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Antoñanzas J, Salido-Vallejo R, Morelló-Vicente A, Oteiza-Rius I, Munarriz R, España A, Aguado-Gil L. Improvement in quality of life in patients with Hailey-Hailey disease treated with ablative CO 2 laser. J Dtsch Dermatol Ges 2024; 22:996-998. [PMID: 38864831 DOI: 10.1111/ddg.15390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 01/26/2024] [Indexed: 06/13/2024]
Affiliation(s)
- Javier Antoñanzas
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | | | | | - Inés Oteiza-Rius
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - Rita Munarriz
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - Agustín España
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - Leyre Aguado-Gil
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
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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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Patel PM, Sanchez-Melendez SN, Nambudiri VE. A narrative review of studies assessing the quality of life in patients with generalized pustular psoriasis. Exp Dermatol 2023; 32:1227-1234. [PMID: 36922363 DOI: 10.1111/exd.14787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/09/2023] [Accepted: 02/25/2023] [Indexed: 03/18/2023]
Abstract
Generalized pustular psoriasis (GPP) is a clinical entity distinct from psoriasis, associated with a poor clinical prognosis, often resulting in severe systemic complications and mortality. The relapsing nature of the disease with recurrent or intermittent flares imposes a significant burden on patients' quality of life (QoL). Although inadequately studied, QoL data in GPP patients has been a recent point of investigation. We conducted a literature search on PubMed/MEDLINE using the following search terms: 'generalized pustular psoriasis' OR 'pustular psoriasis' AND 'quality of life'. We identified 12 relevant articles that provide insight into the large impact of GPP on the QoL of patients, the burden of the disease and the treatment, and the success of new treatment options in making a clinically important difference to QoL. This review illustrates a need for routine assessment of the QoL in interventional clinical trials for GPP and during physician encounters. This information can help guide clinicians on how to tailor the treatment approach from the patient's perspective or illustrate whether new therapies offer meaningful benefits to patient care as we enter an era of exciting new treatments for this challenging condition.
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Affiliation(s)
- Payal M Patel
- Department of Dermatology, Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA
| | - Stephanie N Sanchez-Melendez
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Ponce Health Sciences University, School of Medicine, Ponce, Puerto Rico
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Zhao Q, Liu L, Li X, Yang L, Jiang X. An Unexpected Finding: Treatment History Associated with the Quality of Life in Chinese Patients with Port-Wine Stains. Clin Cosmet Investig Dermatol 2023; 16:1969-1975. [PMID: 37533495 PMCID: PMC10391529 DOI: 10.2147/ccid.s421296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
Background Port-wine stains (PWS) are predominantly located on the face and neck. Hence, PWS affect not only aesthetic appearance but may also cause psychological distress. However, very few studies have researched on the quality of life (QoL) in Chinese patients with PWS. Aim To evaluate QoL in patients with PWS. Methods and Materials Skindex-29 and Dermatology Life Quality Index (DLQI) were used to investigate the QoL of the patients with PWS and healthy controls. Results In total, 198 adults with PWS and 200 healthy controls were included. The scores of symptomatic, emotional and functional dimensions of Skindex-29 in the observational group were significantly higher as compared with the control group (P<0.05). Female gender, lesion location and the treatment history (such as pulsed dye laser or photodynamic therapy) had a negative impact on the scores (emotional and functional dimensions) of the patients with PWS. The median DLQI score was 3 points in the observational group and 0 points in the control group (P<0.05), and QoL of patients who had a history of previous treatments was diminished. Conclusion The QoL of patients with PWS is impaired. Patients' QoL is negatively influenced by female gender, lesion location and treatment history. The Skindex-29 scale seems to be more applicable to the study of QoL of patients with PWS.
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Affiliation(s)
- Qian Zhao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Department of Medical Cosmetology, Chengdu Second People’s Hospital, Chengdu, Sichuan, 610021, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Lian Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xiaoxue Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Lihua Yang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
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Hopkins ZH, Kuceki G, Taliercio VL, Snyder AM, Stoddard GJ, Duffin KC, Hess R, Secrest AM. Evaluation of Skindex-16 construct validity in routinely collected psoriasis data: a retrospective analysis of the relationship between overall physician global assessment scores and Skindex-16 and measure discordance. Arch Dermatol Res 2022; 315:1151-1159. [DOI: 10.1007/s00403-022-02491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/14/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022]
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Current quality of life assessment tools may not fully address dermatological adverse events from anti-cancer therapies. Support Care Cancer 2022; 30:9681-9685. [DOI: 10.1007/s00520-022-07424-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/16/2022] [Indexed: 11/12/2022]
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The impact of genital lichen sclerosus and lichen planus on quality of life: A review. Int J Womens Dermatol 2022; 8:e042. [PMID: 36000015 PMCID: PMC9387966 DOI: 10.1097/jw9.0000000000000042] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
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[Translated article] Patient-Reported Outcome Measures in Real-World Atopic Dermatitis Studies in Spain: A Systematic Review. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Armario-Hita J, Artime E, Vidal-Vilar N, Huete T, Díaz-Cerezo S, Moro R, Lizán L, Frutos FOD. Medidas de los resultados percibidos por el paciente en estudios de vida real en dermatitis atópica en España: revisión sistemática de la literatura. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:685-704. [DOI: 10.1016/j.ad.2022.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022] Open
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Kirsten N, Rustenbach S, von Kiedrowski R, Sorbe C, Reich K, Augustin M. Which PASI Outcome Is Most Relevant to the Patients in Real-World Care? Life (Basel) 2021; 11:life11111151. [PMID: 34833027 PMCID: PMC8618980 DOI: 10.3390/life11111151] [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: 09/20/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 12/19/2022] Open
Abstract
In psoriasis treatment, there is a high need to define meaningful endpoints and differences from the patient perspective to analyze patient-relevant differences of frequently used outcome methods for psoriasis under real-world conditions. A sample of 3116 patients from the German Psoriasis-Registry PsoBest was analyzed for clinical as well as patient-reported outcomes (PRO) after 3- and 6-month treatment. The parameters PASI, DLQI, and PBI were intercorrelated and related to two anchoring variables: (1) patient satisfaction with treatment and (2) perceived complete clearance. Baseline data were as follows: PASI 10.5 ± 9.1, DLQI 12.4 ± 3.4, and PBI 2.7 ± 0.3. There was an almost linear relationship between "complete patient satisfaction" and the relative differences in PASI in the range from PASI 25 to PASI 90. However, there was no additional benefit between PASI 90 and PASI 100. The same finding resulted from the anchoring variable "perception of complete healing". When related to DLQI outcomes, relative PASI changes as well as absolute changes and PASI at 3 and 6 months showed relevant differences between the PASI classes 25 to 90 but not between PASI 90 and PASI 100. Under real-world conditions, changes in PASI and DLQI reflect patient-relevant benefits.
