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Aggarwal P, Choi J, Sutaria N, Roh YS, Wongvibulsin S, Williams KA, Huang AH, Boozalis E, Le T, Chavda R, Gabriel S, Kwatra SG. Clinical characteristics and disease burden in prurigo nodularis. Clin Exp Dermatol 2021; 46:1277-1284. [PMID: 33969517 DOI: 10.1111/ced.14722] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/17/2021] [Accepted: 05/04/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by intense pruritus, but information on patient experience and impact on quality of life (QoL) remains understudied. AIM To characterize disease characteristics and QoL in a global sample of patients with PN. METHODS An anonymous survey was distributed via patient support groups for PN. RESULTS In total, 231 members responded to the survey. The majority of respondents reported itch localized both to nodules and to intervening skin (67.0%). Associated symptoms included prickling, pain, stinging and burning. The extensor lower legs (69% right, 67.3% left) and flexor forearms (66.1% right, 62% left) were the most common sites of itch. Participants reported frequent healthcare utilization, with 36.3% visiting a doctor ≥ 10 times in the past year. Physician-diagnosed anxiety (45.4%), depression (16.4%) and the atopic triad (18.7%) were commonly reported. Patients with PN had mean scores of 16.4, 11.6 and 16.8 on the Dermatology Life Quality Index, Pittsburgh Sleep Quality Index and 5-Dimensions Itch, respectively. CONCLUSIONS Severe pruritus with accompanying pain, stinging and burning is characteristic of PN, with the majority of patients experiencing itch in both nodular and interlesional skin. Patients further report decreased QoL scores and impaired sleep. Patient experiences should guide future management of PN.
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Affiliation(s)
- P Aggarwal
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - N Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y S Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Wongvibulsin
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K A Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A H Huang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E Boozalis
- Division of Dermatology, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - T Le
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Chavda
- Galderma SA, Lausanne, Switzerland
| | | | - S G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Sutaria N, Parthasarathy V, Roh YS, Choi J, Bordeaux ZA, Trinh P, Le TK, Semenov YR, Kwatra SG. Itch in skin of colour: a multicentre cross-sectional study. Br J Dermatol 2021; 185:652-654. [PMID: 33893648 DOI: 10.1111/bjd.20403] [Citation(s) in RCA: 4] [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] [Received: 02/13/2021] [Revised: 03/31/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- N Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - V Parthasarathy
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y S Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Z A Bordeaux
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P Trinh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - T K Le
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y R Semenov
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - S G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Sutaria N, Choi J, Roh YS, Alphonse MP, Adawi W, Lai J, Pollock JR, Fontecilla Biles N, Gabriel S, Chavda R, Kwatra SG. Association of prurigo nodularis and infectious disease hospitalizations: a national cross-sectional study. Clin Exp Dermatol 2021; 46:1236-1242. [PMID: 33763852 DOI: 10.1111/ced.14652] [Citation(s) in RCA: 3] [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: 01/25/2021] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Prurigo nodularis (PN) is associated with a variety of systemic comorbidities, including infectious diseases such as HIV and viral hepatitis. There are limited data on other infectious disease comorbidities in patients with PN. AIM To characterize infectious disease hospitalizations among patients with PN and the associated cost burden. METHODS We searched the 2016-2017 National Inpatient Sample, a cross-sectional sample of 20% of all US hospitalizations, for infectious disease hospitalizations among patients with PN. Associations of PN with infections and related costs were determined using multivariable logistic and linear regression, adjusting for age, race, sex and insurance type. RESULTS PN was associated with any infection overall (OR = 2.98, 95% CI 2.49-3.56), and with HIV, cutaneous, hepatobiliary, central nervous system, bacterial, viral and fungal/parasitic infections and for sepsis. Patients with PN had a higher mean cost of care (US$11 667 vs. US$8893, P < 0.001) and length of stay (5.5 vs. 4.2 days, P < 0.001) for any infection overall and for 7 of 13 other infections. Adjusting for age, race, sex and insurance coverage, PN was associated with higher cost (+30%, 95% CI +17 to +44%) and higher length of stay (+30%, 95% CI +18 to +44%) for any infection overall, and for several specific infections. These associations remained with alternate regression models adjusting for severity of illness. CONCLUSION There is a high infectious disease burden among patients with PN, corresponding to higher healthcare utilization and spending. Clinicians must be aware of these associations when treating these patients with immunomodulatory drugs.
