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Alamillo-Velazquez J, Ortiz-Morales G, Gonzalez-Gonzalez SE, Lopez-Altamirano DF, Rodríguez-Garcia A. Actinic conjunctivitis and its relationship with prurigo in an indigenous population from the Highlands of Chiapas, Mexico. Int Ophthalmol 2024; 44:4. [PMID: 38315255 DOI: 10.1007/s10792-024-02925-0] [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: 09/16/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE Actinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis that affects high-risk populations. We analyzed the clinical manifestations and onset of actinic conjunctivitis (AC), and its relationship with prurigo (AP) in a susceptible population. METHODS This prospective observational cohort study was performed on Indigenous populations from the highlands of Chiapas, Mexico. Thorough dermatological and ophthalmological examinations were performed in patients attending a primary health care center. The clinical features, labor and environmental factors, onset timing, and clinical staging of AC and AP were analyzed. RESULTS Of the 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC, and 14 patients (25.9%) had AP. The mean age at diagnosis was 36.18 ± 18.52 years (6-70 years). The mean residential altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 h a day (0.5-12 h). A total of 90.7% reported exposure to biomass fuels during cooking, and 50% to farm animals. AC was the sole manifestation in 70% of the cases. All patients had nasal and temporal photo-exposed conjunctiva. Among the eyes, 12.9% were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. A total of 83.3% of the patients had hyperpigmented lesions, and 35.1% had evaporative dry eye disease. CONCLUSIONS AC may be the initial or sole manifestation of AP. Most AC cases (87%) were initially observed at the advanced stages of the disease. Although solar exposure was not associated with late AC stages, a positive association was found with farm animal exposure. Evaporative dry eye associated with meibomian gland dysfunction has not been previously reported in patients with AC.
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Affiliation(s)
- Jimena Alamillo-Velazquez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Institute of Ophthalmology and Visual Sciences, Monterrey, Mexico
| | - Gustavo Ortiz-Morales
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Institute of Ophthalmology and Visual Sciences, Monterrey, Mexico
| | | | - Daniel F Lopez-Altamirano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Clinical Pathology Department, Hospital San Jose Tec Salud, Monterrey, Mexico
| | - Alejandro Rodríguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
- Institute of Ophthalmology and Visual Sciences, Hospital Zambrano-Hellion TecSalud. Av, Batallon de San Patricio No. 112, Col. Real de San Agustin, CP. 66270, San Pedro Grarza Garcia, Nuevo León, Mexico.
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Issa NT, Riva H, Jafferany M. INDIVIDUAL ARTICLE: Prurigo Nodularis: Current Clinicopathologic Overview and Psychodermatological Perspectives. J Drugs Dermatol 2023; 22:SF365502s6-SF365502s11. [PMID: 38051853 DOI: 10.36849/jdd.sf365502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Prurigo nodularis (PN) is a quintessential neurocutaneous condition characterized by neural sensitization and intractable itch leading to intense scratching. This causes the formation of nodules with epidermal thickening and further release of pro-inflammatory mediators that recruit immune cells and increase dermal nerve proliferation and hypertrophy perpetuating the itch-scratch cycle. Those with PN have a significant quality-of-life (QoL) burden due to itch, anxiety, and sleep disturbance. In addition, PN exhibits psychiatric comorbidities that affect mental wellbeing such as depression, mood disorders, and substance abuse. This paper serves as an overview of the clinicopathologic aspects of PN, the burden of PN on QoL, and the psychodermatological aspects of the disease state. J Drugs Dermatol. 2023;22:12(Suppl 2):s6-11.
