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Klein C, Oji V, Sommer R, Augustin M, Ständer S, Salzmann S, Kiekbusch K, Bodes J, Danzer MF, Traupe H, Fischer J, Steinke S, Süßmuth K. Personal, financial and time burden in inherited ichthyoses: A survey of 144 patients in a university-based setting. J Eur Acad Dermatol Venereol 2024; 38:1809-1817. [PMID: 38523469 DOI: 10.1111/jdv.19804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/14/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patients with inherited ichthyosis suffer from scaling due to mutations affecting the epidermal barrier. Symptomatic treatment with ointments, bathing and mechanical scale removal can alleviate the disease, but therapy is time and cost intensive. OBJECTIVES We investigated costs, time and disease burden of ichthyoses. The study addresses difficulties of the healthcare situation for patients with ichthyoses and reveals potential improvements. MATERIALS AND METHODS We developed a questionnaire addressing time and financial effort for the treatment. Additionally, we collected data of the Dermatology Life Quality Index (DLQI) and the Pruritus Life Quality (5PLQ) questionnaires to determine the impact of ichthyosis and associated pruritus on quality of life (QoL). RESULTS We recruited 144 patients with ichthyosis (median age: 23; 53.5% female) from the Department of Dermatology in Muenster (Germany) and the German patient support group including common, rare and syndromic subtypes. Eighty-seven percent reported applying topical therapeutics at least once per day, 66.4% several times with an overall median duration of 15 min. Highest single expenditure of time was due to balneotherapy (n = 115; median bathing time: 40 min). In 81.9%, the health insurance did not completely cover the costs for topical treatment causing additional financial burden to the patient with a median of 71 € per quarter, herein creams being the largest cost factor (50 €). Patients with Netherton syndrome showed the highest median expenditure (170 €). The QoL impairment under treatment was moderate (median DLQI: 8.5 points). Pruritus was prevalent in 79.9% and showed a distinct impact on QoL (median 5PLQ: 7.5 points) without any significant difference between the subtypes (p = 0.37). CONCLUSION Patients suffering from ichthyoses have a large and lifelong overall burden in mild and severe subtypes. Since continuous topical treatment is required, financial and psychosocial support needs to be considered beyond dermatological care.
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Affiliation(s)
- C Klein
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Buddenturm, Münster, Germany
| | - R Sommer
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - M Augustin
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Ständer
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Center of Chronic Pruritus, University Hospital of Münster, Münster, Germany
- Section Pruritus Medicine, Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - S Salzmann
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - K Kiekbusch
- Support Group "Selbsthilfe Ichthyose e. V.", Mittenwalde, Germany
| | - J Bodes
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - M F Danzer
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - J Fischer
- Medical Center, Faculty of Medicine, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - S Steinke
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Hohenzollernring, Münster, Germany
- Medical School OWL, University of Bielefeld, Bielefeld, Germany
| | - K Süßmuth
- Department of Dermatology and Allergology, Helios Klinikum Berlin-Buch, Campus of Medical School Berlin, Berlin, Germany
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El Hachem M, De Marco R, Soria de Francisco JM, Audouze A, Aldwin-Easton M, Skayem C, Taieb C, Saint Aroman M, Ghienne H, Baissac C, Mazereeuw J, Bodemer C. Ichthyosis: multinational European study on patient characteristics, involved body sites and impact on quality of life. Br J Dermatol 2024; 190:773-775. [PMID: 38427773 DOI: 10.1093/bjd/ljae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/06/2024] [Accepted: 02/29/2024] [Indexed: 03/03/2024]
Abstract
We present the first large multinational study of ichthyosis to better understand the disease characteristics, the body sites involved and the effect of the disease on the quality of life of patients.
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Affiliation(s)
- May El Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, ERN-Skin HCP, Rome, Italy
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3
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Severino-Freire M, Granier Tournier C, Chiaverini C, Audouze A, Morice-Picard F, Texier H, Dreyfus I, Bing-Lecointe AC, Mallet S, Bodemer C, Fischer J, Jonca N, Mazereeuw-Hautier J. French national protocol for the management of congenital ichthyosis. Ann Dermatol Venereol 2024; 151:103247. [PMID: 38513308 DOI: 10.1016/j.annder.2024.103247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/27/2023] [Indexed: 03/23/2024]
Abstract
Congenital ichthyoses (CI) comprise a heterogeneous group of monogenic genetic skin diseases characterized by diffuse scaling, often associated with skin inflammation. Diagnosis of the individual form of ichthyosis is complex and is guided by clinical expertise. CI usually has a major impact on quality of life (QOL) and thus requires lifelong treatment. To date, there are no curative therapies, although various symptomatic treatment options exist. The present protocol for the management of CI has been drawn up in accordance with the recommendations published in 2012 by the French National Authority for Health, based on a literature review, with the help and validation of members of the French network for rare skin diseases (FIMARAD). It provides a summary of evidence and expert-based recommendations and is intended to help clinicians with the management of these rare and often complex diseases.