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Affiliation(s)
- N Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y S Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M P Alphonse
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - W Adawi
- Eastern Virginia Medical School, Norfolk, VA, USA
| | - J Lai
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J R Pollock
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - N Fontecilla Biles
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Gabriel
- Galderma SA, Prescription GBU, Lausanne, Switzerland
| | - R Chavda
- Galderma SA, Prescription GBU, Lausanne, Switzerland
| | - S G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Cartron AM, Nguyen TH, Roh YS, Kwatra MM, Kwatra SG. Janus kinase inhibitors for atopic dermatitis: a promising treatment modality. Clin Exp Dermatol 2021; 46:820-824. [PMID: 33484582 DOI: 10.1111/ced.14567] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/12/2022]
Abstract
Atopic dermatitis (AD) is chronic, pruritic, inflammatory skin disease that affects a significant portion of the population in industrialized nations. For nonresponders to conventional therapies, AD can significantly reduce sleep quality and quality of life. AD pathogenesis is multifactorial and involves multiple immune pathways, with recent evidence of T helper (Th)2, Th17 and Th22 axis attenuation in various AD endotypes and racial subtypes. Inhibition of the conserved Janus kinase (JAK) signalling pathway represents a promising therapeutic avenue to reduce the activation of multiple proinflammatory mediators involved in AD pathogenesis. JAK inhibitors exist in both oral and topical forms with variable specificity for the receptor tyrosine kinases JAK1, JAK2, JAK3 and tyrosine kinase 2. Oral formulations include abrocitinib, upadacitinib, baricitinib and gusacitinib, and are most appropriate for patients with moderate to severe AD. Emerging topical formulation in development include ruxolitinib and deglocitinib, which may be used in patients with localized AD and also adjunctively with systemic therapy in patients with more severe disease. With observed rapidity in itch relief and accompanying dramatic reduction in inflammatory lesion count, JAK inhibitors represent a promising new treatment to revolutionize the management of AD.
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Affiliation(s)
- A M Cartron
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - T H Nguyen
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Y S Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M M Kwatra
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - S G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Jung IK, Park SC, Lee YR, Bin SA, Hong YD, Eun D, Lee JH, Roh YS, Kim BM. Development of a stiffness-angle law for simplifying the measurement of human hair stiffness. Int J Cosmet Sci 2018; 40:157-164. [DOI: 10.1111/ics.12447] [Citation(s) in RCA: 2] [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] [Received: 02/05/2017] [Accepted: 11/21/2017] [Indexed: 11/28/2022]
Affiliation(s)
- I. K. Jung
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - S. C. Park
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - Y. R. Lee
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - S. A. Bin
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - Y. D. Hong
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - D. Eun
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - J. H. Lee
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
| | - Y. S. Roh
- Bruker Optics; 338 Pangyo-ro Bundang-gu Seongnam-si, Gyeonggi-do Republic of Korea
| | - B. M. Kim
- AMOREPACIFIC R&D CENTER; Bora-Dong 314-1 Yongin-Si South Korea
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Ko YH, Kim HJ, Roh YS, Park CK, Kwon CK, Park MH. Atypical Fabry's disease. An oligosymptomatic variant. Arch Pathol Lab Med 1996; 120:86-9. [PMID: 8554452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Fabry's disease is a rare, inherited, X-linked metabolic storage disease with ceramide hexoside due to alpha-galactosidase A deficiency. Patients with typical Fabry's disease usually present with several clinical manifestations of corneal dystrophy, neurologic abnormalities, cardiovascular disease, heavy proteinuria, and characteristic cutaneous angiokeratoma. However, atypical Fabry's disease with oligosymptomatic phenotype presents with symptoms restricted solely to cardiocytes or kidney and might be diagnosed by chance during a routine endomyocardial or renal biopsy examination. In this article, we report a case of Fabry's disease incidentally diagnosed in a 34-year-old man who presented with intermittent trace or 1(+) proteinuria only. This patient had no history of renal disease in any other family member. A renal biopsy to evaluate trace proteinuria revealed histologic and ultrastructural findings compatible with Fabry's disease. Subsequent to the renal biopsy, a skin biopsy on a few initially unrecognized, scattered, dark-pinkish scrotal papules showed typical angiokeratoma. A biochemical enzymatic assay of alpha-galactosidase in urine and plasma revealed a markedly decreased enzyme level in the hemizygous range.
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Affiliation(s)
- Y H Ko
- Department of Pathology, Hanyang University, College of Medicine, Seoul, Korea
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Roh YS, Dequeker J, Mulier JC. Bone mass in osteoarthrosis, measured in vivo by photon absorption. J Bone Joint Surg Am 1974; 56:587-91. [PMID: 4822517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Roh YS, Dequeker J, Mulier JC. Trabecular pattern of the upper end of the femur in primary osteoarthrosis and in symptomatic osteoporosis. J Belge Radiol 1974; 57:89-94. [PMID: 4839790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Dequeker J, Roh YS, Van Dessel D, Gautama K, Burssens A. Bone mineral estimation in vivo by photon absorptiometry. Influence of skeletal size and its value for detecting osteoporosis. J Belge Rhumatol Med Phys 1973; 28:293-301. [PMID: 4794042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Roh YS, Dequeker J, Mulier JC. Cortical bone remodeling and bone mass in primary osteoarthrosis of the hip. Invest Radiol 1973; 8:351-4. [PMID: 4198990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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12
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Roh YS, Dequeker J, Mulier JC. Cortical bone remodeling and bone mass in poliomyelitis. Acta Orthop Belg 1973; 39:758-71. [PMID: 4751689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Roh YS, Dequeker J, Mulier JC. Osteoarthrosis at the hand skeleton in primary osteoarthrosis of the hip and in normal controls. Clin Orthop Relat Res 1973:90-4. [PMID: 4689134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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