2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T59e,Appropriate tapering strategy for corticosteroids in ulcerative colitis (UC) is uncertain. To compare the efficacy and safety of two steroid tapering regimens in patients with active UC. We randomised patients with active UC with initial steroid response after 2 weeks to short (total 6 weeks) or long taper (total 10 weeks). Randomization was stratified for acute severe UC. The primary outcome was steroid-free clinical remission at 6 months. Secondary outcomes included assessment of symptomatic remission, relapse rate, endoscopic and histological scores, and safety. Of 94 patients (48 in long, 46 in short taper) randomised, short taper was inferior to long taper in inducing clinical remission at 6 months (RR = 2.19; CI 1.08-4.46; p = 0.02). The relapse rates were similar in the long (37%) and short taper (46%) arms (HR: 0.34; CI: 0.10-1.11; p = 0.42). The median UCEIS scores (3 vs. 2; p = 0.23) and Nancy scores [2 (IQR 0-3) vs. 1.5 (0.75-3); p = 0.4] were not different between arms. Adverse events in the long and short taper arms, such as acne (14.58% vs. 2.16%), myopathy (8.33% vs. 6.52%), skin changes (2.08% vs. 2.17%), mood changes (0% vs. 4.34%), cytopenia (0% vs. 2.17%), and headache (6.25% vs. 6.52%) were similar. A shorter taper duration of 6 weeks was inferior to a longer taper of 10 weeks in achieving clinical remission of UC at 6 months. CTRI Number: CTRI/2021/06/034129.31:Taa0,ABSTRACT Background Appropriate tapering strategy for corticosteroids in ulcerative colitis (UC) is uncertain. Aim To compare the efficacy and safety of two steroid tapering regimens in patients with active UC. Methods We randomised patients with active UC with initial steroid response after 2 weeks to short (total 6 weeks) or long taper (total 10 weeks). Randomization was stratified for acute severe UC. The primary outcome was steroid‐free clinical remission at 6 months. Secondary outcomes included assessment of symptomatic remission, relapse rate, endoscopic and histological scores, and safety. Results Of 94 patients (48 in long, 46 in short taper) randomised, short taper was inferior to long taper in inducing clinical remission at 6 months (RR = 2.19; CI 1.08–4.46; p = 0.02). The relapse rates were similar in the long (37%) and short taper (46%) arms (HR: 0.34; CI: 0.10–1.11; p = 0.42). The median UCEIS scores (3 vs. 2; p = 0.23) and Nancy scores [2 (IQR 0–3) vs. 1.5 (0.75–3); p = 0.4] were not different between arms. Adverse events in the long and short taper arms, such as acne (14.58% vs. 2.16%), myopathy (8.33% vs. 6.52%), skin changes (2.08% vs. 2.17%), mood changes (0% vs. 4.34%), cytopenia (0% vs. 2.17%), and headache (6.25% vs. 6.52%) were similar. Conclusion A shorter taper duration of 6 weeks was inferior to a longer taper of 10 weeks in achieving clinical remission of UC at 6 months. Trial Registration CTRI Number: CTRI/2021/06/034129 32:T46c,Neonatal Multisystem Inflammatory Syndrome (MIS-N) is believed to result either from the transplacental transfer of maternal SARS-CoV-2 antibodies or from a delayed hyperinflammatory response triggered by the neonate's own immune reaction to SARS-CoV-2 infection. In this study we aim to explore the clinical presentation, laboratory findings, and current approaches to the diagnosis and management of MIS-N in neonates. A total of 15 infants with MIS-N followed in Bursa Uludag University Neonatal Intensive Care Unit between January 2022 and January 2023 were included in this retrospective study. Eight mothers had a history of COVID-19 disease during pregnancy. All of neonates had cardiac involvement (supraventricular tachycardia, persistant sinusal bradycardia or AV block) and 10 infants had respiratory failure. All infants had elevated inflammatory biomarkers and received steroids or/and IVIG. Two infants died. The common presentation of MIS-N included cardiac aritmia and respiratory failure. Newborns with MIS-N may be at higher risk for adverse outcomes. Early diagnosis and treatment are important in these patients.33:T43c,Among the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]).34:T946,VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined genetic disease with an estimated prevalence of 1 in 4269 men older than 50 years and is marked by systemic inflammation, progressive bone marrow failure, and inflammatory cutaneous manifestations. To define the spectrum of cutaneous manifestations in VEXAS syndrome and the association of these findings with clinical, genetic, and histological features. This observational cohort study included data from 112 patients who were diagnosed with VEXAS-defining genetic variants in UBA1 between 2019 and 2023. Data were collected from medical record review or from patients with VEXAS directly evaluated at the National Institutes of Health in Bethesda, Maryland. To define the spectrum of cutaneous manifestations in VEXAS in association with genetic, histological, and other clinical findings. A secondary outcome was cutaneous response to treatment in VEXAS. Among the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]). Results of this cohort study show that skin manifestations are a common and early manifestation of VEXAS syndrome. Genetic evaluation for VEXAS should be considered in older male patients with cutaneous vasculitis, neutrophilic dermatoses, or chondritis. Awareness of VEXAS among dermatologists is critical to facilitate early diagnosis.35:Tbbc,ImportanceVEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined genetic disease with an estimated prevalence of 1 in 4269 men older than 50 years and is marked by systemic inflammation, progressive bone marrow failure, and