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Wolf P, Ceovic R, Conrad C, Falkensteiner K, Graier T, Kołt-Kamińska M, Marovt M, Mateeva V, Maul JT, Navarini AA, Nicolescu AC, Ratzinger G, Pavlovsky L, Sanzharovskaya M, Szegedi A, Reich A. Characteristics and management of generalized pustular psoriasis (GPP): Experience from the Central and Eastern Europe (CEE) GPP Expert Network. J Eur Acad Dermatol Venereol 2024. [PMID: 38279888 DOI: 10.1111/jdv.19808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/06/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Generalized pustular psoriasis (GPP) is a rare, inflammatory skin disease characterized by widespread eruption of sterile pustules with or without systemic symptoms. OBJECTIVES This study aimed to describe the demographics of patients with GPP in Central and Eastern Europe (CEE), present the clinical characteristics of individual GPP flares and explore the current treatment landscape. METHODS Patient demographics were collected at the times of last observation and previous treatment. Characteristics of a patient's last (most recent) and most severe (from all documented episodes) flare were provided at clinician's discretion. RESULTS Fifty-eight patients were recruited from 12 centres in nine CEE countries; median (range) age was 61 (16-92) years and 60.3% (35 out of 58) were female. The most common comorbidities were hypertension (43.1% [25 out of 58]) and hyperlipidaemia (32.8% [19 out of 58]). Thirty-four patients (58.6%) presented with concomitant plaque psoriasis before or during the course of GPP. Data from two separate flares were recorded in 26 individuals; in 32 patients, the most recent flare was reported as the most severe. Over 90% of patients with a flare episode classified as most severe by clinicians were hospitalized, with >75% of these individuals having a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) total score of 3 or 4. Systemic symptoms were more common in patients with a GPPGA score of 3 or 4 but were also manifest in individuals with a GPPGA score ≤2. A significant correlation was observed between a combined systemic disease score of clinical and laboratory features and both GPPGA total score (r = 0.385, p < 0.001) and GPPGA pustulation subscore (r = 0.305, p < 0.05). CONCLUSIONS Considerable heterogeneity in the presentation of GPP flares was observed, both between patients and within-patient. All GPP flares were associated with a significant clinical burden, highlighting the unmet need for accurate and early diagnosis.
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Affiliation(s)
- P Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - R Ceovic
- Department of Dermatology and Venereology, School of Medicine University of Zagreb, University Hospital Centre Zagreb, Zagreb, Croatia
| | - C Conrad
- Department of Dermatology, Lausanne University Hospital, Lausanne, Switzerland
| | - K Falkensteiner
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - T Graier
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Kołt-Kamińska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - M Marovt
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - V Mateeva
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J-T Maul
- Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - A A Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - A C Nicolescu
- Emergency Clinical Hospital Agrippa Ionescu, Bucharest, Romania
| | - G Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - L Pavlovsky
- Division of Dermatology, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | | | - A Szegedi
- Department of Dermatology, University of Debrecen, Debrecen, Hungary
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
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2
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Antal D, Pór Á, Hegyi K, Kovács I, Szegedi A, Bai P, Szántó M. 330 Poly(ADP-ribose) polymerase (PARP)-2 promotes inflammation in psoriasis by regulating estradiol biosynthesis in keratinocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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3
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Szabó L, Kapitány A, Somogyi O, Gáspár K, Dajnoki Z, Szegedi A. 407 Investigation of antimicrobial peptides in atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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4
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Somogyi O, Kapitány A, Szabó L, Gáspár K, Dajnoki Z, Szegedi A. 355 Permeability barrier characteristics of hidradenitis suppurativa. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Antal D, Janka EA, Szabó J, Szabó IL, Szegedi A, Gáspár K, Bai P, Szántó M. Culture-based analyses of skin bacteria in lesional moist, and unaffected dry and sebaceous skin regions of hidradenitis suppurativa patients. J Eur Acad Dermatol Venereol 2022; 36:e731-e733. [PMID: 35642981 DOI: 10.1111/jdv.18254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- D Antal
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - E A Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - J Szabó
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I L Szabó
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - K Gáspár
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - P Bai
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,MTA-DE Lendület Laboratory of Cellular Metabolism, University of Debrecen, Debrecen, Hungary.,Faculty of Medicine, Research Center for Molecular Medicine, University of Debrecen, Debrecen, Hungary
| | - M Szántó
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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6
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Dajnoki Z, Somogyi O, Medgyesi B, Jenei A, Szabó L, Gáspár K, Hendrik Z, Gergely P, Imre D, Póliska S, Törőcsik D, Zouboulis CC, Prens EP, Kapitány A, Szegedi A. Primary alterations during the development of hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2021; 36:462-471. [PMID: 34724272 PMCID: PMC9298903 DOI: 10.1111/jdv.17779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/02/2021] [Indexed: 12/01/2022]
Abstract
Background Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the apocrine gland‐rich (AGR) skin region. The initial steps of disease development are not fully understood, despite intense investigations into immune alterations in lesional HS skin. Objectives We aimed to systematically investigate the inflammatory molecules involved in three stages of HS pathogenesis, including healthy AGR, non‐lesional HS and lesional HS skin, with the parallel application of multiple mRNA and protein‐based methods. Methods Immune cell counts (T cells, dendritic cells, macrophages), Th1/Th17‐related molecules (IL‐12B, TBX21, IFNG, TNFA, IL‐17, IL10, IL‐23A, TGFB1, RORC, CCL20), keratinocyte‐related sensors (TLR2,4), mediators (S100A7, S100A8, S100A9, DEFB4B, LCN2, CAMP, CCL2) and pro‐inflammatory molecules (IL1B, IL6, TNFA, IL‐23A) were investigated in the three groups by RNASeq, RT‐qPCR, immunohistochemistry and immunofluorescence. Results Epidermal changes were already detectable in non‐lesional HS skin; the epidermal occurrence of antimicrobial peptides (AMPs), IL‐1β, TNF‐α and IL‐23 was highly upregulated compared with healthy AGR skin. In lesional HS epidermis, TNF‐α and IL‐1β expression remained at high levels while AMPs and IL‐23 increased even more compared with non‐lesional skin. In the dermis of non‐lesional HS skin, signs of inflammation were barely detectable (vs. AGR), while in the lesional dermis, the number of inflammatory cells and Th1/Th17‐related mediators were significantly elevated. Conclusions Our findings that non‐lesional HS epidermal keratinocytes produce not only AMPs and IL‐1β but also high levels of TNF‐α and IL‐23 confirm the driver role of keratinocytes in HS pathogenesis and highlight the possible role of keratinocytes in the transformation of non‐inflammatory Th17 cells (of healthy AGR skin) into inflammatory cells (of HS) via the production of these mediators. The fact that epidermal TNF‐α and IL‐23 appear also in non‐lesional HS seems to prove these cytokines as excellent therapeutic targets.
