51
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Passeron T, Krutmann J, Andersen ML, Katta R, Zouboulis CC. Clinical and biological impact of the exposome on the skin. J Eur Acad Dermatol Venereol 2021; 34 Suppl 4:4-25. [PMID: 32677068 DOI: 10.1111/jdv.16614] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/05/2020] [Indexed: 12/29/2022]
Abstract
The skin exposome is defined as the totality of environmental exposures over the life course that can induce or modify various skin conditions. Here, we review the impact on the skin of solar exposure, air pollution, hormones, nutrition and psychological factors. Photoageing, photocarcinogenesis and pigmentary changes are well-established consequences of chronic exposure of the skin to solar radiation. Exposure to traffic-related air pollution contributes to skin ageing. Particulate matter and nitrogen dioxide cause skin pigmentation/lentigines, while ozone causes wrinkles and has an impact on atopic eczema. Human skin is a major target of hormones, and they exhibit a wide range of biological activities on the skin. Hormones decline with advancing age influencing skin ageing. Nutrition has an impact on numerous biochemical processes, including oxidation, inflammation and glycation, which may result in clinical effects, including modification of the course of skin ageing and photoageing. Stress and lack of sleep are known to contribute to a pro-inflammatory state, which, in turn, affects the integrity of extracellular matrix proteins, in particular collagen. Hormone dysregulation, malnutrition and stress may contribute to inflammatory skin disorders, such as atopic dermatitis, psoriasis, acne and rosacea.
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Affiliation(s)
- T Passeron
- Côte d'Azur University, Department of Dermatology, University Hospital Centre Nice, Nice, France.,Côte d'Azur University, INSERM U1065, C3M, Nice, France
| | - J Krutmann
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.,Medical faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - M L Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP)/Escola Paulista de Medicina, São Paulo, Brazil
| | - R Katta
- Volunteer Clinical Faculty, Baylor College of Medicine, McGovern Medical School at UT Health, Houston, TX, USA
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
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52
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Schicchi A, Tresoldi MM, Petrolini VM, Lonati D, Perrone M, Locatelli CA. Guttate psoriasis: a case of unusual evolution of an occupation-related skin chemical burns. LA MEDICINA DEL LAVORO 2021; 112:168-170. [PMID: 33881011 PMCID: PMC8095325 DOI: 10.23749/mdl.v112i2.11113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
Introduction: Chemical burns are a risk in domestic and occupational accidents due to the common use of caustic agents. Long-term sequelae are normally due to the amount of skin and underlying tissues damaged. We describe a case of work-related chemical burns with unusual evolution in guttate psoriasis. Case Report: A 36 years-old man was admitted to the Emergency Department (ED) three-hours after a work accident. During the cleaning of an industrial hydraulic system, a jet of hydrochloric acid 20% injured his face and upper limbs. At ED admission, he presented first and second-degree skin burns on the frontal region, on the scalp, on the right forearm, and earlobe. Plastic surgery management consisted in wound topical dressing with silver sulfadiazine and paraffin gauze twice a week for one month. Forty-eight hours after the latter topical treatment (45-days after the work accident), in the same anatomical regions of the previous burn scars, he developed a skin reaction with itchy erythema. The application of topical products was suspended without improvement, excluding an allergic reaction. Within few days, a generalized guttate psoriasis was evident on the whole body. Discussion: Despite many prevention actions, work-related burns are a relatively common cause of hospitalization and may involve up to 80% of patients admitted to a burn unit. Guttate psoriasis has not been described as a sequelae of chemical burns. In our case, the others most frequent factors causing guttate psoriasis have been ruled out. Considering the temporal link between the development of guttate psoriasis and the work accident, hydrochloric acid skin burns might have promoted the systemic inflammatory mediators’ mechanism involved in the development of guttate psoriasis lesion’s after the dermal injury.
