MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'NeLM - Dermatology' source. Sun, 28 Mar 2010 14:03:50 +0100 http://www.medworm.com/index.php?rid=3209691&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FCochrane-review-Oral-potassium-iodide-for-the-treatment-of-sporotrichosis%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Abstract   Background Sporotrichosis is a subacute or chronic disease, usually affecting the skin caused by a dimorphic (existing in two forms), aerobic (oxygen requiring) fungus called Sporothrix schenckii. Oral potassium iodide is widely used for cutaneous sporotrichosis in clinical medicine with more and more reports published. However, the benefits and adverse reactions of these treatments have not yet been systematically reviewed.   Objectives To assess the effects of oral potassium iodide for the treatment of sporotrichosis.   Search strategy In July 2009 we searched the Cochrane Skin Group Specialised Skin Register, the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) in The ... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3209691 Wed, 27 Jan 2010 00:00:00 +0100 3209691 http://www.medworm.com/index.php?rid=3209690&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Class-Focused-Reviews%2FTopical-tacrolimus-and-pimecrolimus-in-the-treatment-of-cutaneous-lupus-erythematosus-an-evidence-based-evaluation%2F Source: DARE Area: Evidence > Drug Class Focused Reviews CRD Summary: This review evaluated the efficacy of topical pimecrolimus and tacrolimus in the treatment of cutaneous lupus erythematous. The authors reported that tacrolimus and pimecrolimus showed efficacy in the treatment of systemic lupus, erythematous cutaneous lesions, subacute cutaneous lupus erythematous and discoid lupus erythematous, although further research was necessary. The conclusions should be treated with caution due to poor-quality data and methodological flaws. CRD Commentary: The review question was clear, but the inclusion criteria were not explicitly stated. Language restrictions were not applied to the search, thus reducing the possibility of language bias. The authors did not report any attempts to identify ... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3209690 Wed, 27 Jan 2010 00:00:00 +0100 3209690 http://www.medworm.com/index.php?rid=3209692&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FCKS-topic-review-Hirsutism%2F Source: Clinical Knowledge Summaries (CKS) Area: Evidence > Guidelines This CKS topic covers the management of women with hirsutism in primary care. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3209692 Tue, 26 Jan 2010 00:00:00 +0100 3209692 http://www.medworm.com/index.php?rid=3183097&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2010---January%2F182%2FReview-Managing-co-morbid-disease-in-patients-with-psoriasis%2F Source: BMJ Area: News In this review article, the authors look at co-morbid diseases in patients with psoriasis, focusing on their relation to psoriasis and how their presence influences treatment decisions and management for these patients.   The following issues are discussed:   . Which co-morbidities are now recognised as important in psoriasis? . How is psoriasis related to its co-morbidities? . How can co-morbidities be diagnosed early? . How might co-morbidities influence treatment decisions? . What's new in psoriasis management? . What can we learn from psoriasis as a model of an immune mediated inflammatory disorder?   The following tips are given for non-specialists:   . Only severe psoriasis confers a substa... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3183097 Mon, 18 Jan 2010 00:00:00 +0100 3183097 http://www.medworm.com/index.php?rid=3183096&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FEpiduo-0125-Gel-Adapalene-1-mgBenzoyl-Peroxide-25-mg---New-product%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes New cutaneous treatment of Acne vulgaris when comedones, papules and pustules are present.  Epiduo should be applied to the entire acne affected areas once a day in the evening to clean and dry skin.  Early signs of clinical improvement usually appear after 1 to 4 weeks of treatment. See SPC for full details (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3183096 Mon, 18 Jan 2010 00:00:00 +0100 3183096 http://www.medworm.com/index.php?rid=3173309&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2010---January%2F14%2FRCT-Ustekinumab-vs-etanercept-in-psoriasis%2F Source: N Engl J Med Area: News A controlled trial found that ustekinumab gave better outcomes in moderate to severe psoriasis than etanercept.   