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Ferreira BR, Katamanin OM, Jafferany M, Misery L. Psychodermatology of Chronic Pruritus: An Overview of the Link Between Itch and Distress. Dermatol Ther (Heidelb) 2024; 14:1799-1809. [PMID: 38914907 DOI: 10.1007/s13555-024-01214-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/10/2024] [Indexed: 06/26/2024] Open
Abstract
Chronic pruritus (CP) is defined as an unpleasant sensation causing a desire to scratch and lasting > 6 weeks. It has a multifactorial etiology but is more frequently associated with chronic inflammatory dermatoses and systemic disorders. Psychogenic pruritus and neurological disorders are other less common etiologies, while, in some patients, it is idiopathic. CP appears to be processed by non-histaminergic pathway, contributing to its complexity and therapeutic challenge. Moreover, regardless of the etiology, it is multidimensional, including cognitive, motivational and affective components. There is a close link between psychological distress and pruritus, with particular clinical expression in chronic inflammatory dermatoses, involving the activation of the hypothalamic-pituitary-adrenal axis (and its cutaneous equivalent), the sympathetic nervous system, the release of hormones and peptides, the role of immune cells (T and B cells, macrophages) and immune-related cells in the skin (mast cells, dendritic cells and keratinocytes). Moreover, there is strong evidence that psychological factors influence the experience of pruritus. CP can also cause psychiatric disorders, including but not limited to anxiety and depression, and also lead to significant quality of life (QoL) impairment. Thereby, although a psychodermatological assessment should ideally be carried out in the context of a specific psychodermatology consultation, a brief mental health assessment could be part of the general dermatological approach to these patients. Considering that mental health, QoL and pruritus are closely linked, psychotherapeutic interventions and/or psychotropic drugs should thus be considered in some patients as an adjunct to the pharmacological treatment of CP.
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Affiliation(s)
- Bárbara R Ferreira
- Univ Brest, LIEN, Brest, France.
- Department of Dermatology, Algarve University Hospital Centre, ULS Algarve, Faro, Portugal.
| | - Olivia M Katamanin
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL, USA
| | - Mohammad Jafferany
- College of Medicine/CMU Medical Education Partners Saginaw, Central Michigan University, Mt Pleasant, MI, USA
| | - Laurent Misery
- Univ Brest, LIEN, Brest, France
- Department of Dermatology, Brest University Hospital, Brest, France
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Gu Y, Ye X, Zhao W, He S, Zhang W, Zeng X. The circadian syndrome is a better predictor for psoriasis than the metabolic syndrome via an explainable machine learning method - the NHANES survey during 2005-2006 and 2009-2014. Front Endocrinol (Lausanne) 2024; 15:1379130. [PMID: 38988999 PMCID: PMC11233539 DOI: 10.3389/fendo.2024.1379130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To explore the association between circadian syndrome (CircS) and Metabolic Syndrome (MetS) with psoriasis. Compare the performance of MetS and CircS in predicting psoriasis. Methods An observational study used data from the NHANES surveys conducted in 2005-2006 and 2009-2014. We constructed three multiple logistic regression models to investigate the relationship between MetS, CircS, and their components with psoriasis. The performance of MetS and CircS in predicting psoriasis was compared using five machine-learning algorithms, and the best-performing model was explained via SHAP. Then, bidirectional Mendelian randomization analyses with the inverse variance weighted (IVW) as the primary method were employed to determine the causal effects of each component. Result A total of 9,531 participants were eligible for the study. Both the MetS (OR = 1.53, 95%CI: 1.07-2.17, P = 0.02) and CircS (OR = 1.40, 95%CI: 1.02-1.91, P = 0.039) positively correlated with psoriasis. Each CircS algorithmic model performs better than MetS, with Categorical Features+Gradient Boosting for CircS (the area under the precision-recall curve = 0.969) having the best prediction effect on psoriasis. Among the components of CircS, elevated blood pressure, depression symptoms, elevated waist circumference (WC), and short sleep contributed more to predicting psoriasis. Under the IVW methods, there were significant causal relationships between WC (OR = 1.52, 95%CI: 1.34-1.73, P = 1.35e-10), hypertension (OR = 1.68, 95%CI: 1.19-2.37, P = 0.003), depression symptoms (OR = 1.39, 95%CI: 1.17-1.65, P = 1.51e-4), and short sleep (OR = 2.03, 95%CI: 1.21-3.39, p = 0.007) with psoriasis risk. Conclusion CircS demonstrated superior predictive ability for prevalent psoriasis compared to MetS, with elevated blood pressure, depression symptoms, and elevated WC contributing more to the prediction.
