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Stephan B, Rustenbach SJ, Ben-Anaya N, Augustin M, Boehncke WH, Hertl M, Mrowietz U, Staubach-Renz P, Thaçi D, von Kiedrowski R, Sorbe C. Basic Susceptibility of Patients with Psoriasis under Systemic Therapy for Respiratory Infections: Data from the German Psoriasis Registry PsoBest. J Clin Med 2024; 13:3713. [PMID: 38999279 PMCID: PMC11242749 DOI: 10.3390/jcm13133713] [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: 04/29/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Patients with psoriasis under systemic treatments are in focus regarding their susceptibility to respiratory infections. To analyse real-world data for respiratory infections in patients with psoriasis under systemic treatments. Methods: We analysed data of the prospective, non-interventional German Psoriasis Registry PsoBest and compared rates for respiratory infections of 13,823 patients on systemic treatments for psoriasis and/or psoriatic arthritis in different therapy cohorts before the COVID-19 pandemic. Results: In total, 1415 respiratory infections were observed in 970 patients. Significant differences were observed between biologics and non-biologics, but not within these groups. The highest event rates (events/100 patient years) were identified for TNF-α inhibitors, 8.1, (CI 7.4-8.9), followed by 7.0 for IL-17 inhibitors (6.2-7.9), 5.7 for IL-12/23 and IL-23 inhibitors (5.1-6.5), 4.8 for methotrexate (4.3-5.4), 3.7 for small molecules (3.3-4.2), and 2.7 for retinoids (1.2-5.1). Conclusions: Overall, the susceptibility for respiratory infections in patients under systemic therapy for psoriasis is low compared to published study data and is sufficient as comparative data for COVID-19 studies.
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Affiliation(s)
- Brigitte Stephan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Stephan Jeff Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Nesrine Ben-Anaya
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Wolf-Henning Boehncke
- Department of Dermatology and Venereology, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Michael Hertl
- Department of Dermatology, University Hospital Marburg, 35043 Marburg, Germany;
| | - Ulrich Mrowietz
- Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany;
| | - Petra Staubach-Renz
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany;
| | | | - Christina Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
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2
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Schön MP. The tick and I: Parasite-host interactions between ticks and humans. J Dtsch Dermatol Ges 2022; 20:818-853. [PMID: 35674196 DOI: 10.1111/ddg.14821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Ticks, particularly hard ticks (Ixodidae), which are among the most important vectors of dangerous infectious agents, feed on their hosts for extended periods of time. With this lifestyle, numerous adaptations have evolved in ticks and their hosts, the pharmacological importance of which is increasingly being recognized. Many bioactive substances in tick saliva are being considered as the basis of new drugs. For example, components of tick cement can be developed into tissue adhesives or wound closures. Analgesic and antipruritic salivary components inhibit histamine or bradykinin, while other tick-derived molecules bind opioid or cannabinoid receptors. Tick saliva inhibits the extrinsic, intrinsic, or common pathway of blood coagulation with implications for the treatment of thromboembolic diseases. It contains vasodilating substances and affects wound healing. The broad spectrum of immunomodulatory and immunosuppressive effects of tick saliva, such as inhibition of chemokines or cellular immune responses, allows development of drugs against inflammation in autoimmune diseases and/or infections. Finally, modern vaccines against ticks can curb the spread of serious infections. The medical importance of the complex tick-host interactions is increasingly being recognized and translated into first clinical applications. Using selected examples, an overview of the mutual adaptations of ticks and hosts is given here, focusing on their significance to medical advance.
