American Journal of Clinical Dermatology

Forty-seven cases of juvenile pemphigus vulgaris have been reported in the English literature. Histology of lesional skin and direct immunofluorescence of perilesional skin are both necessary for a complete diagnosis. The autoimmune bullous condition can affect the skin and mucous membranes individually, but typically affects both concurrently. Disease characteristics in juvenile patients are similar to those in adults; however, a disruption of biologic and social development is of particular concern during adolescence. Although systemic corticosteroids have been used to successfully treat the disease in most cases, long-term use is often necessary for adequate control. Adverse effects from therapy can have devastating effects during this critical period of hormonal changes, physical and mental growth, and social and cultural development that occurs during adolescence. Newer therapies must be designed to adequately treat juvenile patients while also limiting serious adverse effects

Laboratory and animals studies have suggested a possible protective effect of coffee consumption on the development of melanoma. However, the results of epidemiological studies investigating this association have been inconclusive. A systematic review and meta-analysis of published studies was conducted to evaluate any association between coffee consumption and melanoma. Observational studies were searched for in MEDLINE, EMBASE, and the Cochrane Central Register from inception to September 1, 2015. The Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines were followed in conducting this study. We identified nine observational studies with a total of 927,173 study participants, of which 3787 had melanoma. With random-effects modeling, the pooled relative risks (RR) for melanoma among regular coffee drinkers was 0.75 (95 % confidence interval [CI] 0.63–0.89, p = 0.001) compared with controls. Visual inspection of a funnel plot suggested publication bias, although Egger’s test (p = 0.981) delineated no small-study effects. The pooled relative risks for melanoma among decaffeinated coffee drinkers was, however, not statistically significant at 0.92 (95 % CI 0.82–1.05, p = 0.215). There is some evidence for the beneficial effects of regular coffee consumption on melanoma. More prospective cohort studies with systematic quantification of coffee consumption would be necessary to further elucidate this association.

Efforts have been recently made to investigate simple, objective, accurate, and reproducible methods of clinical/noninvasive assessment of nonsegmental vitiligo. However, studies have mostly considered quantitative or semiquantitative parameters, almost neglecting the purely qualitative appearance of vitiligo lesions at a given moment and over time. The objective of this study was to investigate the dynamics of macromorphologic alterations taking place within vitiligo patches. This was a prospective study of a vitiligo cohort. Consecutive patients affected by nonsegmental vitiligo. Enrolled patients affected by nonsegmental vitiligo underwent a dermatology visit once monthly for 12 months. Vitiligo lesions were photographed at each visit under both room light and Wood’s light, and analyzed via a morphometric, digitalized software capable of detecting quantitative changes of white areas. Pictures depicting changing patches were evaluated in order to assess clinical morphology. Ninety patients were included for the final analysis and 360 lesions were evaluated, 102 of which (28.9 %) showed changes of white areas. Subjective evaluation highlighted two distinct depigmentation patterns, which were present either alone or in combination: (1) a sharply defined band of intermediate color between the depigmented center and the surrounding normal skin, which was defined as ‘marginal hypopigmentation;’ and (2) pinpoint hypopigmented/depigmented macules centered by a follicle, which we named ‘perifollicular depigmentation.’ On the other hand, only one repigmentation pattern was detected, the already known ‘perifollicular repigmentation.’ The depigmentation process in vitiligo seems to follow only two specific patterns. This preliminary study represents, in our opinion, a valuable background for future research aiming to investigate the dynamics of vitiligo pathogenesis or assess depigmentation/repigmentation patterns for monitoring treatment response.

The endocannabinoid system is a complex and nearly ubiquitous network of endogenous ligands, enzymes, and receptors that can also be stimulated by exogenous compounds such as those derived from the marijuana plant, Cannabis sativa. Recent data have shown that the endocannabinoid system is fully functional in the skin and is responsible for maintaining many aspects of skin homeostasis, such as proliferation, differentiation, and release of inflammatory mediators. Because of its role in regulating these key processes, the endocannabinoid system has been studied for its modulating effects on both inflammatory disorders of the skin and skin cancer. Although legal restrictions on marijuana as a Schedule I drug in the USA have made studying cannabinoid compounds unfavorable, an increasing number of studies and clinical trials have focused on the therapeutic uses of cannabinoids. This review seeks to summarize the current, and rapidly expanding field of research on the broad potential uses of cannabinoids in inflammatory and neoplastic diseases of the skin.

Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identified as a key cytokine involved in the pathogenesis of psoriasis and psoriatic arthritis. In this review, we summarize our understanding of IL-17 and its role in psoriasis and psoriatic arthritis, as well as key findings from clinical trials using anti-IL-17 medications for the treatment of the aforementioned diseases. Secukinumab, ixekizumab, and brodalumab are three anti-IL-17 medications used for treating psoriasis, of which only secukinumab is FDA approved; ixekizumab and brodalumab remain under clinical development. Results from clinical trials show that these three medications are highly effective in treating psoriasis and appear to be as safe as other biologic treatments that are FDA approved.