Photodynamic Therapy Plus Topical Corticosteroid for Erosive Oral Lichen Planus: A Randomized Clinical Trial.

To evaluate the safety and efficacy of dazdotuftide (TRS01 eye drops), a novel, steroid-free, anti-inflammatory drug in patients with active anterior noninfectious uveitis (NIU), following previous studies in which it had shown a favorable risk/benefit profile with regards to safety and specifically intraocular pressure (IOP) safety profile. A randomized, double-masked, multicenter, active-controlled phase 3 trial. Adults (≤75 years of age) and pediatric patients, with active anterior NIU, with or without uveitic glaucoma, on stable medical therapy for NIU or who had received no prior therapy, requiring further treatment for an active NIU flare-up. Patients eligible for inclusion had Anterior Chamber Cell (ACC) Grade 2 or Grade 3 on Visual Analog Scale in the study eye. Patients were randomized 2:1 to topical TRS01 1% or prednisolone acetate 1% administered 4 times daily for 28 days. Key ocular assessments included slit-lamp examination, ocular pain, Best Corrected Visual Acuity, IOP and dilated ophthalmoscopy. Resolution of inflammation (ACC = 0), clinically meaningful improvement of ACC, ocular pain, flare, and IOP changes on Day 28. The Full Analysis Set included 136 patients; the mean age was 43 years in the TRS01 arm and 42 years in the prednisolone acetate arm. 48% of TRS01 vs 68% of prednisolone acetate patients achieved ACC Grade = 0 on Day 28 (95.1% Confidence Interval (CI): -0.37, -0.02; P = .0311) and 64% of TRS01 vs 89% prednisolone acetate patients experienced clinically meaningful improvement of ACC Grade = 0 or 1, ie, ≤5 cells (95.1% CI: -0.33, -0.06; P = .0049). While TRS01 was found to be inferior to topical steroids to control ACC, TRS01 was noninferior to topical steroids to control flare and ocular pain and exhibited a superior IOP safety compared to topical steroids. For patients who reached ACC = 0, TRS01-treated patients benefited from statistically significantly improved safety outcomes for IOP (including change from baseline and at each IOP threshold evaluated [P < .05]) versus steroid-treated patients. TRS01 offers the potential to serve as an effective and safe treatment option in NIU that meets the urgent need for a drug that controls inflammation without the steroids' associated risk of IOP elevation.

Purpose: To report a rare case of infectious keratitis complicating acute corneal hydrops (ACH) in a patient with Down syndrome and to discuss risk factors, clinical features, and management strategies. Observation: A 20-year-old female with Down syndrome, atopic dermatitis, and a history of eye rubbing presented with acute corneal hydrops. Anterior segment OCT confirmed the rupture of Descemet’s membrane. Initial conservative treatment was initiated. Three days later, the patient presented with severe infectious keratitis. Corneal cultures grew Staphylococcus aureus, sensitive to topical tobramycin and ciprofloxacin. Gradual resolution of the infiltrate and the corneal edema was observed, leading to formation of a central corneal opacity after one month of treatment. Conclusion: Infectious keratitis is an uncommon but rapidly progressive complication of ACH. The reported risk factors included atopic dermatitis, eye rubbing, the use of topical corticosteroids and contact lens wear. Early detection through careful clinical assessment and imaging is critical to initiate antibiotic treatment. Despite infection control, visual prognosis remains poor due to residual corneal scarring and neovascularization. Prophylactic antibiotics may be considered in high-risk cases to prevent superinfection.

