Abstract Tapinarof is an aryl hydrocarbon receptor agonist approved for the treatment of atopic dermatitis (AD) and psoriasis. While common adverse events include headache and folliculitis, comedones and perifollicular hyperpigmentation are under-recognized. Here, we report eight patients with AD or psoriasis who developed comedones and/or perifollicular hyperpigmentation during therapy. Lesions developed primarily at application sites; however, in one patient, lesions occurred at a distant site. Lesions appeared on the face in six patients, the legs in one and the arms in one. Time of onset ranged from 1 to 8 months after initiation of tapinarof therapy. Tapinarof was discontinued in all cases. Three patients were treated with topical adapalene/benzoyl peroxide, with partial improvement in one and minimal improvement in two. One patient showed gradual improvement without additional treatment, whereas the remaining five showed no or minimal improvement during follow-up. Our cases provide important information on under-recognized adverse events during tapinarof therapy.
Background:The use of high-intensity statins is recommended to improve the prognosis of coronary artery disease. However, it remains unclear whether they offer a short-term benefit after percutaneous coronary intervention (PCI), regardless of the acute coronary syndrome (ACS) status. Methods and Results:We performed a post hoc analysis of STOPDAPT-3, which compared 1-month aspirin-free prasugrel monotherapy followed by clopidogrel monotherapy with 1-month dual antiplatelet therapy (DAPT) followed by aspirin monotherapy in patients with ACS or a high bleeding risk undergoing PCI. High-intensity statins were defined as the maximum approved dose of strong statins in Japan (e.g., rosuvastatin 10 mg, atorvastatin 20 mg, or pitavastatin 4 mg). Two co-primary endpoints were the study-defined cardiovascular composite endpoint and bleeding endpoint, assessed between hospital discharge and 1 year after randomization. Among 5,823 patients discharged alive, 2,829 (48.6%) received high-intensity statins (ACS 54.4%; non-ACS 31.5%; P<0.001). The 1-year post-discharge cumulative incidence of cardiovascular events was similar between patients who received high-intensity statins and those who did not (3.90% vs. 4.27%, P=0.51; adjusted HR 1.03; 95% CI 0.74-1.44; P=0.84). Conclusions:In STOPDAPT-3, high-intensity statin therapy at discharge was not associated with a reduced risk of cardiovascular events 1 year after PCI, under the limitations of having no laboratory test or prescription data available during the follow up.
OBJECTIVES:To evaluate long-term oncologic outcomes and recurrence patterns after laparoscopic radical nephroureterectomy (LRNU) performed more than five years earlier. PATIENTS AND METHODS:We retrospectively analyzed patients who underwent LRNU before 2020 at nine Japanese institutions. Nonurothelial recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazard models were applied to identify prognostic factors. Initial recurrence sites were assessed, with particular focus on disseminated recurrence. RESULTS:A total of 1102 patients were included, with a median follow-up of 57 months. Clinically locally advanced disease was observed in 212 patients (19%), including 178 (16%) with cT3-4 tumors and 64 (6%) with cN-positive disease. Lymphadenectomy was performed in 557 cases (51%). The 5-year RFS rates for pT < 1, pT1, pT2, pT3, and pT4 were 92%, 87%, 70%, 48%, and 20%, respectively. The corresponding CSS rates were 96%, 94%, 81%, 61%, and 21%, and the corresponding OS rates were 84%, 78%, 71%, 53%, and 15%. Older age at surgery and advanced pathological features were independent predictors of poorer RFS, CSS, and OS. Regarding recurrence patterns, distant recurrence occurred in 203 patients (18%), local recurrence in 127 (11%), and urothelial recurrence in 489 (45%). Disseminated recurrence was rare, occurring in 25 patients (2%), including 18 with retroperitoneal carcinomatosis and 3 (0.3%) with port-site recurrence. CONCLUSIONS:Our findings suggest that LRNU provides favorable long-term oncologic outcomes with low disseminated recurrence rates, appearing comparable to historical outcomes of open surgery.
This study aimed to assess the clinical utility of serum interferon-lambda 3 (IFN-λ3) as a sequential biomarker for treatment response and disease control in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM)-associated interstitial lung disease (ILD). Serum IFN-λ3 levels were measured in 24 patients with anti-MDA5 antibody-positive DM-ILD at diagnosis and 1 month after initiating immunosuppressive therapy. Patients were categorized into two groups based on clinical outcomes: a good control group (n = 16; survived without relapse for ≥ 1 year) and a poor control group (n = 8; died from ILD progression or relapse within 1 year). Changes in serum IFN-λ3 levels and differences between groups were analyzed. In the good control group, serum IFN-λ3 levels significantly decreased from 94.6 to 12.7 pg/mL (p < 0.001), whereas no significant change was observed in the poor control group (129.0 to 118.8 pg/mL). Furthermore, serum IFN-λ3 levels at 1 month were significantly lower in the good control group than in the poor control group (p = 0.004). Serum IFN-λ3 levels may reflect short-term treatment response and could serve as a useful sequential biomarker for assessing disease control in patients with anti-MDA5 antibody-positive DM-ILD.
