Ph.I. Spuls

Diagnostic criteria for atopic dermatitis: a systematic review

Background  Atopic dermatitis (AD) has a wide spectrum of dermatological manifestations and despite various validated sets of diagnostic criteria that have been developed over the past decades, there is disagreement about its definition. Nevertheless, clinical studies require valid diagnostic criteria for reliable and reproducible results.

EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference

To cite this article: Schram ME, Spuls PI, Leeflang MMG, Lindeboom R, Bos JD, Schmitt J. EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference. Allergy 2012; 67: 99–106.

Photo(chemo)therapy in the management of atopic dermatitis: an updated systematic review with implications for practice and research

Photo(chemo)therapy is a common treatment modality in patients with atopic dermatitis (AD), but evidence on its effectiveness has not been recently systematically reviewed.

Is there a rural/urban gradient in the prevalence of eczema? A systematic review.

Background  Eczema affects approximately 10% of all schoolchildren in the western world and has shown an increase over the past decades in ‘developing’ countries. Numerous factors have been suggested that might contribute to the increasing prevalence of eczema. A plausible explanation is the role of environmental factors. As part of the ‘hygiene hypothesis’ it has been thought that eczema is more common in urban than in rural communities, but such a notion has never been assessed systematically.

Drug survival is not significantly different between biologics in patients with psoriasis vulgaris: a single‐centre database analysis

Drug survival depends on several factors such as dosing, effectiveness, quality‐of‐life improvement and safety, and could be seen as an overall marker for treatment success. Such data for biologics in psoriasis treatment are sparse.

Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross‐trial comparison: clinical signs, symptoms, quality of life and long‐term control.

Brodalumab and ixekizumab, anti‐interleukin‐17‐receptor antibodies for psoriasis: a critical appraisal

Aim  Papp et al. (N Engl J Med 2012; 366: 1181–9) and Leonardi et al. (N Engl J Med 2012; 366: 1190–9) respectively assessed the efficacy and safety of brodalumab (AMG 827), a human monoclonal antibody directed against interleukin (IL)‐17RA, the receptor of IL‐17A and ixekizumab (LY2439821), a humanized anti‐IL‐17 monoclonal antibody for the treatment of moderate‐to‐severe plaque psoriasis.

Experience with biologics for psoriasis in daily practice: switching is worth a try.

SIR, Not all patients with psoriasis who start biological therapy are treated satisfactorily: effectiveness may be too limited, serious side-effects may occur or treatment may be otherwise intolerable. When treatment optimization has failed or is impossible, the next step might be another biologic. Etanercept, efalizumab, infliximab and adalimumab are registered biologics for psoriasis, although marketing authorization of efalizumab was recently suspended for safety considerations. Although the excellent phase III trial results appear less impressive in routine practice, the biologics have enriched the treatment armamentarium. Following high costs and often strict reimbursement criteria, they form the end of the therapeutic spectrum. In our experience most patients respond well to long-term biological treatment. When a biologic fails, however, switching to another biologic is common, despite limited evidence. Our purpose was to provide evidence on the effectiveness and tolerability of switching between biologics for psoriasis in daily practice. Also, we compared characteristics of patients continuing, stopping or switching their first biologic. Since the first registration in 2005, we have used biologics in routine practice in our psoriasis referral centre. Consistent data collection on demographics, effectiveness, quality of life and safety resulted in a prospective biologic registry comprising over 3 years of routine experience with biologics for

A randomized comparison of excimer laser versus narrow-band ultraviolet B phototherapy after punch grafting in stable vitiligo patients

Background  Ultraviolet radiation following punch grafting may stimulate the migration of melanocytes from the grafts into the vitiliginous skin, thereby increasing the rate of repigmentation. We compared the effects of the 308‐nm xenon chloride excimer laser (EL) vs. narrow‐band ultraviolet B (NB‐UVB) after punch grafting in patients with vitiligo.

Knowledge, attitudes and use of the guidelines for the treatment of moderate to severe plaque psoriasis among Dutch dermatologists

Background  In 2003, the Dutch psoriasis guidelines were among the first evidence‐based medicine guidelines in dermatology. Although pivotal, the implementation of dermatological guidelines has not been assessed.