inflammatory cutaneous manifestations.ObjectiveTo define the spectrum of cutaneous manifestations in VEXAS syndrome and the association of these findings with clinical, genetic, and histological features.Design, Setting, and ParticipantsThis observational cohort study included data from 112 patients who were diagnosed with VEXAS-defining genetic variants in UBA1 between 2019 and 2023. Data were collected from medical record review or from patients with VEXAS directly evaluated at the National Institutes of Health in Bethesda, Maryland.Main Outcomes and MeasuresTo define the spectrum of cutaneous manifestations in VEXAS in association with genetic, histological, and other clinical findings. A secondary outcome was cutaneous response to treatment in VEXAS.ResultsAmong the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]).Conclusions and RelevanceResults of this cohort study show that skin manifestations are a common and early manifestation of VEXAS syndrome. Genetic evaluation for VEXAS should be considered in older male patients with cutaneous vasculitis, neutrophilic dermatoses, or chondritis. Awareness of VEXAS among dermatologists is critical to facilitate early diagnosis.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Systemic Corticosteroid: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Systemic Corticosteroid (modality). Clinician-written summaries and actionable practice insights. 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Findings reflect provider perceptions only.","value_numeric":null}],"summaries":{"what_studied":"Semi-structured interviews with 65 HCPs (61 dermatologists, 4 nurse practitioners) across the US and 5 European countries explored how providers assess nonsegmental vitiligo (NSV) severity and how those assessments drive treatment and management decisions.","key_result":"HCPs used inconsistent definitions of NSV severity — most centered on patient-reported QOL, lesion extent, and location. Topical corticosteroids, calcineurin inhibitors, systemic steroids, topical JAK inhibitors, and phototherapy were all in use, but with notable regional variation. Key barriers included access, adherence, safety risks, and lack of durable long-term options.","limitations":"Qualitative design limits generalizability; sample skewed heavily toward dermatologists (61/65), with only 4 nurse practitioners and no patient perspectives included. Country-level breakdown and exact regional differences are not fully detailed.","practice_takeaway":"No standardized severity criteria exist for NSV, so clinicians should proactively incorporate QOL measures and shared decision-making into every assessment and treatment plan. Awareness of access and durability barriers — especially for phototherapy and JAK inhibitors — is essential when setting realistic treatment goals with patients."}},{"doi":"10.1183/16000617.0032-2026","pmid":"42386313","title":"Implementing acute exacerbations of COPD care bundles: evidence, effectiveness and future directions","journal_title":"European Respiratory Review","journal_issn":"0905-9180","published_at":"2026-07-01T00:00:00.000Z","url":"https://doi.org/10.1183/16000617.0032-2026","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-08T13:26:37.172Z","updated_at":"2026-07-08T13:26:37.172Z","tags":[{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"condition","value":"Acute Exacerbation of COPD","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"condition","value":"Chronic Obstructive Pulmonary Disease","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Care Bundle","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Digital Health Decision Support","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Noninvasive Ventilation","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Pulmonary Rehabilitation","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"Impact flag 'limited_evidence' reflects heterogeneous real-world effectiveness, not absence of plausible benefit; some controlled studies do show significant short-term readmission reductions.","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"Level of evidence set to 5 (narrative review/expert synthesis); individual trials cited within the review include higher-quality designs but the review itself does not perform a formal meta-analysis.","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"No sample size tag was applied — this is a narrative review synthesising multiple studies rather than a single study with one N; the largest cited meta-analysis included 65,945 patients.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesised evidence (PubMed, Embase, Cochrane; 2000–2025) on the structure, implementation and clinical impact of care bundles for acute exacerbations of COPD (AECOPD), covering both the acute in-hospital phase and the discharge/transitional care period.","key_result":"Discharge-focused bundles were associated with fewer readmissions in pooled analyses (risk ratio 0.80, 95% CI 0.65–0.99), but no significant benefit for mortality or HRQoL. One transition-bundle trial reduced 7-day readmissions from 5.5% to 1.0% and 30-day from 18.2% to 15.1%, yet 90-day rates were unchanged. Large real-world multisite studies showed no reduction in 28-day (OR 1.02) or 90-day COPD readmission (OR 1.00), in-hospital mortality (OR 1.01) or 90-day mortality (OR 1.05), highlighting marked heterogeneity.","limitations":"- Narrative review design with no meta-analysis; evidence synthesis is qualitative and selective.\n- Underlying trials are heterogeneous in bundle content, fidelity reporting and outcome definitions, limiting direct comparison.