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Yin M, Yang C, Guo Y, Yang X, Dou X. Comorbidities of Chronic Prurigo: A Systematic Review and Meta-Analysis. Dermatology 2023; 240:32-41. [PMID: 37883943 DOI: 10.1159/000534660] [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: 10/21/2022] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Chronic prurigo (CPG) is an inflammatory skin disease. Comorbidities including dermatological, cardiovascular, and psychiatric diseases have been reported in patients with CPG; however, the evidence has not been systematically evaluated. We aim to summarize the comorbidities, discuss underlying pathogenesis, and highlight the evaluation of CPG patients. METHODS We performed a systematic search using PubMed, Embase, and Web of Science databases for all articles reporting possible associated diseases with CPG. Pooled random-effects odds ratios (ORs) with 95% CI were calculated. RESULTS A total of 17 studies were included in this systematic review. Statistically significant association (p <0.05) with CPG has been demonstrated with atopic diseases: atopic dermatitis (pooled OR, 10.91; 95% CI, 3.65-32.67), allergic rhinitis (2.66; 1.12-6.27), asthma (3.23; 1.55-6.74); infectious diseases: hepatitis B (pooled OR, 2.15; 95% CI, 1.11-4.14); endocrine diseases: diabetes (pooled OR, 4.93; 95% CI, 1.13-21.56), type 1 diabetes (2.46; 2.16-2.81), type 2 diabetes (1.89; 1.34-2.68), hyperlipoproteinemia (2.90; 1.61-5.22); cardiovascular diseases: heart failure (pooled OR, 4.13; 95% CI, 1.15-14.91), hypertension (3.17; 1.56-6.45); respiratory system diseases: chronic obstructive pulmonary disease (pooled OR, 3.19; 95% CI, 1.42-7.16); urinary system diseases: chronic kidney disease (pooled OR, 4.16; 95% CI, 1.79-9.66); digestive system disease: inflammatory bowel disease (pooled OR, 2.06; 95% CI, 1.26-3.36); and others: osteoporosis (pooled OR, 3.08; 95% CI, 1.70-5.59), thyroid disease (1.70; 1.17-2.47). CONCLUSION CPG is associated with various systemic disorders. Recognition of comorbidities is critical to the appropriate management of affected patients.
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Affiliation(s)
- Mengting Yin
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Chener Yang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
- Shantou University Medical College, Shantou, China
| | - Yang Guo
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xu Yang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xia Dou
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
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Kim HS, Kim HJ, Ahn HS. Impact of Chronic Kidney Disease Severity on the Risk of Prurigo Nodularis: A Population-Based Cohort Study. Acta Derm Venereol 2022; 102:adv00781. [PMID: 35971831 PMCID: PMC9677257 DOI: 10.2340/actadv.v102.2227] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
While dialysis is linked with prurigo nodularis, little is known about the impact of non-dialysis chronic kidney disease on prurigo nodularis. The influence of chronic kidney disease on development of prurigo nodularis was measured using the Korean National Health Insurance and National Health Screening Program data, identifying 17,295,576 individuals without prior prurigo nodularis. Chronic kidney disease severity was determined by the estimated glomerular filtration rate (in ml/min/1.73 m2) calculated from serum creatinine, and proteinuria detected with urine dipstick. Prurigo nodularis incidence during follow-up was determined. Over a median follow-up period of 9.72 years, 58,599 individuals developed prurigo nodularis, with an incidence rate of 3.59 per 10,000 person-years. Among different variables, estimated glomerular filtration rate was the strongest risk factor for prurigo nodularis. Compared with estimated glomerular filtration rate ≥ 90, estimated glomerular filtration rate 15–29 (hazard ratio 1.31, 95% confidence interval 1.05–1.62) and end-stage renal disease (hazard ratio 1.46, 95% confidence interval 1.25–1.69) were associated with higher risks. The presence of proteinuria independently increased the risk of prurigo nodularis, increased risks associated with estimated glomerular filtration rate 15–29 and endstage renal disease, and caused risk associated with estimated glomerular filtration rate 30–59 to become significant. With differential impact of chronic kidney disease severity on the risk of prurigo nodularis, preservation of renal function would potentially translate into lower risk of prurigo nodularis.
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Affiliation(s)
| | - Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Inchon-ro 73, Seongbuk-gu, Seoul 02841, Korea.