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Affiliation(s)
- Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Germany
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3
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Schön MP. Die Zecke und ich: Parasiten-Wirt-Interaktionen zwischen Zecken und Menschen. J Dtsch Dermatol Ges 2022; 20:818-855. [PMID: 35711058 DOI: 10.1111/ddg.14821_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
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4
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Diamanti E, Föhr J, Papageorgiou A, Herbst M, Jahn S. Immunologie in der dermatologischen Praxis – wieviel, warum, wann? AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1699-5440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ZusammenfassungDie Haut als Grenzorgan zum Körperäußeren realisiert viele immunologische Abwehrfunktionen. Folglich sind Immunologie und Dermatologie eng miteinander verknüpft. Die Diagnostik immunologischer Hauterkrankungen und deren Immuntherapie, labormedizinische Analysen, Hyposensibilisierung – Begegnungen mit der Immunologie finden auch in einer dermatologischen Praxis im Alltag nahezu ständig statt. Ziel dieser Arbeit ist es, praxisnah aufzuzeigen, wie uns Dermatologen die Immunologie in unserer Fachdisziplin helfen kann.
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Affiliation(s)
| | - Julia Föhr
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
- Klinik für Dermatologie und Allergologie, Philipps-Universität Marburg
| | | | - Matthias Herbst
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
| | - Sigbert Jahn
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
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5
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Hollstein MM, Münsterkötter L, Schön MP, Bergmann A, Husar TM, Abratis A, Eidizadeh A, Schaffrinski M, Zachmann K, Schmitz A, Holsapple JS, Stanisz‐Bogeski H, Schanz J, Fischer A, Groß U, Leha A, Zautner AE, Schnelle M, Erpenbeck L. Interdependencies of cellular and humoral immune responses in heterologous and homologous SARS-CoV-2 vaccination. Allergy 2022; 77:2381-2392. [PMID: 35124800 PMCID: PMC9111248 DOI: 10.1111/all.15247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 12/27/2022]
Abstract
Background Homologous and heterologous SARS‐CoV‐2 vaccinations yield different spike protein‐directed humoral and cellular immune responses. This study aimed to explore their currently unknown interdependencies. Methods COV‐ADAPT is a prospective, observational cohort study of 417 healthcare workers who received vaccination with homologous ChAdOx1 nCoV‐19, homologous BNT162b2 or with heterologous ChAdOx1 nCoV‐19/BNT162b2. We assessed humoral (anti‐spike‐RBD‐IgG, neutralizing antibodies, and avidity) and cellular (spike‐induced T‐cell interferon‐γ release) immune responses in blood samples up to 2 weeks before (T1) and 2–12 weeks following secondary immunization (T2). Results Initial vaccination with ChAdOx1 nCoV‐19 resulted in lower anti‐spike‐RBD‐IgG compared with BNT162b2 (70 ± 114 vs. 226 ± 279 BAU/ml, p < .01) at T1. Booster vaccination with BNT162b2 proved superior to ChAdOx1 nCoV‐19 at T2 (anti‐spike‐RBD‐IgG: ChAdOx1 nCoV‐19/BNT162b2 2387 ± 1627 and homologous BNT162b2 3202 ± 2184 vs. homologous ChAdOx1 nCoV‐19 413 ± 461 BAU/ml, both p < .001; spike‐induced T‐cell interferon‐γ release: ChAdOx1 nCoV‐19/BNT162b2 5069 ± 6733 and homologous BNT162b2 4880 ± 7570 vs. homologous ChAdOx1 nCoV‐19 1152 ± 2243 mIU/ml, both p < .001). No significant differences were detected between BNT162b2‐boostered groups at T2. For ChAdOx1 nCoV‐19, no booster effect on T‐cell activation could be observed. We found associations between anti‐spike‐RBD‐IgG levels (ChAdOx1 nCoV‐19/BNT162b2 and homologous BNT162b2) and T‐cell responses (homologous ChAdOx1 nCoV‐19 and ChAdOx1 nCoV‐19/BNT162b2) from T1 to T2. Additionally, anti‐spike‐RBD‐IgG and T‐cell response were linked at both time points (all groups combined). All regimes yielded neutralizing antibodies and increased antibody avidity at T2. Conclusions Interdependencies between humoral and cellular immune responses differ between common SARS‐CoV‐2 vaccination regimes. T‐cell activation is unlikely to compensate for poor humoral responses.
