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Introduction: Locally advanced basal cell carcinoma (LA-BCC) is defined as that BCC in which there is radiological confirmation of invasion of certain neighboring structures in depth and also, usually, a BCC that is of a sufficient size and invasion (although there is no radiological demonstration of deep invasion) in which surgery and radiotherapy are not adequate, are insufficient or are contraindicated to achieve the cure of the tumor, either due to characteristics of the tumor itself or of the patient. Sonidegib is indicated for the treatment of adult patients with locally advanced basal cell carcinoma that is not amenable to curative surgery or radiotherapy. Material and methods: This is a retrospective, multicenter and descriptive study in nine centers in Andalusia, Spain. Patients treated with sonidegib for >3 months for locally advanced BCC were included from 1 January 2021 to 1 January 2023. Epidemiological, efficacy and safety data were collected. Results: In the present study, a total of 38 patients were included, with a median age of 76.23 years (range 40–101). Prior treatment was surgery (31.57%; n = 25), radiotherapy (15.78%; n = 6), vismodegib (31.57%; n = 12). Eleven patients had not received prior treatment. LA-BCC were located in the cephalic pole, face or scalp. There was a total response in 9/38 patients (23.7%), partial response in 25/38 patients (65.8%) and no response in 4 patients (10.52%). In 6/34 patients, the dose was reduced to 200 mg every other day until it was discontinued due to adverse effects. The main adverse effects reported were dysgeusia (n = 8), asthenia (n = 8), = 6), muscle spasms (n = 6), alopecia (n = 4) and gastrointestinal intolerance (n = 4). Discussion: Sonidegib is the second iHh authorized for the treatment of adult patients with locally advanced BCC who are not amenable to curative surgery or radiotherapy, based on the results of the phase II clinical trial, BOLT. Sonidegib shows good effectiveness and an acceptable safety profile in routine clinical practice in the sample presented. [ABSTRACT FROM AUTHOR]

There is a lack of real practice studies comparing ustekinumab and ixekizumab effectiveness and safety. The main aim of this study was to compare the effectiveness and safety of both drugs used to treat moderate‐to‐severe psoriasis patients over 52 weeks. The secondary objective was to identify which clinical variables could have an impact on its effectiveness. A retrospective observational study was carried out, comparing the first 28 patients treated with ustekinumab after its commercialization was compared to the first 35 patients treated with ixekizumab. Although a higher level of skin clearance was achieved with ixekizumab with a PASI 90 and 100 response of 54.3% and 40% compared to 42.9% and 25% for ustekinumab, these differences were not statistically significant. Ixekizumab achieved a higher PASI 90 response in those patients with BMI > 27 (slightly overweight), which was statistically significant (P =.024). Ustekinumab had a greater survival at 52 weeks than ixekizumab, with a trend towards statistical significance (P =.052). Ixekizumab achieved higher skin clearance rates (PASI 90 and 100 response) than ustekinumab, with no statistically significant differences. However, ixekizumab should be specially considered in overweight patients. [ABSTRACT FROM AUTHOR]

There are no studies which directly compare efficacy in Psoriasis Area and Severity Index (PASI) response of secukinumab and ixekizumab. The main aim of this study was to compare the efficacy and safety of both drugs used to treat moderate‐to‐severe psoriasis patients over 52 weeks. Secondary objectives were to identify which factors related to prior biologic treatment influenced their efficacy and analyze data obtained at 12 weeks. A retrospective observational study was carried out, in which a group of the first 59 patients treated with secukinumab after its commercialization, was compared with another group of the first 29 patients treated with ixekizumab. The PASI 75, 90, and 100 response obtained at 52 weeks was 64.4%, 49.2%, and 41.4% for secukinumab and 75.9%, 62.1%, and 41.4% for ixekizumab, respectively, with no statistically significant differences. Regarding previous biological treatment, both treatments showed a decrease in efficacy as the number of prior biologics increases. No differences were found between secukinumab and ixekizumab in bio‐naïve or bio‐experienced patients, with the exception of a higher PASI 75 response at week 52 for ixekizumab in those patients with two or more previous biologics (P =.039) Secukinumab and ixekizumab have demonstrated high efficacy and safety, with no statistically significant differences. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system that shares similar immunopathogenic mechanisms with chronic plaque psoriasis, such as the overexpression of the Th17 pathway. We report a 50-year-old male patient with MS and severe chronic plaque psoriasis who presented to Hospital Virgen de la Victoria, Málaga, Spain, in 2019. He was successfully treated with ixekizumab (anti-interleukin [IL]-17A and IL-17A/F monoclonal antibody). The treatment achieved complete skin clearance (i.e. a Psoriasis Area Severity Index 100 response) with no adverse event and no evidence of progression of the neurological disease either. [ABSTRACT FROM AUTHOR]

