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Chernyshov PV, Finlay AY, Tomas-Aragones L, Zuberbier T, Kocatürk E, Manolache L, Pustisek N, Svensson A, Marron SE, Sampogna F, Bewley A, Salavastru C, Koumaki D, Augustin M, Linder D, Abeni D, Salek SS, Szepietowski J, Jemec GB. Quality of life measurement in urticaria: Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient-Oriented Outcomes and Urticaria and Angioedema. J Eur Acad Dermatol Venereol 2024. [PMID: 38855825 DOI: 10.1111/jdv.20157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces on quality of life (QoL) and patient-oriented outcomes and on urticaria and angioedema recommendations for the assessment of Health-related (HR) QoL in all patients with urticaria in research and practice are as follows: to use the DLQI for adults and the CDLQI for children as dermatology-specific and the CU-Q2oL as a disease-specific HRQoL instruments in urticaria; to use generic instruments to provide comparison of data on urticaria with non-dermatologic diseases, or to compare with healthy volunteers or the general population; to select validated HRQoL instruments with appropriate age limits; to present exact numeric data for HRQoL results; correct title of any HRQoL instrument should be used, along with its correct abbreviation and the reference to its original publication, where possible. The EADV TFs discourage the use of non-validated HRQoL instruments and modified HRQoL instruments that have not undergone standard validation.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - T Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - E Kocatürk
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - L Manolache
- Department of Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - A Bewley
- Barts Health NHS Trust, London, UK
- Queen Mary University, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - J Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
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Ghalamkarpour F, Araghi F, Tabari M, Moslemi Haghighi S, Pourgholi E. Comparing quality of life, anxiety, depression, sleep disturbance, and associated factors in vitiligo and alopecia areata patients. J Cosmet Dermatol 2024; 23:1808-1815. [PMID: 38169098 DOI: 10.1111/jocd.16158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/24/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION AND OBJECTIVES Vitiligo and alopecia areata (AA) are two autoimmune skin diseases that affect patients' quality of life (QoL) and give rise to psychosocial complications, such as depression, negative self-image, less joyful social engagements, and low self-esteem. These two disorders have common and uncommon characteristics. Therefore, in this study, we tried to evaluate the similarities and differences in the psychological parameters including quality of life, sleep disturbance, anxiety, and depression levels between, vitiligo and AA patients. MATERIALS AND METHODS Patients with either vitiligo or AA visiting the outpatient dermatology clinic from November 2017 to December 2020 have been included in this study. Persian versions of three questionnaires including the dermatology life quality index (DLQI), hospital anxiety and depression scale (HADS), and Pittsburgh sleep quality index (PSQI), have been used to assess the QoL, sleep disturbance, anxiety, and depression levels in patients. RESULTS In total, 188 patients, including 94 (50%) cases of AA and 94 (50%) patients with vitiligo, met the criteria. In AA patients, a significantly higher DLQI score was found (p-value = 0.002) compared to the vitiligo cases, which means a better QoL in vitiligo patients. Additionally, AA patients had higher scores of anxiety (P-value<0.001) and depression (p-Value<0.001). However, sleep disturbance (64.9% of AA patients vs. 59.3% of vitiligo patients; p-Value = 0.4888) was not significantly different between the two groups. CONCLUSIONS Our data showed lower QoL and higher levels of anxiety and depression in AA patients compared to vitiligo cases, but no difference was seen in sleep disturbance in the PSQI-P score.
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Affiliation(s)
- Fariba Ghalamkarpour
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Elnaz Pourgholi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abdelghaffar M, Hwang E, Damsky W. Cutaneous Sarcoidosis. Clin Chest Med 2024; 45:71-89. [PMID: 38245372 DOI: 10.1016/j.ccm.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Sarcoidosis is a multisystem disease that most commonly affects the lungs, lymphatic system, eyes, and skin but any organ may be involved. Cutaneous sarcoidosis most commonly presents as pink-red to red-brown papules and plaques that commonly affect the head and neck. With the skin being readily accessible for evaluation and biopsy, when sarcoidosis is suspected, dermatologic evaluation may be helpful for establishing a definitive diagnosis. Treatment strategy depends on the severity and distribution of skin lesions and should incorporate patient preference and treatment considerations for other organs that may be involved.
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Affiliation(s)
- Mariam Abdelghaffar
- School of Medicine, Royal College of Surgeons in Ireland, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland
| | - Erica Hwang
- Department of Dermatology, Yale School of Medicine, 333 Cedar Street, LCI 501 PO Box 208059, New Haven, CT 06520, USA
| | - William Damsky
- Department of Dermatology, Yale School of Medicine, 333 Cedar Street, LCI 501 PO Box 208059, New Haven, CT 06520, USA; Department of Pathology, Yale School of Medicine, 310 Cedar Street, LH 108, PO Box 208023, New Haven, CT 06520, USA.
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Roldan-Contreras SE, Mendoza Martínez JR, Marin-Hernandez E, Coronado-Malagón M. Acquired Perforating Dermatosis and Dermatology Life Quality Index in Patients Receiving hemodialysis. Nefrologia 2024; 44:251-255. [PMID: 38555206 DOI: 10.1016/j.nefroe.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/19/2023] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Acquired perforating dermatosis (APD) is a frequent disorder in hemodialysis patients and the effect on the quality of life is poorly described. We investigated the prevalence of APD in hemodialysis patients, measured and compared APD-associated quality of life. METHODS We developed a prospective, observational, and descriptive study. We invited patients over the age of 18 in hemodialysis. Data was obtained from their electronic file and a dermatological examination was performed. The Dermatology Life Quality Index (DLQI) was applied. Descriptive analysis of demographic variables, clinical features, and dermoscopy findings, as well as comparison of DLQI scores, was made. RESULTS The sample consisted of 46 patients, with a prevalence of APD of 11%. Patients with APD were leaner and younger compared to patients without APD. The time on hemodialysis was longer in patients with APD compared to those without APD, with a median of 90 versus 32 months (p = 0.015). The impact on quality of life was greater in patients with APD compared to those without APD, with some effect in all patients with APD and 33% in patients without APD (p = 0.001). Patients with APD had more frequent pruritus compared to those without APD (p = 0.007). CONCLUSIONS Age, time on hemodialysis and BMI are associated with the presence of APD. Patients with APD had a higher prevalence of pruritus and a greater impact on quality of life in dermatology compared to patients without APD.
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Affiliation(s)
| | - José Roberto Mendoza Martínez
- Centro Nacional de Programas Preventivos y Control de Enfermedades, Secretaría de Salud, Gobierno de México, Ciudad de México, CDMX, Mexico
| | - Eduardo Marin-Hernandez
- Medicina Interna, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos (HCSAE), Ciudad de México, CDMX, Mexico; Dermatología, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos (HCSAE), Ciudad de México, CDMX, Mexico
| | - Martín Coronado-Malagón
- Medicina Interna, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos (HCSAE), Ciudad de México, CDMX, Mexico.
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Hwang HW, Ryou S, Jeong JH, Lee JW, Lee KJ, Lee SB, Shin HT, Byun JW, Shin J, Choi GS. The Quality of Life and Psychosocial Impact on Female Pattern Hair Loss. Ann Dermatol 2024; 36:44-52. [PMID: 38325433 PMCID: PMC10861302 DOI: 10.5021/ad.23.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Alopecia, a benign dermatologic condition affecting both genders, particularly harms female patients due to psychosocial effects. Female pattern hair loss (FPHL), the primary cause of hair loss in women, lacks sufficient Korean epidemiological studies examining its psychosocial aspects. OBJECTIVE This study aimed to explore FPHL's psychosocial impacts, including quality of life (QoL), depression, anxiety, medical consumption, and hair loss factors in Korean women. METHODS A total of 202 patients with FPHL were interviewed using a validated questionnaire to assess the QoL, psychological impact, and pattern of medical consumption. The severity of hair loss was evaluated using the "basic and specific (BASP) classification" by dermatologists. The Hair-Specific Skindex-29 (HSS29) was used to assess the QoL and Beck depression inventory (BDI), Beck anxiety inventory (BAI) to evaluate psychological aspects, and medical expenses and the number of clinic visits to determine medical consumption. RESULTS The global HSS29 score of FPHL was 40.97±18.92, indicating a notable impact on QoL. The mean BDI and BAI scores were 14.47 and 10.06, respectively. In multivariable regression analysis, HSS29, BDI, and BAI scores were most affected by the severity of hair loss (p<0.001). CONCLUSION FPHL damages the psychosocial aspects of patients, such as QoL, depression, and medical consumption, according to the severity of hair loss.