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Wongvibulsin S, Sutaria N, Williams KA, Huang AH, Choi J, Roh YS, Hong M, Kelley D, Pahalyants V, Murphy W, Alphonse MP, Bakhshi P, Walia A, Semenov YR, Kwatra SG. A Nationwide Study of Prurigo Nodularis: Disease Burden and Healthcare Utilization in the United States. J Invest Dermatol 2021; 141:2530-2533.e1. [PMID: 33823182 PMCID: PMC8603386 DOI: 10.1016/j.jid.2021.02.756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Shannon Wongvibulsin
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nishadh Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kyle A Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy H Huang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Justin Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Youkyung Sophie Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Hong
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Davis Kelley
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vartan Pahalyants
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Harvard Business School, Boston, Massachusetts, USA
| | - William Murphy
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Harvard Business School, Boston, Massachusetts, USA
| | - Martin Prince Alphonse
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pegah Bakhshi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anant Walia
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yevgeniy R Semenov
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Wikström K, Verkko H, Sinikumpu SP, Jokelainen J, Tasanen K, Huilaja L. Comorbidities of Prurigo Nodularis in Finland Between 1996 and 2019. Acta Derm Venereol 2021; 101:adv00508. [PMID: 34230981 PMCID: PMC9413652 DOI: 10.2340/00015555-3872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lanza G, Cosentino FII, Ferri R, Lanuzza B, Siragusa M, Tripodi M, Schepis C. Cognitive Impairment in Inpatients with Prurigo Nodularis and Psychiatric Comorbidities. Int J Environ Res Public Health 2021; 18:ijerph18126265. [PMID: 34207921 PMCID: PMC8296039 DOI: 10.3390/ijerph18126265] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prurigo nodularis (PN) is a chronic refractory itchy dermatosis. Although psychiatric comorbidity is known, research in cognitive impairment is lacking. We evaluated the occurrence and types of cognitive impairment in a series of inpatients with PN. METHODS This was a retrospective chart review of all the patients with PN admitted to a referral neurological institute from September 2018 to March 2021. Any neurological and psychiatric disorder, along with neuroactive drugs taken, were concomitantly assessed. RESULTS A total of 16 patients with PN (median age: 70 years, two males) were selected from a total of 1806 hospital admissions. Most of them had a neurodegenerative cognitive disorder, from mild cognitive impairment (8) to Alzheimer's disease (1), followed by mixed disorder (degenerative and vascular) in six and vascular dementia in one. Comorbid psychiatric diseases (anxiety and depression) were more common than either individual condition, followed by bipolar disorder, whereas two patients did not show psychiatric manifestations. Most patients were on combined treatment with benzodiazepines and antidepressants. CONCLUSION Cognitive impairment can be observed in PN. In addition to screening for psychiatric comorbidity and initiating appropriate treatment or referral, clinicians may also consider the presence of cognitive impairment in PN of both degenerative and vascular origin.
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Affiliation(s)
- Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
- Correspondence: ; Tel.: +39-095-3782448
| | - Filomena Irene Ilaria Cosentino
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
| | - Raffaele Ferri
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
| | - Bartolo Lanuzza
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
| | - Maddalena Siragusa
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
| | - Mariangela Tripodi
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
| | - Carmelo Schepis
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (R.F.); (B.L.); (M.S.); (M.T.); (C.S.)
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Ständer S, Ketz M, Kossack N, Akumo D, Pignot M, Gabriel S, Chavda R. Epidemiology of Prurigo Nodularis compared with Psoriasis in Germany: A Claims Database Analysis. Acta Derm Venereol 2020; 100:adv00309. [PMID: 33021323 PMCID: PMC9309863 DOI: 10.2340/00015555-3655] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prurigo nodularis is an itchy skin disease with unknown epidemiology. This study aimed to describe the epidemiology of prurigo nodularis compared with that of psoriasis. The German sickness fund claims database, with 2,783,175 continuously insured patients, included 1,720 patients diagnosed with prurigo nodularis and 51,390 with psoriasis. Patients with prurigo nodularis were averagely 8 years older than psoriasis patients and more often were women (p < 0.001). Annual incidence was a constant 0.02% in prurigo nodularis, and decreased steadily from 0.53 to 0.42% in psoriasis; cumulative incidence was 0.1% for prurigo nodularis and 1.9% for psoriasis. Prevalence was 0.1% for prurigo nodularis and 4.7% for psoriasis, with a one-year mortality of 5.4% for prurigo nodularis and 1.2% for psoriasis (p < 0.001). The most frequent pre-existing comorbidities in patients with prurigo nodularis were inflammatory dermatoses and depression. This epidemiological study found a low prevalence of prurigo nodularis, manifesting different demographics and comorbidities compared with psoriasis.
