On- and Off-Label Uses of Apremilast in Dermatology

Apremilast is an oral small-molecule phosphodiesterase 4 inhibitor with a multilevel immunomodulating mechanism of action. It has received approval in many countries for the use in moderate-tosevere plaque psoriasis and active psoriatic arthritis in adults. Herein, we review the literature concerning the use of apremilast in dermatology, with a focus on both the on- and the off-label uses of this medication in dermatologic conditions. This paper is a systematic overview of all the reported uses of apremilast in dermatology described in the literature so far and was conducted according to the PRISMA Guidelines for systematic reviews. There are several original articles, case series and case reports In the literature that present either encouraging or less promising results concerning the efficacy and safety of apremilast in numerous inflammatory dermatological diseases. Despite the potential effectiveness of apremilast in various indications, however, randomized clinical trials on larger patient cohorts and with long-term follow-up are necessary in order to adequately establish the role of apremilast in dermatology overall

On- and Off-Label Uses of Apremilast in Dermatology

Apremilast is an oral small-molecule phosphodiesterase 4 inhibitor with a multilevel immunomodulating mechanism of action. It has received approval in many countries for the use in moderate-tosevere plaque psoriasis and active psoriatic arthritis in adults. Herein, we review the literature concerning the use of apremilast in dermatology, with a focus on both the on- and the off-label uses of this medication in dermatologic conditions. This paper is a systematic overview of all the reported uses of apremilast in dermatology described in the literature so far and was conducted according to the PRISMA Guidelines for systematic reviews. There are several original articles, case series and case reports In the literature that present either encouraging or less promising results concerning the efficacy and safety of apremilast in numerous inflammatory dermatological diseases. Despite the potential effectiveness of apremilast in various indications, however, randomized clinical trials on larger patient cohorts and with long-term follow-up are necessary in order to adequately establish the role of apremilast in dermatology overall

PACE-4-Expression in Uveamelanomen

Zum besseren Verständnis der pathogenetischen Mechanismen des Uveamelanoms, mit dem Ziel der Entwicklung von wirksamen Therapieoptionen, wurde die Rolle der Proproteinkonvertase PACE4 bei diesen Tumoren untersucht. PACE4 ist beteiligt bei der Prozessierung von Vorläuferproteinen. Es spielt eine wichtige Rolle sowohl bei normalen Zellfunktionen als auch bei der Onkogenese in diversen Tumoren, inklusiv kutanen Melanomen. Es wurden 34 enukleierte Uveamelanome mittels Immunhistochemie auf die Expression von PACE4 untersucht. Die PACE4 Expression wurde mit histopathologischen Charakteristika der Tumoren, wie Tumorzellmorphologie, Tumorlokalisation, Vorhandensein von Nekrosen und Mitosen, Beteiligung des Ziliarkörpers und extraokulärer Beteiligung und mit dem klinischen Verlauf der Patienten, insbesondere der Metastasierung, korreliert. Es wurde gezeigt, dass PACE4 bei den Uveamelanomen, zum Teil mit großen quantitativen Unterschieden und verschiedenen Expressionsmustern, exprimiert wird. Eine Korrelation der PACE4-Expression mit den histopathologischen Parametern oder dem klinischen Verlauf wurde nicht gesehen. Entsprechend ist eine prognostische Aussage aufgrund der PACE4-Expression nicht zu treffen. <br

Primary Burkitt lymphoma of the thyroid gland in a 28-year-old female

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Patient outcomes following surgical management of thyroid nodules classified as Bethesda category III (AUS/FLUS)

Introduction: The Bethesda classification system for reporting thyroid cytopathology is the standard for interpreting fine needle aspirate (FNA). Because of its heterogeneity and inconsistent reporting, atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), known as Bethesda category III, is the most controversial category. Thyroid nodules that fall within Bethesda categories III–IV have an overall risk of malignancy of between 15 and 40%. The aim of this study was to determine the malignancy rate in Bethesda III nodules. Material and methods: A retrospective study was performed for 1166 patients who underwent thyroid surgery for multinodular goitre (MNG) or solitary nodular goitre (SNG) in our institution between June 2010 and May 2020. Data retrieved included demographic characteristics of the patients, FNB cytology, thyroid function test results, type of thyroidectomy, and final histology results. Results: During the study period, 29.5% (344/1166) of patients with an FNA categorized as AUS/FLUS underwent thyroid surgery. Of these 344 patients, 190 were diagnosed with MNG and 154 with SNG. Incidental malignancy was found in 35 of 190 cases of MNG (18.42%) and 31 of 154 cases of SNG (20.13%). The most common malignant tumour type in either category was the follicular variant of papillary thyroid carcinoma. Conclusions: The current study demonstrates that patients with a FNA categorized as AUS/FLUS may have a higher risk of malignancy than traditionally believed. Reconsideration may be necessary to guidelines that recommend observation or repeat FNA in this category of patients

Cutaneous Side Effects of Modern Targeted Therapy and Immunotherapy in Patients with Dermatological Malignancies

The advent of immunotherapy and targeted therapies in treating dermatological malignancies has dramatically changed the landscape of dermato-oncology in recent years. Their superior efficacy compared to previous therapeutic options, such as chemotherapy, has resulted in their use in treating devastating malignancies, such as melanoma or unresectable/metastatic basal cell and squamous cell carcinoma. Skin toxicity is a critical safety consideration, among other adverse reactions, that can occur under treatment with these agents. This article aims to summarize the cutaneous side effects of immune checkpoint inhibitors and targeted dermato-oncological therapies. Although the skin side effects of these agents are primarily mild, they can occasionally affect the decision for treatment continuation and the quality of life of the affected patients. Therefore, physicians must be acquainted with the specific cutaneous toxicity profile of such treatments to mitigate their impact on the patients and optimize the overall outcome of dermato-oncological therapy