-
Acta Dermato-venereologica Mar 2020
Meta-Analysis
Topics: Humans; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Genetic; Risk Factors; Vitiligo
PubMed: 32162672
DOI: 10.2340/00015555-3448 -
Frontiers in Medicine 2022Dermatological conditions can have a substantial impact on psychological as well as physical health yet dedicated face-to-face psychological support for patients is...
BACKGROUND
Dermatological conditions can have a substantial impact on psychological as well as physical health yet dedicated face-to-face psychological support for patients is lacking. Thus, individuals may require additional support to self-manage dermatological conditions effectively. Digital technology can contribute to long-term condition management, but knowledge of the effectiveness of digital interventions addressing psychological (cognitive, emotional, and behavioural) aspects of dermatological conditions is limited.
OBJECTIVES
To identify, determine the effectiveness, and explore people's views and experiences of digital interventions supporting the psychological health of people with dermatological conditions.
METHODS
A mixed methods systematic review informed by JBI methodology. The protocol was registered on PROSPERO. Eight electronic databases were searched for papers written between January 2002 and October 2021. Data screening and extraction were conducted in Covidence. The methodological quality of studies were scrutinised against JBI critical appraisal tools. Intervention characteristics were captured using the Template for Intervention Description and Replication checklist and guide. Data were synthesised using a convergent segregated approach. The results were reported in a narrative summary.
RESULTS
Twenty-three papers were identified from 4,883 references, including 15 randomised controlled trials. Nineteen interventions were condition-specific, 13 were delivered online, 16 involved an educational component, and 7 endorsed established, evidence-based therapeutic approaches. Improvements in knowledge, mood, quality of life, the therapeutic relationship, and reduced disease severity in the short to medium term, were reported, although there was substantial heterogeneity within the literature. Thirteen studies captured feedback from users, who considered various digital interventions as convenient and helpful for improving knowledge, emotion regulation, and personal control, but technical and individual barriers to use were reported. Use of established qualitative methodologies was limited and, in some cases, poorly reported.
CONCLUSION
Some web-based digital psychological interventions seem to be acceptable to people living with mainly psoriasis and eczema. Whilst some digital interventions benefitted cognitive and emotional factors, heterogeneity and inconsistencies in the literature meant definitive statements about their effectiveness could not be drawn. Interdisciplinary and patient-centred approaches to research are needed to develop and test quality digital interventions supporting the psychological health of adults living with common and rare dermatological conditions.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=285435], identifier [CRD42021285435].
PubMed: 36405626
DOI: 10.3389/fmed.2022.1024879 -
Evidence-based Complementary and... 2020Fire needle therapy has been reported as an effective treatment for vitiligo. However, current clinical evidence has not been systematically evaluated. The aim of this...
INTRODUCTION
Fire needle therapy has been reported as an effective treatment for vitiligo. However, current clinical evidence has not been systematically evaluated. The aim of this study was to determine whether fire needle therapy is effective and safe for treating vitiligo.
METHODS
Seven databases were searched until October 2019 for randomized controlled trials on fire needle therapy, with and without conventional treatments, versus any type of conventional therapy for treating vitiligo. The RevMan 5.3.5 software was used to perform meta-analysis of the included studies.
RESULTS
Forty-seven trials comprising 3618 patients were included. Fire needle combined with conventional vitiligo treatments had a higher efficacy (risk ratio (RR): 1.55, 95% confidence interval (CI): 1.46-1.65, < 0.00001 and RR: 1.41, 95% CI: 1.24-1.61, < 0.00001, respectively) and a greater effect on restoring the color of the area of the skin lesion (mean difference (MD): 3.40, 95% CI: 2.11-4.69, < 0.00001), increasing the pigment point of vitiligo (MD: 0.83, 95% CI: 0.54-1.13, < 0.00001) and improving the cytokine level (MD: 8.10, 95% CI: 6.94-9.27, < 0.00001) and effectual time (MD: -4.76, 95% CI: -7.33 to -2.19, =0.0003) than traditional methods. Limb lesions (RR: 1.60, 95% CI: 1.31-1.95, < 0.00001) were more effectively treated when the treatments included fire needles, whereas the therapeutic effect of fire needles on either the head and neck (RR: 1.13, 95% CI: 0.78-1.64, =0.52) or torso lesions (RR: 1.22, 95% CI: 0.82-1.81, =0.33) was not significantly different compared to that without fire needles. No statistically significant differences in adverse effects (RR: 1.15, 95% CI: 0.89-1.49, =0.28) and recurrence rates (RR: 0.90, 95% CI: 0.17-4.92, =0.91) during the follow-up period were observed between treatment with and without fire needles.
CONCLUSIONS
Fire needle therapy combined with other conventional treatments is useful in treating vitiligo. Further studies with larger sample sizes should be performed to make a conclusive judgment. This trial is registered with CRD42018094918.
PubMed: 32908571
DOI: 10.1155/2020/8492097 -
International Journal of Molecular... Aug 2021In health, the non-recirculating nature and long-term persistence of tissue-resident memory T cells (TRMs) in tissues protects against invading pathogens. In disease,...