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Affiliation(s)
- Sonja Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, DE-48149 Münster, Germany. E-mail:
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Gründel S, Pereira MP, Storck M, Osada N, Schneider G, Ständer S, Zeidler C. Analysis of 325 Patients with Chronic Nodular Prurigo: Clinics, Burden of Disease and Course of Treatment. Acta Derm Venereol 2020; 100:adv00269. [PMID: 32556359 PMCID: PMC9234994 DOI: 10.2340/00015555-3571] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic nodular prurigo presents with multiple pruriginous nodules and severe pruritus. This study aims to explore the treatment course and regimens in patients with chronic nodular prurigo and to analyse predictive factors contributing to therapeutic success. A total of 325 patients with chronic nodular prurigo (male 37.5%) were analysed concerning demographic data, pruritus intensity, medical history, psychological impairment, quality of life, treatment duration, regimens and outcome. These parameters were compared with 325 sex- and age-matched patients with chronic pruritus on non-lesional skin. Treatment success was dependent on duration and regime of treatment and independent of age, sex and initial itch intensity. Non-responders displayed a higher percentage of inflamed nodules, a higher portion of excoriated nodules and a higher impairment of quality of life and mood factors before initiation of treatment. Gabapentinoids and immunosuppressants proved to be the most successful therapeutic agents. Compared with patients with chronic pruritus, those with chronic nodular prurigo needed longer duration of therapy.
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Affiliation(s)
- Sonja Gründel
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
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Abstract
Prurigo nodularis is a chronic skin condition that presents significant challenges for treatment and quality of life, with little known about disease prevalence. This study assessed the prevalence of prurigo nodularis in Poland using publicly maintained database case records and diagnostic codes for prurigo nodularis (L28.1) and other prurigo (L28.2). For the period 2016–18, the prevalence of prurigo nodularis increased from 5.82 to 6.52 cases per 100,000 population. The total prevalence of all prurigo diagnoses over the same period remained relatively stable, with a small increase from 9.04 to 9.26 cases per 100,000 population. Regional data largely followed the overall trend. In an analysis of 58 prurigo nodularis cases identified at the Department of Dermatology at the University of Rzeszów, 43.1% of patients were initially misdiagnosed by the referring physician. Thus, more than one-third of patients with prurigo nodularis may initially be misdiagnosed.
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Affiliation(s)
- Anna Ryczek
- Department of Dermatology, University of Rzeszow, Szopena street 2, PL-35-055 Rzeszów, Poland
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Huang AH, Williams KA, Kwatra SG. Prurigo nodularis: Epidemiology and clinical features. J Am Acad Dermatol 2020; 83:1559-1565. [PMID: 32454098 DOI: 10.1016/j.jaad.2020.04.183] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [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: 03/05/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/14/2022]
Abstract
Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by intensely pruritic, hyperkeratotic nodules that favor the extensor surfaces of the extremities and the trunk. In addition to its significant impact on quality of life, many patients with PN are recalcitrant to therapy because there are currently no therapies approved by the US Food and Drug Administration. In the first article of this 2-part continuing medical education series, we describe the broader epidemiology, patient demographics, physical examination findings, and symptoms to aid in the timely recognition and diagnosis of PN. Furthermore, we quantify the burden of comorbidities in PN by discussing the broad spectrum of systemic diseases and mental health conditions that have been associated with this condition. The second article of this 2-part series focuses on the pathogenesis of PN and provides detailed algorithms for comprehensive work-up and management.
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Affiliation(s)
- Amy H Huang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Kyle A Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
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Sampogna F, Abeni D, Gieler U, Tomas Aragones L, Lien L, Poot F, Jemec GBE, Szabó C, Linder D, van Middendorp H, Halvorsen JA, Balieva F, Szepietowski JC, Romanov DV, Marron SE, Altunay IK, Finlay AY, Salek SS, Kupfer J, Misery L, Dalgard FJ. Exploring the EQ-5D Dimension of Pain/Discomfort in Dermatology Outpatients from a Multicentre Study in 13 European Countries. Acta Derm Venereol 2020; 100:adv00120. [PMID: 32250441 PMCID: PMC9128924 DOI: 10.2340/00015555-3477] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Accepted: 04/02/2020] [Indexed: 11/16/2022] Open
Abstract
Pain and discomfort are important symptoms in dermatology. The aim of this cross-sectional, multicentre study was to describe the prevalence of pain/discomfort and its associations in patients with several dermatological conditions across 13 European countries. The outcome was the prevalence of pain/discomfort according to a question of the EQ-5D questionnaire. Data collected from November 2011 to February 2013 were complete for 3,509 consecutive outpatients. Moderate or extreme pain/discomfort was reported by 55.5% of patients and 31.5% of controls with no skin conditions. The highest proportions were reported by patients with hidradenitis suppurativa (92.9%), leg ulcer (81.4%), prurigo (80%) and lichen planus (75.6%). Pain/discomfort was associated with older age, low educational level, clinical severity, flare on scalp or hands, itch, depression, anxiety, low quality of life, and thoughts of suicide. It is important to enquire specifically about pain/discomfort during clinical consultations and to address it when planning a patient's care.