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Affiliation(s)
- Z Dajnoki
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - O Somogyi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Debrecen, Hungary
| | - B Medgyesi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Debrecen, Hungary
| | - A Jenei
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Debrecen, Hungary
| | - L Szabó
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Debrecen, Hungary
| | - K Gáspár
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Hendrik
- Department of Forensic Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - P Gergely
- Department of Forensic Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Imre
- Department of Pathology, Hetényi Géza County Hospital, Szolnok, Hungary
| | - S Póliska
- Genomic Medicine and Bioinformatics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - C C Zouboulis
- Genomic Medicine and Bioinformatics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - E P Prens
- Laboratory for Experimental Immunodermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - A Kapitány
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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7
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Somogyi O, Kapitány A, Szabó L, Medgyesi B, Andrásdi Z, Gáspár K, Dajnoki Z, Szegedi A. 227 Primary Changes in the Development of Hidradenitis Suppurativa. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Szabó L, Dajnoki Z, Somogyi O, Palatka R, Andrásdi Z, Gáspár K, Kapitány A, Szegedi A. 193 Different Skin Regions are Characterized by Distinct Epimmunome Patterns. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Koszorú K, Hajdu K, Borza J, Bodai K, Szabó Á, Bató A, Szegedi A, Brodszky V, Rencz F, Sárdy M. 080 The impact of atopic dermatitis on health-related quality of life. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Dajnoki Z, Medgyesi B, Szabó L, Somogyi O, Andrásdi Z, Gáspár K, Kapitány A, Szegedi A. 116 Weak Links in the Permeability Barrier of the Skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Hajdu K, Kapitány A, Dajnoki Z, Soltész L, Baráth S, Hendrik Z, Veres I, Szegedi A, Gáspár K. Improvement of clinical and immunological parameters after allergen-specific immunotherapy in atopic dermatitis. J Eur Acad Dermatol Venereol 2020; 35:1357-1361. [PMID: 33131126 DOI: 10.1111/jdv.17018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergen immunotherapy (AIT) is considered a curative treatment in some atopic diseases, but in AD contradictory clinical results exist and the action of AIT has not been elucidated. In the literature, there is no evidence for parallel investigations of permeability barrier, cutaneous and blood immune responses after AIT in AD. OBJECTIVES The objective was to investigate immune parameters in the blood and skin and to detect clinical and barrier changes after AIT in AD. METHODS Mild-to-moderate AD patients (n = 14) with concomitant allergic rhinitis to house dust mites were selected. All patients received topical treatment, while eight patients were randomly selected for adjuvant AIT also. At baseline and after 6 months, clinical, barrier and immunological investigations (serum and skin tests) were performed. In selected patients, biopsies from atopy patch tests (APTs) were analysed by immunohistochemistry for AD-relevant immune cells and mediators. RESULTS In the adjuvant AIT group, clinical parameters and barrier functions improved significantly. Blood immune parameters displayed no significant changes. Post-AIT APT became negative in all patients in the AIT group, but remained positive in the non-AIT group. Cutaneous dendritic cell and T-cell recruitment decreased significantly after allergen challenge in the AIT group, but no significant changes in skin or serum immunoglobulin E levels or prick test (SPT) reactivity were detected. CONCLUSIONS Allergen immunotherapy is a beneficial adjuvant treatment for sensitized AD patients. AIT improves not only clinical symptoms, but also permeability barrier functions. The effect of AIT on sensitization should be detected by APT, not by SPT.
