Abstract：
BACKGROUND:Severe atopic dermatitis (AD) is increasingly treated with systemic immuno-modulatory drugs yet their safety is unclear. OBJECTIVE:We evaluated the comparative risk of serious bacterial and opportunistic infections among users of systemic immuno-modulatory medications in patients with severe AD in routine care. METHODS:In a population-based claims data study we identified adult patients with AD who were treated with systemic drugs. The incidence of serious bacterial and opportunistic infections leading to hospitalization was computed using ICD diagnosis codes. Relative risks were computed after 1:1 propensity score matching. RESULTS:Up to 232,611 patients with AD were eligible. The incidence of serious infections was 7.53 per 1,000 (7.18-7.89) among systemic non-biologics and 7.38 per 1,000 (5.68-9.57) among phototherapy treated patients, and 2.6 per 1,000 (0.45-14.3) dupilumab users. After matching, compared to methotrexate, cyclosporine had significantly reduced 6-month risk (RR=0.87), while prednisone, azathioprine and mycophenolate showed increased risks (RR= 1.78, 1.89 and 3.31, respectively). Small numbers of dupilumab users showed no increase in risk (RR=0.33; 0.03 - 3.20). CONCLUSION:In this population-based study of adult AD patients, cyclosporine and methotrexate have the lowest 6-month risks of serious infections. Increased risks were observed for prednisone, azathioprine, and mycophenolate relative to methotrexate.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Schneeweiss MC,Perez-Chada L,Merola JFdoi
10.1016/j.jaad.2019.05.073subject
Has Abstractpub_date
2019-05-31 00:00:00eissn
0190-9622issn
1097-6787pii
S0190-9622(19)30877-1pub_type
杂志文章abstract：BACKGROUND:The genetic heterogeneity of melanomas and melanocytic nevi of the female genital tract is poorly understood. OBJECTIVE:We aim to characterize the frequency of mutations of the following genes: BRAF, NRAS, KIT, GNA11, and GNAQ in female genital tract melanomas. We also characterize the frequency of BRAF mut...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2014.03.033
更新日期：2014-08-01 00:00:00
abstract：:Recent advances in our basic understanding of immunology, specifically the roles of various cell types involved in immune response and the action of cytokines they produce, has radically changed our understanding of the origin of inflammatory dermatoses, and other autoimmune diseases. Broadened comprehension of the im...
journal_title：Journal of the American Academy of Dermatology
pub_type： 信件,评审
doi：10.1016/j.jaad.2005.10.059
更新日期：2006-03-01 00:00:00
abstract：:Unilateral dermatomal superficial telangiectasia (UDST) may be congenital or acquired. Acquired UDST may occur coincident with physiologic states of estrogen increase, including puberty and pregnancy in women and adrenarche in men. Acquired UDST may also occur in estrogenized pathologic states such as chronic hepatic ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(83)70051-4
更新日期：1983-04-01 00:00:00
abstract：:A case of Flegel's disease, or hyperkeratosis lenticularis perstans, is reported. This rare chronic disorder is characterized by asymptomatic hyperkeratotic papules, usually located on the lower extremities. Most reported cases have been from Europe. We report a case of hyperkeratosis lenticularis perstans from our in...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(87)80060-9
更新日期：1987-01-01 00:00:00
abstract：BACKGROUND:The efficacy of the skin self-examination (SSE) to detect artificial changes in the size of nevi has not been evaluated in a controlled setting. OBJECTIVE:Our purpose was to determine the sensitivity and specificity of the SSE in detecting artificial changes in mole size in patients at high risk for melanom...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1067/mjd.2000.104895
更新日期：2000-05-01 00:00:00
abstract：BACKGROUND:Pigmented Spitz nevi have distinct clinical features but often may be difficult to differentiate from malignant melanoma by clinical criteria. OBJECTIVE:The purpose of this study was to use a new noninvasive diagnostic approach to improve the clinical diagnosis of Spitz nevi. METHODS:Epiluminescence micros...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(92)70240-g
更新日期：1992-11-01 00:00:00
abstract：:The term "the contact urticaria syndrome," proposed in 1975, has been generally accepted and led to proliferation of new examples. This paper summarizes this clinical material and presents a diagnostic and pathogenetic evaluation method. The risks (and minimization, thereof) of systemic skin test-induced reactions are...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/s0190-9622(81)70099-9
更新日期：1981-09-01 00:00:00
