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ts reserved.IMPORTANCE Capillary malformation-arteriovenous malformation (CM-AVM) syndrome is a recently described syndrome with distinctive cutaneous lesions. Very little is known about the histopathology of these lesions. OBJECTIVE The purpose of the study was to evaluate the histopathological characteristics of the pink macules of the CM-AVM syndrome and to investigate if these pink macules could be classified as capillary malformations or arteriovenous malformations based on their histopathological features. DESIGN-SETTINGS-PARTICIPANTS We conducted a retrospective multicenter study involving 8 hospitals in Spain. Fifteen biopsies from pink macules of the CM-AVM syndrome were analyzed, and compared with 5 biopsies of diverse capillary malformations and 3 stage I arteriovenous malformations. RESULTS Pink macules' biopsies of the CM-AVM syndrome showed similar features including a high vascular density encompassing capillaries and numerous thick walled arterioles mainly located in the superficial dermis, a predominancepecific treatments in the future. This article is protected by copyright. All rights reserved.Capsule endoscopy (CE) is now recommended for evaluating patients with overt or occult obscure gastrointestinal bleeding (OGIB), iron deficiency anemia, inflammatory bowel disease (IBD), and small intestinal tumors in patients with polyposis syndrome.1 Nearly 20 years have passed since its first application to humans; remarkable improvements have already been made to achieve a wider view and clear images in addition to the exclusively adaptive frame-rate technology, which adjusts the rate of image capture depending on the movement speed. This article is protected by copyright. All rights reserved.We appreciate that our study on the results of the guideline-based treatment of pemphigus was read with great interest by Dr. selleck Amber's group.[1] Our results showed a high achievement rate for complete remission (98.8%) and a comparatively low relapse rate (14.3%) when the Japanese guidelines for the management of pemphigus were followed.[2] Treatment plan is determined not only by scientific outcomes, but also by insurance system, government policy or socioeconomic status. National health insurance basically covers the entire medical costs in Japan, and anti-CD20 monoclonal antibody, rituximab, has not been approved for patients with pemphigus yet as of February 2020. This article is protected by copyright. All rights reserved.AIMS To select a core list of standard outcomes for diabetes to be routinely applied internationally, including patient-reported outcomes. METHODS We conducted a structured systematic review of outcome measures, focusing on adults with either type 1 or type 2 diabetes. This process was followed by a consensus-driven modified Delphi panel, including a multidisciplinary group of academics, health professionals and people with diabetes. External feedback to validate the set of outcome measures was sought from people with diabetes and health professionals. RESULTS The panel identified an essential set of clinical outcomes related to diabetes control, acute events, chronic complications, health service utilisation, and survival that can be measured using routine administrative data and/or clinical records. Three instruments were recommended for annual measurement of patient-reported outcome measures the WHO Well-Being Index for psychological well-being; the depression module of the Patient Health Questionnaire for depression; and the Problem Areas in Diabetes scale for diabetes distress. A range of factors related to demographic, diagnostic profile, lifestyle, social support and treatment of diabetes were also identified for case-mix adjustment. CONCLUSIONS We recommend the standard set identified in this study for use in routine practice to monitor, benchmark and improve diabetes care. The inclusion of patient-reported outcomes enables people living with diabetes to report directly on their condition in a structured way. © 2020 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.Micropigmentation, also termed medical tattooing, can be a useful alternative treatment for patients with vitiligo who are resistant to conventional treatments. To assess the benefits and risks of micropigmentation in the treatment of refractory vitiligo, 25 lesions of 14 patients with vitiligo (Fitzpatrick skin types III and IV) were subjected to micropigmentation using an electric tattooing machine between December 2018 and March 2019. The procedure was repeated until satisfactory results were obtained. Treatment response was assessed by color matching of the treated lesion and surrounding skin using a 4-point scale (poor, fair, good and excellent). Excellent color matching was achieved in 80% (20/25) of cases after a median of three (range, 1-5) treatment sessions. Procedure-associated pain was considerable, but no anesthetic injection was needed. Immediate erythema and swelling were noticed after each procedure, but resolved within a few days. Overall, the treatment was tolerable. This study was limited by a small sample, no control group and a short follow-up period. This study revealed that micropigmentation was beneficial for patients with refractory vitiligo who had light to moderately colored skin. Pigment selection, implantation depth and selection of body parts amenable to treatment were critical. © 2020 Japanese Dermatological Association.BACKGROUND Cashew nut (CN) allergy prevalence has increased over the last few years. In children allergic to CN, complete avoidance of pistachio is usually recommended, but recent study showed that only one third of children allergic to CN were also allergic to pistachio. The aim of our study was to identify predictive factors of allergy to pistachio in children allergic to CN. METHODS All children who had a positive oral food challenge (OFC) to CN between November 2013 and October 2017 in the Paediatric Allergy Department of the University Hospital of Nancy were included. Logistic regression models were used to predict the probability of allergy to pistachio. RESULTS Among the 147 children included, tolerance or allergy to pistachio was known for 51. Out of these, 40 were allergic to pistachio (78.4%). Children allergic to pistachio had a larger weal size of skin prick test to CN (P = .01) and pistachio (P = .0007) and a lower reaction dose to CN (P less then .0001). In multivariate analysis, only the reaction dose to CN was significantly associated with allergy to pistachio.
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