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Affiliation(s)
- Hye Won Hwang
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Sunmin Ryou
- Department of Dermatology, Inha University Hospital, Incheon, Korea
| | - Jun Hyeong Jeong
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jae Won Lee
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Kyung-Ju Lee
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Seon Bok Lee
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Hyun-Tae Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Byun
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jeonghyun Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Gwang Seong Choi
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea.
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Mahfouz MS, Alqassim AY, Hakami FA, Alhazmi AK, Ashiri AM, Hakami AM, Khormi LM, Adawi YM, Jabrah AA. Common Skin Diseases and Their Psychosocial Impact among Jazan Population, Saudi Arabia: A Cross-Sectional Survey during 2023. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1753. [PMID: 37893471 PMCID: PMC10608052 DOI: 10.3390/medicina59101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Skin problems are a widespread issue that affects people in both developing and wealthy countries, posing significant public health concerns. These disorders can profoundly impact individuals' social and psychological well-being. In this study, we aimed to determine the prevalence of the most common skin diseases in the Jazan region of southwestern Saudi Arabia and investigate their impact on patients' quality of life and psychological and social well-being. Materials and Methods: An observational cross-sectional survey conducted among a random sample of 940 adults ≥ 18 years in the Jazan region, Saudi Arabia. Four standardized questionnaires were used for data collection: Patient Health Questionnaire (PHQ-9), a five-dimension questionnaire (EQ-5D), Rosenberg Self-Esteem Scale, and Loneliness Scale (ULS-8). Results: The most prevalent skin conditions involved hair loss, which was reported by (61.1%) of the study population. These disorders significantly affected a higher percentage of females (71.9%) compared to males (46.3%) (p < 0.001). Melasma was more common in females (14.1%) than in males (4.3%) p < 0.001. The lowest prevalence was found for urticaria. Those with acne and hair loss reported higher mean scores on the PHQ-9 Scale than the group without these conditions (p < 0.05 for all). Patients with alopecia, acne, and melasma also reported significantly lower self-esteem scores compared to those without these skin conditions (p < 0.05 for all). Regarding the activity domain of QoL, participants with skin conditions reported no problems doing usual activities, compared to those without skin problems (p < 0.001). Conclusions: In conclusion, research revealed that the most prevalent skin condition was hair loss. Further, an association was found between skin diseases and the mental and social well-being of those affected, resulting in a negative impact on their quality of life. The results call for improving the condition of patients with skin diseases, improving their quality of life, and providing appropriate interventions.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Fanan Adel Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Abrar Khalid Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Amjad Mohammed Ashiri
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Alaa Marwei Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Linan Mohammed Khormi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Yara Mohammed Adawi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Asmaa Ahmed Jabrah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
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Nurzyńska-Wierdak R, Pietrasik D, Walasek-Janusz M. Essential Oils in the Treatment of Various Types of Acne-A Review. PLANTS (BASEL, SWITZERLAND) 2022; 12:90. [PMID: 36616219 PMCID: PMC9824697 DOI: 10.3390/plants12010090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Acne is a chronic, common disease that poses a significant therapeutic, psychological and social problem. The etiopathogenesis of this disease is not fully understood. Drugs used in general and external therapy should have anti-seborrhoeic, anticomadogenic, bactericidal, bacteriostatic, and anti-inflammatory properties. Acne treatment is often associated with the long-term use of antibiotics, contributing to the global antibiotic resistance crisis. In order to solve this problem, attention has been paid to essential oils and their terpene components with potent antimicrobial, anti-inflammatory, and antioxidant properties. Research shows that certain essential oils effectively reduce inflammatory acne lesions through mechanisms related to the sebaceous glands, colonization of Cutibacterium acnes, and reactive oxygen species (ROS). An example is tea tree oil (TTO), a more commonly used topical agent for treating acne. TTO has antimicrobial and anti-inflammatory activity. The paper presents the latest scientific information on the activity and potential use of specific essential oils in treating acne. Evidence of antibacterial, anti-inflammatory, and antioxidant activity of several essential oils and their main components was presented, indicating the possibility of using them in the treatment of acne.
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Picardo M, Huggins R, Jones H, Marino R, Ogunsola M, Seneschal J. The humanistic burden of vitiligo: a systematic literature review of quality-of-life outcomes. J Eur Acad Dermatol Venereol 2022; 36:1507-1523. [PMID: 35366355 PMCID: PMC9790455 DOI: 10.1111/jdv.18129] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/04/2022] [Indexed: 12/30/2022]
Abstract
Despite historical mischaracterization as a cosmetic condition, patients with the autoimmune disorder vitiligo experience substantial quality-of-life (QoL) burden. This systematic literature review of peer-reviewed observational and interventional studies describes comprehensive evidence for humanistic burden in patients with vitiligo. PubMed, EMBASE, Scopus and the Cochrane databases were searched through February 10, 2021, to qualitatively assess QoL in vitiligo. Two independent reviewers assessed articles for inclusion and extracted data for qualitative synthesis. A total of 130 included studies were published between 1996 and 2021. Geographical regions with the most studies were Europe (32.3%) and the Middle East (26.9%). Dermatology-specific instruments, including the Dermatology Life Quality Index (DLQI; 80 studies) and its variants for children (CDLQI; 10 studies) and families (FDLQI; 4 studies), as well as Skindex instruments (Skindex-29, 15 studies; Skindex-16, 4 studies), were most commonly used to measure humanistic burden. Vitiligo-specific instruments, including the Vitiligo-specific QoL (VitiQoL; 11 studies) instrument and 22-item Vitiligo Impact Scale (VIS-22; 4 studies), were administered in fewer studies. Among studies that reported total scores for the overall population, a majority revealed moderate or worse effects of vitiligo on patient QoL (DLQI, 35/54 studies; Skindex, 8/8 studies; VitiQoL, 6/6 studies; VIS-22, 3/3 studies). Vitiligo also had a significant impact on the QoL of families and caregivers; 4/4 studies reporting FDLQI scores indicated moderate or worse effects on QoL. In general, treatment significantly (P < 0.05) improved QoL, but there were no trends for types or duration of treatment. Among studies that reported factors significantly (P ≤ 0.05) associated with reduced QoL, female sex and visible lesions and/or lesions in sensitive areas were most common. In summary, vitiligo has clinically meaningful effects on the QoL of patients, highlighting that greater attention should be dedicated to QoL decrement awareness and improvement in patients with vitiligo.
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Affiliation(s)
- M. Picardo
- San Gallicano Dermatological Institute IRCCSRomeItaly
| | | | - H. Jones
- Incyte CorporationWilmingtonDEUSA
| | | | | | - J. Seneschal
- Department of Dermatology and Pediatric DermatologyNational Reference Center for Rare Skin DisordersHôpital Saint‐AndréCNRS, UMR‐5164, ImmunoConCept, F‐33000BordeauxFrance
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Heiskanen SL, Niskala J, Jokelainen J, Tasanen K, Huilaja L, Sinikumpu SP. Hyperhidrosis Comorbidities and Treatments: A Register-based Study among 511 Subjects. Acta Derm Venereol 2022; 102:adv00656. [PMID: 35088873 PMCID: PMC9558338 DOI: 10.2340/actadv.v102.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hyperhidrosis is a dermatological condition that causes psychosocial impairment and has a negative impact on patients’ quality of life. The epidemiology of hyperhidrosis is currently poorly understood. The aim of this study was to analyse comorbidities and treatments in 511 subjects with hyperhidrosis selected from the patient records of Oulu University Hospital. The mean age of patients with local hyperhidrosis was 27.9 years and the majority were female (62.7%). The most common anatomical site of symptoms in the youngest age group was the palms, whereas the axillae were a more common site in advanced age. Depression was a common comorbidity in both local (11.6%) and generalized hyperhidrosis (28.6%). Anxiety affected 12.7% of patients with generalized hyperhidrosis. In 36.8% of the patients with local hyperhidrosis there was a delay in diagnosis of more than 10 years. The most commonly used treatments included topical antiperspirants, iontophoresis and botulin toxin injections.