abstract：:Six patients with lymphomatoid papulosis demonstrated a clonal T-cell population in skin lesions by polymerase chain reaction methods. Two of these patients showed identical T-cell clones in their peripheral blood T cells as well. In one case, the clone persisted in the blood despite clearing of skin lesions with meth...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2005.01.014
更新日期：2005-07-01 00:00:00
abstract：:A 38-year-old woman came for treatment of multiple clear vesicles and hemorrhagic papules on the posterior aspect of the right shoulder and the right axillary vault of 5 years' duration. These lesions would spontaneously manifest as clear or blood-filled vesicles (or both) and appear to be exacerbated by physical cont...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2005.04.086
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:Port-wine stains (PWS) may thicken and darken with age. Little is known about the pathogenesis and epidemiology of PWS hypertrophy because of the lack of large studies. OBJECTIVE:We sought to assess the prevalence and characteristics of patients with hypertrophic PWS. METHODS:Medical records and clinical p...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2012.05.027
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:The impact of dermatology consultation on the care of children with oncologic conditions is unknown. OBJECTIVE:To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients. METHOD:Retrospective review of pediatric oncology patients with outpati...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2017.06.005
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis. OBJECTIVE:We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients w...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2016.06.012
更新日期：2016-11-01 00:00:00
abstract：:We report the excellent therapeutic response obtained with amikacin alone and in combination with trimethoprim-sulfamethoxazole in the treatment of 15 patients with actinomycotic mycetoma who had a poor response to the traditional pharmacologic agents and/or in whom important organs such as lungs, spinal cord, and bon...
journal_title：Journal of the American Academy of Dermatology
pub_type： 临床试验,杂志文章
doi：10.1016/s0190-9622(87)70227-8
更新日期：1987-09-01 00:00:00
abstract：:Technological advance in society and medicine has brought tremendous improvements and convenience but also a degree of depersonalization. The personal and pastoral aspects of medical practice, which are probably more important in helping patients toward health than we realize, are becoming increasingly stifled by heal...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1067/mjd.2000.109290
更新日期：2000-11-01 00:00:00
abstract：:The case of a 2-year-old Puerto Rican boy is presented. Clinical and histologic features are detailed because he showed peculiar jet black patches of pigmentation on the fingers of the right hand. This case, except for the lack of progression of the disease after a 2-year period of follow-up, shows many similarities t...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(80)80391-4
更新日期：1980-02-01 00:00:00
abstract：BACKGROUND:There is a lack of data on outcomes of management of pemphigus in children. OBJECTIVE:We sought to evaluate rituximab treatment in childhood and juvenile pemphigus. METHOD:All cases of pemphigus treated with rituximab in patients younger than 18 years were included. Clinical and epidemiologic data and deta...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2014.05.071
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Often after biopsy a skin cancer appears to resolve clinically and a repeat biopsy may be done on the area in question before proceeding with further treatment. OBJECTIVE:Our purpose was to assess the value of a subsequent biopsy in the treatment of skin cancers previously diagnosed by biopsy results. METH...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(92)70159-d
更新日期：1992-07-01 00:00:00
abstract：:To evaluate the possible association of other malignancies with basal cell carcinoma, we reviewed 1973 consecutive patients with basal cell carcinoma. We searched the Swedish Cancer Registry for records reporting malignancies in the study population (1958-1984) and the expected number of malignancies was calculated on...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(91)70189-9
更新日期：1991-08-01 00:00:00
abstract：:Pigmented purpuric dermatosis can occasionally be caused by various medications. No reported cases of oral hypoglycemic agents causing pigmented purpuric dermatosis exist. We report a case of glipizide-induced pigmented dermatosis. ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(99)70335-x
更新日期：1999-11-01 00:00:00
