffering due to impaired quality of life. We tried to assess the impact of tinea on quality of life (QoL) of the patients.: To assess the impact of superficial dermatosis on quality of life using the Dermatology Life Quality Index (DLQI) questionnaire.: Cross-sectional, Observational study.: All patients between the age group of 18 to 70 years presenting with superficial dermatophytosis of more than 3 weeks duration were included after confirming the diagnosis with KOH mount. The patients filled in the DLQI after which scores were calculated and the effect on QoL was assessed. : Out of the 170 patients included in the study, majority of them (77, 45.3%) felt that tinea had a very large effect on their QoL and a very few patients (7, 4.1%) felt that tinea had a small effect on their QoL. Out of the 36 (21.2%) patients who felt that their condition had an extremely large effect on their QoL, majority of the patients had tinea corporis et cruris et faciei.: Superficial dermatophytosis has a very large effect on the Quality of Life of the patients and it impacts their lives adversely leading to psychological, social and financial problems.

Dermatology life quality index in patients of acne vulgaris presenting to a tertiary care hospital: an observational study

<p class="abstract"><strong>Background: </strong>Acne vulgaris is a common, chronic disorder resulting from the inflammation of pilosebaceous unit, present with clinically various forms. It is usually prevalent in adolescent may persist in adulthood. This study was conducted to evaluate the quality of life (QoL) in patients suffering from acne vulgaris.</p><p class="abstract"><strong>Methods:</strong> Hospital based cross sectional study was conducted in 60 patients. Dermatology life quality index (DLQI) questionnaire was used to observe the effect of acne among patients.</p><p class="abstract"><strong>Results: </strong>Total numbers of patients enrolled were 60 (43 females,17 males). The mean age was 24.85±5.63 years. Maximum patients were of the age group 26-30 years (22 patients; 36%) and least were of 31-36 age group. Out of 60 patients, 29 patients had grade II acne followed by 20 with grade I acne, grade III acne was present in 11 patients. Most of the patients 31 (52%) were having “moderate impact” on quality of life followed by 23 (38%) with “small impact” on QOL. There was a significant positive correlation between grade of acne and DLQI (Pearson correlation=0.753, p=0.00).</p><p class="abstract"><strong>Conclusions: </strong>Our study showed significant impairment of QoL in acne patients. DLQI increases with increase in severity of acne. Treatment of acne should not be guided only by the clinical grade of acne, but take into consideration the psychosocial impact the condition has on the patient. Adequate counselling along with early treatment of acne vulgaris is essential in order to reduce the disease related psychosocial sequelae and increase treatment efficacy.</p>