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Affiliation(s)
- Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; (S.R.); (C.S.); (K.R.); (M.A.)
- Correspondence: ; Tel.: +49-40-7410-55428; Fax: +49-40-7410-55348
| | - Stephan Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; (S.R.); (C.S.); (K.R.); (M.A.)
| | - Ralph von Kiedrowski
- Dermatology Office and Dermatology Study Center (CMSS) Dr. Ralph von Kiedrowski, Selters/Westerwald, Kirchstraße 1, 56242 Selters, Germany;
| | - Christina Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; (S.R.); (C.S.); (K.R.); (M.A.)
| | - Kristian Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; (S.R.); (C.S.); (K.R.); (M.A.)
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; (S.R.); (C.S.); (K.R.); (M.A.)
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Batchelor JM, Thomas KS, Akram P, Azad J, Bewley A, Chalmers JR, Cheung ST, Duley L, Eleftheriadou V, Ellis R, Ferguson A, Goulding JM, Haines RH, Hamad H, Ingram JR, Laguda B, Leighton P, Levell N, Makrygeorgou A, Meakin GD, Millington A, Ogboli M, Rajasekaran A, Ravenscroft JC, Rogers A, Sach TH, Santer M, Stainforth J, Tan W, Wahie S, White J, Whitton ME, Williams HC, Wright A, Montgomery AA. Home-based narrowband UVB, topical corticosteroid or combination for children and adults with vitiligo: HI-Light Vitiligo three-arm RCT. Health Technol Assess 2020; 24:1-128. [PMID: 33245043 PMCID: PMC7750863 DOI: 10.3310/hta24640] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Systematic reviews suggest that narrowband ultraviolet B light combined with treatments such as topical corticosteroids may be more effective than monotherapy for vitiligo. OBJECTIVE To explore the clinical effectiveness and cost-effectiveness of topical corticosteroid monotherapy compared with (1) hand-held narrowband ultraviolet B light monotherapy and (2) hand-held narrowband ultraviolet B light/topical corticosteroid combination treatment for localised vitiligo. DESIGN Pragmatic, three-arm, randomised controlled trial with 9 months of treatment and a 12-month follow-up. SETTING Sixteen UK hospitals - participants were recruited from primary and secondary care and the community. PARTICIPANTS Adults and children (aged ≥ 5 years) with active non-segmental vitiligo affecting ≤ 10% of their body area. INTERVENTIONS Topical corticosteroids [mometasone furoate 0.1% (Elocon®, Merck Sharp & Dohme Corp., Merck & Co., Inc., Whitehouse Station, NJ, USA) plus dummy narrowband ultraviolet B light]; narrowband ultraviolet B light (narrowband ultraviolet B light plus placebo topical corticosteroids); or combination (topical corticosteroids plus narrowband ultraviolet B light). Topical corticosteroids were applied once daily on alternate weeks and narrowband ultraviolet B light was administered every other day in escalating doses, with a dose adjustment for erythema. All treatments were home based. MAIN OUTCOME MEASURES The primary outcome was self-assessed treatment success for a chosen target patch after 9 months of treatment ('a lot less noticeable' or 'no longer noticeable' on the Vitiligo Noticeability Scale). Secondary outcomes included blinded assessment of primary outcome and percentage repigmentation, onset and maintenance of treatment response, quality of life, side effects, treatment burden and cost-effectiveness (cost per additional successful treatment). RESULTS In total, 517 participants were randomised (adults, n = 398; and children, n = 119; 52% male; 57% paler skin types I-III, 43% darker skin types IV-VI). At the end of 9 months of treatment, 370 (72%) participants provided primary outcome data. The median percentage of narrowband ultraviolet B light treatment-days (actual/allocated) was 81% for topical corticosteroids, 77% for narrowband ultraviolet B light and 74% for combination groups; and for ointment was 79% for topical corticosteroids, 83% for narrowband ultraviolet B light and 77% for combination. Target patch location was head and neck (31%), hands and feet (32%), and rest of the body (37%). Target patch treatment 'success' was 20 out of 119 (17%) for topical corticosteroids, 27 out of 123 (22%) for narrowband ultraviolet B light and 34 out of 128 (27%) for combination. Combination treatment was superior to topical corticosteroids (adjusted risk difference 10.9%, 95% confidence interval 1.0% to 20.9%; p = 0.032; number needed to treat = 10). Narrowband ultraviolet B light was not superior to topical corticosteroids (adjusted risk difference 5.2%, 95% confidence interval -4.4% to 14.9%; p = 0.290; number needed to treat = 19). The secondary outcomes supported the primary analysis. Quality of life did not differ between the groups. Participants who adhered to the interventions for > 75% of the expected treatment protocol were more likely to achieve treatment success. Over 40% of participants had lost treatment response after 1 year with no treatment. Grade 3 or 4 erythema was experienced by 62 participants (12%) (three of whom were using the dummy) and transient skin thinning by 13 participants (2.5%) (two of whom were using the placebo). We observed no serious adverse treatment effects. For combination treatment compared with topical corticosteroids, the unadjusted incremental cost-effectiveness ratio was £2328.56 (adjusted £1932) per additional successful treatment (from an NHS perspective). LIMITATIONS Relatively high loss to follow-up limits the interpretation of the trial findings, especially during the post-intervention follow-up phase. CONCLUSION Hand-held narrowband ultraviolet B light plus topical corticosteroid combination treatment is superior to topical corticosteroids alone for treatment of localised vitiligo. Combination treatment was relatively safe and well tolerated, but was effective in around one-quarter of participants only. Whether or not combination treatment is cost-effective depends on how much decision-makers are willing to pay for the benefits observed. FUTURE WORK Development and testing of new vitiligo treatments with a greater treatment response and longer-lasting effects are needed. TRIAL REGISTRATION Current Controlled Trials ISRCTN17160087. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 64. See the NIHR Journals Library website for further project information.
