Dermatology最新文献

{"title":"Prognosis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Cohort Study of 216 Patients in an Inpatient Dermatology Department.","authors":"Nguyen Dac Thuy Luong, Hoang Vuong Ngoc Duc, Thi Thuy Trang Vu, Khiem Hung Tran, Van Bac Pham","doi":"10.1159/000542623","DOIUrl":"10.1159/000542623","url":null,"abstract":"<p><strong>Introduction: </strong>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions. However, only a few studies have investigated the clinicodemographic and laboratory parameters predicting SJS and TEN outcomes other than mortality, such as severe complications or increased length of hospital stays. Our objectives are to identify admission risk factors predictive of severe complications and the accompanying clinical or biochemical markers associated with prolonged hospitalization.</p><p><strong>Methods: </strong>A retrospective cohort study over a 9-year period (2013-2022).</p><p><strong>Results: </strong>The study included 216 patients with SJS (n = 122), SJS/TEN overlap (n = 71), and TEN (n = 23). On multivariate analysis, the clinical factor on admission that was predictive of severe complications was blood urea nitrogen (BUN) >8.3 mmol/L (p = 0.007). Furthermore, BSA epidermal detachment >10% (p < 0.001), Severity-of-illness score for TEN (SCORTEN-1) ≥2 (p = 0.04), and positive skin culture (p = 0.04), from which the Prolonged Hospitalization Risk Score was created, were predictive of length of hospital stays >10 days. Using systemic methylprednisolone at a mean dose ≥1 mg/kg/day for a median duration of 10.5 days was not shown to increase or reduce complication rates of SJS/TEN and shorten hospital stays.</p><p><strong>Conclusion: </strong>BUN >8.3 mmol/L present at admission is a risk factor for severe complications of SJS/TEN. BSA involvement >10%, SCORTEN-1 ≥2, and positive skin culture on admission are useful markers to predict extended hospitalization.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Smartphone Data to Frequently Measure Atopic Dermatitis Severity and Understand Triggers: A Decentralized 12-Week Observational Study.","authors":"Zarqa Ali, Johan Anker Chrom Allerup, Anders Daniel Andersen, Justin M Ko, John R Zibert, Simon Francis Thomsen","doi":"10.1159/000542771","DOIUrl":"10.1159/000542771","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) severity is traditionally evaluated during in-office consultations; however, this does not provide continuous monitoring and any intermittent flare/remission cycles are usually not recorded. The aim was to apply smartphone technology to evaluate AD severity, to explore if severity based on highly frequent sampling of photographs is associated with patient reported outcomes, and to investigate disease fluctuations and trigger associations based on passively collected environmental data.</p><p><strong>Methods: </strong>In this 12-week decentralized observational study, adult patients with AD were recruited online and used a tailored remote clinical trial platform app to perform all study tasks including capturing photographs and completing the Patient-Oriented Eczema Measure (POEM) weekly. AD severity was assessed based on photographs using the Eczema Area and Severity Index (EASI) and Scoring Atopic Dermatitis (SCORAD). Geographical location collected in the app was used to retrieve data on ambient temperature and carbon monoxide (CO), a common air pollutant.</p><p><strong>Results: </strong>A total of 42 patients (35 women) were recruited online. A total of 712 photographs were taken, with an average of 17 photographs per participant. Photographic SCORAD (r = 0.450) and EASI (r = 0.206) were significantly associated with subjective severity POEM. Patients experiencing AD fluctuation (n = 10) based on SCORAD had significantly higher risk of also having a psychiatric disorder (60 vs. 17%, p = 0.008). Anxiety was significantly associated with disease fluctuation based on EASI (40 vs. 7%, p = 0.01), and a tendency was observed for depression (40 vs. 13%, p = 0.06). Decreasing temperature was significantly associated with higher POEM (estimate -0.18, p = 0.012) and EASI score (estimate -0.14, p = 0.007), but not with SCORAD. High levels of CO were significantly associated with higher SCORAD (estimate 15.9, p < 0.001).