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Kridin K, Kafri N, Cohen AD. Is vitiligo associated with an increased risk of cardiovascular outcomes? Perceptions from a population-based study. Australas J Dermatol 2024; 65:384-386. [PMID: 38528737 DOI: 10.1111/ajd.14251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Khalaf Kridin
- Unit of Dermatology and Skin Research Laboratory, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Niv Kafri
- Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Arnon D Cohen
- Clalit Health Services, Tel-Aviv, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Jacobson ME, Rick JW, Gerbens LAA, Baghoomian W, Gould LJ, Marzano AV, Chen DM, Oakes DL, Dissemond J, Yamamoto T, Shinkai K, Nolan B, Lobato D, Thomas KS, Ortega-Loayza AG. A core domain set for pyoderma gangrenosum trial outcomes: an international eDelphi and consensus study from the UPGRADE initiative. Br J Dermatol 2024; 190:392-401. [PMID: 37952167 DOI: 10.1093/bjd/ljad420] [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: 07/27/2023] [Revised: 09/24/2023] [Accepted: 11/16/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Pyoderma gangrenosum (PG) is a rare ulcerative skin condition with no current standardized outcomes or outcome measures. With a rich investigational therapeutic pipeline, standardization of outcomes and improvement of data quality and interpretability will promote the appropriate and consistent evaluation of potential new therapies. Core outcome sets (COS) are agreed, standardized sets of outcomes that represent the minimum that should be measured and reported in all clinical trials of a specific condition. OBJECTIVES To identify and reach a consensus on which domains (what to be measured) should be included in the Understanding Pyoderma Gangrenosum: Review and Analysis of Disease Effects (UPGRADE) core domain set for clinical trials in PG. METHODS Collaborative discussions between patients and PG experts, and a systematic review of the literature identified items and prospective domains. A three-round international eDelphi exercise was performed to prioritize the domains and refine the provisional items (consensus: ≥ 70% of participants rating a domain as 'extremely important' and < 15% of participants voting 'not important'), followed by an international meeting to reach consensus on the core domain set (consensus: < 30% disagreement). Item-generation discussions and consensus meetings were hosted via online videoconferences. The eDelphi exercise and consensus voting were performed using Qualtrics survey software. Participants were adults with PG, healthcare professionals, researchers and industry representatives. RESULTS Collaborative discussions and systematic reviews yielded 115 items, which were distilled into 15 prospective domains. The eDelphi exercise removed the three lowest-priority domains ('laboratory tests', 'treatment costs' and 'disease impact on family') and ranked 'pain', 'quality of life' and 'physical symptoms' as the highest-priority prospective domains. Consensus was reached on the domains of 'pain', 'quality of life' and 'clinical signs'. The domain of 'disease course/disease progression' narrowly failed to reach consensus for inclusion in the core set (32% of participants voted 'no'). Refinement of this domain definition will be required and presented for consideration at future consensus meetings. CONCLUSIONS The UPGRADE core domain set for clinical trials in PG has been agreed by international multistakeholder consensus. Future work will develop and/or select outcome measurement instruments for these domains to establish a COS.
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Affiliation(s)
- Michael E Jacobson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Jonathan W Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Louise A A Gerbens
- Department of Dermatology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection, and Immunity, Amsterdam, the Netherlands
| | - Wenelia Baghoomian
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Lisa J Gould
- South Shore Health Center for Wound Healing, Weymouth, MA, USA
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Diana M Chen
- Genentech Incorporated, South San Francisco, CA, USA
| | - Debbie L Oakes
- South Shore Health Center for Wound Healing, Weymouth, MA, USA
| | - Joachim Dissemond
- Department of Dermatology, Venerology, and Allergology, University of Essen-Duisburg, Essen, Germany
| | - Toshiyuki Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Kanade Shinkai
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Kim S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
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Kridin K, Jeshurun E, Weinstein O, Cohen AD. Risk and determinants of herpes zoster in bullous pemphigoid: a large-scale population-based study. Arch Dermatol Res 2024; 316:73. [PMID: 38236286 DOI: 10.1007/s00403-023-02776-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/21/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Khalaf Kridin
- Unit of Dermatology and Skin Research Laboratory, Galilee Medical Center, Nahariya, Israel.