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Affiliation(s)
| | | | | | - Kaisa Tasanen
- Department of Dermatology and Medical Research Center Oulu, PEDEGO Research Unit, University of Oulu, Oulu University Hospital, Oulu, Finland.
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Cuervo MM, Sanclemente G, Barrera LM. Clinical and sociodemographic features and quality of life in patients with atopic dermatitis who attended dermatology teaching clinics in Medellín, Antioquia and its metropolitan area. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2021; 41:676-691. [PMID: 34936253 PMCID: PMC8765345 DOI: 10.7705/biomedica.5978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/14/2021] [Indexed: 06/14/2023]
Abstract
Introduction: Atopic dermatitis is a cutaneous, inflammatory, chronic disease, very frequent in the world and it imposes a high clinical and quality of life impact in patients. To date there are no local studies describing the general features in our population. Objective: To evaluate the socio demographic, clinical and life quality features in patients with atopic dermatitis from Medellín city and its metropolitan area. Materials and methods: cross sectional, descriptive study, that included patients who attended some teaching dermatological clinics. Data collection included sociodemographic and clinical features in addition to clinical issues and quality of life measurements. Results: A total of 13 patients were included. 36,3% manifested a sleeping disturbance, 38,1% attention deficit; 44,2% reported asthma in the childhood. EASI and SCORAD scores were 6,9 and 32,4, respectively, which indicates a mild-moderate compromise. Regarding quality of Life, Skindex-29 showed average scores for the symptomatic, emotional and functional dominions of 37,7, 25,09 and 16,9, respectively, and a total score of 24,78. In EQ-5D scores, the most altered component was the presence of pain or discomfort (17,6%) and the presence of anxiety or depression (12,1%), which enhances the symptomatic and emotional impact of the disease. Conclusion: These results confirm that patients with atopic dermatitis present similar features to those reported in other studies from different countries, highlighting the burden of the disease in adults and its impact in neuropsychiatric and emotional domains.
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Affiliation(s)
- Miguel Mateo Cuervo
- Facultad de Medicina, Sección Dermatología, Universidad de Antioquia, Medellín, Colombia.
| | - Gloria Sanclemente
- Grupo de Investigación Dermatológica, Universidad de Antioquia, Medellín, Colombia.
| | - Lina Marcela Barrera
- Grupo de Investigación Dermatológica, Universidad de Antioquia, Medellín, Colombia.
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Sanclemente G, Hernandez N, Chaparro D, Tamayo L, Lopez A. Epidemiologic features and burden of atopic dermatitis in adolescent and adult patients: A cross-sectional multicenter study. World Allergy Organ J 2021; 14:100611. [PMID: 34934471 PMCID: PMC8654971 DOI: 10.1016/j.waojou.2021.100611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is considered as one of the most frequent chronic skin conditions. Previous AD epidemiologic studies have been mainly retrospective and/or have been performed through surveys instead of in-person visits. Epidemiological studies concerning AD in Latin American countries are scarce. OBJECTIVE To describe sociodemographic and clinical features and the economic burden of AD on children and adult patients in Colombia through in-person visits. METHODS This was a cross-sectional study of 212 patients that included sociodemographic and clinimetric data. The diagnostic criteria of Hanifin and Rajka was used and data relating to disease distribution, disease severity (through the BSA: Body surface area; EASI: Eczema Area and Severity Index; SCORAD: Scoring Atopic Dermatitis), Fitzpatrick's skin phototypes, personal and familiar history of allergic diseases, previous treatments, and personal history of comorbidities, was collected. RESULTS Patient age range was 12-76, and 52.8% were female. Disease distribution was mainly flexural (19.6%). Early age start, Denni-Morgan fold, and infections tendency were more frequent in adolescents compared to adults. Mean age of diagnosis was 12 years old, AD diagnosis was made mostly by a dermatologist, 48.1% (102 patients) reported alcohol consumption, and 59% of consumers were heavy drinkers. Comorbidities found were: chronic rhinitis (68.9%) food allergy (32.5%), allergic conjunctivitis (29.7%), and asthma (28.8%). Around 81% earned less than $896 US dollars and 59% invested 6-30% of their monthly budget yearly, and 40% had work or school absenteeism. Mean scores of BSA, EASI, and SCORAD involvement were 32.6, 13.7, and 42.4, respectively. CONCLUSIONS This study adds well-supported data through an in-depth clinical and economical characterization of Colombian adolescents and adult patients with atopic dermatitis and shows its high impact and burden on patients and their families. It also contributes to understand the burden of AD in Latin America.
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Affiliation(s)
- Gloria Sanclemente
- Group of Investigative Dermatology (GRID), University of Antioquia, Medellín, Colombia
| | | | | | | | - Angela Lopez
- IPS Fototerapia Bojanini y López SAS, Bogotá, Colombia
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Ezzedine K, Eleftheriadou V, Jones H, Bibeau K, Kuo FI, Sturm D, Pandya AG. Psychosocial Effects of Vitiligo: A Systematic Literature Review. Am J Clin Dermatol 2021; 22:757-774. [PMID: 34554406 PMCID: PMC8566637 DOI: 10.1007/s40257-021-00631-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 12/11/2022]
Abstract
Background Patients with vitiligo experience reduced quality of life. Objective To comprehensively describe the available evidence for psychosocial burden in vitiligo. Methods A systematic review of observational studies and clinical trials identified using PubMed, EMBASE, Scopus, and the Cochrane databases was performed through 1 March, 2021, to assess psychosocial comorbidities in vitiligo. Two independent reviewers performed an assessment of articles and extracted data for qualitative synthesis. Results Included studies (N = 168) were published between 1979 and 1 March, 2021; 72.6% were published since 2010. Disorders including or related to depression (41 studies, 0.1–62.3%) and anxiety (20 studies, 1.9–67.9%) were the most commonly reported. The most prevalent psychosocial comorbidities were feelings of stigmatization (eight studies, 17.3–100%), adjustment disorders (12 studies, 4–93.9%), sleep disturbance (seven studies, 4.6–89.0%), relationship difficulties including sexual dysfunction (ten studies, 2.0–81.8%), and avoidance or restriction behavior (12.5–76%). The prevalence of most psychosocial comorbidities was significantly higher vs healthy individuals. Factors associated with a significantly higher burden included female sex, visible or genital lesions, age < 30 years (particularly adolescents), and greater body surface area involvement, among others. The most commonly reported patient coping strategy was lesion concealment. Limitations Available studies were heterogeneous and often had limited details; additionally, publication bias is possible. Conclusions The results of this systematic review show that vitiligo greatly affects psychosocial well-being. The extent of psychosocial comorbidities supports the use of multidisciplinary treatment strategies and education to address the vitiligo-associated burden of disease. Protocol Registration PROSPERO (CRD42020162223). Graphic Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s40257-021-00631-6.
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Affiliation(s)
- Khaled Ezzedine
- Department of Dermatology, Henri Mondor University Hospital and Université Paris-Est Créteil Val de Marne, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, Paris, France.
| | | | | | | | | | | | - Amit G Pandya
- Palo Alto Foundation Medical Group, Mountain View, CA, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Stefanov SR, Andonova VY. Lipid Nanoparticulate Drug Delivery Systems: Recent Advances in the Treatment of Skin Disorders. Pharmaceuticals (Basel) 2021; 14:1083. [PMID: 34832865 PMCID: PMC8619682 DOI: 10.3390/ph14111083] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/12/2022] Open
Abstract
The multifunctional role of the human skin is well known. It acts as a sensory and immune organ that protects the human body from harmful environmental impacts such as chemical, mechanical, and physical threats, reduces UV radiation effects, prevents moisture loss, and helps thermoregulation. In this regard, skin disorders related to skin integrity require adequate treatment. Lipid nanoparticles (LN) are recognized as promising drug delivery systems (DDS) in treating skin disorders. Solid lipid nanoparticles (SLN) together with nanostructured lipid carriers (NLC) exhibit excellent tolerability as these are produced from physiological and biodegradable lipids. Moreover, LN applied to the skin can improve stability, drug targeting, occlusion, penetration enhancement, and increased skin hydration compared with other drug nanocarriers. Furthermore, the features of LN can be enhanced by inclusion in suitable bases such as creams, ointments, gels (i.e., hydrogel, emulgel, bigel), lotions, etc. This review focuses on recent developments in lipid nanoparticle systems and their application to treating skin diseases. We point out and consider the reasons for their creation, pay attention to their advantages and disadvantages, list the main production techniques for obtaining them, and examine the place assigned to them in solving the problems caused by skin disorders.