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Affiliation(s)
- Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM, Via dei Monti di Creta 104, IT-00167 Rome, Italy
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Singam V, Patel KR, Silverberg JI. Association of prurigo nodularis and lichen simplex chronicus with hospitalization for mental health disorders in US adults. Arch Dermatol Res 2020; 312:587-593. [PMID: 32078024 DOI: 10.1007/s00403-020-02046-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/28/2020] [Accepted: 02/08/2020] [Indexed: 11/26/2022]
Abstract
Prurigo nodularis (PN) and lichen simplex chronicus (LSC) are debilitating chronic pruritic diseases that can lead to and be exacerbated by psychosocial distress. However, little is known about the mental health (MH) comorbidities of PN/LSC. We sought to evaluate the likelihood and cost-burden of MH comorbidities and emergencies associated with PN/LSC. Data were examined from the 2002-2012 Nationwide Inpatient Sample, including a representative ~ 20% sample of US hospitalizations (n = 87,053,155 admissions). Inpatients with vs. without PN/LSC had higher odds of MH disorders overall (39.4% vs. 20.0%; adjusted odds ratio [95% confidence interval, CI] 2.26 [2.13-2.41]) and in all 15 individual MH disorders examined. Inpatients with vs. without PN/LSC were more likely to be admitted with a primary diagnosis of a MH disorder (4.5% vs. 2.2%; 2.16 [1.91-2.45]), particularly developmental, psychotic, and mood disorders, history of MH disorders or substance abuse, and cognitive disorders. PN/LSC were associated with prolonged inpatient length of stay, and an excess $0.69 million in inpatient costs of care indirectly related to hospitalization for MH disorders. In conclusion, inpatients with PN/LSC had increased likelihood of comorbid MH disorders and emergencies requiring hospitalization. Optimized approaches are needed for screening and managing MH comorbidities in PN/LSC.
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Affiliation(s)
- Vivek Singam
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA
| | - Kevin R Patel
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Abstract
Prurigo nodularis (PN) is a subtype of chronic prurigo presenting single to multiple symmetrically distributed, hyperkeratotic and intensively itching papules and nodules. PN evolves along with chronic pruritus in the context of diverse dermatological, systemic, neurological or psychiatric conditions. Permanent scratching is possibly a major trigger of PN, although its exact pathophysiology remains unclear. Current state-of-the-art therapy for PN consists of topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) therapy, systemic administration of gabapentinoids, μ-opioid receptor antagonists, antidepressants or immunosuppressants. Novel treatment concepts, such as inhibitors of neurokinin-1, opioid and interleukin-31 receptors, have been developed and are currently being clinically tested.
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Affiliation(s)
- Claudia Zeidler
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Von- Esmarch-Str. 58, DE-48149 Münster, Germany.
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15
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Karabinta Y, Konaté I, Dicko A, Cissé L, Samaké M, Touré A, Traoré B, Fofana Y, Touré S, Faye O, Dao S. [Epidemiological and clinical aspects of prurigo in HIV infected patients in Fousseyni N'Daou hospital of Kayes, Mali]. Mali Med 2018; 33:13-16. [PMID: 30484578] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Prurigo is one of the most common dermatological conditions during HIV infection and AIDS. It appears as an immunosuppression marker associated with HIV infection. The study objective was to determine the prevalence of prurigo in people living with the human immunodeficiency virus (PLHIV) in Fousseyni N'Daou Hospital of Kayes, and to describe the socio-demographic aspects of patients and lesions associated with prurigo among PLHIV. METHODS It was a descriptive cross-sectional study included all cases of HIV infected patients with prurigo in the Dermatology-Venomology Department of Fousseyni N'DAOU Hospital from January 1, 2015 to August 31, 2015. RESULTS We collected 121 cases of prurigo. The hospital prevalence was 14.5% among PLHIV with 65% Female and the average age was 34.8 years old (SD: 15-81 years). The elementary lesions associated with prurigo were seropapules (40.2%), vesiculo-crusts (13%), excoriated papules (33.3%), lichenified papules (10.8%), and cicatricial lesions (2.7%). The prurigo was generalized in 68.5% of cases and localized in 31.24%. More than half of our patients had weight loss, fever, diarrhea and oral candidiasis in their medical history. Patients were infected with HIV1 in 60.03% and HIV1+ 2 in 24.3%. More than the half of our patients had a CD4 count inferior to 250 cells/mm3 at the time of prurigo diagnosis. CONCLUSION In our study, prurigo remains a common condition in PLHIV, particularly in patients with low CD4 counts. Early detection and rapid antietroviral therapy can reduce the frequency of prurigo in PLHIV.