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Affiliation(s)
- Azzurra Schicchi
- Pavia Poison Control Centre - National Toxicology Information Centre - Clinical and Experimental Lab, Toxicology Unit - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
| | - Marco M Tresoldi
- Plastic and Reconstructive Surgery, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Department of Surgery, Istituti Clinici Scientifici Maugeri, Pavia, Italy..
| | - Valeria M Petrolini
- 1. Pavia Poison Control Centre - National Toxicology Information Centre - Clinical and Experimental Lab, Toxicology Unit - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
| | - Davide Lonati
- Pavia Poison Control Centre - National Toxicology Information Centre - Clinical and Experimental Lab, Toxicology Unit - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
| | - Maria Perrone
- Emergency Department, IRCCS Policlinico San Matteo, Pavia (Italy).
| | - Carlo A Locatelli
- Pavia Poison Control Centre - National Toxicology Information Centre - Clinical and Experimental Lab, Toxicology Unit - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
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53
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Ninosu N, Roehrich F, Diehl K, Peitsch WK, Schaarschmidt ML. Psoriasis care during the time of COVID-19: real-world data on changes in treatments and appointments from a German university hospital. Eur J Dermatol 2021; 31:183-191. [PMID: 33871361 PMCID: PMC8356542 DOI: 10.1684/ejd.2021.4016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND COVID-19 poses significant challenges for care of patients with chronic inflammatory skin diseases including psoriasis. OBJECTIVES To investigate changes in treatment and/or appointments for psoriasis patients in a German university hospital due to the pandemic. MATERIALS & METHODS A postal survey was conducted between May 15 and June 15, 2020. Potential determinants of changes were analysed with descriptive statistics and multivariate logistic regression. RESULTS Out of 205 respondents, 19.5% missed an appointment and 9.8% changed therapy due to the pandemic. Treatment alterations were encouraged by patients (50%) and physicians (40%), whereas cancellations of appointments mostly occurred on patients' request (70%). Several patient-related key drivers of changes, including sociodemographic, disease- and health-related characteristics were identified. Changes in treatment and appointments were associated with higher psoriasis severity scores and more frequent disease aggravations. CONCLUSION It is particularly crucial to tailor psoriasis care to individual needs in order to protect the physical and mental well-being of patients during the pandemic.
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Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Fabio Roehrich
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, 68167 Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249 Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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54
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Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E. New Insights in Physical Therapy and Rehabilitation in Psoriatic Arthritis: A Review. Rheumatol Ther 2021; 8:639-649. [PMID: 33710586 PMCID: PMC8217348 DOI: 10.1007/s40744-021-00298-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/03/2021] [Indexed: 01/18/2023] Open
Abstract
Psoriatic arthritis (PsA) is a complex, multiform and chronic inflammatory disease characterized by the association of psoriasis and arthritis with other musculoskeletal and extra-articular manifestations. The treatment of PsA is rapidly evolving due to the introduction of new biologic and small-molecule drugs, and the aim of treatment is to induce a condition of remission or low disease activity in all disease domains. However, unmet treatment needs still persist for those patients with impaired function, reduced quality of life or comorbidities. In this context, physical therapy and rehabilitation could provide additional benefits by reducing disease activity and improving function. Although a large number of studies have assessed the role of physical therapy and exercise in other forms of chronic inflammatory arthritis, such as axial spondyloarthritis and rheumatoid arthritis, evidence on their effect on persons with PsA is still lacking. However, some studies have reported the potential positive role of physical therapy on the different disease domains of PsA, in helping to improve disease activity, prevent or improve articular impairment, improve pain management and improve quality of life. Here, we review current evidence on physical therapy, exercise and rehabilitation in patients with PsA. In particular, we review the literature focusing on each domain, to provide evidence of efficacy and effectiveness of exercise and rehabilitation on skin, peripheral arthritis, axial involvement, dactylitis, enthesitis and comorbidities.
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Affiliation(s)
- Fabio Massimo Perrotta
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Silvia Scriffignano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Devis Benfaremo
- Clinica Medica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Mario Ronga
- Orthopedics and Trauma Operative Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University Hospital G. Martino, University of Messina, Messina, Italy
| | - Michele Maria Luchetti
- Clinica Medica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Ennio Lubrano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy.
