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New insights into infectious skin diseases
Infectious skin diseases are very common and have been at the centre of clinical interest in recent years. The potential for the newly emerged coronavirus to induce a great heterogeneity of skin manifestations and complex interactions with the skin was surprising. Skin manifestations of COVID-19 infection can be grouped into five main morphological patterns, with different timing throughout the disease course and a different relationship to disease severity. Some of these underlying pathophysiological mechanisms and clinical manifestations have not previously been observed in other viral diseases. Variability of skin presentations has also been observed to be in relation to a patients’ age, comorbidities and some genetic factors. In addition, vaccines against COVID-19 infection can cause a subset of local or generalised skin reactions, similar to those in mild or moderate COVID-19 infection, even in the absence of the intact virus. There are also numerous reports of many immune-mediated skin diseases worsening during the infection or after vaccination.
Skin infections in response to other well known old pathogens, remain a challenge, due to changing epidemiology, different clinical characteristics and increasing treatment resistance. For example, resistance of dermatophytes to antifungal drugs, increasing treatment resistance of staphylococci and some other bacteria, as well as reports on scabies treatment resistance, have become a concern.
With a lack of novel treatment possibilities, multidrug-resistant species in skin infections pose a significant global threat. A rational treatment approach in bacterial, fungal and parasitic skin infections with updated treatment recommendations are therefore of great importance, along with appropriate preventive measures.
News and trends in Dermatology-oncology
After numerous years with only incremental changes in how we treat skin cancer patients, the last year has seen several exciting new molecules and strategies! Among them Relatlimab, Tebentafusp, Lifileucel, Lenvatinib just for melanoma treatment alone. New treatment options for other skin cancers have emerged, including the PD-1 antibody Cemiplimab, now approved for 2nd-line BCC treatment, whilst Tirbanibulin emerges as a new treatment option for actinic keratosis. The trend and goal in dermato-oncology seems obvious: effective precision medicine, but how far have we come in 2022? Find out during this informative overview presenting consistent data.
Will JAK inhibitors fulfill the expectations of patients with alopecia areata?
The treatment of alopecia areata is a significant challenge. JAK inhibitors may develop into a first group of drugs dedicated to the treatment of patients of alopecia areata.
These new developments are observed with great enthusiasm and excitement by doctors and patients alike, however new FDA warnings raise some concerns. In this presentation we analyse the possible future advantages and safety measures associated with treating alopecia areata with JAK inhibitors.
New tools for self-examination
Recommended by many medical associations and cancer agencies, skin self-examination is one of the most powerful strategies for secondary prevention in melanoma and non-melanoma skin cancer. Multiple efforts have gone into promoting self-examination, not only to high-risk patients but also to the general population for the secondary prevention of skin cancer. Recently, several mobile apps have been developed to enhance skin self-examination and improve their performance. A randomized control trial which analyzed if tele-dermatoscopy is an added benefit to naked-eye skin self-examination, showed the value of the app in promoting it but not a specific benefit. Clearly, further efforts are needed to improve skin self-examination in different populations.
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