In health, the non-recirculating nature and long-term persistence of tissue-resident memory T cells (TRMs) in tissues protects against invading pathogens. In disease, pathogenic TRMs contribute to the recurring traits of many skin diseases. We aimed to conduct a systematic literature review on the current understanding of the role of TRMs in skin diseases and identify gaps as well as future research paths. EMBASE, PubMed, SCOPUS, Web of Science, Clinicaltrials.gov and WHO Trials Registry were searched systematically for relevant studies from their inception to October 2020. Included studies were reviewed independently by two authors. This study was conducted in accordance with the PRISMA-S guidelines. This protocol was registered with the PROSPERO database (ref: CRD42020206416). We identified 96 studies meeting the inclusion criteria. TRMs have mostly been investigated in murine skin and in relation to infectious skin diseases. Pathogenic TRMs have been characterized in various skin diseases including psoriasis, vitiligo and cutaneous T-cell lymphoma. Studies are needed to discover biomarkers that may delineate TRMs poised for pathogenic activity in skin diseases and establish to which extent TRMs are contingent on the local skin microenvironment. Additionally, future studies may investigate the effects of current treatments on the persistence of pathogenic TRMs in human skin.
Topics: CD8-Positive T-Lymphocytes; Humans; Immunologic Memory; Lymphoma, T-Cell, Cutaneous; Organ Specificity; Psoriasis; Skin; Skin Diseases; T-Lymphocytes; Vitiligo
PubMed: 34445713
DOI: 10.3390/ijms22169004 -
Aesthetic Surgery Journal. Open Forum Sep 2021Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome.
BACKGROUND
Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome.
OBJECTIVES
This article reviews various conditions that medical tattooing has been empirically studied in terms of patient satisfaction outcomes, makes practice recommendations, and suggests future directions for research.
METHODS
This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data were provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author's practice to illustrate emerging medical tattooing applications that need further evaluation.
RESULTS
Eighteen studies met the inclusion criteria and addressed the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple-areola complex reconstruction.
CONCLUSIONS
The application of medical tattooing has shown high levels of patient satisfaction across conditions. The practice recommendation grade is "B" or recommend since the level of evidence for these interventions ranged from III to IV according to the American Society of Plastic Surgeons guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using randomized controlled trial methodology with waitlist controls is needed.
PubMed: 34159314
DOI: 10.1093/asjof/ojab015 -
Melanoma Research Oct 2019Immune checkpoint inhibitors (ICIs), which target CTLA-4 or PD-(L)1 molecules, have shown impressive therapeutic results. Durable responses, however, are only observed...
Immune checkpoint inhibitors (ICIs), which target CTLA-4 or PD-(L)1 molecules, have shown impressive therapeutic results. Durable responses, however, are only observed in a segment of the patient population and must be offset against severe off-target immune toxicity and high costs. This calls for biomarkers that predict response during ICI treatment. Although many candidate biomarkers exist, as yet, there has been no systematic overview of biomarkers predictive during. Here, we provide a systematic review of the current literature of ICI treatment to establish an overview of candidate predictive biomarkers during ICI treatment in melanoma patients. We performed a systematic Medline search (2000-2018, 1 January) on biomarkers for survival or response to ICI treatment in melanoma patients. We retrieved 735 publications, of which 79 were finally included in this systematic review. Blood markers were largely studied for CTLA-4 ICI, whereas tumor tissue markers were analyzed for PD-(L)1 ICI. Blood cytology and soluble factors were more frequently correlated to overall survival (OS) than response, indicating their prognostic rather than predictive nature. An increase in tumor-infiltrating CD8 + T-cells and a decrease in regulatory T-cells were correlated to response, in addition to mutational load, neoantigen load, and immune-related gene expression. Immune-related adverse events were also associated frequently with a favorable response and OS. This review shows the great variety of potential biomarkers published to date, in an attempt to better understand response to ICI therapy; it also highlights the candidate markers for future research. The most promising biomarkers for response to ICI treatment are the occurrence of immune-related adverse events (especially vitiligo), lowering of lactate dehydrogenase, and increase in activated CD8 + and decrease in regulatory T-cells.
Topics: Antibodies, Monoclonal; Antineoplastic Agents, Immunological; B7-H1 Antigen; Biomarkers, Tumor; CD8-Positive T-Lymphocytes; CTLA-4 Antigen; Cell Cycle; Humans; Immunotherapy; Melanoma; Prognosis; Skin Neoplasms; T-Lymphocytes, Regulatory; Treatment Outcome
PubMed: 30855527
DOI: 10.1097/CMR.0000000000000589 -
Current Oncology (Toronto, Ont.) Feb 2024The reference to vitiligo-like lesions (VLLs) induced by immune checkpoint inhibitors (ICIs) as a valuable predictive marker of treatment success of immunotherapy with... (Observational Study)
Observational Study
The reference to vitiligo-like lesions (VLLs) induced by immune checkpoint inhibitors (ICIs) as a valuable predictive marker of treatment success of immunotherapy with ICIs in melanoma has been mentioned in the literature. Its role in non-small cell lung cancer (NSCLC)-treated patients remains a poorly recognized phenomenon with uncertain significance regarding its predictive value. A retrospective, observational, single-center report was performed, with descriptive analysis of clinicopathological and treatment characteristics of patients with stage IV NSCLC who developed ICI-induced VLL between January 2018 and December 2022, contextualized in a comprehensive review of the literature and reported cases regarding this phenomenon. During the first 5 years' experience of ICI use in stage IV NSCLC treatment, three cases of ICI-induced VLLs were diagnosed. In line with the previous reports, two of the three presented cases exhibited treatment response and favorable prognosis. The recognition and understanding of the pathophysiological processes underlying ICI-induced VLLs may represent a promising opportunity to identify a predictive marker of tumor response to ICIs, with impact in treatment selection and patient management. It also may contribute to the recognition of new patterns of molecular expression that could lead to improvements in therapeutic development.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Immunotherapy; Lung Neoplasms; Retrospective Studies; Vitiligo
PubMed: 38392077
DOI: 10.3390/curroncol31020083