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The article focuses on recent developments in Lyme disease treatment and diagnosis, including the potential of combination therapy to address persister bacteria and improved diagnostic tests. These developments aim to combat the disease's persistence following missed or delayed diagnoses and treatment.

The article focuses on the two-day National Academies of Science, Engineering, and Medicine (NASEM) workshop on chronic illness related to long Covid-19 infections, held in Washington in July 2023. It highlighted the need for physicians' training, unified research, and clinical support. It urged a shift in understanding akin to long COVID-19 infections. Physician opined on the need to identify improved methods for managing and treating these conditions.

Daniel C. Butler, MD, is an associate professor of dermatology at the University of Arizona College of Medicine with a focus on geriatric dermatology. He emphasizes the importance of healthy aging in dermatology and advocates for a broader perspective on aging skin. Butler discusses research priorities, the 4M model of geriatrics, and practical tips for working with older patients in dermatology. He highlights the need for population-based research, improved clinical care, and access to novel treatment options for older adults. [Extracted from the article]

Dr. Sarah Cigna, an ob.gyn. specializing in sexual health, emphasizes the importance of collaboration between ob.gyns and dermatologists in managing vulvar pain and dermatoses. She highlights the need for increased training in vulvar dermatology for both specialties and announces the launch of a joint Vulvar Dermatology Clinic at The George Washington University in 2025. Dr. Cigna provides insights on approaching patient history and exams, diagnosing and treating various vulvar issues, and the significance of considering autoimmune, infectious, and noninfectious causes of vulvar itch. She also discusses the role of mast cell proliferation in vulvar and vestibular pain and itching. [Extracted from the article]

The article discusses the importance of collaboration between obstetricians/gynecologists and dermatologists in managing vulvar dermatoses, highlighting the need for specialized care in this neglected area of medicine. The joint Vulvar Dermatology Clinic at The George Washington University will address complex cases with unclear etiology or ineffective treatment. The text also covers various causes of vulvar pain and itch, emphasizing the significance of a comprehensive history and examination to differentiate between infectious and noninfectious causes, autoimmune conditions like lichen sclerosus and lichen planus, and other conditions such as vulvar Crohn's disease, neuropathic itch, and pelvic floor muscle spasm. [Extracted from the article]

The article discusses research by Lisa Beck, MD, presented at the Revolutionizing Atopic Dermatitis conference 2023, on the closure of the LIBERTY AD open-label extension study of dupilumab after 5 years.It is reported that the remaining patients showed stable and sustained improvements in skin lesions and pruritus, with no new emergent side effects, supporting the long-term efficacy and safety of dupilumab for atopic dermatitis.

This article discusses the management and evaluation of chronic itch in older adults. The author, Dr. Shawn G. Kwatra, highlights the use of immunoglobulin E (IgE) and eosinophils as reliable biomarkers for type 2 inflammation in chronic pruritus of unknown origin (CPUO). These biomarkers can help differentiate between immune-driven itch and neuropathic itch. The article also mentions the potential use of immunomodulatory therapies, such as dupilumab and JAK inhibitors, in treating CPUO. Additionally, the article discusses the association between chronic pruritus and PD-1 inhibitors, as well as the importance of conducting a malignancy workup for patients with CPUO. [Extracted from the article]

This article discusses the diagnosis and treatment of cutaneous immune-related adverse events (cirAEs) in oncology patients receiving immune checkpoint inhibitors (ICIs). The author emphasizes the importance of specific diagnosis based on morphology and histopathology, as well as treating rashes in a similar way as in the non-ICI setting. Older patients are just as prone to cirAEs as younger patients. The article also highlights recent developments, such as new diagnostic criteria for dermatologic immune-related adverse events and the impact of corticosteroids on the efficacy of ICI therapy. The author provides recommendations for managing cirAEs, including the use of prednisone and alternative therapies. Additionally, the article discusses the approach to morbilliform eruptions, the soak and smear technique, ICI-induced bullous pemphigoid, and the caution with antibiotics in the ICI setting. [Extracted from the article]

Atopic dermatitis (AD) can occur in older adults, even those aged 90 years and older, contrary to previous beliefs that it only starts in childhood. The prevalence of AD in the United States is around 6-8% throughout adulthood, with one in four adults reporting adult-onset disease. Risk factors and immune differences exist between adult-onset and childhood-onset AD. Older adults with AD have a unique serum cytokine pattern and higher levels of certain cytokines compared to younger patients. Air pollution may also play a role in the onset of AD in older age. Sleep disturbance is a common issue in older adults with AD, and treatment can be complicated due to medication side effects, comorbidities, and other aspects of aging. Further research is needed to better understand and treat AD in older adults. [Extracted from the article]