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Affiliation(s)
- K Hajdu
- Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Gyula Petrányi Doctoral School of Allergy and Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Kapitány
- Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Dajnoki
- Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Soltész
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - S Baráth
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Hendrik
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I Veres
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - K Gáspár
- Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Gergely LH, Gáspár K, Brodszky V, Kinyó Á, Szegedi A, Remenyik É, Kiss NF, Bató A, Péntek M, Gulácsi L, Sárdy M, Bánvölgyi A, Wikonkál N, Rencz F. Validity of EQ-5D-5L, Skindex-16, DLQI and DLQI-R in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:2584-2592. [PMID: 32618022 DOI: 10.1111/jdv.16642] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Numerous generic, skin- and disease-specific health-related quality of life (HRQoL) measures are available for patients with hidradenitis suppurativa (HS). Yet, robust psychometric evidence is lacking in many aspects of these outcome measures. OBJECTIVES We sought to determine convergent and known-groups validity of multiple generic and skin-specific HRQoL measures and to identify predictors of impaired HRQoL in patients with HS. METHODS Between 2017 and 2019, a multicentre cross-sectional study was carried out involving 200 consecutive HS patients. HRQoL outcomes included the EQ-5D-5L, EQ visual analogue scale (EQ VAS), Skindex-16, Dermatology Life Quality Index (DLQI) and DLQI-Relevant (DLQI-R). Disease severity was graded by HS-Physician's Global Assessment (HS-PGA) scale and the Modified Sartorius scale (MSS). RESULTS Overall, 77%, 56%, 51%, 46% and 28% reported problems in the pain/discomfort, usual activities, anxiety/depression, mobility and self-care dimensions of EQ-5D-5L. Mean ± SD EQ VAS, DLQI and DLQI-R scores were 64.29 ± 22.68, 11.75 ± 8.11 and 12.19 ± 8.33, respectively. Skindex-16 responses indicated that the emotional burden of HS (64.55 ± 29.28) far exceeded those of functioning (49.40 ± 34.70) and physical symptoms (46.74 ± 29.36). EQ-5D-5L, EQ VAS, DLQI, DLQI-R and Skindex-16 total scores had moderate or strong correlations with each other (range: |0.487| to |0.993|), weak or moderate correlations with HS-PGA (|0.350| to |0.433|) and weak correlations with MSS (|0.324| to |0.389|). DLQI-R slightly outperformed DLQI both in terms of convergent and known-groups validity. Being female, lower education level, more severe disease and genital involvement were associated with worse HRQoL (P < 0.05). CONCLUSION This study provides high-quality evidence that among skin-specific outcomes, the DLQI, DLQI-R and Skindex-16, and among generic instruments, the EQ-5D-5L are suitable to be used in HS patients. In future research, we recommend the use of existing well-validated HRQoL tools instead of developing new measures for each study. The development of composite measures that combine physician- and patient-reported outcomes is not supported by evidence in HS. [Correction added on 25 July 2020, after first online publication: in the Abstract section, the ± signs were missing and have been added to this version.].
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Affiliation(s)
- L H Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - K Gáspár
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N F Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bató
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Budapest, Hungary
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13
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Rencz F, Gergely L, Wikonkál N, Gáspár K, Péntek M, Gulácsi L, Tamási B, Poór A, Kinyó Á, Bali G, Hidvégi B, Sárdy M, Hajdu K, Szegedi A, Remenyik É, Bata‐Csörgő Z, Holló P, Baji P, Brodszky V. Dermatology Life Quality Index (DLQI) score bands are applicable to DLQI‐Relevant (DLQI‐R) scoring. J Eur Acad Dermatol Venereol 2020; 34:e484-e486. [DOI: 10.1111/jdv.16398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Budapest Hungary
| | - L.H. Gergely
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - N. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Gáspár
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Medical School Pécs Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Hajdu
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Szeged Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - P. Baji
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
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Szegedi A, Verweij P, van Duijnhoven W, Mackle M, Cazorla P, Karson C, Fennema H. Meta-analysis of the efficacy of asenapine for acute schizophrenia: comparisons with placebo and other atypical antipsychotics. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73215-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IntroductionAsenapine is an FDA-approved atypical antipsychotic (AAP) indicated in adults for treatment of schizophrenia.ObjectivePresent meta-analyses of asenapine vs placebo and other antipsychotics in acute schizophrenia.AimFurther demonstrate the efficacy of asenapine in acute schizophrenia.MethodsPANSS total score changes from baseline to week 6 were assessed using last observation carried forward (LOCF) and mixed model for repeated measures (MMRM). Comparisons of asenapine and antipsychotics vs placebo were obtained from 4 placebo-controlled asenapine studies. Head-to-head comparisons among AAPs assessed in the same trials (including those for which no direct comparisons are available) were conducted with network meta-analyses using a published database (Leucht et al, Am J Psychiatry 2009;166:152–166) of 74 studies updated with data from 5 AAP-controlled asenapine trials.ResultsPANSS change from baseline with asenapine exceeded that of placebo (LOCF: 3.7 [95% CI, 1.5–5.9], P = 0.001; MMRM: 4.1 [95% CI, 1.6–6.5], P = 0.001), a treatment effect comparable to other antipsychotics (LOCF: 4.1 [95% CI, 1.7–6.5], P = 0.001; MMRM: 4.6 [95% CI, 1.9–7.3], P = 0.001). Head-to-head network meta-analysis reported comparable efficacy with asenapine and other AAPs; PANSS differences ranged from 3.9 points better than ziprasidone (95% CI, 0.3–7.4) to 2.9 points worse than olanzapine (95% CI, -5.-0.1).DiscussionThese meta-analyses demonstrate superiority of asenapine over placebo in acute schizophrenia, with treatment effects of asenapine at least comparable to antipsychotics used in the same studies. Further, the network meta-analysis suggests the efficacy of asenapine for acute schizophrenia is comparable to that of established AAPs.