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55
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Afonina IS, Van Nuffel E, Beyaert R. Immune responses and therapeutic options in psoriasis. Cell Mol Life Sci 2021; 78:2709-2727. [PMID: 33386888 PMCID: PMC11072277 DOI: 10.1007/s00018-020-03726-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023]
Abstract
Psoriasis is a chronic inflammatory disease of the skin that affects about 2-3% of the population and greatly impairs the quality of life of affected individuals. Psoriatic skin is characterized by excessive proliferation and aberrant differentiation of keratinocytes, as well as redness caused by increased dilation of the dermal blood vessels and infiltration of immune cells. Although the pathogenesis of psoriasis has not yet been completely elucidated, it is generally believed to arise from a complex interplay between hyperproliferating keratinocytes and infiltrating, activated immune cells. So far, the exact triggers that elicit this disease are still enigmatic, yet, it is clear that genetic predisposition significantly contributes to the development of psoriasis. In this review, we summarize current knowledge of important cellular and molecular mechanisms driving the initiation and amplification stages of psoriasis development, with a particular focus on cytokines and emerging evidence illustrating keratinocyte-intrinsic defects as key drivers of inflammation. We also discuss mouse models that have contributed to a better understanding of psoriasis pathogenesis and the preclinical development of novel therapeutics, including monoclonal antibodies against specific cytokines or cytokine receptors that have revolutionized the treatment of psoriasis. Future perspectives that may have the potential to push basic research and open up new avenues for therapeutic intervention are provided.
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Affiliation(s)
- Inna S Afonina
- Unit of Molecular Signal Transduction in Inflammation, Center for Inflammation Research, Ghent University - VIB, Technologiepark 71, B-9052, Ghent, Belgium
- Department for Biomedical Molecular Biology, Ghent University, Technologiepark 71, B-9052, Ghent, Belgium
| | - Elien Van Nuffel
- Unit of Molecular Signal Transduction in Inflammation, Center for Inflammation Research, Ghent University - VIB, Technologiepark 71, B-9052, Ghent, Belgium
- Department for Biomedical Molecular Biology, Ghent University, Technologiepark 71, B-9052, Ghent, Belgium
| | - Rudi Beyaert
- Unit of Molecular Signal Transduction in Inflammation, Center for Inflammation Research, Ghent University - VIB, Technologiepark 71, B-9052, Ghent, Belgium.
- Department for Biomedical Molecular Biology, Ghent University, Technologiepark 71, B-9052, Ghent, Belgium.
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56
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Chen G, Chen ZM, Fan XY, Jin YL, Li X, Wu SR, Ge WW, Lv CH, Wang YK, Chen JG. Gut-Brain-Skin Axis in Psoriasis: A Review. Dermatol Ther (Heidelb) 2020; 11:25-38. [PMID: 33206326 PMCID: PMC7859123 DOI: 10.1007/s13555-020-00466-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Psoriasis is a common skin disease, with chronic inflammation and a complex etiology. It has long been recognized that chronic skin conditions and mental health disorders are often co-morbid. Thus, the concept of the gut–brain–skin axis emphasized in mental health disorders may also regulate the health of skin. Results The gut microbiota has been found to be the bridge between the immune system and nervous system. By leveraging clinical cases and animal models of psoriasis, an important communication pathway has been identified along the gut–brain–skin axis that is associated with the modulation of neurotransmitters from the microbiota. Furthermore, mammalian neurotransmitters, including dopamine, serotonin, or γ-aminobutyric acid (GABA), can be produced and/or consumed by several types of bacteria. Other studies suggest that manipulating these neurotransmitters by bacteria may have an effect on host physiology, and the levels of neurotransmitter can be altered by microbiota-based interventions. Conclusions Nonetheless, it is unknown whether or not the manipulation of neurotransmitter levels by bacteria can affect the occurrence and development of psoriasis. Notably, preliminary experiments found that oral consumption of probiotics improves the clinical symptoms in patients with psoriasis, perhaps correlated with the gut microbiome-mediated crosstalk between the immune system and the nervous system by secreting neurotransmitters in psoriasis. In this review, the communication along the gut–brain–skin axis is discussed.