\n- Real-world effectiveness is highly context-dependent (staffing, service organisation, post-discharge support), so findings may not generalise across settings.","practice_takeaway":"Implement AECOPD care bundles as structured delivery frameworks—not checklists—covering optimised pharmacotherapy, inhaler technique education, smoking cessation, pulmonary rehabilitation referral and a time-defined early follow-up (within 7–30 days, with telephone contact at 72 h for high-risk patients). Benefit depends on multidisciplinary team roles, audit-and-feedback cycles and strong post-discharge support rather than on adding more bundle components."}},{"doi":"10.1093/bjd/ljag086.427","pmid":null,"title":"BG10 Herpes simplex virus infection in bullous pemphigoid: diagnostic and management implications","journal_title":"British Journal of Dermatology","journal_issn":"0007-0963","published_at":"2026-06-26T00:00:00.000Z","url":"https://doi.org/10.1093/bjd/ljag086.427","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-06T13:36:18.221Z","updated_at":"2026-07-06T13:36:18.221Z","tags":[{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"condition","value":"Bullous Pemphigoid","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"condition","value":"Herpes Simplex Virus Infection","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"generic","value":"aciclovir","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"modality","value":"Antiviral Agent","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"sample_size","value":"n=2","value_numeric":2},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"warning","value":"The 2-week antiviral course recommendation is attributed to 'emerging evidence' cited by the authors but not detailed within this abstract — the underlying data quality is unclear.","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"warning","value":"The distinction between true HSV reactivation and occult HSV colonization of affected skin is acknowledged as unresolved by the authors.","value_numeric":null},{"paper_doi":"10.1093/bjd/ljag086.427","tag_type":"warning","value":"Very small case series (n=2); findings and management recommendations should be interpreted with caution and cannot be generalized without larger studies.","value_numeric":null}],"summaries":{"what_studied":"Two cases of extensive, severe bullous pemphigoid (BP) complicated by concomitant HSV-1 infection, examining the diagnostic utility of early lesion swabbing and outcomes with combined antiviral and systemic corticosteroid therapy.","key_result":"Both patients improved with antiviral therapy plus systemic corticosteroids; one patient with persistent HSV-1 positivity on cutaneous swabs required long-term aciclovir prophylaxis. Emerging evidence cited supports a prolonged antiviral course of up to 2 weeks over the standard 5-day regimen for complete viral eradication.","limitations":"Only two cases reported, limiting generalizability; difficulty distinguishing HSV reactivation from occult colonization of affected skin and mucosa; no controlled comparison of antiviral regimen durations within this report.","practice_takeaway":"Maintain a high index of suspicion for HSV-1 co-infection in patients with extensive BP, especially before starting immunosuppressive therapy — swab lesions early and consider a 2-week antiviral course rather than the standard 5 days. In difficult-to-treat cases with persistent HSV-1 positivity, long-term aciclovir prophylaxis alongside BP treatment may be warranted."}},{"doi":"10.2147/ccid.s619152","pmid":"42299444","title":"Management of Recurrent Linear IgA Dermatosis of Childhood in the Absence of Histopathology and Immunofluorescence: A Case Report from a Low-Resource Setting in South-Western Uganda","journal_title":"Clinical, Cosmetic and Investigational Dermatology","journal_issn":"1178-7015","published_at":"2026-06-01T00:00:00.000Z","url":"https://doi.org/10.2147/ccid.s619152","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:40.065Z","updated_at":"2026-06-16T13:54:40.065Z","tags":[{"paper_doi":"10.2147/ccid.s619152","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"condition","value":"Autoimmune Blistering Disease","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"condition","value":"Linear IgA Dermatosis of Childhood","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"generic","value":"cefixime","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"generic","value":"dapsone","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"modality","value":"Sulfonamide Antibiotic","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.2147/ccid.s619152","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"warning","value":"Diagnosis was made purely on clinical grounds without histopathology or direct immunofluorescence, which are the gold standards; a degree of diagnostic uncertainty remains.","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"warning","value":"G6PD screening was not performed prior to dapsone initiation — a known safety requirement — due to resource constraints; absence of clinical hemolysis signs does not exclude subclinical risk.","value_numeric":null},{"paper_doi":"10.2147/ccid.s619152","tag_type":"warning","value":"Progressive worsening with each recurrence over 10 years is noted as atypical and is not well-characterized in the existing literature; causal mechanisms are speculative.","value_numeric":null}],"summaries":{"what_studied":"A 12-year-old girl in rural South-Western Uganda with recurrent Linear IgA Dermatosis of Childhood (LAD-C) spanning 10 years was diagnosed clinically — without histopathology or direct immunofluorescence — and treated with dapsone, systemic corticosteroids, antibiotic prophylaxis, and wound care.","key_result":"Within one week of starting dapsone 50 mg/day plus prednisolone 20 mg/day, new blister formation ceased, existing bullae resolved, and progressive re-epithelialization occurred; labs showed no hematologic toxicity at one week.","limitations":"- No histopathology, direct immunofluorescence, or microbiological cultures performed, leaving residual diagnostic uncertainty.