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Affiliation(s)
- M Severino-Freire
- University Hospital Center of Toulouse, Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, 24, Chemin de Pouvourville, TSA 30030 Toulouse Cedex 9, France
| | - C Granier Tournier
- University Hospital Center of Toulouse, Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, 24, Chemin de Pouvourville, TSA 30030 Toulouse Cedex 9, France
| | - C Chiaverini
- University Hospital Center of Nice, Department of Dermatology, Archet 2 Hospital, CS 23079, 06202 Nice Cedex 3, France
| | - A Audouze
- Association Ichtyose France, 37 rue du Golf, 03700 Bellerive sur Allier, France
| | - F Morice-Picard
- Department of Dermatology, University Hospital Center of Bordeaux - Hôpital Saint André, 1 Rue Jean Burguet, 33075 Bordeaux Cedex, France
| | - H Texier
- University Hospital Center of Toulouse, Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, 24, Chemin de Pouvourville, TSA 30030 Toulouse Cedex 9, France
| | - I Dreyfus
- University Hospital Center of Toulouse, Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, 24, Chemin de Pouvourville, TSA 30030 Toulouse Cedex 9, France
| | - A-C Bing-Lecointe
- Hospital Annecy-Genevois site Annecy, 1 Avenue De L'hôpital, 74370 Annecy, France
| | - S Mallet
- Department of Dermatology, University Hospital Center of Marseille, 264 rue Saint-Pierre, 13005 Marseille, France
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75743 Paris cedex 15, France
| | - J Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - N Jonca
- University Hospital Center of Toulouse, Hôpital Purpan, Cell Biology and Cytology Laboratory, Institut Fédératif de Biologie, Toulouse F-31300, France
| | - J Mazereeuw-Hautier
- University Hospital Center of Toulouse, Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, 24, Chemin de Pouvourville, TSA 30030 Toulouse Cedex 9, France.
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Butala S, Mazereeuw-Hautier J, Paller AS. Ichthyosis: presentation and management. Curr Opin Pediatr 2023; 35:467-474. [PMID: 37345742 DOI: 10.1097/mop.0000000000001264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
PURPOSE OF REVIEW This review focuses on the presentation and management of ichthyoses and highlights recent advances in treatment that hold promise for better targeted therapy. RECENT FINDINGS The ichthyoses are a group of rare genetic diseases with a wide phenotypic spectrum, characterized most often by generalized hyperkeratosis and scaling with variable erythema. The highly visible scaling and frequent itch contribute to decreased quality of life. Management for ichthyosis focuses on symptomatic relief and scale reduction with emollients, keratolytics, and retinoids. Recent advances in immune profiling and genotype-phenotype mapping have increased understanding of ichthyosis and shifted focus to pathogenesis-based targeted therapies with emerging biologics, small molecular inhibitors, and gene therapy. SUMMARY This article discusses clinical assessment and genotyping to make the diagnosis of specific forms of ichthyosis, provides guidance for management, and reviews new treatment options with systemic agents.
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Affiliation(s)
- Sneha Butala
- Department of Pediatrics, Yale New Haven Health - Bridgeport Site, Bridgeport, Connecticut; Pediatric Healthcare Associates, Shelton, Connecticut, USA
| | - Juliette Mazereeuw-Hautier
- Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Paul Sabatier University, Toulouse, France
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Psychosocial implications of rare genetic skin diseases affecting appearance on daily life experiences, emotional state, self-perception and quality of life in adults: a systematic review. Orphanet J Rare Dis 2023; 18:39. [PMID: 36823650 PMCID: PMC9951542 DOI: 10.1186/s13023-023-02629-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Since the beginning of human genetic research, there are very few publications sharing insights of the negative impact of rare genetic skin diseases (RGSD) on patients' experiences. This systematic review assessed the psychosocial implications of these conditions in terms of daily life experiences, emotional state, self-perception, and Quality of Life (QoL). METHODOLOGY A systematic review was carried out on albinism, neurofibromatosis type 1 (NF1), birthmarks and inherited ichthyosis. The PubMed, Scopus, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection, and SOCindex databases were queried. Inclusion criteria were adult patients with one of these RGSDs. Simple descriptive statistics and qualitative content analysis were conducted to summarize the main results reported by the authors. RESULTS Of the 9987 articles retrieved, 48 articles were included: albinism (16), NF1 (16), inherited ichthyosis (10), birthmarks (6). The majority of the studies on albinism were conducted in Africa. Twenty-seven studies quantitatively assessed diverse psychological parameters: 13 showed a significant impact of the disease on QoL, five on emotional state, two on self-representation and two others on psychiatric comorbidities. Disease severity and visibility were good predictors of QoL (except for albinism). Body image and appearance concerns were also associated with QoL and emotional state. The 19 qualitative studies highlighted recurring themes across each of these diseases: discrimination and stigma during childhood and adolescence, discomfort in social interactions, guilt of transmission, the importance of social support from family and friends, altered daily life functioning, altered romantic and sex life, limited academic and professional aspirations, lack of interest and support from the medical field, and the unpredictability of the evolution of the disease. The only two mixed-method studies in this review were unable to contribute to any inferential analyses but could corroborate some of the qualitative findings. CONCLUSION These results showed that RGSDs have a significant impact on different aspects of patients' lives. This review has demonstrated that there is a real need for support systems for patients with these diseases. Such systems should be developed to provide them with necessary information and to guide them through an appropriate care pathway.