Background: Biological therapy dose modification is a common practice in the long‐term treatment of plaque psoriasis. Objective: The objective of the study was to determine prevalence, characteristics of patients, effectiveness, treatment survival of secukinumab dose reduction (SEC‐DR) strategy and assess its safety and cost implications. Methods: A retrospective, observational, multicenter cohort study was conducted in patients with plaque psoriasis treated with secukinumab and up to 2 years of follow‐up. Results: In 63/347 patients with an initial standard dose regimen, SEC‐DR was tried at any moment in 18.2% of them after sustained response. In 51 patients, the interval between administrations was increased while in 12 patients, monthly dose was reduced to 150 mg. Successful SEC‐DR was achieved in 77.8% of the patients, with sustained PASI response to the end of the study. Survival of secukinumab treatment and safety profile were not compromised by DR. The use of DR saved 33% of the cost, including failures in which standard treatment was resumed. Limitations: The proper of the study designed and the arbitrary definition of "DR success." Conclusion: Off‐label SEC‐DR strategy was used in patients with sustained response to standard dose regimen; this strategy showed long‐term efficacy without compromising treatment survival or worsening the safety profile while also being cost saving. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the levels of anxiety, depression, and quality of life of individuals living with acne patients (cohabitants). The study included patients, cohabitants, and controls; a total of 204 participants. Patients' health-related quality of life was measured with the Dermatology Life Quality Index (DLQI), while cohabitants' quality of life was measured with the Family Dermatology Life Quality Index (FDLQI). The psychological state of all participants was measured with the Hospital Anxiety and Depression Scale (HADS). Presence of acne impaired the quality of life of 89.4% of the cohabitants. The FDLQI scores of cohabitants were significantly associated with the DLQI scores of the patients (rp = 0.294; p = 0.044). Anxiety and depression levels in cohabitants were significantly higher than in controls (p < 0.01). In conclusion, acne may have a negative impact on quality of life and psychological well-being of patients and their cohabitants. [ABSTRACT FROM AUTHOR]

Background Safety is an important consideration in decisions on treatment for patients with moderate-to-severe psoriasis and the study of drug safety is the main purpose of the BIOBADADERM registry. The combination of a biologic agent and a conventional systemic drug [generally methotrexate (MTX)] is a common treatment in clinical practice. However, there is a paucity of evidence from real-world practice on the safety of such combination regimens in the treatment of psoriasis. Objectives The primary objective of this study was to ascertain whether the use of regimens combining biologic drugs with MTX in the management of moderate-to-severe psoriasis increases the risk of adverse events (AEs) or serious AEs (SAEs). We compared monotherapy using tumour necrosis factor (TNF), interleukin (IL)-17 and IL-23 inhibitors with the use of the same drugs in combination with MTX. Methods Using data from the BIOBADADERM registry, we compared biologic monotherapies with therapies that were combined with MTX. We estimated adjusted incidence rate ratios (aIRR) using a random effects Poisson regression with 95% confidence intervals for all AEs, SAEs, infections and serious infections and other AEs by system organ class. Results We analysed data from 2829 patients and 5441 treatment cycles, a total of 12 853 patient-years. The combination of a biologic with MTX was not associated with statistically significant increases in overall risk of AEs or SAEs in any treatment group. No increase in the total number of infections or serious infections in patients receiving combined therapy was observed for any group. However, treatment with a TNF inhibitor combined with MTX was associated with an increase in the incidence of gastrointestinal AEs (aIRR 2.50, 95% CI 1.57–3.98; P < 0.002). Conclusions The risk of AEs and SAEs was not significantly increased in patients with moderate-to-severe psoriasis receiving different classes of biologic drugs combined with MTX compared with those on biologic monotherapy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which focuses on trichomegaly of the eyelashes and facial hypertrichosis induced by erlotinib.