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Affiliation(s)
- Moritz M. Hollstein
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Lennart Münsterkötter
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
| | - Michael P. Schön
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational Dermatology University Medical Center Göttingen Göttingen Germany
| | - Armin Bergmann
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Thea M. Husar
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Anna Abratis
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Abass Eidizadeh
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Meike Schaffrinski
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Karolin Zachmann
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Anne Schmitz
- Department of Dermatology University of Münster Münster Germany
| | | | - Hedwig Stanisz‐Bogeski
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Julie Schanz
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
- Department of Hematology and Medical Oncology University Medical Center Göttingen Göttingen Germany
| | - Andreas Fischer
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
- Division Vascular Signaling and Cancer German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Uwe Groß
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
| | - Andreas Leha
- Department of Medical Statistics University Medical Center Göttingen Göttingen Germany
| | - Andreas E. Zautner
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
- Institute of Medical Microbiology and Hospital Hygiene Medical Faculty Otto‐von‐Guericke University Magdeburg Magdeburg Germany
| | - Moritz Schnelle
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Luise Erpenbeck
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
- Department of Dermatology University of Münster Münster Germany
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6
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Wahrnehmung der Corona‐Pandemie durch Neurodermitispatienten – Ergebnisse aus dem Neurodermitisregister TREATgermany. J Dtsch Dermatol Ges 2022; 20:45-58. [PMID: 35040570 DOI: 10.1111/ddg.14655_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Claudia Helmert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Eva Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Annice Heratizadeh
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | | | - Inken Harder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Knut Schäkel
- Hautklinik, Universitätsklinikum Heidelberg, Ruprecht-Karls Universität Heidelberg
| | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | | | | | | | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie am Campus Mitte (CCM), Charité - Universitätsmedizin Berlin
| | - Uwe Schwichtenberg
- Hautpraxen Derma-nord, Derma-nord Hautarztpraxen Dr. Schwichtenberg, Bremen-Nord
| | | | | | | | | | - Thomas Werfel
- Exzellenzcluster RESIST (EXC 2155), Hannover Medizinische Hochschule Hannover
| | - Stephan Weidinger
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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7
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Perception of the coronavirus pandemic by patients with atopic dermatitis - Results from the TREATgermany registry. J Dtsch Dermatol Ges 2021; 20:45-57. [PMID: 34958179 DOI: 10.1111/ddg.14655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND TREATgermany, a registry for patients with moderate to severe atopic dermatitis (AD), established an additional questionnaire in spring 2020 to investigate the effects of the coronavirus pandemic on the daily life of patients with AD. MATERIAL AND METHODS A questionnaire was used to analyze general information regarding a patient's experience of the coronavirus pandemic and, using the Inventory of Life-Changing Events, the resulting personal burden. To analyze possible associations between disease severity (EASI score, oSCORAD, IGA, PGA, POEM), quality of life (DLQI) and personal burden, t-tests, analyses of variance and correlations were evaluated, controlled for sex and age. RESULTS 58 % (n = 233) of the included 400 registry patients reported high burden scores caused by the coronavirus pandemic, regardless of an actual infection. Men showed significantly higher burden scores than women, and younger than older respondents (both P = 0.03). There were no differences in burden scores related to the physician's assessment of disease severity. However, patients with higher quality of life impairments and higher disease severity perceived the burden of the coronavirus pandemic as less severe (DLQI P = 0.019, PGA P = 0.044). CONCLUSIONS Our data show that registry patients considered the coronavirus pandemic as a life-changing event and perceived the burden differently. This should be taken into account in the treatment of patients with moderate to severe AD as well as in further studies.