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6
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Gutiérrez-Cerrajero C, Sprecher E, Paller AS, Akiyama M, Mazereeuw-Hautier J, Hernández-Martín A, González-Sarmiento R. Ichthyosis. Nat Rev Dis Primers 2023; 9:2. [PMID: 36658199 DOI: 10.1038/s41572-022-00412-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 01/20/2023]
Abstract
The ichthyoses are a large, heterogeneous group of skin cornification disorders. They can be inherited or acquired, and result in defective keratinocyte differentiation and abnormal epidermal barrier formation. The resultant skin barrier dysfunction leads to increased transepidermal water loss and inflammation. Disordered cornification is clinically characterized by skin scaling with various degrees of thickening, desquamation (peeling) and erythema (redness). Regardless of the type of ichthyosis, many patients suffer from itching, recurrent infections, sweating impairment (hypohidrosis) with heat intolerance, and diverse ocular, hearing and nutritional complications that should be monitored periodically. The characteristic clinical features are considered to be a homeostatic attempt to repair the skin barrier, but heterogeneous clinical presentation and imperfect phenotype-genotype correlation hinder diagnosis. An accurate molecular diagnosis is, however, crucial for predicting prognosis and providing appropriate genetic counselling. Most ichthyoses severely affect patient quality of life and, in severe forms, may cause considerable disability and even death. So far, treatment provides only symptomatic relief. It is lifelong, expensive, time-consuming, and often provides disappointing results. A better understanding of the molecular mechanisms that underlie these conditions is essential for designing pathogenesis-driven and patient-tailored innovative therapeutic solutions.
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Affiliation(s)
- Carlos Gutiérrez-Cerrajero
- Department of Medicine, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amy S Paller
- Departments of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | | | | | - Rogelio González-Sarmiento
- Department of Medicine, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
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7
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Walsh C, Leavey G, Mc Laughlin M, Paller AS, Irvine AD, Browne F, Mellerio JE, Bewley A. Novel mixed-method, inclusive protocol involving global key stakeholders, including carers as experts, to co-develop relevant Caregiver-Reported Outcome Domains (CRODs) in skin disease. BMJ Open 2023; 13:e068893. [PMID: 36657764 PMCID: PMC9853252 DOI: 10.1136/bmjopen-2022-068893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Ichthyoses comprise a heterogenous group of rare genetic skin disorders that involves the entire skin surface, often with additional syndromic features, and pose many clinical challenges. Without curative intervention, the mainstay of life-long symptom management is supportive in nature and can remain the responsibility of the caregiver. Although impact on the wider family is considered an important outcome of policies and services, there is a lack of caregiver consensus on what outcome domains to measure to fully assess the impact of ichthyosis on the patient and the caregiver. This project aims to identify a set of core outcome domains towards a core outcome set for ichthyosis that can measure all relevant concepts of ichthyosis in clinical practice, service delivery and research. METHODS AND ANALYSIS Following the COMET (Core Outcome Measures in Effectiveness Trials) initiative, this project will employ a mixed-method study design which was developed using public and patient involvement and an international multidisciplinary expert group (clinical experts, patients and their representatives, policymakers, researchers and service providers). Experts by experience, or caregivers, will be recruited through online ichthyosis support groups. Phase one will focus on item generation and involve: (1) a systematic literature review, (2) a multimethods international qualitative study with ichthyosis caregivers and (3) co-development of items for an e-survey. Phase two, item refinement, will employ a novel four-pronged consensus approach: (1) an e-Delphi survey, (2) statistical analysis of e-Delphi survey results, (3) online qualitative feedback and (4) an online consensus discussion. All methodological considerations will be clearly linked with each Core Outcome Set-STAndards for Developing recommendation. ETHICS AND DISSEMINATION Research Ethics Committee approval obtained from the School of Psychology, Ulster University (UK)(Ref:REC/20/0004). Results will be presented in published international peer-reviewed journals, at scientific meetings and support groups. REGISTRATION COMET database (January 2019).
