Clinical and Experimental Dermatology最新文献

{"title":"Dose escalation and associated economic outcomes in patients with psoriasis treated with biologics: a retrospective analysis of German health claims data.","authors":"Andreas Pinter, Ahmed M Soliman, Karina C Manz, Valeria Weber, Paul Ludwig, Anja Mocek, Ariane Höer, Sven G Richter, Mark G Lebwohl","doi":"10.1093/ced/llae245","DOIUrl":"10.1093/ced/llae245","url":null,"abstract":"<p><strong>Background: </strong>In Germany, several biologic therapies are available for the treatment of moderate-to-severe plaque psoriasis, with the option of exceeding recommended dosages if standard dosing does not achieve a satisfactory treatment response.</p><p><strong>Objectives: </strong>To examine dose escalation in patients with biologic-treated psoriasis and its implications on the costs for German statutory health insurance (SHI).</p><p><strong>Methods: </strong>We conducted a retrospective, noninterventional cohort study using German SHI health claims data from 2016 to 2021. Adult patients initiating biologic treatment were included in drug-specific cohorts. The odds for dose escalation, defined as the exceedance of the individually received daily dose over the maintenance dose recommended by the European product information, were compared between cohorts using multivariate logistic regression. The impact of dose escalation on SHI expenditure was analysed with a generalized linear model.</p><p><strong>Results: </strong>The relative frequency of dose escalation varied between cohorts [range 1%, < 5/92 (risankizumab) to 43%, < 5/7 (infliximab)]. Compared with patients treated with risankizumab, the odds for dose escalation were statistically significantly (P < 0.05) higher in patients treated with all other biologic drugs except tildrakizumab. Patients with dose escalation during the maintenance phase accrued on average €6473 more in direct healthcare costs to SHI over a 1-year period compared with those without dose escalation, with statistical significance (P < 0.05) after controlling for differences in covariates.</p><p><strong>Conclusions: </strong>Compared with patients treated with other biologics, dose escalation during the maintenance phase was lowest among patients treated with risankizumab. Dose escalation was associated with higher costs and thus a higher economic burden for German SHI.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1591-1600"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of hidradenitis suppurativa with cigarette smoking and cannabis use: a cross-sectional study in the All of Us Research Program.","authors":"Gloria F Chen, William D Shipman, Christine Hodelin, Henry C Hsia, Jeffrey M Cohen, Anna Eisenstein","doi":"10.1093/ced/llae521","DOIUrl":"https://doi.org/10.1093/ced/llae521","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin cancer decision-making in people with dementia.","authors":"Melanie Page, Leila Asfour, Andrew Y Finlay","doi":"10.1093/ced/llae243","DOIUrl":"10.1093/ced/llae243","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1738-1739"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient's experience of progressive hemifacial atrophy.","authors":"Conor Larney, Rosemarie Watson, Dylan Murray, Alan D Irvine","doi":"10.1093/ced/llae255","DOIUrl":"10.1093/ced/llae255","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1729-1730"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of germline variants in patients with hereditary melanoma study criteria in a real clinical practice setting.","authors":"Jose Maria Villa-Gonzalez, Sergio Carrera Revilla, Lara Lombardero Gutiérrez, Jesús Gardeazabal García","doi":"10.1093/ced/llae221","DOIUrl":"10.1093/ced/llae221","url":null,"abstract":"<p><strong>Background: </strong>Five to twelve per cent of melanoma cases show aggregation of melanomas or other related tumours within the same family or individual. Genes such as CDKN2A or BAP1, among others, have been associated with this condition.</p><p><strong>Objectives: </strong>To describe the epidemiology and clinical characteristics of patients in whom a germline genetic study was performed due to suspected hereditary melanoma.</p><p><strong>Methods: </strong>This was a retrospective descriptive study that included patients from Cruces University Hospital who underwent a germline genetic analysis for hereditary melanoma from 2016 to 2023, having met any of the following criteria: (i) presence of two or more melanomas in the same individual; (ii) a melanoma and a pancreatic cancer in the same individual; (iii) presence of a melanoma in an individual and one or more first- or second-degree relatives with melanoma or pancreatic cancer; (iv) first- or second-degree relative of an individual with a known deleterious variant in genes associated with melanoma predisposition; or (v) incidental discovery of deleterious variants in genes associated with predisposition to melanoma, within hereditary cancer panels carried out for reasons other than melanoma.</p><p><strong>Results: </strong>In total, 59 families were included, comprising 69 patients (64% women). Among these, 8% of families (13% of patients) presented pathogenic/likely pathogenic (P/LP) variants: 6% of families (6% of patients), excluding criteria (iv) and (v), showed P/LP variants in CDKN2A, and 2% of families (1% of patients) presented P/LP variants in BAP1, BRCA2 and TERF2IP.