Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers: A Systematic Review and Meta-analysis.


Importance:Exercise is recommended as an adjuvant treatment for venous leg ulceration (VLU) to improve calf muscle pump function. However, the association of exercise with VLU healing has not been properly aggregated, and the effectiveness of different exercise interventions has not been characterized. Objective:To summarize the association of different exercise interventions with VLU healing when used as an adjuvant to any form of compression. Data Sources:The Cochrane Controlled Trials Register, MEDLINE, Embase, CINAHL, PsycInfo, and SCOPUS databases were searched through October 9, 2017. Study Selection:Randomized clinical trials (RCTs) of any exercise compared with no exercise in participants with VLU were included, where compression was used as standard therapy and a healing outcome was reported. Independent title screening and full text review by 2 authors (A.J., J.S.) with appeal to a third author (J.P.) if disagreement was unresolved. Of the 519 articles screened, a total of 6 (1.2%) studies met the inclusion criteria for systematic review, including 5 for meta-analysis. Data Extraction and Synthesis:Independent quality assessment for Cochrane risk of bias and data extraction by 2 authors with appeal to third author if disagreement unresolved (PRISMA). Data pooled using fixed effects model. Main Outcomes and Measures:The a priori primary outcome was any healing outcome (proportion healed, time to healing, or change in ulcer area). Secondary outcomes (adverse events, costs, and health-related quality of life) were only collected if a primary outcome was reported. Results:Six RCTs were identified and 5 (190 participants) met inclusion criteria for meta-analysis. The exercise interventions were progressive resistance exercise alone (2 RCTs, 53 participants) or combined with prescribed physical activity (2 RCTs, 102 participants), walking only (1 RCT, 35 participants), or ankle exercises (1 RCT, 40 participants). Overall, exercise was associated with increased VLU healing at 12 weeks although the effect was imprecise (additional 14 cases healed per 100 patients; 95% CI, 1-27 cases per 100; P = .04). The combination of progressive resistance exercise plus prescribed physical activity appeared to be most effective, again with imprecision (additional 27 cases healed per 100 patients; 95% CI, 9-45 cases per 100; P = .004). Conclusions and Relevance:The evidence base may now be sufficiently suggestive for clinicians to consider recommending simple progressive resistance and aerobic activity to suitable patients with VLU while further research is produced.


JAMA Dermatol


JAMA dermatology


Jull A,Slark J,Parsons J




Has Abstract


2018-11-01 00:00:00














  • Immune reconstitution reactions in human immunodeficiency virus-negative patients: report of a case and review of the literature.

    abstract:BACKGROUND:Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon initially described in patients with human immunodeficiency virus. Upon initiation of combination antiretroviral therapy, recovery of cellular immunity triggers inflammation to a preexisting infection or antigen that causes paradoxical worsen...

    journal_title:JAMA dermatology

    pub_type: 杂志文章,评审


    authors: Scharschmidt TC,Amerson EH,Rosenberg OS,Jacobs RA,McCalmont TH,Shinkai K

    更新日期:2013-01-01 00:00:00

  • Transparency and Dermatologic Device Approval by the US Food and Drug Administration.

    abstract:Importance:The US Food and Drug Administration approves Class III medical devices via the premarket approval pathway, often requiring clinical data on safety and efficacy. Manufacturers can submit incremental device changes via supplemental applications, which are not subjected to such vetting measures and can cause un...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Ezaldein HH,Scott JF,Yin ES,Ventura A,DeRuyter NP,Leffell DJ

    更新日期:2018-03-01 00:00:00

  • Efficacy and Safety of Multiple Dupilumab Dose Regimens After Initial Successful Treatment in Patients With Atopic Dermatitis: A Randomized Clinical Trial.

    abstract:Importance:The dupilumab regimen of 300 mg every 2 weeks is approved for uncontrolled, moderate to severe atopic dermatitis (AD). Objective:To assess the efficacy and safety of different dupilumab regimens in maintaining response after 16 weeks of initial treatment. Design, Setting, and Participants:The Study to Conf...