\n- G6PD screening and methemoglobin testing were unavailable, creating an unquantified safety risk with dapsone.\n- Single case report from one site; findings cannot be generalized.","practice_takeaway":"In resource-limited settings where immunofluorescence is unavailable, LAD-C can be diagnosed clinically using lesion morphology (annular 'string-of-pearls' bullae), recurrence pattern, and exclusion of key differentials — and dapsone should not be withheld pending confirmatory testing. Clinicians must monitor closely for dapsone-related hemolysis and methemoglobinemia, especially when G6PD status is unknown."}},{"doi":"10.1001/jamadermatol.2026.1183","pmid":"42126851","title":"Intraocular Pressure During Short-Term Topical or Systemic Corticosteroid Treatment","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2026-05-13T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13173421/","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-20T13:23:20.384Z","updated_at":"2026-05-20T13:23:20.384Z","tags":[{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"condition","value":"Corticosteroid-Induced Glaucoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"condition","value":"Elevated Intraocular Pressure","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"generic","value":"betamethasone valerate","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"generic","value":"hydrocortisone","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"generic","value":"hydrocortisone butyrate","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"modality","value":"Topical Corticosteroid","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"sample_size","value":"n=84","value_numeric":84},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"warning","value":"Full-text was inaccessible; summary is based solely on the abstract and results sections provided.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"warning","value":"Sample sizes are very small across all 3 studies, limiting statistical power to detect modest IOP increases.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"warning","value":"Study 3 included only males with overweight/obesity; results may not generalize to females or lean individuals.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1183","tag_type":"warning","value":"The asymmetric IOP decrease in the right eye only (study 1) is unexplained and may reflect measurement variability or chance rather than a true treatment effect.","value_numeric":null}],"summaries":{"what_studied":"Three RCTs evaluated IOP changes during short-term treatment with periocular TCS (hydrocortisone 1.0% or hydrocortisone-17-butyrate 0.1% for 4 weeks), whole-body betamethasone 17-valerate (0.1%) for up to 6 weeks, or oral prednisolone (50 mg for 10 days) in a total of 84 participants with atopic dermatitis, healthy controls, or males with overweight/obesity.","key_result":"Short-term corticosteroid use did not increase IOP in any of the 3 RCTs; in study 1, right-eye IOP actually decreased in AD patients vs. untreated controls (−2.5 mm Hg; 95% CI, −3.9 to −1.1 mm Hg; P = .002), while IOP remained stable in studies 2 and 3.","limitations":"Very small sample sizes (n=24, 36, and 24); study 3 enrolled only males with overweight/obesity, limiting generalizability; maximum treatment duration was 6 weeks, so longer-term IOP risks remain unaddressed.","practice_takeaway":"Short-term topical or systemic corticosteroid use appears unlikely to raise IOP, supporting its ocular safety in the near term. Clinicians can be cautiously reassured when prescribing short courses, but longer-term IOP monitoring remains prudent."}},{"doi":"10.1002/clt2.70174","pmid":"42086893","title":"Biphasic, Refractory, and Persistent Anaphylaxis in Children","journal_title":"Clinical and Translational Allergy","journal_issn":"2045-7022","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1002/clt2.70174","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-16T13:22:24.958Z","updated_at":"2026-05-16T13:22:24.958Z","tags":[{"paper_doi":"10.1002/clt2.70174","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"condition","value":"Anaphylaxis","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"condition","value":"Biphasic Anaphylaxis","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"condition","value":"Persistent Anaphylaxis","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"condition","value":"Refractory Anaphylaxis","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"generic","value":"adrenaline","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"generic","value":"epinephrine","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"modality","value":"Epinephrine","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"sample_size","value":"n=393","value_numeric":393},{"paper_doi":"10.1002/clt2.70174","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"warning","value":"Comparisons among BA, RA, and PA subgroups were not statistically feasible due to very small subgroup sizes (n=6–14 each); subgroup-level findings are descriptive only.","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"warning","value":"Drug-induced anaphylaxis is overrepresented due to the tertiary referral nature of the center, limiting generalizability to community