Background: Bullous pemphigoid (BP) is an autoimmune disease characterized by the appearance of very pruritic subepidermal blisters. It appears mostly in the elderly and is associated with multiple comorbidities, which makes its management and treatment difficult. The purpose of this systematic review is to compile current information on published cases of BP treated with omalizumab (omalizumab) and dupilumab (dupilumab) in order to obtain information on clinical efficacy and safety data available. Methods: A literature search of all cases of BP treated with omalizumab/dupilumab published in the literature up to January 2024 was performed using the Pubmed database. After an exhaustive search, a total of 61 studies encompassing 886 patients met the inclusion criteria and were included in the review. Results: The majority of patients with BP treated with omalizumab/dupilumab presented a significant improvement in symptomatology, being very safe drugs with minimal side effects. The main limitation of the presented review is the quality of the included studies, most of them being case series or individual cases. The development of studies with a higher level of scientific evidence in the near future would be of great interest. Conclusions: Both omalizumab and dupilumab appear to be effective options for treating BP in patients refractory to other pharmacological therapies. They are drugs with a good safety profile and the adverse reactions associated with their use are infrequent and generally mild.
Background/Objectives: Baricitinib, a selective Janus kinase (JAK) 1 and 2 inhibitor, has recently emerged as a therapeutic option for patients with severe alopecia areata (AA). The aim of this study was to identify clinical and biological predictors of early therapeutic response to baricitinib in patients with AA in real-world clinical practice. Methods: A retrospective cohort study was conducted including patients with AA initiating baricitinib between January 2022 and January 2025. Patients were stratified into early responders and non-early responders. Univariate and multivariate logistic regression analyses were performed to assess factors independently associated with early therapeutic response. Results: A total of 44 patients with AA treated with baricitinib were included, the majority being female (65.9%, 29/44), with a mean age of 37.3 years (SD 16.1). Early responders accounted for 34.1% (15/44) of the cohort. In multivariate analysis, early response to baricitinib was independently associated with a lower baseline Severity of Alopecia Tool (SALT) score, shorter disease duration, and elevated erythrocyte sedimentation rate (ESR) at baseline (p < 0.05). Receiver Operating Characteristic (ROC) curve analyses were performed to determine optimal thresholds for predicting early therapeutic response: ESR ≥ 9 mm/h, baseline SALT score ≤ 60%, and disease duration ≤ 7 years. Conclusions: Baseline stratification using easily obtainable clinical and laboratory parameters may help identify patients most likely to benefit from initiating treatment with baricitinib. Our findings support the existence of a therapeutic window of opportunity in AA, particularly in patients with lower disease burden, shorter disease duration, and elevated ESR values.
15 October 2024 in JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Background/Objectives: Melanoma is a skin cancer that can lead to a poor prognosis. Unlike other oncologic diseases, there is scarce evidence regarding sexual function in melanoma patients, as well as factors associated with sexual dysfunction (SD). The aim of this study was to evaluate SD in a cohort of melanoma patients, as well as to describe associated factors. Methods: A cross-sectional analysis was conducted in individuals diagnosed with melanoma. Data regarding sociodemographic characteristics, clinical stage of the disease, quality of life, and sexual functioning were obtained through the use of validated assessment tools. The duration of the study was from 1 January 2023 to 1 January 2024. Results: Seventy-five patients were included. The mean age was 52.70 ± 14.07 years, and 61.33% (46/75) were females. Melanomas at stages III or IV comprised 18.67% (14/75) of the sample. A negative impact of the melanoma on sexual function was reported by 29.33% (22/75) of patients, with low sexual desire being the most frequent cause. Female SD was associated with older age, shorter disease duration, greater depression rates, and visible scar location after melanoma surgery (p < 0.05). Male SD correlated with higher anxiety and depression rates and worse quality of life (p < 0.05). No association was found for melanoma stage in any case (p > 0.30). Conclusions: Melanoma patients may suffer from SD, which can be associated with mood status disturbances, poor quality of life, and older age. Since the most frequent causes of a negative impact on sexuality are a reduction in sexual desire and the side effects of melanoma surgery, patients should be specifically asked about sexuality to improve holistic care of the disease, irrespective of disease stage.