To report 1.5-year real-world outcomes on the incidence of sterile intraocular inflammation (IOI) following intravitreal aflibercept 8mg injections, with emphasis on differences between vial and pre-filled syringe (PFS) use. This retrospective multicenter study reviewed the electronic medical records of all patients who received aflibercept 8mg injections at Vista Augenklinik sites between March 1, 2024, and November 30, 2025. The primary outcome was the incidence of IOI per injection. Secondary analyses included stratification by treatment indication and by vial versus PFS administration. A total of 2631 injections were administered to 453 eyes of 398 patients. IOI was documented in 41 eyes (37 patients), corresponding to an incidence of 1.56% per injection (95% confidence interval [CI], 1.21-2.41), 9.05% per eye (95% CI, 7.13-13.0), and 9.30% per patient (95% CI, 7.0-13.32). Mean time to presentation was 7.3days (range 2-31) after a mean of 4.7 injections. All cases presented with anterior chamber and/or vitreous inflammation without posterior involvement. No retinal vasculitis or infiltrates were observed. Inflammation resolved with topical corticosteroids and/or nonsteroidal anti-inflammatory drugs (NSAIDs), with no significant change in best-corrected visual acuity (VA) compared to pre-event VA (20/32 versus 20/35 Snellen equivalent, p = 0.62). The incidence differed significantly between formulations: 2.26% per injection with the vial versus 0.21% per injection with the PFS (p = 0.010). In a real-world setting, aflibercept 8mg was associated with a higher incidence of IOI than reported in pivotal trials, particularly when administered from vials. Conversion to the PFS markedly reduced the incidence, suggesting a formulation- or preparation-related effect. All cases were mild, anterior, and reversible under topical therapy without long-term visual impact.

Dry eye disease (DED) is a multifactorial inflammatory disorder characterized by tear-film hyperosmolarity, immune activation, and neurosensory dysfunction, which contribute to sustained ocular surface damage. Severe DED is common in autoimmune diseases, especially Sjögren syndrome (SS) and rheumatoid arthritis (RA), and is often refractory to first-line treatments. Current evidence on anti-inflammatory therapies was summarized by experts, and the management of challenging cases of autoimmune-related DED followed in different tertiary centers was presented. Short courses of topical corticosteroids rapidly suppress disease flares and improve clinical signs, including breakup time and ocular surface staining. However, careful stewardship is required, as prolonged use may elevate intraocular pressure, induce cataract formation, and increase infectious risk. For long-term control, immunomodulators such as cyclosporine A (CsA), lifitegrast, and tacrolimus attenuate T-cell-mediated inflammation, promote goblet cell recovery, and stabilize the tear film. Newer CsA formulations have further improved bioavailability and tolerability. Five challenging cases including DED associated with SS or RA, refractory keratopathy, and corneal epithelial defect were described. Management included biological tears, lid-based care, and punctal plugs combined with once-daily CsA, leading to re-epithelialization, symptom relief, and visual stabilization. Adjunctive measures included oral doxycycline to improve meibomian gland function and reduce inflammation. Regular follow-up optimized treatment tapering, safety monitoring, and patient adherence. In two cases, urgent surgical intervention (conjunctival flap, amniotic membrane transplantation, and penetrating keratoplasty) was required. Autoimmune-related DED requires a stepwise treatment regimen for the stabilization of the ocular surface and the prevention of irreversible damage. This approach involves an initial short course of corticosteroids, followed by sustained immunomodulation (with CsA as the cornerstone), and supplemented by adjunctive therapies targeting meibomian glands and ocular surface epithelium. Multidisciplinary coordination and regular monitoring are essential for maintaining long-term ocular surface homeostasis and satisfactory quality of life and visual function.