</p><p><strong>Conclusion: </strong>In this small study with a predominance of young adults, primarily women, we were able to recruit patients and monitor AD entirely remotely via smartphone-enabled photographic assessments; patients reported outcomes and passively collected environmental data without physical contact between patient and investigator.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study.","authors":"Erkan Alpsoy, Bilge Fettahlıoglu Karaman, Duriye Deniz Demirseren, S Levent Cınar, Nida Kacar, Aylin Türel Ermertcan, Emel Bulbul Baskan, Derya Ucmak, Kifayet Mammadli, Fadime Kılınc, Serkan Yazici, Selami Aykut Temiz, Tugba Özkök Akbulut, Arzu Ataseven, Aysun Şikar Aktürk, Hayriye Sarıcaoğlu, Meltem Türkmen, Fatmagül Gülbaşaran, Burhan Engin, Hatice Kaya Özden, Koray Durmaz, Müge Güler Özden, Hilal Özdemir, Bengü Çevirgen Cemil, Sezgi Sarıkaya Solak, Serap Günes Bilgili, İbrahim Halil Yavuz, Göknur Özaydın Yavuz, Münevver Güven, Algün Polat Ekinci, Tuğba Atcı, Didem Didar Balci, Aylin Oztürk, İlknur Kıvanç Altunay, Ezgi Özkur, Ece Ugurer, Ayse Serap Karadag, Göknur Kalkan, Sevilay Kılıc, Bilgen Erdoğan, Savas Yayli, Leyla Baykal Selçuk, Levent Dönmez, Aslı Bilgic","doi":"10.1159/000542670","DOIUrl":"10.1159/000542670","url":null,"abstract":"<p><strong>Introduction: </strong>The natural history, the progression of a disease process in an individual over time, has not yet been fully elucidated in hidradenitis suppurativa (HS). In this large multicenter study, we aimed to investigate the natural history of HS and its gender differences.</p><p><strong>Methods: </strong>This cross-sectional study included 827 patients. The chronological order of the clinical manifestations for each patient was recorded retrospectively. Sociodemographic characteristics, triggering factors, clinical, treatment, and prognostic features were also evaluated.</p><p><strong>Results: </strong>The mean age of disease onset was significantly younger in women than in men (22.42 ± 9.28 vs. 27.06 ± 20.56, p < 0.001) and those with a family history (p < 0.0001). The mean disease duration was 91.17 ± 83.64 months. The most common symptom was purulent discharge (81%). The mean duration of abscess was shorter in women than in men (3.11 ± 2.65 vs. 3.75 ± 3.75, p = 0.01). The axilla was the most common onset area followed by the inguinal and gluteal regions. The disease ran a more severe course in men. Abscess/inflammatory nodule was defined in the last 6 months in 88.6% of the patients; however, the first 5 years of the disease were the most active disease period in 67.5% of the patients. Multivariate analysis revealed being male, older age, family history, involvement of the axillary, inguinal, and perianal regions independently associated with HS severity. While antibiotic use was the most important factor in improving the disease symptoms, stress was the most common aggravating factor. Biological therapy in men, laser epilation and pregnancy in women were significant alleviating factors, whereas weight gain was a more common aggravating factor for women.</p><p><strong>Conclusion: </strong>HS shows a relentlessly progressive course with inflammatory attacks, but the first years of the disease are the most active period. This study confirms that environmental and hormonal factors may play an important role in the disease course, probably with other endogenous or exogenous factors.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nodular Vasculitis: Retrospective Study of an Uncommon Disease in a Non-Tuberculosis Endemic Country with Focus on Treatment Modalities and Efficacy.","authors":"Carole Guillet, Xenia Hauser, Andrea Stillhard, Peter Schmid-Grendelmeier, Isabel Kolm","doi":"10.1159/000542488","DOIUrl":"10.1159/000542488","url":null,"abstract":"<p><strong>Introduction: </strong>Nodular vasculitis (NV) is a rare form of panniculitis primarily affecting middle-aged females, presenting as painful, sometimes ulcerated nodules on the dorsal lower legs. Erythema induratum of Bazin (EIB) is a form of NV and is considered a manifestation of cutaneous tuberculin hypersensitivity. This retrospective study aims to analyze demographics, clinicopathological findings, laboratory results, and treatment outcomes of NV in a non-TB endemic country.