Abstract:
:Systemic sclerosis is an uncommon autoimmune connective tissue disease with multiorgan system involvement and significant associated morbidity and mortality. Cutaneous signs and clinical manifestations are of particular importance, as they may be recognized before systemic manifestations, allowing earlier risk stratification into the limited and diffuse cutaneous subtypes, as well as earlier initiation of treatment. Important cutaneous manifestations include Raynaud's phenomenon, digital ulcers, cutaneous sclerosis, calcinosis cutis, telangiectasias, pruritus, and dyspigmentation. Despite investigation of a wide variety of treatments, no FDA-approved pharmacologic therapies exist for systemic sclerosis, and data from high-quality studies are limited. In the following review, we will discuss skin-directed therapies. Although there is evidence to support specific treatments for Raynaud's phenomenon, digital ulcers, and cutaneous sclerosis, there are limited rigorous studies evaluating the treatment of other cutaneous signs and clinical manifestations. Additional randomized-controlled trials and large observational studies are necessary to develop future evidence-based treatment options.
journal_name
Clin Dermatoljournal_title
Clinics in dermatologyauthors
Pearson DR,Werth VP,Pappas-Taffer Ldoi
10.1016/j.clindermatol.2018.04.004subject
Has Abstractpub_date
2018-01-01 00:00:00pages
459-474issue
4eissn
0738-081Xissn
1879-1131pii
S0738-081X(18)30063-4journal_volume
36pub_type
杂志文章,评审abstract::All patients with leprosy have some degree of nerve involvement. Perineural inflammation is the histopathologic hallmark of leprosy, and this localization may reflect a vascular route of entry of Mycobacterium leprae into nerves. Once inside nerves, M. leprae are ingested by Schwann cells, with a wide array of consequ...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2014.07.008
更新日期:2015-01-01 00:00:00
abstract::Heinrich Koebner (1838-1904) presented in a meeting in 1872 and reported in 1877 the emergence of psoriatic lesions following trauma to healthy skin areas of patients with psoriasis. Since then, the Koebner phenomenon has been the subject of research, as it offers a unique opportunity in the investigation of the disea...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2013.05.012
更新日期:2013-11-01 00:00:00
abstract::There are numerous barriers to conducting clinical research in pregnancy, including ethical considerations, logistical difficulties, and federal regulations. Due to these challenges, there is a paucity of data on the safe and appropriate use of dermatologic therapies in pregnancy, even for easily accessed over-the-cou...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2016.02.014
更新日期:2016-05-01 00:00:00
abstract::While autoimmunity as cause of disease is well-established, other categories of immune-mediated diseases that are not produced by targeting of self-antigens by antibodies is in the process of being described. These so-called autoinflammatory diseases arise when an inappropriate activation of antigen-independent mechan...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2014.02.004
更新日期:2014-07-01 00:00:00
abstract::As new laser devices continue to emerge, it becomes increasingly important for the clinical dermatologist to understand the basic principles behind their operation. A fundamental understanding of how lasers interact with tissue will enable the physician to choose the most appropriate laser for a given clinical situati...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
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更新日期:2006-01-01 00:00:00
abstract::In life there are some people who are confident enought that they do not require reassurance and then there are others that need it constantly just to be able to function in their daily living. I am fortunate enough to experience the gift of reassurance and being able to give it back. As a first time mother, many of t...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2015.10.002
更新日期:2015-11-01 00:00:00
abstract::Most defects in dermatologic surgery can be repaired by primary closure. If this is not feasible, then local flaps should be employed. Where flaps are unfeasible or would result in an additional cosmetic deformity, then a full-thickness skin graft should be employed. If the defect is too large for a full-thickness ski...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/0738-081x(87)90031-9
更新日期:1987-10-01 00:00:00
abstract::The quest for clarifying the pathophysiology of atopic dermatitis (eczema) has lasted for 25 centuries. Yearning to discern the primum movens of atopic dermatitis, physicians aimed to identify the curative therapy. Recent scientific efforts has brought to the light an ever-growing amount of interplaying pathophysiolog...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2009.03.009
更新日期:2010-01-01 00:00:00
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journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2003.12.030
更新日期:2004-01-01 00:00:00
abstract::Monitoring patients on therapy consists of 2 parts: evaluation of response and mitigation of risk. Biologics for the treatment of psoriasis are no different. Although laboratory assessments are sometimes necessary, the key elements to appropriate monitoring are clinical assessments and vigilant reinforcement of signs ...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2007.11.001
更新日期:2008-09-01 00:00:00
abstract::The relationship between pregnancy and diseases of the elastic fibers, such as pseudoxanthoma elasticum, cutis laxa, and anetoderma, is discussed in this article. Dermatologists and other physicians must be aware that these problems may be present in pregnant women and must also know how to counsel those who suffer fr...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2005.10.005
更新日期:2006-03-01 00:00:00
abstract::The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada both require the teaching and demonstration of general competencies, which include professionalism and ethics as a condition of training program accreditation and specialty certification, respectively. R...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2009.02.015
更新日期:2009-07-01 00:00:00
abstract::Lymphedematous areas are sites of regional immune destabilization depicting a typical example of an immunocompromised cutaneous district (ICD). This study evaluates the expression of some components of the skin innate immunity on lymphedematous limbs with the aim to clarify some facets of the ICD. Patients selected un...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2014.04.006