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Affiliation(s)
- Guang Chen
- Department of Basic Medical Sciences, Taizhou University Hospital, Taizhou University, No 1139 Shifu Road, Jiaojiang District, Taizhou, China.,Department of Dermatology, Taizhou Second People's Hospital, No 2 Shuinan east road, Tiantai Country, Taizhou, China
| | - Zai-Ming Chen
- Department of Dermatology, Taizhou Second People's Hospital, No 2 Shuinan east road, Tiantai Country, Taizhou, China
| | - Xiao-Yan Fan
- Department of Basic Medical Sciences, Taizhou University Hospital, Taizhou University, No 1139 Shifu Road, Jiaojiang District, Taizhou, China
| | - Yue-Lei Jin
- Department of Basic Medical Sciences, Taizhou University Hospital, Taizhou University, No 1139 Shifu Road, Jiaojiang District, Taizhou, China
| | - Xin Li
- Department of Basic Medical Sciences, Taizhou University Hospital, Taizhou University, No 1139 Shifu Road, Jiaojiang District, Taizhou, China.,Department of Medicine, Jiamusi University, No 148 Xuefu road, Xiangyang District, Jiamusi, China
| | - Shi-Ren Wu
- Department of Dermatology, Taizhou Second People's Hospital, No 2 Shuinan east road, Tiantai Country, Taizhou, China
| | - Wei-Wei Ge
- Department of Dermatology, Taizhou Second People's Hospital, No 2 Shuinan east road, Tiantai Country, Taizhou, China
| | - Cao-Hua Lv
- Department of Dermatology, Taizhou Second People's Hospital, No 2 Shuinan east road, Tiantai Country, Taizhou, China
| | - Yao-Kun Wang
- Department of Medicine, Jiamusi University, No 148 Xuefu road, Xiangyang District, Jiamusi, China
| | - Jin-Guang Chen
- Department of Basic Medical Sciences, Taizhou University Hospital, Taizhou University, No 1139 Shifu Road, Jiaojiang District, Taizhou, China.
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57
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Li X, Liu L, Zhang Y, Li L. Efficacy of psychological intervention for patients with psoriasis vulgaris: a prospective study. J Int Med Res 2020; 48:300060520961674. [PMID: 33115312 PMCID: PMC7780611 DOI: 10.1177/0300060520961674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective The study aim was to examine the effect of a psychological intervention on patients with psoriasis vulgaris. Methods Participants in this prospective study were 205 patients with psoriasis vulgaris, 104 who received a psychological intervention (study group) and 101 who received routine nursing care (control group). An additional 291 healthy subjects formed a non-psoriasis group. The Symptom Checklist-90 (SCL-90), Generic Quality of Life Inventory (GQOLI), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate psychological status and quality of life. Results There were significant differences in SCL-90 and GQOLI scores between the study and non-psoriasis groups. After treatment, the study group showed significantly improved scores on the SCL-90 and GQOLI compared with the control group. Scores on the SDS (mean ± standard deviation: 31.99 ± 4.54 vs. 44.08 ± 4.52) and SAS (28.36 ± 4.52 vs. 40.14 ± 6.33) were improved in the study group. In addition, patients in the study group showed higher satisfaction rate and compliance rate than those in the control group. Conclusion Psychological intervention may be beneficial for improving quality of life and the therapeutic efficacy of drugs in patients with psoriasis.