</p><p><strong>Methods: </strong>Data of NV patients were extracted from the electronic hospital database of the University Hospital Zurich. Patients were included only if histopathologically confirmed diagnosis of NV and sufficient information on demographics, treatment, and follow-up were available.</p><p><strong>Results: </strong>We conducted a 20-year retrospective study, including 62 patients with NV. The most common site of involvement was the lower extremities. Disease duration varied from several months to over 20 years. Histopathological examination revealed lobular panniculitis, with or without vasculitis, and granuloma formation. Tuberculosis association was assessed through the QuantiFERON test and mycobacteria PCR, showing positive results in 22 or 37 (59%) tested cases and in 2 out of 27 cases (7.4%), respectively. Comorbidities were found in over half of the patients. Treatment modalities included topical corticosteroids, antitubercular therapy, systemic steroids, and potassium iodide. Almost 50% of all patients experienced relapses despite treatment.</p><p><strong>Conclusion: </strong>Topical steroids, antitubercular therapy, systemic steroids, and potassium iodide showed similar response rates. Tuberculostatic therapy upon detecting latent TB is recommended. Considering the high recurrence rate and potential side effects of systemic therapies, we recommend first-line treatment with potent topical steroids and compression stockings.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous Metaplasia of Lactiferous Ducts (Zuska's Disease) of the Breast: Clinical and Histopathologic Manifestations.","authors":"Rewan M Abdelwahab, Nessa Aghazadeh Mohandesi, Charles D Sturgis, Afsaneh Alavi","doi":"10.1159/000542622","DOIUrl":"10.1159/000542622","url":null,"abstract":"<p><strong>Introduction: </strong>Squamous metaplasia of lactiferous duct (SMOLD), also known as Zuska's disease, is an uncommon, recurrent inflammatory fistulizing disease of the breast that strongly correlates with smoking in premenopausal patients. Clinical and imaging findings may overlap with other breast conditions. SMOLD is well recognized by breast pathologists; however, the dermatology literature on this condition remains scarce.</p><p><strong>Methods: </strong>In this retrospective study, we reviewed 29 patients with SMOLD diagnosed at Mayo Clinic.</p><p><strong>Results: </strong>The mean age of the patient cohort is 50.3 with a range of 30 to 81 years. One patient (3.7%) had hidradenitis suppurativa of the retroareolar area. Patient smoking history demonstrated prior/current smokers of 37.9% (11/29), lifetime nonsmokers with significant secondhand exposure 6.9% (2/29), and unknown smoking status 3.4% (1/29). One patient had a personal history of invasive ductal carcinoma, and 10.3% (3/29) had a history of breast cancer in a first-degree relative. The clinical presentation of the patient cohort includes areolar papules, nodules, and draining tract/fistula 13.7% (4/29); pustular cyst/abscess on the breast 13.7% (4/29); breast mass 3.4% (1/29); pain breast discomfort/pain 13.7% (4/29); nipple retraction 3.4% (1/29); and asymptomatic with nipple calcifications on mammogram 3.4% (1/29). A total of 77.8% (7/9) of patients with bacterial cultures demonstrated polymicrobial growth. Overall, 37.9% (11/29) of patients received at least one round of antibiotic therapy. In total, 27.6% (8/29) of patients underwent invasive intervention. Staphylococcus, Streptococcus, and Cutibacterium species were the most frequent causes of infection in our patient cohort.</p><p><strong>Conclusions: </strong>We confirm previous findings of strong association between SMOLD and current/former smoking status and a potential, novel correlation between extensive secondhand exposure and SMOLD development. While both medical and surgical interventions are employed in patient management, many patients ultimately require complete excision of the involved duct(s). Dermatologists should consider SMOLD in the differential diagnosis of patients presenting with breast abscess, fistulizing tracts with mass, and breast pain.