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Affiliation(s)
- Carleen Walsh
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | | | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alan D Irvine
- Department of Clinical Medicine, University of Dublin Trinity College, Dublin, Ireland
| | - Fiona Browne
- Department of Dermatology, Children's Health Ireland (CHI), Dublin, Ireland
| | - Jemima E Mellerio
- Department of Dermatology, St. John's Institute of Dermatology, St. Thomas' Hospital, London, UK
| | - Anthony Bewley
- Department of Clinical Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
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Sharma M, Hemrajani P, Sharath Kumar BC. Quality of life among pediatric patients and their families suffering from congenital ichthyosis - A cross-sectional study. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2022. [DOI: 10.4103/ijpd.ijpd_136_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hake L, Süßmuth K, Komlosi K, Kopp J, Drerup C, Metze D, Traupe H, Hausser I, Eckl KM, Hennies HC, Fischer J, Oji V. Quality of life and clinical characteristics of self-improving congenital ichthyosis within the disease spectrum of autosomal recessive congenital ichthyosis. J Eur Acad Dermatol Venereol 2021; 36:582-591. [PMID: 34908195 DOI: 10.1111/jdv.17873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of ichthyoses presenting at birth. Self-improving congenital ichthyosis (SICI) is a subtype of ARCI and is diagnosed when skin condition improves remarkably (within years) after birth. So far, there is sparse data on SICI and quality of life (QoL) in this ARCI subtype. This study aims to further delineate the clinical spectrum of SICI as a rather unique subtype of ARCI. OBJECTIVES This prospective study included 78 patients (median age: 15 years) with ARCI who were subdivided in SICI (n=18) and non-SICI patients (nSICI, n=60) by their ARCI phenotype. METHODS Quality of life (QoL) was assessed using the (Children's) Dermatology Life Quality Index. Statistical analysis was performed with Chi-square- and t-tests. RESULTS The genetically confirmed SICI patients presented causative mutations in the following genes: ALOXE3 (8/16; 50.0%), ALOX12B (6/16; 37.5%), PNPLA1 (1/16; 6.3%) and CYP4F22 (1/16; 6.3%). Hypo-/anhidrosis and insufficient Vitamin D levels (< 30 ng/ml) were often seen in SICI patients. Brachydactyly (a shortening of the 4th and 5th finger) was statistically more frequent in SICI (p=0.023) than nSICI patients. A kink of the ear's helix was seen in half of the SICI patients and tends to occur more frequently in patients with ALOX12B mutations (p=0.005). QoL was less impaired in patients under the age of 16, regardless of ARCI type. CONCLUSIONS SICI is an underestimated, milder clinical variant of ARCI including distinct features such as brachydactyly and kinking of the ears. Clinical experts should be aware of these features when seeing neonates with a collodion membrane. SICI patients should be regularly checked for clinical parameters such as hypo-/anhidrosis or vitamin D levels and monitored for changes in quality of life.
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Affiliation(s)
- L Hake
- Department of Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - K Süßmuth
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - K Komlosi
- Institute of Human Genetics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Kopp
- Institute of Human Genetics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C Drerup
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - D Metze
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - I Hausser
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - K M Eckl
- Department of Biological and Geographical Sciences, University of Huddersfield, Huddersfield, United Kingdom.,Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria.,Department of Biology, Edge Hill University, Ormskirk, UK
| | - H C Hennies
- Department of Biological and Geographical Sciences, University of Huddersfield, Huddersfield, United Kingdom.,Cologne Center for Genomics, University Hospital Cologne, Cologne, Germany
| | - J Fischer
- Institute of Human Genetics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - V Oji
- Department of Dermatology, University Hospital Münster, Münster, Germany
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Xerfan EMS, Facina AS, Tomimori J, Tufik S, Andersen ML. The importance of evaluating sleep complaints in children with ichthyoses: a commentary on physical and psychological growth impairment. J Clin Sleep Med 2021; 17:1147-1148. [PMID: 33682676 DOI: 10.5664/jcsm.9208] [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] [Indexed: 11/13/2022]
Abstract
NONE Ichthyosis, as a debilitating disease, can cause significant physical and psychological damage to children and their families, which also includes sleep impairment. We call attention to the importance of evaluating sleep complaints in these patients, given the scarcity of studies on this subject. As the disease commonly results in severe skin injury, it can affect social relationships and the life and sleep quality of the individuals, leading to significant psychologic damage that can persist throughout their lives.
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Affiliation(s)
- Ellen M S Xerfan
- Programa de Pós-Graduação em Medicina Translacional, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Anamaria S Facina
- Departamento de Dermatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jane Tomimori
- Programa de Pós-Graduação em Medicina Translacional, Universidade Federal de São Paulo, São Paulo, Brazil.,Departamento de Dermatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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TROIANO GIANMARCO, LAZZERI GIACOMO. A review of quality of life of patients suffering from ichthyosis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E374-E378. [PMID: 33150225 PMCID: PMC7595076 DOI: 10.15167/2421-4248/jpmh2020.61.3.1450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
Introduction Ichthyoses include a heterogeneous group of skin diseases often characterized by persistent scaling and hyperkeratosis with variable erythema, pruritus, and sweating impairment. The aim of our review was to assess the quality of life in patients with ichthyosis. Methods In July 2018 we performed a systematic search in the electronic database PubMed (MEDLINE). The MESH term “quality of life” was combined, through the Boolean operator AND with the key word “ichthyosis”. We considered eligible for the systematic review studies written in English. Results The literature search yielded 63 publications, but 7 studies were included in the review. Studies were published in 2003-2014 and involved a minimum of 10 and a maximum of 235 patients. Authors used 5 types of tools: Dermatology Life Quality Index (DLQI), Dermatitis Family Impact Questionnaire (DFI), Nottingham Health Profile (NHP) questionnaire, Short Form Questionnaire 36 and 12 (SF-36, SF-12). Many patients reported worse scores than general population. Patients referred physical problems related to pain (which negatively influenced the mobility). Conclusions Ichthyosis considerably impaired the QoL, especially for paediatric patients. Further studies and efforts should be done to manage and treat the pain.