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
| | - Efrat Jeshurun
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Orly Weinstein
- Clalit Health Services, Tel-Aviv, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Ben-Gurion Ave, Beer Sheva, Israel
| | - Arnon D Cohen
- Clalit Health Services, Tel-Aviv, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Ben-Gurion Ave, Beer Sheva, Israel
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Lee S, Lee JY, Ju HJ, Lee JH, Koh SB, Bae JM, Han JH. Association of All-Cause and Cause-Specific Mortality Risks With Pyoderma Gangrenosum. JAMA Dermatol 2023; 159:151-159. [PMID: 36542392 PMCID: PMC9857499 DOI: 10.1001/jamadermatol.2022.5437] [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: 05/02/2022] [Accepted: 10/18/2022] [Indexed: 12/24/2022]
Abstract
Importance Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Few studies have evaluated the mortality outcomes of patients with PG. Objective To investigate all-cause and cause-specific mortality in patients with PG. Design, Setting, and Participants This retrospective population-based cohort study used data from the National Health Insurance Service database of Korea and the National Death Registry of Korea from patients with incident PG (≥3 documented visits with an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code of L88) during January 2003 to December 2019. For comparison, a 1:20 cohort of age-, sex-, insurance type-, and income level-matched controls without any documented visit with an ICD-10 code of L88 during the entire observation was included. Exposures Pyoderma gangrenosum. Main Outcomes and Measures The participants were observed from the index date to their death, emigration, or the end of the observation period to investigate all-cause and cause-specific mortality during the 17-year study period. Results In total, 3386 patients with PG (1450 women [42.8%]; mean [SD] age, 57.8 [16.4] years) and 67 720 controls (29 000 women [42.8%]; mean [SD] age, 57.8 [16.3] years) were analyzed. All-cause mortality risk was greater in patients with PG than in controls (adjusted hazard ratio [aHR], 2.122; 95% CI, 1.971-2.285) after adjustment for smoking, drinking, body mass index, and comorbidities. Patients experienced greater mortality of infectious disease (aHR, 3.855; 95% CI, 2.640-5.628), neoplasm (aHR, 1.618; 95% CI, 1.363-1.920), hematologic disease (aHR, 12.298; 95% CI, 3.904-38.734), endocrine disease (aHR, 6.322; 95% CI, 5.026-7.953), neurologic disease (aHR, 2.039; 95% CI, 1.337-3.109), cardiovascular disease (aHR, 1.979; 95% CI, 1.645-2.382), respiratory disease (aHR, 1.757; 95% CI, 1.365-2.263), gastrointestinal disease (aHR, 2.278; 95% CI, 1.522-3.408), connective tissue disease (aHR, 8.685; 95% CI, 4.963-15.199), and kidney/urogenital disease (aHR, 3.617; 95% CI, 2.488-5.259) than controls. Compared with idiopathic PG (aHR, 2.062; 95% CI, 1.897-2.241), PG that was associated with solid organ cancer (aHR, 2.313; 95% CI, 1.956-2.737) and hematologic cancer (aHR, 8.330; 95% CI, 5.473-12.679) showed greater mortality, whereas PG that was associated with inflammatory bowel diseases showed a slightly better prognosis (aHR, 1.742; 95% CI, 0.964-3.148). Conclusions and Relevance The results of this cohort study suggest that patients with PG had a higher all-cause and cause-specific mortality risk than the general population.
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Affiliation(s)
- Solam Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ju Yeong Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hae Lee
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju Hee Han
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Navarro-Sánchez A, Luri-Prieto P, Compañ-Rosique A, Navarro-Ortiz R, Berenguer-Soler M, Gil-Guillén VF, Cortés-Castell E, Navarro-Cremades F, Gómez-Pérez L, Pérez-Tomás C, Palazón-Bru A, Montejo AL, Pérez-Jover V. Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case-Control Study. J Clin Med 2021; 10:jcm10194401. [PMID: 34640419 PMCID: PMC8509279 DOI: 10.3390/jcm10194401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 12/17/2022] Open
Abstract
Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case–control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.
