What's already known about this topic?

• Vitiligo is a skin disease with limited treatment options.
• Most of the published vitiligo clinical trials are of poor methodological quality.

What does this study add?

• There are still important variations in study design and outcome measures in vitiligo clinical trials.
• Individual trials showed short-term benefit from topical corticosteroids and various forms of ultraviolet combined with topical preparations.
• Long-term follow-up and patient-rated outcomes should be incorporated into study design, and more studies should assess psychological interventions.

What's already known about this topic?

• Many interventions have been tried for hidradenitis suppurativa (HS).
• Evidence supporting the choice of intervention for HS is often limited.

What does this study add?

• Moderate-quality evidence suggests that adalimumab given weekly and infliximab are effective, whereas adalimumab every other week is ineffective.
• There are very limited or no randomized controlled trial data in HS for antibiotic therapy, retinoids, oral immunomodulators or the timing and type of surgery to perform.

Linked Comment: Blok. Br J Dermatol 2016; 174: 953–954

What's already known about this topic?

• One important side-effect in photodynamic therapy (PDT) of actinic keratoses (AKs) is post-treatment erythema, which enhances patient down time.
• Corticosteroid use before and just after PDT can reduce treatment-induced erythema.

What does this study add?

• Pulse-PDT (30-min methyl aminolaevulinate, illumination after 3 h) and especially corticosteroid pulse-PDT reduced treatment-induced erythema without affecting the efficacy of the treatment of multiple mild AKs.
• Pulse-PDT and topical corticosteroids may make PDT treatment of large areas more acceptable.

What's already known about this topic?

• Inhibition of Janus kinase (JAK) signalling is emerging as an important therapeutic target in the treatment of psoriasis.

What does this study add?

• This study shows that GSK2586184 is efficacious in the treatment of plaque psoriasis over a 12-week period.
• Our results suggest that JAK1 selective inhibition may be an effective treatment option for patients with plaque-type psoriasis, without the laboratory changes seen with broader JAK inhibition.
• Our study details the gene expression profile changes observed in uninvolved and involved skin at baseline and in involved skin after 2 weeks of treatment with GSK2586184.

Plain language summary available online

What's already known about this topic?

• Precise information on the epidemiology of chronic spontaneous urticaria (CSU) in Italy is lacking.

What does this study add?

• Annual incidence and prevalence rates of CSU in Italy were calculated from 2002 to 2013 using data from a national database of general practitioners.
• Demographic and clinical determinants associated with the occurrence of CSU were determined.

What's already known about this topic?

• Actinic keratosis is one of the most common conditions treated by dermatologists in western countries.

What does this study add?

• The overall prevalence of actinic keratoses in patients visiting dermatologists was 0.52% in two hospitals in China, which is much lower than in western countries.

Linked Comment: Wakkee and Nijsten. Br J Dermatol 2016; 174:954

What's already known about this topic?

• The proinflammatory cytokine tumour necrosis factor (TNF)-α is prevalent in many inflammatory diseases, including psoriasis.
• Not much attention has been given to the role of TNF-α in the frequently used Aldara-induced skin inflammation model.

What does this study add?

• Mice constitutively lacking the expression of TNF-α developed significantly less Aldara-induced skin inflammation compared with wild-type mice, strengthening the importance of the use of this model in the study of psoriasis.

Linked Comment: Kurschus. Br J Dermatol 2016; 174:955–956

What's already known about this topic?

• The use of serum to test for specific IgG and IgA autoantibodies to epitopes on bullous pemphigoid antigen II (BP180; collagen XVII) by enzyme-linked immunosorbent assay has been documented.
• Circulating autoantibodies may relate to disease activity and have been reported to be associated with a more severe clinical presentation in mucous membrane pemphigoid (MMP).

What does this study add?

• The study demonstrates for the first time that saliva provides a practical alternative to serum in the diagnosis of MMP as IgG and IgA antibodies to BP180-NC16a can be detected in saliva.
• The detection of secretory IgA antibodies is demonstrated for the first time and indicates local production of autoantibodies to the noncollagenous domain of BP180. This may help provide more insight into the pathogenesis of the disease.

Linked Comment: Schmidt. Br J Dermatol 2016; 174: 956–957

Plain language summary available online

What's already known about this topic?