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Affiliation(s)
- Stefan R. Stefanov
- Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University of Varna, 9002 Varna, Bulgaria;
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Farabi B, Seminario-Vidal L, Jamgochian M, Akay BN, Atak MF, Rao BK, Karagaiah P, Grabbe S, Goldust M. Updated review on prognostic factors in mycosis fungoides and new skin lymphoma trials. J Cosmet Dermatol 2021; 21:2742-2748. [PMID: 34687485 DOI: 10.1111/jocd.14528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ten-year survival rates in mycosis fungoides (MF) broadly varies, however, there is no standardized prognostic index available. This is presumably due to low prevalence, heterogeneity, and diagnostic challenges in MF. Recent studies have focused on identifying objective prognostic indices by using different parameters for survival determinants. The Cutaneous Lymphoma International Prognostic Index (CLIPI) and the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) represent prototypical studies that identify prognostic factors, seeking to improve management and outcomes in early-stage MF. Detecting these factors and stratifying MF patients according to their disease progression risk may help to manage these patients more efficiently. AIMS Review the current literature to determine the risk factors determining prognosis in MF. METHODOLOGY A Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar" using key words 'prognostic factor', 'prognostic indicator', 'mycosis fungoides', 'Sezary syndrome', 'Skin Lymphoma', 'Cutaneous Lymphoma'. Articles published in English language were considered for the review. RESULTS The strongest prognostic factor in MF patients is the stage of the disease. T stage and the presence of extracutaneous disease are the most important factors for survival. Other factors that are associated with worse prognosis are male gender, age >60, presence of plaques, folliculotropism, eosinophilia and lymph node stage above N1/Nx. Elevated LDH was associated with later tumor stages and large cell phenotype at diagnosis had a better prognosis. KIR3DL2 was associated with malignant transformation. CONCLUSION The PROCLIPI study has assessed risk factors collected in MF patients from different countries and across different ethnicities following a rigorous clinicopathologic process. The findings presented here illustrated that disease prognosis in early stages depends on many contributing factors. Detection and stratification of such factors may allow a personalized approach to management of these patients.
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Affiliation(s)
- Banu Farabi
- Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, New Jersey, USA
| | - Lucia Seminario-Vidal
- Department of Dermatology, Department of Cutaneous Oncology, Moffitt Cancer Center and Research Institute, University of South Florida Health Morsani College of Medicine, Tampa, Florida, USA
| | - Marielle Jamgochian
- Department of Dermatology, Robert Wood Johnson Medical Center, Rutgers University, New Brunswick, New Jersey, USA
| | | | | | - Babar K Rao
- Dermatology Department, Weil Cornell Medicine, NY, Somerset, New Jersey, USA
| | - Priyanka Karagaiah
- Department of dermatology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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Huang CH, Fu Y, Chi CC. Health-Related Quality of Life, Depression, and Self-esteem in Patients With Androgenetic Alopecia: A Systematic Review and Meta-analysis. JAMA Dermatol 2021; 157:963-970. [PMID: 34232264 DOI: 10.1001/jamadermatol.2021.2196] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Androgenetic alopecia (AGA) is associated with trichodynia, anxiety, low self-esteem, and depression, which have implications for quality of life. However, no systematic evaluation has been performed on the association of AGA with health-related quality of life (HRQOL). Objective To systematically examine the association of AGA with HRQOL and psychiatric disorders. Data Sources Cochrane Library, PubMed, Embase, and WanFang databases were searched from inception through January 24, 2021. Study Selection Case series, case-control studies, cross-sectional studies, cohort studies, and randomized clinical trials that examined either HRQOL or psychiatric disorders in patients with AGA were included. Studies published in languages other than English and Mandarin were excluded. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was used. The risk of bias in included studies was assessed with the Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool. A random-effects model meta-analysis was performed to calculate the pooled effect on HRQOL. A subgroup analysis according to sex and geographic regions was also conducted. Main Outcomes and Measures The outcome was HRQOL of patients with AGA. Results A total of 41 studies involving 7995 patients was included. The pooled Dermatology Life Quality Index score was 8.16 (95% CI, 5.62-10.71). The pooled Hair-Specific Skindex-29 score indicated moderate impairment of emotions, with the meta-analysis showing a score of 29.22 (95% CI, 24.17-34.28) in the emotion dimension. The pooled Center for Epidemiologic Studies Depression Scale score did not indicate depression, with the meta-analysis showing a score of 14.98 (95% CI, 14.28-15.68). Factors that had a direct association with HRQOL included married or coupled status and receipt of medical treatments, whereas factors that had an inverse association with HRQOL included higher self-rated hair loss severity, lower visual analog scale score, and higher educational level. Conclusions and Relevance This systematic review and meta-analysis found a significant association of AGA with moderate impairment of HRQOL and emotions, but no association was found with depressive symptoms. The findings suggest that patients with AGA may need psychological and psychosocial support.
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Affiliation(s)
- Chun-Hsien Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun Fu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Papadimitropoulos E, Romiti R, Haro JM, Brnabic A, Gómez-Martín D, Firmino Goncalves L, Burge R. Burden of Disease for Psoriasis in Argentina, Brazil, Colombia, and Mexico. Value Health Reg Issues 2021; 26:126-134. [PMID: 34343848 DOI: 10.1016/j.vhri.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/09/2021] [Accepted: 05/05/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Psoriasis (PsO) is a chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations. The disease is also associated with lower quality of life, lower work productivity, and higher healthcare costs. The objective of this study was to conduct a systematic literature review of the disease burden for PsO in Argentina, Brazil, Colombia, and Mexico. METHODS PubMed/MEDLINE, Web of Science, SciELO, and LILACS were searched for publications in English, Spanish, or Portuguese from 2003 to July 2018. RESULTS A total of 680 records were retrieved and 13 articles were included. In Latin America, PsO has a negative impact on the physical and mental well-being as shown by substantially lower scores on measures of quality of life (eg, 12-item Short-Form Health Survey) for patients than the general population. Patients with PsO reported higher levels of presenteeism, activity impairment, and work productivity loss. The estimated annual costs per patient with PsO in Colombia were $3497.58 and $2160.92 for the private sector and public scenario, respectively. CONCLUSIONS Although evidence on the full cost and impact of PsO in Latin America is scarce and further research is needed, the burden in these regions is significant and comparable with that in other parts of the world.
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Affiliation(s)
- Emmanuel Papadimitropoulos
- Eli Lilly and Company, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
| | - Ricardo Romiti
- Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, Sao Paulo, Brazil
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | | | | | | | - Russel Burge
- Eli Lilly and Company, Indianapolis, IN, USA; Division of Pharmaceutical Sciences, University of Cincinnati, Cincinnati, OH, USA
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Osafo N, Yeboah OK, Antwi AO. Endocannabinoid system and its modulation of brain, gut, joint and skin inflammation. Mol Biol Rep 2021; 48:3665-3680. [PMID: 33909195 DOI: 10.1007/s11033-021-06366-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
The discovery of endogenous cannabinoid receptors CB1 and CB2 and their endogenous ligands has generated interest in the endocannabinoid system and has contributed to the understanding of the role of the endocannabinoid system. Its role in the normal physiology of the body and its implication in pathological states such as cardiovascular diseases, neoplasm, depression and pain have been subjects of scientific interest. In this review the authors focus on the endogenous cannabinoids, and the critical role of cannabinoid receptor signaling in neurodegeneration and other inflammatory responses such as gut, joint and skin inflammation. This review also discusses the potential of endocannabinoid pathways as drug targets in the amelioration of some inflammatory conditions. Though the exact role of the endocannabinoid system is not fully understood, the evidence found much clearly points to a great potential in exploiting both its central and peripheral pathways in disease management. Cannabinoid therapy has proven promising in several preclinical and clinical trials.