更新日期:2014-09-01 00:00:00
abstract::Ethical issues commonly arise in inpatient dermatology consultations. We describe the case of an inpatient suffering from a severe, undiagnosable skin condition that raises key principles of medical ethics. The four principles include autonomy, nonmaleficence, beneficence, and justice. Ethical situations faced by inpa...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2011.06.019
更新日期:2012-09-01 00:00:00
abstract::This contribution, which is somewhat of a departure from the usual format, will focus on dermatologic conditions that are consequences of the patients' choices of employment, hobby, or even other forms of recreation. Most of the cutaneous changes involve the hands and feet, and each is labeled according to the anatomi...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2016.09.002
更新日期:2017-01-01 00:00:00
abstract::Diabetes mellitus is a metabolic disorder characterized by elevated fasting and postprandial blood glucose levels. It is also accompanied with a variety of multisystem complications that include the blood vessels, nervous system, eyes, kidneys, and skin. The main cutaneous complications are discussed. ...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2007.10.015
更新日期:2008-05-01 00:00:00
abstract::The gut is the largest lymphoid organ in the body. The human microbiome is composed of trillions of bacteria. The DNA of these bacteria dwarfs the human genome. Diet and ethanol can cause rapid shifts in the number and types of bacteria in the gut. The psoriatic microbiome is similar to that seen in alcoholics; there ...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2018.03.011
更新日期:2018-01-01 00:00:00
abstract::Bites, stings and infestations can be fatal. Anaphylaxis to vespids and bees can be prevented with immunotherapy. Patients should be referred to an allergist. The acute care and prevention of arthropod injury is discussed below. ...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2004.06.010
更新日期:2005-03-01 00:00:00
abstract::The large majority of cases reported worldwide as zygomycosis are infections caused by fungi belonging to the order Mucorales. These infections are invasive, often lethal, and they primarily affect immunocompromised patients. Cutaneous zygomycosis is the third most common clinical presentation, after sinusitis and pul...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2012.01.010
更新日期:2012-11-01 00:00:00
abstract::Cutaneous zygomycosis is a fungal infection caused by zygomycetes that affects the skin. It occurs in uncontrolled diabetic patients and immunosuppressed individuals. It has 2 clinical forms: primary cutaneous zygomycosis and secondary cutaneous zygomycosis. The first is characterized by necrotic lesions and the fungu...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2011.09.013
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journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2008.04.004
更新日期:2008-07-01 00:00:00
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journal_title:Clinics in dermatology
pub_type: 历史文章,杂志文章
doi:10.1016/j.clindermatol.2019.09.002
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abstract::The development of immunotherapy has led to a paradigm shift in the treatment of both solid and hematologic malignancies. As immunomodulatory therapies are employed with increasing frequency, a greater number of immune-related adverse reactions are being reported, and the majority of these involve the skin. As a resul...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2020.06.011
更新日期:2020-01-01 00:00:00
abstract::With a prevalence of 2% to 3%, psoriasis is a very common chronic disease worldwide and generates therapy costs and continuing cost for health insurance and patients and their families. Cost-political changes in health care and the ever increasing health-economic demands in all areas of the health system make it neces...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2007.10.024
更新日期:2008-09-01 00:00:00
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journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2004.01.001
更新日期:2004-07-01 00:00:00
abstract::Medical clinicians are used to being consulted by patients who want to restore their youthful appearance. Although structural changes to the face and body may be achieved with surgery, for example, face lifts, the impression of youth also relies heavily on young-looking skin. It is desirable to have thicker and tighte...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2007.09.006
更新日期:2008-03-01 00:00:00
abstract::In summary, there is much overlap among the three types of localized cutaneous pemphigoid discussed. They all tend to affect the same age group, in general. They all may remain regional or be associated with a generalized eruption consistent with bullous pemphigoid. These three variants of subepidermal blistering dise...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/0738-081x(87)90048-4
更新日期:1987-01-01 00:00:00
abstract::The cause and effect between ultraviolet light and cutaneous lupus erythematosus (CLE) is clear. In LE patients indeed, photosensitivity is one of the major diagnostic criteria of the systemic form of lupus erythematosus. This strong clinical association has led to the postulate that abnormal photosensitivity particip...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2003.12.017
更新日期:2004-03-01 00:00:00
abstract::Major gaps still exist in the knowledge about leprosy, particularly with regard to how it spreads. Leprosy epidemiology remains complicated due to the specific characteristics of Mycobacterium leprae. To describe epidemiologic trends for the 21st century, the first part of this paper gives an overview of the epidemiol...
journal_title:Clinics in dermatology
pub_type: 杂志文章
doi:10.1016/j.clindermatol.2015.11.001
更新日期:2016-01-01 00:00:00
abstract::Genodermatoses are inherited disorders presenting with cutaneous manifestations with or without the involvement of other systems. The majority of these disorders, particularly in cases that present with a cutaneous patterning, may be explained in the context of genetic mosaicism. Despite the barriers to the genetic an...
journal_title:Clinics in dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.clindermatol.2020.03.008
更新日期:2020-01-01 00:00:00