abstract：:Multiple basal cell epitheliomas developed in two psoriatic patients during treatment with orally administered 8-methoxypsoralen and long-wave ultraviolet radiation (PUVA). Twenty-two basal cell epitheliomas (BCEs) were seen in the two patients, 80% occurring in non-sun-exposed areas. Since neither patient had any his...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(80)80362-8
更新日期：1980-05-01 00:00:00
abstract：:Epithelioid hemangioendothelioma (EHE) is a unique tumor, mainly of adults, which is characterized by epithelioid or histiocytoid endothelial cells. It is a low-grade malignant vascular tumor first described as a distinctive entity in 1982 by Weiss and Enzinger. An 8-year-old girl presented with an approximately 3-yea...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(00)90267-6
更新日期：2000-05-01 00:00:00
abstract：BACKGROUND:Cutaneous calcification is an acquired disorder whereby insoluble, amorphous calcium salts deposit in the skin. Classically, cutaneous calcification is categorized as metastatic, dystrophic, idiopathic, or iatrogenic. OBJECTIVE:The purpose of this study was to further elucidate the underlying pathogenic mec...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.jaad.2010.01.046
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:Botulinum toxin type A (BTX-A) is widely used for facial esthetics but is incompletely studied. OBJECTIVE:This study was conducted to evaluate the efficacy and safety of BTX-A treatment of glabellar lines. METHODS:Patients with moderate to severe glabellar lines at maximum frown received intramuscular inje...
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：10.1067/mjd.2002.121356
更新日期：2002-06-01 00:00:00
abstract：BACKGROUND:Hyperlipidemia has received little attention as a side effect of cyclosporine therapy for severe psoriasis. OBJECTIVE:We report changes in fasting serum lipids in patients treated with low-dose oral cyclosporine for psoriasis and discuss their significance. METHODS:Twenty-two patients with severe, recalcit...
journal_title：Journal of the American Academy of Dermatology
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/0190-9622(92)70213-y
更新日期：1992-09-01 00:00:00
abstract：BACKGROUND:The incidence of cutaneous nontuberculous mycobacteria (NTM) infections is increasing. These infections are a diagnostic and therapeutic challenge. OBJECTIVE:We investigated the clinical features, diagnosis, and management of cutaneous NTM infections. METHODS:A retrospective case series studied 78 patients...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2019.04.022
更新日期：2019-09-01 00:00:00
abstract：:Reflections from instruments in the surgical field involving the CO2 laser beam present a serious ocular hazard. In addition to the use of plastic or glass protective eyewear, this hazard can be minimized by utilizing anodized instruments and recognizing the specific distances at which various reflections are no longe...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/s0190-9622(87)70268-0
更新日期：1987-11-01 00:00:00
abstract：BACKGROUND:Recently, an automated robotic hair restoration device was developed and is increasingly being used for hair restoration. OBJECTIVE:We sought to analyze the hair follicles of Korean patients that were harvested by a hair restoration robotic device. METHODS:Data were reviewed from a total of 22 patients who...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2014.07.058
更新日期：2015-01-01 00:00:00
abstract：:Based upon case reports and small case series, it has been known for many years that some types and subtypes of inherited epidermolysis bullosa (EB) may be at risk for developing one or more extracutaneous complications. Many of these are associated with considerable morbidity; some may result in death. Only over the ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.jaad.2009.03.052
更新日期：2009-09-01 00:00:00
abstract：:Discoid lupus erythematosus lesions show hyperkeratosis and atrophy, which may reflect abnormal epidermal proliferation, differentiation, or both. In this investigation, markers for epidermal proliferation, differentiation and inflammation were studied in cutaneous lesions of discoid lupus erythematosus. Frozen sectio...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/0190-9622(91)70303-j
更新日期：1991-12-01 00:00:00
abstract：:Direct-to-consumer teledermatology is radically changing the way some patients obtain dermatologic care. Many direct-to-consumer teledermatology services offer care to patients younger than 18 years, but policies and standards are nonuniform. For pediatric patients, direct-to-consumer teledermatology is a substantial ...
journal_title：Journal of the American Academy of Dermatology
pub_type： 杂志文章
doi：10.1016/j.jaad.2016.08.002
更新日期：2016-11-01 00:00:00