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Brodszky V, Tamási B, Hajdu K, Péntek M, Szegedi A, Sárdy M, Bata-Csörgő Z, Kinyó Á, Gulácsi L, Rencz F. Disease burden of patients with pemphigus from a societal perspective. Expert Rev Pharmacoecon Outcomes Res 2020; 21:77-86. [PMID: 31978314 DOI: 10.1080/14737167.2020.1722104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: Cost-of-illness studies are widely used for healthcare decision-making; however, no such study is available in pemphigus from the societal perspective. The purpose of this analysis was to estimate annual cost-of-illness per patient with pemphigus from a societal perspective. Areas covered: Between 2014 and 2017, a multicenter, cross-sectional study was carried out. Consecutive pemphigus patients aged ≥18 years were recruited at all four university dermatology departments in Hungary. Direct and indirect costs were calculated, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. Generalized linear model was used to analyze predictors of costs. Atotal of 109 patients with pemphigus enrolled with amean age of 57.1 (SD 14.8) years. Total cost per pemphigus patient was €3,995 (SD €7,526) peryear, with productivity loss (58%) and informal care (19%) accounting for the majority. Annual means of 189 and 41 working hours were lost due to absence from work and reduced productivity, respectively. Younger age and pemphigus vulgaris were associated with higher costs (p < 0.05). Expert opinion: This is the first cost-of-illness study applying the societal perspective in pemphigus. Our results indicate a substantial economic burden on society, mainly driven by productivity loss and informal care.
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Affiliation(s)
- V Brodszky
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - K Hajdu
- Departments of Dermatology, University of Debrecen , Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen , Debrecen, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - A Szegedi
- Departments of Dermatology, University of Debrecen , Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen , Debrecen, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged , Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs , Pécs, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program , Budapest, Hungary
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16
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Kovács D, Hegyi K, Szegedi A, Deák D, Póliska S, Rühl R, Zouboulis C, Törőcsik D. Isotretinoin is indirectly effective in sebocytes. Br J Dermatol 2019; 182:1052-1054. [DOI: 10.1111/bjd.18562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- D. Kovács
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - K. Hegyi
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - D. Deák
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Sz. Póliska
- Department of Biochemistry and Molecular Biology Genomic Medicine and Bioinformatics Core Facility Faculty of Medicine University of Debrecen Debrecen Hungary
| | - R. Rühl
- Paprika Bioanalytics BT Debrecen Hungary
| | - C.C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane Dessau Germany
| | - D. Törőcsik
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
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17
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Rencz F, Gulácsi L, Péntek M, Szegedi A, Remenyik É, Bata‐Csörgő Z, Bali G, Hidvégi B, Tamási B, Poór A, Hajdu K, Holló P, Kinyó Á, Sárdy M, Brodszky V. DLQI‐R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea. Br J Dermatol 2019; 182:1167-1175. [DOI: 10.1111/bjd.18435] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Nádor u 7 H‐1051 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A. Szegedi
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Korányi fasor 6 H‐6720 Szeged Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - K. Hajdu
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Akác u 1 H‐7632 Pécs Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
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18
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Somogyi O, Medgyesi B, Jenei A, Dajnoki Z, Gáspár K, Hendrik Z, Szegedi A, Kapitány A. 243 Permeability and immune barrier differences of healthy human skin. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Tamasi B, Brodszky V, Pentek M, Gulacsi L, Hajdu K, Sardy M, Szegedi A, Bata-Csorgo Z, KInyo A, Rencz F. 176 Measuring quality of life with the EQ-5D in patients with pemphigus vulgaris and pemphigus foliaceus. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Medgyesi B, Béke G, Kapitány A, Janka E, Gáspár K, Szabó I, Bíró T, Szegedi A, Dajnoki Z. 224 Revealing Barrier Alterations in Rosacea Skin at the Molecular Level. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Szegedi A. Connections between atopic dermatitis and ageing. Br J Dermatol 2019; 182:9-10. [DOI: 10.1111/bjd.18306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Szegedi
- Division of Dermatological Allergology Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
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22
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Hajdu K, Brodszky V, Stalmeier PFM, Ruzsa G, Tamási B, Gulácsi L, Péntek M, Sárdy M, Bata-Csörgő Z, Kinyó Á, Szegedi A, Rencz F. Patient-assigned health utility values for controlled and uncontrolled pemphigus vulgaris and foliaceus. J Eur Acad Dermatol Venereol 2019; 33:2106-2113. [PMID: 31265151 DOI: 10.1111/jdv.15765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 06/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The assessment of health-related quality of life (HRQoL) in patients with pemphigus is now of increasing interest due to the availability of highly effective new therapies. Preference-based HRQoL values or health utilities required for medical and financial decision-making are not yet available directly from pemphigus patients. OBJECTIVE To obtain health utility values for current health and hypothetical health states from the perspective of pemphigus patients. METHODS A cross-sectional questionnaire survey was carried out with pemphigus patients. Disease severity was rated by Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Patients were asked to evaluate their current health as well as three common hypothetical pemphigus health states [uncontrolled pemphigus vulgaris (PV), uncontrolled pemphigus foliaceus (PF) and controlled PV/PF] by using composite time trade-off (cTTO). Multiple regression was applied to explore determinants of utility values. RESULTS Responses of 108 patients (64.8% women, mean age 57.4 years) were analysed. Mean ABSIS score was 11.6. The mean utility values for the hypothetical uncontrolled PV, uncontrolled PF and controlled PV/PF health states were 0.41, 0.52 and 0.66 with cTTO. The mean cTTO scores for current health were higher compared with the hypothetical health states (0.76; P < 0.001). Patients with higher ABSIS, worse pain intensity scores and those having a caregiver reported lower utility values for current health (P < 0.05). CONCLUSIONS In pemphigus, HRQoL impairment expressed in utility values seems to be considerable, especially in comparison with other chronic dermatological conditions (e.g. psoriasis, atopic eczema, chronic hand eczema). These health utilities inform physicians, policymakers and funders about the overall extent of health loss in pemphigus and provide evidence to guide medical decisions and cost-effectiveness analyses of treatment strategies. Future research is needed to evaluate the caregiver burden in pemphigus.
