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 and symptoms, which may portend undesirable adverse effects to the patient. Identifying expected response to therapy establishes one objective of monitoring. There is no precise threshold for response, but given the array of therapies and the relatively high response rates, a 75% improvement in clinical disease state is reasonable. Less well established is a reasonable time over which the expected improvement should occur. For alefacept, there are no data to support a plateau in response. Efalizumab and etanercept show trends to optimal response between 24 and 36 weeks, suggesting at least 6 months of therapy is required to categorically define a treatment failure. Infliximab is contrary to the other 3 biologics showing very thorough response in nearly all patients by week 14 but progressive loss of response during a subsequent 34 weeks of therapy. Categorizing adverse events into simple silos of probability and severity helps identify appropriate monitoring strategies. A greater number of patients treated with longer courses of therapy, coupled with careful observations and reporting, will better define risks and benefits. The better risks and benefits are understood, the more precise monitoring guidelines can be defined.
journal_name
Clin Dermatoljournal_title
Clinics in dermatologyauthors
Papp KAdoi
10.1016/j.clindermatol.2007.11.001subject
Has Abstractpub_date
2008-09-01 00:00:00pages
515-21issue
5eissn
0738-081Xissn
1879-1131pii
S0738-081X(07)00261-1journal_volume
26pub_type
杂志文章,评审abstract：:Psoriasis is a chronic, inflammatory and hyperproliferative skin disease with a genetic basis. While epidermal hyperplasia and altered keratinocyte differentiation are prominent features, considerable evidence indicates that psoriasis is immunologically mediated. Recently, the identification of HLA-Cw6 as the disease ...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2007.08.007
更新日期：2007-11-01 00:00:00
abstract：:Facial erythema (the "red face") is a straightforward clinical finding, and it is evident even to the untrained eye; however, a red face does not represent a single cutaneous entity. It may be due to a plethora of distinct underlying conditions of varying severity, including rosacea, demodicosis, dermatomyositis, lupu...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2016.10.015
更新日期：2017-01-01 00:00:00
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：:Mal de Meleda is an hereditary palmoplantar keratoderma named for the Mljet Island in Croatia. The lives of those affected by this disease represent a complex situation that encompasses members of a vulnerable group. They require enlightenment and should be approached with awareness, taking into account their overall ...
journal_title：Clinics in dermatology
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.clindermatol.2019.01.003
更新日期：2019-01-01 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：:Although dermatology does not lead the list of specialties most commonly sued for malpractice, anyone who has been the recipient of a malpractice claim is often traumatized both personally and professionally. Every day dermatologists must address various ethical concerns that have legal implications. Herein, we chose ...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2011.06.004
更新日期：2012-03-01 00:00:00
abstract：:Skin phototyping refers to a skin classification scheme based on how the skin responds to sun exposure. The Fitzpatrick classification is the most widely accepted method of skin phototyping, based on a person's tendency to sunburn and ability to tan. Apart from estimating the initial therapeutic dose of UV light, skin...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2019.07.010
更新日期：2019-01-01 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
更新日期：2012-07-01 00:00:00
abstract：:The attractiveness of the human body has always been an important issue in the fields of sociology, psychology, and psychiatry and also in the field of dermatology. In psychodermatology, one often discovers how all these fields intermingle to produce elaborate situations and extreme human difficulties. Perfect skin is...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2014.02.016
更新日期：2014-11-01 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：: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：: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：:Oral manifestations of nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissue, salivary glands, and perioral skin. This contribution reviews how the water-soluble vitamins (B(2), B(3), B(6), B(12), C, and folic acid), fat-soluble vitamins (A, D, and E), and minerals (calcium, fluoride, iro...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2010.03.025
更新日期：2010-07-01 00:00:00
abstract：:Shortly after syphilis appeared in Europe at the time of Columbus' voyage to the New World, the big pox, as it was often known, became a serious issue in Russia for diagnosis, treatment, and prevention. Members of the Russian royal family were made aware of the disease from adolescence onward. Czar Peter the Great had...