Dermatoporosis is a condition characterized by the chronic fragility of aging and sun-damaged skin. It can lead to serious medical complications and comorbidities. Dermatologists can address this condition through holistic and creative combination treatments, such as topical retinoids and alpha hydroxy acids, as well as counseling on sun-protective measures and nutrition. The use of vitamin D analogues and bioflavonoids, along with a higher protein intake, may also be beneficial. Recognizing dermatoporosis as a medical condition can help validate patients' experiences and improve their care. [Extracted from the article]

A committee of experts from the National Academies of Science, Engineering, and Medicine (NASEM) is examining the treatment for chronic illness associated with Lyme disease. The committee will present "consensus findings" on treatment recommendations for chronic illness after Lyme disease, but will not make specific recommendations on diagnosis and treatment approaches. There is a lack of research and consensus on the treatment of Lyme Infection-Associated Chronic Illness (Lyme IACI), with few randomized controlled trials and no approved therapies. The committee aims to address this gap and provide guidance for advancing treatment. [Extracted from the article]

A recent Cochrane Systematic Review has confirmed that magnesium sulfate significantly reduces the risk of cerebral palsy in preterm births and may also reduce the risk of severe neonatal intraventricular hemorrhage. However, it is still unclear whether the effects of magnesium sulfate vary based on patient characteristics or treatment characteristics. The American College of Obstetricians and Gynecologists advises institutions to develop their own guidelines for magnesium sulfate use. The review included six randomized controlled trials and found that magnesium sulfate reduced the risk of cerebral palsy and death or cerebral palsy. However, it also increased maternal adverse effects. Further research is needed to determine the optimal use of magnesium sulfate. [Extracted from the article]

A retrospective study of almost 800 patients aged 60 years and older with atopic dermatitis (AD) found that the condition most commonly presented on the extensor surfaces and trunk, with lichenification and nummular lesions being the most frequent rash characteristics. The study also revealed that the use of topical corticosteroids was the most common treatment, followed by oral corticosteroids and antihistamines. The researchers noted that AD in older individuals presents as a unique phenotype compared to younger ages, which may inform dermatologists' diagnosis and treatment of AD in this population. Further research is needed to understand the specific features and optimal treatments for AD in older patients. [Extracted from the article]

A large prospective cohort study in the Netherlands found that weight-bearing recreational activity was associated with a 22% increased risk of developing knee osteoarthritis (OA), but only in individuals with low levels of lower-limb muscle mass. The study suggests that tailored advice for physical activity is important, especially for those with low muscle mass. Non-weight-bearing activities such as biking, swimming, or water exercises, along with strengthening exercises, may be beneficial for individuals with low muscle mass to prevent knee OA. The study also found no significant association between weight-bearing or non-weight-bearing physical activity and incident radiographic knee OA in individuals with knee pain at baseline. Thigh circumference can be used as an indicator of muscle mass in clinical practice. [Extracted from the article]

A Danish study presented at the 2024 Rheumatology Winter Clinical Symposium highlighted the overlap between inflammatory bowel disease (IBD) and spondyloarthritis (SpA). The study found that about half of newly diagnosed IBD patients had findings consistent with SpA. This suggests that there may be underdiagnosis of SpA among IBD patients and emphasizes the importance of considering joint symptoms when making treatment choices for IBD. Additionally, the study emphasized the role of central pain in driving residual symptoms in patients on biologic disease-modifying antirheumatic drugs (bDMARDs) for axial SpA. Other key studies highlighted included a retrospective cohort study on ankylosing spondylitis (AS) incidence in US military personnel and the GO-BACK withdrawal and retreatment trial of golimumab. The study also mentioned the termination of a phase 2 study on tildrakizumab and the approval of an intravenous formulation of secukinumab for axSpA. The future of the biologic pipeline for SpA is focused on new pathways in the IL-17 arena. [Extracted from the article]

Leflunomide, a drug approved by the FDA in 1998 for the treatment of rheumatoid arthritis (RA), has been largely overlooked and dismissed in favor of biologics. However, recent clinical trial data suggests that leflunomide should be reconsidered as a treatment option. Studies have shown that leflunomide is as effective as methotrexate, a standard treatment for RA, and can be used in combination with other agents. While leflunomide has similar side effects to methotrexate, it may offer a cost benefit in developing countries where biologics are not as accessible. [Extracted from the article]

New research presented at the Diabetes in Pregnancy Study Group of North America (DPSG) meeting explores the relationship between the intrauterine environment and long-term health outcomes in offspring. The studies aim to understand the mechanisms behind the transgenerational impact of maternal diabetes and obesity on the risk of obesity and diabetes in children. The prevalence of childhood obesity and type 2 diabetes has been increasing, making it crucial to understand the fetal origins of these conditions. Researchers are conducting cohort studies and basic research to investigate the associations and potential mechanisms involved in transgenerational obesity and diabetes. [Extracted from the article]

The article reports on a presentation by Dr. Jonette Elizabeth Keri on therapies for acne at the annual Integrative Dermatology Symposium. Dr. Keri stated that myo-inositol promotes the entry of glucose into the cell and is a safe and often effective supplements to recommend for acne. She was asked about a case of an adult female with acne during a panel discussion. She also mentioned the best advice for patients.

