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Barker C, Alshaikh H, Elston D. Dermatology practice updates in mycobacterial disease. Int J Dermatol 2024; 63:714-725. [PMID: 38095207 DOI: 10.1111/ijd.16969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 05/25/2024]
Abstract
Atypical mycobacterial infections are commonly acquired through exposure to water, and tuberculosis remains highly endemic in many parts of the world. In this era of global connection, travel, and immigration, it is more important than ever to maintain a high index of suspicion for infection from cutaneous tuberculosis and atypical mycobacteria. Epidemics related to surgical procedures have been related to inadequate sterilization, as almost 50% of public water supplies harbor mycobacteria. Improved diagnostic techniques for these microbes, including Auramine-Rhodamine staining and rapid detection of mycobacteria and drug susceptibilities through PCR and MALDI-TOF, have improved detection and treatment outcomes. Given an increasing number of patients on immunosuppressive therapies, clinicians must remain vigilant.
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Affiliation(s)
- Catherine Barker
- Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Hesham Alshaikh
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
- Department Mohs Micrographic and Dermatologic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dirk Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
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2
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Kist MN, Svoboda R, Maczuga S, Wang L, Foulke GT, Helm MF. Annual tuberculosis screening in patients on biologics has questionable value. J Am Acad Dermatol 2024:S0190-9622(24)00484-5. [PMID: 38467307 DOI: 10.1016/j.jaad.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Madison N Kist
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Ryan Svoboda
- Department of Dermatology, UMass Medical Center, Worcester, Massachusetts
| | - Steven Maczuga
- Department of Dermatology, Milton S. Hershey Penn State Medical Center, Hershey, Pennsylvania
| | - Li Wang
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Galen T Foulke
- Department of Dermatology, Milton S. Hershey Penn State Medical Center, Hershey, Pennsylvania; Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Matthew F Helm
- Department of Dermatology, Milton S. Hershey Penn State Medical Center, Hershey, Pennsylvania.
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Khanna U, Gallop J, Ellis A, Hu J, Galadari A, Saklecha A, Gordon SM, Husni ME, Rieder F, Fernandez AP. Routine rescreening for latent tuberculosis has low utility in patients with chronic immune-mediated inflammatory diseases treated with biologics: A single-center, retrospective cohort study. J Am Acad Dermatol 2022; 87:841-843. [PMID: 35597388 PMCID: PMC10022868 DOI: 10.1016/j.jaad.2022.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Urmi Khanna
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | | | - Ariana Ellis
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jeffery Hu
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Department of Dermatology, University of Wisconsin, Madison, Wisconsin
| | - Abdulaziz Galadari
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Anokhi Saklecha
- University of California, San Diego College of Medicine, San Diego, California
| | - Steve M Gordon
- Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio
| | - M Elaine Husni
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, Ohio
| | - Florian Rieder
- Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anthony P Fernandez
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Department of Pathology, Cleveland Clinic, Cleveland, Ohio.
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Shah P, Rebick G, Bajaj S, Desvignes L, Lo Sicco K. Evidenced-based guidelines for tuberculosis screening before biologic treatment initiation. J Am Acad Dermatol 2020; 83:e25-e26. [DOI: 10.1016/j.jaad.2020.02.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/25/2022]
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Bragazzi NL, Riccò M, Pacifico A, Malagoli P, Kridin K, Pigatto P, Damiani G. COVID-19 knowledge prevents biologics discontinuation: Data from an Italian multicenter survey during RED-ZONE declaration. Dermatol Ther 2020; 33:e13508. [PMID: 32415727 PMCID: PMC7267153 DOI: 10.1111/dth.13508] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
Abstract
SARS‐CoV‐2 become pandemics and there is still a dearth of data about its the potentially among dermatological patients under biologics. We aimed to assess health literacy, disease knowledge, treatment dissatisfaction and biologics attitudes toward COVID‐19. We performed a cross‐sectional, questionnaire‐based survey on 98/105 consecutive dermatological patients treated with biologics—51 suffering from plaque psoriasis, 22 from atopic dermatitis, and 25 from hidradenitis suppurativa. An ad hoc, validated questionnaire has 44 items investigating the following domains: knowledge of COVID‐19 related to (a) epidemiology, (b) pathogenesis, (c) clinical symptoms, (d) preventive measures, and (e) attitudes. Patients data and questionnaires were collected. Despite only 8.1% thought that biologics may increase the risk of COVID‐19, 18.4% and 21.4% of the patients were evaluating the possibility to discontinue or modify the dosage of the current biologic therapy, respectively. Globally, male patients (P = .001) with higher scholarity level (P = .005) displayed higher knowledge of COVID‐19. Patients with lower DLQI (P = .006), longer disease duration (P = .051) and lower scholarity (P = .007) have thought to discontinue/modify autonomously their biologic therapy. At the multivariate logistic regression, only the knowledge of epidemiology and preventive measures resulted independent predictors of continuation vs discontinuation and modification vs no modification, respectively. Dermatologists should promote COVID‐19 knowledge to prevent biologics disruption.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Matteo Riccò
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Khalaf Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lűbeck, Lűbeck, Germany
| | - Paolo Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Fernandez AP, Ellis A, Khanna U, Galadari A. Reply to: "Evidence-based guidelines for tuberculosis screening before biologic treatment initiation". J Am Acad Dermatol 2020; 83:e27-e28. [PMID: 32222450 DOI: 10.1016/j.jaad.2020.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Anthony P Fernandez
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Department of Pathology, Cleveland Clinic, Cleveland, Ohio.
| | - Ariana Ellis
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; Northeast Ohio Medical University, Rootstown, Ohio
| | - Urmi Khanna
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
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