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In this cost analysis, Almutairi et al evaluate the cost-effectiveness, at the population level, of talimogene laherparepvec plus ipilimumab combination therapy vs ipilimumab monotherapy for unresectable melanoma. They demonstrate a prohibitive $1.6 million cost for 1 additional patient to achieve objective disease response; however, this should not preclude use of combination therapy for individuals when indicated. DiMagno and Emanuel provide an Editorial.
Author Audio Interview
In this meta-analysis of 67 real-world case reports of patients with chronic idiopathic urticaria (CIU) treated with omalizumab, Tharp et al find a larger improvement in weekly Urticaria Activity Score than that found in randomized clinical trials. They also find benefits in complete and partial response rates and low adverse event rates that meet or exceed those of clinical trials. These real-world findings might inform clinical practice expectations and help guide policy decisions.
Continuing Medical Education
In this cohort study of participants in the Copenhagen Prospective Study on Asthma in Childhood 2000, Thorsteinsdottir et al demonstrate an association between persistent childhood atopic dermatitis (AD) and known genetic AD risk variants, paternal asthma and AD, high social circumstances, diagnostic minor criteria, and disease severity at onset. Knowing these associated factors can help guide clinician practice at disease onset.
This study evaluates the use of a model combining convolutional neural network (CNN) analysis with dermoscopic and close-up images to diagnose nonpigmented lesions. Tschandl et al demonstrate that the combination CNN model achieved a higher percentage of correct diagnoses than human raters overall, but not compared with experts. The combination CNN model warrants further study, but its uses are currently limited in clinical practice.
Squamous cell carcinoma (SCC) is the most frequent malignant neoplasm found in solid organ transplant recipients and is associated with a more aggressive disease course and higher risk of metastasis and death than in the general population. In this case series of 51 solid organ transplant recipients who developed SCC, Lanz et al evaluate the clinicopathologic characteristics of the SCC. Their findings suggest that facial anatomical site, poor differentiation, larger tumor diameter and/or depth, and perineural invasion are important risk factors.
Highlights. JAMA Dermatol. 2019;155(1):5. doi:10.1001/jamadermatol.2018.3493
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