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Herranz-Pinto P, Figueras Nart I, Monte-Boquet E, Tortajada Goitia B. Improving the Management and Follow-up of Atopic Dermatitis: A Delphi Process Report of Consensus Between Hospital Dermatologists and Pharmacists. Actas Dermosifiliogr 2023; 114:708-717. [PMID: 37088291 DOI: 10.1016/j.ad.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/28/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
Managing atopic dermatitis, one of the most common dermatologic conditions, is often challenging. To establish consensus on recommendations for responding to various situations that arise when treating atopic dermatitis, a group of hospital pharmacists and dermatologists used the Delphi process. A scientific committee developed a Delphi survey with 2 blocks of questions to explore the group's views on 1) evaluating response to treatment in the patient with atopic dermatitis and 2) cooperation between the dermatology department and the hospital pharmacy service. The experts achieved an overall rate of consensus of 86% during the process. Conclusions were that dermatologists and hospital pharmacists must maintain good communication and coordinate their interventions to optimize the management of atopic dermatitis and patients' responses to treatment.
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Affiliation(s)
- P Herranz-Pinto
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.
| | - I Figueras Nart
- Servicio de Dermatología, Hospital Universitario Bellvitge, Barcelona, España
| | - E Monte-Boquet
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, España
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Herranz-Pinto P, Figueras Nart I, Monte-Boquet E, Tortajada Goitia B. [Translated article] Improving the Management and Follow-up of Atopic Dermatitis: A Delphi Process Report of Consensus Between Hospital Dermatologists and Pharmacists. Actas Dermosifiliogr 2023; 114:T708-T717. [PMID: 37453542 DOI: 10.1016/j.ad.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/02/2023] [Indexed: 07/18/2023] Open
Abstract
Managing atopic dermatitis, one of the most common dermatologic conditions, is often challenging. To establish consensus on recommendations for responding to various situations that arise when treating atopic dermatitis, a group of hospital pharmacists and dermatologists used the Delphi process. A scientific committee developed a Delphi survey with two blocks of questions to explore the group's views on (1) evaluating response to treatment in the patient with atopic dermatitis and (2) cooperation between the dermatology department and the hospital pharmacy service. The experts achieved an overall rate of consensus of 86% during the process. Conclusions were that dermatologists and hospital pharmacists must maintain good communication and coordinate their interventions to optimize the management of atopic dermatitis and patients' responses to treatment.
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Affiliation(s)
- P Herranz-Pinto
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain.
| | - I Figueras Nart
- Servicio de Dermatología, Hospital Universitario Bellvitge, Barcelona, Spain
| | - E Monte-Boquet
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Prajapati V, Glick B, Spelman L, Figueras Nart I, Calimlim B, Ladizinski B, Wu T, Liu Y, Davis J, Aydin H, Ehst B. 308 Incremental improvements after switching from dupilumab (DUPI) to upadacitinib (UPA) in the Heads Up open-label extension (OLE) study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.316] [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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Exposito‐Serrano V, Curto‐Barredo L, Aguilera Peiro P, Gómez Armayones S, Serra‐Baldrich E, Spertino J, Bonfill Ortí M, Figueras Nart I, Melé‐Ninot G, Baliu‐Piqué C, Sala Cunill A, Labrador‐Horrillo M, Guilabert Vidal A, Fernández Chico N, Giménez‐Arnau A. Omalizumab for the treatment of chronic inducible urticaria in 80 patients. Br J Dermatol 2020; 184:167-168. [DOI: 10.1111/bjd.19425] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/05/2020] [Accepted: 07/26/2020] [Indexed: 12/25/2022]
Affiliation(s)
- V. Exposito‐Serrano
- Departments of Dermatology atDepartment of Dermatology Hospital Universitari Parc Taulí. Sabadell
| | | | | | | | | | - J. Spertino
- Department of Dermatology Hospital de la Santa Creu i Sant Pau