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    更新日期:2020-02-01 00:00:00

  • Hydroxychloroquine-induced pigmentation in patients with systemic lupus erythematosus: a case-control study.

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  • Cyclosporine Treatment of Drug-Induced Hypersensitivity Syndrome.

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    journal_title:JAMA dermatology

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    authors: Kirchhof MG,Wong A,Dutz JP

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    abstract:Importance:Melanoma treatment has been revolutionized with the development of immune-based therapies that offer durable clinical responses in a subset of patients. Clinical outcomes after treatment by immunotherapy can be influenced by the host's immune system. The immune system is modified with age by age-related immu...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Perier-Muzet M,Gatt E,Péron J,Falandry C,Amini-Adlé M,Thomas L,Dalle S,Boespflug A

    更新日期:2018-01-01 00:00:00

  • Immunologic Overlap of Helper T-Cell Subtypes 17 and 22 in Erythrodermic Psoriasis and Atopic Dermatitis.

    abstract:IMPORTANCE:Psoriasis and atopic dermatitis (AD) are inflammatory diseases thought to be mediated by helper T-cell subtypes 1 and 2 (TH1 and TH2), respectively. Although psoriasis and AD show histopathologic differences during chronic disease, they are difficult to distinguish histologically during erythrodermic exacerb...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Moy AP,Murali M,Kroshinsky D,Duncan LM,Nazarian RM

    更新日期:2015-07-01 00:00:00

  • Prevalence of Pubic Hair Grooming-Related Injuries and Identification of High-Risk Individuals in the United States.

    abstract:Importance:Pubic hair grooming is a common practice that can lead to injury and morbidity. Objective:To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. De...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Truesdale MD,Osterberg EC,Gaither TW,Awad MA,Elmer-DeWitt MA,Sutcliffe S,Allen I,Breyer BN

    更新日期:2017-11-01 00:00:00

  • Risk of Serious Infection With Biologic and Systemic Treatment of Psoriasis: Results From the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

    abstract:IMPORTANCE:The efficacy of treatment for psoriasis must be balanced against potential adverse events. OBJECTIVE:To determine the effect of treatment on the risk of serious infections in patients with psoriasis. DESIGN, SETTING, AND PARTICIPANTS:A multicenter, longitudinal, disease-based registry (Psoriasis Longitudin...

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    authors: Kalb RE,Fiorentino DF,Lebwohl MG,Toole J,Poulin Y,Cohen AD,Goyal K,Fakharzadeh S,Calabro S,Chevrier M,Langholff W,You Y,Leonardi CL

    更新日期:2015-09-01 00:00:00

  • Pseudoaneurysm formation and repair after Mohs micrographic surgery: a report of 3 cases.

    abstract:IMPORTANCE:Pseudoaneurysm is a well-known complication of trauma and iatrogenic injury to the vasculature. We report 3 cases of postsurgical pseudoaneurysm after Mohs surgery. OBSERVATIONS:Three patients who underwent Mohs surgery for nonmelanoma skin cancers presented between 2 and 4 weeks after surgery with several ...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Dunbar SW,Hurst EA

    更新日期:2014-05-01 00:00:00

  • Costs and Consequences Associated With Misdiagnosed Lower Extremity Cellulitis.

    abstract:Importance:Inflammatory dermatoses of the lower extremity are often misdiagnosed as cellulitis (aka "pseudocellulitis") and treated with antibiotics and/or hospitalization. There is limited data on the cost and complications from misdiagnosed cellulitis. Objective:To characterize the national health care burden of mis...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Weng QY,Raff AB,Cohen JM,Gunasekera N,Okhovat JP,Vedak P,Joyce C,Kroshinsky D,Mostaghimi A

    更新日期:2017-02-01 00:00:00

  • Proliferative Nodules vs Melanoma Arising in Giant Congenital Melanocytic Nevi During Childhood.

    abstract:Importance:The differential diagnosis between proliferative nodules (PNs) and melanoma arising in congenital melanocytic nevi (CMN) is crucial, as patients with PNs most often experience no increased risk of melanoma with metastases and death. Objective:To analyze the utility of immunohistochemistry and fluorescence i...

