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Braun C, Bourrel-Bouttaz M, Revol O, Verdu V, Montagnon A, Bérard F, Nosbaum A. Atopic Dermatitis and Self-Image Design: A Real-Life Study in Children Using Drawings. Dermatitis 2024; 35:S98-S102. [PMID: 36724458 DOI: 10.1089/derm.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Atopic dermatitis (AD) induces alterations of external appearance and self-esteem, with impact on the personal development of the children. However, tools for estimating such suffering are lacking. We aimed to assess how children with AD represent themselves through their drawings. Methods: In this retrospective study, we included children (<18 years) suffering from AD who followed the instruction "draw yourself with and without eczema" at the end of a routine follow-up consultation. Drawings were interpreted with the child and then classified in different analysis groups by 5 independent evaluators. Results: A total of 64 children (41 [64.1%] girls and 23 [35.9%] boys, median [range] age 8 [3-7] years) made 64 drawings. Five groups of drawing were identified: "amputee" (n = 8, 12.5%), "identical" (n = 18, 28.1%), "sad" (n = 19, 29.7%), "complex" (n = 11, 17.2%), and "other" (n = 8, 12.5%). Univariate analysis found that age was differently distributed among the different drawing groups (P = 0.0047), as was the predominance of light colors (P = 0.038). The distribution of the other variables (gender, investigator global assessment score, active AD, and duration of activity) was not different among drawing groups. Conclusions: The drawing allows a majority of the AD children to express their self-image with and without eczema, as well as their feelings and their interactions with the environment and with their entourage. The visual tool proposed herein could be used during consultations, to (a) become aware of the need to treat AD, (b) better evaluate the impact of AD burden in childhood, and (c) adjust appropriately AD treatment.
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Affiliation(s)
- Camille Braun
- From the Service de Pédiatrie, Pneumologie, Allergologie et Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France
| | - Magali Bourrel-Bouttaz
- Cabinet de Dermatologie, Chambéry, France
- Service D'immunologie Clinique et Allergologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Olivier Revol
- Service de Psychopathologie du Développement de L'enfant et de L'adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Virginie Verdu
- Service D'immunologie Clinique et Allergologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Anaïs Montagnon
- Service D'immunologie Clinique et Allergologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Frédéric Bérard
- Service D'immunologie Clinique et Allergologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Audrey Nosbaum
- Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France
- Service D'immunologie Clinique et Allergologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
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Bilimoria S, Tegtmeyer K, Lio P. Advances in the Translational Science of Dermatitis. Immunol Allergy Clin North Am 2021; 41:361-373. [PMID: 34225894 DOI: 10.1016/j.iac.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The cycle of converting mechanistic insight into therapeutic interventions is called translational science. It has been relatively sluggish in atopic dermatitis (AD), but finally pathomechanisms have been identified and therapeutic targets selected and refined. From inflammatory mediators, skin barrier enhancement, itch relief, and alteration of the microbiota, several therapies have been proposed and are actively being studied for AD, suggesting an end to the drought of innovation.
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Affiliation(s)
- Sara Bilimoria
- Northwestern University Feinberg School of Medicine, 363 West Erie Street, Suite 350, Chicago, IL 60616, USA
| | - Kyle Tegtmeyer
- Northwestern University Feinberg School of Medicine, 363 West Erie Street, Suite 350, Chicago, IL 60616, USA
| | - Peter Lio
- Northwestern University Feinberg School of Medicine, 363 West Erie Street, Suite 350, Chicago, IL 60616, USA.