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Doolan BJ, Koye D, Ling J, Cains GD, Baker C, Foley P, Dolianitis C. Treatment modalities and risk of adverse events associated with biologic therapy: A 10-year observational review of the Australasian Psoriasis Registry. Australas J Dermatol 2020; 62:e47-e54. [PMID: 32885846 DOI: 10.1111/ajd.13450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/02/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease affecting ~2-3% of the Australasian population. Therapeutic options include topical agents, phototherapy, systemic immunomodulators and biologic agents. Biologics present an acceptable short- and medium-term safety profile, derived mainly from randomised controlled trials (RCTs) and, however, may not represent real-world rates of adverse events (AEs). METHODS A retrospective, observational study of patients enrolled in The Australasian Psoriasis Registry from April 2008 to October 2018 was conducted. Data were collected from 104 sites in Australia and New Zealand. Patient characteristics, treatments and AE data were collected. AEs were classified by MedDRA System events. RESULTS 2094 patients were included (3765 patient-treatments), comprising; 1110 phototherapy, 1280 systemic and 1375 biologic therapy patient-treatments. Treatment arms were not mutually exclusive. The mean ± SD from date of diagnosis of psoriasis to commencement of biologic therapy was 8.9 ± 12.3 years. Methotrexate had the longest exposure time (3740.3 patient-years), and ustekinumab had the longest median (95% CI) time on treatment, 4.3 years (2.2, 6.6). AE differences on biologic treatment were present between patients who would have been eligible or ineligible for RCTs. Approximately 29% of registry patients would have been excluded from clinical trials enrolment. Patients ineligible for RCTs had increased adjusted hazard ratios (95% CI) of: infections and infestations (2.3, 1.7-3.1; P < 0.001), cardiac (8.2, 3.5-25.6; P < 0.001), gastrointestinal (3.5, 1.52-8.0; P < 0.001), hepatobiliary (5.6 1.7-19.1; P < 0.001), psychiatric (4.7, 1.5-14.1; P = 0.006) and eye disorders (4.8 1.5-15.6; P = 0.008), compared to those eligible for RCTs. Incidence rates in the trial eligible patients were similar to those reported from RCT rates. CONCLUSIONS This study establishes treatment modalities in use for severe psoriasis and the clinical rates of AEs associated with biologic therapy.
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Affiliation(s)
- Brent J Doolan
- Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Skin Health Institute, Carlton, Victoria, Australia.,The Skin Hospital, Sydney, New South Wales, Australia
| | - Digsu Koye
- The Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Joanna Ling
- The Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Geoffrey D Cains
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia.,School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Baker
- Skin Health Institute, Carlton, Victoria, Australia.,Department of Dermatology and Medicine, St Vincent's Hospital, Melbourne, The University of Melbourne, Fitzroy, Victoria, Australia
| | - Peter Foley
- Skin Health Institute, Carlton, Victoria, Australia.,Department of Dermatology and Medicine, St Vincent's Hospital, Melbourne, The University of Melbourne, Fitzroy, Victoria, Australia
| | - Con Dolianitis
- Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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Svoboda SA, Ghamrawi RI, Owusu DA, Feldman SR. Treatment Goals in Psoriasis: Which Outcomes Matter Most? Am J Clin Dermatol 2020; 21:505-511. [PMID: 32424692 DOI: 10.1007/s40257-020-00521-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psoriasis is a chronic immune-mediated inflammatory disease that predominantly affects the skin and joints. Its detrimental effects on the physical, psychosocial, and emotional well-being of patients leads to a significant reduction in quality of life (QoL). The goals of treatment focus on decreasing disease severity and improving QoL for patients; accomplishing these goals requires physicians to understand both the full impact of the disease on a patient's life and the outcomes that matter most to patients. The use of outcome measures, both physician- and patient-reported, can assist clinicians in evaluating the disease burden and its effect on QoL and in identifying patient preferences for treatment, ultimately enhancing quality of care. However, current outcome measures have many limitations and do not adequately capture patients' needs and priorities. Nevertheless, physicians treating patients with psoriasis are encouraged to utilize these instruments while remaining cognizant of each of their limitations. As there is no consensus on an outcome measure that fully encompasses the complexities of psoriasis and its impact on patients, instruments that are appropriate and applicable to dermatologists and their patients should be developed.
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Affiliation(s)
- Steven A Svoboda
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA.
| | - Rima I Ghamrawi
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
| | - Dorellie A Owusu
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Dermatology, University of Southern Denmark, Odense, Denmark
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14
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Puig L. Patient-Reported Outcomes in Psoriasis Validated in Spain: PROs and Cons. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Puig L. Patient reported outcomes en psoriasis validados en España: PROs y contras. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:518-519. [DOI: 10.1016/j.ad.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022] Open
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Patient-reported outcomes assessment tools for use in psoriasis in Spain: A systematic review. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Urakawa R, Tarutani M, Kubota K, Uejima E. Hand Foot Syndrome Has the Strongest Impact on QOL in Skin Toxicities of Chemotherapy. J Cancer 2019; 10:4846-4851. [PMID: 31598155 PMCID: PMC6775515 DOI: 10.7150/jca.31059] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 06/07/2019] [Indexed: 11/27/2022] Open
Abstract
Background: Chemotherapy often results in dermatologic toxicities, which decrease quality of life (QOL) of cancer patients. These adverse skin reactions sometimes happen simultaneously. Though previous reports have demonstrated that skin reactions influence QOL, those reports were focused on only one kind of skin toxicity or on the most serious skin toxicity. The aim of this study is to demonstrate the contribution of each skin toxicity to QOL. Methods: This is a cross-sectional study at Kinki Central Hospital. Patients were enrolled who underwent skin toxic chemotherapy from April 1 to June 30, 2017. DLQI and Skindex29 were used to grade the QOL of patients. Also, the severity of skin toxicities was evaluated based on National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 (NCI-CTCAE ver4.0). We investigated how QOL changed with patient demographic and clinical characteristics, the worst skin toxicity grade, and each skin toxicity using statistical analyses. Results: No significant differences were detected between QOL scores (total score of DLQI, emotions domain, symptoms domain, functioning domain and total score of Skindex29) and patient demographic and clinical characteristics (P values were 0.155, 0.086, 0.052, 0.312 and 0.114, respectively). There were statistically significant QOL differences among the grades of the worst skin toxicity (P values were <0.001). Xerosis, paronycia, pigmentation, and hand foot syndrome showed statistically significant associations with some QOL domains analyzed by multiple logistic regression analyses adjusted by demographic characteristics. When adjusted by both demographic characteristics and other skin toxicities, three of xerosis, paronycia, and pigmentation showed no statistically significant associations, but hand foot syndrome showed statistically significant associations in all subdomains and total score of Skindex29 (P values were <0.05). Conclusions: Hand foot syndrome was a stronger factor in decreasing QOL than xerosis, paronychia, pigmentation, or rash. Therefore, especially in hand foot syndrome, prevention, early detection, and daily medical care are necessary to maintain QOL.