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Affiliation(s)
- K Hajdu
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - P F M Stalmeier
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - G Ruzsa
- Doctoral School of Psychology, Institute of Psychology, Eötvös Loránd University of Sciences, Budapest, Hungary.,Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Budapest, Hungary
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23
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ‐5D in pemphigus. Br J Dermatol 2019. [DOI: 10.1111/bjd.17652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. EQ‐5D 在天疱疮中的效度. Br J Dermatol 2019. [DOI: 10.1111/bjd.17668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Rencz F, Brodszky V, Gulácsi L, Péntek M, Poór A, Holló P, Szegedi A, Remenyik É, Sárdy M, Langenbruch A, Radtke M, Gutknecht M, Augustin M. Time to revise the Dermatology Life Quality Index scoring in psoriasis treatment guidelines. J Eur Acad Dermatol Venereol 2019; 33:e267-e269. [DOI: 10.1111/jdv.15537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Premium Postdoctoral Research Programme Hungarian Academy of Sciences Nádor u. 7 H‐1051 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Szegedi
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
- Department of Dermatological Allergology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
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Rencz F, Gulácsi L, Péntek M, Poór A, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the DLQI in psoriasis. Br J Dermatol 2018. [DOI: 10.1111/bjd.17214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. 银屑病中 DLQI 新评分公式的提议. Br J Dermatol 2018. [DOI: 10.1111/bjd.17228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jenei A, Dajnoki Z, Medgyesi B, Gáspár K, Béke G, Kinyó Á, Méhes G, Hendrik Z, Dinya T, Törőcsik D, Zouboulis CC, Prens EP, Bíró T, Szegedi A, Kapitány A. Apocrine Gland-Rich Skin Has a Non-Inflammatory IL-17-Related Immune Milieu, that Turns to Inflammatory IL-17-Mediated Disease in Hidradenitis Suppurativa. J Invest Dermatol 2018; 139:964-968. [PMID: 30391261 DOI: 10.1016/j.jid.2018.10.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/27/2018] [Accepted: 10/22/2018] [Indexed: 12/20/2022]
Affiliation(s)
- A Jenei
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Dajnoki
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - B Medgyesi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - K Gáspár
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Béke
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology, and Oncodermatology, University of Pécs, Pécs, Hungary
| | - G Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Hendrik
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - T Dinya
- Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - E P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Kapitány
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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29
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the Dermatology Life Quality Index in psoriasis. Br J Dermatol 2018; 179:1102-1108. [PMID: 29968311 DOI: 10.1111/bjd.16927] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Not relevant' responses (NRRs) on the Dermatology Life Quality Index (DLQI) may occur in up to 40% of patients with psoriasis. As these responses are scored as the item of the questionnaire having no impact on the patients' lives at all, it is more difficult for these patients to fulfil the DLQI > 10 criterion required by clinical guidelines to become candidates for systemic treatment including biologics. OBJECTIVES We propose a new scoring system for the DLQI that corrects for the bias in the NRR option and test its construct validity in a sample of patients with psoriasis. METHODS Data from 242 patients (104 of whom marked at least one NRR) from two earlier cross-sectional surveys were reanalysed. For each patient, the DLQI score was calculated in two ways: (i) according to the original scoring and (ii) by applying a new scoring formula (DLQI-R) that adjusts the total score for the number of NRRs. The construct validity of the DLQI-R was tested against the Psoriasis Area and Severity Index (PASI) and EQ-5D-3L. RESULTS The mean DLQI and DLQI-R scores were 9·99 ± 7·52 and 11·0 ± 8·02, respectively. The DLQI-R allowed eight more patients (3·3%) to achieve the 'PASI > 10 and DLQI > 10' threshold. The results were robust when limiting the maximum number of NRRs allowed to two or three. Compared with the DLQI, DLQI-R correlated slightly better with PASI (rs = 0·59 vs. 0·57) and EQ-5D-3L index scores (rs = -0·58 vs. -0·54). CONCLUSIONS The DLQI-R seems to be a valid scoring system for avoiding the bias in the NRR option and can help to improve patients' access to biologics.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor u. 7, H-1051, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata-Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ-5D in patients with pemphigus vulgaris and pemphigus foliaceus. Br J Dermatol 2018; 180:802-809. [PMID: 29897626 DOI: 10.1111/bjd.16883] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND No studies to date have employed the EuroQoL EQ-5D questionnaire to assess health-related quality of life (HRQoL) in patients with pemphigus. OBJECTIVES To evaluate the HRQoL of patients with pemphigus by the EQ-5D and to analyse the convergent and known-groups validity of the EQ-5D in this patient population. METHODS Between 2014 and 2017, a multicentre cross-sectional study was carried out. Outcome measures included the five-level EQ-5D (EQ-5D-5L), Dermatology Life Quality Index (DLQI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and an average pain intensity visual analogue scale (VAS) for the past 3 months. RESULTS In total, 109 consecutive patients with pemphigus participated in the study (mean age 57 years; 64% women). Among the EQ-5D dimensions, the most problems were reported regarding pain/discomfort (50%), mobility (43%) and anxiety/depression (43%). No significant difference was found in mean EQ-5D index scores between patients with pemphigus vulgaris and those with pemphigus foliaceus (0·81 vs. 0·86, P = 0·14). The mean EQ-5D index scores of patients with limited, moderate, significant and extreme pemphigus were 0·88, 0·82, 0·72 and 0·67, respectively (P = 0·001). The number of comorbidities was associated with greater impairment in EQ-5D index scores (P < 0·001). DLQI (rs = -0·62, P < 0·001) and the average pain intensity VAS (rs = -0·59, P < 0·001) more strongly correlated with the EQ-5D index scores than did ABSIS (rs = -0·40, P < 0·001). CONCLUSIONS This is the first study employing the EQ-5D questionnaire in pemphigus. The EQ-5D is a valid measure of HRQoL in patients with pemphigus that can be useful both in clinical practice and in economic evaluations to assess the health gains associated with new effective treatments.