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Affiliation(s)
- Yunfan Gu
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical college, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Dermatology, Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xinglan Ye
- School of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Wenting Zhao
- First Clinical College, Hubei University of Chinese Medicine, Wuhan, China
| | - Shiwei He
- First Clinical College, Hubei University of Chinese Medicine, Wuhan, China
| | - Weiming Zhang
- School of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Xianyu Zeng
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical college, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Alazaidah R, Samara G, Aljaidi M, Haj Qasem M, Alsarhan A, Alshammari M. Potential of Machine Learning for Predicting Sleep Disorders: A Comprehensive Analysis of Regression and Classification Models. Diagnostics (Basel) 2023; 14:27. [PMID: 38201336 PMCID: PMC10802836 DOI: 10.3390/diagnostics14010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/23/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
Sleep disorder is a disease that can be categorized as both an emotional and physical problem. It imposes several difficulties and problems, such as distress during the day, sleep-wake disorders, anxiety, and several other problems. Hence, the main objective of this research was to utilize the strong capabilities of machine learning in the prediction of sleep disorders. In specific, this research aimed to meet three main objectives. These objectives were to identify the best regression model, the best classification model, and the best learning strategy that highly suited sleep disorder datasets. Considering two related datasets and several evaluation metrics that were related to the tasks of regression and classification, the results revealed the superiority of the MultilayerPerceptron, SMOreg, and KStar regression models compared with the other twenty three regression models. Furthermore, IBK, RandomForest, and RandomizableFilteredClassifier showed superior performance compared with other classification models that belonged to several learning strategies. Finally, the Function learning strategy showed the best predictive performance among the six considered strategies in both datasets and with respect to the most evaluation metrics.
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Affiliation(s)
- Raed Alazaidah
- Department of Data Science and AI, Faculty of Information Technology, Zarqa University, Zarqa 13110, Jordan; (R.A.); (M.H.Q.)
| | - Ghassan Samara
- Department of Computer Science, Faculty of Information Technology, Zarqa University, Zarqa 13110, Jordan;
| | - Mohammad Aljaidi
- Department of Computer Science, Faculty of Information Technology, Zarqa University, Zarqa 13110, Jordan;
| | - Mais Haj Qasem
- Department of Data Science and AI, Faculty of Information Technology, Zarqa University, Zarqa 13110, Jordan; (R.A.); (M.H.Q.)
| | - Ayoub Alsarhan
- Department of Information Technology, Faculty of Prince Al-Hussein Bin Abdullah II for Information Technology, The Hashemite University, Zarqa 13133, Jordan;
| | - Mohammed Alshammari
- Faculty of Computing and Information Technology, Northern Border University, Rafha 91431, Saudi Arabia
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Borghi A, De Giorgi A, Monti A, Cappadona R, Manfredini R, Corazza M. Investigating Chronotype and Sleep Quality in Psoriatic Patients: Results from an Observational, Web-Based Survey. J Pers Med 2023; 13:1604. [PMID: 38003919 PMCID: PMC10672655 DOI: 10.3390/jpm13111604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Psoriasis is an inflammatory disease for which the implications and repercussions go far beyond the skin. Psoriasis patients suffer not only due to its skin manifestations and related symptoms but also because of comorbidities and a huge emotional impact. OBJECTIVE The objective of this study was to investigate chronotype and sleep quality in a group of Italian psoriatic patients. MATERIALS AND METHODS An observational, cross-sectional, web-based study was set up by the Dermatology and Clinical Medicine Sections of the Department of Medical Sciences, University of Ferrara, Italy. The web questionnaire was sent to an email list of an Italian association of psoriatic patients with the aim of recording their main demographic, social, historical, and clinical data. The survey included two questionnaires: the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburg Sleep Quality Index (PSQI). RESULTS Two hundred and forty-three psoriatic patients (mean age 52.9 ± 12.8 yrs., 32.5% males and 67.5% females) filled out the questionnaire. A good 63.8% of them were affected with psoriasis for more than 10 years, 25.9% reported having a diffuse psoriasis, and 66.7% were on treatment at the time they completed the questionnaire. With reference to chronotype, the mean MEQ score was 55.2 ± 10.7; furthermore, 44% of the patients were "morning-oriented types", M-types, or "larks", 44.5% were "intermediate-types" or I-types, and 11.5% were "evening-oriented types", E-types, or "owls". No correlations were found between chronotype and psoriasis extension. Based on the PSQI results, 72.8% of the study population was judged to have a low sleep quality. Sleep disturbance was significantly related to female sex, living alone, and the presence of comorbidities. CONCLUSIONS Sleep disturbance is very common in psoriatic patients, especially in those with comorbidities, in females, and in patients who live alone. The chronotype in psoriatic patients does not appear different when compared to the general population, nor does it seem to have any link with psoriasis severity.