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Pascal C, Maucort‐Boulch D, Gilibert S, Bottigioli D, Verdu V, Jaulent C, Hacard F, Bérard F, Nicolas J, Nosbaum A. Therapeutic management of adults with atopic dermatitis: comparison with psoriasis and chronic urticaria. J Eur Acad Dermatol Venereol 2020; 34:2339-2345. [DOI: 10.1111/jdv.16329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 02/18/2020] [Indexed: 01/06/2023]
Affiliation(s)
- C. Pascal
- Université Claude Bernard Lyon 1 Lyon Cedex 03 France
| | - D. Maucort‐Boulch
- Université Claude Bernard Lyon 1 Lyon Cedex 03 France
- Department of Biostatics and Bioinformatic Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
| | - S. Gilibert
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
| | - D. Bottigioli
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
| | - V. Verdu
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
| | - C. Jaulent
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
| | - F. Hacard
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
- CIRI (International Center for Infectiology Research) INSERM U1111 Ecole Normale Supérieure de Lyon CNRS UMR 5308 Université Claude Bernard Lyon 1 Lyon France
| | - F. Bérard
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
- CIRI (International Center for Infectiology Research) INSERM U1111 Ecole Normale Supérieure de Lyon CNRS UMR 5308 Université Claude Bernard Lyon 1 Lyon France
| | - J.‐F. Nicolas
- Université Claude Bernard Lyon 1 Lyon Cedex 03 France
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
- CIRI (International Center for Infectiology Research) INSERM U1111 Ecole Normale Supérieure de Lyon CNRS UMR 5308 Université Claude Bernard Lyon 1 Lyon France
| | - A. Nosbaum
- Université Claude Bernard Lyon 1 Lyon Cedex 03 France
- Allergology and Clinical Immunology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France
- CIRI (International Center for Infectiology Research) INSERM U1111 Ecole Normale Supérieure de Lyon CNRS UMR 5308 Université Claude Bernard Lyon 1 Lyon France
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Abstract
Skin eruptions are commonly encountered in the neonatal and infant period and can be a source of concern for providers and parents alike. We present a brief, clinically focused discussion on topics commonly encountered by the pediatrician with a focus on pearls of knowledge to help distinguish diseases from one another and from more serious conditions. We review miliaria, transient neonatal pustular melanosis, neonatal cephalic pustulosis, erythema toxicum neonatorum, diaper dermatitis, seborrheic dermatitis, and atopic dermatitis. Treatment strategies are also discussed. [Pediatr Ann. 2019;48(1):e16-e22.].
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Zozaya N, Martínez-Galdeano L, Alcalá B, Armario-Hita JC, Carmona C, Carrascosa JM, Herranz P, Lamas MJ, Trapero-Bertran M, Hidalgo-Vega Á. Determining the Value of Two Biologic Drugs for Chronic Inflammatory Skin Diseases: Results of a Multi-Criteria Decision Analysis. BioDrugs 2018; 32:281-291. [PMID: 29808418 PMCID: PMC5990558 DOI: 10.1007/s40259-018-0284-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Multi-criteria decision analysis (MCDA) is a tool that systematically considers multiple factors relevant to health decision-making. The aim of this study was to use an MCDA to assess the value of dupilumab for severe atopic dermatitis compared with secukinumab for moderate to severe plaque psoriasis in Spain. METHOD Following the EVIDEM (Evidence and Value: Impact on DEcision Making) methodology, the estimated value of both interventions was obtained by means of an additive linear model that combined the individual weighting (between 1 and 5) of each criterion with the individual scoring of each intervention in each criterion. Dupilumab was evaluated against placebo, while secukinumab was evaluated against placebo, etanercept and ustekinumab. A retest was performed to assess the reproducibility of weights, scores and value estimates. RESULTS The overall MCDA value estimate for dupilumab versus placebo was 0.51 ± 0.14. This value was higher than those obtained for secukinumab: 0.48 ± 0.15 versus placebo, 0.45 ± 0.15 versus etanercept and 0.39 ± 0.18 versus ustekinumab. The highest-value contribution was reported by the patients' group, followed by the clinical professionals and the decision makers. A fundamental element that explained the difference in the scoring between pathologies was the availability of therapeutic alternatives. The retest confirmed the consistency and replicability of the analysis. CONCLUSIONS Under this methodology, and assuming similar economic costs per patient for both treatments, the results indicated that the overall value estimated of dupilumab for severe atopic dermatitis was similar to, or slightly higher than, that of secukinumab for moderate to severe plaque psoriasis.
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Affiliation(s)
- Néboa Zozaya
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain.
| | - Lucía Martínez-Galdeano
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain
| | - Bleric Alcalá
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain
| | | | - Concepción Carmona
- Department of Healthcare, Servicio Extremeño de Salud, Mérida, Badajoz, Spain
| | - Jose Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Pedro Herranz
- Department of Dermatology, La Paz Universitary Hospital-Carlos III, Madrid, Spain
| | - María Jesús Lamas
- Servicio de Farmacia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - Marta Trapero-Bertran
- Faculty of Economics and Social Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Álvaro Hidalgo-Vega
- Fundación Weber, Majadahonda, Madrid, Spain
- Universidad de Castilla-La Mancha, Campus de Toledo, Toledo, Spain
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