What's already known about this topic?

• Liver fibrosis is a known side-effect of methotrexate treatment.
• Currently, procollagen III aminoterminal propeptide is the most widely used method for monitoring of methotrexate-induced liver fibrosis.
• Alternative combined serum markers have been shown to be more accurate than single markers in the assessment of liver fibrosis.

What does this study add?

• To our knowledge, this is the first study to assess the Enhanced Liver Fibrosis test in the assessment of methotrexate-associated liver fibrosis.

What's already known about this topic?

• While the role of epidermal pigmentation in characterizing human skin of differing geographical origins is well characterized, potential differences in dermal composition and epidermal structure are less well defined.

What does this study add?

• This unique study compares dermal extracellular matrix composition and epidermal morphology of skin from three groups with diverse geographical ancestry.
• This study identifies previously unappreciated differences in the abundance and architecture of dermal fibrillar collagens, collagen VII anchoring fibrils and the elastic fibre network.
• It highlights potential functional and clinical differences in skin of diverse geographical origins, which may have arisen as a consequence of adaptations to ancestral environments.

What's already known about this topic?

• Periostin is a matricellular protein that modulates wound healing and fibrosis.
• Recent findings indicate that periostin plays an important role in the pathogenesis of atopic dermatitis (AD).
• T helper (Th)2 cytokine-induced periostin activates keratinocytes, which amplify Th2 inflammation, leading to the maintenance of allergic skin inflammation.
• Whether differential levels of periostin are associated with the severity and clinical phenotype of AD has not been elucidated.

What does this study add?

• Serum periostin level was significantly elevated in patients with AD.
• Positive correlations were observed with disease severity, thymus and activation-regulated chemokine level, lactate dehydrogenase level and eosinophil count.
• Expression of periostin was elevated in serum and skin of patients with AD with erythroderma and lichenification, but not in those with prurigo-type AD, even when widely distributed over the body.
• Periostin may reflect the disease severity and clinical phenotype of AD.

What's already known about this topic?

• There is no established optimal surgical management for lentigo maligna (LM).
• LM may spread beyond the visible pigmented border.

What does this study add?

• Some 62% of LMs contain amelanotic extensions.
• Excision margins of 6 mm were sufficient for 96% of well-defined LMs but insufficient for ill-defined, recurrent or incompletely excised lesions.
• LMs showing nesting require significantly wider excision margins than those without melanocyte nesting.
• Contralateral control biopsies do not help to distinguish between involved and uninvolved tissue.

What's already known about this topic?

• An increasing incidence of nonmelanoma skin cancer in more affluent populations has been linked to leisure exposure to ultraviolet radiation.

What does this study add?

• This study shows, at a population level, a continuing increase in incidence of both BCC and SCC, with the largest increase in young populations.
• There is a link between affluence and skin cancer, but only in urban populations.

What's already known about this topic?

• Current knowledge about the epidemiology and comorbidities of patients with hidradenitis suppurativa (HS) is limited.
• Further research will rely on electronic databases.

What does this study add?

• Using an increasing number of disease codes yielded a greater positive predictive value (PPV), which was as high as 81·9% for two codes in a 5-year period.
• Specific terms to describe HS in the medical record, including ‘hydradenitis’, ‘boil’, ‘draining’, ‘abscess’, ‘fistula’, ‘cyst’ and ‘nodule’, could be used to improve the PPV.

What's already known about this topic?

• The biochemical properties of the loss-of-function variants of LMX1b that cause nail-patella syndrome (NPS) remain largely unknown.

What does this study add?

• For a given transcription factor, any defect impairing nuclear localization, DNA binding and cofactor recruitment would result in pathogenic haploinsufficiency.
• These defects might be the underlying mechanism employed by truncated LMX1b-R198X, the biochemical properties of which are shown herein to cause NPS.

What's already known about this topic?

• A two-compound ointment containing calcipotriol 50 μg g⁻¹ and betamethasone dipropionate 0·5 mg g⁻¹ is an effective treatment for moderate-to-severe psoriasis in adults.
• Studies on its effectiveness in paediatric psoriasis are not available.

What does this study add?

• In this prospective observational study, we provide daily clinical practice evidence on the effectiveness and safety of calcipotriol/betamethasone dipropionate ointment in children with mild-to-moderate plaque psoriasis.

What's already known about this topic?

• Sunscreen chemicals are among the most common agents causing photoallergic (PA) contact responses in adults.
• Sunscreen products are frequently applied in childhood.
• Currently, few studies of photopatch testing in children have been reported.

What does this study add?

• This largest reported series of photopatch testing in children reveals that 6·4% of children undergoing photoinvestigation had PA contact reactions to ultraviolet (UV) filters and/or sunscreen products.
• The most common UV filter responsible for PA contact reaction was benzophenone-3.
• Overall 5·7% of children showed contact allergic reactions, mostly to their sunscreen products.

What's already known about this topic?

• Excessive exposure to ultraviolet radiation causes inflammation, immune suppression and mutations, and can ultimately lead to cancer.

What does this study add?

• Novel ultraviolet B (UVB) target genes related to calcium signalling were identified in organotypic epidermal cultures.
• The gene most downregulated by UVB was rClca2, a chloride channel-associated protein, expressed as two isoforms in epidermis, in a differentiation-related manner.

What's already known about this topic?

• Currently, a 3-month topical application of the ultrapotent corticosteroid clobetasol propionate (CP) represents the first-line treatment for vulvar lichen sclerosus (VLS)
• To date there are no randomized clinical trials comparing the efficacy and safety of CP with other topical corticosteroids in treating VLS.

What does this study add?

• Our results show that CP and mometasone furoate have similar efficacy and tolerability in the treatment of VLS.
• Consistent with this, both corticosteroids could equally represent the first-line treatment for the disease.

What's already known about this topic?

• Fumaric acid esters (FAEs) are an effective and generally well-tolerated treatment for psoriasis.
• Common side-effects that limit tolerance of therapy include gastrointestinal upset and flushing.

What does this study add?

• FAEs have a 4-year drug survival of 60%, which compares favourably with biologic therapies.
• Discontinuation of treatment with FAEs is highest during the first year of therapy.
• A significant subset of patients responds to a low dose of FAEs.

What's already known about this topic?

• Guttate psoriasis can either resolve or progress to chronic plaque psoriasis (CPP).
• Patients with CPP have impaired epidermal Langerhans cell (LC) migration.

What does this study add?

• LC migration occurs in guttate psoriasis, thereby differentiating it from CPP, but at a lower level than in healthy individuals, and is restored upon clearance.
• These data provide insights not only into the mechanisms of LC mobilization, but also into factors that determine the resolution of psoriasis.