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Affiliation(s)
- Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Alfredo De Giorgi
- Clinical Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy;
| | - Alberto Monti
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Rosaria Cappadona
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Roberto Manfredini
- Clinical Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy;
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Michalski P, Palazzo-Michalska V, Michalska-Bańkowska A, Bańkowski M, Grabarek BO. Impact of Alcohol Consumption, Smoking, and Diet on the Severity of Plaque Psoriasis: A Comprehensive Assessment using Clinical Scales and Quality of Life Measures. Med Sci Monit 2023; 29:e941255. [PMID: 37528577 PMCID: PMC10405633 DOI: 10.12659/msm.941255] [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: 05/27/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effects of alcohol intake, assessed using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire, on the severity of plaque psoriasis using the Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI) scales, and quality of life using the Dermatology Life Quality Index (DLQI) questionnaire. MATERIAL AND METHODS The diagnosis of psoriasis was made based on the clinical picture. We enrolled 24 patients with psoriasis vulgaris, and the AUDIT test conducted at the time of follow-up indicated a possible risky/harmful pattern of alcohol consumption or alcohol dependence syndrome among the patients (>8 points). The comparison group consisted of 20 psoriatic patients and AUDIT <8 points. The BSA and PASI scales were used to determine the severity of psoriasis, and the DLQI questionnaire assessed patients' quality of life and how they felt during the week preceding the survey. RESULTS As the amount and frequency of alcohol consumed increased, the exacerbation of lesions measured according to the PASI and BSA scales was significantly higher (P<0.05), and the quality of life decreased (P<0.05). We noted that inadequate and excessive dietary intake of total protein, total fat, and assimilable carbohydrates were associated with statistically significantly higher values of BSA and PASI scores and, thus, more severe psoriatic lesions (P<0.05). CONCLUSIONS An unbalanced diet, alcohol abuse, and smoking negatively affect the course of psoriasis vulgaris, hence the importance of patient education.
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Affiliation(s)
- Piotr Michalski
- Department of Biochemistry, Faculty of Medicine in Zabrze, Academy of Silesia, Katowice, Poland
| | | | | | - Mirosław Bańkowski
- Individual Specialist Medical Practice Mirosław Bańkowski, Czeladź, Poland
| | - Beniamin Oskar Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, Katowice, Poland
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Scoditti E, Garbarino S. Nutrition, Sleep, Circadian Rhythms, and Health Implications: "Come Together". Nutrients 2022; 14:nu14235105. [PMID: 36501133 PMCID: PMC9739973 DOI: 10.3390/nu14235105] [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: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
Over the last few years, novel and important aspects of nutrition that are often overlooked in nutritional epidemiology, experimental research, and recommendations for health maintenance and disease prevention concerning the circadian rhythmicity of feeding, as well as the bidirectional interaction of nutrition with central and peripheral endogenous circadian clocks, and with other rhythmic behaviors including the sleep-wake cycle have received increasing attention from the research community [...].
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Affiliation(s)
- Egeria Scoditti
- National Research Council (CNR), Institute of Clinical Physiology (IFC), 73100 Lecce, Italy
- Correspondence:
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy
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