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Affiliation(s)
- Ryuta Urakawa
- Department of Pharmacy, Osaka University Dental Hospital, 1-8 Yamada-oka, Suita, Osaka, Japan.,Graduate School and School of Pharmaceutical Sciences, Osaka University, 1-6 Yamada-oka, Suita, Osaka, Japan
| | - Masahito Tarutani
- Department of Dermatology, Kinki Central Hospital, 3-1 Kurumazuka, Itami, Hyogo, Japan
| | - Kazumi Kubota
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Etsuko Uejima
- Graduate School and School of Pharmaceutical Sciences, Osaka University, 1-6 Yamada-oka, Suita, Osaka, Japan
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Patient-reported outcomes assessment tools for use in psoriasis in Spain: A systematic review. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:561-584. [PMID: 31101318 DOI: 10.1016/j.ad.2019.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To review the literature on validated tools for measuring patient-reported outcomes (PROs) in psoriasis in Spain. To evaluate the psychometric properties of the tools and describe the results of their practical application. MATERIAL AND METHODS Systematic review of studies validating or using instruments for assessing PROs in Spanish patients with psoriasis. Literature searches were performed in international (PubMed/Medline) and Spanish (Medes, Ibecs) databases. We also searched databases of instruments for measuring PROs (BiblioPRO, PROQOLID). The review included studies published in English or Spanish up to January 9, 2017. We also checked the reference lists of the key publications identified. The quality of the questionnaires was evaluated based on their psychometric properties (construct, transcultural adaptation, reliability, validity, feasibility, and sensitivity to change). RESULTS Eighteen publications were included. Six articles described the validation of Spanish versions of 5 PROs tools: 4 health-related quality of life (HRQoL) questionnaires specific to psoriasis and dermatologic diseases and 1 questionnaire specific to satisfaction with treatment. Our assessment of the HRQoL tools' psychometric properties showed that the PSO-LIFE questionnaire received the highest scores, although specific properties varied from instrument to instrument. The 12 remaining articles were observational studies that used the validated instruments. In use, these tools detected the high impact of psoriasis on HRQoL, especially in young female patients with severe disease. CONCLUSIONS We identified 5 specific instruments validated in Spain for scoring PROs in patients with psoriasis. The tools' psychometric properties vary, and it is essential to understand their strengths and weaknesses when selecting the right one for each situation. In use, these questionnaires are able to detect the high impact of psoriasis on patients' HRQoL. PROs provide useful information to complement routine clinical findings in psoriasis and may contribute to improving disease management.
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Lynde CW, Beecker J, Dutz J, Flanagan C, Guenther LC, Gulliver W, Papp K, Rahman P, Sholter D, Searles GE. Treating to Target(s) With Interleukin-17 Inhibitors. J Cutan Med Surg 2019; 23:3S-34S. [DOI: 10.1177/1203475418824565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: The treat-to-target (T2T) strategy has become established in several medical specialties as a key guidance to optimal therapeutic decision making. T2T may be effective in the assessment of the biologic class of agents called interleukin (IL)-17 inhibitors, which are emerging as a safe and effective treatment option for autoimmune inflammatory conditions such as plaque psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Objective: The objective of this article is to use a T2T approach for the evaluation of the effectiveness and safety of IL-17 inhibitors in the management of patients with plaque psoriasis, PsA, and AS. Methods: Following a comprehensive literature search, a full-day meeting was convened to discuss and identify the T2T targets for psoriasis, PsA, and AS. Clinical trial evidence was presented for the approved IL-17 inhibitors—secukinumab, ixekizumab, and brodalumab—to assess whether these data meet T2T safety and efficacy targets. Results: All 3 approved agents were significantly superior to placebo and active controls in the achievement of T2T targets for psoriasis. Secukinumab and ixekizumab were likewise associated with significantly better outcomes than controls in the PsA targets, and secukinumab resulted in significant AS target improvements vs placebo. The IL-17 inhibitors were also associated with low rates of serious adverse events and exacerbations of common comorbid conditions. Conclusion: Phase III trial results support the T2T benefit and safety of IL-17 inhibitors according to their specific indications for the management of patients with plaque psoriasis, PsA, and AS.
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Affiliation(s)
- Charles W. Lynde
- University of Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
- Probity Medical Research, Markham, ON, Canada
| | - Jennifer Beecker
- The Ottawa Hospital, ON, Canada
- The University of Ottawa, ON, Canada
- Probity Medical Research, Ottawa, ON, Canada
| | - Jan Dutz
- University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | | | | | - Wayne Gulliver
- Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Kim Papp
- Probity Medical Research, Waterloo, ON, Canada
| | - Proton Rahman
- Memorial University of Newfoundland, St. John’s, NL, Canada
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20
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Wechter T, Heath M, Aung-Din D, Sahni D, Cline A, Feldman SR. Current Psoriasis Efficacy Outcome Measures in Clinical Trials. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0237-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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21
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Kwan Z, Bong YB, Tan LL, Lim SX, Yong ASW, Ch'ng CC, Tan MP, Ismail R. Determinants of quality of life and psychological status in adults with psoriasis. Arch Dermatol Res 2018; 310:443-451. [PMID: 29687328 DOI: 10.1007/s00403-018-1832-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 03/24/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
We investigated whether disease severity and clinical manifestations were associated with depression, anxiety, stress and quality of life in adults with psoriasis. Participants were recruited from a dermatology outpatient clinic at a teaching hospital. Information on sociodemographic characteristics, disease severity, presence of arthropathy and head involvement was specifically recorded. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Quality of life and psychological symptoms were measured using the Dermatology Life Quality Index (DLQI) and the Depression Anxiety Stress Scale (DASS), respectively. One hundred individuals were recruited. Unadjusted analysis revealed that head involvement was associated with depression [odds ratio (OR) 8.509; 95% confidence interval (CI) 1.077-67.231] and anxiety (OR 6.46; 95% CI 1.401-29.858). Severe disease was associated with a poorer quality of life compared to mild disease (OR 3.750; 95% CI 1.330-10.577). Younger age was associated with an increased risk of depression [mean difference (MD) - 8.640; 95% CI - 16.390 to - 0.890], anxiety (MD - 11.553; 95% CI - 18.478 to- 4.628), stress (MD - 11.440; 95% CI - 19.252 to - 3.628) and severely impaired quality of life (MD - 12.338; 95% CI - 19.548 to - 5.127). Following adjustments for age and disease severity, anxiety, stress and depression remained associated with severely impaired quality of life.
