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Dirr MA, Ahmed A, Schlessinger DI, Haq M, Shi V, Koza E, Ma M, Christensen RE, Ibrahim SA, Schmitt J, Johannsen L, Asai Y, Baldwin HE, Berardesca E, Berman B, Vieira AC, Chien AL, Cohen DE, Del Rosso JQ, Dosal J, Drake LA, Feldman SR, Fleischer AB, Friedman A, Graber E, Harper JC, Helfrich YR, Jemec GB, Johnson SM, Katta R, Lio P, Maier LE, Martin G, Nagler AR, Neuhaus IM, Palamar M, Parish LC, Rosen T, Shumack SP, Solomon JA, Tanghetti EA, Webster GF, Weinkle A, Weiss JS, Wladis EJ, Maher IA, Sobanko JF, Cartee TV, Cahn BA, Alam M, Kang BY, Iyengar S, Anvery N, Alpsoy E, Bewley A, Dessinioti C, Egeberg A, Engin B, Gollnick HPM, Ioannides D, Kim HS, Lazaridou E, Li J, Lim HG, Micali G, de Oliveira CMM, Noguera-Morel L, Parodi A, Reinholz M, Suh DH, Sun Q, van Zuuren EJ, Wollina U, Zhou Y, Zip C, Poon E, Pearlman R. Rosacea Core Domain Set for Clinical Trials and Practice: A Consensus Statement. JAMA Dermatol 2024:2817890. [PMID: 38656294 DOI: 10.1001/jamadermatol.2024.0636] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Importance Inconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea. Objective To develop a rosacea core outcome set (COS) based on key domains that are globally relevant and applicable to all demographic groups to be used as a minimum list of outcomes for reporting by rosacea clinical trials, and when appropriate, in clinical practice. Evidence Review A systematic literature review of rosacea clinical trials was conducted. Discrete outcomes were extracted and augmented through discussions and focus groups with key stakeholders. The initial list of 192 outcomes was refined to identify 50 unique outcomes that were rated through the Delphi process Round 1 by 88 panelists (63 physicians from 17 countries and 25 patients with rosacea in the US) on 9-point Likert scale. Based on feedback, an additional 11 outcomes were added in Round 2. Outcomes deemed to be critical for inclusion (rated 7-9 by ≥70% of both groups) were discussed in consensus meetings. The outcomes deemed to be most important for inclusion by at least 85% of the participants were incorporated into the final core domain set. Findings The Delphi process and consensus-building meetings identified a final core set of 8 domains for rosacea clinical trials: ocular signs and symptoms; skin signs of disease; skin symptoms; overall severity; patient satisfaction; quality of life; degree of improvement; and presence and severity of treatment-related adverse events. Recommendations were also made for application in the clinical setting. Conclusions and Relevance This core domain set for rosacea research is now available; its adoption by researchers may improve the usefulness of future trials of rosacea therapies by enabling meta-analyses and other comparisons across studies. This core domain set may also be useful in clinical practice.
