​Author(s): Ahad T.; Riley A.; Martindale E.; von Bremen B.; Owen C.
Source: Pediatric Dermatology; 2018; vol. 35 (no. 1)
Publication Date: 2018
Publication Type(s): Article
PubMedID: 29159956
Available  at Pediatric Dermatology -  from Wiley Online Library Medicine and Nursing Collection 2018 - NHS
Abstract:Vulvar swelling is a rare manifestation of metastatic Crohn's disease in children. It often predates gastrointestinal symptoms and can be the first presentation of pediatric Crohn's disease. We report three cases of pediatric Crohn's disease presenting with vulvar swelling. We discuss this rare presentation and its treatment and highlight the importance of recognizing it so that prompt investigation and appropriate management can be initiated.Copyright © 2017 Wiley Periodicals, Inc.
Database: EMBASE

Author(s): Tian T.M.; Daly B.M.; Owen C.M.
Source: BMJ (Online); 2018; vol. 361
Publication Date: 2018
Publication Type(s): Note
Available  at BMJ   
Database: EMBASE

​Author(s): Ismail D.; Owen C.M.
Source: British Journal of Dermatology; Jul 2018; vol. 179 ; p. 159-160
Publication Date: Jul 2018
Publication Type(s): Conference Abstract
Abstract:Lichen sclerosus (LS) is a chronic inflammatory dermatosis predominantly affecting the anogenital region in prepubertal girls and postmenopausal women. The underlying cause is not fully known, although many aetiological factors have been implicated. It has an estimated prevalence of 1 in 900 girls (Powell J, Wojnarowska F. Childhood lichen sclerosus: an increasingly common problem. J Am Acad Dermatol 2001; 44: 803-6) and typical clinical features include white atrophic plaques, erosions, fissures and ecchymoses in the anogenital region. 

​Author(s): Jabbar-Lopez Z.K.; Smith C.H.; Yiu Z.Z.N.; Warren R.B.; Ward V.; Exton L.S.; Mohd Mustapa M.F.; Samarasekera E.; Burden A.D.; Murphy R.; Owen C.M.; Parslew R.; Venning V.
Source: Journal of Investigative Dermatology; Dec 2017; vol. 137 (no. 12); p. 2644-2646
Publication Date: Dec 2017
Publication Type(s): Article
Database: EMBASE
 

Author(s): Smith C.H.; Jabbar-Lopez Z.K.; Peleva E.; MacMahon E.; Nelson-Piercy C.; Yiu Z.Z.; Warren R.B.; Bale T.; Burden A.D.; Coates L.C.; Cruickshank M.; Pottinger E.; Samarasekera E.J.; Hadoke T.; Strudwicke C.; Murphy R.; Owen C.M.; Parslew R.; Stoddart J.; Venning V.A.; Exton L.S.; Mohd Mustapa M.F.

Source: British Journal of Dermatology; Sep 2017; vol. 177 (no. 3); p. 628-636
Publication Date: Sep 2017

Publication Type(s): Article
​
Available  at British Journal of Dermatology -  from Wiley Online Library Medicine and Nursing Collection 2017 - NHS

Database: EMBASE

Author(s): Jabbar-Lopez Z.K.; Yiu Z.Z.N.; Warren R.B.; Ward V.; Exton L.S.; Mohd Mustapa M.F.; Samarasekera E.; Burden A.D.; Murphy R.; Owen C.M.; Parslew R.; Venning V.; Smith C.H.

Source: Journal of Investigative Dermatology; Aug 2017; vol. 137 (no. 8); p. 1646-1654

Publication Date: Aug 2017

Publication Type(s): Article

Abstract:Multiple biologic treatments are licensed for psoriasis. The lack of head-to-head randomized controlled trials makes choosing between them difficult for patients, clinicians, and guideline developers. To establish their relative efficacy and tolerability, we searched MEDLINE, PubMed, Embase, and Cochrane for randomized controlled trials of licensed biologic treatments for skin psoriasis. We performed a network meta-analysis to identify direct and indirect evidence comparing biologics with one another, methotrexate, or placebo. We combined this with hierarchical cluster analysis to consider multiple outcomes related to efficacy and tolerability in combination for each treatment. Study quality, heterogeneity, and inconsistency were evaluated. Direct comparisons from 41 randomized controlled trials (20,561 participants) were included. All included biologics were efficacious compared with placebo or methotrexate at 3-4 months. Overall, cluster analysis showed adalimumab, secukinumab, and ustekinumab were comparable in terms of high efficacy and tolerability. Ixekizumab and infliximab were differentiated by very high efficacy but poorer tolerability. The lack of longer term controlled data limited our analysis to short-term outcomes. Trial performance may not equate to real-world performance, and so results need to be considered alongside real-world, long-term safety and effectiveness data. These data suggest that it is possible to discriminate between biologics to inform clinical practice and decision making (PROSPERO 2015:CRD42015017538).Copyright © 2017 The Authors
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Database: EMBASE

Author(s): Iskandar I.Y.K.; Ashcroft D.M.; Warren R.B.; Evans I.; McElhone K.; Griffiths C.E.M.; Owen C.M.; Burden A.D.; Smith C.H.; Reynolds N.J.

