1
|
Yang X, Feng Z, Cai M. Elevated Specific Pro-Inflammatory Cytokines in Peripheral Circulation Indicate an Increased Risk of Anxiety and Depression in Rosacea. J Inflamm Res 2024; 17:4443-4452. [PMID: 39006492 PMCID: PMC11246074 DOI: 10.2147/jir.s468773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Objective Pro-inflammatory cytokines mediate the course of rosacea, anxiety, and depression through various means such as immunity and inflammation. This study aims to further explore the relationship between rosacea, anxiety, and depression through changes in the levels of pro-inflammatory cytokines. Methods 280 rosacea patients were included in the rosacea group, divided into: rosacea without mental disorders, rosacea with anxiety, rosacea with depression, and rosacea with combined anxiety and depression. The mental control group included 210 anxiety and depression patients, divided into: anxiety, depression, and combined anxiety and depression. The healthy control group consisted of 70 healthy individuals. Serum specimens were collected and ELISA was used to detect major pro-inflammatory cytokines. CEA, IGA, GFSS, RosaQoL, HAMA, and HAMD-24 were used for the diagnosis and severity assessment of rosacea and anxiety and depression. Results This study primarily used the Chi-Square test, Kruskal-Wallis H-test, generalized linear model, and binary logistic regression to evaluate the data. IL-1β, IL-17, and IL-8 levels in rosacea patients and anxiety/depression patients were higher than those in the healthy population (P<0.001), and TNF-α levels in rosacea patients were higher than those in the healthy population (P<0.001). There was an interaction between rosacea, anxiety, and depression in terms of IL-1β, IL-17, and IL-8 levels (P<0.001). Elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with anxiety and depression in rosacea (all P<=0.05). Conclusion It was confirmed that the elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with the onset of anxiety and depression in rosacea. The interaction of the above inflammatory factors suggests a possible common inflammatory mechanism in the coexistence of rosacea and mental disorders. TNF-α only increased in patients with rosacea, combined with the skin-to-mental irreversible phenomenon, indicating that this cytokine may be a key and potential therapeutic target for the onset of rosacea.
Collapse
Affiliation(s)
- Xiaoting Yang
- Department of Dermatology and Venereology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, People’s Republic of China
| | - Zuxing Feng
- Department of Psychiatry, The Psychiatry Hospital of Yunnan, Kunming, Yunnan, 650224, People’s Republic of China
| | - Mei Cai
- Department of Dermatology and Venereology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, People’s Republic of China
| |
Collapse
|
2
|
Chernyshov PV, Tomas-Aragones L, Zuberbier T, Kocatürk E, Manolache L, Pustisek N, Svensson Å, Marron SE, Sampogna F, Bewley A, Salavastru C, Koumaki D, Augustin M, Linder D, Abeni D, Salek SS, Szepietowski JC, Jemec GB. Quality of life measurement in assessing treatment effectiveness in urticaria: European experts position statement. Int J Dermatol 2024. [PMID: 38965063 DOI: 10.1111/ijd.17366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
In this study, the European Academy of Dermatology and Venereology (EADV) Task Forces on Quality of Life and Patient-Oriented Outcomes and Urticaria and Angioedema has examined the Health-Related Quality of Life (HRQoL) measurement in the treatment of urticaria. The Dermatology Life Quality Index was the most frequently used HRQoL instrument in clinical trials on urticaria. Many reports of clinical trials of urticaria gave no exact numeric results related to HRQoL changes, making clear conclusions and comparisons with other studies impossible. The interpretation of HRQoL impairment data is more difficult when assessed by instruments without severity stratification systems. The minimal clinically significant difference (MCID) is a more clinically oriented and relevant parameter than depending on statistically significant changes in HRQoL scores. Therefore, using HRQoL instruments with established MCID data in clinical trials and clinical practice is preferred.