A. Sahuquillo-Torralba, Dr. P. Coto-Segura, Dr. O. Baniandrés, Dr. R. Feltes, and Dr. M. Alsina contributed to data collection, discussed the results, and commented on the manuscript. Dr. S. Armesto, Dr. E. Herrera-Acosta, Dr. D. Vidal, Dr. E. Vilarrasa, Dr. R. Rivera, Dr. P. de la Cueva, Dr. I. Belinchón, Dr. G. Carretero, Dr. L. Rodríguez, Dr. [Extracted from the article]

The aim of the study was to assess the long‐term effectiveness and safety of secukinumab in Spanish patients with moderate‐to‐severe psoriasis in a daily practice setting. Nationwide multicenter, observational, retrospective, non‐interventional, single‐cohort study including patients who initiated treatment with secukinumab in daily clinical practice conditions. Subjects were followed for a minimum of 3 months and a maximum of 24 months. Psoriasis Area Severity Index (PASI), Body Surface Area and Physician's Global Assessments were collected at baseline and months 3, 6, 12, 18 and 24 during treatment. Adverse events and reasons for secukinumab withdrawal were collected and classified for analyses. A total of 384 patients were enrolled in the study. Median PASI declined rapidly from 14.3 at baseline to 2.7 at month 3, 2.1 at month 12, and remained low (2.8) at month 24. Within the group of patients with PASI ≥10 at baseline (n = 278), 58.3%, 60.4% and 56.5% achieved a PASI90 response at months 3, 12 and 24, respectively. As for absolute PASI, 86.5%, 69.5%, 42.7% and 37% achieved PASI <5, < 3, < 1 and 0, respectively, at month 3. Secukinumab was more effective in biologic‐naïve patients and in those with lower Body Mass Index. Secukinumab presented a good long‐term safety profile. Secukinumab was effective and safe in a routine clinical setting, in a large cohort of patients with moderate‐to‐severe plaque psoriasis, in the short‐, medium‐ and long‐term (up to 24 months). [ABSTRACT FROM AUTHOR]

Regarding therapy, almost all clinical trials exclude patients with pustular psoriasis, limiting the evidence to support therapy for these patients. G.C. has been reimbursed by Janssen, Abbvie, Novartis, Pfizer, MSD and Celgene for advisory service and conferences. There were 3864 patients with PP, 41 patients with generalized pustular psoriasis (GPP) and 294 patients with palmoplantar pustular psoriasis (PPP) included in the study. [Extracted from the article]

Psoriasis is a chronic dermatological disease with great impact on patients' quality of life (QoL). The main objective of this study was to assess the impact of secukinumab treatment on different patient‐reported outcomes (PROs) during a long‐term follow‐up in Spanish patients with moderate‐to‐severe psoriasis under real‐world conditions. Retrospective, observational, open‐label, nationwide multicenter cohort study that included patients who initiated treatment with secukinumab in daily clinical practice conditions. PROs assessing disease impact and QoL included Dermatology Life Quality Index (DLQI), Patient's Global Psoriasis Assessment, Itch Numerical Rating Scale and EuroQoL Thermometer Visual Analogue Scale. Outcomes, including PROs and Psoriasis Area and Severity Index (PASI), were assessed at months 3, 6, 12, 18, and 24 during treatment. A total of 238 patients were enrolled in the study. Patients had a mean DLQI score of 14.9 at baseline; 78.3%, 73.7%, and 71.7% of them achieved a DLQI 0/1 response at months 6, 12, and 24, respectively. DLQI score was lower in the long term for naïve patients. A sharp decrease in mean DLQI was observed during the first 3 months, reaching a plateau that was maintained until the end of follow‐up. Similar findings were observed for the rest of QoL assessments. There was a close association between improvement in QoL and skin clearance (PASI), which progressively increased during follow‐up. In this study, secukinumab sustainably improved patient's QoL during a 24‐month follow‐up, with strongest effects in patients naïve to biological therapies and with a direct correlation with PASI improvement. [ABSTRACT FROM AUTHOR]