The lack of data on the optimal timing of delivery for pregnancies complicated by diabetes is a major challenge in obstetrics, according to Katherine Laughon Grantz, MD, MS, of the National Institute of Child Health and Human Development. The prevalence of gestational diabetes mellitus (GDM) has been increasing, along with the prevalence of prepregnancy obesity, which raises the risk of gestational and type 2 diabetes. The American College of Obstetricians and Gynecologists offers recommendations for delivery timing based on the type and control of diabetes, but these recommendations are mainly based on retrospective data. Only two randomized controlled trials have investigated delivery timing in the context of diabetes, and both were underpowered to study neonatal outcomes. Dr. Grantz is currently recruiting for a randomized trial to determine the optimal time to initiate delivery for uncontrolled GDM-complicated pregnancies. Retrospective studies have shown associations between diabetes and neonatal respiratory morbidity, but the pathophysiology is not fully known. Other retrospective studies have found differences in neonatal morbidity and mortality based on gestational age at delivery. Overall, there is a need for more research to determine the best timing for delivery in pregnancies complicated by diabetes. [Extracted from the article]

Researchers at the biennial meeting of the Diabetes in Pregnancy Study Group of North America discussed the challenges in treating gestational diabetes mellitus (GDM). The treatment of GDM is hindered by poor trial quality, conflicting clinical practice guidelines, and the inability to predict individual risk and treatment response. The American College of Obstetricians and Gynecologists recommends insulin as the preferred first-line therapy, while the Society of Maternal-Fetal Medicine accepts metformin as a safe alternative. A $12 million multicenter study called the DECIDE trial aims to provide clarity by comparing the effectiveness of oral metformin and insulin in preventing GDM-associated complications. GDM is a heterogeneous condition, and researchers are exploring individualized treatment options based on the underlying physiological processes. The use of incretin mimetics and intensive glycemic targets for overweight or obese patients with GDM is also being investigated. [Extracted from the article]

The article emphasizes the inadequate awareness and proactive measures regarding cardiovascular risks in patients with psoriatic disease. Dermatologists and rheumatologists are urged to play a more consistent role in primary cardiovascular prevention, with a focus on early and screening for risk factors. Topics include the cardiovascular risk in psoriatic disease, the lack of awareness among patients and healthcare providers, and the recommended guidelines for cardiovascular risk assessment.

The article focuses on challenges in treating palmoplantar pustulosis, a form of psoriasis localized to the hands and feet, where IL-36 receptor antagonists, particularly spesolimab, show limited efficacy compared to generalized pustular psoriasis; It discusses higher impact on quality of life for acral psoriatic diseases, along with potential treatments like IL-17 and IL-23 blockade, TNF inhibition; and the investigation of Janus kinase (JAK) inhibitors.

The article discusses the challenges of treating tough-to-treat psoriasis patients, exploring potential causes such as genetic endotypes, immunologic factors, lower serum drug levels, anti-drug antibodies, female sex & comorbidities. Topics include the persistence of psoriatic arthritis (PsA) patients on tumor necrosis factor inhibitors; decline in efficacy of various biologics over time; and the need for better guidelines & treatment algorithms for patients who fail multiple biologic agents.

The article offers information on the potential role of dietary supplements in managing vitiligo, particularly as adjuvants to phototherapy through antioxidant pathways. Topics include the scarcity of data on supplement use for vitiligo; the theoretical basis of efficacy; and specific supplements such as Ginkgo biloba, vitamins C, E, D and alpha-lipoic acid, along with insights from studies on their impact on repigmentation.

The article considers the potential of cystic fibrosis as a framework for the research into the genetics of familial pulmonary fibrosis (FPF) and other lung diseases. It suggests the link between different subtypes of fibrotic interstitial lung disease to the same mutation in genes linked to FPF. It refers to cystic fibrosis transmembrane conductance regulator (CFTR) gene as the first lung disease gene discovered using gene-mapping techniques.

