Abstract：
BACKGROUND:Methotrexate has been used both as monotherapy and as an adjunct to corticosteroids in the treatment of alopecia areata (AA), though there exists a paucity of definitive evidence and guidelines in this setting. OBJECTIVES:To 1) determine the efficacy and risks associated with methotrexate therapy for AA, 2) determine the differences in efficacy of combination (methotrexate plus corticosteroids) versus stand-alone (methotrexate) treatment, and 3) determine the relative efficacy of methotrexate in adult versus pediatric populations. METHODS:A systematic review and meta-analysis was performed according to recommended PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] guidelines. RESULTS:Methotrexate has reasonable effectiveness in patients with severe AA; adults appear to be more responsive to methotrexate treatment than pediatric patients. Combination treatment results in a higher complete response rate than methotrexate stand-alone treatment. A large proportion of patients had recurrence in the setting of tapering treatment. Complication rates were acceptable and similar between adult and pediatric patients. LIMITATIONS:The studies reviewed were retrospective observational studies with heterogeneity between centers in terms of methotrexate dosages and protocols in use for AA, and there was a lack of data beyond 1 year for the adjunctive treatments. CONCLUSION:Methotrexate is an effective monotherapy or adjunct therapy in combination with corticosteroids in the treatment of severe AA.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Phan K,Ramachandran V,Sebaratnam DFdoi
10.1016/j.jaad.2018.06.064subject
Has Abstractpub_date
2019-01-01 00:00:00pages
120-127.e2issue
1eissn
0190-9622issn
1097-6787pii
S0190-9622(18)32223-0journal_volume
80pub_type
杂志文章,meta分析abstract：BACKGROUND:Hypopigmented macules have been described infrequently as a presenting form of mycosis fungoides (MF). OBJECTIVE:This study was designed to clarify general characteristics of a hypopigmented MF variant. METHODS:Seven new cases were investigated with the use of descriptive epidemiology techniques. Demograph...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(95)91337-8
更新日期：1995-06-01 00:00:00
abstract：:Polymorphous sweat gland carcinoma is an unusual, recently described variant of low-grade malignant adnexal neoplasm of the skin characterized by a prolonged clinical course and predilection for the extremities. We describe a case of recurrent polymorphous sweat gland carcinoma in a 56-year-old man who presented with ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1067/mjd.2002.120458
更新日期：2002-06-01 00:00:00
abstract：BACKGROUND:Paradoxical hidradenitis suppurativa (HS) induced by biologic agents (BA) is scarcely reported. OBJECTIVE:We sought to describe the clinical characteristics and outcome of patients developing paradoxical HS under BA. METHODS:This was a multicenter nationwide retrospective study asking physicians to report ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jaad.2016.01.018
更新日期：2016-06-01 00:00:00
abstract：:Keratoacanthoma (KA) is currently considered a benign epithelial neoplasm. We report a patient with a lesion diagnosed as a KA that behaved aggressively like a squamous cell carcinoma (SCC). Similar reports are not uncommon in the literature. Because there are currently no criteria by which KA can be differentiated fr...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/s0190-9622(84)80010-9
更新日期：1984-02-01 00:00:00
abstract：:Lipedema is characterized by symmetric lower extremity enlargement secondary to the deposition of fat. Lipedema is not rare, but it is commonly misdiagnosed as lymphedema. We describe a 20-year-old woman with massive lower extremity enlargement that did not respond to compression therapy. Magnetic resonance imaging of...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2006.09.023
更新日期：2007-08-01 00:00:00
abstract：:Carcinoma erysipelatodes, also known as inflammatory metastatic carcinoma, is a type of cutaneous metastatic disease. We describe a 64-year-old woman with metastatic breast carcinoma who presented with a blistering erythematous eruption resembling erysipelas with formation of vesicles and bullae. She was found to have...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1053/jd.1999.v40.a95643
更新日期：1999-05-01 00:00:00
abstract：:We report a detailed clinical, histopathologic, and photobiologic study of 16 Dutch patients with actinic reticuloid. All were middle-aged or elderly men who had persistent plaques on light-exposed skin only (two patients), extension of lesions to nonexposed areas (four patients), or prolonged or persistent episodes o...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：BACKGROUND:Molluscum contagiosum (MC) is a common and at times severely disfiguring cutaneous viral infection in patients with human immunodeficiency virus (HIV) infection. OBJECTIVE:The purpose of this study was to describe the clinical course of MC in patients with HIV infection and to examine the relation between p...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(92)70226-6