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Affiliation(s)
- B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - K Hajdu
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Korányi fasor 6, H-6720, Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Akác u. 1, H-7632, Pécs, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Nádor u. 7, H-1051, Budapest, Hungary
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31
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Lovászi M, Gácsi A, Csányi E, Kovács D, Eyerich K, Kemény L, Szegedi A, Zouboulis C, Eyerich S, Törcsik D. 1029 Sebum component lipids penetrate through the epidermis and modulate macrophage – P. acnes interaction. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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32
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Dajnoki Z, Béke G, Kapitány A, Gáspár K, Póliska S, Hendrik Z, Péter Z, Törcsik D, Bíró T, Szegedi A. 720 Topographical differences in immune and barrier functions of human skin. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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33
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Popova M, Trendafilova I, Zgureva D, Kalvachev Y, Boycheva S, Novak Tušar N, Szegedi A. Polymer-coated mesoporous silica nanoparticles for controlled release of the prodrug sulfasalazine. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2018.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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34
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Lovászi M, Mattii M, Eyerich K, Gácsi A, Csányi E, Kovács D, Rühl R, Szegedi A, Kemény L, Ståhle M, Zouboulis CC, Eyerich S, Törőcsik D. Sebum lipids influence macrophage polarization and activation. Br J Dermatol 2017. [PMID: 28646583 DOI: 10.1111/bjd.15754] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND As lipids are known to regulate macrophage functions, it is reasonable to suppose that a sebocyte-macrophage axis mediated by sebum lipids may exist. OBJECTIVES To investigate if sebocytes could contribute to the differentiation, polarization and function of macrophages with their secreted lipids. METHODS Oil Red O lipid staining and Raman spectroscopy were used to assess the dermal lipid content and penetration. Immunohistochemistry was used to analyse the macrophage subsets. Human peripheral blood monocytes were differentiated in the presence of either supernatant from human SZ95 sebocytes or major sebum lipid components and activated with Propionibacterium acnes. Macrophage surface markers and their capacity to uptake fluorescein isothiocyanate-conjugated P. acnes were detected by fluorescence-activated cell sorting measurements. Cytokine protein levels were evaluated by enzyme-linked immunosorbent assay and Western blot analysis. RESULTS Sebaceous gland-rich skin had an increased dermal lipid content vs. sebaceous gland-poor skin to which all the tested sebum component lipids could contribute by penetrating the dermoepidermal barrier. Of the lipids, oleic acid and linoleic acid promoted monocyte differentiation into alternatively activated macrophages. Moreover, linoleic acid also had an anti-inflammatory effect in P. acnes-activated macrophages, inhibiting the secretion of interleukin (IL)-1β, IL-6 and tumour necrosis factor (TNF)-α. Squalene, palmitic acid, stearic acid and oleic acid augmented the secretion of IL-1β, even in the absence of P. acnes, whereas oleic acid had a selective effect of inducing IL-1β but downregulating IL-6 and TNF-α secretion. CONCLUSIONS Our results suggest a role for sebaceous glands in modulating innate immune responses via their secreted lipids that are of possible pathological and therapeutic relevance.
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Affiliation(s)
- M Lovászi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - M Mattii
- ZAUM - Centre for Allergy and Environment, Technische Universität and Helmholtz Centre Munich, Member of the German Centre for Lung Research (DZL), Munich, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - A Gácsi
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - E Csányi
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - D Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - R Rühl
- MTA-DE Public Health Research Group of the Hungarian Academy of Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Division of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,MTA-SZTE Dermatological Research Group, University of Szeged, Szeged, Hungary
| | - M Ståhle
- Unit of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Centre, Brandenburg Medical School Theodore Fontane, Dessau, Germany
| | - S Eyerich
- ZAUM - Centre for Allergy and Environment, Technische Universität and Helmholtz Centre Munich, Member of the German Centre for Lung Research (DZL), Munich, Germany
| | - D Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Unit of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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35
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Rencz F, Poór AK, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Herszényi K, Jókai H, Beretzky Z, Brodszky V. A detailed analysis of 'not relevant' responses on the DLQI in psoriasis: potential biases in treatment decisions. J Eur Acad Dermatol Venereol 2017; 32:783-790. [PMID: 29114942 DOI: 10.1111/jdv.14676] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/16/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Dermatology Life Quality Index (DLQI) is the most common health-related quality of life measure in dermatology that is widely used in treatment guidelines for psoriasis. Eight of the 10 questions of the DLQI offer a 'not relevant' response (NRR) option that is scored as the item had no impact on patients' life at all. OBJECTIVE To explore the occurrence of NRRs on the DLQI in psoriasis patients and to examine the effect of several socio-demographic and clinical factors on giving NRRs. METHODS Data were obtained from two cross-sectional surveys among psoriasis patients at two academic dermatology clinics in Hungary. Health-related quality of life was measured by employing DLQI and EQ-5D-3L, while disease severity was graded by