journal_title：Clinics in dermatology
pub_type： 历史文章,杂志文章
doi：10.1016/j.clindermatol.2019.09.002
更新日期：2020-01-01 00:00:00
abstract：:A new or changing melanocytic nevus in a child or adolescent often leads to concern in parents and physicians. To avoid undue alarm and unnecessary procedures, dermatologists should be aware of the natural history and clinical spectrum of nevi in pediatric patients, as well as findings that are potentially worrisome i...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2014.12.015
更新日期：2015-05-01 00:00:00
abstract：:Skin, together with its appendages, forms an organ with several defensive roles; among them it acts as a barrier, which is one of its very important protective functions. There has been increased interest in studying the effects of age on these functions. There are different intensities and timing involved in this pro...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2011.08.024
更新日期：2012-05-01 00:00:00
abstract：:Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chroni...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2017.01.009
更新日期：2017-01-01 00:00:00
abstract：:Any infectious illness presenting with an eruption in a pregnant patient may be associated with an increased risk of fetal loss. The viruses that can infect the placenta during maternal infection and can be transmitted to the fetus and cause congenital disease include the rubella virus, the measles virus, the varicell...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2019.10.020
更新日期：2020-01-01 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：:Hailey-Hailey disease, also called benign familial pemphigus, is a late-onset blistering disorder that affects the flexures. There are typically painful erosions and cracks in affected areas. Lesions generally begin between 20 and 40 years of age. In two third of all cases, positive family history is detected. In path...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2015.04.006
更新日期：2015-07-01 00:00:00
abstract：:Psoriasis is a chronic inflammatory disorder that is mediated by elements of the innate and adaptive immune systems. Its characteristic features in the skin consist of inflammatory changes in both dermis and epidermis, with abnormal keratinocyte differentiation and proliferation. Despite the elucidation of many aspect...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2007.08.016
更新日期：2007-11-01 00:00:00
abstract：:Skin cancer is both common and responsible for significant morbidity and mortality. Opportunities for both primary and secondary prevention are available to both dermatologists and non-dermatologists. Counseling selected patients about ultraviolet avoidance and proper use of sunscreens is recommended. Due to technical...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2013.05.002
更新日期：2013-11-01 00:00:00
abstract：:Injection of neurotoxins and filling agents for the treatment of facial aesthetics has increased dramatically during the past few decades due to an increased interest in noninvasive aesthetic improvements. An aging but still youth-oriented population expects effective treatments with minimal recovery time and limited ...
journal_title：Clinics in dermatology
pub_type： 杂志文章,评审
doi：10.1016/j.clindermatol.2011.08.005
更新日期：2011-11-01 00:00:00
abstract：:Dr. Ida Lystic is an assistant professor in the Division of Gastroenterology at the Byron Edwards & Samuel Thompson (BEST) Medical Center. Before becoming one of the BEST doctors, she completed her fellowship training at the Owen T. Henry and Eugene Rutherford (OTHER) Medical Center and her MD degree at the prestigiou...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2018.02.001
更新日期：2018-01-01 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
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 deeply rooted fascination with beauty penetrates society worldwide. The indulgence to look and feel beautiful pervades all ages, genders, and nationalities, with research conferring a remarkable tendency to agree on measures of attractiveness among these disparate groups. Research has found that beautiful people d...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2016.04.006
更新日期：2016-01-01 00:00:00
abstract：:The legal landscape in dermatology is constantly evolving. Dermatologists should nurture strong physician-patient relationships with proper informed consent and stay abreast of legal issues as they pertain to today's practice of medicine. Medicolegal issues that have risen to the forefront include wrong-site surgery, ...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2015.07.001
更新日期：2016-01-01 00:00:00
abstract：:In 2002, new guidelines for interactions with the pharmaceutical industry and physicians were published as an official code of conduct. Adherence to the guidelines was voluntary, and there were no provisions for discipline to companies who did not subscribe to the code or who subscribed but did not comply. Many of the...
journal_title：Clinics in dermatology
pub_type： 杂志文章
doi：10.1016/j.clindermatol.2009.02.005
更新日期：2009-07-01 00:00:00
abstract：:José Maria Vargas, (1786-1854), who was born on March 10, 1796, graduated with a Doctor of Medicine degree from the Central University of Venezuela in 1808. He was subsequently imprisoned in 1813 by the Spanish authorities for his independence activities. When finally freed, he traveled to Edinburgh for postgraduate m...
journal_title：Clinics in dermatology
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.clindermatol.2019.07.004
更新日期：2020-01-01 00:00:00
