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Journal of Cutaneous Medicine and... 2023
Topics: Humans; Interleukin Inhibitors; Vitiligo; Antibodies, Monoclonal; Ustekinumab; Psoriasis; Treatment Outcome; Interleukin-23
PubMed: 36802834
DOI: 10.1177/12034754231157646 -
The British Journal of Dermatology Feb 2023In 2015, a major achievement in vitiligo research was the development of an internationally agreed upon core outcome domain set for randomized clinical trials (RCTs)....
BACKGROUND
In 2015, a major achievement in vitiligo research was the development of an internationally agreed upon core outcome domain set for randomized clinical trials (RCTs). Three outcomes were identified as being essential: repigmentation, side-effects/harms and maintenance of gained repigmentation. Four items were further recommended for inclusion. The following recommendations then followed: repigmentation should be assessed by measuring the percentage of repigmentation in quartiles (0-25%, 26-50%, 51-79%, 80-100%) and cosmetic acceptability of the results should be assessed using the Vitiligo Noticeability Scale.
OBJECTIVES
The primary objective of this study was to assess uptake of the core outcome domain set for RCTs in vitiligo. Secondary objectives were to update the systematic review on outcomes reported in vitiligo RCTs, and to assess whether repigmentation and cosmetic acceptability of the results were measured using the above-mentioned recommended scales.
METHODS
We searched PubMed, Cochrane Library (CENTRAL and Systematic Reviews) and ClinicalTrials.gov for vitiligo RCTs between November 2009 and March 2021. Screening and data extraction were independently performed on title and summary by two researchers. All outcomes and outcome measures reported in eligible RCTs were retrieved and collated.
RESULTS
In total, 174 RCTs were identified: 62 were published between 2009 and 2015, and 112 were published between 2016 and 2021.Thirty-eight different outcomes were reported. Repigmentation was the primary outcome in 89% of trials (150 of 169). Forty-nine different tools were used to measure repigmentation. Side-effects and harms were reported in 78% of trials (136 of 174). Maintenance of gained repigmentation was reported in only 11% of trials (20 of 174) and duration of follow-up varied greatly from 1 to 14 months. Cosmetic acceptability of the results and cessation of disease activity were assessed in only 2% of trials (four of 174). Quality of life of patients with vitiligo was assessed in 13% of trials (22 of 174). Finally, only 11 of 112 RCTs (10%) published between 2016 and 2021 reported all three essential core outcome domains (repigmentation, side-effects and maintenance of gained repigmentation) and none of the trials reported both essential and recommended core outcome domains.
CONCLUSIONS
Efforts are still needed to close the gap between set recommendations and RCT outcome reporting.
Topics: Humans; Drug-Related Side Effects and Adverse Reactions; Outcome Assessment, Health Care; Quality of Life; Randomized Controlled Trials as Topic; Treatment Outcome; Vitiligo
PubMed: 36763863
DOI: 10.1093/bjd/ljac074 -
The British Journal of Dermatology Feb 2023
Meta-Analysis
Topics: Humans; Vitiligo; Lupus Erythematosus, Systemic; Comorbidity; Hypopigmentation
PubMed: 36680305
DOI: 10.1093/bjd/ljac038 -
The Journal of Investigative Dermatology May 2023Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases... (Meta-Analysis)
Meta-Analysis
Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases in patients with vitiligo and quantify their associations compared with those in healthy controls. A comprehensive search of MEDLINE and EMBASE from the inception to June 2022 was conducted. Observational studies on prevalent diseases in patients with vitiligo compared with those in healthy controls were included, whereas studies limited to pediatrics or providing only laboratory results were excluded. A total of 78 studies were eligible for analyses. Patients with vitiligo showed higher risks of having comorbid autoimmune and connective tissue diseases, including alopecia areata (OR = 2.63, 95% confidence interval [CI] = 2.50‒2.78), discoid lupus erythematosus (OR = 2.54, 95% CI = 1.74‒3.72), Sjogren's syndrome (OR = 2.50, 95% CI = 1.98‒3.16), myasthenia gravis (OR = 2.30, 95% CI = 1.74‒3.02), systemic lupus erythematosus (OR = 1.96, 95% CI = 1.52‒2.52), and rheumatoid arthritis (OR = 1.82, 95% CI = 1.55‒2.15). Thyroid diseases, diabetes mellitus, metabolic syndrome, sensorineural hypoacusis, and ophthalmic abnormalities were also more prevalent in patients with vitiligo. In conclusion, vitiligo is associated with various systemic diseases. Physicians should evaluate and manage potential comorbid conditions in patients with vitiligo.