Psoriasis Area and Severity Index (PASI). Multivariate logistic regression was applied to determine the predictors of providing NRRs. RESULTS Mean age of the 428 patients was 49 years, and 65% were males. Mean PASI, DLQI and EQ-5D-3L index scores were 8.4 ± 9.5, 6.8 ± 7.4 and 0.74 ± 0.28, respectively. Overall, 38.8% of the patients had at least one NRR: 19.6% (one), 11.5% (two), 5.1% (three) and 2.6% (more than three). Most NRRs occurred in sport, sexual difficulties and working/studying items of the DLQI (28.4%, 16.4% and 14.0%, respectively). Female gender (OR 1.65; 95% CI 1.04-2.61), older age (OR 1.05; 95% CI 1.03-1.07) and higher PASI score (OR 1.03; 95% CI 1.01-1.06) were associated with providing more NRRs, whereas highly educated patients (OR 0.34; 95% CI 0.16-0.72) and those with a full-time job (OR 0.47; 95% CI 0.29-0.77) less frequently tended to tick NRRs. CONCLUSION The high rate of psoriasis patients with NRRs, especially among women, less educated and elderly patients, indicates a content validity problem of the measure. A reconsideration of the use of the DLQI for medical and financial decision-making in psoriasis patients is suggested.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, University of Debrecen, Debrecen, Hungary
| | - B Hidvégi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Z Beretzky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Szabó I, Herczeg-Lisztes E, Szollosi A, Szegedi A, Bíró T, Oláh A. 263 (-)-cannabidiol differentially influences hair growth. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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37
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Jenei A, Gáspár K, Dajnoki Z, Béke G, Medgyesi B, Kinyó Á, Hendrik Z, Dinya T, Szegedi A, Kapitány A. 478 Immune status of healthy apocrine gland-rich skin regions and its alterations in Hidradenitis Suppurativa. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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38
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Tamási B, Brodszky V, Hajdu K, Kárpáti S, Gulácsi L, Szegedi A, Bata-Csörgö Z, Kinyó Á, Péntek M, Rencz F. 015 The impact of pemphigus on health-related quality of life: First results with the EQ-5D questionnaire. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Rencz F, Poór A, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Brodszky V. 017 Women, elderly and less educated psoriasis patients provide more ‘not relevant’ responses on the Dermatology Life Quality Index - is it a problem? J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Khasawneh A, Baráth S, Medgyesi B, Béke G, Dajnoki Z, Gáspár K, Jenei A, Pázmándi K, Bácsi A, Szegedi A, Kapitány A. 365 Myeloid but not plasmacytoid blood DCs possess Th1 polarizing and Th1/Th17 recruiting capacity in psoriasis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Hajdu K, Irinyi B, Gyimesi E, Kapitány A, Dajnoki Z, Bata‐Csörgő Z, Kinyó Á, Kiss F, Gáspár K, Szegedi A. A simple, combined test can improve the diagnosis of autoimmune urticaria. Br J Dermatol 2017; 177:864-866. [DOI: 10.1111/bjd.15175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Hajdu
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - B. Irinyi
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - E. Gyimesi
- Department of Laboratory Medicine Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Kapitány
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Zs. Dajnoki
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Zs. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Center University of Szeged Szeged Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Pécs Hungary
| | - F. Kiss
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Center for Medical Education Cardiff University Cardiff U.K
| | - K. Gáspár
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Division of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
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Khasawneh A, Baráth S, Béke G, Dajnoki Z, Jenei A, Medgyesi B, Gáspár K, Szegedi A, Kapitány A. 374 Characterization of peripheral blood dendritic cells in psoriasis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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43
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Janka E, Töröcsik D, Gáspár K, Bodnár E, Sawhney I, Csordás A, Kovács Z, Herédi E, Szegedi A, Remenyik É. 041 The association between early-onset and late-onset psoriasis and co-morbidities in a case-control study. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Herédi E, Végh J, Pogácsás L, Gáspár K, Varga J, Kincse G, Zeher M, Szegedi A, Gaál J. Subclinical cardiovascular disease and it's improvement after long-term TNF-α inhibitor therapy in severe psoriatic patients. J Eur Acad Dermatol Venereol 2016; 30:1531-6. [DOI: 10.1111/jdv.13649] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/04/2016] [Indexed: 11/29/2022]
Affiliation(s)
- E. Herédi
- Division of Dermatological Allergology; Department of Dermatology; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - J. Végh
- Division of Clinical Immunology; Institute of Internal Medicine; Clinical Centre; University of Debrecen; Debrecen Hungary
| | - L. Pogácsás
- Division of Dermatological Allergology; Department of Dermatology; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - K. Gáspár
- Division of Dermatological Allergology; Department of Dermatology; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - J. Varga
- Department of Nuclear Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - G. Kincse
- Department of Rheumatology; Kenézy Gyula Hospital; Debrecen Hungary
| | - M. Zeher
- Division of Clinical Immunology; Institute of Internal Medicine; Clinical Centre; University of Debrecen; Debrecen Hungary
| | - A. Szegedi
- Division of Dermatological Allergology; Department of Dermatology; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - J. Gaál
- Division of Clinical Immunology; Institute of Internal Medicine; Clinical Centre; University of Debrecen; Debrecen Hungary
- Department of Rheumatology; Kenézy Gyula Hospital; Debrecen Hungary
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Affiliation(s)
- A Szegedi
- Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, Debrecen, 4032, Hungary.