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Risk Factors Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease in Psoriatic Patients.","authors":"Kirley Küçük, Christophe Moreno, Hassane Nijmi, Mathieu Daoud, Dillon Mintoff, Fabienne Willaert, Farida Benhadou","doi":"10.1159/000541796","DOIUrl":"10.1159/000541796","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common cause of chronic liver disease. Patients suffering from psoriasis are at an increased risk of developing MASLD. Psoriasis and MASLD share a pro-inflammatory cytokine milieu; however, it is still unclear whether these conditions are related through shared metainflammatory processes or shared comorbidities such as obesity, diabetes, insulin resistance, and metabolic syndrome. The aim of our study was to better characterize the anthropometric and metabolic profile of psoriatic patients with MASLD.</p><p><strong>Methods: </strong>We conducted a prospective, single-center, cross-sectional study between June 2014 and August 2017. Recruitment was restricted to adult patients with psoriasis. Blood analysis, liver ultrasonography, and a FibroScan were performed. Blood investigations, baseline anthropometric measurements, and components of fatty liver disease (hepatic ultrasound, FibroScan) were assessed.</p><p><strong>Results: </strong>A total of 100 patients were recruited, of which, 43% (65.1% men, n = 28) were diagnosed with MASLD. The mean BMI was significantly higher in MASLD than in non-MASLD (27.7 kg/m2 vs. 30.1 kg/m2, p =< 0.001). The mean waist circumference in MASLD patients was significantly higher than in non-MASLD patients (105.6 cm vs. 97.2 cm, p = 0.005). There was no significant difference between the mean age of both patient groups (50.4 vs. 47.3 years, p = 0.26). Psoriatic arthritis was more prevalent in MASLD than in the non-MASLD group (14.3% vs. 1.8%, p = 0.004). Biochemical analysis revealed significantly higher C-peptide level in patients with MASLD compared with patients without MASLD (2.5 vs. 1.6 ng/mL, p = 0.036). Moreover, MASLD patients were found to have a lower HDL level and higher glycemia, triglyceridemia, cholesterol, and LDL levels than non-MASLD patients. A total of 16.3% of patients with MASLD had fibrosis stage ranging from F2 to F4 based on liver stiffness measurement compared with only 10.6% of patients without MASLD.</p><p><strong>Discussion: </strong>We identified parameters which were more prevalent in patients with psoriasis having MASLD, specifically a high BMI, elevated triglyceride levels, decreased HDL levels, and an elevated level of C-peptide. Patients with psoriasis and MASLD were more likely to suffer from comorbid psoriatic arthritis, despite having similar psoriasis disease severity as measured by PASI.</p><p><strong>Conclusion: </strong>This study highlights the importance of screening patients with psoriasis for MASLD to prevent the progression to liver fibrosis.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brodalumab Is Effective for Psoriasis Patients with Difficult-To-Treat Body Regions: Results from an Observational Clinical Study.","authors":"Stephanie Dauth, Ann Christina Foldenauer, Konstantin Hallmann, Christina Kunz, Anke König, Isabel Haferland, Christine Möser, Michaela Koehm, Andreas Pinter","doi":"10.1159/000542348","DOIUrl":"10.1159/000542348","url":null,"abstract":"<p><strong>Introduction: </strong>Brodalumab, a human monoclonal antibody that selectively inhibits the interleukin (IL)-17 receptor subunit A, has been approved for the treatment of moderate-to-severe plaque psoriasis. The treatment benefit of brodalumab has been clearly demonstrated in multiple clinical studies. However, data on effectiveness for difficult-to-treat body regions, especially in everyday clinical practice, are still limited.