Source: British Journal of Dermatology; May 2017; vol. 176 (no. 5); p. 1297-1307

Available in full text at British Journal of Dermatology -  from John Wiley and Sons

Abstract:Background: Treatment modifications, including dose escalations, dose reductions, switches, discontinuations and restarts of biologics may be necessary in the management of psoriasis but the patterns of usage are incompletely defined. Objectives: To examine the treatment utilization patterns of adalimumab, etanercept and ustekinumab among biologic-naive and non-naive patients with psoriasis enrolled in the British Association of Dermatologists Biologic Interventions Register (BADBIR). Methods: The study cohort included adults with chronic plaque psoriasis who were followed up for >= 12 months. Treatment modifications were assessed during the first year of therapy. The time-trend method, comparing the cumulative dose (CD) patients received with the recommended cumulative dose (RCD), was used to assess dosing patterns. Concomitant use of other systemic treatments was also examined. Results: In total, 2980 patients (adalimumab: 1675; etanercept: 996; ustekinumab: 309) were included; 79.2% were biologic-naive. Over 12 months, 77.4% of patients continued the biologic, 2.6% restarted therapy after a break of >= 90 days, 2.5% discontinued, and 17.5% switched biologic therapy. Most patients (85.7%) received the RCD of the biologic, although 8.1% were exposed to a higher CD. In total, 749 (25.1%) patients used conventional systemic therapies concomitantly with a biologic at some stage; methotrexate was used most commonly (458; 61.2%). Of those using combination therapy, 454 (60.6%) continued the use of the conventional systemic therapy for > 120 days after the start of the biologic. Conclusions: More than one-third of patients experienced treatment modifications within the first year of initiating a biologic. Conventional systemic therapies, particularly methotrexate, were commonly used concurrently, which should be considered when evaluating treatment response and adverse events to biologics in real-world observational studies.Copyright © 2016 British Association of Dermatologists
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Database: EMBASE

Author(s): Shah M.

Source: Clinical and Experimental Dermatology; 2017

Available in full text at Clinical and Experimental Dermatology -  from John Wiley and Sons

Abstract:It is important to assess outcomes for medical interventions in order to focus scarce resources on outcomes with a known positive benefit. An open, observational study was performed to assess the clinical outcomes of 600 male patients with a genital skin problem attending a specialist secondary care dermatology facility. Patients were mainly referred by general practitioners and genitourinary medicine physicians. Outcome was measured at 3 and 6 months, and was determined by clinical examination and assessment of patient symptoms. The mean age of the group was 45.3 years. The commonest diagnoses were lichen sclerosus (30.5%), balanitis (17.3%), eczema (12.8%), lichen planus (7.3%), psoriasis (7.2%) and benign lesions (5.5%). The commonest presenting symptoms were genital rash (43%), genital soreness, pain or burning (17.5%), and penile lesions (15.7%). Lichen sclerosus and all forms of balanitis were more common in uncircumcised patients, whereas lichen planus was more common in circumcised males. Short-term outcome was excellent, with 11.5% of patients being reassured and discharged on their first visit, and after 6 months 58% of all patients were clear and 12% had improved. Only 4.5% reported no improvement in symptoms. Diagnostic biopsy demonstrated malignant or premalignant lesions in nearly a fifth of those having a procedure. Close working with urological and genitourinary medicine colleagues is important to manage the various aspects of male health.Copyright © 2017 British Association of Dermatologists.
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Database: EMBASE

Author(s): Collier, Nicholas J; Chaing, Nicole Y Z; Coulson, Ian H

Source: Journal of the American Academy of Dermatology; Feb 2017; vol. 76 (no. 2); p. e43

Publication Date: Feb 2017

Publication Type(s): Journal Article
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Database: Medline

Author(s): Singh M.; Calonje E.; Farquharson N.; Owen C.; Howat A.J.; Singh S.; Francis N.

Source: Clinical and Experimental Dermatology; 2017

Publication Date: 2017

Publication Type(s): Journal: Article In Press

Available in full text at Clinical and Experimental Dermatology -  from John Wiley and Sons

Abstract:Morphoea (localized scleroderma) is a cutaneous inflammatory condition characterized by the development of indurated and discoloured plaques. The histological features of morphoea typically include a superficial and deep perivascular and periadnexal chronic inflammatory infiltrate associated with variable degrees of dermal and/or subcutaneous sclerosis. The infiltrate is typically composed of lymphocytes, macrophages and conspicuous plasma cells. The early stages of morphoea may have a very prominent inflammatory infiltrate associated with subtle sclerosis. In addition, the inflammatory infiltrate may show a perineural and rarely intraneural distribution. We report two cases of morphoea that histologically showed plasma cell endoneuritis associated with subtle dermal sclerosis. These two cases highlight the potential for diagnostic confusion with infectious and inflammatory diseases, particularly leprosy and lupus. Copyright © 2017 British Association of Dermatologists.
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Database: EMBASE