Introduction Atopic dermatitis (AD) is a chronic type 2 inflammatory disease, which often needs long-term treatment. The fully human monoclonal antibody dupilumab and the humanized monoclonal antibody nemolizumab have both demonstrated efficacy and safety in AD clinical trials. However, no head-to-head comparisons have been performed. In the absence of direct comparisons between medicinal products, Bucher indirect treatment comparisons (ITCs), in which treatment effects of the medicinal products are anchored to a common comparator (e.g. placebo), provide a robust and widely accepted method of evaluating relative efficacy. Objective To report the results of a placebo-anchored Bucher ITC comparing efficacy of dupilumab plus topical corticosteroids (TCS) every 2 weeks (q2w) versus nemolizumab plus TCS every 4 weeks (q4w) for moderate-to-severe AD over 16 weeks of therapy. Methods A placebo-anchored Bucher ITC was conducted using data from the published phase 3 clinical trial LIBERTY AD CHRONOS (NCT02260986) and the replicate phase 3 clinical trials ARCADIA 1 (NCT03985943) and ARCADIA 2 (NCT03989349). Data at Week 16 for the following doses were used: 300 mg dupilumab + TCS q2w, or placebo + TCS (LIBERTY AD CHRONOS), and 30 mg nemolizumab + TCS q4w, or placebo + TCS (ARCADIA 1 and 2). Non-responder imputation was used in all clinical trials for the binary outcomes, which were assessed in this ITC. Outcomes at Week 16 included proportion of patients achieving Investigator’s Global Assessment score 0/1 (IGA-0/1; clear/almost clear skin), ≥75% improvement from baseline in Eczema Area and Severity Index (EASI-75) and ≥4-point improvement from baseline in Peak Pruritus Numeric Rating Scale (PP-NRS ∆ ≥4). Odds ratios (ORs) with 95% confidence intervals (CIs) are reported. Meta-analysis ORs are provided for ARCADIA 1 and 2 combined. The number needed to treat (NNT) for achieving those outcomes were also computed to compare treatment benefits. Results Baseline disease characteristics were similar between LIBERTY AD CHRONOS and ARCADIA 1 and 2, supporting the use of Bucher ITC. Patients treated with dupilumab + TCS vs nemolizumab + TCS had a significantly higher likelihood of achieving IGA-0/1 (OR = 2.61; 95%CI 1.49, 4.57), EASI-75 (OR = 4.09, 95%CI 2.41, 6.96), and PP-NRS ∆ ≥4 (OR = 1.76, 95%CI 1.02, 3.02) at Week 16. When comparing these two treatments, dupilumab + TCS demonstrated greater treatment efficacy than nemolizumab + TCS across all 3 outcomes. The NNT to observe 1 patient achieving IGA 0/1, EASI-75, and PP-NRS ∆ ≥4 was 4, 3, and 3 respectively for dupilumab + TCS vs placebo + TCS, compared with 9, 8, and 5 respectively for nemolizumab + TCS vs placebo + TCS. Conclusions This placebo-anchored Bucher ITC analysis demonstrated that the likelihood of achieving improvements in AD signs and itch is significantly higher for patients treated with dupilumab + TCS q2w vs nemolizumab + TCS q4w at Week 16. Based on the NNT analysis, dupilumab + TCS demonstrated greater treatment efficacy across all assessed outcomes compared with nemolizumab + TCS, requiring substantially fewer patients to be treated to achieve the same clinical benefits.

