High levels of efficacy were demonstrated in randomized controlled trials assessing the efficacy of guselkumab; however, real-life data are lacking. In this retrospective cohort study, we assessed the efficacy and safety of guselkumab in a cohort of psoriasis patients heavily pretreated with biologic agents. Primary efficacy endpoint was the percentage of patients achieving ≥psoriasis area and severity index (PASI) 90 response at week 24. The cohort included 33 patients of mean age 60 ± 13 years. Guselkumab was initiated after a mean of 4.0 ± 1.0 prior biologics failed over a mean period of 7. 4 ± 3.8 years. The mean duration of guselkumab treatment was 9.5 ± 3.7 months; 29 patients completed at least 24 weeks of treatment. At week 24, 22 patients (76%) achieved response of PASI 75 or higher, 18 (62%) achieved PASI 90 or higher, five (17%) PASI 100, and seven (24%) ≤PASI 50. No adverse effects were observed. This study confirms the efficacy and safety of guselkumab in real-world clinical practice, although for a lesser degree compared with clinical trials.

This case-series study suggests that deep dermatophytosis is a separate entity, distinct from Majocchi's granuloma. It occurs only in immunocompromised patients and is characterized by discrete nodules, an indolent course, the absence of follicular invasion, and proximity to a superficial dermatophyte infection. Systemic antifungal treatment leads to complete resolution. The urgent need for the treatment of superficial fungal infections in immunocompromised patients is emphasized.

No abstract

No abstract

Oncogenic miR-155 appears to contribute to the cancerous phenotype of MyLa and MJ cells, but not of Hut78 cells, by interrupting activation of the G2/M checkpoint in response to SL111, and decreasing apoptosis in response to SL111 and SAHA, thereby facilitating tumour growth. These findings have implications for the potential development of novel therapeutic modalities for MF incorporating miR-155 inhibitors.

Summary Background Early‐stage mycosis fungoides (MF) includes involvement of dermatopathic lymph nodes (LNs) or early lymphomatous LNs. There is a lack of unanimity among current guidelines regarding the indications for initial staging imaging in early‐stage presentation of MF in the absence of enlarged palpable LNs. Objectives To investigate how often imaging is performed in patients with early‐stage presentation of MF, to assess the yield of LN imaging, and to determine what disease characteristics promoted imaging. Methods A review of clinicopathologically confirmed newly diagnosed patients with cutaneous patch/plaque (T1/T2) MF from PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) data. Results PROCLIPI enrolled 375 patients with stage T1/T2 MF: 304 with classical MF and 71 with folliculotropic MF. Imaging was performed in 169 patients (45%): 83 with computed tomography, 18 with positron emission tomography–computed tomography and 68 with ultrasound. Only nine of these (5%) had palpable enlarged (≥ 15 mm) LNs, with an over‐representation of plaques, irrespectively of the 10% body surface area cutoff that distinguishes T1 from T2. Folliculotropic MF was not more frequently imaged than classical MF. Radiologically enlarged LNs (≥ 15 mm) were detected in 30 patients (18%); only seven had clinical lymphadenopathy. On multivariate analysis, plaque presentation was the sole parameter significantly associated with radiologically enlarged LNs. Imaging of only clinically enlarged LNs upstaged 4% of patients (seven of 169) to at least IIA, whereas nonselective imaging upstaged another 14% (24 of 169). LN biopsy, performed in eight of 30 patients, identified N3 (extensive lymphomatous involvement) in two and N1 (dermatopathic changes) in six. Conclusions Physical examination was a poor determinant of LN enlargement or involvement. Presence of plaques was associated with a significant increase in identification of enlarged or involved LNs in patients with early‐stage presentation of MF, which may be important when deciding who to image. Imaging increases the detection rate of stage IIA MF, and identifies rare cases of extensive lymphomatous nodes, upstaging them to advanced‐stage IVA2.

Thrombosis associated with acute cytomegalovirus infection has been reported many times in the literature since the mid 1980s – mainly in case reports and in small case series, but also in four controlled studies. Still, many physicians are unaware of this association although acute cytomegalovirus infection diagnosis in a thrombosis patient may warrant antiviral therapy and may affect anticoagulation therapy duration. Accordingly, the clinical characteristics of patients with thrombosis and acute cytomegalovirus infection are reviewed, and the current knowledge concerning this unique association is presented herein. We believe it is time to add acute cytomegalovirus infection to the list of thrombosis triggers.

Background: The Norton scale is used for assessing pressure ulcer risk. The association between admission Norton scale scores (ANSS), hospitalization length, complications, and mortality in elderly patients admitted to internal medicine departments has never been studied. Objective: To determine if ANSS are associated with hospitalization length, complications, in-hospital mortality, and 1-year mortality in elderly patients admitted to an internal medicine department. Methods: Medical charts of consecutive elderly (≥65 years) patients admitted to a single internal medicine department between January and March 2009 were studied for ANSS, demographics, comorbidities, hospitalization length, complications during hospitalization, in-hospital mortality, and 1-year mortality. Complications during hospitalization included acute coronary syndrome, major arrhythmias, major bleeding, stroke, systemic infections, organ failure, thromboembolism, etc. ANSS ≤14 were considered low. Results: The final cohort included 259 elderly patients: 54.4% were women, the mean age was 81.6 years, and the mean hospitalization length was 3.7 days. Overall, 7.3% of the patients had complications other than pressure ulcers, 3.9% died during hospitalization, and 28.6% died within 1 year. The mean ANSS was 15.4, and 37.8% of the patients had low ANSS. Patients with low ANSS had longer hospitalization (4.7 vs. 2.9 days; p = 0.002), a higher incidence of complications during hospitalization (odds ratio: 3.9; p = 0.006), and higher rates of in-hospital mortality (odds ratio: 7.0; p = 0.007) relative to patients with high ANSS. Regression analysis showed that ANSS were independently negatively associated with hospitalization length, complications during hospitalization, and in-hospital mortality (p < 0.0001, p = 0.003, and p = 0.018, respectively) regardless of age, gender, comorbidities, and pressure ulcer appearance. Rates of 1-year mortality were similar in patients with low and high ANSS. Conclusions: The Norton scale may be used for predicting hospitalization length, complications during hospitalization other than pressure ulcers, and in-hospital mortality in elderly patients admitted to an internal medicine department.