Collapse
Affiliation(s)
| | | | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Emek Kocatürk
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | | | | | - Åke Svensson
- Department of Dermatology and Venereology, Skåne University Hospital, Malmö, Sweden
| | - Servando E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | | | - Anthony Bewley
- Barts Health NHS Trust, London, UK
- Queen Mary University, London, UK
| | - Carmen Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Dimitra Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dennis Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | | | - Sam S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| |
Collapse
|
3
|
Chernyshov PV, Finlay AY, Tomas-Aragones L, Zuberbier T, Kocatürk E, Manolache L, Pustisek N, Svensson A, Marron SE, Sampogna F, Bewley A, Salavastru C, Koumaki D, Augustin M, Linder D, Abeni D, Salek SS, Szepietowski J, Jemec GB. Quality of life measurement in urticaria: Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient-Oriented Outcomes and Urticaria and Angioedema. J Eur Acad Dermatol Venereol 2024. [PMID: 38855825 DOI: 10.1111/jdv.20157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces on quality of life (QoL) and patient-oriented outcomes and on urticaria and angioedema recommendations for the assessment of Health-related (HR) QoL in all patients with urticaria in research and practice are as follows: to use the DLQI for adults and the CDLQI for children as dermatology-specific and the CU-Q2oL as a disease-specific HRQoL instruments in urticaria; to use generic instruments to provide comparison of data on urticaria with non-dermatologic diseases, or to compare with healthy volunteers or the general population; to select validated HRQoL instruments with appropriate age limits; to present exact numeric data for HRQoL results; correct title of any HRQoL instrument should be used, along with its correct abbreviation and the reference to its original publication, where possible. The EADV TFs discourage the use of non-validated HRQoL instruments and modified HRQoL instruments that have not undergone standard validation.
Collapse
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - T Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - E Kocatürk
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - L Manolache
- Department of Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - A Bewley
- Barts Health NHS Trust, London, UK
- Queen Mary University, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - J Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| |
Collapse
|
4
|
Takahashi KH, Utiyama TO, Bagatin E, Picosse FR, Almeida FA. Efficacy and safety of botulinum toxin for rosacea with positive impact on quality of life and self-esteem. Int J Dermatol 2024; 63:590-596. [PMID: 38246911 DOI: 10.1111/ijd.17040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Rosacea is a prevalent chronic inflammatory skin disease with a multifactorial pathophysiology. It compromises several skin structures, including the proliferation and dilation of dermal blood vessels, primarily in the central areas of the face, accompanied by significant psychosocial impairment, leading to reduced quality of life (QoL) and self-esteem. There are consensus guidelines for its treatment, but few options for the erythema. This study hypothesizes that treating rosacea skin lesions with botulinum toxin (BTX) could improve signs and symptoms, resulting in enhanced QoL and self-esteem. METHODS This interventional, open, uncontrolled, and prospective study, conducted at a single center, included 33 individuals diagnosed with rosacea, treated with standard therapeutic options according to the rosacea subtype plus superficial injections of BTX, and followed up for 90 days. Botulinum toxin injections were applied on Days 1 and 14. Clinical features and side effects were assessed at each visit; QoL, self-esteem, and medication adherence questionnaires were administered on Days 1 and 90. RESULTS Treatment with BTX yielded improvement in the clinical signs of rosacea, registered by the investigators, and reported by 94% of the participants. Improved QoL scores (P < 0.05) and a notable increase in self-esteem scores (P < 0.001) were demonstrated. Rare adverse events were observed. CONCLUSIONS The utilization of BTX superficial injections in patients with rosacea was safe and effective, improving the clinical appearance of the lesions. Despite some limitations, to our knowledge, this is the first study that showed the positive impact of this treatment modality on both QoL and self-esteem.
Collapse
Affiliation(s)
- Katia H Takahashi
- Dermatology Outpatient Clinic, Department of Clinics, Faculty of Medical and Health Sciences at Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Thais O Utiyama
- Dermatology Outpatient Clinic, Department of Clinics, Faculty of Medical and Health Sciences at Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Edileia Bagatin
- Dermatology Outpatient Clinic, Department of Clinics, Faculty of Medical and Health Sciences at Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Fabíola R Picosse
- Dermatology Outpatient Clinic, Department of Clinics, Faculty of Medical and Health Sciences at Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Fernando A Almeida
- Dermatology Outpatient Clinic, Department of Clinics, Faculty of Medical and Health Sciences at Pontifical Catholic University of São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Chernyshov PV, Tomas-Aragones L, Manolache L, Pustisek N, Darlenski R, Marron SE, Koumaki D, Pochynok TV, Szepietowski JС, Wala-Zielinska K, Wójcik E, Szepietowska M, Lisicki B, Tsidylo IG, Chernyshov AV, Poot F, Magin P. Bullying in persons with skin diseases. J Eur Acad Dermatol Venereol 2024; 38:752-760. [PMID: 38059435 DOI: 10.1111/jdv.19683] [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: 06/26/2023] [Accepted: 10/23/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND There are few studies on bullying in skin diseases. Persons with skin diseases are especially prone to bullying. OBJECTIVES This component of the project 'Bullying among Dermatologic Patients' aimed to study the prevalence and nature of bullying in patients with skin diseases from different countries and age groups. METHODS Data were collected from participants of international social media groups for patients with skin diseases, in-patients and out-patients with skin diseases, and parents of children with skin diseases from six European countries. School and university students from Poland and Ukraine were asked to answer the question: Have you been bullied because of skin problems? RESULTS Bullying was reported in 1016 patients with 36 different skin diseases. Prevalence of self-reported and parental-reported bullying was quite heterogeneous among different countries In total, self-reported bullying was noted by 25.6% of patients with skin diseases during face-to-face consultations, by 63.7% of respondents from international patients' groups and by 12.2% of school and university students. Parental-reported bullying was detected in 34.5% of 3-4 years old children with skin diseases. The peak of bullying prevalence occurred between the ages of 13 and 15. The most prevalent forms of bullying were verbal abuse and social isolation. Physical abuse was the least often reported form of bullying. Only 33.2% of participants talked to anyone about being bullied. Negative long-term effects of bullying were reported by 63% of respondents. CONCLUSIONS Skin disease-related bullying was reported by patients in all centres of the project. The main manifestations of bullying were similar in different countries and among patients with different skin diseases. International activities aimed to decrease or prevent skin disease-related bullying in different age groups are needed. These activities should be multidirectional and target teachers, parents of classmates and classmates of children with skin diseases, patients' parents and patients themselves.