settings.","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"warning","value":"Serum tryptase data were incomplete; biomarker-based phenotype validation was not possible.","value_numeric":null},{"paper_doi":"10.1002/clt2.70174","tag_type":"warning","value":"The study excluded idiopathic and mast cell disorder-related anaphylaxis, which may undercount true phenotype frequency in broader populations.","value_numeric":null}],"summaries":{"what_studied":"This 15-year retrospective study (2010–2025) at a Turkish tertiary pediatric allergy center compared biphasic (BA), refractory (RA), and persistent anaphylaxis (PA) phenotypes against conventional anaphylaxis in 393 children (≤18 years, 529 episodes), examining triggers, severity, clinical features, and management.","key_result":"Only 6.6% of episodes met criteria for BA (3.5%), RA (1.5%), or PA (1.5%). These phenotypes occurred in older children, were more often drug- or venom-triggered (vs. food in conventional anaphylaxis), showed more cardiovascular manifestations and greater severity (p<0.001), and had higher systemic corticosteroid use. IM adrenaline was given in only 69.2% of Group 2 and 52.3% of Group 1 cases — no significant difference between groups. One drug-induced RA patient died.","limitations":"- Small numbers in each rare phenotype prevented direct BA vs. RA vs. PA comparisons or multivariable analyses.\n- Retrospective design; serum tryptase not available for all patients.\n- Tertiary referral center with overrepresentation of drug-induced cases, limiting generalizability.","practice_takeaway":"IM adrenaline was underused even in these high-risk phenotypes — clinicians should give it promptly in all grades of anaphylaxis severity, including mild cases that may progress to biphasic reactions. Drug- or venom-triggered anaphylaxis in older children warrants vigilance for prolonged observation given higher risk of BA, RA, or PA."}},{"doi":"10.1111/all.70332","pmid":"42011838","title":"Meta‐Analysis on the Harm of Systemic Glucocorticosteroids in Inflammatory Upper Airway Disease and Asthma: An EAACI Task Force","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-21T00:00:00.000Z","url":"https://doi.org/10.1111/all.70332","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:37.793Z","updated_at":"2026-05-09T13:22:37.793Z","tags":[{"paper_doi":"10.1111/all.70332","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Exact total sample size (N) was not reported in the abstract; the sample_size tag has been omitted.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Study scope is limited to inflammatory airway diseases; generalizability to other sGCS indications is uncertain.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"The 500 mg–1 g prednisolone-equivalent threshold is a pooled meta-analytic signal — individual patient risk may vary based on comorbidities, genetics, and concurrent medications.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis evaluated adverse effects (AEs) of systemic glucocorticosteroids (sGCS) in chronic inflammatory upper and lower airway diseases (rhinitis, rhinosinusitis, asthma), examining both short- and long-term risks and whether a dose-response relationship exists between daily/cumulative sGCS dosage and AE occurrence.","key_result":"Cumulative sGCS doses between 500 mg and 1 g prednisolone-equivalent significantly increased the risk of most AEs, with risk rising incrementally with higher doses — including risks from repeated short courses, not just long-term continuous use.","limitations":"The review focuses on airway diseases, so findings may not generalize to sGCS use in other conditions. Heterogeneity across included studies in dosing definitions and AE reporting may affect pooled estimates. The acceptable cumulative threshold remains empirically uncertain given variable individual susceptibility.","practice_takeaway":"Avoid cumulative sGCS exposure reaching 500 mg prednisolone-equivalent by prioritizing steroid-sparing therapies (e.g., biologics) early. Even repeated short courses carry meaningful harm — steroid stewardship should be applied rigorously in rhinitis, rhinosinusitis, and asthma management."}},{"doi":"10.1111/apt.70509","pmid":"41482657","title":"Clinical Trial: Long Versus Short Tapering of Steroids in Steroid Responsive Moderate to Severely Active Ulcerative Colitis—A Randomised Controlled Trial","journal_title":"Alimentary Pharmacology & Therapeutics","journal_issn":"0269-2813","published_at":"2026-01-03T00:00:00.000Z","url":"https://doi.org/10.1111/apt.70509","source_score":36,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-07","doi":"10.1111/apt.70509","days":"14","issn":"0269-2813","rank":"9","field":"Clinical Medicine","score":"36","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1111/apt.70509","title":"Clinical Trial: Long Versus Short Tapering of Steroids in Steroid Responsive Moderate to Severely Active Ulcerative Colitis-A Randomised Controlled Trial.","journal":"Alimentary pharmacology & therapeutics","methods":"","results":"Of 94 patients (48 in long, 46 in short taper) randomised, short taper was inferior to long taper in inducing clinical remission at 6 months (RR = 2.19; CI 1.08-4.46; p = 0.02). The relapse rates were similar in the long (37%) and short taper (46%) arms (HR: 0.34; CI: 0.10-1.11; p = 0.42). The median UCEIS scores (3 vs. 2; p = 0.23) and Nancy scores [2 (IQR 0-3) vs. 1.5 (0.75-3); p = 0.4] were not different between arms. Adverse events in the long and short taper arms, such as acne (14.58% vs. 2.16%), myopathy (8.33% vs. 6.52%), skin changes (2.08% vs. 2.17%), mood changes (0% vs. 4.34%), cytopenia (0% vs. 2.17%), and headache (6.25% vs. 6.52%) were similar.","abstract":"$30","keywords":["Mayo score","corticosteroid","histologic remission","relapse","remission","ulcerative colitis"],"pubmed_id":"41482657","conclusions":"A shorter taper duration of 6 weeks was inferior to a longer taper of 10 weeks in achieving clinical remission of UC at 6 months.","publication_date":"2026-01-03T00:00:00"},"crossref":{"DOI":"10.1111/apt.70509","URL":"https://doi.org/10.1111/apt.70509","ISSN":["0269-2813","1365-2036"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.70509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Clinical Trial: Long Versus Short Tapering of Steroids in Steroid Responsive Moderate to Severely Active Ulcerative Colitis—A Randomised Controlled Trial"],"author":[{"given":"Ankit","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Amol N.