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Affiliation(s)
- Y Karabinta
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
- Faculté de médecine et d'Odontostomatologie
| | - I Konaté
- Faculté de médecine et d'Odontostomatologie
- Service des Maladies Infectieuses, CHU du Point G
| | - A Dicko
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
- Faculté de médecine et d'Odontostomatologie
| | - L Cissé
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
| | - M Samaké
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
| | - A Touré
- Service de dermatologie-Vénéréologie de hôpital Fousseyni N'Daou de Kayes (HFDK)
| | - B Traoré
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
| | - Y Fofana
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
| | - S Touré
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
| | - O Faye
- Centre national d'appui à la lutte contre la maladie (CNAM), Bamako, Mali
- Faculté de médecine et d'Odontostomatologie
| | - S Dao
- Faculté de médecine et d'Odontostomatologie
- Service des Maladies Infectieuses, CHU du Point G
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Abstract
Prurigo pigmentosa, also referred to as Nagashima's disease, is a rare inflammatory skin condition of unknown etiology. It typically presents as pruritic erythematous papules, papulovesicles, and vesicles appearing in a reticular pattern on the back, chest, or neck. The histological features of prurigo pigmentosa vary according to the stage of the disease. Early-stage disease is characterized by a superficial perivascular infiltrate of neutrophils; spongiosis and necrotic keratinocytes commonly appear in later stages. The etiology of prurigo pigmentosa has yet to be determined. Oral minocycline is usually the first-line therapy for prurigo pigmentosa. However, doxycycline, macrolide antibiotics, and/or dapsone (diaminodiphenyl sulfone) may be indicated for some patients. We describe the key features of prurigo pigmentosa, including the epidemiology, clinical and histologic presentation, differential diagnosis, postulated pathogenesis, and treatment options for this condition.
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Affiliation(s)
- Bryce D Beutler
- University of Nevada School of Medicine, 1060 Wiegand Road, Encinitas, CA, 92024, USA.
| | - Philip R Cohen
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
| | - Robert A Lee
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
- Dermatopathology, University of California San Diego, San Diego, CA, USA.
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17
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Sparsa A, Boulinguez S, Liozon E, Roux C, Peyrot I, Doffoel-Hantz V, Labrousse F, Vidal E, Bordessoule D, Bonnetblanc JM, Bédane C. Predictive Clinical Features of Eczema Craquelé Associated with Internal Malignancy. Dermatology 2007; 215:28-35. [PMID: 17587836 DOI: 10.1159/000102030] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 01/17/2007] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To describe a series of hospitalized patients with eczema craquelé (EC) and the possible correlations between clinical features of EC and cancer in an open prospective observational study. PATIENTS AND INTERVENTIONS The study population comprised 68 consecutive patients included between January 1, 1999 and December 31, 2000 who were followed up through December 2004. All patients who had localized or generalized EC were included. Patients underwent complete clinical examinations, routine laboratory tests, chest x-rays, abdominal ultrasound, and cutaneous biopsies performed on EC. MAIN OUTCOME MEASURES AND RESULTS Rates of EC associated with cancer, clinical features of eczema, rate of recalcitrant eczema, relationship to other clinical prognostic factors, and paraneoplastic evolution were evaluated. Cancer was diagnosed in 32 patients (47%). We observed a significant difference in the presenting clinical signs of EC between patients with malignant tumors and patients without cancer. In patients with malignancies, EC was widespread on the trunk and we noted deep red and inflammatory fissures. In all cases, EC led to the discovery of malignancy or recurrence of cancer. CONCLUSION Widespread EC, topical corticosteroid resistance, and deep red and inflammatory fissures were significantly correlated with neoplasia.