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Affiliation(s)
- Claudia Helmert
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Haufe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | | | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité Berlin, Berlin, Germany
| | | | | | - Jens Rossbacher
- Practice Jens Rossbacher/Dr. med. Klaus Spickermann, Hautzentrum, Friedrichshain, Germany
| | | | | | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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8
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Hertl M, Welzel J. Corona – und kein Ende? J Dtsch Dermatol Ges 2021; 19:1403-1404. [PMID: 34661366 DOI: 10.1111/ddg.14630_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Gamon E, Tammena D, Wattenberg M, Augenstein T. [Rare superinfection in a COVID-19 patient-A chronology]. Anaesthesist 2021; 71:38-49. [PMID: 34427689 PMCID: PMC8383027 DOI: 10.1007/s00101-021-01018-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
Bei einem 55-jährigen Mann, der sich zur elektiven Ablation bei Vorhofflimmern in der Klinik befand, wurde nach einer Reanimationssituation auf der peripheren Station ein SARS-CoV-2-Abstrich positiv getestet. Anamnestisch gab es im Vorwege gesicherten Kontakt zu einem COVID-19-positiven Patienten. Im Verlauf entwickelte sich das Vollbild einer COVID-19-Pneumonie mit umfangreicher intensivmedizinischer Behandlung. Nach rund 2‑wöchiger Therapie musste das Weaning bei erneuter Verschlechterung abgebrochen werden, und es ergaben sich bei dem wiederholt hochseptischen Patienten mikrobiologische Nachweise einer Superinfektion mit Cryptococcus neoformans und später Leclercia adecarboxylata. Der Patient wurde erfolgreich behandelt und überlebte die Erkrankung.
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Affiliation(s)
- E Gamon
- Klinik für Anästhesiologie, Intensivmedizin und Notfallmedizin, Klinikum Links der Weser, Bremen, Deutschland.
| | - D Tammena
- Klinik für Anästhesiologie, Intensivmedizin und Notfallmedizin, Klinikum Links der Weser, Bremen, Deutschland
| | - M Wattenberg
- Klinik für Anästhesiologie, Intensivmedizin und Notfallmedizin, Klinikum Links der Weser, Bremen, Deutschland
| | - T Augenstein
- Klinik für Anästhesiologie, Intensivmedizin und Notfallmedizin, Klinikum Links der Weser, Bremen, Deutschland
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10
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Jahn S, Föhr J, Diamanti E, Herbst M. [Treatment of atopic dermatitis with dupilumab : A retrospective cohort analysis from dermatological practice]. DER HAUTARZT 2021; 72:1071-1078. [PMID: 34328514 PMCID: PMC8323538 DOI: 10.1007/s00105-021-04868-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 11/28/2022]
Abstract
Wir präsentieren die Ergebnisse einer retrospektiven Datenauswertung von 44 Patienten einer Praxiskohorte, deren atopische Dermatitis (AD) über bis zu 3 Jahre mit dem IL(Interleukin)-4/13-Rezeptor-Antikörper Dupilumab behandelt wurde. Die Betreuung erfolgte in den letzten 21 Monaten in einer Spezialsprechstunde Immundermatologie, in der die aufwendige Dokumentation realisiert werden konnte. Die Charakteristika der Kohorte hinsichtlich Alters- und Geschlechterverteilung, Schwere und Dauer der Erkrankung sind vergleichbar mit den großen Patientenkollektiven der Zulassungsstudien. Die therapeutische Effizienz unter Praxis-Alltagsbedingungen erwies sich als sehr gut (Anteil Patienten EASI [Eczema Area and Severity Index] 50, 75, 90 nach 16 Wochen: 94, 84, 60 %) und anhaltend (86 % EASI 90 nach 52 Wochen Therapie). Etwa die Hälfte unserer Patienten hatte anamnestisch oder bei Therapiebeginn eine Beteiligung der Gesichtshaut und/oder Augen. Diese Patientengruppe erwies sich als betreuungsintensiver, weil die Gesichts- und periorbitale Dermatitis sowie begleitende Konjunktividen verzögert abheilten, zu Rezidiven neigten und häufig einer zusätzlichen topischen Therapie bedurften. Wir haben keine schweren Nebenwirkungen in den hier ausgewerteten 48 Patientenjahren festgestellt. Dupilumab erwies sich als sichere und effiziente Therapie für die atopische Dermatitis in der dermatologischen Praxis.