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Affiliation(s)
- GIANMARCO TROIANO
- Correspondence: Gianmarco Troiano, Department of Molecular & Developmental Medicine, University of Siena, Italy - E-mail:
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12
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El Hachem M, Abeni D, Diociaiuti A, Rotunno R, Gesualdo F, Zambruno G, Bodermer C. Italian translation, cultural adaptation, and pilot testing of a questionnaire to assess family burden in inherited ichthyoses. Ital J Pediatr 2019; 45:26. [PMID: 30782190 PMCID: PMC6381706 DOI: 10.1186/s13052-019-0618-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/11/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Inherited ichthyoses are rare disorders characterized by generalized skin scaling. Among them, autosomal recessive congenital ichthyoses (ARCI) form a major subgroup presenting lifelong and severely disabling cutaneous and extracutaneous features and symptoms for which no curative treatment is available. Management relies on daily time-consuming and distressing topical medications. Disease manifestations, symptoms, and daily care affect not only the patient self-perception, but also different dimensions of patient and family life. To date, there is only a French validated ichthyosis-specific questionnaire, "Family Burden in Ichthyosis" (FBI), for the evaluation of family disease burden. It addresses economical aspects, daily life, familial and personal relationships, work, and psychological impact. The aim of our study was to develop an Italian translation of the French FBI questionnaire and to pilot-test it in ARCI patients. METHODS The guidelines for cross-cultural adaptation of health-related quality of life measures were followed. Specifically, two independent forward translations were produced, followed by a reconciliation step by a multidisciplinary expert committee and back-translation. Revision of the original text and all translations was performed by the expert committee leading to a final version, which was pilot-tested by cognitive debriefing on 10 caregivers whose comments were evaluated by the committee. RESULTS The translation and reconciliation process led to minor changes in five items in order to clarify the questions in relation to the possible answers or to obtain semantic/idiomatic/cultural equivalence of the Italian version with the French one. The cognitive debriefing process resulted into further minor wording modifications in four items to describe more precisely the disease impact according to parents' comments. The FBI developer approved the final Italian FBI version. CONCLUSIONS The Italian version of the FBI generated in the present study is a useful instrument to measure the impact of ichthyosis on family daily life, education and working activities, psychological implications, and the disease economic load. The questionnaire will be further validated through a multicenter Italian study on burden of ARCI. A validated Italian questionnaire is a valuable tool for future clinical trials. In addition, it can be used to rapidly identify family distressing situations, which require attention and prompt intervention.
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Affiliation(s)
- May El Hachem
- Dermatology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Roberta Rotunno
- Dermatology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Francesco Gesualdo
- Multifactorial and Complex Disease Research Area, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Giovanna Zambruno
- Dermatology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Christine Bodermer
- Department of Dermatology, Necker-Enfants Malades Hospital, Centre de Référence National pour les Maladies Génétiques à Expression Cutanée (MAGEC), APHP, Paris, France
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13
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Mazereeuw-Hautier J, Vahlquist A, Traupe H, Bygum A, Amaro C, Aldwin M, Audouze A, Bodemer C, Bourrat E, Diociaiuti A, Dolenc-Voljc M, Dreyfus I, El Hachem M, Fischer J, Gånemo A, Gouveia C, Gruber R, Hadj-Rabia S, Hohl D, Jonca N, Ezzedine K, Maier D, Malhotra R, Rodriguez M, Ott H, Paige DG, Pietrzak A, Poot F, Schmuth M, Sitek JC, Steijlen P, Wehr G, Moreen M, O'Toole EA, Oji V, Hernandez-Martin A. Management of congenital ichthyoses: European guidelines of care, part one. Br J Dermatol 2018; 180:272-281. [PMID: 30216406 DOI: 10.1111/bjd.17203] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/21/2022]
Abstract
These guidelines for the management of congenital ichthyoses have been developed by a multidisciplinary group of European experts following a systematic review of the current literature, an expert conference held in Toulouse in 2016 and a consensus on the discussions. They summarize evidence and expert-based recommendations and are intended to help clinicians with the management of these rare and often complex diseases. These guidelines comprise two sections. This is part one, covering topical therapies, systemic therapies, psychosocial management, communicating the diagnosis and genetic counselling.
