Patients with AS were previously found to have increased intestinal permeability using the 51Cr-EDTA resorption test. In order to discover whether this alteration has taken place prior to, or as a consequence of the disease, we studied the intestinal permeability to 51Cr-EDTA in 20 patients with AS, 65 of their healthy relatives, and 25 normal volunteers. We also considered the HLA B27 antigen, the serum immunoglobulin A levels, the disease activity, the existence of peripheral arthritis, the ESR, the CRP values and the intake of drugs at the time of study. Gut permeability was found to have increased in the patients and their healthy relatives compared to the control group. No difference in gut permeability was found between patients and relatives regardless of whether they had the HLA B27 antigen or not. The increased intestinal permeability in the patients had no relation to the disease activity, to the presence of peripheral arthritis or to the intake of NSAIDs. Gut permeability was shown to bear no relation to IgA levels, ESR or CRP. Our findings suggest that the increase in gut permeability in AS patients and their relatives is a primary defect and may be an aetiologic factor in this disease.

Rheumatic diseases are extensively managed with biological disease-modifying antirheumatic drugs (bDMARDs), but a notable proportion of patients withdraw in the long term because of lack of effectiveness, adverse events, or the patient’s decision. The present real-world analysis showed the effectiveness, retention, and safety data collected in the Spanish BIOBADASER registry for patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA, including ankylosing spondylitis (AS) and non-radiographic axSpA) treated with secukinumab, a human antibody against interleukin-17A (IL-17A), for more than 12 months. Six hundred and thirty-nine patients were analysed (350, 262, and 27 PsA, AS, and nr-axSpA patients, respectively). The results showed an improvement in the disease activity after 1 year of treatment, in terms of decreases of the mean Disease Activity Score 28 using C-reactive protein (DAS28-CRP), the mean Disease Activity Psoriatic Arthritis (DAPSA) score, swollen joint counts (SJC), and tender joint counts (TJC) in PsA patients and decreases in the mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the mean Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA patients. This improvement was maintained or increased after 2 and 3 years of treatment, indicating that secukinumab is effective in both naïve and non-responder patients. Retention rates were higher when secukinumab was used as the first-line biological treatment, although they were also adequate in the second and third lines of treatment. Collected safety data were consistent with previous reports. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-022-00446-9.

RA patients treated with TCZ show lower plasma concentrations of Lp(a) compared with patients without BT.

BackgroundChronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload.Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated.Method/designRandomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable.The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up.The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations.The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder.Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat.DiscussionThe study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions.Trial registrationThis study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.

in all cases, indicating the difficulty in identifying these lesions clinically. In fact, there was a report of a 12-year-old with ectopic sebaceous glands on the penis, which were clinically similar to ours, but histologically, the lesions demonstrated epidermal hyperplasia rather than sebaceous gland hyperplasia. 6 Clinically, SH of the penile shaft should be differentiated from pearly penile papules, molluscum contagiosum, Bowenoid papulosis, genital warts and lichen nitidus. Pearly penile papules are arranged in rows and are usually localized at the coronal edge. In our case, the papules were irregularly distributed and not confined to the coronal edge. Bowenoid papulosis and genital warts are multiform in size and shape and grow substantially with time, whereas in our case, the papules were uniform and showed minimal change over time. The individual lesions in lichen nitidus are white, glistening and flat, which is distinct from the yellowish, dome-shaped papules of SH.Histologically, the differential diagnoses include ectopic sebaceous glands, naevus sebaceous, sebaceous adenoma and sebaceous epithelioma. Although there is no universally accepted definition of SH, Wick et al . 1 defined SH by the presence of ≥ 4 sebaceous lobules attached to an infundibulum of a pilosebaceous unit. The cells comprising the lobules are fully mature with a thin rim of basaloid cells present at the periphery. It must be distinguished from ectopic sebaceous glands, where a group of small, mature sebaceous lobules are situated around a small sebaceous duct without an attached follicle. Naevus sebaceous differs from SH by the presence of hamartomatous pilosebaceous units, papillomatous epidermal hyperplasia and frequent apocrine elements. Sebaceous adenoma and sebaceous epithelioma commonly show multilayers of undifferentiated basaloid cells in the periphery. 1 In conclusion, our case suggests that SH should be considered in the differential diagnosis of a patient with tiny papular lesions on the penis. It is important to reassure the patient that this condition is not infectious. There is no need to pursue treatment other than for cosmetic reasons. References1 Wick MR, Swanson PE, Barnhill RL. Sebaceous and pilar tumors. In: Crowson AN, Barnhill RL, eds. Textbook of Dermatopathology , 2nd edn. The McGraw-Hill, New York, 2004: 709-715. 2 Hyman AB, Brownstein MH. Tyson's 'glands'. Ectopic sebaceous glands and papillomatosis penis. Arch Dermatol 1969; 99 : 31-36. 3 Vergara G, Belinchón I, Sivestre JF, Albares MP, Pascual JC. Linear sebaceous gland hyperplasia of the penis: a case report. J Am Acad Dermatol 2003; 48 : 149-150. 4 Kumar A, Kossard S. Band-like sebaceous hyperplasia over the penis. Australas J Dermatol 1999; 40 : 47-48. 5 Carson HJ, Massa M, Reddy V. Sebaceous gland hyperplasia of the penis.