Topics: Humans; Child; Vitiligo; Comorbidity; Sjogren's Syndrome; Lupus Erythematosus, Systemic; Thyroid Diseases; Autoimmune Diseases
PubMed: 36574529
DOI: 10.1016/j.jid.2022.10.021 -
Journal of Personalized Medicine Dec 2022In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the... (Review)
Review
In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the dorsal sides of the hands, this "vitiligo phenotype" may lead to the investigation of certain associated pathologies that sometimes have no obvious clinical impact. To assess the link between skin depigmentation and autoimmune pathologies, we conducted a systematic review involving article selection from the PubMed database. Patients with coexisting thyroid pathologies were found to have a predisposition for developing acral vitiligo and depigmentation of the wrists, and autoimmune thyroid pathologies appeared to be the only coexisting autoimmune or inflammatory diseases in vitiligo patients to show a pattern of distribution. The association of concomitant thyroid dysfunction with depigmentation of the hands was found to be so strong that the absence of depigmented macules on the hands may exclude the coexistence of an autoimmune thyroid pathology. Although the frequency of acral involvement in patients with vitiligo and autoimmune pathologies is higher, the mechanism by which thyroid dysfunction influences this distribution pattern remains incompletely elucidated and requires future studies.
PubMed: 36556267
DOI: 10.3390/jpm12122048 -
Evidence-based Complementary and... 2022The aim of this systematic review was to identify randomized controlled trials that looked at the effects of in any form on different skin diseases. Up to March 2022,... (Review)
Review
The aim of this systematic review was to identify randomized controlled trials that looked at the effects of in any form on different skin diseases. Up to March 2022, the online databases of Scopus, Web of Science, PubMed, Embase, Google Scholar, and Cochrane trials were searched. This study included 14 records of people who had experienced different types of skin disease including atopic dermatitis, vulgaris, arsenical keratosis, psoriasis, vitiligo, acute cutaneous leishmaniasis, warts, eczema, and acne. The mean SD age of the patients was 28.86 (4.49); [range: 18.3-51.4], with females accounting for 69% (506 out of 732) of the total. The follow-up mean SD was 8.16 (1.3) (ranged: 4 days to 24 weeks). The odds ratio (OR) was found to be 4.59 in a meta-analysis (95% CI: 2.02, 10.39). Whereas the null hypothesis in this systematic review was that lotion had no impact, OR 4.59 indicated that lotion could be effective. The efficacy of essential oil and extract has been demonstrated in most clinical studies. However, more research is needed to completely evaluate and validate the efficacy or inadequacy of therapy with , although it appears that it can be used as an alternative treatment to help people cope with skin problems.
PubMed: 36518853
DOI: 10.1155/2022/7993579 -
Journal of Cosmetic Dermatology Mar 2023Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation.
OBJECTIVES
To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis.
METHODS
We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.
RESULTS
A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy [OR = 32.35, 95% CI (1.79, 586.05)], Er: YAG laser+ topical 5% 5-FU [OR = 10.74, 95% CI (4.05, 28.49)], needling/micro-needling [OR = 3.42, 95% CI (1.18, 9.88)], betamethasone intramuscular injection [OR = 3.08, 95% CI (1.17, 8.13)], topical tacrolimus [OR = 2.54, 95% CI (1.30, 4.94)], and oral Chinese herbal medicine compound [OR = 2.51, 95% CI (1.40, 4.50)] integrated with NB-UVB were more efficacious in excellent to complete repigmentation response rate (≥75%). Besides, NB-UVB+ Er: YAG laser+ topical 5% 5-FU [OR = 0.17, 95% CI (0.04, 0.67)] and NB-UVB+ needling/micro-needling [OR = 0.24, 95% CI (0.06, 0.88)] were less likely evaluated as ineffective repigmentation response (≤25%).
