BackgroundNovel agents with good safety profiles are needed in the management of chronic kidney disease–associated pruritus (CKD‐AP). This study aims to assess the efficacy and safety of topical gabapentin in the treatment of CKD‐AP.MethodsThe authors conducted a randomized, double‐blind, vehicle‐controlled study. The key inclusion criteria were: (i) patients on hemodialysis for at least 8 weeks, and (ii) a baseline visual analog scale (VAS) pruritus score ≥5. Patients were randomized into two groups. Topical 6% gabapentin was used in the experimental group while plain permeation cream was used for the control group. The primary endpoint was the mean change in pruritus scores using the VAS (MCPS‐VAS) from baseline after 1 and 2 weeks of once daily application.ResultsThirty patients (15 per group) were included in the analysis. Treatment with 6% topical gabapentin resulted in significantly decreased mean pruritus scores at 1 week (mean score 2.7; range 0–5; P < 0.001) and 2 weeks (mean score 1.3, range 0–5; P < 0.001) from baseline (mean score 5.9; range 5–8). The MCPS‐VAS of the two groups were not significantly different (P = 0.8) after 1 week. However, the MCPS‐VAS of the experimental group (mean change −4.6; range 0–7) was significantly greater (P = 0.01) compared to control (mean change −2.6; range −1 to 5) after 2 weeks. There were no drug‐related adverse events reported.ConclusionOur results suggest that short‐term use of topical gabapentin may significantly decrease CKD‐AP severity after 2 weeks with no reported acute adverse events.

Recurrent aphthous stomatitis (RAS) is an oral condition characterized by frequent attacks of painful oral ulcers. Complex aphthosis (CA) is a severe form of RAS described as the almost constant presence of ≥3 oral ulcers with or without genital aphthosis. Management of primary CA varies, but most patients warrant the use of systemic agents. Because of prolonged treatment, it is preferred to use systemic medications with the least side effects. Herein, we present a case of a primary idiopathic CA. Workup and examination were done to exclude Adamantiades-Behçet's disease and other diseases. The patient was shifted to montelukast after poor tolerance to colchicine. Favorable control of CA was noted during the 5month follow-up period while the patient was on montelukast.

Background: Elevated epidermal interleukin (IL)-36 expression distinguishes psoriasis from eczematous dermatitis, but other psoriasiform dermatitides (PDs) have not been thoroughly investigated for IL-36 expression. In this study, we assess the IL-36 staining pattern (IL36-SP) in psoriasis variants and other PDs including lichen simplex chronicus (LSC), prurigo nodularis (PN), lichen planus (LP), tinea, pityriasis rubra pilaris (PRP), mycosis fungoides (MF), pemphigus foliaceus (PF), acute generalized exanthematous pustulosis (AGEP), impetigo (IMP), and syphilis (SY).Methods: IL-36 immunostaining was performed on 307 cases of psoriasis and various PDs. IL36-SP in the upper epidermis was graded on a scale of 0-4.Results: High IL36-SP occurred in all variants of psoriasis, as well as in AGEP, PRP, PN, tinea, IMP, and LP (P > 0.05). SY, PF, LSC, and MF showed a lower IL36-SP (P ≤ 0.05) compared with psoriasis. Conclusion:All variants of psoriasis exhibit high IL36-SP. IL-36 staining can assist in differentiating MF, PF, SY, and LSC from psoriasis, particularly MF and LSC, which have consistent low IL-36 expression. AGEP, PRP, tinea, IMP, PN, and LP exhibit high IL-36 expression similar to psoriasis, indicating Th17 activation in these diseases.

No abstract

No abstract