• Dermatomyositis (DM) and systemic lupus erythematosus (SLE) have common skin features, including dermal mucin deposition and interferon signature.

What does this study add?

• PSMB9 and versican V1, a core protein for glycosaminoglycan, were upregulated, while type I collagen was downregulated in both DM and SLE skin.
• The interferon signature reduces collagen in dermal fibroblasts of DM and SLE skin, while interferon-induced PSMB9 overexpression induces transforming growth factor (TGF)-β2/β3 in epidermal keratinocytes, which results in versican overexpression in dermal fibroblasts.
• The TGF-β2–ΔDiHS-diS1 pathway is responsible for the specific molecular changes to DM skin.

What is the translational message?

• PSMB9 in the skin of patients with dermatomyositis and systemic lupus erythematosus has great potential as a diagnostic and therapeutic tool.

What's already known about this topic?

• Individuals allergic to para-phenylenediamine (PPD) have shown a lower response rate to forearm testing simulating hair dye use when the hair dye product contained 2-methoxymethyl (ME)-PPD instead of PPD.

What does this study add?

• This study investigates whether PPD-allergic individuals tolerate full hair dyeing with their selected ME-PPD hair dye shade, if they did not respond to forearm pretesting with that hair dye at day 2.

Linked Comment: Pongpairoj et al. Br J Dermatol 2016; 174: 957–958

What's already known about this topic?

• No data exist about psychiatric disorders in patients with skin-restricted lupus (SRL).

What does this study add?

• Patients with SRL have a high prevalence of current and lifetime major depressive disorder, generalized anxiety disorder and panic disorder, current suicide risk, alcohol dependence and lifetime agoraphobia.
• Patients with SRL often lack specialized mental health care.

Linked Comment: Bewley. Br J Dermatol 2016; 174:958–959

Plain language summary available online

What's already known about this topic?

• The longest follow-up studies after liposuction performed in patients with lipo-edema were performed over an average period of 4 years.

What does this study add?

• This study adds new information concerning specific complaints after an average period of 8 years following liposuction in patients with lipoedema.
• These complaints include oedema, spontaneous pain, sensitivity to pressure, bruising, restriction of movement, cosmetic impairment and reduction in quality of life.

Linked Comment: Szolnoky. Br J Dermatol 2016; 174:959–960

Plain language summary available online

What's already known about this topic?

• Solar ultraviolet B (UVB) radiation is the major source of vitamin D (vitD) for humans and it is strongly associated with vitD status.
• UVB radiation at wavelengths that can induce vitD synthesis can be approximated by total UV or UVB radiation, sunshine hours or latitude, typically averaged over a large geographical region and long time period, yielding unreliable approximations.

What does this study add?

• Information on ambient UVB exposure at wavelengths required for vitD synthesis (vitD-UVB), adjusted for cloud cover and ozone layer, is a powerful yet underutilized tool to study the relationships between UVB, vitD and health outcomes.
• There was significant geographical variation in vitD-UVB, even within a small geographical area at a northern latitude.
• Measured ambient vitD-UVB dose at place of residence is a good predictor of vitD status.

Linked Comment: Dawe. Br J Dermatol 2016; 174:960

Plain language summary available online

What's already known about this topic?

• Dermoscopy is insufficient to differentiate between lentigo maligna (LM) and pigmented actinic keratosis (PAK).

What does this study add?

• White and evident follicles, scales and red colour represent significant diagnostic clues for PAK.
• Intense pigmentation and grey rhomboidal lines appear highly suggestive of LM.
• These novel findings might improve the early detection of LM, while reducing unnecessary biopsies for PAK.

What's already known about this topic?

• According to the concept of endogenous fluorescence or autofluorescence of skin, certain molecules native to skin fluoresce or emit light upon illumination.
• Endogenous fluorescence has been used as a clinical research method. Fluorescence spectra or maps are acquired by spectroscopy and subsequently correlated to physiology.

What does this study add?

• This study demonstrates the effectiveness of a novel ultraviolet fluorescence excitation photography system in its ability to image rapidly proliferating epidermal skin lesions by capturing endogenous fluorescence emissions.
• The images captured using this method are instantly available and do not require interpretation or reconstruction.

Linked Comment: Youn. Br J Dermatol 2016;174:961

Plain language summary available online