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Affiliation(s)
- Agnès Sparsa
- Department of Dermatology, Dupuytren University Hospital, Limoges, France.
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18
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Abstract
During the last century of modern dermatology, more than 30 skin diseases have been described first by physicians from Japan. Many of those conditions were disorders of pigmentation and keratinization, which are quite common in Oriental patients. Since the late 1940s, a number of skin diseases first reported in Japan have gained attention internationally among them being Kimura disease, hypomelanosis of Ito, Kawasaki disease, adult T-cell leukemia/ lymphoma, eosinophilic pustular folliculitis, prurigo pigmentosa, and Ofuji's papuloerythroderma. In this article, we review skin diseases that were first established as distinct entities in Japan, in order to familiarize readers of the Western literature with these conditions.
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Affiliation(s)
- Yuichi Teraki
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
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19
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Affiliation(s)
- M M Black
- St. John's Institute of Dermatology, St. Thomas' Hospital, London, UK
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20
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Mahé A, Simon F, Coulibaly S, Tounkara A, Bobin P. Predictive value of seborrheic dermatitis and other common dermatoses for HIV infection in Bamako, Mali. J Am Acad Dermatol 1996; 34:1084-6. [PMID: 8647980 DOI: 10.1016/s0190-9622(96)90295-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A Mahé
- Institut Marchoux, Bamako, Mali
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21
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Vaughan RW, Baker CS, Page G, Proby CM, Breathnach SM, Hawk JL. HLA-DR4 may determine expression of actinic prurigo in British patients. J Invest Dermatol 1996; 106:362-7. [PMID: 8601742 DOI: 10.1111/1523-1747.ep12343141] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Human leukocyte antigen (HLA) associations have been reported in Amerindian patients with actinic prurigo. To determine if similar associations are present in the British Caucasoid population with actinic prurigo, 26 patients underwent serological typing for HLC Class I and II antigens. DNA analysis by both sequence-specific priming and group-specific amplification with single-stranded oligonucleotide probe hybridization was used to confirm the DR and DQ typing and to perform DR4 subtyping. All patients were DR4 positive, and 25 of 26 patients were DQ7 positive. DR4 subtyping revealed 12 of 20 patients tested to be DRB1*0407. A nonsignificant association was also found with HLA B55 that is in linkage disequilibrium with DRB1*0407. No HLA associations were found in 25 British Caucasoid patients with polymorphic light eruption. DRB1*0407 is rare in European Caucasoids without actinic prurigo, and HLA-DR4 may have an important role in determining expression of this disease.
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22
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Pradinaud R, Sainte-Marie D, Strobel M, Degarve B, Roul S. [Prurigo in tropical area. Importance of its association with HIV infection]. Bull Soc Pathol Exot 1993; 86:512-516. [PMID: 7819812] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The term prurigo applies to a classic chronic skin disease of children (P. strophulus) which is becoming found very seldom in developed countries, but remains extraordinarily prevalent in tropical areas. This striking geographical distribution relies on its ectoparasitic origin. Some peculiar aspects of prurigo, observed in French Guyana (South America), are reported. The original point is a new aspect of adult acquired prurigo, associated with HIV infection, which appears to be one of the features characteristic of tropical AIDS. This HIV associated prurigo (HAP) is the revelating event, in as high as 20% of HIV infected people, significatively those with less than 200 CD4 cells. HAP appears as a marker of HIV infection with poor sensitivity, but much higher specificity (92%), with no correlation with acquisition's risk factors. Just like infantile prurigo, HAP can be considered an arthropod bite reaction which seems to be enhanced in HIV infected people living in tropical environment.
