Transient acantholytic dermatosis (Grover's disease).
الأحد، ديسمبر 1
الجمعة، نوفمبر 1
الأربعاء، أكتوبر 30
Breaking news
FDA Clears
First Topical Form of Minocycline for Acne, i.e. 4% minocycline topical foam
(Amzeeq, Foamix Pharmaceuticals) to treat inflammatory lesions of nonnodular
moderate to severe acne vulgaris in adults and in children aged 9 years or
older.
الاثنين، أكتوبر 14
Breaking news
In this month, October 2019, the US-FDA has approved trifarotene cream 0.005% (Aklief, Galderma), as the first new retinoid molecule to be approved in >20 years for the once-daily topical treatment of acne vulgaris, both facial (forehead, cheeks, nose, and chin) and truncal (chest, shoulders, and back), in patients aged 9 years or older.
Trifarotene is the only topical retinoid that selectively targets retinoic acid receptor (RAR) gamma, the most common RAR found in the skin.
الثلاثاء، أكتوبر 1
الأحد، سبتمبر 1
Dr. Ghamriny's image of the month, September 2019
Granular parakeratosis, axilla (the most common site)
الاثنين، أغسطس 19
Tranexamic acid in melasma: Why and how?
Tranexamic acid (trans-4-aminomethylcyclohexanecarboxylic
acid; TXA; a synthetic lysine analog which has an antifibrinolytic effect
through the reversible blockade of lysine-binding sites on plasminogen
molecules) is a procoagulant agent that is FDA-approved for treatment of
menorrhagia and to prevent hemorrhage in patients with hemophilia undergoing
tooth extractions. Tranexamic acid
exerts effects on pigmentation via its inhibitory effects on UV light-induced
plasminogen activator and plasmin activity (UV radiation induces plasminogen
activator synthesis and increases plasmin activity in keratinocytes, which stimulates the
release of arachidonic acid via phospholipase A2. Free arachidonic acid
stimulates melanogenesis via its metabolite, prostaglandin E2. Increased
plasmin itself elevates α-melanocyte-stimulating hormone, which activates
melanin synthesis in melanocyte. Plasmin also plays a role in the release of
basic fibroblast growth factor [FGF], which is again a potent melanocyte growth
factor. All of these processes result in more melanin production in the skin). Methods of TXA administration
in melasma (as a single or adjuvant treatment) include oral tabs (250 mg twice daily for ±3
months; a safe therapeutic option, easy to administer with few and mild side
effects; e.g. heartburn, nausea, abdominal pain, and epigastric discomfort), topical
(2% emulsion, 3% cream & 5% solution), intradermal injection in the
concentration of 4mg/mL, and in combination with microneedling.
الخميس، أغسطس 1
السبت، يوليو 27
الأربعاء، يوليو 17
تنويه
الأسبوع القادم بإذن الله تعالى تصدر الطبعة العاشرة من كتاب الغمريني الكبير في الأمراض الجلدية - 4 أجزاء - في مكتبات كليات الطب في مصر
Next week, God Willing, comes the 10th edition of
"Ghamriny's Clinical Dermatology", a 4-volume edition, 2019
in all medical bookstores in Egypt.
This will be the last edition based on the current book structure and backbone. After 2-3 years, God Willing, a totally new concept & structure would be adopted; hopefully for a better way of presenting information and advances in dermatology.
الاثنين، يوليو 15
Nice Case
Tinea corporis incognito due to previous wrong diagnosis of a dermatologist and the use of a topical steroid (above).
The same case, one week later, after treatment with a systemic and a topical antifungal treatments (below).
الاثنين، يوليو 1
السبت، يونيو 1
الجمعة، مايو 24
Breaking news, May 2019
Risankizumab (Skyrizi®) is now FDA-approved (May, 2019) for the treatment of moderate to severe plaque psoriasis in adult patients who are eligible for systemic medication or phototherapy.
Risankizumab is a humanized monoclonal IgG1 antibody antagonist of IL-23, a cytokine mediator of chronic inflammation). By binding the p19 subunit of IL-23, it prevents IL-23 receptor binding and thereby inhibits a pro-inflammatory response. It is a SC-injected medication, dosed at 150 mg, and given at weeks 0 and 4 and subsequently, every 12 weeks.
الأربعاء، مايو 22
Guidelines on systemic therapy for metastatic or unresectable cutaneous melanoma and recommendations for adjuvant systemic therapies (National Comprehensive Cancer Network; May 2019):
A. Systemic therapy for metastatic or unresectable disease:
A. Recommended first-line therapy (metastatic or unresectable disease):
• Anti–programmed cell death protein 1 (PD1)
monotherapy: Pembrolizumab, nivolumab.