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Affiliation(s)
- Xiaoli Li
- Department of Dermatology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Liangliang Liu
- Department of Otorhinolaryngology, The School Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yanfei Zhang
- Department of Dermatology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Li Li
- Department of Dermatology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China
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58
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El-Komy MHM, Mashaly H, Sayed KS, Hafez V, El-Mesidy MS, Said ER, Amer MA, AlOrbani AM, Saadi DG, El-Kalioby M, Eid RO, Azzazi Y, El Sayed H, Samir N, Salem MR, El Desouky ED, Zaher HAEM, Rasheed H. Clinical and epidemiologic features of psoriasis patients in an Egyptian medical center. JAAD Int 2020; 1:81-90. [PMID: 34409325 PMCID: PMC8362248 DOI: 10.1016/j.jdin.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 02/01/2023] Open
Abstract
Background Identification of epidemiologic and phenotypic variations of psoriasis among different ethnic groups can further our understanding of this perplexing disease, aiming at better management of patients worldwide. Objective To provide a descriptive analysis of psoriasis patients registered at Kasr Al-Ainy Psoriasis Unit Disease Registry. Methods This retrospective single-center registry study included patient records between November 2015 and November 2018 (2534 patients). Sociodemographic and phenotypic data were analyzed. Results The mean age of the registered patients was 39.3 years and 56.3% were men. Stress was the main precipitating factor (48.3%), whereas the most common symptom reported was itching (82.4%). The median body mass index was 27.5, and the median percentage of body surface area involved was 10.0. The mean Psoriasis Area Severity Index score was 8.7, and the mean Psoriasis Disability Index score was 13.0. Both parameters correlated positively, and both showed significantly higher means in smokers. Limitations Despite that the study was performed at a highly specialized tertiary care center with a high flow of patients, this was still a single-center registry. Conclusions This work shows that the characteristics of Egyptian patients with psoriasis are comparable to those of other studied ethnic groups, with minor differences.
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Affiliation(s)
- Mohamed Hussein Medhat El-Komy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba Mashaly
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khadiga S Sayed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Vanessa Hafez
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa S El-Mesidy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman R Said
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa A Amer
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya M AlOrbani
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina G Saadi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona El-Kalioby
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem O Eid
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yousra Azzazi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hagar El Sayed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nesrin Samir
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa R Salem
- Department of Public Health and Community, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman D El Desouky
- Department of Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hesham Abd El-Moaty Zaher
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hoda Rasheed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
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Wan MT, Pearl RL, Chiesa Fuxench ZC, Takeshita J, Gelfand JM. Anticipated and Perceived Stigma Among Patients With Psoriasis. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2020; 5:93-99. [PMID: 33733037 PMCID: PMC7963348 DOI: 10.1177/2475530320924009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Perceived stigma among patients with psoriasis (PWP) is associated with poorer quality of life. OBJECTIVE To determine the prevalence and predictors of stigmatizing attitudes that PWP expect and experience from others. METHODS We conducted a survey using validated outcome measures to assess the extent to which PWP anticipate and perceive stigma from others. Demographic and clinical characteristics were obtained from electronic medical records. RESULTS Patients (n = 106) were 48.11% female, 70.75% white, and had a mean age ± SD of 47.90 ± 16.19 years old. Of all, 25.47% self-reported their psoriasis as severe. Mean physician global assessment score ± SD was 2.98 ± 1.81. Two-thirds (66.98%) of patients reported that, in response to seeing their psoriasis-affected skin, they anticipated others to stereotype them as "contagious." Linear regression analyses demonstrated that patient-reported severe psoriasis, compared to mild psoriasis, was associated with greater anticipation of negative stereotypes, social avoidance, and perceived stigma from others (P values < .05). Physician-measured body surface area and global assessment scores were not significantly associated with any outcome. CONCLUSION Prevalence of anticipated and perceived stigma among PWP is high. Our results suggest that objective measures of severity may not identify patients at risk of stigma-related distress. Additional methods, such as directly inquiring about stigmatizing experiences, may be needed.