The study involved patients with moderate to severe psoriasis, who were randomised to receive either ustekinumab (blocks the actions of the cytokines interleukin-12 and interleukin-23), 45 mg or 90 mg for two doses, four weeks apart, or etanercept 50mg twice weekly for 12 weeks. A double-dummy technique was used to preserve blinding. Primary outcome was the proportion of patients with at least 75% improvement in the psoriasis area-and-severity index (PASI) at week 12.   Of 1175 patients screened, 903 were randomised to treatment (ustekinumab 45 mg n=209, 90mg n=347, etanercept n=347). At twelve weeks, more patients in the ustek... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3173309 Thu, 14 Jan 2010 00:00:00 +0100 3173309 http://www.medworm.com/index.php?rid=3168837&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FPatient-Safety%2FMHRA-Drug-Safety-Update-Risk-of-Stevens-Johnson-syndrome-with-phenytoin%2F Source: MHRA Area: Evidence > Medication Safety The January 2010 issue of Drug Safety Update from the MHRA features an article discussing the possible increased risk of Stevens-Johnson syndrome (SJS) in association with phenytoin treatment in individuals of Thai and Han Chinese ethnic origin with the patients with human leukocyte antigen (HLA) allele HLA-B*1502.   Further information on a recently published study recognising this possible increased risk is provided.   The authors note that the prevalence of HLA-B*1502 is estimated at between 8.2% and 9% of the Thai population and 8.6% of Han Chinese. The prevalence of HLA-B*1502 is extremely low in the Caucasian population (1-2%); however, no conclusions can be drawn at present on the risk association between phenytoin-... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3168837 Wed, 13 Jan 2010 00:00:00 +0100 3168837 http://www.medworm.com/index.php?rid=3150455&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2010---January%2F072%2FChlorhexidine-alcohol-better-than-povidone-iodine-for-pre-operative-skin-cleansing%2F This study aimed to determine whether chlorhexidine 2% in isopropanol 70% was more effective than aqueous povidone-iodine 10% solution as a pre-operative antiseptic. Eligible patients were adults undergoing clean-contaminated surgery, without a history of allergy to either of the preparations used, and with no evidence of infection at or near to the surgical site. They were randomised to pre-operative skin cleansing with one agent or the other; patients and investigators remained blind to the agent used. Primary outcome was any surgical-site infection within 30 days after ... (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3150455 Thu, 07 Jan 2010 00:00:00 +0100 3150455 http://www.medworm.com/index.php?rid=3102868&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F18%2FEuropean-CHMP-begins-review-of-topical-formulations-of-ketoprofen%2F Source: EMEA Area: News The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA) has started a safety review of topical formulations of ketoprofen because of concerns over serious photosensitivity reactions, following a request by French regulatory authorities. The CHMP will assess the benefit-risk balance of these medicines and make a recommendation about whether their marketing authorisations should be maintained, changed, suspended or revoked. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3102868 Fri, 18 Dec 2009 00:00:00 +0100 3102868 http://www.medworm.com/index.php?rid=3086151&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F14%2FNHS-Health-Technology-Assessment-Comparison-of-three-dressings-for-diabetic-foot-ulcers-%2F Source: Health Technology Assessment Area: News According to the results of a multicentre randomised controlled trial, conducted as part of the NHS HTA programme, N-A® (a non-adherent, knitted, viscose filament gauze), Inadine® (an iodine-impregnated dressing), and Aquacel® dressings are of similar effectiveness when used to manage diabetic foot ulcers.  The authors therefore conclude that 'there is no reason why the least costly of the three dressings could not be used more widely across the UK National Health Service, thus generating potentially substantial savings'.    Full details of the study can be accessed at the link below.  Briefly, 317 adults with type 1 or 2 diabetes and a chronic (?6 weeks) full-thickness foot ulcer were randomised to treatment with ... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3086151 Mon, 14 Dec 2009 00:00:00 +0100 3086151 http://www.medworm.com/index.php?rid=3076903&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F10%2FNHS-Evidence-expert-commentary-on-TNF-blockers-in-psoriasis-%2F Source: NHS Evidence Area: News The December edition of 'Eyes on Evidence' from NHS Evidence features an expert commentary on a paper (Dharamsi et al) illustrating the risks and benefits of TNF blockers in relation to risks that patients with psoriasis understand. This paper found that "for many patients with severe psoriasis, the benefits of TNF blocker may greatly outweigh the risks. The drugs were shown to have remarkable efficacy in patients with severe psoriasis and the risks of serious adverse events are relatively rare and were comparable to the risks patients take on a regular basis such as driving a car."   