This Athena details the case of a 34-year-old male who develops a new pruritic rash four weeks after commencing a biologic medication for psoriasis.

Owing to their inherent role in immunomodulation, concerns have long existed about the use of biologic therapies in patients with active tuberculosis (TB). Most guidelines currently list active TB as an absolute contraindication to the use of immunomodulatory therapies. Contrary to this, we present a case of a patient with active disseminated TB who was safely treated with the interleukin-17 inhibitor bimekizumab.

AbstractPyoderma gangrenosum (PG) is a complex disease with limited therapeutic options. Here we report the use of higher dose of guselkumab, a monoclonal antibody targeting interleukin (IL‐) 23, in the treatment of PG in a medically complex patient. This case contributes additional evidence supporting the potential effectiveness of guselkumab in the treatment of PG and highlights the necessity for larger studies to confirm these findings.

Drug survival measures the rate and duration of adherence to a given therapeutic agent and evaluates its long‐term effectiveness, safety, and real‐world utility. The SUSTAIN study sought to establish the drug survival and effectiveness of secukinumab for patients with severe chronic plaque psoriasis (CPP) in the Australian clinical setting.

Australasian Journal of DermatologyVolume 62, Issue 2 p. e313-e316 Letter to the Editors Tildrakizumab as a potential long-term therapeutic agent for severe Hidradenitis Suppurativa: A 15 months experience of an Australian institution Yonatan Kok, Corresponding Author Yonatan Kok yonathan.kok@gmail.com orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this author Yonatan Kok, Corresponding Author Yonatan Kok yonathan.kok@gmail.com orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this author First published: 17 March 2021 https://doi.org/10.1111/ajd.13559Citations: 1 Conflict of interest: None declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume62, Issue2May 2021Pages e313-e316 RelatedInformation

Australasian Journal of DermatologyVolume 61, Issue 4 p. e488-e490 Letter to the Editors Tildrakizumab in the treatment of moderate-to-severe hidradenitis suppurativa Yonatan Kok, Corresponding Author yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorAnne Howard, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorGeorge Varigos, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJohannes Kern, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this author Yonatan Kok, Corresponding Author yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorAnne Howard, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorGeorge Varigos, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJohannes Kern, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this author First published: 06 July 2020 https://doi.org/10.1111/ajd.13377Citations: 5 Conflict of interest: Prof Varigos had received an unrestricted research grant from Sun Pharma, outside the submitted work, and has been on the advisory board for Sun Pharma. A/Prof Kern is a site principal investigator for clinical trials from AbbVie (NCT03926169) and UCB Biopharma (EudraCT 2019-002551-42). Sun Pharma had no role in the study design, data collection, data analysis, interpretation of data, writing of the manuscript or publication decisions. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume61, Issue4November 2020Pages e488-e490 RelatedInformation

Australasian Journal of DermatologyVolume 61, Issue 3 p. 292-294 Letter to the Editors Measuring treatment response to adalimumab in hidradenitis suppurativa patients: An observational study Yonatan Kok, Corresponding Author Yonatan Kok yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorAnna Braue, Anna Braue Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorJohannes S. Kern, Johannes S. Kern Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia Department of Dermatology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, GermanySearch for more papers by this authorGeorge Varigos, George Varigos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this author Yonatan Kok, Corresponding Author Yonatan Kok yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorAnna Braue, Anna Braue Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorJohannes S. Kern, Johannes S. Kern Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia Department of Dermatology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, GermanySearch for more papers by this authorGeorge Varigos, George Varigos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this author First published: 17 February 2020 https://doi.org/10.1111/ajd.13245Citations: 1 Conflict of interest: Yonatan Kok: Sub-investigator in clinical trials for atopic dermatitis sponsored by AbbVie. Johannes S. Kern: Investigator in clinical trials for atopic dermatitis sponsored by AbbVie. Con Dolianitis: Past advisory board member for AbbVie. All other authors: No conflict of interest that would influence the author’s objectivity. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume61, Issue3August 2020Pages 292-294 RelatedInformation

Australasian Journal of DermatologyVolume 61, Issue 3 p. e373-e374 Letter to the Editors Tildrakizumab in the treatment of PASH syndrome: A potential novel therapeutic target Yonatan Kok, Corresponding Author Yonatan Kok yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorGeorge Varigos, George Varigos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorAnne Howard, Anne Howard Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Dermatology, The Western Hospital, Footscray, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this author Yonatan Kok, Corresponding Author Yonatan Kok yonatan.kok@mh.org.au orcid.org/0000-0002-0604-1183 Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, AustraliaSearch for more papers by this authorJenny Nicolopoulos, Jenny Nicolopoulos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorGeorge Varigos, George Varigos Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this authorAnne Howard, Anne Howard Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Dermatology, The Western Hospital, Footscray, Victoria, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, The University of Melbourne, Parkville, Victoria, AustraliaSearch for more papers by this author First published: 13 April 2020 https://doi.org/10.1111/ajd.13285Citations: 5 Conflict of interest: The dermatology department at Royal Melbourne Hospital had received compassionate supplies for tildrakizumab from Sun Pharma. Author George Varigos had received an unrestricted research grant from Sun Pharma outside the submitted work. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume61, Issue3August 2020Pages e373-e374 RelatedInformation