    journal_title:JAMA dermatology

    pub_type: 杂志文章,多中心研究


    authors: Vergier B,Laharanne E,Prochazkova-Carlotti M,de la Fouchardière A,Merlio JP,Kadlub N,Avril MF,Bodemer C,Lacoste C,Boralevi F,Taieb A,Ezzedine K,Fraitag S

    更新日期:2016-10-01 00:00:00

  • Changes in Use of Radiotherapy Among Dermatologists From 2013 to 2017.

    abstract:Importance:Concerns have been raised about the use of radiotherapy (RT) by dermatologists. Little is known about temporal trends in payment for RT among dermatologists. Objective:To characterize changes in RT use and payment among dermatologists treating patients enrolled in Medicare. Design, Setting, and Participant...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Nguyen KD,Chen HW,Adamson AS

    更新日期:2020-12-23 00:00:00

  • Association of Vitamin D Receptor Polymorphisms With the Risk of Nonmelanoma Skin Cancer in Adults.

    abstract:Importance:Protective effects of UV-B radiation against nonmelanoma skin cancer (NMSC) are exerted via signaling mechanisms involving the vitamin D receptor (VDR). Recent studies have examined single-nucleotide polymorphisms (SNPs) in the VDR, resulting in contradictory findings as to whether these polymorphisms increa...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Burns EM,Guroji P,Ahmad I,Nasr HM,Wang Y,Tamimi IA,Stiefel E,Abdelgawwad MS,Shaheen A,Muzaffar AF,Bush LM,Hurst CB,Griffin RL,Elmets CA,Yusuf N

    更新日期:2017-10-01 00:00:00

  • Acquired cutis laxa associated with heavy chain deposition disease involving dermal elastic fibers.

    abstract:IMPORTANCE:Acquired cutis laxa is a rare cutaneous manifestation of hematologic malignancy. We report a case of γ heavy chain deposition disease (HCDD) associated with acquired cutis laxa, renal involvement, and hypocomplementemia and propose a mechanism of elastic fiber degradation in the skin of this patient with HCD...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: O'Malley JT,D'Agati VD,Sherman WH,Grossman ME

    更新日期:2014-11-01 00:00:00

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    abstract:Clinical Question:Which treatments have been shown to be effective in randomized clinical trials (RCTs) for hidradenitis suppurativa (HS) in adults? Bottom Line:There is high-quality evidence of benefit from adalimumab given weekly, while every other week dosing is ineffective, with reductions in Dermatology Life Qual...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Ingram JR

    更新日期:2017-05-01 00:00:00

  • The Risk of Anal Carcinoma After Anogenital Warts in Adults Living With HIV.

    abstract:Importance:In the US, incidence of and mortality due to anal carcinoma are rising faster than for most other cancers. Identifying populations who have a higher risk of developing anal cancers is critical to target preventive interventions. Objective:To assess the risk of developing anal carcinoma in adults living with...

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    pub_type: 杂志文章


    authors: Arnold JD,Byrne ME,Monroe AK,Abbott SE,District of Columbia Cohort Executive Committee.

    更新日期:2021-01-13 00:00:00

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    abstract:Importance:Atopic dermatitis (AD) and allergic contact dermatitis (ACD) have a dynamic relationship not yet fully understood. Investigation has been limited thus far by a paucity of data on the overlap of these disorders in pediatric patients. Objective:To use data from the Pediatric Contact Dermatitis Registry to elu...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Jacob SE,McGowan M,Silverberg NB,Pelletier JL,Fonacier L,Mousdicas N,Powell D,Scheman A,Goldenberg A

    更新日期:2017-08-01 00:00:00

  • Association of Histologic Regression With a Favorable Outcome in Patients With Stage 1 and Stage 2 Cutaneous Melanoma.