</p><p><strong>Methods: </strong>In this exploratory observational clinical study, psoriasis patients suffering from nail and scalp involvement who received brodalumab during routine clinical care were enrolled at 7 centers in Germany. Patients were observed for over 60 weeks. The co-primary endpoints were 75% improvement in Psoriasis Scalp Severity Index (PSSI75) at week 12 and 75% improvement in Nail Psoriasis Severity Index (NAPSI75) at week 24. Secondary endpoints included assessment of general skin and disease outcomes, quality-of-life, and patient satisfaction with treatment.</p><p><strong>Results: </strong>Eighty-seven patients were included. Mean age was 46.8 years, 70.1% patients were male, and mean body mass index was 28.9 kg/m2. The co-primary endpoints were achieved by more than 90% of patients who met criteria for effectiveness analyses (n = 62): 93.6% of patients achieved PSSI75 at week 12 and 90.3% of patients achieved NAPSI75 at week 24. Median body surface area involvement improved from 14% at baseline to 1.5% and 1% at weeks 12 and 24, respectively. Median Dermatology Life Quality Index scores improved from 16 at baseline to 2 and 1 at weeks 12 and 24, respectively. Improvements were maintained in the majority of patients throughout the 60-week study. Brodalumab was well tolerated and patients were highly satisfied with the treatment.</p><p><strong>Conclusion: </strong>Outcomes assessed in this study, including assessments of scalp and nail symptoms, improved following initiation of brodalumab therapy. This study of psoriasis patients in a real-world setting supports the long-term clinical effectiveness of brodalumab on difficult-to-treat body regions.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Satisfaction in Patients with Hidradenitis Suppurativa: A Real-World Survey from the EU5 and USA.","authors":"John R Ingram, Vincenzo Bettoli, Jasmine I Espy, Georgios Kokolakis, Antonio Martorell, Axel P Villani, Hayley Wallinger, Isabel Truman, Emily Coak, Torben Kasparek, Elisa Muscianisi, Craig Richardson, Alexa B Kimball","doi":"10.1159/000542343","DOIUrl":"10.1159/000542343","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a debilitating, inflammatory skin disorder. Treatment strategies in patients with HS are challenging; real-world evidence in a HS population is warranted for greater disease understanding. The objective of this analysis was to describe real-world treatment patterns and treatment satisfaction in patients with HS.</p><p><strong>Methods: </strong>This was a cross-sectional market research survey with retrospective data collection in patients with HS from the USA and five European countries (France, Germany, Italy, Spain, and the UK) between November 2020 and April 2021, using physician- and patient-reported surveys. Eligible physicians were general dermatologists actively managing patients with HS; dermatologists were required to have consulted with ≥2 patients with HS in the previous 12 months. Adult (≥18 years) and adolescent (10-17 years) HS patients visiting a participating dermatologist were included. Outcomes included treatment patterns, flare status, treatments prescribed in response to flares, previous surgeries, barriers to biologics, and patient- and physician-reported satisfaction with the disease control provided by treatment.</p><p><strong>Results: </strong>Survey data from 1,787 patients were collected from 312 dermatologists. The most frequently prescribed treatments were topicals, oral antibiotics, and antiseptic washes/creams at diagnosis and sampling. At sampling, biologics were more frequently prescribed in patients with more severe disease (prescribed in 26.6%, 31.0%, and 52.4% of patients with mild, moderate, and severe disease, respectively); oral antibiotics (48.8%), topicals (37.4%), and biologics (34.3%) were the most frequently prescribed treatment classes in response to a flare. Of patients currently not receiving a biologic, dermatologists reported that 18.9% of patients' condition warranted their use. Approximately one quarter of dermatologists (24.5%) and patients (27.4%) were not satisfied with current treatment; of patients who were dissatisfied, 12.8% reported they would never raise their dissatisfaction with their doctor.</p><p><strong>Conclusion: </strong>These real-world data suggest a high disease burden and potential undertreatment in patients with HS. Patients received multiple treatments, and a notable proportion underwent surgery. Robustly integrating the patient voice in HS treatment decisions may lead to better outcomes and improved treatment satisfaction.