Recurrent cutaneous eosinophilic vasculitis characterized by annular purpuric lesions: A case report

A 71-year-old woman presented with a persistent, intensely pruritic cutaneous eruption localized on the palmoplantar regions, lips and palate. The histological findings allowed to make the diagnosis of recurrent cutaneous eosinophilic vasculitis, a very rare cutaneous vasculitis characterized clinically by multiple erythematous or purpuric erythematous papules or plaques or angioedema with a relapsing course in the absence of systemic involvement and histologically by a necrotizing vasculitis of the dermal small vessels with a dominant eosinophilic infiltration. The patient was treated with oral methylprednisolone and pentoxifylline which led to a rapid resolution of the cutaneous lesions

Use of biologics during the COVID-19 pandemic: lessons learned from psoriasis

Introduction: Given the increased infectious risk associated with biologics, particularly with TNFα inhibitors, concerns were raised over the safety of these agents in relation to SARS-CoV-2 infection. Furthermore, the impact of biologics on SARS-CoV-2 vaccination was questioned. Areas covered: In this review, studies conducted on patients with moderate to severe plaque psoriasis treated with biologics during the COVID-19 pandemic have been analyzed, including 1) the safety of biologics in psoriatic patients in terms of increased risk and/or worse outcome of SARS-CoV-2 infection; and 2) whether biologic agents could affect the safety and response to SARS-CoV-2 vaccines in psoriatic patients. Expert opinion: Current evidence indicates that the use of biologics in psoriatic patients does not seem to be associated with an increased COVID-19 infection risk or worse outcome, with TNFα inhibitors being even protective of severe COVID-19 relative to other treatments or no treatment at all. Furthermore, biologic treatment does not seem to have a significant impact on the response and safety of vaccines in patients with psoriasis treated with biologics. However, uncertainty remains given the limitations of current studies which are often of short duration, limited sample sizes and do not stratify on specific biologic classes

Cost per responder of Adalimumab biosimilars MSB11022 and ABP 501 versus the originator and methotrexate in chronic plaque psoriasis

Background: Pharmacoeconomic studies comparing the cost of adalimumab biosimilars versus the originator and conventional drugs in psoriasis are lacking. Research design and methods: To assess the cost per responder of adalimumab biosimilars versus the originator and methotrexate for psoriasis treatment. A cost per responder analysis comparing adalimumab biosimilars MSB11022 (Idacio®) and ABP 501 (Amgevita®), and methotrexate to the originator (Humira®) was performed. The incremental cost per responder was calculated by multiplying the cost of treatment based on the perspective of the National Healthcare System and number needed to treat for each therapy. Results: Considering the PASI75 response rate at 16 weeks, the cost per responder for MSB11022 and ABP 501 compared to the originator was € 500 versus 1,831 and € 968 versus 1,949, respectively. For the same endpoint, the cost per responder for subcutaneous or oral methotrexate was € 543 or 34 compared to 2,117 for adalimumab originator. At an indirect comparison among methotrexate, MSB11022 and ABP 501, the costs per PASI75 responder at week 16 were 2%, 26%, 27% and 50% of that of the originator, respectively. Conclusions: The use of biosimilars was confirmed as a valuable pharmacoeconomic strategy to lower healthcare cost in patients with psoriasis

Pyoderma gangrenosum associated with pseudo-PelgerHuët anomaly in a patient with idiopathic myelofibrosis

Pseudo-Pelger-Huët anomaly is a condition in which almost all the granulocytes are hyposegmented and/or hypogranulated. It is typically recognized in peripheral blood smears and represents a marker of several disorders, such as myeloproliferative diseases and myelodysplasia. The occurrence of the pseudoPelger-Huët anomaly in the cutaneous infiltrate of pyoderma gangrenosum is very rare. We describe the case of a 70-year-old man with idiopathic myelofibrosis who developed pyoderma gangrenosum. Histological examination showed an infiltrate consisting of granulocytic elements with features of dysmaturity and segmentation anomalies (hypo- and hypersegmented forms), suggestive of pseudo-Pelger-Huët anomaly. Methylprednisolone treatment resulted in progressive improvement of pyoderma gangrenosum

Price variability of TNF-α inhibitor biosimilars among European countries

Dear Editor, The treatment of psoriasis has been revolutionized by biological drugs. Despite their excellent efficacy and safety, their high cost represents a hindrance to a wider and early us

Bleomycin-induced Flagellate Dermatitis: a Case Report

Flagellate dermatitis represents a unique cutaneous eruption associated with several causes, including treatment with certain chemotherapeutic agents, ingestion of toxins and rheumatologic conditions like adult-onset Still\u2019s disease and dermatomyositis. We present the case of a 35-year-old woman with stage IIA Hodgkin lymphoma who was treated with the ABVD chemotherapy regimen (doxorubicin, bleomycin, vinblastine and dacarbazine). During the third cycle of chemotherapy, she developed multiple linear erythematous macules and hyperpigmentation in a striking flagellate-like pattern localized on the upper chest, submammary folds, neck and upper part of the back. The lesions resolved completely within three months after the withdrawal of bleomycin. Clinicians should be aware of this distinctive cutaneous toxicity in patients receiving bleomycin combination chemotherapy

A case of kerion celsi caused by Trichophyton tonsurans

A case of kerion celsi caused by Trichophyton tonsuran

Bleomycin-induced Flagellate Dermatitis: a Case Report

Flagellate dermatitis represents a unique cutaneous eruption associated with several causes, including treatment with certain chemotherapeutic agents, ingestion of toxins and rheumatologic conditions like adult-onset Still’s disease and dermatomyositis. We present the case of a 35-year-old woman with stage IIA Hodgkin lymphoma who was treated with the ABVD chemotherapy regimen (doxorubicin, bleomycin, vinblastine and dacarbazine). During the third cycle of chemotherapy, she developed multiple linear erythematous macules and hyperpigmentation in a striking flagellate-like pattern localized on the upper chest, submammary folds, neck and upper part of the back. The lesions resolved completely within three months after the withdrawal of bleomycin. Clinicians should be aware of this distinctive cutaneous toxicity in patients receiving bleomycin combination chemotherapy

A case of genital primary syphilis with superimposed impetigo

A case of genital primary syphilis with superimposed impetig

Relapse of psoriatic arthritis in patients with active psoriasis switched from tumour necrosis factor-α to interleukin-17A inhibitor

Interleukin (IL)-17A inhibitors are indicated for the treatment of chronic plaque psoriasis and psoriatic arthritis (PsA), and they could inhibit the radiographic progression of PsA.1 However, IL-17A inhibitors might not be as effective in PsA as they are in plaque psoriasis, at least for some patients. Indeed, from January to December 2018 a total of 162 patients were treated with secukinuma