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    journal_title:JAMA dermatology

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    authors: El Sharouni MA,Aivazian K,Witkamp AJ,Sigurdsson V,van Gils CH,Scolyer RA,Thompson JF,van Diest PJ,Lo SN

    更新日期:2020-12-23 00:00:00

  • Sunbed use, user characteristics, and motivations for tanning: results from the German population-based SUN-Study 2012.

    abstract:OBJECTIVES:To calculate sunbed use prevalence rates, to investigate the motivations for tanning, and to identify typical target groups for interventions to prevent skin cancer. DESIGN:Cross-sectional, representative, population-based study, primary analysis of the SUN-Study 2012 (Sunbed-Use: Needs for Action-Study). ...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Schneider S,Diehl K,Bock C,Schlüter M,Breitbart EW,Volkmer B,Greinert R

    更新日期:2013-01-01 00:00:00

  • Association Between Mediterranean Anti-inflammatory Dietary Profile and Severity of Psoriasis: Results From the NutriNet-Santé Cohort.

    abstract:Importance:Psoriasis is a chronic inflammatory disease. The Mediterranean diet has been shown to reduce chronic inflammation and has a positive effect on the risk of metabolic syndrome and cardiovascular events. Thus, we hypothesized a positive effect on the onset and/or severity of psoriasis. Objective:To assess the ...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Phan C,Touvier M,Kesse-Guyot E,Adjibade M,Hercberg S,Wolkenstein P,Chosidow O,Ezzedine K,Sbidian E

    更新日期:2018-09-01 00:00:00

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    journal_title:JAMA dermatology

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    authors: Cabral ES,Chen FW,Egbert BM,Swetter SM

    更新日期:2014-08-01 00:00:00

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    更新日期:2017-02-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:2017-11-01 00:00:00

  • Association of Serum Ustekinumab Levels With Clinical Response in Psoriasis.

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    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Tsakok T,Wilson N,Dand N,Loeff FC,Bloem K,Baudry D,Duckworth M,Pan S,Pushpa-Rajah A,Standing JF,de Vries A,Alsharqi A,Becher G,Murphy R,Wahie S,Wright A,Griffiths CEM,Reynolds NJ,Barker J,Warren RB,Burden AD,Ris

    更新日期:2019-09-18 00:00:00

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    journal_title:JAMA dermatology

    pub_type: 杂志文章,多中心研究


    authors: Nelson CA,Zhong CS,Hashemi DA,Ashchyan HJ,Brown-Joel Z,Noe MH,Imadojemu S,Micheletti RG,Vleugels RA,Wanat KA,Rosenbach M,Mostaghimi A

    更新日期:2020-03-01 00:00:00

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    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Machado MO,Stergiopoulos V,Maes M,Kurdyak PA,Lin PY,Wang LJ,Shyu YC,Firth J,Koyanagi A,Solmi M,Alavi A,Piguet V,Carvalho AF

    更新日期:2019-06-05 00:00:00

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    abstract:Importance:Staged excision of lentigo maligna (LM) often requires multiple stages and can result in significant cosmetic morbidity. Imiquimod cream has been used off-label as monotherapy in the treatment of LM and may be used in the neoadjuvant setting prior to staged excision as a strategy to reduce the size of the su...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Donigan JM,Hyde MA,Goldgar DE,Hadley ML,Bowling M,Bowen GM

    更新日期:2018-08-01 00:00:00

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    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Sanchez MI,Rabinovitz HS,Oliviero MC,Elgart GW,Perez C,Puig S,Malvehy J,Grichnik JM

    更新日期:2014-06-01 00:00:00

  • Prognostic Factors, Treatment, and Survival in Dermatofibrosarcoma Protuberans.

    abstract:Importance:There is limited information regarding the influence of patient demographics, tumor characteristics, and treatment type on the survival of patients with dermatofibrosarcoma protuberans (DFSP). Objective:To assess prognostic factors and to evaluate the influence of treatment modality on overall survival of p...

    journal_title:JAMA dermatology

    pub_type: 杂志文章


    authors: Criscito MC,Martires KJ,Stein JA

    更新日期:2016-12-01 00:00:00