Introduction Nemolizumab, the first interleukin-31 receptor alpha antagonist, is approved in multiple regions for moderate-to-severe atopic dermatitis (AD; adults and adolescents) and prurigo nodularis (PN; adults). Eczematous events (AD, eczema, nummular eczema) were common in PN pivotal trials (OLYMPIA 1: NCT04501666, OLYMPIA 2: NCT04501679), while no imbalance in AD events was observed in AD trials (ARCADIA 1: NCT03985943, ARCADIA 2: NCT03989349). Objective To characterize cutaneous adverse events (CAEs) associated with nemolizumab using pooled data from four phase 3 trials in AD and PN. Methods This exploratory post-hoc analysis combined data from the initial period of the AD phase 3 trials (the AD pool) and PN phase 3 trials (the PN pool). Frequently reported AEs (≥5% in either arm and indication), and categories/subcategories of defined safety areas of interest (SAOI) were analyzed. Incidence rates, exposure-adjusted incidence rates (EAIR; per 100 patient-years), rate ratio (RR) and 95% CI were calculated without multiplicity adjustment. Investigator-reported AEs were coded using MedDRA v25.0. Results 1135 (AD) and 370 patients (PN) received nemolizumab; 584 (AD) and 186 patients (PN) received placebo. In AD, EAIR were 219.9 (nemolizumab) vs 207.9 (placebo) for any AE (RR 1.1, 95% CI 0.9-1.2) and 5.6 vs 4.0 for SAEs (RR 1.4, 95% CI 0.6-3.3); in PN, 336.0 vs 259.6 for any AE (RR 1.3, 95% CI 1.0-1.6) and 14.8 vs 22.2 for SAEs (RR 0.7, 95% CI 0.3-1.3). The most frequent SAOI in both AD and PN pools was CAEs; EAIR 56.9 (nemolizumab) vs 43.2 (placebo; RR 1.3, 95% CI 1.0-1.7) in AD; 90.7 vs 83.0 (RR 1.1, 95% CI 0.8-1.5) in PN. The most frequent CAE subcategory in both indications was eczema-like CAEs, with AD being the most frequent preferred term in both indications (EAIR 37.5 [nemolizumab] vs 31.0 [placebo; RR 1.2, 95% CI 0.9-1.7] in AD; 38.8 vs 13.1 [RR 3.0, 95% CI 1.5-6.0] in PN). Eczema-like CAEs were mostly rated as mild 36% (nemolizumab) vs 30% (placebo; AD) and 66% vs 56% (PN); and moderate in 48% vs 57% (AD) and 34% vs 33% (PN). The median latency to the first events was 43.5 (nemolizumab) vs 42.0 days (placebo; AD) and 30.0 vs 52.0 days (PN); median duration was 22.0 vs 28.0 days (AD) and 38.0 vs 28.0 days (PN). Events generally resolved by end of the study (AD: 60% [nemolizumab] vs 68% [placebo]; PN: 58% vs 56%), were mostly treated with topical corticosteroids (AD: 31% [nemolizumab] vs 47% [placebo]; PN: 58% vs 44%), and most patients continued with study drug. Conclusion Overall AE and SAE rates were similar with nemolizumab versus placebo. Eczema-like events were generally mild/moderate, resolved with topical corticosteroids and rarely required study-drug discontinuation. These findings support clinicians in anticipating and managing eczema-like events associated with nemolizumab.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itch and eczematous lesions. Nemolizumab, an interleukin-31 receptor alpha antagonist, has shown efficacy and safety with background topical corticosteroids and/or topical calcineurin inhibitors in the ARCADIA 1&amp;2 phase 3 trials, and is approved for the treatment of moderate-to-severe AD in individuals aged ≥12 years in several countries including, the US and Europe. However, there is a need for a study that better reflects real-world settings and routine clinical practice beyond the limitations of controlled trials. Objective: To report key design features of RE-UNITE-AD study. Methods: RE-UNITE-AD (NCT06988605) is a prospective, multicenter, non-interventional study (NIS) in adults and adolescents with moderate-to-severe AD who are newly initiated on nemolizumab per physician’s discretion in accordance with the local label. This AD study aims to enroll 1000 participants across 200 sites in Europe and North America. AD patients with peak pruritus numerical rating scale (PP-NRS) score ≥7 without prior biologic/Janus kinase inhibitors (JAKi) (or use more than 3 months before baseline) or PP-NRS ≥4 for those with recent discontinuation of biologic/JAK inhibitors (less than 3 months before baseline) are eligible for this study. Patients with any PP-NRS score may be enrolled if the reason for discontinuation of prior biologic/JAKi is safety-related. Patients who have contraindication(s) for the use of nemolizumab per the local label and/or treatment with a drug under clinical development/investigation within 3 months prior to baseline are excluded. Primary endpoints evaluated Investigator’s Global Assessment (IGA) and PP-NRS scores in clinical practice at month 6. Secondary endpoints evaluated Eczema Area and Severity Index, Scoring Atopic Dermatitis, IGA, PP-NRS, Average Pruritus-NRS, Sleep Disturbance-NRS, and Pain-NRS scores through month 12. Additional assessments include itch-scratch behaviour, quality of life, and patient-perceived benefit. Safety endpoints include serious adverse events regardless of causality and non-serious adverse drug reactions. Conclusion: This NIS reflects real-world clinical practice and is expected to complement the existing evidence from pivotal trials on the clinical effectiveness and safety of nemolizumab in patients with moderate-to-severe AD.