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Affiliation(s)
- Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Yii Bonn Bong
- Institute of Research Management and Services, University of Malaya, Kuala Lumpur, Malaysia
| | - Leng Leng Tan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shu Xian Lim
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Adrian Sze Wai Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chin Chwen Ch'ng
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rokiah Ismail
- School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, UCSI University, Kuala Lumpur, Malaysia
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Jun M, Keum DI, Lee S, Kim BJ, Lee WS. Quality of Life with Alopecia Areata versus Androgenetic Alopecia Assessed Using Hair Specific Skindex-29. Ann Dermatol 2018; 30:388-391. [PMID: 29853767 PMCID: PMC5929970 DOI: 10.5021/ad.2018.30.3.388] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/21/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Myungsoo Jun
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong In Keum
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Solam Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Beom Jun Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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23
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Haines RH, Thomas KS, Montgomery AA, Ravenscroft JC, Akram P, Chalmers JR, Whitham D, Duley L, Eleftheriadou V, Meakin G, Mitchell EJ, White J, Rogers A, Sach T, Santer M, Tan W, Hepburn T, Williams HC, Batchelor J. Home interventions and light therapy for the treatment of vitiligo (HI-Light Vitiligo Trial): study protocol for a randomised controlled trial. BMJ Open 2018; 8:e018649. [PMID: 29615444 PMCID: PMC5893933 DOI: 10.1136/bmjopen-2017-018649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Vitiligo is a condition resulting in white patches on the skin. People with vitiligo can suffer from low self-esteem, psychological disturbance and diminished quality of life. Vitiligo is often poorly managed, partly due to lack of high-quality evidence to inform clinical care. We describe here a large, independent, randomised controlled trial (RCT) assessing the comparative effectiveness of potent topical corticosteroid, home-based hand-held narrowband ultraviolet B-light (NB-UVB) or combination of the two, for the management of vitiligo. METHODS AND ANALYSIS The HI-Light Vitiligo Trial is a multicentre, three-arm, parallel group, pragmatic, placebo-controlled RCT. 516 adults and children with actively spreading, but limited, vitiligo are randomised (1:1:1) to one of three groups: mometasone furoate 0.1% ointment plus dummy NB-UVB light, vehicle ointment plus NB-UVB light or mometasone furoate 0.1% ointment plus NB-UVB light. Treatment of up to three patches of vitiligo is continued for up to 9 months with clinic visits at baseline, 3, 6 and 9 months and four post-treatment questionnaires.The HI-Light Vitiligo Trial assesses outcomes included in the vitiligo core outcome set and places emphasis on participants' views of treatment success. The primary outcome is proportion of participants achieving treatment success (patient-rated Vitiligo Noticeability Scale) for a target patch of vitiligo at 9 months with further independent blinded assessment using digital images of the target lesion before and after treatment. Secondary outcomes include time to onset of treatment response, treatment success by body region, percentage repigmentation, quality of life, time-burden of treatment, maintenance of response, safety and within-trial cost-effectiveness. ETHICS AND DISSEMINATION Approvals were granted by East Midlands-Derby Research Ethics Committee (14/EM/1173) and the MHRA (EudraCT 2014-003473-42). The trial was registered 8 January 2015 ISRCTN (17160087). Results will be published in full as open access in the NIHR Journal library and elsewhere. TRIAL REGISTRATION NUMBER ISRCTN17160087.
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Affiliation(s)
- Rachel H Haines
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Kim S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Jane C Ravenscroft
- Department of Paediatric Dermatology, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Perways Akram
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Diane Whitham
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham Health Science Partners, Queen's Medical Centre, Nottingham, UK
| | - Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham Health Science Partners, Queen's Medical Centre, Nottingham, UK
| | | | - Garry Meakin
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Eleanor J Mitchell
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Jennifer White
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Andy Rogers
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Tracey Sach
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Miriam Santer
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Wei Tan
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Trish Hepburn
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Jonathan Batchelor
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Influence of ulceration etiology on the global quality of life and its specific dimensions, including the control of pain, in patients with lower limb vascular insufficiency. Postepy Dermatol Alergol 2018; 34:471-477. [PMID: 29507563 PMCID: PMC5831284 DOI: 10.5114/ada.2017.71116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/24/2016] [Accepted: 07/20/2016] [Indexed: 11/26/2022] Open
Abstract
Introduction The results of previous studies suggest that the quality of life in patients with lower limb ulcerations is markedly poorer than in the general population – with regard to physical, mental and social spheres. This complex character of that parameter necessitates comprehensive analyses of its specific aspects, including the level of the acceptance of illness and associated pain symptoms. Aim To compare the quality of life and its specific dimensions in patients with lower limb ulcerations of various etiology. Material and methods Patients with the ulcerations resulting from venous (n = 101) or arterial pathologies (n = 98), or having mixed etiology (n = 99) were examined with the: 1) Skindex-29 instrument, 2) Acceptance of Illness Scale, 3) Beliefs about Pain Control Questionnaire, and 4) Coping Strategy Questionnaire. Results The average quality of life related to physical symptoms was significantly higher in patients with venous ulcerations. Patients with ulcerations of arterial etiology more frequently used catastrophizing, and less often ignored pain sensations, used coping self-statements, and increased their activity levels; they were characterized by lower levels of control and poorer ability to decrease the pain. The internal locus of pain control increased proportionally to the global quality of life scores and levels of illness acceptance. Control over pain and ability to decrease the pain were more effective in individuals who used ignoring pain sensations, increasing the activity level, coping self-statements, and reinterpreting pain than in those using catastrophizing or praying and hoping strategies. Conclusions Physical complaints seem to be the basic determinant of the quality of life in patients with the lower limb ulceration, irrespective of its etiology.
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Ogunsanya ME, Kalb SJ, Kabaria A, Chen S. A systematic review of patient-reported outcomes in patients with cutaneous lupus erythematosus. Br J Dermatol 2016; 176:52-61. [PMID: 27416958 DOI: 10.1111/bjd.14868] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2016] [Indexed: 12/31/2022]
Abstract
Cutaneous lupus erythematosus (CLE) is a chronic dermatological autoimmune disease marked by photosensitive lesions that can lead to hyperpigmentation changes, scarring and hair loss. Health-related quality of life (HRQoL) in patients with CLE is severely impaired. Given the heterogeneous nature of CLE, health perceptions of patients can differ significantly from those of clinicians. It is important to use subjective measures, such as patient-reported outcomes (PROs), to capture HRQoL data in patients with CLE. We conducted a systematic review of published PRO instruments used in measuring HRQoL in patients with CLE. Also, we examined the disease burden on HRQoL in patients with CLE. To identify studies, PubMed/MEDLINE, Web of Science and CINAHL were searched using 'CLE/cutaneous lupus erythematosus' in combination with PRO-related keywords such as 'quality of life', 'self-report' and 'instrument'. English-language articles published between 2003 and 2014 were identified. A total of 482 citations were identified in the initial search. Eleven studies met our inclusion criteria, and five PRO instruments were found to be used: Skindex (versions 16 and 29), Dermatology Life Quality Index, 36-Item Short-Form Health Survey, and visual analogue scales for pain and pruritus. Patients with CLE reported having poor quality of life and experienced symptoms ranging from pain, pruritus and fatigue to photosensitivity. There is a limited number of studies examining PRO in patients with CLE. While our findings suggest that quality of life in patients with CLE is poor, further studies are needed to understand better the impact of CLE from patients' perspectives.