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Strategies and Corticophobia among Healthcare Professionals Involved in the Care for Atopic Dermatitis: A Dutch Survey.","authors":"Aviël Ragamin, Karlijn F van Halewijn, Renske Schappin, Willemijn C A M Witkam, Nicolette J T Arends, Jaap Hoogeterp, Arthur M Bohnen, Gijs Elshout, Marie L A Schuttelaar, Suzanne G M A Pasmans","doi":"10.1159/000542421","DOIUrl":"10.1159/000542421","url":null,"abstract":"<p><strong>Introduction: </strong>Various healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs.</p><p><strong>Methods: </strong>Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCSs). Higher scores reflect a more negative attitude.</p><p><strong>Results: </strong>A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists, other HCPs showed greater reluctance to TCS. This difference was highlighted by the finding that half of GPs reported to prescribed only TCS of mild potency for infants with severe AD, while few dermatologists (9%) reported a similar approach. Dermatologists had lowest TOPICOP-P scores (median: 19, IQR: 12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR: 31-44, pharmacy assistants: median: 36, IQR: 31-42). More corticophobia was significantly associated with prescription of a lower TC potency class in prescribing HCPs (B -0.04, 95% CI: -0.07 to 0.01, p = 0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube.</p><p><strong>Conclusions: </strong>This study shows the differences in management of AD and reluctance toward TCS in HCPs. Furthermore, corticophobia among HCPs and its influence on the selection of TCS potency class and recommendations were demonstrated. To reduce corticophobia and improve care for AD, more education is needed.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Territory-Wide Follow-Up of Primary and Secondary Extramammary Paget Disease of 2 Decades: Effects of Local Disease on Survival.","authors":"Joanna Ka Man Ng, Agnes Wai Sze Chan, Christina Man-Tung Cheung, Edric Chi-Ching Ip, Paul Cheung Lung Choi, Wendy Wan Hang Lau, Jacqueline Ho Sze Lee, Joshua Jing Xi Li","doi":"10.1159/000541394","DOIUrl":"10.1159/000541394","url":null,"abstract":"<p><strong>Introduction: </strong>Extramammary Paget disease (EMPD) is an uncommon malignant cutaneous neoplasm that are divided into primary and secondary forms. In this multicenter study, histologically proven cases of primary and secondary EMPD were reviewed for clinical outcomes with subgroup analysis for secondary EMPD.</p><p><strong>Methodology: </strong>Cases of EMPD were identified from pathology report of the involved institutions over a period of over 2 decades. Cases of secondary EMPD were identified review of case notes, radiology, and pathology reports. Clinicopathological and outcome data were retrieved for statistical analysis.</p><p><strong>Results: </strong>A total of 109 cases were retrieved, including 19 cases of secondary EMPD, most commonly associated with colorectal (n = 6), anal (n = 5), and prostatic carcinomas (n = 3). A difference was observed between older age and secondary (vs. primary) EMPD (p = 0.016), but no differences were seen in other clinico-demographical parameters. Male sex (p = 0.018), age over 60 years (p = 0.004), and involvement of margins (resectable) (p = 0.018) were associated with shorter OS. For DSS, involvement of margins (p = 0.009) was an adverse predictor. Secondary EMPD had a shorter DSS than primary EMPD (p = 0.005). Multivariable analysis confirmed all above associations (p < 0.05). In subgroup analysis for secondary EMPD, margin involvement remained associated with shorter OS (p = 0.007) and DSS (p = 0.003).</p><p><strong>Conclusions: </strong>Secondary EMPD is associated with poorer outcomes. Margin involvement is strong and independent indicator of shorter OS and DSS, including secondary EMPD. Resectability is a strong predictor of favorable outcome and excision with clear margins should be attempted when surgically feasible.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}