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Affiliation(s)
- Newman Osafo
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Oduro K Yeboah
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aaron O Antwi
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Vinay N, Ranugha PSS, Betkerur JB, Shastry V, Ashwini PK. Non-venereal genital dermatoses and their impact on quality of life-A cross-sectional study. Indian J Dermatol Venereol Leprol 2021; 88:354-359. [PMID: 33871197 DOI: 10.25259/ijdvl_329_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Lesions on the external genitalia could be venereal or non-venereal. Non-venereal genital dermatoses are common and may cause considerable anxiety to patients, particularly if noticed after sexual intercourse. However, this aspect has not been studied much till now. OBJECTIVES Our study proposes to describe the profile of non-venereal genital dermatoses and determine their impact on quality of life both social and sexual, using the dermatology life quality index questionnaire. METHODS We recruited patients aged 18 years and above, who were diagnosed to have non-venereal genital dermatoses during the study period. A detailed history was obtained and clinical examination done with relevant investigations when necessary. The dermatology life quality index was assessed and graded in all patients using Finlay dermatology life quality index questionnaire. RESULTS A total of 293 patients with non-venereal genital dermatoses were seen and 25 different dermatoses were observed. Men 242(82.6%) outnumbered women. The commonest age group affected was 31-50 years 144(50%). Chronic inflammatory dermatoses 135(41.6%) constituted the majority of cases. Scrotal dermatitis 46(15.7%), lichen simplex chronicus 37(12.6%), vitiligo 31(10.6%) were seen most frequently. In the study group, 111(37.9%) patients had moderate and 133(45.4%) had large impact on the quality of life. Erectile dysfunction was seen in 48(19.8%) men and 9(3.7%) had premature ejaculation. A significant effect on dermatology life quality index was found with increasing age (P = 0.007), positive marital status (P = 0.006), history of unprotected sex (P < 0.001), history of recurrences (P = 0.002) and venereophobia. (P = 0.008). LIMITATIONS The number of women in the study group was less compared to men and we could not ascertain the type of sexual dysfunction in them. CONCLUSION Non-venereal genital dermatoses are common, more so among men. They have a significant impact on the quality of life of the individual. Recognizing and addressing this problem will help in managing these patients effectively.
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Affiliation(s)
- N Vinay
- Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - P S S Ranugha
- Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Jayadev B Betkerur
- Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Veeranna Shastry
- Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - P K Ashwini
- Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Everaars KE, Welbie M, Hummelink S, Tjin EPM, de Laat EH, Ulrich DJO. The impact of scars on health-related quality of life after breast surgery: a qualitative exploration. J Cancer Surviv 2021; 15:224-233. [PMID: 32816201 PMCID: PMC7966197 DOI: 10.1007/s11764-020-00926-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/01/2020] [Indexed: 12/02/2022]
Abstract
PURPOSE The purpose of this research was to explore women's experiences after breast surgery with scar characteristics and symptoms, and its impact on their health-related quality of life (HRQOL). MATERIAL AND METHODS A qualitative study using semi-structured face-to-face interviews was conducted among women following prophylactic, oncologic, or reconstructive breast surgery in the Netherlands. A directed content analysis was performed using guiding themes. Themes were "physical and sensory symptoms," "impact of scar symptoms," "personal factors," "impact of scar interventions," and "change over time." RESULTS The study population consisted of 26 women after breast surgery. Women experienced a wide range of symptoms like adherence, stiffness, pain, and uncomfortable sensations. Scar characteristics as visibility, location, texture, and size, influenced satisfaction with their appearance. The impact of scar symptoms is reflected in physical, social, emotional, and cognitive functioning, thereby affecting HRQOL. The experienced impact on HRQOL depended on several factors, like personal factors as the degree of acceptance and environmental factors like social support. CONCLUSION Women can experience a diversity of scar characteristics and symptoms, which play a central role in the perceived impact on HRQOL. Since scarring can have a considerable impact on HRQOL, scarring after prophylactic, oncologic and reconstructive breast surgery should be given more attention in clinical practice and research. IMPLICATIONS FOR CANCER SURVIVORS Considering scarring as a common late effect after breast surgery and understanding the variety of experiences, which could impact HRQOL of women, can be beneficial in sufficient information provision, expectation management, and informed decision making.
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Affiliation(s)
- Kristel E. Everaars
- Department of Plastic Surgery, Radboudumc, Geert Grooteplein-Zuid 10, 6500 HB Nijmegen, The Netherlands
- Research Center Healthy and Sustainable Living, Research group Innovation in Healthcare Processes in Pharmacology, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands
| | - Marlies Welbie
- Research Center Healthy and Sustainable Living, Research group Methodology of Practice-Based Research, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands
| | - Stefan Hummelink
- Department of Plastic Surgery, Radboudumc, Geert Grooteplein-Zuid 10, 6500 HB Nijmegen, The Netherlands
| | - Esther P. M. Tjin
- Research Center Healthy and Sustainable Living, Research group Innovation in Healthcare Processes in Pharmacology, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands
| | - Erik H. de Laat
- Department of Plastic Surgery, Radboudumc, Geert Grooteplein-Zuid 10, 6500 HB Nijmegen, The Netherlands
| | - Dietmar J. O. Ulrich
- Department of Plastic Surgery, Radboudumc, Geert Grooteplein-Zuid 10, 6500 HB Nijmegen, The Netherlands
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Patient Perspectives of the Social, Emotional and Functional Impact of Alopecia Areata: A Systematic Literature Review. Dermatol Ther (Heidelb) 2021; 11:867-883. [PMID: 33770385 PMCID: PMC8163950 DOI: 10.1007/s13555-021-00512-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Alopecia areata (AA) is a chronic, autoimmune disease of hair loss, which can significantly affect the emotional and psychological well-being of patients. A systematic literature review was conducted to better understand the burden of AA from the patient perspective. Methods Embase, MEDLINE and Cochrane databases were searched for published studies (2008–2018) reporting on assessments of health-related quality of life (HRQoL) for patients with AA. Qualitative, and quantitative data were collected. Results The review included 37 studies encompassing a range of clinical outcome assessment (COA) tools. None of the COA tools were specific for AA, and only one study used the Hairdex scale, which was designed to evaluate HRQoL in patients with disorders of the hair and scalp. All studies reported substantial impact on HRQoL due to AA, both overall and in domains related to personality (i.e. temperament and character), emotions and social functioning. Acute stress was also noted, and several studies identified lack of emotional awareness (alexithymia) in 23–50% of the patients with AA. Conclusions Although it is well-established that patients with AA experience anxiety and depression, they also experience a decrease in HRQoL in many other areas, including personality, emotions, behaviors and social functioning, and these changes may be accompanied by acute stress and alexithymia. There is a need to achieve consensus on a core set of measures for AA and to develop and validate AA-specific measurement tools for use in future studies, to attain a clearer understanding of the impact of AA on patients. Trial Registration PROSPERO registration number; CRD42019118646. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00512-0. Alopecia areata (AA) is a disease in which a person’s immune system attacks their hair follicles, from which hairs grow, causing hair loss. Studies have shown that people with AA may have a lower quality of life, and studies have reported higher rates of depression and anxiety in people with AA than in people without AA. Study design: We reviewed published studies to better understand how AA affected people socially, emotionally and in their day-to-day functioning. We also looked at how healthcare providers measured these social, emotional and day-to-day effects on people with AA. Our review included 37 published studies that used several evaluation tools to measure the impacts of AA. These included a variety of questionnaires that were answered by people with AA. Results: The studies reported that AA negatively affected the personality, emotions, behaviors and/or social functioning of many people with AA. However, none of the evaluation tools that were used in those studies were specific for AA, and most of the evaluation tools did not include questions about the hair or scalp. Conclusions: We recommend that a group of people familiar with AA (practitioners, researchers and patients) work together to develop an evaluation tool that is designed specifically for people with AA. This evaluation tool can then be used in future studies to better understand how AA affects people socially, emotionally and in their day-to-day functioning.
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DEVELOPMENT OF THE EMULGE LFOR THE ANDROGENIC ALOPECIA TREATMENT. EUREKA: HEALTH SCIENCES 2020. [DOI: 10.21303/2504-5679.2020.001427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Androgenic alopecia (AGA) is the most common alopecia that is heritable, androgen-dependent and occurs in both sexes with defined patterns such as Male pattern hair loss in men and Female pattern hair loss in women. AGA affects at least 50 % of men by the age of 50 years, and up to 70 % of all males in later life.
The aim.The research was aimed to substantiate the optimal concentration of excipients and active pharmaceutical ingredients (APIs) of the emulgel intended for the topical treatment of androgenic alopecia.