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Affiliation(s)
- J Mazereeuw-Hautier
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | - A Vahlquist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58,, D-48149, Münster, Germany
| | - A Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - C Amaro
- Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - M Aldwin
- Ichthyosis Support Group, PO Box 1242, Yateley, GU47 7FL, U.K
| | - A Audouze
- Association Ichtyose France, Bellerive sur Allier, France
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris
| | - E Bourrat
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France
| | - A Diociaiuti
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - M Dolenc-Voljc
- Department of Dermatovenereology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - I Dreyfus
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | - M El Hachem
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - J Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Gånemo
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - C Gouveia
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris
| | - D Hohl
- Department of Dermatology, Hôpital de Beaumont, Lausanne, Switzerland
| | - N Jonca
- Epithelial Differentiation and Rheumatoid Autoimmunity Unit (UDEAR), UMR 1056 Inserm - Toulouse 3 University, Purpan Hospital, Toulouse, France
| | - K Ezzedine
- Department of Dermatology, Hôpital Henri Mondor, EA EpiDerm, UPEC-Université Paris-Est Créteil, 94010, Créteil, France
| | - D Maier
- Dermatology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, U.K
| | - M Rodriguez
- Department of Ear, Nose and Throat, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - H Ott
- Division of Pediatric Dermatology and Allergology, Auf Der Bult Children's Hospital, Hanover, Germany
| | - D G Paige
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, U.K
| | - A Pietrzak
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - F Poot
- ULB-Erasme Hospital, Department of Dermatology, Brussels, Belgium
| | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - J C Sitek
- Department of Dermatology and Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - P Steijlen
- Department of Dermatology, Maastricht University Medical Centre, GROW Research School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - G Wehr
- Selbsthilfe Ichthyose, Kürten, Germany
| | - M Moreen
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Belgium
| | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58,, D-48149, Münster, Germany.,Hautarztpraxis am Buddenturm, Rudolf-von-Langen-Straße 55, D-48147, Münster, Germany
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14
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Torkamani N, Phal P, Savarirayan R, Simm P, Varigos G, Wark J. Concomitant extraspinal hyperostosis and osteoporosis in a patient with congenital ichthyosis. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2016; 13:157-159. [PMID: 27920816 DOI: 10.11138/ccmbm/2016.13.2.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ichthyosiform dermatosis is a term referred to a group of disorders that have as their basis a disorder of keratinization (1). These conditions which are present at birth result in a generalized dry, scaly skin without any inflammation. There are several types of ichthyosis based on their clinical presentation and mode of inheritance. The most common types are: ichthyosis vulgaris, X-linked recessive ichthyosis, epidermolytic hyperkeratosis (bullous), lamellar ichthyosis and non-bullous ichthyosiform erythroderma. Lamellar ichthyosis, which is inherited in an autosomal recessive pattern, shows genetic heterogeneity with the most severe type being due to mutations in the transglutaminase-1 gene. This condition presents with skin changes at birth and cases are referred to as collodion babies. Initially, the stratum corneum is smooth and appears as though it is covered with cellophane. This layer is discarded a few days after birth, leaving a generalized inflamed and scaly appearance. The skin is tight at this stage and may cause ectropion, and difficulties in feeding and temperature regulation. Lamellar ichthyosis is characterized by plate-like scales that last for life and can significantly impact the patient's quality of life (2). We report here a case of multiple extraspinal hyperostoses concomitant with marked osteoporosis and vitamin D deficiency in a patient taking acitretin for 20 years due to severe congenital lamellar ichthyosis.
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Affiliation(s)
- Niloufar Torkamani
- The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Pramit Phal
- Department of Radiology, Epworth Medical Imaging, Melbourne, Australia
| | - Ravi Savarirayan
- Victorian Clinical Genetics Service, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Peter Simm
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - George Varigos
- The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - John Wark
- The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
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15
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Dufresne H, Hadj-Rabia S, Taieb C, Bodemer C. Development and validation of an epidermolysis bullosa family/parental burden score. Br J Dermatol 2015; 173:1405-10. [DOI: 10.1111/bjd.14072] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 12/27/2022]
Affiliation(s)
- H. Dufresne
- Department of Dermatology; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC); Institut Imagine; Hôpital Universitaire Necker-Enfants Malades; 149 Rue de Sèvres 75015 Paris France
| | - S. Hadj-Rabia
- Department of Dermatology; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC); Institut Imagine; Hôpital Universitaire Necker-Enfants Malades; 149 Rue de Sèvres 75015 Paris France
- NSERM U1163, Université Paris Descartes - Sorbonne Paris Cité, Institut Imagine; 149 Rue de Sèvres 75015 Paris France
| | - C. Taieb
- Public Health and Quality of Life; Pierre Fabre; Paris France
| | - C. Bodemer
- Department of Dermatology; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC); Institut Imagine; Hôpital Universitaire Necker-Enfants Malades; 149 Rue de Sèvres 75015 Paris France
- NSERM U1163, Université Paris Descartes - Sorbonne Paris Cité, Institut Imagine; 149 Rue de Sèvres 75015 Paris France