Atopic dermatitis (AD) affects 15%-20% of children worldwide, with most treatment in primary care. Initial management of new-onset infantile AD remains poorly characterized. This retrospective cohort study included 3053 patients aged 0-2 years diagnosed with AD at pediatric and family medicine clinics at a single institution. Demographic, comorbidities, and treatment information were collected. The mean age was 0.6 years at initial diagnosis; 54.4% were male. Of 3053 patients, 1015 (33.2%) had ≥ 1 additional atopic comorbidity or complication, most commonly asthma (28.8%), allergy (33.4%), allergic rhinitis (34.7%), conjunctivitis (41.8%), and bacterial infection (6.7%). At diagnosis, 66.8% (2038/3053) received prescription therapy, mostly topical (57.3%, 1743/3043 initial prescriptions). Common treatments at visit 1 (V1) included topical corticosteroid (TCS, 48.4%, 1472/3043 prescriptions), topical antifungal (4.4%, 134/3043), oral antihistamine (4.0%, 121/3043), while only 0.2% (7/3043) received topical calcineurin inhibitors. TCS potency was predominantly low (71.5%, 1053/1472), with medium (27.3%, 402/1472) and high (1.2%, 17/1472) less frequent. 78/1261 children (6.2%) changed potency of TCS between V1 and visit 2 (V2), with 5.2% escalating and 1.0% de-escalating therapy. Escalation was significantly associated with existing atopic comorbidities/complications (OR 3.15, p < 0.001). Fewer than half of children received anti-inflammatory prescriptions at their initial AD visit. More research is needed to investigate whether this finding represents mild cases or undertreatment. Children with allergic comorbidities were more likely to require escalation to stronger TCS, warranting future exploration of the relationship between initial therapies and disease severity or comorbidity development.

Topical and systemic corticosteroids in the modern Management of Atopic Eczema: A scoping review.

Generalized pustular psoriasis (GPP) is rare, chronic, and associated with life-threatening complications. We investigated the burden of GPP in France. Using data from 2010 to 2021 in the Système National des Données de Santé database, healthcare resource utilization (HCRU), costs, comorbidities, mortality, and treatments were compared among GPP (N = 4351), plaque psoriasis (N = 12,945), and general population (N = 12,981) cohorts, matched for sex, age, Charlson Comorbidity Index (CCI) score, and region. GPP prevalence and incidence were also investigated. Annually, there were 0.5-0.8 new GPP cases per 100,000 people. Across the cohorts, 54.5-54.7% of people were male, with mean age 58.7-59.5years and mean CCI score 1.98-2.06. The GPP cohort incurred significantly greater HCRU and costs versus the plaque psoriasis and general population cohorts, including greater proportions of patients receiving emergency care (78% vs 63% and 55%) and intensive care (28% vs 17% and 14%), longer hospitalizations (mean 38.5 vs 26.2 and 22.4days per patient), and higher medication costs (€4360 vs €1991 and €1543 per patient-year), respectively. Despite similar CCI scores, GPP was associated with more cardiometabolic and psychological comorbidities versus the plaque psoriasis and general population cohorts, e.g., hypertension (37% vs 21% and 20%), obesity (21% vs 9% and 6%), depression (13% vs 4% and 4%), alcohol abuse (16% vs 3% and 3%), and sleep disorders (8% vs 4% and 3%), respectively. Treatments in the GPP cohort were those used for plaque psoriasis, including topical steroids (77%), systemic steroids (50%), and biologics (23%). Twelve-month survival was 86.9% (GPP), 97.5% (plaque psoriasis), and 90.0% (the general population). HCRU, costs, and comorbidities with GPP were often double those for comparator cohorts, and mortality was higher. These findings highlight the need to use GPP-targeted treatments that improve patient outcomes and may reduce the burden on healthcare systems.