Limited information is available regarding the risk of incident liver disease in patients with psoriasis receiving systemic therapies. To describe the liver safety findings of conventional and modern systemic therapies for moderate-to-severe psoriasis, and to compare the relative incidence rates of hepatic adverse events (AEs) for each drug. All the patients on the BIOBADADERM registry were included. Crude and adjusted incidence rate ratios (cIRR and aIRR, respectively) of hepatic AEs, using anti-TNF drugs as reference, were determined. Outcomes of interest were hypertransaminasemia, nonalcoholic fatty liver disease (NADFLD) and a group of other, less represented, hepatic AEs. Our study included 3,171 patients exposed to systemic drugs (6279 treatment cycles). Incident hypertransaminasemia was the most frequent hepatic AE (incidence rate of 21 per 1000 patients-years [CI 95% 18–23]), followed by NAFLD (8 cases per 1000 patients-years [95% CI 6–10]). Methotrexate (aIRR 3.06 [2.31–4.4]; p = 0.000) and cyclosporine (aIRR 2.37 [1.05–5.35]; p =.0378) were associated with an increased risk for hypertransaminasemia when compared to anti-TNF-α agents. No differences were observed between different groups of biologics. Conventional therapies were not associated with new incident NAFLD. Comparative information of the incidence of hepatic AEs could facilitate drug selection in moderate-to-severe psoriasis. [ABSTRACT FROM AUTHOR]

Introduction: There is limited and conflicting evidence over the real-world drug survival of secukinumab (SEC) in patients with psoriasis, especially in the long term. Our objective was to analyze the short- and long-term survival of SEC (S-SEC) and its predictive factors for the treatment of psoriasis. Methods: Patients clinically diagnosed with plaque psoriasis and under treatment with secukinumab (n = 384) in a daily practice setting were analyzed in a retrospective, multicenter study performed in a nationwide cohort and followed up for a period of 2 years. Kaplan–Meier curve was plotted to analyze drug survival time, and log-rank test was performed to compare several groups. Factors related to speed of treatment discontinuation were studied with a Cox regression model. Results: The overall cumulative secukinumab drug survival rates observed at 6, 12, 18, and 24 months were 97.1%, 89.0%, 81.1%, and 74.3%, respectively. Obesity [hazard ratio (HR), 1.809, CI 95% 1.114–2.962; p = 0.004] and previous experience with biological therapies, particularly those who had been treated with ≥ 2 biologicals with different mechanisms of action (HR 3.476, CI 95% 1.875–6.444; p = 0.017) were associated with an early discontinuation, whereas psoriatic arthritis was associated with delayed discontinuation, (HR 0.493, CI 95% 0.265–0.917; p = 0.025). Conclusions: In our study, we found that cumulative secukinumab drug survival for psoriasis patients for the period 6–18 months was in the range of real-world evidence studies. Additionally, we observed a relatively high long-term survival rate at 24 months (74.3%). [ABSTRACT FROM AUTHOR]

The effect of sex on systemic therapy for psoriasis has not been well studied. The aim of this study was to analyse a large multicentre Spanish cohort of 2,881 patients with psoriasis (58.3% males), followed from January 2008 to November 2018, to determine whether sex influences prescription, effectiveness of therapy, and the risk of adverse events. The results show that women are more likely than men to be prescribed biologics. There were no differences between men and women in effectiveness of therapy, measured in terms of drug survival. Women were more likely to develop adverse events, but the difference in risk was small and does not justify different management. Study limitations include residual confounding and the use of drug survival as a proxy for effectiveness. [ABSTRACT FROM AUTHOR]

Background: Surgical excision is the preferred method of eradicating Bowen´s disease (BD). Photodynamic therapy (PDT) has been successfully used for treatment of actinic keratosis, basal cell carcinoma, and BD. Objective: Our aim was to evaluate the efficacy and tolerability of PDT for treatment of extensive BD. Method: Eighteen patients with 23 biopsy-proven BD lesions were treated with PDT. We defined as extensive those lesions large than 3 cm. Methyl aminolevulinate cream was applied for 3 h before illumination with an light emitting diode light source at a wavelength of 630 nm (energy density of 37 J/cm²). Treatment was repeated 1 week later. Results: After 12 weeks of treatment, 22 of 23 BD lesions (90%) showed complete clinical response. Only three lesions recurred after a follow-up period of 12 months. Cosmetic outcome at 12 months was good or excellent in 94% of patients. Conclusion: Methyl aminolevulinate PDT is an effective treatment option for extensive BD with excellent cosmesis. [ABSTRACT FROM AUTHOR]

