No abstract

A total of 10 patients were recruited to evaluate the efficacy and safety of abrocitinib for lichen sclerosus. All patients reported rapid control of pruritus at week 2 and achieved Investigator's Global Assessment 0 or 1 at week 12. This study suggests that the abrocitinib could be an effective and safe treatment option for LS, based on the significant improvements in investigator evaluation, patientreported outcomes, and skin imaging findings.

We found that overall 0.7% of patients were positive to this allergen with a relevance rate of 45%. However, internationally positivity rates are decreasing; falling from 0.78% from 1980 to 2009 to just 0.03% from 2010 to 2018 at a tertiary patch test centre in the United Kingdom. 9 We found 31 positive and eleven relevant reactions to dodecyl gallate. Dodecyl gallate, the ester of dodecanol and gallic acid, is an antioxidant and preservative in foods and cosmetics. In our patients, reactions were caused by cosmetics, handling cooking oils and margarine and ingested food. Gallates are often excluded from baseline series because of difficulty ascertaining relevance. However, gallate reactions may be rising and our results suggest that ongoing surveillance is needed and future consideration of inclusion in the ABS if local data confirm increased positivity and relevance rates. 10 Several ABS allergens are not included in our local baseline series. This is a limitation of our study as they were not tested in consecutive patients as the local standard series used over the study period differ from the ABS. For example, methylisothiazolinone was positive in 13.5% of patients tested, but only 1.3% of all patients presenting for patch testing overall because only 155 patients were tested to MI.In conclusion, we report the performance of ABS allergens in detecting positive and relevant reactions in a population undergoing patch testing in Sydney. The ABS detected 72.9% of relevant reactions. Missed allergens included fragrances and dodecyl gallate. The two clinics at Darlinghurst and Westmead have since adopted the ABS and unified their supplementary allergen series.

Acute generalized exanthematous pustulosis is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base. Most cases of acute generalized exanthematous pustulosis (AGEP) clear quickly with a systemic corticosteroid, but severe or recalcitrant cases may need other systemic therapies. In this case, a man in his 40 s with a history of psoriasis consulted a physician about widespread erythema, pustules, target lesions, and fever after the administration of a quadruple antituberculosis drug. Routine laboratory testing revealed elevated white blood cell count and C-reactive protein. The histopathology showed subcorneal pustules, spongiosis as well as lymphocyte and eosinophils infiltration in the dermis. The patient was diagnosed with definitive AGEP according to the diagnostic score from the EuroSCAR study. Cutaneous lesions especially pustules and erythema multiforme-like lesions on the upper arms and palms are crucial for distinguishing AGEP from Generalized pustular psoriasis. The patient was treated with secukinumab as a result of his failure to respond to topical corticosteroids and constrain of systemic steroids. Remission with secukinumab therapy was safe without increased risks of infections. This case indicates that secukinumab is a potential therapy that can rapidly improve the clinical symptoms of AGEP.

No abstract