Organizing pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. The pathological pattern of organizing pneumonia may be idiopathic or related to a determined cause, termed secondary organizing pneumonia. We report a 68-year-old woman with a longstanding history of chronic plaque psoriasis, treated with the tumor necrosis factor (TNF) inhibitor, adalimumab. After 8 years of treatment, she developed a gradual-onset, non-productive cough with associated generalized fatigue and mild dyspnea. Radiological investigations demonstrated ground-glass opacities in the left lower lobe and bronchoscopy revealed a fibroinflammatory process consistent with organizing pneumonia. Her biologic treatment was ceased and corticosteroid treatment commenced, with resolution of both her symptoms and the radiological findings. Given the increasing incidence of biologic treatment in the management of dermatological conditions, clinicians should be aware of secondary organizing pneumonia as a possible side effect of TNF inhibitor therapy.

The Journal of DermatologyVolume 45, Issue 12 p. e333-e334 Letter to the Editor From biologic to biologic: Ulcerative colitis in the setting of psoriasis treatment Brent J. Doolan, Corresponding Author Brent J. Doolan brent.doolan@mh.org.au orcid.org/0000-0002-9497-0504 Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaCorrespondence: Brent J. Doolan, B.Sc., M.B.B.S., Department of Dermatology, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic. 3050, Australia. Email: brent.doolan@mh.org.auSearch for more papers by this authorBarbara Radulski, Barbara Radulski Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaSearch for more papers by this author Brent J. Doolan, Corresponding Author Brent J. Doolan brent.doolan@mh.org.au orcid.org/0000-0002-9497-0504 Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaCorrespondence: Brent J. Doolan, B.Sc., M.B.B.S., Department of Dermatology, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic. 3050, Australia. Email: brent.doolan@mh.org.auSearch for more papers by this authorBarbara Radulski, Barbara Radulski Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaSearch for more papers by this authorCon Dolianitis, Con Dolianitis Department of Dermatology, The Royal Melbourne Hospital, Melbourne, AustraliaSearch for more papers by this author First published: 31 May 2018 https://doi.org/10.1111/1346-8138.14491Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume45, Issue12December 2018Pages e333-e334 RelatedInformation

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This is a case of a 26-year-old Caucasian woman with a lifelong history of an episodic urticaria associated with arthralgia, precipitated by exposure to cold. She had no other significant past medical history. She reported several family members with a history of very similar episodic eruptions without definitive diagnoses. An examination showed an urticarial eruption over her limbs with no other systemic findings. A baseline full blood examination, serology and autoimmune screen were normal. A skin biopsy was consistent with urticaria, with dermal oedema and a perivascular infiltrate. Following genetic testing, she was found to be heterozygous for a mutation, p.Ala439Val in the NLRP3 gene, known to cause familial cold autoinflammatory syndrome (FCAS), which typically presents with urticaria, conjunctivitis and arthralgia, as described in this patient. FCAS is one subtype of a group of conditions known as cryopyrin-associated periodic syndromes (CAPS). CAPS are rare, autosomal dominant inherited conditions with a spectrum of phenotypes, characterised by increased interleukin-1β release with subsequent local and systemic proinflammatory and pyrogenic effects.

We describe an unusual case of multidrug-resistant miliary tuberculosis diagnosed 9 months after the commencement of infliximab treatment for psoriasis despite negative pretreatment tuberculosis screening, including chest X-ray and interferon-gamma release assay. After 4 months' treatment with amikacin, ethambutol, pyrazinamide and moxifloxacin, infliximab was restarted with concomitant anti-TB medications. No recurrence of tuberculosis has been detected 12 months after recommencing infliximab.

Multicentric reticulohistiocytosis (MRH), a rare histiocytic systemic condition characterized by mutilating arthritis and multiple cutaneous nodules, has been associated with malignancy including that of the breast, thyroid and colon. An unsubstantiated link with infectious agents such as mycobacterium tuberculosis has been described. Many treatments have been used with varying success. We describe the case of a 60-year-old man with MRH and no underlying malignancy who initially responded well to azathioprine and whose disease recurred upon cessation. A second course of azathioprine administered in conjunction with antituberculous treatment resulted in disease control. Broader associations and features of this rare disease are discussed.

A 41-year-old man with prolidase deficiency has had chronic leg ulcers and recurrent cellulitis for most of his life. Until recently he had been hospitalized at least annually for this and suffered significant morbidity as a result. Since commencing topical 5% proline in white soft paraffin ointment to treat the leg ulcers, there has been marked improvement in the ulcers and decreased frequency of hospitalizations for cellulitis. This lends further support to the use of topical proline in the treatment of patients with skin ulcers secondary to prolidase deficiency.

A 37-year-old male developed facial papules 6 months post renal-pancreatic transplant. Histological findings were consistent with localized papular mucinosis; electrophoresis showed no paraprotein. A trial of erbium and aura lasers, at ablative doses, produced no improvement. Independent treatments with oral doxycycline, itraconazole, acitretin, and isotretinoin also had no effect. The facial papules improved spontaneously, 2 years after first presentation and 8 months after treatment ceased. The patient remains clear of lesions.