Efficacy of combining pulse corticotherapy and methotrexate in alopecia areata: Real-life evaluation

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Lichen Planus triggered by infliximab biosimilar CT-P13 and recurred during secukinumab treatment

Abstract

we read with interest the manuscript published by Gonzales et al,¹ highlighting lichenoid reactions as an emerging side effect of biologics, with special regard to infliximab-biosimilar. We recently observed a 50-year-old male patient with a long-standing history of moderate-to-severe psoriasis, who developed oral lichen planus (LP) triggered by infliximab biosimilar CT-P13. Interestingly the same patient experienced cutaneous and oral LP when treated with IL-17A blocker, secukinumab. The patient suffered for hypertension, in treatment with valsartan, and anxiety. He previously failed to respond to phototherapy, methotrexate, etanercept and adalimumab.

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Irradiance, as well as body site and timing of readings, is important in determining ultraviolet A minimal erythemal dose

Abstract

Irradiance, as well as body site and timing of readings, is important in determining ultraviolet A minimal erythemal dose. (Response to Gambichler et al. July BJD)

Gambichler et al. demonstrated that, in their population, using a 25 mWcm⁻² ultraviolet A-1 (UVA-1) source the median 24-hour delayed minimal erythema dose (MED) on the inner forearm was > 130 Jcm⁻².¹ This differs from the 20 Jcm⁻² to 28 Jcm⁻² median MED reported from our centre.²

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Risk of malignancies associated with ustekinumab

Abstract

A recently published report by Florek et al.¹ associates malignancies with ustekinumab (STELARA^®) treatment. Janssen emphasizes patient safety and welcomes rigorous safety analyses from other parties. However, it is unclear how this report adds to the understanding of ustekinumab's safety profile.

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Chronic Poststernotomy Pain: Incidence, Risk Factors, Treatment, Prevention, and the Anesthesiologist's Role.

Chronic pain following median sternotomy is common after cardiac surgery. If left untreated, chronic sternal pain can reduce quality of life, affecting sleep, mood, activity level, and overall satisfaction. This has a significant societal effect given the large number of cardiac surgeries annually. Although a number of pathophysiologic processes and risk factors are assumed to contribute, the exact cause and major risk factors remain unknown. Moreover, the treatment of chronic poststernotomy pain is often inadequate, relying on opioids and other medications that provide minimal benefit to the patient and have significant adverse effects. Indeed, little is known regarding the prevention of chronic pain development following sternotomy. This review aims to present the current, limited data regarding the incidence, risk factors, treatment, and prevention of chronic poststernotomy pain and to identify areas of future research to improve management of this common complaint following cardiac surgery. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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The Spread of Ultrasound-Guided Injectate From the Adductor Canal to the Genicular Branch of the Posterior Obturator Nerve and the Popliteal Plexus: A Cadaveric Study.

Background and Objectives: The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Reduced hip adductor motor function could be avoided by a posterior obturator nerve block inside the popliteal fossa. The aim of this study was to evaluate the spread of dye after a distal adductor canal (AC) injection to the popliteal fossa and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve by dissection. We also assessed the spread of dye into the popliteal fossa after a distal femoral triangle injection. Methods: Ten milliliters of dye was injected into the distal part of the AC in 10 cadaver sides and into the distal part of the femoral triangle in 3 sides. Dissection was used to assess the spread of the injectate and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve, as well as the saphenous and medial vastus nerves. Results: The popliteal plexus and the genicular branch of the posterior obturator nerve were dyed in all 10 dissections after AC injections. No dye spread into the popliteal fossa after femoral triangle injections. Conclusions: Injection of 10 mL of dye into the distal part of the AC spreads into the popliteal fossa and colors the popliteal plexus and the genicular branch of the posterior obturator nerve. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Murine typhus masquerading as retiform purpura-like rashes

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