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:There are multiple therapeutic options for the treatment of moderate to severe psoriasis. The process of choosing among potential treatment options requires both the physician and the patient to weigh the benefits of individual modalities against their potential risks. Traditional systemic therapies for psor...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.jaad.2008.12.031
更新日期：2009-06-01 00:00:00
abstract：:Certain scalp hair shafts from 2 of 10 cases of pili annulati examined by scanning electron microscopy exhibited an unusual weathering pattern. The majority of affected hair shafts showed minor surface abnormalities at regular intervals (nodes) associated with the underlying spaces. However, in a few examples, there w...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1067/mjd.2001.114748
更新日期：2001-10-01 00:00:00
abstract：BACKGROUND:Garment-related terms have been used to describe the pattern of distribution of giant congenital melanocytic nevi (GCMN). OBJECTIVE:We sought to describe patterns of distribution of GCMN and propose a classification scheme. METHODS:Photographic records of patients with GCMN from the Hospital Clinic of Barc...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2016.05.042
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Dermatitis herpetiformis (DH) is highly associated with celiac disease. Recently, tissue transglutaminase (tTG) was identified as the autoantigen of IgA antibodies in celiac disease. The prevalence of antibodies to tTG in DH patients is not known. OBJECTIVE:The purpose of this study was to determine whether...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(99)70253-7
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:Reducing people's exposure to ultraviolet radiation is the primary strategy for skin cancer prevention. OBJECTIVE:We sought to provide comprehensive national data on preventive behaviors and risk assessment for Australia. METHODS:A national survey was conducted in summer 2003-2004. In 8 weekly cross-sectio...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2008.06.011
更新日期：2008-10-01 00:00:00
abstract：:Four cases of Laugier-Hunziker syndrome are described. In all patients (two men and two women between 39 and 57 years of age) pigmentation of the lower lip and hard palate was found. in addition, two patients had involvement of the buccal mucosa; another patient also had pigmentation of the upper lip, the gums, the so...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/0190-9622(91)70244-v
更新日期：1991-10-01 00:00:00
abstract：:Lipoid proteinosis is a rare autosomal recessive condition characterized by a diffuse mucocutaneous infiltration with histopathologic deposits that are positive for periodic acid-Schiff reagent and a sudanophil substance. We present a 9-year-old boy with lipoid proteinosis. His parents are siblings. He had classical m...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(86)70045-5
更新日期：1986-02-01 00:00:00
abstract：:A case of porphyria cutanea tarda in a human immunodeficiency virus-infected patient with hemophilia is reported. Onset of skin manifestations of porphyria cutanea tarda coincided with deterioration of immune function. However, acquired immunodeficiency syndrome has not yet developed with a follow-up interval of 39 mo...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/0190-9622(92)70122-v
更新日期：1992-05-01 00:00:00
abstract：:A tumor is reported that had remarkable pathologic changes showing with light microscopy a pattern in some portions consistent with tubular apocrine adenoma, while other areas were suggestive of syringoid eccrine carcinoma. Perineural invasion, commonly seen in syringoid eccrine carcinoma and never before reported in ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(84)70221-0
更新日期：1984-10-01 00:00:00
abstract：OBJECTIVE:We sought to develop a validated, reliable pruritus-specific quality-of-life (QOL) instrument, ItchyQoL. METHODS:From 21 in-depth interviews with patients with pruritus, we developed 22 pruritus-specific items, and hypothesized 3 major constructs that explain the way pruritus affects patients' QOL: symptoms,...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2008.04.006
更新日期：2008-08-01 00:00:00
abstract：:The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jaad.2020.09.006. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2020.09.014
更新日期：2020-09-14 00:00:00
abstract：:Renewed interest in experimental photocarcinogenesis was stimulated by the observation that skin cancers induced in mice by ultraviolet radiation are highly antigenic. Most of these cancers are rejected by the immune system on transplantation into a normal, genetically identical animal. This finding raised the questio...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/s0190-9622(86)70017-0
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Onychomycosis is an increasing problem with limited therapeutic options. OBJECTIVE:We evaluated the safety and efficacy, of oral terbinafine, a new fungicidal antimycotic, in patients with toenail onychomycosis. METHODS:A North American multicenter, double-blind, placebo-controlled study evaluated the myco...