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Affiliation(s)
- McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Misha Haq
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Victoria Shi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Eric Koza
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Melissa Ma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rachel E Christensen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lena Johannsen
- Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yuka Asai
- Division of Dermatology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Enzo Berardesca
- Phillip Frost Department of Dermatology and Cutaneous Surgery Miller School of Medicine, University of Miami, Miami, Florida
| | - Brian Berman
- Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
| | - Ana Carolina Vieira
- Ophthalmology Department, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - David E Cohen
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | | | | | - Lynn A Drake
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Steven R Feldman
- Pathology and Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Adam Friedman
- Department of Dermatology, George Washington School of Medicine and Health Science, Washington, DC
- Universitätsklinik für Dermatologie und Venerologie, Innsbruck, Austria
| | - Emmy Graber
- The Dermatology Institute of Boston Affiliate, Northeastern University, Boston, Massachusetts
| | - Julie C Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | | | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | | | - Rajani Katta
- McGovern Medical School at UTHealth, Houston, Texas
| | - Peter Lio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lisa E Maier
- Department of Dermatology, University of Washington, Seattle
| | - George Martin
- Dr George Martin Dermatology Associates, Kihei, Hawaii
| | - Arielle R Nagler
- Ambulatory Quality and Network Integration, The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Isaac M Neuhaus
- Department of Dermatology, University of California, San Francisco
| | - Melis Palamar
- Department of Ophthalmology, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Lawrence C Parish
- Jefferson Center for International Dermatology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Stephen P Shumack
- Royal North Shore Hospital of Sydney, St Leonards, New South Wales, Australia
| | - James A Solomon
- University of Central Florida College of Medicine, Florida State College of Medicine, Tallahassee
- Department of Dermatology, Carle-Illinois College of Medicine, Urbana
| | - Emil A Tanghetti
- Center for Dermatology and Laser Surgery, Sacramento, California
| | - Guy F Webster
- Department of Dermatology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | | | - Edward J Wladis
- Department of Ophthalmology, Lions Eye Institute, Albany Medical College, Albany, New York
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Joseph F Sobanko
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Todd V Cartee
- Department of Dermatology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Brian A Cahn
- Department of Dermatology, University of Illinois, Chicago
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Anthony Bewley
- Barts Health National Health Service Trust and Queen Mary University, London, United Kingdom
| | - Clio Dessinioti
- Department of Dermatology, Andreas Sygros Hospital, University of Athens, Athens, Greece
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Burhan Engin
- Dermatology Department, Cerrahpaşa Medical Faculty, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Harald P M Gollnick
- Dermatology Department, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Dimitrios Ioannides
- First Department of Dermatology-Venereology, Aristotle University Medical School Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Hei Sung Kim
- Department of Dermatology, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Elizabeth Lazaridou
- Second Department of Dermatology-Venereology, Aristotle University School of Medicine, Thessaloniki, Greece
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha Shi, China
| | | | | | | | - Lucero Noguera-Morel
- Department of Dermatology, Hospital Infantil, Universidad Niño Jesús, Madrid, Spain
| | - Aurora Parodi
- Department of Health Sciences, University of Genoa, Ospedale-Policlinico San Martino, IRCCS Genova, Italy
| | | | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Shuaifuyuan, Beijing, China
| | - Esther J van Zuuren
- Department of Dermatology B1-Q, Leiden University Medical Centre, RC Leiden, the Netherlands
| | - Uwe Wollina
- Department of Dermatology and Allergology, StädtischesKlinikum Dresden, Friedrichstr, Dresden, Germany
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine Zip
- Department of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ross Pearlman
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Masilamoni GJ, Weinkle A, Papa SM, Smith Y. Cortical Serotonergic and Catecholaminergic Denervation in MPTP-Treated Parkinsonian Monkeys. Cereb Cortex 2021; 32:1804-1822. [PMID: 34519330 DOI: 10.1093/cercor/bhab313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/05/2021] [Accepted: 08/07/2021] [Indexed: 11/14/2022] Open
Abstract
Decreased cortical serotonergic and catecholaminergic innervation of the frontal cortex has been reported at early stages of Parkinson's disease (PD). However, the limited availability of animal models that exhibit these pathological features has hampered our understanding of the functional significance of these changes during the course of the disease. In the present study, we assessed longitudinal changes in cortical serotonin and catecholamine innervation in motor-symptomatic and asymptomatic monkeys chronically treated with low doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Densitometry and unbiased stereological techniques were used to quantify changes in serotonin and tyrosine hydroxylase (TH) immunoreactivity in frontal cortices of 3 control monkeys and 3 groups of MPTP-treated monkeys (motor-asymptomatic [N = 2], mild parkinsonian [N = 3], and moderate parkinsonian [N = 3]). Our findings revealed a significant decrease (P < 0.001) in serotonin innervation of motor (Areas 4 and 6), dorsolateral prefrontal (Areas 9 and 46), and limbic (Areas 24 and 25) cortical areas in motor-asymptomatic MPTP-treated monkeys. Both groups of symptomatic MPTP-treated animals displayed further serotonin denervation in these cortical regions (P < 0.0001). A significant loss of serotonin-positive dorsal raphe neurons was found in the moderate parkinsonian group. On the other hand, the intensity of cortical TH immunostaining was not significantly affected in motor asymptomatic MPTP-treated monkeys, but underwent a significant reduction in the moderate symptomatic group (P < 0.05). Our results indicate that chronic intoxication with MPTP induces early pathology in the corticopetal serotonergic system, which may contribute to early non-motor symptoms in PD.