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16
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Vahlquist A, Blockhuys S, Steijlen P, van Rossem K, Didona B, Blanco D, Traupe H. Oral liarozole in the treatment of patients with moderate/severe lamellar ichthyosis: results of a randomized, double-blind, multinational, placebo-controlled phase II/III trial. Br J Dermatol 2015; 170:173-81. [PMID: 24102348 PMCID: PMC4232915 DOI: 10.1111/bjd.12626] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 01/22/2023]
Abstract
Summary
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Affiliation(s)
- A Vahlquist
- Department of Medical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden
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17
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Dreyfus I, Chouquet C, Ezzedine K, Henner S, Chiavérini C, Maza A, Pascal S, Rodriguez L, Vabres P, Martin L, Mallet S, Barbarot S, Dupuis J, Mazereeuw-Hautier J. Prevalence of inherited ichthyosis in France: a study using capture-recapture method. Orphanet J Rare Dis 2014; 9:1. [PMID: 24393603 PMCID: PMC3892037 DOI: 10.1186/1750-1172-9-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/20/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Inherited ichthyoses represent a group of rare skin disorders characterized by scaling, hyperkeratosis and inconstant erythema, involving most of the tegument. Epidemiology remains poorly described. This study aims to evaluate the prevalence of inherited ichthyosis (excluding very mild forms) and its different clinical forms in France. METHODS Capture - recapture method was used for this study. According to statistical requirements, 3 different lists (reference/competence centres, French association of patients with ichthyosis and internet network) were used to record such patients. The study was conducted in 5 areas during a closed period. RESULTS The prevalence was estimated at 13.3 per million people (/M) (CI95%, [10.9 - 17.6]). With regard to autosomal recessive congenital ichthyosis, the prevalence was estimated at 7/M (CI 95% [5.7 - 9.2]), with a prevalence of lamellar ichthyosis and congenital ichthyosiform erythroderma of 4.5/M (CI 95% [3.7 - 5.9]) and 1.9/M (CI 95% [1.6 - 2.6]), respectively. Prevalence of keratinopathic forms was estimated at 1.1/M (CI 95% [0.9 - 1.5]). Prevalence of syndromic forms (all clinical forms together) was estimated at 1.9/M (CI 95% [1.6 - 2.6]). CONCLUSIONS Our results constitute a crucial basis to properly size the necessary health measures that are required to improve patient care and design further clinical studies.
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Affiliation(s)
- Isabelle Dreyfus
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - Cécile Chouquet
- Institut de Mathématiques de Toulouse, Laboratoire de Statistique et Probabilités, CNRS (UMR 5219), Paul Sabatier University, Toulouse, France
| | - Khaled Ezzedine
- Reference Centre for Rare Skin Diseases, Dermatology Department, CHU Bordeaux, Bordeaux, France
| | - Sophie Henner
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - Christine Chiavérini
- Reference Centre for epidermolysis bullosa, Dermatology Department, CHU Nice, Nice, France
| | - Aude Maza
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - Sandrine Pascal
- Institut de Mathématiques de Toulouse, Laboratoire de Statistique et Probabilités, CNRS (UMR 5219), Paul Sabatier University, Toulouse, France
| | - Lauriane Rodriguez
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - Pierre Vabres
- Competence Centre for Rare Skin Diseases Dermatology Department, CHU Dijon, Dijon, France
| | | | | | - Sébastien Barbarot
- Competence Centre for Rare Skin Diseases Dermatology Department, CHU Nantes, Nantes, France
| | - Jérôme Dupuis
- Institut de Mathématiques de Toulouse, Laboratoire de Statistique et Probabilités, CNRS (UMR 5219), Paul Sabatier University, Toulouse, France
| | - Juliette Mazereeuw-Hautier
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France
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18
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Aufenvenne K, Larcher F, Hausser I, Duarte B, Oji V, Nikolenko H, Del Rio M, Dathe M, Traupe H. Topical enzyme-replacement therapy restores transglutaminase 1 activity and corrects architecture of transglutaminase-1-deficient skin grafts. Am J Hum Genet 2013; 93:620-30. [PMID: 24055110 DOI: 10.1016/j.ajhg.2013.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 07/17/2013] [Accepted: 08/01/2013] [Indexed: 11/19/2022] Open
Abstract
Transglutaminase-1 (TG1)-deficient autosomal-recessive congenital ichthyosis (ARCI) is a rare and severe genetic skin disease caused by mutations in TGM1. It is characterized by collodion babies at birth, dramatically increased transepidermal water loss (TEWL), and lifelong pronounced scaling. The disease has a tremendous burden, including the problem of stigmatization. Currently, no therapy targeting the molecular cause is available, and the therapeutic situation is deplorable. In this study, we developed the basis for a causative therapy aiming at the delivery of the enzyme to the inner site of the keratinocytes' plasma membrane. We prepared sterically stabilized liposomes with encapsulated recombinant human TG1 (rhTG1) and equipped with a highly cationic lipopeptide vector to mediate cellular uptake. The liposomes overcame the problems of insufficient cutaneous delivery and membrane penetration and provided excellent availability and activity of rhTG1 in primary keratinocytes. To demonstrate the general feasibility of this therapeutic approach in a humanized context, we used a skin-humanized mouse model. Treatment with rhTG1 liposomes resulted in considerable improvement of the ichthyosis phenotype and in normalization of the regenerated ARCI skin: in situ monitoring showed a restoration of TG1 activity, and cholesterol clefts vanished ultrastructurally. Measurement of TEWL revealed a restoration of epidermal barrier function. We regard this aspect as a major advance over available nonspecific approaches making use of, for example, retinoid creams. We conclude that this topical approach is a promising strategy for restoring epidermal integrity and barrier function and provides a causal cure for individuals with TG1 deficiency.