</p><p><strong>Conclusions: </strong>The frequencies of P/LP variants in CDKN2A are similar to those previously described. This study could contribute to the knowledge of the characteristics of patients who meet genetic study criteria for hereditary melanoma in a setting of real-world clinical practice.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1532-1536"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya fever's chromatic chronicle: a kaleidoscope of pigmentary alterations.","authors":"Vijayasankar Palaniappan, Hima Gopinath, Kaliaperumal Karthikeyan","doi":"10.1093/ced/llae242","DOIUrl":"10.1093/ced/llae242","url":null,"abstract":"<p><p>Chikungunya fever (CKF), a neglected tropical disease caused by the chikungunya virus, manifests with skin pigmentary changes in a significant portion of people. A myriad of pigmentary alterations in individuals with CKF have been documented in the literature. This review highlights the pathogenesis, clinical features, histopathology, diagnosis and treatment of CKF-associated pigmentation. Notable presentations include the 'Chik sign' often seen in neonates and children. Treatment involves reassurance and topical agents for persistent pigmentation. Understanding these pigmentary changes is crucial for accurate diagnosis and management, facilitating improved patient outcomes. Further research is warranted to fully elucidate the underlying mechanisms and optimize therapeutic strategies.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1489-1495"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of hidradenitis suppurativa: evaluating factors influencing recurrence and complications after 284 complete excisions.","authors":"Tsung-Hsien Chang, Yi-Shuan Sheen, Yi-Hua Liao","doi":"10.1093/ced/llae246","DOIUrl":"10.1093/ced/llae246","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa (HS) is a chronic inflammatory disorder associated with tunnel formation and scarring. Surgical excision is a potential curative therapy for HS.</p><p><strong>Objectives: </strong>To characterize the surgical outcomes of patients with HS undergoing complete excision and to identify the risk factors associated with postoperative recurrence.</p><p><strong>Methods: </strong>This retrospective 16-year cohort study enrolled patients ≥ 20 years who underwent complete excision for HS lesions at the National Taiwan University Hospital. We assessed the rates of postsurgical recurrence and complications and estimated the odds ratio (ORs) with 95% confidence intervals (CIs) of their association with potential risk factors using generalized estimating equations.</p><p><strong>Results: </strong>In total, 136 patients with HS and the 284 corresponding complete excisions were identified. Recurrence developed in 88 of 284 (31.0%) operations and complications occurred in 102 (35.9%). Common types of complications included wound dehiscence, hypertrophic scars and surgical-site infection. Clinical factors associated with a lower risk of recurrence were male sex [adjusted OR (aOR) 0.48, 95% CI 0.23-0.98], surgery at atypical body sites (aOR 0.28, 95% CI 0.08-0.99) and wound repair by split-thickness skin graft (aOR 0.31, 95% CI 0.12-0.77). Wound dehiscence was associated with an increased risk of recurrence (aOR 2.55, 95% CI 1.21-5.42). No independent factors were identified as being associated with composite postoperative complications.</p><p><strong>Conclusions: </strong>Complete excision alone can be effective in curing HS in Asian populations. Recurrence developed in about one-third of the complete excisions performed for HS. Sex, surgical body sites, methods of wound repair and wound dehiscence were major determinants for recurrence.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1554-1560"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Welsh primary schools Sunproofed? Results of a national survey, part 2: sun protection practices in primary schools in Wales.","authors":"Rachel A Abbott, Daniel Tod, Kirsty Lanyon, Timothy Driscoll, Swetha Prathap, Alan Watkins, Julie Peconi","doi":"10.1093/ced/llae218","DOIUrl":"10.1093/ced/llae218","url":null,"abstract":"<p><strong>Background: </strong>Skin cancer rates are on the rise globally. School sun safety programmes are recommended by the World Health Organization to reduce the risk of future skin cancer at the population level; however, these are encouraged but not mandated in Wales.</p><p><strong>Objectives: </strong>To explore current sun protection practices and sun safety education in primary schools in Wales and whether these are linked to the existence of a formal sun safety policy.</p><p><strong>Methods: </strong>An online survey to all 1241 Welsh primary schools asking about sun safety practices, education and formal policies was undertaken.