The commentary concluded "by using terms such as number needed to treat and number needed to harm Dharamsi et al have developed some useful information that could for... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3076903 Thu, 10 Dec 2009 00:00:00 +0100 3076903 http://www.medworm.com/index.php?rid=3072874&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FGolimumab%2F Source: London Cancer New Drugs Group Area: Evidence > Drug Specific Reviews   Golimumab is a high affinity, fully humanised anti-tumour necrosis factor-? (anti-TNF-?) monoclonal antibody.   It was approved in October 2009 in the EU for the treatment of ankylosing spondylitis (AS), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) (in combination with methotrexate, (MTX)).     Golimumab is given as a 50mg subcutaneous injection once a month.   Five phase 3, double-blind, placebo-controlled, randomised trials have been carried out: - Ankylosing spondylitis:   GO-RAISE - Psoriatic arthritis: GO-REVEAL - Rheumatoid arthritis: GO-FORWARD (active RA despite methotrexate), GO-AFTER (up to 3 anti-TNF-?'s used alrea... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3072874 Thu, 10 Dec 2009 00:00:00 +0100 3072874 http://www.medworm.com/index.php?rid=3068503&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FMedicines-Q--A%2FDo-statins-cause-alopecia%2F Source: London Medicines Information Service Area: Evidence > Medicines Q & A As hair loss is a generally accepted male characteristic, drug-induced alopecia may be mistaken as part of a natural process and therefore under reported. There have been reports of alopecia associated with the use of all UK licensed statins but there is insufficient data to confidently attribute hair loss to statin use. Case studies suggest an association but as yet there is insufficient information to suggest a mechanism, make comparisons of the individual incidence of alopecia between the various statins or propose a class effect. The greatest number of reports of alopecia is for simvastatin but this may be related to e.g. market share, length of time on market. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3068503 Wed, 09 Dec 2009 00:00:00 +0100 3068503 http://www.medworm.com/index.php?rid=3064397&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FNizoral-2-Cream-ketoconazole---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes changes to: Section 4.8 (Undesirable Effects) - The safety of ketoconazole cream was evaluated in 1079 subjects who participated in 30 clinical trials. Ketoconazole cream was applied topically to the skin. The most commonly reported (?1% incidence) ADRs were: application site pruritus (2%), skin burning sensation (1.9%), and application site erythema (1%). Inclusion of table on SPC with ADRs that have been reported from either clinical trial or postmarketing experiences Section 4.9 (Overdose) - Topical Application: Excessive topical application may lead to erythema, oedema and a burning sensation, which will disappear upon discontinuation of the treatment. Ingestion: In the e... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3064397 Mon, 07 Dec 2009 00:00:00 +0100 3064397 http://www.medworm.com/index.php?rid=3058064&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FPatient-Safety%2FMHRA-advises-of-reports-of-severe-hypersensitivity-reactions-with-etravirine-Intelence%2F Source: Drug Safety Update Area: Evidence > Medication Safety In the December issue of Drug Safety Update, the MHRA has advised that cases of severe hypersensitivity syndromes, including drug rash with eosinophilia and systemic symptoms (DRESS) and toxic epidermal necrolysis (TEN), sometimes fatal, have been reported with etravirine (Intelence®). The drug must be immediately discontinued if severe rash or hypersensitivity reaction is suspected, as delay in stopping treatment after the onset of severe rash may result in a life-threatening reaction. Patients who have stopped treatment because of hypersensitivity reactions should not restart etravirine. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3058064 Fri, 04 Dec 2009 00:00:00 +0100 3058064 http://www.medworm.com/index.php?rid=3053991&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F03%2FLonger-term-safety-data-for-adalimumab%2F Source: Ann Rheum Dis Area: News Analysis of clinical trial data covering use up to 9 years (but mostly <5 years) found no indication of a significant increase in mortality or cancer incidence among patients treated with adalimumab.   