Materials and methods. In this study the samples of the emulgel bases containing different carbomer Ultrez10 concentrationsin the range of 0.3–0.6 % and its neutralizers (0.1 % of potassium sorbate and 0 % or 0.2 % of triethanolamine) were used. Colloidal and thermal stability, pH, rheological properties (structural viscosity, mechanical stability, degree of thixotropy) of these samples were determined. The emulgel samples with different percentages of the Serenoa repens dry extract and the Sophora japonica tincture were used in the biopharmaceutical studies. The samples of the emulgel with the antioxidant butylhydroxytoluene different concentrations (0 %, 0.01 %, 0.02 %, 0.03 %) were used to determine acid value during 1 year of the emulgel storage.
Results and discussion. It was experimentally substantiated the optimal ratio of the emulgel ingredients that provide good APIs release and necessary consumer properties of the semi-solid remedy like application compliance, safety and storage stability.
Conclusions. Physicochemical, rheological and biopharmaceutical properties of emulgel bases have been studied. It was found that the base №2 (in which the concentrations of Carbomer Ultraz 10, potassium sorbate and triethanolamine are 0.3 %, 0.1 %, 0.2 % respectively) possessed the optimal properties. Considering the results of the complete range of experimental research it was developed the final formulation of the emulgel intended for AGA treatment which included the concentration of the APIs, neutralizers, preservatives, antioxidant and fragrance.
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Gómez-Escobar LG, Mora-Ochoa H, Vargas Villanueva A, Spineli L, Sanclemente G, Couban R, García E, Chapman E, Yepes-Nuñez JJ. Effectiveness and adverse events of topical and allergen immunotherapy for atopic dermatitis: a systematic review and network meta-analysis protocol. Syst Rev 2020; 9:222. [PMID: 32988419 PMCID: PMC7523328 DOI: 10.1186/s13643-020-01472-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is an inflammatory chronic condition that affects the skin of children and adults and has an important impact on the quality of life. Treatments for AD are based on environmental controls, topical and systemic therapies, and allergen-specific immunotherapy (AIT). However, it remains unclear the effectiveness and adverse events of AIT and all conventional topical treatments compared with placebo and each other for AD. METHODS We will search five electronic databases [Central Cochrane register of controlled trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and LILACS] from inception until November 2019 with no language restriction, and we will include experimental studies [randomized controlled trials (RCTs), and quasi-RCTs]. The primary outcome is global and specific skin symptoms assessment. Secondary outcomes are hospital length of stay, quality of life, and adverse events. Reviewers independently will extract data from the studies that meet our inclusion criteria and will assess the risk of bias of individual primary studies. We will conduct random effects pairwise meta-analyses for the observed pairwise comparisons with at least two trials. Then, we will perform random-effects Bayesian network meta-analysis (NMA) to obtain treatment effects for all possible comparisons and to provide a hierarchy of all interventions for each outcome. Possible incoherence between direct and indirect sources of evidence will be investigated locally (if possible) and globally. To investigate sources of statistical heterogeneity, we will perform a series of meta-regression analyses based on pre-specified important effect modifiers. Two authors will appraise the certainty of the evidence for each outcome applying the GRADE's framework for NMA. DISCUSSION The findings of this systematic review will shed the light on the effectiveness and adverse events of all possible comparisons for treating AD and on the quality of the collated evidence for recommendations. It will also provide critical information to health care professionals to comprehend and manage this disease at different age stages, treatment type, duration, and severity of atopic dermatitis. SYSTEMATIC REVIEW REGISTRATION PROSPERO Protocol ID CRD42019147106.
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Affiliation(s)
| | | | | | - Loukia Spineli
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | | | - Rachel Couban
- Department of Health Research Methods, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth García
- Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá D.C., Colombia
| | - Edgardo Chapman
- Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá D.C., Colombia
| | - Juan José Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá D.C., Colombia. .,Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá D.C., Colombia.
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23
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Ezzedine K, Bennani M, Shourick J, Taieb C. A Method for Designing a Patient Burden Questionnaire in Dermatology. Clin Cosmet Investig Dermatol 2020; 13:521-528. [PMID: 32821144 PMCID: PMC7417926 DOI: 10.2147/ccid.s260323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/07/2020] [Indexed: 12/02/2022]
Abstract
Introduction In recent years, the concept of “disease burden” has been given a central role in evaluating patient care, particularly in skin diseases. Measuring patient-reported outcomes (PRO) such as symptoms and disease burden may be useful. Aim To present a methodology that facilitates the development and validation of burden questionnaires for patients suffering from skin diseases. Methodology Based on past published burden questionnaires, a methodology for designing skin disease burden questionnaires was to be developed. Results Based on 16 burden questionnaires developed and published over the last 10 years, the authors propose a standardized methodology for the easy design and validation of disease burden questionnaires for patients with chronic skin diseases. The authors provide detailed guidance for the conception, development and validation of the questionnaires, including reliability, internal consistency, external validity, cognitive debriefing, testing–retesting, translation and cross-cultural adaptation, as well as for statistical analysis. Conclusion The proposed methodology enhances the design and validation of disease burden questionnaires in dermatology. Burden questionnaires may be used in clinical research as well as in daily clinical practice.
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Affiliation(s)
- Khaled Ezzedine
- University Hospital Henri-Mondor, Department of Dermatology, Créteil, France
| | | | | | - Charles Taieb
- Necker Enfants Malades Hospital, Paris, France.,European Market Maintenance Assessment, Paris, France
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24
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Turan Ç, Metin N, Utlu Z, Öner Ü, Kotan ÖS. Change of the diagnostic distribution in applicants to dermatology after COVID-19 pandemic: What it whispers to us? Dermatol Ther 2020; 33:e13804. [PMID: 32530503 PMCID: PMC7300472 DOI: 10.1111/dth.13804] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 01/09/2023]
Abstract
We aim to evaluate the change in the diagnostic spectrum in dermatology outpatient applications compared to before COVID-19. All patients were enrolled from the Department of Dermatology between February 12 and May 8, 2020, the duration of 4 weeks before COVID-19 and 8 weeks after were analyzed in three parts consisting of 4 weeks. Data obtained from the database such as age, gender, diagnoses were anonymized. Repeated applications with the same diagnosis in 10 days after the first presentation were ignored. Compared to the pre-outbreak, there was a 3.5-fold decrease in dermatology applications in the first month after COVID-19 and an 8.8-fold in the second month. We found a significant increase in the frequency of diagnoses such as generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster after COVID-19. The frequency declined in diseases such as verruca vulgaris, hyperpigmentation, skin tag, melanocytic nevus, and seborrheic keratosis/solar lentigo. It has been found that the frequencies of most diseases, including acne (⁓25% of patients), did not change. We think that many factors, such as affecting the quality of life, risk perception, increased stress burden may cause a change in the diagnostic distribution of the dermatology applications.
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Affiliation(s)
- Çağrı Turan
- Department of Dermatology and Venereology, the Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Nurcan Metin
- Department of Dermatology and Venereology, the Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Zeynep Utlu
- Department of Dermatology and Venereology, the Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ümran Öner
- Department of Dermatology and Venereology, the Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Özgür Sadık Kotan
- Department of Dermatology and Venereology, the Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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25
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Andra C, Suwalska A, Dumitrescu AM, Kerob D, Delva C, Hasse-Cieślińska M, Solymosi A, Arenbergerova M. A Corrective Cosmetic Improves the Quality of Life and Skin Quality of Subjects with Facial Blemishes Caused by Skin Disorders. Clin Cosmet Investig Dermatol 2020; 13:253-257. [PMID: 32280256 PMCID: PMC7125304 DOI: 10.2147/ccid.s240437] [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] [Received: 11/28/2019] [Accepted: 02/27/2020] [Indexed: 11/23/2022]
Abstract
Background Facial blemishes resulting from skin disorders have a significant effect on the patient’s self-esteem and impact quality of life (QOL). Aim To assess the impact of a corrective cosmetic (CC) on QOL on top of skin quality parameters. Methods An international observational study was conducted on subjects with visible facial flaws that would benefit from a corrective cosmetic. Investigators collected data regarding demographics, QOL using the Skindex-16 scale, skin dryness and tautness, subject and investigator satisfaction, cosmetic acceptability and tolerance at baseline and after 4 to 6 weeks of daily use. Results A total of 1840 subjects participated; the mean age was 31.5±11.1 and 95% were women. Acne accounted for 48.9% of skin conditions, followed by melasma (16.7%) and rosacea (15.3%). Of the subjects 81.2% had at least 10% of the face affected and the condition was rated as disfiguring by 45.3% of the subjects; 45.0% and 44.4%, respectively, had neither taut nor dry skin at baseline. Baseline Skindex-16 scores for symptoms, emotions, functioning and overall were 1.4±1.3, 3.5±1.6, 2.4±1.8 and 2.4±1.3, respectively, on a scale from 0 to 6. Compliance was 96.0±10.6%. At the end of the study, Skindex-16 scores had significantly (p<0.0001) improved for all parameters, as did skin dryness and tautness. Subject and investigator satisfaction were high or very high; cosmetic acceptability was high or very high and local tolerance good or very good. Conclusion The tested corrective cosmetic significantly improved the QOL of subjects with significant facial flaws, skin tautness and dryness, and was well tolerated.
