A 67-year-old woman presented with pruritus affecting her right shoulder. Two years later, her symptoms had progressed, with pruritus spreading to involve both her upper arms and mid-back. This was associated with a paraprotein. Topical treatments, systemic antihistamines and mirtazapine failed to relieve her symptoms, but she responded to a selective serotonin reuptake inhibitor in the absence of any psychological disorder.
The present case series describes the clinical profile and course of eight patients from North India who developed chronic arsenic toxicity, a serious yet preventable complication arising from the use of CAM for the management of psoriasis.
Our letter appraises a recent retrospective cohort study on cardiac involvement in severe cutaneous adverse reactions, including drug reaction with eosinophilia and systemic symptoms and Stevens–Johnson syndrome/toxic epidermal necrolysis. It highlights several methodological limitations such as the single-centre design, potentially overinclusive definitions of cardiac injury, neglect of phenotypic heterogeneity and lack of long-term follow-up.
In this retrospective real-world study of older adults with long-standing treatment-refractory immunological eruption of ageing, dupilumab was associated with rapid, substantial and sustained improvement in pruritus with a favourable safety profile. Most patients exhibited T helper 2 (Th2) skewed immunological features, including elevated IgE levels, low vitamin D and dermal eosinophilia, supporting a potential role of Th2-driven immunosenescence in disease pathogenesis. Although baseline immunological abnormalities were associated with more rapid early improvement, larger prospective studies are needed to validate predictive biomarkers and establish standardized treatment strategies for immunological eruption of ageing.
Standardized photographic methods for pyoderma gangrenosum (PG) severity staging remain poorly defined despite the central role of image-based assessment in monitoring disease course. In this pilot paired validation study, smartphone images obtained under standardized conditions yielded PG severity ratings comparable to DSLR images across 4 expert dermatologists, supporting simple image-capture protocols as a practical framework for reproducible PG photography.