| | | | | | - G. Melé‐Ninot
- Department of Dermatology Hospital Universitari Sagrat Cor
| | - C. Baliu‐Piqué
- Department of Dermatology Hospital d’Igualada‐Consorci Sanitari de l’Anoia
| | - A. Sala Cunill
- Department of Dermatology Allergology Department Hospital Universitari Vall d’Hebron
| | - M. Labrador‐Horrillo
- Department of Dermatology Allergology Department Hospital Universitari Vall d’Hebron
| | | | - N. Fernández Chico
- Departments of Dermatology atDepartment of Dermatology Hospital Universitari Parc Taulí. Sabadell
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Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, Navarro Fernández I, Ruiz-Villaverde R, Falkenhain-López D, Llamas Velasco M, García-Gavín J, Baniandrés O, González-Cruz C, Morillas-Lahuerta V, Cubiró X, Figueras Nart I, Selda-Enriquez G, Romaní J, Fustà-Novell X, Melian-Olivera A, Roncero Riesco M, Burgos-Blasco P, Sola Ortigosa J, Feito Rodriguez M, García-Doval I. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol 2020; 183:71-77. [PMID: 32348545 PMCID: PMC7267236 DOI: 10.1111/bjd.19163] [Citation(s) in RCA: 846] [Impact Index Per Article: 211.5] [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] [Accepted: 04/28/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The cutaneous manifestations of COVID-19 disease are poorly characterized. OBJECTIVES To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings. METHODS We carried out a nationwide case collection survey of images and clinical data. Using a consensus we described five clinical patterns. We later described the association of these patterns with patient demographics, the timing in relation to symptoms of the disease, the severity and the prognosis. RESULTS The lesions may be classified as acral areas of erythema with vesicles or pustules (pseudo-chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo-chilblain pattern frequently appears late in the evolution of the COVID-19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID-19. The severity of COVID-19 shows a gradient from less severe disease in acral lesions to more severe in the latter groups. The results are similar for confirmed and suspected cases, in terms of both clinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo-chilblain and vesicular). CONCLUSIONS We provide a description of the cutaneous manifestations associated with COVID-19 infection. These may help clinicians approach patients with the disease and recognize cases presenting with few symptoms. What is already known about this topic? Previous descriptions of cutaneous manifestations of COVID-19 were case reports and mostly lacked illustrations. What does this study add? We describe a large, representative sample of patients with unexplained skin manifestations and a diagnosis of COVID-19, using a consensus method to define morphological patterns associated with COVID-19. We describe five clinical patterns associated with different patient demographics, timing and prognosis, and provide illustrations of these patterns to allow for easy recognition.
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Affiliation(s)
| | - A Català
- Hospital Plató, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - O Baniandrés
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - X Cubiró
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - I Figueras Nart
- Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | - J Romaní
- Consorci Sanitari Parc Taulí, Sabadell, Barcelona, Spain
| | - X Fustà-Novell
- Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | | | - M Roncero Riesco
- Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | | | | | - I García-Doval
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