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Affiliation(s)
- Sigbert Jahn
- Dermatologische Praxis Dr. Herbst & Kollegen, Rheinstr. 7, 64283, Darmstadt, Deutschland.
| | - Julia Föhr
- Dermatologische Praxis Dr. Herbst & Kollegen, Rheinstr. 7, 64283, Darmstadt, Deutschland
| | - Evangelia Diamanti
- Dermatologische Praxis Dr. Herbst & Kollegen, Rheinstr. 7, 64283, Darmstadt, Deutschland
| | - Matthias Herbst
- Dermatologische Praxis Dr. Herbst & Kollegen, Rheinstr. 7, 64283, Darmstadt, Deutschland
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11
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Kutlu Ö, Öğüt ND, Erbağcı E, Metin A. Dermatologic comorbidities of the patients with severe COVID-19: A case-control study. Dermatol Ther 2021; 34:e14731. [PMID: 33389815 PMCID: PMC7883212 DOI: 10.1111/dth.14731] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/26/2020] [Indexed: 02/06/2023]
Abstract
The current studies focus on the association between COVID-19 and certain comorbidities. To the best of our knowledge, the association between severe COVID-19 and dermatologic comorbidities has not been reported yet. In this study, we aimed to describe the dermatologic comorbidities of patients with severe COVID-19 and compare it with the control group. Patients who have died at Uşak Training and Research Hospital due to COVID-19 and other diseases in the COVID-19 Intensive Care Units and Internal Medicine Intensive Care Units were recruited into the study. Two groups were compared with each other regarding the most common dermatologic comorbidities. A total of 198 patients including 111 patients with COVID-19 and 87 age and sex-matched patients with other diseases were enrolled in the study. The most common dermatologic comorbidities were pruritus (8.1%), eczema (6.3%), skin infections (3.6%), leukocytoclastic vasculitis (1.8%), and urticaria (0.9%) in the COVID-19 group while they were skin infections (9.2%), eczema (3.4%), pruritus (2.3%), and urticaria (1.1%) in the control group. None of patients in the control group had leukocytoclastic vasculitis. There were no significant differences between COVID-19 and control groups in terms of pruritus, eczema, skin infections, and urticaria (P values were .117, .517, .181, .505, and 1.000, respectively). In conclusion, although it is not statistically significant, it appears that pruritus and leukocytoclastic vasculitis are more common in severe COVID-19 patients. These cytokines-related diseases in the immuno-cutaneous systems may give some clues on the COVID-19 severity. Further studies are required to elucidate the relationship between the immuno-cutaneous system and COVID-19 severity.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Uşak University, Uşak, Turkey
| | - Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ece Erbağcı
- Department of Dermatology and Venereology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ahmet Metin
- Department of Dermatology and Venereology, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
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12
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Buhl T, Beissert S, Gaffal E, Goebeler M, Hertl M, Mauch C, Reich K, Schmidt E, Schön MP, Sticherling M, Sunderkötter C, Traidl‐Hoffmann C, Werfel T, Wilsman‐Theis D, Worm M. COVID‐19 und Auswirkungen auf dermatologische und allergologische Erkrankungen. J Dtsch Dermatol Ges 2020; 18:815-825. [PMID: 32881343 PMCID: PMC7461475 DOI: 10.1111/ddg.14195_g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Die durch das Coronavirus SARS‐CoV‐2 verursachte Krankheit COVID‐19 hat sich zu einer Pandemie entwickelt. Bei der Betrachtung von dermatologischen und allergologischen Krankheiten, die potenziell von