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Affiliation(s)
- Gunasingh Jeyaraj Masilamoni
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Udall Center of Excellence for Parkinson's Disease, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Allison Weinkle
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Stella M Papa
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Yoland Smith
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Udall Center of Excellence for Parkinson's Disease, Emory University School of Medicine, Atlanta, GA 30322, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
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Daou H, Hatch LA, Weinkle A, Morey GE, Messina J, Zhang X, Sokol L, Seminario-Vidal L. CD8-positive cutaneous lymphoproliferation associated with large granular lymphocyte leukemia in a patient with X-linked agammaglobulinemia. J Cutan Pathol 2020; 48:567-571. [PMID: 32885480 DOI: 10.1111/cup.13860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022]
Abstract
Patients with primary immunodeficiency are at increased risk for malignancy, especially hematologic neoplasms. This paper reports a unique case of a 47-year-old man with X-linked agammaglobulinemia who presented with progressive asymptomatic violaceous papules and plaques on his face, hands, and trunk for 1 year. Skin biopsies revealed deep, nodular infiltrates of histiocytes and CD8-positive lymphocytes, with a CD4:CD8 ratio of 1:10. Laboratory studies showed cytopenias. Flow cytometry in the skin, blood, and bone marrow (BM) showed a CD3+/CD8+/CD57+ large granular lymphocyte population. BM biopsy showed 30% involvement with these atypical T-cells. T-cell gene rearrangement studies of skin, blood, and BM revealed identical T-cell clones. He was diagnosed with T-large granular lymphocyte leukemia (T-LGLL) with an associated CD8+ cutaneous lymphoproliferation. Skin involvement was suspected to represent infiltration by T-LGLL. However, co-existence of two lymphoproliferative disorders (LPDs), T-LGLL and CD8+ granulomatous LPD, remains a possibility. In general, cutaneous infiltrates associated with LGLL are rare and poorly understood. It has been suggested that they are markers of poor prognosis. Our case report describes skin, blood, and BM findings in an immunosuppressed patient with T-LGLL in detail. These findings have not yet been reported and their significance requires further investigation.
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Affiliation(s)
- Hala Daou
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Leigh A Hatch
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Allison Weinkle
- Department of Dermatology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Gabriel Eli Morey
- Department of Pathology, Moffitt Center and Research Institute, Tampa, Florida, USA.,Department of Cutaneous Oncology, Moffitt Center and Research Institute, Tampa, Florida, USA
| | - Jane Messina
- Department of Pathology, Moffitt Center and Research Institute, Tampa, Florida, USA.,Department of Cutaneous Oncology, Moffitt Center and Research Institute, Tampa, Florida, USA
| | - Xiaohui Zhang
- Department of Pathology, Moffitt Center and Research Institute, Tampa, Florida, USA
| | - Lubomir Sokol
- Department of Malignant Hematology, Moffitt Center and Research Institute, Tampa, Florida, USA
| | - Lucia Seminario-Vidal
- Department of Dermatology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.,Department of Cutaneous Oncology, Moffitt Center and Research Institute, Tampa, Florida, USA
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