The article offers information on a teledermatology clinic program established in an underserved area of Washington, D.C., to provide care for atopic dermatitis (AD) and alopecia areata, with high patient satisfaction. Topics discussed include the challenges of dermatology deserts in underserved communities; the use of telemedicine to educate and treat patients; and the potential for this model to be replicated in other underserved areas across the U.S.

The article discusses recent developments in Lyme disease treatment and diagnosis, including the potential use of combination therapy to target "persister" bacteria and improved diagnostic tests. It discussed these advancements at a National Academies of Science, Engineering & Medicine workshop on infection-associated chronic illnesses; combination therapy and direct diagnostic tests for microbial nucleic acids and proteins could offer new approaches to combat persistent Lyme disease symptoms.

The article discusses links flares of systemic lupus erythematosus (SLE) to overgrowth of the gut bacteria Ruminococcus blautia gnavus. It discusses that SLE patients with spikes in R. gnavus growth, particularly those with severe kidney disease, experienced concordant periods of raised disease activity; underlying instability in the gut microbiome of SLE patients; and the potential role of gut bacteria in driving SLE flares, with implications for future treatments targeting the microbiome.

The article discusses the need for research and treatment strategies for infection-related chronic illnesses, such as long COVID, posttreatment Lyme disease, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) & multiple sclerosis. It emphasizes the importance of education for physicians; growth of multidisciplinary clinics; financially supported clinical care to address these chronic illnesses; and mechanisms of pathogen persistence, viral reactivation & immune dysregulation.

The article focuses on the evolving pulmonary landscape in individuals living with HIV. It highlighting chronic pulmonary obstructive disease (COPD), lung cancer and asthma; leading to worse outcomes, and while immunocompromise plays a role, it is not the only factor contributing to the increased risk; and including chronic immune activation, inflammation, viral persistence in the lung, oxidative stress, dysbiosis and accelerated cellular aging.

The article offers information about dupilumab and sustained improvements in skin lesions and pruritus, and no new emergent side effects. It mentions safety results show a lower incidence of severe treatment-emergent adverse events, and no new adverse events have emerged. Ocular surface disease is the most predominant side effect associated with dupilumab in routine care.

The article offers information on shared decision-making about atopic dermatitis (AD) treatment, including dosing and associated concerns with dupilumab, self-image issues, topical regimen adherence, and disease quantification. Experts provide advice on treatment decisions, safety concerns, and addressing fears about Janus kinase inhibitors, while also discussing the use of dupilumab in the real world and methods to enhance topical adherence for patients with diffuse xerosis.

The article offers information on a post hoc analysis of the JADE EXTEND phase 3 trial, which evaluated the effects of oral abrocitinib in adults with moderate to severe atopic dermatitis (AD) for up to 96 weeks. The analysis found that both younger and older patients treated with abrocitinib showed sustained improvements in skin clearance, itch, and quality of life, with a dose-dependent efficacy up to 96 weeks in the younger age group and up to 48 weeks in the older age group.

The article focuses on the long-term safety of JAK inhibitors, specifically abrocitinib and upadacitinib, in adolescents with moderate to severe atopic dermatitis (AD). The topics covered include the acceptable safety profile of abrocitinib in adolescents with over 96 weeks of exposure; the absence of unique safety concerns in adolescents compared to adults; and also mentions the similar safety profile of upadacitinib in adolescents and adults with up to 4 years of treatment..

The article focuses on two studies that demonstrate the efficacy of Lebrikizumab and dupilumab in treating dermatitis on the face, hands and feet. Lebrikizumab showed significant improvement in facial and hand dermatitis in patients with moderate to severe atopic dermatitis, while dupilumab rapidly improved signs, symptoms and quality of life in adults and adolescents with moderate to severe hand and foot dermatitis.

The article discusses research presented at the Revolutionizing Atopic Dermatitis conference on the long-term safety of JAK-inhibitors in adolescents with atopic dermatitis (AD). The study evaluated the safety profiles of abrocitinib and upadacitinib in adolescents and found that both medications demonstrated acceptable safety profiles with no significant long-term adverse effects observed in patients with moderate to severe AD.

The article discusses research on the efficacy of lebrikizumab and dupilumab in improving facial and hand dermatitis in patients with moderate to severe atopic dermatitis. The studies found that a significant proportion of patients treated with lebrikizumab experienced improvement in facial and hand dermatitis, and dupilumab was found to rapidly improve signs, symptoms, and quality of life in patients with moderate to severe hand and foot dermatitis.

The article discusses research presented at the Revolutionizing Atopic Dermatitis conference by dermatologists Robert Sidbury, Elaine Siegfried, and Lawrence Eichenfield. Topics covered include diagnosing and treating atopic dermatitis in infants, the use of systemic treatment with dupilumab, and the role of food allergy testing in infants with atopic dermatitis.