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Affiliation(s)
- Antonio Navarro-Sánchez
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
| | - Paloma Luri-Prieto
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
| | - Antonio Compañ-Rosique
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Ramón Navarro-Ortiz
- Orthopedic Surgery and Traumatology Service, Torrevieja University Hospital, 03186 Torrevieja, Spain;
| | - María Berenguer-Soler
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
| | - Vicente F. Gil-Guillén
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Ernesto Cortés-Castell
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Felipe Navarro-Cremades
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Luis Gómez-Pérez
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Carla Pérez-Tomás
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
| | - Antonio Palazón-Bru
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Angel L. Montejo
- Psychiatry Service, Clinical Hospital of the University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Paseo San Vicente SN, 37007 Salamanca, Spain
- Department of Psychiatry, Nursing School, University of Salamanca, Av. Donantes de Sangre SN, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-63-9754-620
| | - Virtudes Pérez-Jover
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
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Kridin K, Solomon A, Britva RL, Bitan DT, Cohen AD. Chronic renal comorbidities in pyoderma gangrenosum: a retrospective cohort study. Immunol Res 2021; 69:249-254. [PMID: 33890227 PMCID: PMC8266709 DOI: 10.1007/s12026-021-09187-3] [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] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/22/2021] [Indexed: 12/05/2022]
Abstract
The coexistence of pyoderma gangrenosum (PG) and chronic renal comorbidities has been reported anecdotally. We aimed to assess the bidirectional association between PG and the following chronic renal comorbidities: chronic renal failure (CRF), dialysis, kidney transplantation (KT), and other kidney diseases (OKD). That is to evaluate (i) the risk of the aforementioned diseases among patients with PG (ii) and the odds of PG after a diagnosis of renal comorbidities. A population-based retrospective cohort study was conducted comparing PG patients (n=302) with age-, sex-, and ethnicity-matched control subjects (n=1497) with regard to incident cases of renal comorbidities. A case-control design was additionally adopted to estimate the odds of PG in those with a preexisting history of renal comorbidities. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated by Cox regression and logistic regression, respectively. Patients with PG demonstrated an increased risk of CRF (adjusted HR, 3.68; 95% CI, 2.72-5.97), dialysis (adjusted HR, 27.79; 95% CI, 3.24-238.14), and OKD (adjusted HR, 2.71; 95% CI, 1.55-4.74). In addition, the odds of PG were increased after the diagnosis of CRF (adjusted OR, 2.34; 95% CI, 1.33-4.11), KT (adjusted OR, 5.03; 95% CI, 1.01-25.12), and OKD (adjusted OR, 1.69; 95% CI, 1.04-2.74). Patients with a dual diagnosis of PG and renal diseases presented with PG at an older age and had a higher prevalence of comorbid conditions. In conclusion, a bidirectional association exists between PG and chronic renal conditions. Awareness of this comorbidity may be of benefit for physicians managing patients with PG.
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Affiliation(s)
- Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
| | | | | | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Arnon D Cohen
- Clalit Health Services, Tel-Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Anxiety and depression predispose individuals to an autoimmune bullous diseases- bullous pemphigoid: A large-scale population-based cohort study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01396-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Kridin K, Hammers CM, Ludwig RJ, Cohen AD. Risk of solid malignancies in bullous pemphigoid: A large-scale population-based cohort study. J Dermatol 2020; 48:317-323. [PMID: 33368562 DOI: 10.1111/1346-8138.15685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
The association of bullous pemphigoid (BP) with solid malignancies (SM) is a matter of controversy, as previous studies produced inconclusive findings. The aim of this study was to assess the risk of SM among patients with BP and to evaluate whether a history of SM predisposes individuals to develop subsequent BP. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and race-matched control subjects (n = 19 280) with regard to incident cases of SM. Adjusted hazard ratios (HR) and adjusted odds ratios (OR) were estimated by Cox regression and logistic regression, respectively. The incidence of SM was 13.4 (95% confidence interval [CI], 11.6-15.3) and 14.3 (95% CI, 13.5-15.1) per 1000 person-years among patients with BP and controls, respectively. BP was not associated with an increased risk of SM (adjusted HR, 0.90; 95% CI, 0.77-1.05). Additionally, a history of SM was not related to the risk of subsequent BP (adjusted OR, 1.00; 95% CI, 0.90-1.10). In a stratified analysis, patients with BP had an increased risk of uterine cancer (adjusted HR, 2.56; 95% CI, 1.39-4.72) unlike the 18 remaining analyzed types of SM. Relative to BP patients without SM, those with BP and SM were older, had a male predominance, a higher prevalence of smoking, a higher burden of comorbidities and comparable survival rates. Although patients with BP do not experience an overall increased risk of developing SM, they are more likely to have uterine cancer. Our findings argue against routine extended cancer screening for patients with incident BP, but raise the awareness of uterine cancer among females with BP.
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Affiliation(s)
- Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of, Lübeck, Germany
| | - Christoph M Hammers
- Lübeck Institute of Experimental Dermatology, University of, Lübeck, Germany.,Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of, Lübeck, Germany.,Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Arnon D Cohen
- Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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