Antagonists of tumour necrosis factor (TNF) have been shown to be effective in the treatment of several immune-mediated inflammatory diseases, however clinical trials raised concern over possible increases in risk of some serious adverse effects: these included cancer and tuberculosis (TB). This paper reports an analysis of adverse effect data from clinical trials, including open-label studies and trial extensions. Outcomes for the analysis included serious adverse events and malignancy and mortality rates compared to the general population. &n... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3053991 Thu, 03 Dec 2009 00:00:00 +0100 3053991 http://www.medworm.com/index.php?rid=3053990&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatment-of-New-World-cutaneous-leishmaniasis-a-systematic-review-with-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that although pentavalent antimonials were still effective for patients in Latin America with cutaneous leishmaniasis, cure rates were similar for pentamidine. Evidence appeared to support the authors' conclusions, but differences between studies and the small number of studies that directly compared treatments may have limited the strength of the evidence. [The included studies evaluated pentavalent antimonials, pentamidine, paromomycin (including topical and intravenous formulations) and other drugs including allopurinol and imidazole drugs. ] CRD Commentary: The review question was clearly stated and inclusion criteria defined for intervention, participants and outcome. Several relevant source... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3053990 Thu, 03 Dec 2009 00:00:00 +0100 3053990 http://www.medworm.com/index.php?rid=3041142&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F30%2FCHMP-recommends-product-information-for-oral-phenytoin-updated-to-include-increased-risk-of-Stevens-Johnson-syndrome-in-patients-of-Thai-ethnic-origin-with-HLA-B1502-allele-%2F Source: EMEA Area: News The CHMP Pharmacovigilance Working Party (PhVWP) has concluded that oral phenytoin should only be used in patients of Thai or Han Chinese ethnic origin known to be positive for HLA-B*1502 allele only if the benefits are considered to exceed risks, due to an increased risk of Stevens-Johnson syndrome (SJS).   The PhVWP considered a recent publication showing a significant association between the gene allele HLA-B*1502 and phenytoin-induced SJS in patients of Thai ethnic origin (Epilepsia 2008; 48:1015-1018).  On the basis of this and consultation with the CHMP Pharmacogenomics Working Party, the PhVWP recommended that the product information for oral phenytoin should be updated to reflect this risk, and to state that it should only be used in such pati... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3041142 Mon, 30 Nov 2009 00:00:00 +0100 3041142 http://www.medworm.com/index.php?rid=3001383&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FCKS-topic-review-Chilblains%2F Source: CKS Area: Evidence > Guidelines This Topic Review from the Clinical Knowledge Service (CKS) covers the management of chilblains.   (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=3001383 Tue, 17 Nov 2009 00:00:00 +0100 3001383 http://www.medworm.com/index.php?rid=2997155&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FEfracea-40mg-Modified-Release-Capsules-doxycycline---New-formulation%2F Source: MIMS Area: Other Library Updates > SPC Changes EFRACEA, a new formulation of doxycycline, is indicated to reduce papulopustular lesions in adult patients with facial rosacea. The daily dose is one 40 mg MR capsule in the morning. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2997155 Tue, 17 Nov 2009 00:00:00 +0100 2997155 http://www.medworm.com/index.php?rid=2997156&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F16%2FUncertainties-Page-Should-we-use-bath-emollients-for-atopic-eczema%2F Source: BMJ Area: News The authors of this article discuss the uncertainties surrounding the use of bath emollients as part of the treatment of atopic eczema, which the NHS in England spent around £15.5m on in 2008.   They were unable to identify any published RCTs assessing the clinical efficacy of bath emollients in atopic eczema from a search of the literature.   In addition they state that they are not aware of any longstanding clinical experience of benefit from bath emollients to match that for directly applied emollients, and that the quantities of emollient deposited on the skin during bathing are likely to be far lower than with directly applied emollients.  They conclude that "based on current evidence, bath emollients could be offering little or no bene... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2997156 Mon, 16 Nov 2009 00:00:00 +0100 2997156 http://www.medworm.com/index.php?rid=2964734&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F05%2FJanssen-issues-letter-about-reports-of-toxic-epidermal-necrolysis-and-DRESS-syndrome-associated-with-etravirine-Intelence%2F Source: MHRA Area: News In agreement with the EMEA, Janssen has issued a letter to healthcare professionals about cases of toxic epidermal necrolysis (TEN), one of which resulted in fatality and cases of drug rash with eosinophilia and systemic symptoms (DRESS) syndrome associated with the use of etravirine (Intelence®).The time to onset of DRESS syndrome is usually around 3-6 weeks and the outcome in most of the cases is favourable upon discontinuation and after initiation of corticosteroid therapy. Etravirine must be immediately discontinued if severe rash or hypersensitivity reaction is suspected, as a delay in stopping treatment after the onset of severe rash may result in a life-threatening reaction. The SPC has been revised to include information about these reactions. (Source: NeL... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2964734 Thu, 05 Nov 2009 00:00:00 +0100 2964734 http://www.medworm.com/index.php?rid=2951926&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F02%2FAnnual-evidence-update-on-psoriasis%2F Source: NHS Evidence Area: News NHS Evidence - skin disorders has produced its third annual evidence update on psoriasis, timed to correspond with Psoriasis Awareness Week.  The Update includes links to new systematic reviews and guidelines published over the previous year, and a "what's new" analysis discusses the new evidence and its implications for clinical practice.  Please see the link below for details.  (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2951926 Mon, 02 Nov 2009 00:00:00 +0100 2951926 http://www.medworm.com/index.php?rid=2936311&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F28%2FRCT-and-cost-effectiveness-analysis-suggests-silver-dressings-ineffective-for-venous-leg-ulcers-%2F Source: British Journal of Surgery Area: News According to the results of a prospective randomised trial and cost-effectiveness analysis of silver-donating versus non-silver low-adherence dressings in the treatment of venous leg ulcers there is no evidence to support the routine use of silver-donating dressings beneath compression for venous ulceration.   The VULCAN study was a UK multicentre study that randomised 213 patients to silver-donating dressings (n = 107) or non-antimicrobial, low-adherence dressings (n = 106). Dressings were changed at least weekly and were covered by multilayer compression bandaging. The primary outcome measure was complete ulcer healing at 12 weeks. Secondary outcomes included time to healing, quality of life and cost-effectiveness.   The fo... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2936311 Wed, 28 Oct 2009 00:00:00 +0100 2936311 http://www.medworm.com/index.php?rid=2917676&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FMedicines-Q--A%2FFumaderm-what-is-the-evidence-for-its-efficacy-and-safety-in-psoriasis%2F Source: North West Medicines Information Centre Area: Evidence > Medicines Q & A Fumaderm® (fumaric acid esters) tablets are licensed in Germany for the treatment of adults with moderate to severe plaque psoriasis for whom topical therapy is ineffective. Although unlicensed in the UK and available only through drug import agencies, Fumaderm® is used by specialist dermatology centres. Limited evidence, including only two randomised controlled trials, indicates that Fumaderm® is beneficial in patients with moderate to severe psoriasis, particularly chronic plaque, guttate or pustular disease; at least 50% of patients treated with Fumaderm® will have a reduction of about 70% or more in Psoriasis Area and Severity Index (PASI) score after 16 weeks of treatment. Patients with recalcitr... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2917676 Thu, 22 Oct 2009 23:00:00 +0100 2917676 http://www.medworm.com/index.php?rid=2892156&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Class-Focused-Reviews%2FSafety-of-topical-corticosteroids-in-pregnancy%2F Source: Cochrane Library Area: Evidence > Drug Class Focused Reviews Background Topical corticosteroids are the most frequently prescribed dermatological treatment and are frequently used by pregnant women with skin conditions. However, little is known about their safety in pregnancy.   Objectives To assess the effects of topical corticosteroids on pregnancy outcomes.   