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Affiliation(s)
- Karin Aufenvenne
- Department of Dermatology, University Hospital Münster, 48149 Münster, Germany.
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19
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Dufresne H, Hadj-Rabia S, Méni C, Sibaud V, Bodemer C, Taïeb C. Family burden in inherited ichthyosis: creation of a specific questionnaire. Orphanet J Rare Dis 2013; 8:28. [PMID: 23414570 PMCID: PMC3599730 DOI: 10.1186/1750-1172-8-28] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 02/03/2013] [Indexed: 11/29/2022] Open
Abstract
Background The concept of individual burden, associated with disease, has been introduced recently to determine the “disability” caused by the pathology in the broadest sense of the word (psychological, social, economic, physical). Inherited ichthyosis belong to a large heterogeneous group of Mendelian Disorders of Cornification. Skin symptoms have a major impact on patients’ Quality of Life but little is known about the burden of the disease on the families of patients. Objectives To develop and validate a specific burden questionnaire for the families of patients affected by ichthyosis. Methods Two steps were required. First, the creation of the questionnaire which followed a strict methodological process involving a multidisciplinary team and families. Secondarily, the validation of the questionnaire, including the assessment of its reliability, external validity, reproducibility and sensitivity, was carried out on a population of patients affected by autosomal recessive congenital ichthyosis. A population of parents of patients affected by ichthyosis was enrolled to answer the new questionnaire in association with the Short Form Q12 questionnaire (SF-12) and a clinical severity score was filled for each patient. Results Ninety four families were interviewed to construct the verbatim in order to create the questionnaire and a cognitive debriefing was realized. The concept of burden could be structured around five components: “economic”, “daily life”, “familial and personal relationship”, “work”, and “psychological impact”. As a result, “Family Burden Ichthyosis” (FBI) reproducible questionnaire of 25 items was created. Forty two questionnaires were analyzable for psychometric validation. Reliability (Cronbach’s alpha coefficient = 0.89), reflected the good homogeneity of the questionnaire. The correlation between mental dimensions of the SF-12 and the FBI questionnaire was statistically significant which confirmed the external validity. The mean FBI score was 71.7 ± 18.8 and a significant difference in the FBI score was shown between two groups of severity underlining a good sensitivity of the questionnaire. Conclusions The internal and external validity of the “FBI” questionnaire was confirmed and it is correlated to the severity of ichtyosis. Ichthyoses, and other chronic pathologies, are difficult to assess by clinical or Quality of Life aspects alone as their impact can be multidimensional. “FBI” takes them all into consideration in order to explain every angle of the handicap generated.
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Affiliation(s)
- Hélène Dufresne
- Department of Dermatology, Necker-Enfants Malades Hospital, Centre de Référence National pour les Maladies Génétiques à Expression Cutanée MAGEC, APHP, Paris, France
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20
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Diaz LZ, Browning JC, Smidt AC, Rizzo WB, Levy ML. Complications of ichthyosis beyond the skin. Dermatol Ther 2013; 26:39-45. [DOI: 10.1111/j.1529-8019.2012.01517.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lucia Z. Diaz
- Department of Dermatology; University of Texas Health Science Center-Houston; Houston; Texas
| | - John C. Browning
- Department of Pediatrics and Division of Dermatology; University of Texas Health Science Center at San Antonio; San Antonio; Texas
| | - Aimee C. Smidt
- Departments of Dermatology and Pediatrics; University of New Mexico School of Medicine; Albuquerque; New Mexico
| | - William B. Rizzo
- Department of Pediatrics; University of Nebraska Medical Center; Omaha; Nebraska
| | - Moise L. Levy
- Pediatric Dermatology; Dell Children's Medical Center; Austin; Texas
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21
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Abstract
Skin disease is highly prevalent in the United States, and it has been well-documented that patients with skin disease experience financial, psychological, social, and quality-of-life (QoL) burdens beyond those of the general population. Pediatric patients and their caregivers are particularly vulnerable to the burden of skin disease. Over the past decade disease-specific indices for QoL measurement in pediatric dermatology have been developed. Most of this research has focused on acne, atopic dermatitis, hemangiomas, ichythosis, psoriasis, and vitiligo. This article provides an overview of QoL assessment in pediatric dermatology for these six conditions.
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Affiliation(s)
- Megan M Brown
- Department of Dermatology, University of New Mexico School of Medicine, 1021 Medical Arts Avenue Northeast, Albuquerque, NM 87131, USA
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