journal_title：Journal of the American Academy of Dermatology
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0190-9622(97)70111-7
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND:Non-melanoma skin cancers (NMSCs) are increased in organ transplant recipients, but transplant and immunocompetent squamous and basal cell carcinomas (SCCs, BCCs) have not been compared previously in a single-center study. OBJECTIVE:To compare clinicopathologic features of transplant and immunocompetent NMS...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2005.10.049
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Effective medical treatment for patients with severe hidradenitis suppurativa (HS) is limited. OBJECTIVES:We sought to measure the impact of wide local excision on quality of life in HS Hurley grade III patients and to examine the rate of postoperative complications, disease recurrences, and satisfaction wi...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2017.01.055
更新日期：2017-07-01 00:00:00
abstract：:A 9-year-old girl with systemic lupus erythematosus developed bullous eruption. Histopathologic examination showed subepidermal blistering and immunoglobulins (IgG, IgM, IgA) and complement components (C1q, C3) deposited linearly at the basement membrane zone. IgG in this patient's serum bound to the dermal side of 1 ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(98)70472-4
更新日期：1998-05-01 00:00:00
abstract：BACKGROUND:The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. OBJECTIVE:To determine the predictors of HBV and HCV reactivation in psoriasis patients receiving biologics. METHODS:This study screened 2060 psoriasis patients (3562 treatment episodes) who were t...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2019.12.001
更新日期：2019-12-07 00:00:00
abstract：:We report a case of a patient with scleromyxedema limited to the skin with an associated IgG lambda monoclonal protein treated successfully with high-dose dexamethasone. We encourage the continued investigation of this complex relationship between the clinical presentation of scleromyxedema and its frequently associat...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2004.03.023
更新日期：2004-08-01 00:00:00
abstract：:The regulation of telemedicine in the United States is evolving, with new legislation expanding reimbursement and cross-state licensing capabilities. As telemedicine grows, communities with limited access to traditional dermatologic care may find a solution in teledermatology. A search of the medical literature and on...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2019.11.055
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Acral lentiginous melanomas compose a higher proportion of melanomas and have a higher mortality in ethnic minorities than in whites. Early detection by acral surface inspection during skin examinations may lead to improved acral lentiginous melanoma outcomes. OBJECTIVE:This study compared patient-reported ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2014.03.032
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Confirmation of mild bites caused by Loxosceles reclusa with swab testing has not been previously documented, to our knowledge. METHODS:We report a case using an enzyme-linked immunosorbent assay (ELISA) test. RESULTS:A lesion lacking necrosis or other specific signs of loxoscelism was confirmed by identif...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2006.04.065
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:Although etanercept is used as a continuous therapy for moderate to severe plaque psoriasis, intermittent use may be necessary in some instances. OBJECTIVE:In this randomized, open-label study, we evaluated the effectiveness and safety of continuous versus interrupted etanercept therapy. METHODS:All patien...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jaad.2006.09.002
更新日期：2007-04-01 00:00:00