Collapse
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - R Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
- Department of Dermatology and Venereology, Trakia University, Stara Zagora, Bulgaria
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Greece
| | - T V Pochynok
- Department of Pediatrics Number 1, National Medical University, Kiev, Ukraine
| | - J С Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - K Wala-Zielinska
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - E Wójcik
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - M Szepietowska
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - B Lisicki
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - I G Tsidylo
- Public Non-profit Enterprise Precarpathian Clinical Dermatovenereological Center of the Ivano-Frankivsk Regional Council, Ivano-Frankivsk, Ukraine
| | - A V Chernyshov
- Department of Cellular Radiobiology, State Institution "National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine", Kiev, Ukraine
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - P Magin
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
6
|
Koumaki D, Rovithi E, Gregoriou S, Kouloumvakou S, Papadakis M, Boumpoucheropoulos S, Katoulis A, Evangelou G. Cutaneous body image in patients with rosacea: A cross-sectional study. J Eur Acad Dermatol Venereol 2024; 38:e274-e277. [PMID: 37907276 DOI: 10.1111/jdv.19591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Crete, Greece
| | - Evangelia Rovithi
- Dermatology Department, University Hospital of Heraklion, Crete, Greece
| | - Stamatios Gregoriou
- Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece
| | | | - Marios Papadakis
- Department of Surgery II, Witten/Herdecke University, Witten, Germany
| | | | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | | |
Collapse
|
7
|
Chernyshov PV, Finlay AY, Tomas-Aragones L, Tognetti L, Moscarella E, Pasquali P, Manolache L, Pustisek N, Svensson A, Marron SE, Bewley A, Salavastru C, Suru A, Koumaki D, Linder D, Abeni D, Augustin M, Blome C, Salek SS, Evers AWM, Poot F, Sampogna F, Szepietowski JС. Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology. J Eur Acad Dermatol Venereol 2024; 38:254-264. [PMID: 37877648 DOI: 10.1111/jdv.19570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023]
Abstract
Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments.
Collapse
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Pasquali
- Dermatology Department, Pius Hospital de Valls, Tarragona, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK
- The Royal London Hospital, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Crete, Greece
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Austria
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A W M Evers
- Institute of Psychology, Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | | |
Collapse
|
8
|
Hughes O, Bewley A. Is it really ever 'just acne'? Considering the psychodermatology of acne. Br J Dermatol 2023; 189:i11-i16. [PMID: 37903071 DOI: 10.1093/bjd/ljad251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 11/01/2023]
Abstract
Acne can create a significant burden for people of all ages. However, the psychological consequences might often be overlooked. This review comments on recent evidence in the field of psychodermatology, to highlight the importance of considering a person's mental health in the treatment of acne. A range of presenting issues are discussed, and cases of underserved patients needing additional considerations are highlighted. This article considers how the psychological sequelae can contribute to the pathogenesis of acne, and discusses how psychotherapeutic approaches can be of benefit to people experiencing appearance-related distress. Importantly, attention is paid to the need for clinicians to assess a patient's wellbeing alongside their physical symptoms. In doing this, early intervention can be facilitated if psychological comorbidities are present, with referral to appropriate specialist services, where available. To improve treatment outcomes, the skin and the mind must be addressed together in a multidisciplinary approach to dermatology care.