Systematic Review and Meta Analysis of Allergic Contact Dermatitis from 2-Octyl Cyanoacrylate Adhesives.

Lichen Planus is a chronic, mucocutaneous disease that may affect the oral mucosa, skin, genital mucosa, nails, and scalp. It occurs more frequently in adults than in children. Ten cases of Oral Lichen Planus (OLP), diagnosed in children presenting to the Liverpool University Dental Hospital (UK) Oral Medicine department are presented. The case series includes four male and six female patients, ranging in age from 10 to 17 years at diagnosis. A clinical diagnosis alone was made in five patients and five patients underwent an incisional biopsy, which confirmed a histological diagnosis consistent with OLP. In one case, moderate dysplasia was diagnosed, on a background of OLP. Five patients presented with asymptomatic disease. In symptomatic cases, treatments included topical anesthetic mouthwash and topical steroid preparations. OLP is classified as an oral potentially malignant disorder and approximately 1% of patients develop oral cancer, however no cases of malignant transformation have been reported in children. None of our paediatric patients with OLP have developed oral cancer during a mean follow up time of 2 years. However, ongoing clinical monitoring is required so that malignant change can be detected at the earliest possible stage when treatment is most successful.

Idiopathic granulomatous mastitis (IGM) is a rare, heterogeneous inflammatory breast disease lacking a universally accepted classification or a standardized management pathway. To provide a comprehensive narrative synthesis of the current literature on IGM and to contextualize the Turkish IGM clinical classification and treatment algorithm in relation to existing global evidence. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar (2000-2025). Clinical, radiological, pathological, and therapeutic studies were examined. Previously published Turkish national consensus studies based on a modified Delphi process were incorporated into the synthesis. IGM remains diagnostically challenging due to its diverse presentations and overlap with malignancy. Existing global classification attempts are inconsistent and lack clinical practicality. The Turkish IGM clinical classification addresses these gaps by integrating lesion size, skin involvement, pregnancy/lactation categories, and extramammary findings. Treatment outcomes demonstrate the high efficacy of topical and intralesional steroids, the selective use of systemic immunosuppression, and the limited indications for surgery. The Turkish IGM classification and its associated treatment algorithm provide a practical, standardized framework that aligns with current evidence and may reduce overtreatment and mismanagement in IGM.

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease of the esophagus that has emerged as a major cause of esophageal dysfunction in all ages. Over the past two decades, its frequency has increased worldwide, reflecting both heightened recognition and a rise in occurrence. EoE predominantly affects males and frequently coexists with atopic conditions, underscoring its relationship with allergy. The pathogenesis involves genetic susceptibility, epithelial barrier dysfunction, and dysregulated type 2 immune responses. Variants in genes related to epithelial integrity and immune signaling, such as TSLP and CAPN14, predispose susceptible individuals to aberrant immune responses to food antigens, leading to eosinophil recruitment, mast cell activation, and chronic inflammation, which in turn promotes tissue remodeling and progression toward fibrostenotic disease. Clinical presentation varies with age. Infants and younger children often exhibit feeding difficulties, vomiting, and abdominal pain, whereas older children and adolescents usually present with dysphagia and food impaction. Diagnosis requires integration of clinical symptoms with histologic confirmation of esophageal eosinophilia (≥ 15 eosinophils per high-power field) and exclusion of alternative causes. Management of pediatric EoE aims to achieve and maintain clinical and histologic remission while preventing long-term complications and preserving quality of life. First-line therapeutic options include proton pump inhibitors, swallowed topical corticosteroids, and dietary elimination strategies. Biologic therapy has expanded treatment options for severe or refractory disease. Because symptom improvement alone does not reliably reflect disease control, objective reassessment with endoscopy and biopsies is recommended after treatment and during follow-up. Long-term outcomes of EoE are strongly influenced by diagnostic timing and adequacy of treatment. Early diagnosis, sustained anti-inflammatory therapy, and transition from pediatric to adult care are critical components of an appropriate management. Future directions include the development of precision medicine, identification of biomarkers to guide therapy selection, non-invasive tools for disease monitoring, and strategies aimed at disease modification.