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Spertino J, Curto Barredo L, Rozas Muñoz E, Figueras Nart I, Serra Baldrich E, Bonfill-Ortí M, Expósito-Serrano V, Guilabert A, Melé Ninot G, Villar Buil M, Garcias Ladaria J, García Navarro X, Vilavella M, Bielsa Marsol I, Aparicio Ortiz G, Baliu Piqué C, Álvarez Abella A, Lamas Domenech N, Mascaró J, Gómez S, Torné Gutiérrez J, Vicente Villa A, Gimenez Arnau A. Algorithm for Treatment of Chronic Spontaneous Urticaria with Omalizumab. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Spertino J, Curto Barredo L, Rozas Muñoz E, Figueras Nart I, Gimenez Arnau A, Serra Baldrich E, Bonfill-Ortí M, Expósito-Serrano V, Guilabert A, Melé Ninot G, Villar Buil M, Garcias Ladaria J, García Navarro X, Vilavella M, Bielsa Marsol I, Aparicio Ortiz G, Baliu Piqué C, Álvarez Abella A, Lamas Domenech N, Mascaró JM, Gómez S, Torné Gutiérrez JI, Vicente Villa A, Gimenez Arnau A. Algorithm for Treatment of Chronic Spontaneous Urticaria with Omalizumab. Actas Dermosifiliogr (Engl Ed) 2018; 109:771-776. [PMID: 30107875 DOI: 10.1016/j.ad.2018.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/18/2018] [Revised: 05/20/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Pivotal trials with omalizumab for treatment of chronic spontaneous urticaria (CSU) are generally run over 12 to 24weeks. However, in clinical practice, many patients need longer treatment. In this article, we present an algorithm for treatment with omalizumab. MATERIAL AND METHODS The consensus document we present is the result of a series of meetings by the CSU working group of "Xarxa d'Urticària Catalana i Balear" (XUrCB) at which data from the recent literature were presented, discussed, compared, and agreed upon. RESULTS Treatment with omalizumab should be initiated at the authorized dose, and is adjusted at 3-monthly intervals according to the Urticaria Activity Score Over 7days, the Urticaria Control Test, or both. CONCLUSIONS The algorithm proposed is designed to provide guidance on how to adjust omalizumab doses, how and when to discontinue the drug, and how to reintroduce it in cases of relapse.
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Affiliation(s)
- J Spertino
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | | | - E Rozas Muñoz
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Figueras Nart
- Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | | | - E Serra Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Bonfill-Ortí
- Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | | | - A Guilabert
- Hospital General de Granollers, Granollers, Barcelona, España
| | - G Melé Ninot
- Hospital Universitari Sagrat Cor, Barcelona, España
| | - M Villar Buil
- Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
| | | | - X García Navarro
- Consorci Sanitari del Garraf, Sant Pere de Ribes, Barcelona, España
| | - M Vilavella
- Consorci Sanitari de Terrassa, Terrassa, Barcelona, España
| | | | | | - C Baliu Piqué
- Consorci Sanitari de l'Anoia, Igualada, Barcelona, España
| | | | | | - J M Mascaró
- Hospital Clínic de Barcelona, Barcelona, España
| | - S Gómez
- Hospital Clínic de Barcelona, Barcelona, España
| | | | - A Vicente Villa
- Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
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Figueras Nart I, Cerio R, Dirschka T, Dréno B, Lear JT, Pellacani G, Peris K, Ruiz de Casas A. Defining the actinic keratosis field: a literature review and discussion. J Eur Acad Dermatol Venereol 2017; 32:544-563. [PMID: 29055153 DOI: 10.1111/jdv.14652] [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] [Indexed: 12/17/2022]
Abstract
Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire cancerization field during clinical management, a standardized definition of the AK field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK cancerization field, with the aim of determining a precise definition of the AK field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK field. Therefore, the authors instead propose a clinical definition of field cancerization based on the identification of visible signs of sun damage that are reliable indicators of field cancerization based on expert opinion.
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Affiliation(s)
- I Figueras Nart
- Department of Dermatology, Bellvitge Hospital, Barcelona, Spain
| | - R Cerio
- Department of Cutaneous Medicine and Surgery, The Royal London Hospital and QMUL, Bart's Health NHS Trust, London, UK
| | - T Dirschka
- CentroDerm® Clinic, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
| | - J T Lear
- Manchester Academic Health Science Centre, MAHSC, Manchester University and Salford Royal NHS Foundation Trust, Royal Infirmary, The University of Manchester, Manchester, UK
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - K Peris
- Department of Dermatology, Catholic University of Rome, Rome, Italy
| | - A Ruiz de Casas
- Dermatology Unit, Virgen Macarena University Hospital, Seville, Spain
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