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Affiliation(s)
- Marilyn T Wan
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Zelma C Chiesa Fuxench
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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60
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AlQassimi S, AlBrashdi S, Galadari H, Hashim MJ. Global burden of psoriasis – comparison of regional and global epidemiology, 1990 to 2017. Int J Dermatol 2020; 59:566-571. [DOI: 10.1111/ijd.14864] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/12/2020] [Accepted: 03/01/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Sarah AlQassimi
- College of Medicine and Health Sciences United Arab Emirates University Al Ain United Arab Emirates
| | - Safiya AlBrashdi
- College of Medicine and Health Sciences United Arab Emirates University Al Ain United Arab Emirates
| | - Hassan Galadari
- College of Medicine and Health Sciences United Arab Emirates University Al Ain United Arab Emirates
| | - Muhammad Jawad Hashim
- College of Medicine and Health Sciences United Arab Emirates University Al Ain United Arab Emirates
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61
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Eisert L, Augustin M, Bach S, Dittmann M, Eiler R, Fölster-Holst R, Gerdes S, Hamm H, Höger P, Horneff G, von Kiedrowski R, Philipp S, Pleimes M, Schläger M, Schuster V, Staubach P, Weberschock T, Werner RN, Nast A, Sticherling M. S2k guidelines for the treatment of psoriasis in children and adolescents - Short version part 1. J Dtsch Dermatol Ges 2020; 17:856-870. [PMID: 31437363 DOI: 10.1111/ddg.13907] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The present guidelines are aimed at residents and board-certified physicians in the fields of dermatology, pediatrics, pediatric dermatology and pediatric rheumatology as well as policymakers and insurance funds. They were developed by dermatologists and pediatric dermatologists in collaboration with pediatric rheumatologists using a formal consensus process (S2k). The guidelines highlight topics such as disease severity, quality of life, treatment goals as well as problems associated with off-label drug therapy in children. Trigger factors and diagnostic aspects are discussed. The primary focus is on the various topical, systemic and UV-based treatment options available and includes recommendations for use and treatment algorithms. Other aspects addressed herein include vaccinations in children and adolescents with psoriasis as well as various disease subtypes such as guttate psoriasis, diaper psoriasis, pustular psoriasis and psoriatic arthritis. Finally, we also provide recommendations for imaging studies and the diagnostic workup to rule out tuberculosis prior to initiating systemic treatment. Note: This article constitutes part 1 of the Sk2 guidelines for the treatment of psoriasis in children and adolescents. Part 2 will be published in the next issue. It contains chapters on UV therapy, systemic treatment, tonsillectomy and antibiotics, vaccinations, guttate psoriasis, psoriatic arthritis, complementary medicine, as well as imaging studies and diagnostic workup to rule out tuberculosis prior to systemic treatment.
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Affiliation(s)
- Lisa Eisert
- Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Matthias Augustin
- University Medical Center Hamburg-Eppendorf, Institute for Health Services Research in Dermatology and Nursing (IVDP), Hamburg, Germany
| | - Sabine Bach
- Patient representatives in the German Psoriasis Association
| | - Martin Dittmann
- Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Renate Eiler
- Patient representatives in the German Psoriasis Association
| | - Regina Fölster-Holst
- Department of Dermatology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sascha Gerdes
- Department of Dermatology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Henning Hamm
- Department of Dermatology, Venereology and Allergology, Würzburg University Medical Center, Würzburg, Germany
| | - Peter Höger
- Department of Pediatrics and Pediatric Dermatology/Allergology, Catholic Children's Hospital Wilhelmstift gGmbH, Hamburg, Germany
| | - Gerd Horneff
- Department of Pediatric and Adolescent Medicine, Asklepios Medical Center, Sankt Augustin, Germany
| | | | - Sandra Philipp
- Office-based Dermatologist (in collaboration with Markus Friedrich, MD), Oranienburg, Germany
| | - Marc Pleimes
- Office-based Dermatologist specialized in Pediatric and Adolescent Skin, Heidelberg, Germany