COVID‐19 betroffen sind, stehen wir vor komplexen Herausforderungen, die Pathogenese und Beeinflussung verschiedener immunologischer Signalwege einschließen. Medizinische Behandlungen müssen daher im Zusammenhang mit dieser Infektion oft neu bewertet und in Frage gestellt werden. Dieser Übersichtsartikel fasst den aktuellen Wissensstand zu COVID‐19 hinsichtlich der wichtigsten dermatologischen und allergologischen Erkrankungen zusammen. Es werden aber auch die medizinischen Bereiche beschrieben, für die keine ausreichenden Daten vorliegen. Unter Zusammenfassung der publizierten Daten und grundsätzlicher pathophysiologischer Überlegungen werden hier Schlussfolgerungen für das Management unserer Patienten während der Pandemie gezogen. Wir konzentrieren uns auf häufige Hauterkrankungen mit komplexer immunologischer Pathogenese: Psoriasis, Ekzeme einschließlich atopischer Dermatitis, Typ‐I‐Allergien, blasenbildende Autoimmundermatosen, Kollagenosen, Vaskulitiden und Hautkrebserkrankung. Da viele weitere Hauterkrankungen verwandte oder vergleichbare immunologische Reaktionsmuster aufweisen, können pathophysiologisch ähnliche entzündliche Dermatosen möglicherweise auch mit ähnlichen therapeutischen Überlegungen und Schlussfolgerungen während der Pandemie behandelt werden. Daher soll diese Übersicht Behandlungsempfehlungen auf der Basis bisher publizierter Daten und Empfehlungen zu Therapieentscheidungen auch über die hier diskutierten, häufigsten Erkrankungen hinaus liefern.
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Affiliation(s)
- Timo Buhl
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum GöttingenDeutschland
- Niedersächsisches Institut für BerufsdermatologieUniversitätsklinikum GöttingenDeutschland
| | - Stefan Beissert
- Klinik für DermatologieUniversitätsklinikum Carl Gustav CarusTU DresdenDeutschland
| | - Evelyn Gaffal
- Klinik für DermatologieUniversitätsklinikum MagdeburgDeutschland
| | - Matthias Goebeler
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinik WürzburgDeutschland
| | - Michael Hertl
- Klinik für DermatologiePhilipps‐UniversitätMarburgDeutschland
| | - Cornelia Mauch
- Klinik für DermatologieUniversitätsklinik KölnDeutschland
| | - Kristian Reich
- Translational Research in Inflammatory Skin DiseasesIVDPUniversitätsklinikum Hamburg‐EppendorfDeutschland
| | - Enno Schmidt
- Klinik für DermatologieUniversität zu LübeckDeutschland
- Lübecker Institut für Experimentelle Dermatologie (LIED)Universität zu LübeckDeutschland
| | - Michael P. Schön
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum GöttingenDeutschland
- Niedersächsisches Institut für BerufsdermatologieUniversitätsklinikum GöttingenDeutschland
| | - Michael Sticherling
- Klinik für DermatologieFAU Erlangen‐Nürnberg und Universitätsklinikum ErlangenDeutsches Zentrum für Immuntherapie (DZI)ErlangenDeutschland
| | - Cord Sunderkötter
- Klinik für Dermatologie und VenerologieUniversitätsklinikum Halle‐WittenbergHalle (Saale)Deutschland
| | - Claudia Traidl‐Hoffmann
- Institut für UmweltmedizinUNIKA‐T AugsburgTechnische Universität München und Helmholtz Zentrum MünchenDeutsches Forschungszentrum für Gesundheit und UmweltDeutschland
- Ambulanz für UmweltmedizinUniversitätsklinikum AugsburgDeutschland
| | - Thomas Werfel
- Abteilung für Immundermatologie und AllergieforschungKlinik für Dermatologie und AllergologieMedizinische Hochschule HannoverDeutschland
| | - Dagmar Wilsman‐Theis
- Klinik für Dermatologie und AllergologieUniversitätsklinikumFriedrich‐Wilhelms‐UniversitätBonnDeutschland
| | - Margitta Worm
- Abteilung für Allergologie und ImmunologieKlinik für DermatologieVenerologie und AllergologieCharité ‐ Universitätsmedizin BerlinDeutschland
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