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Jyoti","family":"Grewal","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"J.","family":"Kumaravel","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Muhammad Aaqib","family":"Shamim","sequence":"additional","affiliation":[{"name":"Department of Pharmacology AIIMS Jodhpur India"}]},{"given":"Aravind","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Histopathology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Anuraag","family":"Jena","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Institute of Medical Sciences & SUM Hospital Bhubaneswar Odisha India"}]},{"given":"Anupam K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Ashish","family":"Kakkar","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Usha","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India"}]},{"given":"Vishal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh 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Relapse rates were similar (37% long vs 46% short; HR 0.34; 95% CI 0.10–1.11; p=0.42), endoscopic (UCEIS median 3 vs 2; p=0.23) and histologic (Nancy 2 [IQR 0–3] vs 1.5 [0.75–3]; p=0.4) scores did not differ, and adverse events were comparable (e.g., acne 14.58% vs 2.16%, myopathy 8.33% vs 6.52%, headache 6.25% vs 6.52%).","limitations":"Small sample size (n=94); steroid molecule, induction dose, and exact taper steps were not specified in the abstract; outcomes reported to 6 months only.","practice_takeaway":"In steroid‑responsive active ulcerative colitis, a 10‑week corticosteroid taper achieved higher 6‑month steroid‑free remission than a 6‑week taper, with similar relapse and adverse events. When using systemic steroids in similar patients, prefer a longer (10‑week) taper."}},{"doi":"10.1186/s12887-025-06421-x","pmid":"41469862","title":"Neonatal multisystem inflammatory syndrome (MIS-N) associated with prenatal maternal SARS-CoV-2: a single-center experience","journal_title":"BMC Pediatrics","journal_issn":"1471-2431","published_at":"2025-12-31T00:00:00.000Z","url":"https://doi.org/10.1186/s12887-025-06421-x","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-04","doi":"10.1186/s12887-025-06421-x","days":"7","issn":"1471-2431","rank":"10","field":"Clinical Medicine","score":"18","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1186/s12887-025-06421-x","title":"Neonatal multisystem inflammatory syndrome (MIS-N) associated with prenatal maternal SARS-CoV-2: a single-center experience.","journal":"BMC pediatrics","methods":"","results":"Eight mothers had a history of COVID-19 disease during pregnancy. 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Eight mothers had COVID-19 during pregnancy.","key_result":"All infants had cardiac involvement (supraventricular tachycardia, persistent sinus bradycardia, or AV block); 10/15 had respiratory failure. All had elevated inflammatory biomarkers, all received steroids and/or IVIG, and 2/15 died.","limitations":"Retrospective single-center case series with a small sample (n=15) and no comparator group.","practice_takeaway":"In neonates with suspected MIS-N, anticipate cardiac arrhythmias and possible respiratory failure and prioritize early recognition. In this series, all cases were treated with steroids and/or IVIG and two deaths occurred, underscoring potential severity."}},{"doi":"10.2340/actadv.v105.43633","pmid":"41216774","title":"Transition from Paraneoplastic Pemphigus to Bullous Pemphigoid after a 26-month Remission","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2025-11-11T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v105.43633","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-16","doi":"10.2340/actadv.v105.43633","days":"7","issn":"0001-5555","rank":"9","field":"Clinical Medicine","score":"1","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.2340/actadv.v105.43633","title":"Transition from Paraneoplastic Pemphigus to Bullous Pemphigoid after a 26-month Remission.","journal":"Acta dermato-venereologica","methods":"","results":"","abstract":"","keywords":[],"pubmed_id":"41216774","conclusions":"","publication_date":"2025-11-11T00:00:00"},"crossref":{"DOI":"10.2340/actadv.v105.43633","URL":"https://doi.org/10.2340/actadv.v105.43633","ISSN":["1651-2057","0001-5555"],"link":[{"URL":"https://medicaljournalssweden.se/actadv/article/download/43633/51981","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://medicaljournalssweden.se/actadv/article/download/43633/51981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"adv43633","type":"journal-article","issue":null,"score":1,"title":["Transition from Paraneoplastic Pemphigus to Bullous Pemphigoid after a 26-month