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46
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Rencz F, Holló P, Kárpáti S, Péntek M, Remenyik É, Szegedi A, Balogh O, Herédi E, Herszényi K, Jókai H, Brodszky V, Gulácsi L. Moderate to severe psoriasis patients' subjective future expectations regarding health-related quality of life and longevity. J Eur Acad Dermatol Venereol 2014; 29:1398-405. [PMID: 25491660 DOI: 10.1111/jdv.12884] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/28/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Unrealistic expectations regarding treatments and clinical outcomes may lead to disappointment about therapy and sub-optimal compliance; nonetheless, these expectations have not been studied in psoriasis patients yet. OBJECTIVE To evaluate psoriasis patients' subjective future expectations regarding health-related quality of life (HRQOL) and life expectancy, and to explore clinical features associated with under- or overestimating behaviour. METHODS A cross-sectional questionnaire survey of consecutive adult patients with moderate to severe psoriasis was conducted. HRQOL expectations were recorded by applying the EQ-5D descriptive system for 6 months ahead and for future ages of 60, 70, 80 and 90 respectively. RESULTS In total, 167 patients (71% males) were included in the analysis with mean age of 50.4 ± 12.4 years and mean EQ-5D score of 0.71 ± 0.30. Overall 65% had chronic plaque psoriasis, 35% nail psoriasis, 35% scalp involvement, 29% psoriatic arthritis, 9% inverse psoriasis and 5% palmoplantar psoriasis respectively (combinations occurred). Participants expected 0.1 ± 0.23 mean improvement in EQ-5D within 6 months (P < 0.001) that achieves the minimum clinically important difference. Overall 37% expected improvement and 13% decline; however, 49% expected no changes in any of the five dimensions of EQ-5D within 6 months. Female gender, inverse or palmoplantar involvement and more severe psoriasis were likely associated with higher expectations. Patients at the initiation of their first biological at the time of the survey expected 0.18 ± 0.24 increase that seems to be realistic compared to the EQ-5D utility gain achieved in randomized controlled trials. Males expected by 2.7 ± 11.1 more, while females expected by 5.2 ± 9.3 less life years compared to the average statistical gender- and age-matched life expectancy (P < 0.05). Patients who expected to be alive at ages of 60, 70, 80 and 90 scored their future EQ-5D at ages of 60 to 90: 0.59 ± 0.46, 0.48 ± 0.41, 0.42 ± 0.41 and 0.22 ± 0.47 respectively. CONCLUSION Our findings highlight the importance of exploring expectations that might help to increase patients' compliance.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - É Remenyik
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - O Balogh
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - E Herédi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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47
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Mócsai G, Gáspár K, Nagy G, Irinyi B, Kapitány A, Bíró T, Gyimesi E, Tóth B, Maródi L, Szegedi A. Severe skin inflammation and filaggrin mutation similarly alter the skin barrier in patients with atopic dermatitis. Br J Dermatol 2014; 170:617-24. [PMID: 24251354 DOI: 10.1111/bjd.12743] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND Filaggrin (FLG) deficiency is a well-known predisposing factor for the development of atopic dermatitis (AD). Decreased FLG expression can be the result of haploinsufficiency or severe inflammation, which can cause acquired FLG alterations. FLG mutations are related to several clinical and laboratory parameters of AD; however, some recent data seem to contradict these associations. OBJECTIVES Our aim was to determine which clinical and biochemical parameters are connected to FLG haploinsufficiency and which ones are also associated with acquired FLG alterations due to severe skin symptoms in patients with AD. METHODS We introduced a novel classification of patients with AD, based on FLG mutations and SCORAD (SCORing Atopic Dermatitis). Based on these parameters, we created three groups of patients with AD: mild-to-moderate wild-type (A), severe wild-type (B) and severe mutant (C). In all groups, we assessed laboratory and clinical parameters and performed immunohistochemical analyses. RESULTS Groups B and C contained patients with equally severe symptoms based on the SCORAD. The two severe groups did not differ significantly with respect to barrier-specific parameters, whereas group A had significantly better results for the barrier function measurements. However, significant differences were detected between groups B and C with respect to the allergic sensitization-specific parameters. CONCLUSIONS These findings suggest that skin barrier function correlates with the severity of skin inflammation and can be equally impaired in patients with FLG mutant- and wild-type AD with severe symptoms. Nevertheless, our results also suggest that patients with FLG mutant-type AD may have a higher risk of allergic sensitization compared with patients with the wild-type.
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Affiliation(s)
- G Mócsai
- Department of Dermatology, Medical and Health Science Center, University of Debrecen, 98 Nagyerdei krt, Debrecen, 4032, Hungary; Department of Dermatological Allergology, Medical and Health Science Center, University of Debrecen, 98 Nagyerdei krt, Debrecen, 4032, Hungary
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48
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Mihály J, Sonntag D, Krebiehl G, Szegedi A, Töröcsik D, Rühl R. Steroid concentrations in patients with atopic dermatitis: reduced plasma dehydroepiandrosterone sulfate and increased cortisone levels. Br J Dermatol 2014; 172:285-8. [PMID: 24974914 DOI: 10.1111/bjd.13219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J Mihály
- Department of Biochemistry and Molecular Biology, Medical and Health Science Center, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
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49
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Rencz F, Gulacsi L, Remenyik É, Szegedi A, Holló P, Kárpáti S, Péntek M, Brodszky V. Subjective Expectations Regarding Life Expectancy And Health-Related Quality Of Life In Moderate To Severe Psoriasis Patients. Value Health 2014; 17:A611. [PMID: 27202132 DOI: 10.1016/j.jval.2014.08.2142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Rencz
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
| | - É Remenyik
- University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- University of Debrecen, Debrecen, Hungary
| | - P Holló
- Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Semmelweis University, Budapest, Hungary
| | - M Péntek
- Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
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50
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Yoncheva K, Popova M, Szegedi A, Mihaly J, Tzankov B, Lambov N, Konstantinov S, Tzankova V, Pessina F, Valoti M. Functionalized mesoporous silica nanoparticles for oral delivery of budesonide. J SOLID STATE CHEM 2014. [DOI: 10.1016/j.jssc.2013.12.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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