Immunopathogenic treatment options for psoriasis patients under a restrictive reimbursement environment

Publisher Copyright: © 2020 Ilona Hartmane et al., published by Sciendo.This article is aimed to provide an overview of psoriasis clinical aspects, available treatment options for moderate-to-severe psoriasis in Baltics and summarises recommendations of authors for use of different biologicals in psoriasis patients under a limited reimbursement environment.publishersversionPeer reviewe

Narrow-band UVB therapy and topical calcineurin inhibitors for the treatment of paediatric vitiligo in real clinical practice

Publisher Copyright: © 2020 Ilona Hartmane et al., published by Sciendo.Vitiligo is an acquired chronic skin disease, characterised by progressing, usually symmetric, depigmented areas in human skin. Vitiligo affects 0.5% of the human population, however, optimal treatment combination real clinical practice has yet to be found. The aim of the study was to assess whether combined therapy with ultraviolet B (UVB) therapy and calcineurin inhibitors (CNI) provides superior response in vitiligo patients, compared with phototherapy or topical CNI monotherapy. We performed a retrospective cohort study of children treated for vitiligo from January 2016 to December 2019. Primary outcome measures include clinical efficacy defined by area of repigmentation — good clinical efficacy (re-pigmentation of 50% of lesion surface area), positive clinical efficacy and poor clinical efficacy (re-pigmentation of < 15% of lesion surface area). Secondary outcome measures included reduction of lesion size and tolerability of therapy. A total of 114 patients were recruited in the study, 46 allocated to the topical CNI therapy group, 36 to the narrow band (Nb-UVB), and 32 to the combined therapy group. All treatments statistically significantly decreased lesion surface area compared to the baseline (mean, SD). Local therapy reduced lesions from 8.5 (5.7) to 5.3 (4.2) by 37.3% (p < 0.0001), phototherapy reduced lesions from 9.8 (5.4) to 5.7 (3.92) by 42.3% (p < 0.0001), and combined therapy reduced lesions from 14.2 (4.8) to 6.58 (3.5) by 53.6% (p < 0.0001), with combined therapy showing superior numerical efficacy. Clinical efficacy for CNI monotherapy was 67.4%, for phototherapy — 80.5%, and for combined therapy 93.7%. The safety profile of therapies was consistent with other studies. Our results support the use of combined therapy in vitiligo patients.publishersversionPeer reviewe

Correlation of Immunological and Clinical Changes in Psoriasis Patients Treated with Tumour Necrosis Factor-Alpha (TNF-α) Blocking Biologic Drugs: One-Year Dynamic Observation : one-year dynamic observation

Psoriasis is one of the most common autoimmune dermatoses with a chronic relapsing course. Biologic therapy should be initiated for patients with moderate to severe psoriasis when conventional systemic therapy and phototherapy are ineffective, or their use is limited due to comorbidities. In Latvia, adalimumab is the first choice of biologic drugs for treatment of psoriasis. The correlation between changes in cellular and humoral immunological parameters and clinical signs based on immunological data from psoriasis patients are evaluated in the publication.publishersversionPeer reviewe

Treatment of Skin Oncological Disease Using an Immunosuppressive Medication

Skin cancer or non-melanoma malignant formations, as well as melanomas, are recorded in more than 2-3 million people every year. The most important cause of the occurrence of this disease is the effect of UV radiation on damaged areas of the skin, birthmarks, or sensitive skin (light, capable of burning). Dermatoscopy is one of the most important methods for determining the stage of tumor development, and the simplest method of treatment in the initial stages is the use of immunosuppressive agents that reduce the work of the immune system by preventing the formation of antibodies

Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma

Abstract Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists’ decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alongside its differential diagnoses of melanomas and nevi. Through a three-phase study, we assess its impact on dermatologists’ diagnostic accuracy, diagnostic confidence, and trust in the XAI-support. Our results show strong alignment between XAI and dermatologist explanations. We also show that dermatologists’ confidence in their diagnoses, and their trust in the support system significantly increase with XAI compared to conventional AI. This study highlights dermatologists’ willingness to adopt such XAI systems, promoting future use in the clinic