• Combination targeted therapy for BRAF V600–activating
mutation (preferred if clinically necessary for early response):
Dabrafenib/trametinib, vemurafenib/cobimetinib, encorafenib/binimetinib.
• Useful in certain circumstances:
Nivolumab/ipilimumab.
2. Recommended second-line or subsequent
therapy (disease progression or maximum clinical benefit from BRAF-targeted therapy):
• Preferred regimens: Anti-PD1 monotherapy
(pembrolizumab, nivolumab); nivolumab/ipilimumab; combination targeted therapy
for BRAF V600–activating
mutation (dabrafenib/trametinib, vemurafenib/cobimetinib,
encorafenib/binimetinib).
• Other regimens: Ipilimumab; high-dose IL-2.
• Useful in certain circumstances:
Ipilimumab/intralesional talimogene laherparepvec (T-VEC); cytotoxic agents;
imatinib for tumors with activating mutations of KIT; larotrectinib
for NTRK gene
fusion–positive tumors.
B. Recommended adjuvant
systemic therapies:
1. For stage III (sentinel lymph node
positive) disease:
• Primary treatment: Wide local excision of
primary lesion and sentinel lymph node biopsy, followed by complete lymph node
dissection or nodal ultrasound surveillance.
• Recommended options: Observation, nivolumab,
pembrolizumab, combination dabrafenib/trametinib.
2. For stage III (clinically positive nodes
[no in-transit or satellite metastases]) disease:
• Primary treatment: Wide local excision of
primary lesion and complete lymph node dissection.
• Recommended options: Observation, nivolumab,
pembrolizumab, combination dabrafenib/trametinib.
3. For stage III (clinical or microscopic
satellite/in-transit) disease:
• Primary treatment: Complete surgical
excision to clear margins.
• Recommended options: Observation, nivolumab,
pembrolizumab, combination dabrafenib/trametinib.
4. For stage IV resectable disease:
• Primary treatment: Complete resection.
• Recommended options: Observation, high-dose
ipilimumab (recommended only if patient has prior exposure to anti-PD1
therapy), nivolumab, pembrolizumab.
5. For local satellite/in-transit disease
recurrence:
• Primary treatment: Complete surgical
excision to clear margins.
• Recommended options: Observation, nivolumab,
pembrolizumab, combination dabrafenib/trametinib.
6. For nodal recurrence:
• Primary treatment: Excise nodal metastasis
and complete lymph node dissection (if incomplete or no prior complete lymph
node dissection).
• Recommended options: Observation, high-dose
ipilimumab (recommended only if patient has prior exposure to anti-PD1
therapy), nivolumab, pembrolizumab, combination dabrafenib/trametinib.
الأربعاء، مايو 15
Dr. Ghamriny's image of the month, May 2019
CD4+ small/medium-sized pleomorphic T-cell
lymphoproliferative disorder. Typical site but ulcerated lesion (ulceration occurs in around 10% of cases).
This clinical lesion was initially introduced by 2008 WHO classification as a provisional entity of primary cutaneous small/medium T-cell lymphoma. Because of its indolent behavior, the entity was modified in 2016 to primary cutaneous small/medium-sized T-cell lymphoproliferative disorder. This lymphoproliferative disorder is characterized by the expression of follicular helper T-cell markers, particularly B-cell lymphoma 6 (BCL-6), programmed cell death protein 1 (PD-1), and C-X-C motif chemokine ligand 13 (CXCL-13), while CD10 is usually negative. Molecular studies show a clonal rearrangement of T-cell receptor genes >60% of cases.
This clinical lesion was initially introduced by 2008 WHO classification as a provisional entity of primary cutaneous small/medium T-cell lymphoma. Because of its indolent behavior, the entity was modified in 2016 to primary cutaneous small/medium-sized T-cell lymphoproliferative disorder. This lymphoproliferative disorder is characterized by the expression of follicular helper T-cell markers, particularly B-cell lymphoma 6 (BCL-6), programmed cell death protein 1 (PD-1), and C-X-C motif chemokine ligand 13 (CXCL-13), while CD10 is usually negative. Molecular studies show a clonal rearrangement of T-cell receptor genes >60% of cases.
السبت، أبريل 27
قريبا - ان شاء الله تعالى - بكل المكتبات الطبية في مصر
الطبعة العاشرة (2019) من كتاب الغمريني الكبير في الأمراض الجلدية - 4 أجزاء
Soon in all medical bookstores in Egypt:
the 10th edition of
GHAMRINY'S CLINICAL DERMATOLOGY,
GHAMRINY'S CLINICAL DERMATOLOGY,
4 parts.
الثلاثاء، يناير 1
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