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This survey demonstrates the medical and psychosocial burden of moderate to severe AD in Canadian children. Quality of life, access to care, and disease management are all areas of concern for patients and their families and warrant attention from individual clinicians and the health care system as a whole.

IntroductionAtopic dermatitis (AD) is a recurrent, pruritic inflammatory skin disease with complex immunopathogenesis characterized by a dominant TH2 response. Dupilumab is an interleukin (IL)-4 receptor alpha antagonist that subsequently blocks IL-4 and IL-13 signaling. It has recently been approved for the treatment of adult patients with moderate-to-severe AD whose current treatment options are limited.AimThis article reviews the evidence of clinical efficacy, safety, and patient-reported out-come (PRO) measures from Phase I–III trials of dupilumab in adult patients with moderate-to-severe AD.Evidence reviewResults from clinical trials of dupilumab in adults with moderate-to-severe AD have shown that weekly or biweekly dupilumab injections significantly improve clinical and PROs. Transcriptome and serum analyses also found that dupilumab significantly modulates the AD molecular signature and other TH2-associated biomarkers, compared with placebo. Additionally, concomitant use of dupilumab with topical corticosteroids (TCS) results in a greater improvement in signs and symptoms of AD than with dupilumab use alone. Throughout the trials, common adverse events were headaches, conjunctivitis, and injection site reactions. These were consistently mild–moderate and occurred with similar frequency between the treatment and placebo groups.Place in therapyIn adult patients with moderate-to-severe refractory AD, monotherapy or concomitant use of dupilumab with TCS holds great promise to significantly improve clinical outcomes and quality of life of the patient. Ongoing studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use. Finally, further economic evidence is warranted to compare the long-term costs and benefits of dupilumab with other currently available treatments for moderate-to-severe AD.

Objective The aim of the study was to summarize and review the evidence for the efficacy and safety of adipose-derived stem cells (ADSCs) and platelet-rich plasma (PRP) for the treatment of vulvar lichen sclerosus (LS). Materials and Methods PubMed/MEDLINE, Ovid, Web of Science, and clinicaltrials.gov were searched from inception up to May 7, 2018. Results Seven observational studies were identified, with a total of 98 patients. Both ADSCs and PRP were reported to improve symptoms, quality of life measures, as well as clinical and histological signs of vulvar LS. There is a strong risk of biased estimates of treatment effect. Conclusions Current evidence is weak for ADSCs and/or PRP as treatment for vulvar LS. Further research is needed before recommending this therapy.

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