Remission"],"author":[{"given":"Daisuke","family":"Matsumoto","sequence":"first","affiliation":[]},{"given":"Mako","family":"Mine","sequence":"additional","affiliation":[]},{"given":"Norito","family":"Ishii","sequence":"additional","affiliation":[]},{"given":"Daisuke","family":"Tsuruta","sequence":"additional","affiliation":[]},{"given":"Sho","family":"Hiroyasu","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,11,11]]},"member":"1183","prefix":"10.2340","source":"Crossref","volume":"105","created":{"date-time":"2025-11-11T10:09:13Z","timestamp":1762855753000,"date-parts":[[2025,11,11]]},"indexed":{"date-time":"2025-11-11T10:13:28Z","timestamp":1762856008615,"date-parts":[[2025,11,11]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc/4.0","start":{"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000,"date-parts":[[2025,11,11]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":null,"relation":{},"resource":{"primary":{"URL":"https://medicaljournalssweden.se/actadv/article/view/43633"}},"subtitle":[],"deposited":{"date-time":"2025-11-11T10:09:16Z","timestamp":1762855756000,"date-parts":[[2025,11,11]]},"issn-type":[{"type":"electronic","value":"1651-2057"},{"type":"print","value":"0001-5555"}],"published":{"date-parts":[[2025,11,11]]},"publisher":"MJS Publishing, Medical Journals Sweden AB","reference":[{"DOI":"10.1111/jdv.18931","key":"132407","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Antiga E, Bech R, Maglie R, Genovese G, Borradori L, Bockle B, et al. S2k guidelines on the management of paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2023; 37: 1118–1134.","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"},{"DOI":"10.3389/fimmu.2019.01454","key":"132408","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Hiroyasu S, Turner CT, Richardson KC, Granville DJ. Proteases in pemphigoid diseases. Front Immunol 2019; 10: 1454.","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"},{"DOI":"10.1038/jid.2014.151","key":"132409","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Tsuchisaka A, Kawano H, Yasukochi A, Teye K, Ishii N, Koga H, et al. Immunological and statistical studies of anti-BP180 antibodies in paraneoplastic pemphigus. 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Serial clinicopathologic, DIF/IIF, immunoblot, and ELISA/CLEIA findings were compared over time.","key_result":"The autoantibody profile shifted from PNP with plakin/desmocollin reactivity (anti-COL17 NC16a 37.6 U/mL; BP230 16.4 U/mL; envoplakin/periplakin positive; Dsc1 0.334 U/mL; Dsc2 2.111 U/mL) to BP at 28 months (anti-COL17 51.1 U/mL; BP230 81.5 U/mL; envoplakin/periplakin and desmocollins negative; rat bladder IIF negative). Increasing prednisolone from 2 to 7 mg/day plus topical clobetasol reduced BPDAI from 10 to 0 and lowered anti-COL17 to <3.0 U/mL.","limitations":"Single-case report without mucosal biopsy at baseline, limiting diagnostic completeness. A coincidental onset of BP cannot be excluded, as acknowledged by the authors.","practice_takeaway":"In PNP patients with anti-COL17 antibodies, late transition to BP can occur after clinical remission; long-term serologic monitoring (e.g., COL17/BP230) is prudent. Early detection enabled prompt steroid adjustment and topical therapy with rapid control in this case."}},{"doi":"10.2340/actadv.v105.44373","pmid":"41024729","title":"Cutaneous Graft-Versus-Host Disease Lichen Spinulosus-like: a New Form of Presentation of an Old Entity","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2025-09-30T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v105.44373","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-10-02","doi":"10.2340/actadv.v105.44373","days":"7","issn":"0001-5555","rank":"8","field":"Clinical Medicine","score":"1","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.2340/actadv.v105.44373","title":"Cutaneous Graft-Versus-Host Disease Lichen Spinulosus-like: a New Form of Presentation of an Old Entity.","journal":"Acta dermato-venereologica","methods":"","results":"","abstract":"","keywords":[],"pubmed_id":"41024729","conclusions":"","publication_date":"2025-09-30T00:00:00"},"crossref":{"DOI":"10.2340/actadv.v105.44373","URL":"https://doi.org/10.2340/actadv.v105.44373","ISSN":["1651-2057","0001-5555"],"link":[{"URL":"https://medicaljournalssweden.se/actadv/article/download/44373/51593","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://medicaljournalssweden.se/actadv/article/download/44373/51593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"adv44373","type":"journal-article","issue":null,"score":1,"title":["Cutaneous Graft-Versus-Host Disease Lichen Spinulosus-like: a New Form of Presentation of an Old Entity"],"author":[{"given":"Andrés","family":"Vidal González","sequence":"first","affiliation":[]},{"given":"Laura","family":"Taboada Paz","sequence":"additional","affiliation":[]},{"given":"Sergio","family":"López Alcázar","sequence":"additional","affiliation":[]},{"given":"Luis","family":"Requena Caballero","sequence":"additional","affiliation":[]},{"given":"Marta","family":"Feito Rodríguez","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,9,30]]},"member":"1183","prefix":"10.2340","source":"Crossref","volume":"105","created":{"date-time":"2025-09-30T07:54:48Z","timestamp":1759218888000,"date-parts":[[2025,9,30]]},"indexed":{"date-time":"2025-10-01T15:53:14Z","timestamp":1759333994914,"date-parts":[[2025,10,1]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc/4.0","start":{"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000,"date-parts":[[2025,9,30]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":null,"relation":{},"resource":{"primary":{"URL":"https://medicaljournalssweden.se/actadv/article/view/44373"}},"subtitle":[],"deposited":{"date-time":"2025-09-30T07:54:53Z","timestamp":1759218893000,"date-parts":[[2025,9,30]]},"issn-type":[{"type":"electronic","value":"1651-2057"},{"type":"print","value":"0001-5555"}],"published":{"date-parts":[[2025,9,30]]},"publisher":"MJS Publishing, Medical Journals Sweden AB","reference":[{"DOI":"10.1111/j.1365-4632.2010.04552.x","key":"128115","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Kim S, Choi J, Kim J, Cho B, Kim DW, Park H. 