583 CPSI - An automatic solution to evaluate psoriasis severity

Abstract

Immune checkpoint inhibitors have advanced cancer treatment but commonly cause cutaneous immune-related adverse events, such as skin rash and pruritus. There is limited understanding on how to characterize cutaneous adverse events and their impact on healthrelated quality of life (HRQOL). This systematic review aimed to assess HRQOL outcome measures in studies of immune checkpoint inhibitors and identify if impact from cutaneous adverse events were specifically captured. A systematic literature search of PubMed, Embase, and Web of Science was performed using the following search terms: immune checkpoint inhibitors (avelumab, pembrolizumab, nivolumab, ipilimumab, atezolizumab, durvalumab) and quality of life. Human subject studies in English, including case series, cohorts, or randomized clinical trials, published in 1/2008e11/2018 were included. Among 1500 studies identified on initial screening, 23 studies (22 randomized controlled trials and 1 observational cohort) met inclusion criteria. Nivolumab (12 studies), ipilimumab (6 studies), and combined treatment with both nivolumab and ipilimumab (3 studies) were the most common therapies assessed. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) was used by 14 studies (61%) but did not contain any question related to the skin. Only 4 studies (17%) used questionnaires that included skinrelated questions: 2 used the Functional Assessment of Cancer Therapy-Melanoma (FACT-M), a melanoma-specific quality of life survey that asked about melanoma surgical site (swelling, pain) and overall skin appearance; 2 used the EORTC-QLQ-LC13, which included 1 question on alopecia. In comparison, 22 of 23 studies reported at least 1 cutaneous adverse event. As the use of immune checkpoint inhibitors becomes more widespread, rigorous assessment of the skin-and itch-specific HRQOL impact from immunotherapy will be critical. Medical marijuana is an emerging therapy in dermatology. Cannabinoids can be separated into endocannabinoids, phytocannabinoids, and synthetic cannabinoids. In this presentation, the experiences of a clinical group with over 150 dermatology patients treated with medical marijuana are reviewed, and encompass a variety of conditions, including but not limited to psoriasis, atopic dermatitis, and acne. The latest medical literature, including indications for medical marijuana, mechanisms of action, possible adverse effects and ethical dilemmas are also reviewed. In addition to the previously listed dermatological conditions, potential uses of marijuana in dermatology include skin cancer and seborrheic dermatitis. Treatment with medical marijuana has also been investigated in difficult to treat conditions such as scleroderma, pruritus, Kaposi Sarcoma and hidradenitis suppuritiva. Skin diseases cause recurrent symptoms, disfigurement and depression. Dermatologists routinely underestimate the impact of their patient's skin disease on quality of life (QoL). Patient-reported outcomes (PROs) are validated surveys...