Collapse
Affiliation(s)
- Olivia Hughes
- School of Psychology, Cardiff University, Cardiff, UK
| | - Anthony Bewley
- Barts Health NHS Trust and Queen Mary University of London Medical School, London, UK
| |
Collapse
|
9
|
Guertler A, Volsky A, Eijkenboom Q, Fiedler T, French LE, Reinholz M. Dietary Patterns in Acne and Rosacea Patients-A Controlled Study and Comprehensive Analysis. Nutrients 2023; 15:4405. [PMID: 37892480 PMCID: PMC10609993 DOI: 10.3390/nu15204405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/23/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
As the relationship between exposome factors and inflammatory skin diseases is gaining increasing attention, the objective of this study was to investigate dietary patterns among acne and rosacea patients and to establish the disease risk attributable to nutrition. In this cross-sectional, controlled study, patients' dietary habits were assessed via subjective ratings of beneficial and trigger foods, followed by standardized food frequency surveys (FFS). Scores for disease-specific risk stratification based on dietary habits were proposed. Clinical assessments, dermatologic examinations, and laboratory analyses were performed. A total of 296 patients (acne group (AG) n = 120, control group (ACG) n = 32; rosacea group (RG) n = 105, control group (RCG) n = 39) were included. The significant impact of diet on disease severity was self-reported by 80.8% of the AG and 70.5% of the RG. Leading dietary triggers were found in both groups, while beneficial food items were identified more clearly by the AG. FFS revealed significant dietary differences between the AG, RG, and control groups. Disease-specific scores showed greater precision for acne (odds ratio 14.5 AG, 5.5 RG). The AG had higher insulin-like growth factor (IGF)-1 levels correlating with dairy intake (p = 0.006). Overall, this study underlines the influence of diet on acne and rosacea, providing valuable disease-specific scores for dietary risk stratification. Consuming vegetables, legumes, oily fish, olive oil, and nuts, and limiting meat, cheese, and alcohol appear to be beneficial for both acne and rosacea. Future studies can build on these data to further improve preventive and therapeutic strategies.
Collapse
Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Arina Volsky
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Quirine Eijkenboom
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Tobias Fiedler
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Lars E. French
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| |
Collapse
|
10
|
Hofmeyer S, Weber F, Gerds S, Emmert S, Thiem A. A Prospective Randomized Controlled Pilot Study to Assess the Response and Tolerability of Cold Atmospheric Plasma for Rosacea. Skin Pharmacol Physiol 2023; 36:205-213. [PMID: 37490882 PMCID: PMC10652650 DOI: 10.1159/000533190] [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: 03/29/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Rosacea is a common, facial, chronic inflammatory skin disease. Due to its complex pathogenesis, adequate therapy of rosacea can be challenging. An innovative recent therapeutic tool is cold atmospheric plasma (CAP), which is already established in the treatment of chronic wounds and promising in different other skin diseases. METHODS In a split-face pilot study we investigated dielectric-barrier-discharged CAP in erythemato-telangiectatic (ETR) and/or papulopustular rosacea (PPR). CAP treatment was applied on lesional skin of a randomized side once daily (90 s/area) for 6 weeks. The other untreated side served as control. Co-primary endpoints were ≥1 improvement of the Investigator Global Assessment (IGA) score on the treated side compared to control and a decline of the Dermatology Life Quality Index (DLQI) after 6 weeks. Secondary endpoints included inflammatory lesion count (papules and pustules), skin redness intensity and erythema size. Adverse events (AEs) were recorded constantly. Additionally, participants were weekly assessed for symptoms, skin condition, trigger factors, skin care, treatment success, and local tolerance parameters. All p values were calculated using the Wilcoxon signed-rank test. RESULTS Twelve subjects (ETR, n = 3; ETR and PPR, n = 9) completed the study. DLQI was significantly improved after 6 weeks (p = 0.007). On the CAP-treated side, lesions (p = 0.007) and erythema size (p = 0.041) were significantly reduced compared to the control. IGA (p = 0.2) and skin redness intensity (p = 0.5) did not differ significantly between control and CAP-treated side. No serious AEs occurred and treatment was well tolerated. CONCLUSION CAP is a promising new treatment of rosacea, especially for PPR.
Collapse
Affiliation(s)
- Stella Hofmeyer
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Frank Weber
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Rostock, Germany
| | - Sandra Gerds
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Alexander Thiem
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| |
Collapse
|
11
|
Ring J. Post-COVID dermatology-life will continue to be exciting. J Eur Acad Dermatol Venereol 2023; 37:845-846. [PMID: 37052423 DOI: 10.1111/jdv.19052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- Johannes Ring
- Department Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| |
Collapse
|