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Am J Clin Dermatol 2018; 19: 33–50.","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"}],"short-title":[],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["Acta Dermato-Venereologica"],"reference-count":15,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,9,30]]},"references-count":15,"short-container-title":["Acta Derm Venereol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.2340/actadv.v105.44373","is_oa":true,"title":"Cutaneous Graft-Versus-Host Disease Lichen Spinulosus-like: a New Form of Presentation of an Old Entity","updated":"2025-10-03T07:17:10+00:00","published_date":"2025-09-30","best_oa_location":{"url":"https://medicaljournalssweden.se/actadv/article/download/44373/51593","pmh_id":null,"url_for_pdf":"https://medicaljournalssweden.se/actadv/article/download/44373/51593","url_for_landing_page":"https://doi.org/10.2340/actadv.v105.44373"}}},"created_at":"2025-10-05T07:10:27.601Z","updated_at":"2025-10-06T07:08:34.463Z","tags":[{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"condition","value":"Chronic Graft-Versus-Host Disease","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"generic","value":"methylprednisolone","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"generic","value":"ruxolitinib","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"modality","value":"Extracorporeal Photopheresis","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"warning","value":"Causality between ruxolitinib dose change and eruption is inferred, not proven.","value_numeric":null},{"paper_doi":"10.2340/actadv.v105.44373","tag_type":"warning","value":"Single-case short communication; novelty claim and generalizability are limited.","value_numeric":null}],"summaries":{"what_studied":"A single adolescent post–allogeneic HSCT with new-onset folliculocentric hyperkeratotic spicules resembling lichen spinulosus, assessed with skin biopsy and viral testing. The eruption arose after ruxolitinib was reduced from 2.5 mg BID to 2.5 mg QD and was tracked through subsequent treatment changes in 2023.","key_result":"Lesions appeared after ruxolitinib dose reduction and cleared after intensifying immunosuppression with oral methylprednisolone, extracorporeal photopheresis, and ruxolitinib. Biopsy showed compact parakeratotic hyperkeratosis at the follicular infundibulum with basal melanophagia; TSPyV immunohistochemistry was negative and immunofixation was nonspecific.","limitations":"This is a single-case observation, so generalizability is limited. The attribution to cGVHD relies on clinicopathologic correlation and temporal association with immunosuppression changes rather than a definitive diagnostic test.","practice_takeaway":"In pediatric HSCT recipients, spiny folliculocentric eruptions mimicking lichen spinulosus can signal cutaneous cGVHD; exclude trichodysplasia spinulosa with histology and TSPyV testing. Such lesions may improve with escalation of immunosuppression, including systemic corticosteroids, extracorporeal photopheresis, and JAK inhibitor adjustment."}},{"doi":"10.1001/jamadermatol.2024.1657","pmid":"38865133","title":"Skin Manifestations of VEXAS Syndrome and Associated Genotypes","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2024-06-12T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11170453","source_score":107,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2024-08-24","doi":"10.1001/jamadermatol.2024.1657","days":"30","issn":"2168-6068","rank":"2","field":"Clinical Medicine","score":"107","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2024.1657","title":"Skin Manifestations of VEXAS Syndrome and Associated Genotypes.","journal":"JAMA 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with UBA1-variant–confirmed VEXAS (2019–2023) characterized the spectrum of skin findings and their associations with genotype, histology, and other clinical features; a secondary aim assessed skin response to treatments.","key_result":"Skin involvement occurred in 93/112 (83%) and was the presenting feature in 68/112 (61%); histopathology (64 reports from 60 patients) most often showed leukocytoclastic vasculitis 23/64 (36%), neutrophilic dermatosis 22/64 (34%), and perivascular dermatitis 19/64 (30%). Genotype–phenotype links included p.Met41Leu with neutrophilic infiltrates 14/17 (82%) and p.Met41Val with vasculitic lesions 11/20 (55%) and mixed leukocytic infiltrates 17/20 (85%); prednisone improved skin in 67/73 (92%), while anakinra caused severe injection-site reactions in 12/16 (75%) with ulceration 2/12 (17%) and abscess 1/12 (8%).","limitations":"Data came from mixed sources (retrospective chart review and NIH evaluations), histopathology was available for only 60/112 patients, and treatment response was based on physician impression rather than standardized measures.","practice_takeaway":"In older men with cutaneous vasculitis, neutrophilic dermatoses, or chondritis, consider testing for VEXAS (UBA1). Prednisone often improves skin disease, while anakinra may cause frequent severe injection-site reactions."}}],"initialOffset":12,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Systemic Corticosteroid"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Systemic Corticosteroid"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Systemic Corticosteroid"}}}]]

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