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Affiliation(s)
| | | | | | | | | | | | | | - Monika Arenbergerova
- Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Department of Dermatovenereology, Prague, Czech Republic
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26
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Cannabinoids in the Pathophysiology of Skin Inflammation. Molecules 2020; 25:molecules25030652. [PMID: 32033005 PMCID: PMC7037408 DOI: 10.3390/molecules25030652] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/26/2020] [Accepted: 02/02/2020] [Indexed: 12/22/2022] Open
Abstract
Cannabinoids are increasingly-used substances in the treatment of chronic pain, some neuropsychiatric disorders and more recently, skin disorders with an inflammatory component. However, various studies cite conflicting results concerning the cellular mechanisms involved, while others suggest that cannabinoids may even exert pro-inflammatory behaviors. This paper aims to detail and clarify the complex workings of cannabinoids in the molecular setting of the main dermatological inflammatory diseases, and their interactions with other substances with emerging applications in the treatment of these conditions. Also, the potential role of cannabinoids as antitumoral drugs is explored in relation to the inflammatory component of skin cancer. In vivo and in vitro studies that employed either phyto-, endo-, or synthetic cannabinoids were considered in this paper. Cannabinoids are regarded with growing interest as eligible drugs in the treatment of skin inflammatory conditions, with potential anticancer effects, and the readiness in monitoring of effects and the facility of topical application may contribute to the growing support of the use of these substances. Despite the promising early results, further controlled human studies are required to establish the definitive role of these products in the pathophysiology of skin inflammation and their usefulness in the clinical setting.
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27
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Rastogi MK, Mohan R, Gahalaut P, Mishra N, Thapa M. Effect of Topical Steroid-Dependent Facial Dermatitis on Quality of Life: A Hospital-Based Cross-Sectional Study Using DLQI. Indian J Dermatol 2020; 64:465-470. [PMID: 31896845 PMCID: PMC6862370 DOI: 10.4103/ijd.ijd_176_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The rampant, disturbing, and dismal unrestricted use of topical corticosteroids on face results in steroid-induced dermatitis termed topical steroid-dependent face (TSDF). It is an embarrassing and irritating condition for a patient. There is paucity of data from India regarding the effect of TSDF on the quality of life (QoL) of such patients. Aims The aim of this study was to study the effect of TSDF on the QoL of patients with the help of a validated, easy-to-use, and reproducible dermatology life quality index (DLQI). Methods A cross-sectional study was done among the outpatients seeking treatment for TSDF at a tertiary care hospital of a medical college. Patients were administered Hindi questionnaire version of DLQI. Controls were apparently healthy age- and sex-matched individuals. Results DLQI scores revealed that TSDF had some effect on QoL in 98.11% of study patients. Study group had a mean DLQI score of 11.49. Statistically significant higher DLQI scores were recorded among females, patients aged <20 years and those who had no formal education/illiterate. Conclusions TSDF affects QoL in majority of patients and it has a very large effect on the QoL in more than one-third of the patients.
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Affiliation(s)
- Madhur K Rastogi
- Department of Dermatology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Rikta Mohan
- Department of Dermatology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Pratik Gahalaut
- Department of Dermatology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Nitin Mishra
- Department of Dermatology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Manisha Thapa
- Department of Dermatology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
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28
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Ribeiro Santos Morard M, Betanho Martins R, Lopes Ribeiro AC, Guimarães Rocha Lima P, dos Santos Carvalho B, Junior JCBS. Primary hyperhidrosis prevalence and characteristics among medical students in Rio de Janeiro. PLoS One 2019; 14:e0220664. [PMID: 31518360 PMCID: PMC6744157 DOI: 10.1371/journal.pone.0220664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background Hyperhidrosis is a pathological condition defined by excessive sweating beyond thermoregulatory physiological needs, which can cause substantial psychological impact and impairment of daily activities. Studies regarding its prevalence, however, are scarce and vary widely in their findings. The population of medical students is a particularly interesting subset for its recurring demand of physical contact during patient examination or procedures, and the potential for professional adversity. We aimed at furthering the comprehension of this disease prevalence and characteristics among medical students. Methods Questionnaires inquiring about the presence and characteristics of Primary Hyperhidrosis (PH) were applied through either written or digital means to all eligible medical students enrolled in three Medical Schools in the State of Rio de Janeiro who agreed to take part in the study. Demographic data regarding gender, ethnicity, current age, weight and height was collected in addition to clinical data (sweat site, age of onset, familial history, severity and previous treatments). Severity was evaluated through the Hyperhidrosis Disease Severity Scale (HDSS) and a symptoms survey. Findings Our response rate was roughly 1/3 of all eligible students (900/2700). PH prevalence was 20.56% (185/900). It was similar between men and women (23.08% and 19.41%, respectively) and strongly associated with family history of the disease (Prevalence Ratio of 4.27). Regarding ethnicity, of the total sample 73.78% (664/900) self-declared white, among which 19.28% (128/664) had PH. Mixed-race and other ethnicities encompassed 26.22% (236/900) of the sample, among which 24.15% (57/236) had PH. Most positive subjects (64.32%) presented associated forms of PH. Overall involvement of each site (both associated and isolated) was: 63.78% axillary, 50.81% palmar, 43.24% plantar, 20.54% craniofacial, 18.38% facial flushing and 2.16% gustatory sweating. Mean current age was 23.11(±4.04) years for PH patients, and age of onset was ≤18 years in 93.94% of cases. Regarding body mass index (BMI), 71.09% of PH patients had BMI<25kg/m2 and only 4.69% presented BMI≥30kg/m2, none ≥35kg/m2. Some degree of life quality impairment was reported by 89.20% of PH patients, and 23.89% had HDSS 3 or 4 (moderate to severe). Conclusions PH prevalence among Rio de Janeiro medical students was 20.56%, similar between men and women, predominating associated presentations, axillary, palmar and plantar sites, strong familial history, age of onset before 18 years, and some degree of life impairment.