Incompletely treated vulvar lichen sclerosus can lead to major complications and reduced quality of life. Limited treatment options beyond super-potent topical steroids are available for these recalcitrant cases. In this descriptive, retrospective case series, 3 female patients ages 36-63 presenting with recalcitrant, biopsy-proven vulvar lichen sclerosus were treated with oral upadacitinib at a dosage of 15mg daily and monitored at 1-2 month intervals. All 3 patients experienced clinical improvement in signs of lichen sclerosus and a decrease in symptom severity with minimal side effects. Upadacitinib may be an effective treatment option for recalcitrant vulvar LS. More robust studies are needed to fully evaluate the efficacy and limitations of JAK inhibitors in treating lichen sclerosus.

Up to 50% of patients with inflammatory bowel disease (IBD) have associated oral extraintestinal manifestations (OEIMs). We aim to describe the prevalence of OEIMs in IBD and propose a therapeutic algorithm. Electronic health records of adult patients with IBD who presented with at least one oral symptom between January 2017 and November 2021 at a tri-state tertiary academic medical center were retrospectively reviewed. Data included demographics, IBD history, oral diagnoses, OEIM treatments, clinical outcomes, and comorbidities. A total of 116 patients were included; 67 (57.8%) had Crohn's disease (CD) and 49 (42.2%) had ulcerative colitis (UC). Aphthous ulcers were the most common OEIM (80.2%). Frequently used treatments included compounded or mixed mouthwashes (51.7%), topical corticosteroids (33.6%), systemic corticosteroids (20.7%), and topical anesthetics (19.8%). In CD, colchicine was significantly associated with OEIM improvement (p=0.009). In UC, systemic corticosteroids (p=0.03), colchicine (p=0.048), and topical tacrolimus (p=0.048) were significantly associated with improvement. OEIMs are common in IBD and can influence treatment decisions. Colchicine and topical agents demonstrated benefit in selected cases. These findings support multidisciplinary care and inform a therapeutic algorithm for OEIM management in IBD.

Eosinophilic esophagitis is a chronic immune-mediated inflammatory disorder of the esophagus comprising symptoms of esophageal dysfunction with eosinophilic inflammation. The diagnosis is based on histopathologic criteria with elevated esophageal eosinophil count and the presence of characteristic symptoms such as dysphagia. The goal of treatment is to improve symptoms, induce histopathologic remission, and prevent progression to fibrostenotic disease. In pediatrics, maintaining growth and development are essential considerations in treatment and play a role in the selection of treatment. Mainstays of pharmacologic treatment include proton pump inhibitors, topical corticosteroids, and dietary therapy, all of which are first-line treatment options for pediatric patients with eosinophilic esophagitis. More recently, a biologic therapy, dupilumab (a monoclonal antibody against interleukin-4⍺ receptor), has been approved for eosinophilic esophagitis in patients aged ≥1 year and ≥15 kg. Esophageal dilations are used as an adjunct to medical or dietary therapy for fibrostenotic eosinophilic esophagitis, but do not treat the underlying inflammation. Several emerging biologics that target pathways implicated in the inflammatory mechanisms of eosinophilic esophagitis are currently under investigation in adults; however, studies are lacking in much of the pediatric population. This review outlines updates in treatment approaches for pediatric eosinophilic esophagitis including the use of proton pump inhibitors, new topical corticosteroid formulations, paradigm shifts in dietary therapy approaches, and use of biologics with a focus on pediatric disease.

Intraocular inflammation after intravitreal injection of second-generation anti-VEGF agents observed in a tertiary center over 12 months: What are the specific features?

Medical and surgical approaches to prevent corneal graft rejection in high-risk recipients.