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Affiliation(s)
- M E Ogunsanya
- Health Outcomes and Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, 78712, U.S.A
| | - S J Kalb
- Biogen, Cambridge, MA, 02142, U.S.A
| | - A Kabaria
- College of Pharmacy, The University of Texas at Austin, Austin, TX, 78712, U.S.A
| | - S Chen
- Biogen, Cambridge, MA, 02142, U.S.A
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Health state utility, willingness to pay, and quality of life among Taiwanese patients with psoriasis. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Psoriasis generally does not affect survival but has significant detrimental effect on quality of life (QOL), which may be comparable to that of ischemic heart disease, diabetes, depression, and cancer. The foremost important thing in the management of psoriasis is counseling of the patient. The clinician needs to be empathetic and spend adequate time with the patient and educating the patient about psoriasis. Clinicians should make it clear to the patient that the primary goal of treatment is control of the disease rather than cure. Eating a balanced and low glycemic diet could be an important adjuvant factor in the prevention and treatment of moderate nonpustular psoriasis. Obese people are more likely to have severe psoriasis and psoriatic arthritis than people with an average body mass index. Dietary supplementation with oily fish, rich in n-3 fatty acids, in psoriasis had shown mixed results in trials. Promising results have been documented for parenteral application of n-3 fatty acid, but not with oral supplementation. Increased smoking or alcohol abuse increases the risk of developing psoriasis and may influence disease severity, and hence must be avoided. Soaking in warm water with bath oil can be done in extensive psoriasis for hydration and emollient effect, and bland soaps or soap substitutes should be used; antiseptics should be avoided as they may irritate the skin. Relatively small, localized patches of psoriasis may improve with occlusion, i.e., waterproof adhesive dressings. The use of emollients is an internationally accepted standard adjunctive to the treatment of psoriasis. Dermatology Life Quality Index is a psychometrically sound and responsive measure of psoriasis-specific outcomes and most comprehensively captures the impact of clinical signs and symptoms on patient's well-being.
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Affiliation(s)
- Rashmi Sarkar
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Shikha Chugh
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Shivani Bansal
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
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Thomas C, Kim B, Lam J, Richards S, See A, Kalouche S, Paver R, Fernández Peñas P. Objective severity does not capture the impact of rosacea, acne scarring and photoaging in patients seeking laser therapy. J Eur Acad Dermatol Venereol 2016; 31:361-366. [DOI: 10.1111/jdv.13945] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- C.L. Thomas
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - B. Kim
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - J. Lam
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Melbourne; Melbourne Vic. Australia
| | - S. Richards
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - A. See
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - S. Kalouche
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - R.D. Paver
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
| | - P. Fernández Peñas
- Skin & Cancer Foundation Australia; Sydney NSW Australia
- The University of Sydney; Sydney NSW Australia
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Cheon JJ, Uhm JY, Kang GH, Kang EG, Kim SY, Chang SS. Evaluation of the dermatologic life quality among cleanroom workers in a secondary battery factory. Ann Occup Environ Med 2016; 28:39. [PMID: 27595006 PMCID: PMC5010708 DOI: 10.1186/s40557-016-0125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/22/2016] [Indexed: 12/02/2022] Open
Abstract
Background Cleanroom air is extremely dry, as it is maintained within 1 % of relative humidity. Few studies have assessed the dermatologic life quality of workers in ultralow-humidity environments. Therefore, we aimed to evaluate the dermatologic life quality of cleanroom workers using the Skindex-29, compared to those of non-cleanroom workers. Methods Study participants were 501 cleanroom workers and 157 non-cleanroom workers from a secondary battery factory, who underwent an employee health examination at a single university hospital from September 2014 to September 2015. Results of the self-administered Skindex-29, and McMonnies questionnaire were analyzed. Other information and disease history were also collected during physician's medical examination. Descriptive and multivariate logistic regression analysis were performed. Results The Skindex-29 score was significantly higher in cleanroom workers than in non-cleanroom workers for all domains, Symptom (16.0 ± 15.9 vs. 6.3 ± 10.2, p < 0.001), Emotion (11.3 ± 17.4 vs. 2.5 ± 7.4, p < 0.001), Function (5.2 ± 11.1 vs. 1.6 ± 4.0, p < 0.001), and Overall (10.8 ± 13.4 vs. 3.5 ± 6.2, p < 0.001). The Skindex-29 score of cleanroom workers was similar to that of patients with skin diseases such as psoriasis, other dermatitis, corns, alopecia etc. Among the cleanroom workers, 37 workers had one or more skin diseases. Among the risk factors, ‘working at cleanroom’, ‘possessing skin disease’ and ‘McMonnies score’ had significant strong correlations with Skindex-29 score, meanwhile age, sex, smoking, drinking and exercise had weak correlations with it. ‘Working at cleanroom’ and ‘possessing skin disease’ had highest odds ratios with overall 14.0 (C.I.: 5.9–33.1) and 13.4 (C.I.: 4.5–29.2), and the lowest odds ratios with function domain 3.5(C.I.: 1.7–7.1) and 4.5(C.I.: 2.1–9.5), respectively. The McMonnies score had the highest odds ratio with overall, 6.9(C.I.: 4.5–10.8) and lowest odd ratio with emotion domain 4.2 (C.I.: 2.7–6.4). Conclusions Dermatologic life quality among cleanroom workers in the secondary battery factory is shown to be lower than that among non-cleanroom workers in this study. The study suggests that the Skindex-29 may provide helpful information on the dermatologic life quality of cleanroom workers. Therefore, regarding evaluation of dermatologic life quality using Skindex-29, preventive care is necessary for cleanroom workers in ultralow humidity environment.