</p><p><strong>Results: </strong>In total, 471 (38.0%) schools responded. A minority (22/469, 4.7%) of responding schools reported they had sufficient shade for most activities. In the spring and summer terms, almost two-thirds of schools encourage hat wearing (304/469, 64.8%) and sunscreen (296/468, 63.2%). Although nearly all schools reported that parents were encouraged to apply sunscreen to students before school (449/469, 95.7%), there was wide variation in other sunscreen application practices. Less than one-third of schools (129/445, 29.0%) reported that they include sun protection education in the curriculum in every year group, with 11.7% (52/445) including this in certain years only. Schools with a formal policy were more likely to report more comprehensive sun protection practices, including having sufficient shade [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.04-2.19; P = 0.03], having spare hats for pupils to wear (OR 1.59, 95% CI 1.07-2.37; P = 0.02), providing guidance for staff (OR 5.87, 95% CI 3.05-11.28; P < 0.001), encouraging them to model sun safe behaviours (OR 1.82, 95% CI 1.18-2.80; P = 0.007) and teaching sun protection education as part of the curriculum in every year group (OR 2.56, 95% CI 1.76-3.71; P < 0.001). With respect to sunscreen, the existence of a formal policy did not seem to affect a school's practice.</p><p><strong>Conclusions: </strong>Although in most cases, the existence of a formal policy suggests more comprehensive sun protection practices and education in schools, sun protection measures and education need improvement across the primary school sector in Wales to reverse rising skin cancer rates.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1582-1590"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early intervention and cumulative life course impairment in psoriasis: a review.","authors":"Luisa Maria Halina Arancio, Domenico D'Amico, Stefano Dastoli, Carmen Silvia Fiorella, Marco Manfredini, Gaia Moretta, Giovanni Paolino, Anna Levi, Sara Di Fino, Barbara Zucchi, Stefano Piaserico","doi":"10.1093/ced/llae282","DOIUrl":"10.1093/ced/llae282","url":null,"abstract":"<p><p>Psoriasis is a chronic, systemic, inflammatory disease affecting the skin, joints and other organs. Psoriasis negatively affects patients' quality of life, causing social anxiety and negative coping, thus determining a cumulative life course impairment (CLCI). The concept of CLCI in psoriasis is reinforced by the understanding that psoriasis-associated comorbidities and stigma accumulate over a patient's life course, resulting from an interaction between the burden of stigmatization, physical and psychological comorbidities, coping strategies and external factors. The concept may help identify more vulnerable patients and facilitate more appropriate treatment decisions or earlier referrals. Although some potential risk factors for CLCI have been clarified, no all-encompassing screening tools are available. Patients at risk for CLCI should be identified by applying clinical, personal and psychosocial indicators and predictors individually. Early intervention in psoriasis treatment could improve long-term patient outcomes and modify the disease course. However, more research is needed to clearly define what constitutes 'early' intervention and to identify the most effective strategies for implementation. From a preventive point of view, it is helpful to identify early interventions aimed at reducing the risk of CLCI and establishing a new life course trajectory in patients with psoriasis. This review summarizes the latest developments in CLCI and psoriasis, highlighting knowledge gaps and future directions to make control of CLCI a possible goal for therapies.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1525-1531"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of confocal laser scanning microscopy in histological classification and photodynamic therapy of low-risk basal cell carcinoma.","authors":"Zhen Tang, Tingting Lu, Xue Chen, Jianyun Lu, Shu Ding, Aiyuan Guo, Jian Huang, Lina Tan","doi":"10.1093/ced/llae250","DOIUrl":"10.1093/ced/llae250","url":null,"abstract":"<p><strong>Background: </strong>Confocal laser scanning microscopy (CLSM) is a noninvasive technique utilized for identification and analysis of skin malignancies. Several studies have applied CLSM in monitoring the treatment of basal cell carcinoma (BCC).</p><p><strong>Objectives: </strong>To investigate the diagnostic value of CLSM in low-risk BCC and the evaluation of photodynamic therapy (PDT).</p><p><strong>Methods: </strong>We diagnosed 149 patients with BCC using CLSM and histopathological examination. Based on histopathology, we summarized the classification of low-risk BCC along with imaging features observed through CLSM. Thirty-four patients with low-risk BCC underwent PDT treatment, and we used CLSM to evaluate its efficacy.</p><p><strong>Results: </strong>Out of 149 BCCs examined by CLSM, 52 were diagnosed as the pigmented type, 87 as the nodular type and 10 as the superficial type. After histopathological examination of the 52 BCCs identified as pigmented by CLSM, 44 out of 52 were seen to be pigmented, 5 were nodular and 3 were superficial. The histopathology results were consistent with CLSM for the 87 nodular and 10 superficial BCCs. The distinguishing CLSM feature of nodular BCC was tissue fissures around the tumour, while the pigmented mass was the CLSM characteristic of the pigmented type. The simultaneous occurrence of inflammation and increased vasculature was characteristic of superficial BCC. The effective rate of PDT was 100%, and the cure rate was 68%. At the 12-month follow-up, the recurrence rate of PDT was 12%; 15% for nodular BCC, 10% for pigmented and 0% for superficial.</p><p><strong>Conclusions: </strong>The tissue classification of CLSM for low-risk BCC was consistent with histopathology. CLSM can be used to monitor the -efficacy of PDT for low-risk BCC.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1601-1610"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}