Background: The treatment guidelines for hidradenitis suppurativa (HS) vary among different countries, and several biologics and small molecule inhibitors have been tested for treating moderate-to-severe HS over the past few years. However, treatment guidelines for HS vary among different countries. Methods: A systematic review and meta-analysis was performed to exam the efficacy and serious adverse events (SAEs) of biologics and small-molecule inhibitors in treating moderate-to-severe HS. Binary outcomes were presented as risk ratio (RR) with 95% confidence interval (CI). Results: We included 16 RCTs with a total of 2076 participants on nine biologics and three small-molecule inhibitors for treating moderate-to-severe HS, including adalimumab, anakinra, apremilast, avacopan, bimekizumab, CJM112, etanercept, guselkumab, IFX-1, INCB054707, infliximab, and MABp1. The meta-analysis revealed only adalimumab (RR 1.77, 95% CI, 1.44–2.17) and bimekizumab (RR 2.25, 95% CI, 1.03–4.92) achieved significant improvement on hidradenitis suppurativa clinical response (HiSCR), and adalimumab was superior to placebo in achieving dermatology life quality index (DLQI) 0/1 (RR 3.97; 95% CI, 1.70–9.28). No increase in SAEs was found for all included active treatments when compared with placebo. Conclusions: Adalimumab and bimekizumab are the only two biologics effective in achieving HiSCR with acceptable safety profile, whereas adalimumab is the only biologic effective in achieving DLQI 0/1.

Background and Objectives: To compare the efficacy and safety of biologic treatments for moderate-to-severe pediatric psoriasis approved by the US Food and Drug Administration and European Medicines Agency.Patients and Methods: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for relevant randomized controlled trials (RCTs) were searched for the identification of eligible RCTs until May 7, 2021. Fixed-effect frequentist network meta-analysis (NMA) was performed with the surface under the cumulative ranking curve (SUCRA) calculated for ranking. Our primary outcomes included ≥ 90 % improvement of Psoriasis Area and Severity Index score (PASI 90) at 12-16 weeks and discontinuation owing to adverse events (DAE) through the first 12-16 weeks.Results: Five RCTs involving 798 pediatric psoriasis patients were included. Compared to placebo, all biologic regimens exhibited a significantly higher PASI 90 response but did not differ in the risk for DAE. Based on the SUCRA, secukinumab-low dose (SEC-L) ranked first in the achieved PASI 90 response (84.7 %), followed by ixekizumab (70.8 %).Conclusions: Among all biologic treatments, SEC-L showed the best PASI 90 response without increasing the risk for DAE. More long-term studies are warranted.

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Z.Z.N.Y. was a member of the guideline development group for the British Association of Dermatologists guidelines for biological therapy for psoriasis; he was not involved in the critical appraisal of the guideline he coauthored. C.F. is a section editor while C.-C.C. and Z.Z.N.Y. are associate editors of the British Journal of Dermatology. The remaining authors declare they have no conflicts of interest. Data availability statement:The data that support the findings of this study are available in Appendix S1 and S2 (see Supporting Information).

With the increased radiological investigations applied to lung cancer screening, a growing number of small pulmonary nodules that should undergo biopsy or surgical removal are being identified. Accurate lesion localization is a key prerequisite for successful excision. Unfortunately, repeated pleural punctures in patients with multiple pulmonary nodules (MPNs) may significantly increase the risk of pneumothorax. To illustrate the role and limitations of current techniques for simultaneous localization of MPNs, we searched PubMed, Embase, and the Chinese Electronic Periodical Services for published articles from January 2000 to February 2022. A total of eight references were selected for this systematic review. Compared with techniques for localizing single pulmonary nodules (SPNs), localization of MPNs required a longer procedural time (14−56 min) and demonstrated lower success rates (83.5%−100%). The rates of pneumothorax were markedly higher in patients with MPNs (up to 57.9%) than in those with SPNs (12.7%−32.5%). Various localization methods have been proposed to deal with MPNs, including hook wire, microcoils, and dye localization. Failures most commonly occurred after localization of the first nodule, and the main causes (i.e., hook wire dislodgement, dye diffusion, patient repositioning, or pneumothorax) differed according to the localization technique. Novel approaches – including simultaneous multiple needle insertion and the use of hybrid operating room – hold promise for reducing complications rates and procedural times. Collectively, preoperative percutaneous localization of ipsilateral MPNs is safe and feasible, but future technological innovations are needed in order to enhance localization safety and accuracy.