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Affiliation(s)
- Jae Jung Cheon
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
| | - Jun Young Uhm
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
| | - Gu Hyeok Kang
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
| | - Eun Gye Kang
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
| | - Soo Young Kim
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
| | - Seong Sil Chang
- Department of Occupational & Environmental Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233 Republic of Korea
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Ziemek J, Man A, Hinchcliff M, Varga J, Simms RW, Lafyatis R. The relationship between skin symptoms and the scleroderma modification of the health assessment questionnaire, the modified Rodnan skin score, and skin pathology in patients with systemic sclerosis. Rheumatology (Oxford) 2016; 55:911-7. [PMID: 26880832 PMCID: PMC5854039 DOI: 10.1093/rheumatology/kew003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 01/08/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine how well skin symptoms considered specific to SSc are captured by patient reported outcomes currently used for assessing patients with SSc, the SHAQ, or skin disease, the Skindex-29; and how well these symptoms correlate with the extent of skin disease on physical exam and skin pathology. METHODS SSc patients completed the scleroderma modification of the Health Assessment Questionnaire (SHAQ), Skindex-29 and a Skin Symptom Assessment questionnaire developed for this study. Correlations were assessed between the Skin Symptom Assessment and SHAQ, Skindex-29, modified Rodnan skin score, and skin pathological features including myofibroblast staining completed on the same date. RESULTS Tight, hard and rigid/stiff skin symptoms correlated moderately highly with the modified Rodnan skin score (r = 0.445, P = 0.0008; r = 0.486, P = 0.0002; and r = 0.488, P = 0.0002, respectively). Tight skin symptoms correlated moderately with myofibroblast infiltration (r = 0.544, P = 0.0023) and hyalinized collagen (r = 0.442, P = 0.0164), while both hard and rigid/stiff skin correlated moderately with inflammation (r = 0.401, P = 0.0310 and r = 0.513, P = 0.0045), myofibroblast infiltration(r = 0.480, P = 0.0084 and r = 0.527, P = 0.0033) and hyalinized collagen (r = 0.453, P = 0.0137 and r = 0.478, P = 0.0087), while the SHAQ was not found to correlate with any of these pathological changes. In contrast, painful skin symptoms correlated moderately with the SHAQ (r = 0.413, P = 0.0073), and with the three domains of Skindex-29: Symptoms, Emotions and Functioning. Skindex-29 indicates that dcSSc patient skin symptoms are nearly as severe as those of patients with psoriasis or atopic dermatitis. CONCLUSION Patient reported skin symptoms correlate with clinical and pathological measures in the skin. A validated patient reported skin symptom instrument might considerably improve evaluation of SSc skin disease.
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Affiliation(s)
- Jessica Ziemek
- Department of Medicine, Rheumatology Section, Boston University School of Medicine, Boston, MA and
| | - Ada Man
- Department of Medicine, Rheumatology Section, Boston University School of Medicine, Boston, MA and
| | - Monique Hinchcliff
- Department of Medicine, Rheumatology Section, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - John Varga
- Department of Medicine, Rheumatology Section, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert W Simms
- Department of Medicine, Rheumatology Section, Boston University School of Medicine, Boston, MA and
| | - Robert Lafyatis
- Department of Medicine, Rheumatology Section, Boston University School of Medicine, Boston, MA and
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Parker S, Zhang AL, Zhang CS, Goodman G, Wen Z, Lu C, Xue CC. Oral granulated Chinese herbal medicine (YXBCM01) plus topical calcipotriol for psoriasis vulgaris: study protocol for a double-blind, randomized placebo controlled trial. Trials 2014; 15:495. [PMID: 25526951 PMCID: PMC4302103 DOI: 10.1186/1745-6215-15-495] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/03/2014] [Indexed: 11/23/2022] Open
Abstract
Background Probably related to immune dysfunction, psoriasis vulgaris is a chronic, painful, disfiguring and disabling dermatological disease, carrying an increased risk of serious comorbidities. Current conventional therapies can be costly, show risks of side effects and have limited efficacy, with relapse common on treatment cessation. Chinese herbal medicine is effective in treating psoriasis vulgaris. However, any benefit of adding Chinese herbal medicine to conventional treatments when treating psoriasis vulgaris is yet to be determined. Methods/design This is a pilot randomized, placebo controlled, double-blinded trial. The pilot is primarily to determine the feasibility of undertaking a full size randomized trial. Thirty participants with psoriasis vulgaris and Psoriasis Area Severity Index (PASI) scores ≥7 and ≤12 will be included. Participants will be randomized (in a 1:1 ratio) to receive oral granulated Chinese herbal medicine YXBCM01 plus topical calcipotriol 0.005% or oral YXBCM01 placebo plus topical calcipotriol 0.005% treatment for 12 weeks, with a 12-week follow-up phase. The Chinese herbal medicine or placebo will be administered orally as dissolvable granules. The primary outcome measure will be PASI change (%) from baseline to the end of treatment phase. Secondary outcomes will include safety, key psoriasis-related cytokine changes (for example, IL12, IL17 and IL 23) during the entire trial and symptom relapse rates at the end of the follow-up phase. Discussion The study will evaluate the feasibility of a randomized controlled trial investigating combined conventional and Chinese herbal medicine therapy for psoriasis vulgaris. The ingredients of YXBCM01 were selected based on literature, the expert opinion on herbal medicine and pre-clinical evidence, for instance Chinese herbal medicine possesses anti-inflammatory or antiproliferative properties. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12614000493640.
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Affiliation(s)
| | | | | | | | | | - Chuanjian Lu
- School of Health Sciences, RMIT University, PO Box 71, Bundoora, Victoria 3083, Australia.
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Molina-Leyva A, Jiménez-Moleón J, Naranjo-Sintes R, Ruiz-Carrascosa J. Sexual dysfunction in psoriasis: a systematic review. J Eur Acad Dermatol Venereol 2014; 29:649-55. [DOI: 10.1111/jdv.12845] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 10/13/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A. Molina-Leyva
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Torrecárdenas; Almería Spain
| | - J.J. Jiménez-Moleón
- Dpto de Medicina Preventiva y Salud Pública; Instituto de Investigación Biosanitaria ibs; GRANADA, Hospitales Universitarios de Granada/Universidad de Granada; Granada Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP); Granada Spain
| | - R. Naranjo-Sintes
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Universitario Granada; Granada Spain
| | - J.C. Ruiz-Carrascosa
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Universitario Granada; Granada Spain
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A Quality-of-Life Study of Cutaneous Lupus Erythematosus. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.adengl.2013.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Batalla A, García-Doval I, Peón G, de la Torre C. Estudio de calidad de vida en pacientes con lupus eritematoso cutáneo. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:800-6. [DOI: 10.1016/j.ad.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 04/23/2013] [Accepted: 04/27/2013] [Indexed: 11/16/2022] Open
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Impact of Active and Stable Psoriasis on Health-Related Quality of Life: The PSO-LIFE Study. ACTA ACUST UNITED AC 2013; 104:685-93. [DOI: 10.1016/j.adengl.2013.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 02/21/2013] [Indexed: 11/21/2022]
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Daudén E, Herrera E, Puig L, Sánchez-Carazo J, Toribio J, Perulero N. Impacto en la calidad de vida relacionada con la salud de pacientes con psoriasis activa y estable. Estudio PSO-LIFE. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2013.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Sojević Timotijević Z, Janković S, Trajković G, Majcan P, Perišić S, Dostanić N, Janićijević Hudomal S, Janković J. Identification of psoriatic patients at risk of high quality of life impairment. J Dermatol 2013; 40:797-804. [PMID: 23961725 DOI: 10.1111/1346-8138.12201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 04/18/2013] [Indexed: 11/28/2022]
Abstract
Psoriasis is a systematic chronic disease with large influence on patients' quality of life (QoL). The aim of this study was to assess the QoL of patients with psoriasis using generic, dermatology-specific and psoriasis-specific instruments simultaneously, to investigate the relationships between dimensions or subscales of the questionnaires and to identify categories of patients at risk of a high QoL impairment. The study comprised 100 consecutive patients with psoriasis treated at the Department of Dermatology, Clinical Center "Zvezdara", Belgrade, from January to December 2011. Three QoL questionnaires were administered: the EuroQol-5D (EQ-5D), the Dermatological Life Quality Index (DLQI) and the Psoriasis Disability Index (PDI). The Psoriasis Area and Severity Index was used in evaluating disease severity. According to our results the QoL of psoriatic patients was impaired (the overall DLQI and PDI scores were 10.5 ± 7.2 and 13.4 ± 8.7, respectively, while EQ visual analog scale score was 48.8 ± 25.1). The most predictive factor of QoL impairment was disease severity, followed by sole and nail involvement. Psoriatic arthritis and bleeding were also associated with impaired QoL. Significant correlations between the instruments used in this study were in the expected directions. Mainly strong and moderate significant correlations ranging 0.26-0.84 were seen between DLQI and PDI instruments. A detailed approach to QoL assessment may give to the dermatologist useful information that could be of help in identifying patients belonging to categories at risk of high QoL impairment due to psoriasis, thus guiding them in clinical practice.