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Affiliation(s)
- R Pradinaud
- Service de Dermatologie-Vénérologie, Centre Hospitalier Général, Cayenne
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23
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Abstract
BACKGROUND Actinic prurigo, an idiopathic familial photodermatosis, has been described in Amerindians in Manitoba, Canada, as well as in the United States, Mexico, and South America. OBJECTIVE Our purpose was to describe the clinical features and prognosis of actinic prurigo in Amerindians in Saskatchewan, Canada. METHODS Clinical examinations, questionnaires, phototesting, and laboratory tests were used. RESULTS We present a series of 93 Amerindian patients. The face is the most commonly involved area. A hereditary tendency, cheilitis, and pruritus are prominent features. One third of patients report some lesions, often minor, during the winter. The majority of patients phototested were sensitive to ultraviolet A light. CONCLUSION We find the age of onset of actinic prurigo to be the most important feature in determining the type of eruption and the prognosis for the patient. In general the younger ages of onset (up to 20 years of age) are associated with cheilitis and more acute eruptions and are more likely to improve over 5 years. Those who develop actinic prurigo as adults (21 years of age and older) tend to have a milder and more persistent dermatosis.
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Affiliation(s)
- P R Lane
- Division of Dermatology, University of Saskatchewan, Saskatoon, Canada
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24
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Kuyvenhoven JV, Duijm F. [Trombiculiasis, and epidemic of prurigo caused by mites]. Ned Tijdschr Geneeskd 1990; 134:2351-3. [PMID: 2255379] [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] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In four villagers parasitic prurigo caused by the autumnal chigger (Neotrombicula autumnalis) was diagnosed. The clinical picture consisted of intensely itchy, erythematous papules, at sites where clothes fitted tightly or in body folds. Further investigation in the village revealed that in 16 of the 48 homes at least one person in the preceding two months had suffered from prurigo possibly caused by the autumnal chigger. The characteristics of the parasite, the clinical picture, treatment and prevention are discussed.
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Affiliation(s)
- M M Duran de Rueda
- Dermatology Unit, Universidad Javeriana, Bogotá, Colombia, South America
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26
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Conte A, Coviello C, Rantuccio F. [Pruritus sine materia and prurigo. II. Prurigo]. GIORN ITAL DERMAT V 1986; 121:383-8. [PMID: 3557532] [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: 01/06/2023]
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Vissian L, Baréty M, Motte P, Le Fichoux Y. [Epidemic aspect of parasite pruriginous dermatitis of Pyemotes zwoelferi type (author's transl)]. Ann Dermatol Venereol 1980; 107:21-4. [PMID: 7369656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The responsibility of the Pyemotes in the genesis of certain parasite prurigo is known since the middle of the 19th century. The epidemic that we are describing owes its originality to the species Pyemotes zwoelferi sent in a bunch of dried flowers coming from Yugoslavia. The affection of man by these Pyemotes is essentially due to two factors: one of them is of an ecological nature due to the violent change of the conditions under which the acarian population grew and developed, and the other one linked to the species and the belonging to the ventricosus group. The varieties of the ventricosus group have a host specificity which is by far less narrow than that of the scolity group and they are also the most pathogenic to man.
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Abstract
Eight thousand and thirteen patients were seen in dermatological clinics at Kaduna and Zaria in the Northern guinea savanna of Nigeria. Fungal infections were found in 1,224 cases and scabies in 923 cases, of which 765 patients had secondary infections. Similar results were found in other surveys from Sub-Saharan Africa.
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30
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Rea JN, Newhouse ML, Halil T. Skin disease in Lambeth. A community study of prevalence and use of medical care. Br J Prev Soc Med 1976; 30:107-114. [PMID: 133742 PMCID: PMC478948 DOI: 10.1136/jech.30.2.107] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A community survey of skin disease was carried out in Lambeth, London. A postal questionnaire asking recipients to give details of the presence of skin disease was sent to a stratified sample of 2180 adults; a subsample of 614 persons were interviewed at home and an inspection was made of the exposed parts of their skin. Altogether 92 conditions were identified. These were graded for clinical severity and classified into 13 groups. The overall prevalence of skin disease thought to justify medical care was 22-5%. The most common important condition was eczema with a prevalence of 6-1%. Age, sex, and social class trends in prevalence were found in certain groups of skin disease. Of those with a skin disease thought to justify medical care, only 21% reported having attended their general practitioner in the past six months for a skin complaint. The reported use of medical care and self medication is discussed in relation to the presence of skin disease and other factors.
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31
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Canizares O. Dermatology in India. Arch Dermatol 1976; 112:93-7. [PMID: 1108806] [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: 12/25/2022]
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ODDOZE L. [Statistical note on the etiology of Besnier's prurigo in France]. Acta Allergol 1959; 13:410-6. [PMID: 14428266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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