A descriptive retrospective, study comparing the first 29 patients who received ustekinumab at our unit following its approval in September 2009 with 30 patients who received secukinumab after its marketing in Spain in November 2015 was conducted. The secukinumab treatment group showed higher whitening rates and a higher percentage of patients reached a psoriasis area and severity index (PASI) 75 response (89.65 vs. 73.33%, p = .108) than those in the ustekinumab treatment group at Week 52. The number of patients achieving a PASI 90 response was particularly remarkable and statistically significant (82.75 vs. 43.33%, p = .002). Better PASI 75 response rates were also observed in the secukinumab group than in the ustekinumab group after 52 weeks in biologic‐naïve patients (89 vs. 72%, p = .586) and among those previously treated with one line (92 vs. 100%, p = 1.00) or with two or more previous biologic lines (88 vs. 62%, p = .336). These differences were greater in the number of patients reaching a PASI 90 response in the secukinumab group than in the ustekinumab group in biologic‐naïve patients (78 vs. 63%, p = .642) and in those previously treated with one (92 vs. 50%, p = .083) or with two or more treatment lines (75 vs. 31%, p = .080). These regular‐practice results overlap or surpass those obtained in the CLEAR clinical trial. [ABSTRACT FROM AUTHOR]

The potential role of infrared radiation in photodermatoses has received very little attention, even though the main sources of radiation used for photobiological studies (UVA, UVB and visible light) include infrared radiation. The objective of the work was to assess whether infrared radiation is involved in the development of skin lesions in patients with different types of photodermatoses. Twenty patients with different photodermatoses were exposed to UVA, UVB and visible radiation using a high‐pressure mercury UVA lamp, a fluorescent broadband UVB lamp, a tungsten bulb and a slide projector for visible radiation. Part of the radiation emitted by these lamps was water‐filtered to block infrared radiation above 1300 nm. All 20 patients developed lesions when exposed to different light sources used for phototest. When exposed to same sources without infrared radiation, 17 patients (85%) did not develop any lesions and the other three (15%) developed less severe lesions than in the area exposed to unfiltered light. Our results show that infrared radiation was necessary for the development of skin lesions in 85% of the patients with photodermatoses in our study. We believe that infrared radiation studies should be included in standard photobiology protocols. [ABSTRACT FROM AUTHOR]

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory disease of unknown aetiology that usually occurs in the elderly. It is characterized by sterile pustules, chronic crusted erosions, cicatricial alopecia, and skin atrophy. The histopathology is nonspecific, and its pathophysiology remains undetermined, with various types of local trauma possibly acting as the triggering factor. We describe a case of EPDS in a 75-year-old female in whom there was a marked response to photodynamic therapy with methyl 5-aminolaevulinic acid. [ABSTRACT FROM AUTHOR]

Introduction In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumour and sentinel-node biopsy. The objective of this study is to analyse the prognostic implications of this delay. Patients and method This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival. Results A delay time of 40 days or less (hazard ratio (HR), 1.7; confidence interval (CI), 1.2–2.5) increased Breslow thickness (Breslow ⩾2 mm, HR, >3.7; CI, 1.4–10.7), ulceration (HR, 1.6; CI, 1.1–2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9–4.2), and primary melanoma localised in the head or neck were independently associated with worse melanoma-specific survival (all P < 0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression. Conclusion Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma. [ABSTRACT FROM AUTHOR]

In humans, it is not possible to obtain experimental evidence of when a cancer begins to metastasize. The purpose of this study was to estimate the time of onset of metastatic dissemination in cutaneous melanoma using a model based on its growth rate (GR). The critical time of onset of metastatic dissemination below which no cases of fatal melanomas were seen may be described with a potential function in which this time is inversely proportional to the GR. The critical time of development beyond which a melanoma may metastasize presents great variation. This time was just 1 month for those melanomas with a fast GR, whereas it was over 5 years for those with a very slow GR. Quantitatively, the fastest-growing melanomas began metastasizing with a greater thickness than the slowest-growing melanomas. A correlation exists between the critical time of onset of metastatic potential and the GR of the melanoma. These results may well have relevance to the understanding of mechanisms of tumor dissemination and for the design of future studies on melanomas, irrespective of whether they are basic studies on biomolecular mechamisms or clinical studies. [ABSTRACT FROM AUTHOR]

The article presents the case study of a 55-year-old Spanish woman who was diagnosed with a history of asymptomatic progressively enlarging pigmented lesion on her left mammary nipple and areola, without associated discharge. It notes that a physical examination found a dark brown, well-defined plaque involving the 80% of the areola and the nipple had disappeared. According to inmunohistochemical analysis, the atypical cells were positive for cytokeratins, and epithelial membrane antigen.