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Anyanwu C, Langenhan J, Werth VP. Measurement of disease severity in cutaneous autoimmune diseases. F1000PRIME REPORTS 2013; 5:19. [PMID: 23755366 PMCID: PMC3673224 DOI: 10.12703/p5-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The development of disease-specific outcome instruments for several autoimmune skin diseases including cutaneous lupus erythematosus (CLE), dermatomyositis, vitiligo, pemphigus and alopecia areata has facilitated the objective assessment of disease in clinical trials. Validation of these instruments provides reliable tools to measure disease severity and therapeutic effect in clinical studies. However, the existence of multiple outcome measures for each disease and the lack of uniformity between studies has created a challenge in comparing results across trials. Efforts to address this issue include the Core Outcome Measures in Effectiveness Trials (COMET) initiative and international meetings directed at reaching a consensus. Other challenges with the use of outcome measures include difficulties measuring change in mild disease, measuring response in topical studies, and capturing disease activity in skin with extensive post-inflammatory hyperpigmentation.
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Affiliation(s)
- Cynthia Anyanwu
- Philadelphia VA Medical CenterPhiladelphia, PA
- Department of Dermatology, University of Pennsylvania School of MedicinePhiladelphia, PA
| | - Jamie Langenhan
- Philadelphia VA Medical CenterPhiladelphia, PA
- Department of Dermatology, University of Pennsylvania School of MedicinePhiladelphia, PA
| | - Victoria P. Werth
- Philadelphia VA Medical CenterPhiladelphia, PA
- Department of Dermatology, University of Pennsylvania School of MedicinePhiladelphia, PA
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Eleftheriadou V, Thomas KS, Whitton ME, Batchelor JM, Ravenscroft JC. Which outcomes should we measure in vitiligo? Results of a systematic review and a survey among patients and clinicians on outcomes in vitiligo trials. Br J Dermatol 2013; 167:804-14. [PMID: 22591025 DOI: 10.1111/j.1365-2133.2012.11056.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Relevant and reliable outcomes play a crucial role in the correct interpretation and comparison of the results of clinical trials. There is a lack of consensus around methods of assessment and outcome measures for vitiligo, which makes it difficult to compare results of randomized controlled trials (RCTs) and perform meta-analysis. OBJECTIVES To describe the heterogeneity in outcome measures used in published RCTs of vitiligo treatments, and to report the most desirable outcomes from patients' and clinicians' perspectives. METHODS We conducted a systematic review of outcome measures used in RCTs as well as a survey of the most desirable outcomes identified by patients and clinicians as part of a Vitiligo Priority Setting Partnership. RESULTS Outcomes from 54 eligible trials were analysed and compared with outcomes suggested by patients and clinicians. In the systematic review, 25 different outcomes were reported. Only 22% of trials had clearly stated primary outcome measures. Repigmentation was the most frequently reported outcome in 96% of trials and was measured using 48 different scales. Only 9% of trials assessed quality of life. Thirteen per cent measured cessation of spreading of the disease and 17% of studies reported patients' opinions and satisfaction with the treatment. In contrast, out of 438 suggestions made by patients and clinicians, cosmetically acceptable repigmentation (rather than percentage of repigmentation) was the most desirable outcome (68%), followed by cessation of spread of vitiligo (15%), quality of life (8%) and maintenance of repigmentation (4%). CONCLUSIONS We propose that future vitiligo trials should include repigmentation, cosmetic acceptability of results, global assessment of the disease, quality of life, maintenance of repigmentation, stabilization of vitiligo and side-effects. International consensus among clinicians, researchers and patients is needed to establish an agreed core outcome set for future vitiligo trials.
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Affiliation(s)
- V Eleftheriadou
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham NG7 2NR, UK.
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Chang YC, Werth VP. Update on Epidemiology and Clinical Assessment Tools of Cutaneous Lupus Erythematosus and Dermatomyositis. CURRENT DERMATOLOGY REPORTS 2013; 2:48-57. [PMID: 33585073 PMCID: PMC7880122 DOI: 10.1007/s13671-012-0037-3] [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] [Indexed: 10/27/2022]
Abstract
Cutaneous Lupus Erythematosus (CLE) and Dermatomyositis (DM) are cutaneous autoimmune diseases that have been among the least systematically studied, due in part to the lack of validated outcome instruments in the past. More recent epidemiologic studies have elucidated the incidence and prevalence of these diseases and their subtypes. In addition, the advent of validated clinical outcome measures, including the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), has led to an objective means of measuring activity and damage of the disease. These outcome measures have established the framework for evaluating responsiveness and therapeutic efficacy in clinical trials as well as longitudinal studies to study disease course.
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Affiliation(s)
- Yunyoung C Chang
- Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Victoria P Werth
- Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
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Puig L. Induction phase, primary endpoint, time to decide on primary failure, and therapeutic goals in biologic treatment of psoriasis. J Eur Acad Dermatol Venereol 2012; 27:e257-60. [DOI: 10.1111/j.1468-3083.2012.04585.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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