| | | | - Volker Schuster
- Department of Pediatric and Adolescent Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Petra Staubach
- Department of Dermatology, Mainz University Medical Center, Mainz, Germany
| | - Tobias Weberschock
- Division of Evidence-based Medicine, Department of General Medicine, Frankfurt University Medical Center, Frankfurt am Main, Germany
| | - Ricardo Niklas Werner
- Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Alexander Nast
- Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Michael Sticherling
- Department of Dermatology, Erlangen University Medical Center, Erlangen, Germany
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Eisert L, Augustin M, Bach S, Dittmann M, Eiler R, Fölster-Holst R, Gerdes S, Hamm H, Höger P, Horneff G, von Kiedrowski R, Philipp S, Pleimes M, Schlaeger M, Schuster V, Staubach P, Weberschock T, Werner RN, Nast A, Sticherling M. S2k‐Leitlinie zur Therapie der Psoriasis bei Kindern und Jugendlichen – Kurzfassung Teil 1. J Dtsch Dermatol Ges 2019; 17:856-870. [PMID: 31437372 DOI: 10.1111/ddg.13907_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lisa Eisert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence based Medicine (dEBM)
| | - Matthias Augustin
- Universitätsklinikum Hamburg-Eppendorf, Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Hamburg
| | - Sabine Bach
- Patientenvertreterinnen des Deutschen Psoriasisbundes
| | - Martin Dittmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence based Medicine (dEBM)
| | - Renate Eiler
- Patientenvertreterinnen des Deutschen Psoriasisbundes
| | | | - Sascha Gerdes
- Dermatologie des Universitätsklinikums Schleswig-Holstein, Campus Kiel, Kiel
| | - Henning Hamm
- Universitätsklinikum Würzburg, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Würzburg
| | - Peter Höger
- Katholisches Kinderkrankenhaus Wilhelmstift gGmbH, Pädiatrie und Pädiatrische Dermatologie/Allergologie, Hamburg
| | - Gerd Horneff
- Asklepios Klinik Sankt Augustin, Kinder- und Jugendmedizin, Sankt Augustin
| | | | | | - Marc Pleimes
- Spezialpraxis für Kinder- und Jugendhaut, Heidelberg
| | | | - Volker Schuster
- Universitätsklinik und Poliklinik für Kinder und Jugendliche Leipzig, Leipzig
| | | | - Tobias Weberschock
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt/Main.,Arbeitsgruppe EbM Frankfurt, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt/Main
| | - Ricardo Niklas Werner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence based Medicine (dEBM)
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence based Medicine (dEBM)
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Pancar Yuksel E, Durmus D, Sarisoy G. Perceived stress, life events, fatigue and temperament in patients with psoriasis. J Int Med Res 2019; 47:4284-4291. [PMID: 31311368 PMCID: PMC6753579 DOI: 10.1177/0300060519862658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the perceived stress, life events, fatigue and temperament
profile in patients with psoriasis and to investigate the relationship
between these factors. Methods This cross-sectional study included patients with psoriasis and healthy
control subjects. The two groups were compared regarding the number of life
events, Perceived Stress Scale (PSS) and Multidimensional Assessment of
Fatigue scores. The Temperament Evaluation of Memphis, Pisa, Paris and San
Diego Autoquestionnaire was used to evaluate the personality traits among
the two groups. Results A total of 75 patients with psoriasis (mean ± SD age, 44.94 ± 13.62 years)
and 75 healthy controls (mean ± SD age, 41.10 ± 8.89 years) were included in
the study. A statistically significant difference was found between the two
groups in terms of the presence of life events, PSS score, fatigue and
temperament profiles. Patients with psoriasis with depressive, cyclothymic
and anxious temperament profiles were found to have higher PSS scores. In
the psoriasis group, the PSS scores were positively correlated with the
number of life events. Conclusions Stress and life events were found to be correlated with psoriasis. In the
patients with psoriasis, depressive, cyclothymic and anxious temperament
profiles seemed to be associated with higher perceived stress.
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Affiliation(s)
- Esra Pancar Yuksel
- Department of Dermatology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Durmus
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Gokhan Sarisoy
- Department of Psychiatry, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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