Search strategy On 5th May 2009 we searched the Cochrane Skin Group Specialised Register, the Cochrane Pregnancy and Childbirth Group Specialised Register, CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (from 2003), and EMBASE (from 2005). We searched LILACS, CINAHL, British Nursing Index, SCI-EXPANDED, BIOSIS Previews, Conference Papers Index, and Conference Proceedings Citation Index-Science from... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2892156 Wed, 14 Oct 2009 23:00:00 +0100 2892156 http://www.medworm.com/index.php?rid=2884066&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSMC-accepts-methotrexate-Metoject-pre-filled-syringes-for-severe-psoriasis-and-psoriatic-arthritis%2F Source: Scottish Medicines Consortium (SMC) Area: Evidence > Drug Specific Reviews Following an abbreviated submission, the Scottish Medicines Consortium (SMC) has accepted methotrexate injection 50mg/ml (Metoject®) for use in NHS Scotland for the treatment of severe recalcitrant disabling psoriasis which is not adequately responsive to other forms of therapy (phototherapy, PUVA, and retinoids), and severe psoriatic arthritis in adult patients.   The drug advice notes that this is the first licensed parenteral formulation of methotrexate.  Please see the link below for further details. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2884066 Sun, 11 Oct 2009 23:00:00 +0100 2884066 http://www.medworm.com/index.php?rid=2825931&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F24%2FSIGN-issues-draft-guideline-on-management-of-atopic-eczema-in-primary-care%2F Source: SIGN Area: News The Scottish Intercollegiate Guidelines Network (SIGN) has issued a draft guideline on the management of atopic eczema in primary care for consultation.   The guideline provides recommendations for the management of atopic eczema in children and adults in primary care, and includes advice on the various topical treatments for atopic eczema (including moisturisers, topical corticosteroids, topical calcineurin inhibitors and dressings), anti-infective treatments (such as antibiotics and antiseptics), antihistamines, complementary therapies, and the roles of food allergy and environmental factors.   The consultation period ends on 31 October 2009. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2825931 Wed, 23 Sep 2009 23:00:00 +0100 2825931 http://www.medworm.com/index.php?rid=2825930&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F24%2FSIGN-issues-draft-guidance-on-diagnosis-and-management-of-psoriasis-and-psoriatic-arthritis-in-adults%2F Source: SIGN Area: News The Scottish Intercollegiate Guidelines Network (SIGN) has issued a draft guideline on the management of psoriasis and psoriatic arthritis in adults. It covers the early diagnosis of psoriatic arthritis, screening for co-morbidities, assessment of disease severity, non-pharmacological treatment, psychological interventions, topical therapy, phototherapy, systemic therapy, biological treatments, referral pathways and the provision of patient information.   The consultation period ends on 31st October 2009. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2825930 Wed, 23 Sep 2009 23:00:00 +0100 2825930 http://www.medworm.com/index.php?rid=2821792&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FNICE-issues-guidance-on-ustekinumab-for-the-treatment-of-adults-with-moderate-to-severe-psoriasis%2F Source: NICE Area: Evidence > Guidelines NICE has published guidance (TA 180) recommending ustekinumab as a treatment option for adults with plaque psoriasis when the following criteria are met:   . The disease is severe, as defined by a total Psoriasis Area Severity Index (PASI) score of 10 or more and a Dermatology Life Quality Index (DLQI) score of more than 10. . The psoriasis has not responded to standard systemic therapies, including ciclosporin, methotrexate and PUVA, or the person is intolerant of or has a contraindication to these treatments. . The manufacturer provides the 90 mg dose (two 45 mg vials) for people who weigh more than 100 kg at the same total cost as for a single 45 mg vial.   Ustekinumab treatment should be stopped in people wh... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2821792 Tue, 22 Sep 2009 23:00:00 +0100 2821792 http://www.medworm.com/index.php?rid=2821791&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F23%2FNICE-costing-template-on-ustekinumab-for-the-treatment-of-adults-with-moderate-to-severe-psoriasis%2F Source: NICE Area: News The costing statement accompanying the NICE guidance on ustekinumab for the treatment of adults with moderate to severe psoriasis states that because ustekinumab is one of several biological therapies recommended for the treatment of psoriasis, its implementation is unlikely to result in a significant incremental impact on resources.  Commissioners and providers should take account of their local clinical practice when assessing the financial impact. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2821791 Tue, 22 Sep 2009 23:00:00 +0100 2821791 http://www.medworm.com/index.php?rid=2813224&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FHumira-adalimumab-Pen-and-Syringe---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes In section 4.8 (undesirable effects) the system organ class hepato-biliary disorders in Table 1 has been updated to add very common; elevated liver enzymes. In section 4.8 Table 2 has been updated to add cerebrovascular accident, new onset or worsening of psoriasis (including palmoplantar pustular psoriasis and cardiac disorders) and myocardial infection (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2813224 Sat, 19 Sep 2009 23:00:00 +0100 2813224 http://www.medworm.com/index.php?rid=2813223&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FDaktacort-Hydrocortisone-miconazole--hydrocortisone-Cream---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Irritation, skin burning sensation, anaphylactic reaction, contact dermatitis and erythema have been added as undesirable effects in section 4.8.  (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2813223 Sat, 19 Sep 2009 23:00:00 +0100 2813223 http://www.medworm.com/index.php?rid=2810790&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FLocoid-C-hydrocortisone-butyrate-chlorquinaldol-Cream--Ointment---Product-discontinued%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Locoid C (hydrocortisone butyrate, chlorquinaldol) Cream and Ointments from Astellas have been discontinued. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2810790 Sat, 19 Sep 2009 23:00:00 +0100 2810790 http://www.medworm.com/index.php?rid=2810789&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FVioform-Hydrocortisone-hydrocortisone--clioquinol-Cream-and-Ointment---Product-discontinued%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Vioform hydrocortisone (hydrocortisone / clioquinol) cream and ointment from Novartis consumer health have been discontinued. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2810789 Sat, 19 Sep 2009 23:00:00 +0100 2810789 http://www.medworm.com/index.php?rid=2810788&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FElidel-pimecrolimus-10mgg-cream---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Skin papilloma has been added as an uncommon effect to section 4.8 (undesirable effects). (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2810788 Sat, 19 Sep 2009 23:00:00 +0100 2810788 http://www.medworm.com/index.php?rid=2791273&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FBetesil-betamethasone-2250mg-Medicated-Plaster---New-Product-%2F Source: No information given Area: Other Library Updates > SPC Changes Betesil is a new product indicated for the treatment of inflammatory skin disorders which do not respond to treatment with less potent corticosteroids, such as eczema, lichenification, lichen planus, granuloma annulare, palmoplantar pustulosis and mycosis fungoides. Due to its particular pharmaceutical form, BETESIL is suitable for chronic plaque psoriasis localized in difficult to treat areas (e.g. knees, elbows and anterior face of the tibia on an area not greater than 5% of the body surface).     (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2791273 Sat, 12 Sep 2009 23:00:00 +0100 2791273 http://www.medworm.com/index.php?rid=2783445&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F11%2FAnnual-Evidence-Update-on-eczema-14-18-September-2009-%2F Source: NHS Evidence Area: News NHS Evidence - skin disorders is producing its third Annual Evidence Update on atopic eczema on 14 September 2009, with the results of a search for new national guidance and systematic reviews published since the 2008 Annual Evidence Update. (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2783445 Thu, 10 Sep 2009 23:00:00 +0100 2783445 http://www.medworm.com/index.php?rid=2779860&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F10%2FEvidence-based-treatment-recommendations-for-psoriatic-arthritis%2F Source: Ann Rheum Dis Area: News Evidence based recommendations on the treatment of various clinical manifestations of psoriatic arthritis (PsA) have been published in the Annals of the Rheumatic Diseases. A systematic review of the literature was conducted on treatment of the most significant discrete clinical manifestations (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) and consensus was sought from rheumatologists, dermatologists and PsA patients. This resulted in the development of 19 treatment recommendations for each of the clinical manifestations and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment dec... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2779860 Wed, 09 Sep 2009 23:00:00 +0100 2779860 http://www.medworm.com/index.php?rid=2773380&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSMC-restricts-use-of-etanercept-Enbrel-for-chronic-severe-plaque-psoriasis-in-children-and-adolescents%2F Source: Scottish Medicines Consortium (SMC) Area: Evidence > Drug Specific Reviews The Scottish Medicines Consortium (SMC) has accepted etanercept (EnbrelT) for restricted use within NHS Scotland for the treatment of chronic severe plaque psoriasis in children and adolescents from the age of 8 years who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.   It should be used only when the following criteria are met: . The disease is severe as defined by a total Psoriasis Area Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10; . The psoriasis has failed to respond to standard systemic therapies including ciclosporin, methotrexate and PUVA (psoralen and long-wave ultraviolet radia... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2773380 Mon, 07 Sep 2009 23:00:00 +0100 2773380 http://www.medworm.com/index.php?rid=2748899&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FNICE-issues-guidance-on-alitretinoin-for-the-treatment-of-severe-chronic-hand-eczema%2F Source: NICE Area: Evidence > Guidelines NICE has published guidance on alitretinoin, within its licensed indication, as a treatment option for adults with severe chronic hand eczema that has not responded to potent topical corticosteroids if the person has: . severe disease, as defined by the physician's global assessment (PGA) and . a dermatology life quality index (DLQI) score of 15 or more.   Alitretinoin treatment should be stopped: . as soon as an adequate response (hands clear or almost clear) has been achieved or . if the eczema remains severe (as defined by the PGA) at 12 weeks or . if an adequate response (hands clear or almost clear) has not been achieved by 24 weeks.   Only dermatologists, or physicians with experience in both managing severe chroni... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2748899 Tue, 25 Aug 2009 23:00:00 +0100 2748899 http://www.medworm.com/index.php?rid=2748898&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---August%2F26%2FNICE-costing-template-on-alitretinoin-for-the-treatment-of-severe-chronic-hand-eczema-%2F Source: NICE Area: News In a costing template on alitretinoin for the treatment of severe chronic hand eczema, NICE estimates the total cost saving of implementing its guidance in England to be  £2,989,000 (based on current costs of £83,312,000 and future costs of £80, 323, 000). (Source: NeLM - Dermatology) NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2748898 Tue, 25 Aug 2009 23:00:00 +0100 2748898 http://www.medworm.com/index.php?rid=2748900&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---August%2F25%2FReview-mupirocin-resistance%2F Source: Clin Infect Dis Area: News A narrative review from the US Centers for Disease Control discusses resistance to mupirocin in view of its increasing use in prophylaxis of MRSA (methicillin-resistant Staphylococcus aureus) infection.   The authors discuss the mechanisms and epidemiology of mupirocin resistance, which can be high-level or low-level. These have different mechanisms, and clinical significance: high-level resistance is associated with treatment failure whereas the significance of low-level resistance is uncertain. The rate of resistance is related to level of use, and in at least one case, restrictions on use have resulted in large falls in resistance rates.   Finally, the authors discuss US resistance rates, which are expected to increase due to a numbe... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2748900 Mon, 24 Aug 2009 23:00:00 +0100 2748900 http://www.medworm.com/index.php?rid=2748901&cid=s_38899_12_f&fid=38899&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---August%2F14%2FNICE-issues-final-appraisal-determination-on-ustekinumab-for-psoriasis%2F Source: NICE Area: News NICE has issued a final appraisal determination on ustekinumab for the treatment of moderate to severe psoriasis in which the preliminary recommendation is that it is a treatment option for adults with plaque psoriasis when the following criteria are met:   . The disease is severe, as defined by a total Psoriasis Area Severity Index (PASI) score of 10 or more and a Dermatology Life Quality Index (DLQI) score of more than 10.   . The psoriasis has not responded to standard systemic therapies, including ciclosporin, methotrexate and PUVA (psoralen and long-wave ultraviolet radiation), or the person is intolerant of or has a contraindication to these treatments.   . The manufacturer provides the 90 mg dose (two 45 mg vials) fo... NeLM - Dermatology organizations http://www.medworm.com/rss/comments.php?id=2748901 Thu, 13 Aug 2009 23:00:00 +0100 2748901