CONCLUSIONS
All combination therapies ranked higher than NB-UVB monotherapy in inducing successful repigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5% 5-FU and NB-UVB+ needling/microneedling would be the preferred therapeutic approaches.
Topics: Humans; Vitiligo; Ultraviolet Therapy; Network Meta-Analysis; Combined Modality Therapy; Fluorouracil; Treatment Outcome
PubMed: 36456176
DOI: 10.1111/jocd.15534 -
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 -
Frontiers in Oncology 2022Several studies have reported an association between the occurrence of immune-related adverse events (irAEs) and prognosis in patients with melanoma treated with immune...
Patients with melanoma treated with immune checkpoint inhibitors who had non-thyroid endocrine and skin immune-related adverse events have better prognosis: A systematic review and meta-analysis.
BACKGROUND
Several studies have reported an association between the occurrence of immune-related adverse events (irAEs) and prognosis in patients with melanoma treated with immune checkpoint inhibitors (ICIs), but the results remain controversial. We conducted a systematic review and meta-analysis to investigate the association between irAEs and survival in patients with melanoma treated with ICIs.
METHODS
We searched the PubMed, Web of Science, and China National Knowledge Infrastructure databases through May 5, 2022 for clinical studies evaluating the association between irAEs and in melanoma patients treated with ICIs. Combined hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were calculated using fixed- or random-effects models based on heterogeneity.
RESULTS
A total of 60 articles were included, with 16,520 patients. In patients with melanoma treated with ICIs, the occurrence of irAEs was significantly associated with better OS (HR, 0.58; 95% confidence interval [CI], 0.51-0.66; <0.00001) and PFS (HR, 0.61; 95%CI, 0.51-0.72; <0.00001). Endocrine irAEs (OS, HR, 0.81; 95%CI, 0.72-0.92; =0.001; PFS: HR, 0.84; 95%CI, 0.73-0.96, =0.009), skin irAEs (OS, HR, 0.59; 95%CI, 0.41-0.85; =0.004; PFS: HR, 0.43; 95%CI, 0.36-0.52; <0.00001), vitiligo (OS, HR, 0.22; 95%CI, 0.15-0.31; <0.00001; PFS, HR, 0.33; 95%CI, 0.25-0.44; <0.00001), and grade 1-2 irAEs (OS, HR, 0.67; 95%CI, 0.58-0.78; <0.00001; PFS, HR, 0.62; 95%CI, 0.51-0.76; <0.00001) showed similar results. However, thyroid, lung, gastrointestinal, liver, and grade 3-4 irAEs were not significantly associated with OS and PFS. The occurrence of non-thyroid endocrine irAEs was significantly associated with better OS (HR, 0.22; 95%CI, 0.15-0.31; <0.00001). In patients with melanoma treated with anti-programmed cell death protein 1 (OS, HR, 0.61; 95%CI, 0.51-0.72; <0.00001; PFS, HR, 0.59; 95%CI, 0.47-0.74; <0.00001), the association between irAEs and clinical benefit was clearer than in patients treated with anti-cytotoxic T-lymphocyte-associated protein 4 (OS, HR, 0.68; 95%CI, 0.52-0.89; =0.005; PFS, HR, 0.93; 95%CI, 0.49-1.78; =0.83).
CONCLUSION
Among patients with melanoma treated with ICIs, those who developed non-thyroid endocrine irAEs and cutaneous irAEs have better prognosis. This suggests that non-thyroid endocrine irAEs and cutaneous irAEs may be a prognostic biomarker for patients with melanoma treated with ICIs.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022338308.
PubMed: 36185176
DOI: 10.3389/fonc.2022.976224 -
Journal of the American Academy of... Dec 2022
Topics: Humans; Vitiligo; Hypopigmentation; Radiation Injuries; Demography; Autoimmune Diseases
PubMed: 35995610
DOI: 10.1016/j.jaad.2022.07.042