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Affiliation(s)
- Maria Ribeiro Santos Morard
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- UNESA—Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | - Ricardo Betanho Martins
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | | | - Pedro Guimarães Rocha Lima
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- FMP–Faculdade de Medicina de Petrópolis, Petrópolis, RJ, Brazil
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29
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Molloy K, Jonak C, Woei‐A‐Jin F, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (
PROCLIPI
) study. Br J Dermatol 2019; 182:770-779. [DOI: 10.1111/bjd.18089] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/01/2023]
Affiliation(s)
- K. Molloy
- University Hospitals Birmingham Birmingham U.K
| | - C. Jonak
- Medical University of Vienna Vienna Austria
| | | | | | | | | | | | - R. Knobler
- Medical University of Vienna Vienna Austria
| | - S. Porkert
- Medical University of Vienna Vienna Austria
| | | | - R. Cowan
- Christie Hospital Manchester U.K
| | | | - M. Beylot‐Barry
- Centre Hospitalier Universitaire Hospital de Bordeaux Bordeaux France
| | - E. Berti
- Department of Dermatology Fondazione Ca’ Granda IRCCS OMP Milan Italy
| | | | - T. Estrach
- Hospital Clinico University of Barcelona Barcelona Spain
| | | | - O. Akilov
- University of Pittsburgh School of Medicine Pittsburgh PA U.S.A
| | - L. Vakeva
- Helsinki University Central Hospital Helsinki Finland
| | - M. Prince
- Peter MacCallum Cancer Centre Melbourne Australia
| | - A. Bates
- University Hospital Southampton Southampton U.K
| | | | | | | | | | - O. Servitje
- Hospital Universatari de Bellvitge Barcelona Spain
| | | | | | - M. Wobser
- University Hospital Würzburg Würzburg Germany
| | - J.A. Sanches
- University of São Paulo Medical School São Paulo Brazil
| | - P. McKay
- Beatson West of Scotland Cancer Centre Glasgow U.K
| | - D. Klemke
- Stadtisches Klinikum Karlsruhe Karlsruhe Germany
| | - C. Peng
- University Hospitals Birmingham Birmingham U.K
| | - A. Howles
- University Hospitals Birmingham Birmingham U.K
| | - J. Yoo
- University Hospitals Birmingham Birmingham U.K
| | - F. Evison
- University Hospitals Birmingham Birmingham U.K
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30
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Vasquez D, Aguirre DC, Sanclemente G. Construct validity and responsiveness of the Colombian version of Skindex-29. Br J Dermatol 2019; 181:770-777. [PMID: 30729508 DOI: 10.1111/bjd.17742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent years, the need for international, objective, patient-reported outcomes measures has grown as international collaboration has increased. As most quality-of-life scales have been developed in English, there is a growing need to adapt them transculturally to obtain equivalence between the original instrument and the adapted scale. OBJECTIVES To assess the construct and convergent-discriminant validity and responsiveness of the Colombian version of Skindex-29. METHODS The cross-sectional and longitudinal validity and responsiveness were tested in both healthy and dermatology patients. Construct validity was tested through a confirmatory factor analysis. The convergent-discriminant validity was assessed by examining the Spearman correlation coefficient. Change sensitivity was tested by means of the standardized response mean. The effect size and the minimum detectable change were also assessed. RESULTS A total of 265 participants were included; 21·1% were healthy individuals, and 78·9% patients had either inflammatory or noninflammatory skin diseases. Confirmatory factor analysis showed an adequate comparative fit index and Tucker-Lewis index adjustment for the root mean square error of approximation. Convergent validity showed moderate correlations between the emotions, functioning and physical function or physical role domains. Discriminant validity showed low correlations between overall domains for both scales. Sensitivity to change at the first and third month showed effect sizes in global Skindex scores of 0·92 and 0·82, respectively. CONCLUSIONS The Colombian version of Skindex-29 is a valid and clinically sensitive instrument, which can be used for clinical practice and for research to measure the impact of skin diseases on the quality of life of dermatology patients.
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Affiliation(s)
- D Vasquez
- Institute of Medical Research, School of Medicine, University of Antioquia, Medellín, Colombia
| | - D-C Aguirre
- Institute of Medical Research, School of Medicine, University of Antioquia, Medellín, Colombia
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31
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Mieras LF, Taal AT, Post EB, Ndeve AGZ, van Hees CLM. The Development of a Mobile Application to Support Peripheral Health Workers to Diagnose and Treat People with Skin Diseases in Resource-Poor Settings. Trop Med Infect Dis 2018; 3:E102. [PMID: 30274498 PMCID: PMC6160956 DOI: 10.3390/tropicalmed3030102] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022] Open
Abstract
The high prevalence of skin diseases in resource-poor settings, where health workers with sufficient knowledge of skin diseases are scarce, calls for innovative measures. Timely diagnosis and treatment of skin diseases, especially neglected tropical diseases (NTDs) that manifest with skin lesions, such as leprosy, is crucial to prevent disabilities as well as psychological and socioeconomic problems. Innovative technological methods like telemedicine and mobile health (mHealth) can help to bridge the gap between the burden of skin diseases and the lack of capable staff in resource-poor settings by bringing essential health services from central level closer to peripheral levels. Netherlands Leprosy Relief (NLR) has developed a mobile phone application called the 'SkinApp', which aims to support peripheral health workers to recognize the early signs and symptoms of skin diseases, including skin NTDs, and to start treatment promptly or refer for more advanced diagnostic testing or disease management when needed. Further research is needed to determine how greatly mHealth in general and the SkinApp in particular can contribute to improved health outcomes, efficiency, and cost-effectiveness.
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Affiliation(s)
- Liesbeth F Mieras
- Technical Department, Netherlands Leprosy Relief, 1090 HA Amsterdam, The Netherlands.
| | - Anna T Taal
- Technical Department, Netherlands Leprosy Relief, 1090 HA Amsterdam, The Netherlands.
| | - Erik B Post
- Challenge TB, KNCV Tuberculosis Foundation, Jakarta 12870, Indonesia.
| | - Alcino G Z Ndeve
- Technical Department, Netherlands Leprosy Relief, Maputo, Mozambique.
| | - Colette L M van Hees
- Department of Dermatology, Erasmus Medical Centre, 3000 CA Rotterdam, The Netherlands.
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32
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Radiation Effects of Mobile Phones and Tablets on the Skin: A Systematic Review. Adv Med 2018; 2018:9242718. [PMID: 29850642 PMCID: PMC5925203 DOI: 10.1155/2018/9242718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/21/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Skin health has become a worldwide concern. Most of the studies investigated the effect of mobile phone radiation on DNA and animals, but a few studies were carried out about skin diseases in mobile phone and tablet users. Few systematic studies have examined the relationship between mobile phone exposure and skin diseases. METHODS We evaluated the association between mobile phones and tablets and skin diseases. We checked databases including PubMed, Scopus, Springer, Cochrane, and Google Scholar from 1995 to 2013. The eligibility criteria were descriptive, and observational studies were in English and Persian language, and the subjects were of all ages and reported skin disease. RESULTS Most of the studies focused on signs and less on skin cancer. In total, 6 studies were included with 392119 participants with age over 25 years. In a nationwide cohort study in Denmark for BCC, the IRR (incidence rate ratios) estimates remained near unity among men and women. In the other studies, they reported an increase in temperature, hypersensitivity of warmth, facial dermatitis, angiosarcoma of the scalp, and burning sensations in the facial skin after mobile phone use on the exposed side and more within the auricle and behind/around the ear. CONCLUSIONS Overall evaluations showed that the level of evidence associated with the effects of radiation from the mobile phone and tablet on the skin is poor. This review shows a necessity for more studies in this area.
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33
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de María Díaz Granados L, Quijano MA, Ramírez PA, Aguirre N, Sanclemente G. Quality assessment of atopic dermatitis clinical practice guidelines in ≤ 18 years. Arch Dermatol Res 2017; 310:29-37. [PMID: 29127480 DOI: 10.1007/s00403-017-1791-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/13/2017] [Accepted: 11/01/2017] [Indexed: 12/13/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects the patients' quality of life greatly often from a very young age. Its worldwide incidence in children and adults varies, but it is usually among the first ten causes of dermatological consultation worldwide. There is a wide variety of treatment options for this condition including topical and systemic regimes. The decision to choose a treatment option in dermatological diseases is greatly influenced by the personal experience of each specialist, which increases variability in the selection of available therapies. Clinical practice guidelines (CPGs) not only offer recommendations supported on the available scientific evidence, but also are intended to assist in making appropriate decisions in clinical scenarios. To standardize the way in which CPGs should be developed, an instrument called AGREE II (Appraisal of Guidelines for Research and Evaluation) is used. In this study, ten clinical practice guidelines in ≤ 18 years were evaluated. Six domains (scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence) were assessed for each guideline, by three reviewers. Most of the domains obtained high scores except in the applicability domain. It is suggested that future atopic dermatitis CPGs should emphasize in the facilitating factors and barriers that may influence the application of guideline recommendations.
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Affiliation(s)
- Luz de María Díaz Granados
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - María Adelaida Quijano
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Paola Andrea Ramírez
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Natalia Aguirre
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia.,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia
| | - Gloria Sanclemente
- Group of Investigative Dermatology (GRID), Universidad de Antioquia, Carrera 25 A # 1 A Sur 45, Of 2026, Torre Médica El Tesoro, Medellín, Colombia. .,, Carrera Cra. 51d #62-29, Edif. MUA of.303, Medellín, Antioquia, Colombia. .,IPS Universitaria, Universidad de Antioquia, Cra. 51c #62-42, Medellín, Colombia.
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