Dermatology (Basel, Switzerland)最新文献

{"title":"Assessing Light and Energy-Based Therapy by Optical Coherence Tomography and Reflectance Confocal Microscopy: A Randomized Trial of Photoaged Skin.","authors":"Mette Mogensen,&nbsp;Kristoffer Hendel,&nbsp;Vilde Ung,&nbsp;Emily Wenande,&nbsp;Katrine Togsverd-Bo,&nbsp;Julie L Forman,&nbsp;Merete Haedersdal","doi":"10.1159/000517960","DOIUrl":"https://doi.org/10.1159/000517960","url":null,"abstract":"<p><strong>Background and objectives: </strong>Image-guided quantitative and semi-quantitative assessment of skin can potentially evaluate treatment efficacy. Optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) are ideal for this purpose. This study assessed clinically relevant statistical changes in RCM and OCT features in photoaged skin after light and energy-based therapy.</p><p><strong>Methods: </strong>Novel statistical analyses were performed using OCT and RCM data collected during a previously published trial: a 12-week study of female décolleté skin randomized to four areas treated with thulium laser (L), photodynamic therapy (PDT), combined L-PDT, and control. Eight semi-quantitative RCM scores of photodamage and OCT measurements of skin roughness, blood flow, and epidermal thickness (ET) were evaluated and compared to dermoscopy and clinical skin scores. In statistical analysis, estimated treatment difference (ETD) was calculated.</p><p><strong>Results: </strong>Twelve women with moderate to severe photodamage were included. RCM and OCT data demonstrated a trend towards rejuvenation of epidermis with increased ET, changes in skin surface, and improved honeycomb pattern in RCM. In angiographic OCT, non-significant changes towards more regular capillary meshes were shown, which matched a decline in appearance of gross telangiectasias in dermoscopy. Improved skin tone after laser and L-PDT was identified in RCM, showing less edged papillae in 36% and 45%, and lentigo number declined in 55% of patients after treatments in dermoscopy. Based on clinical scores, L-PDT provided the greatest clinical improvement, which corresponded to superior ETD outcomes in ET and edged papillae shown in OCT and RCM, respectively.</p><p><strong>Conclusion: </strong>Objective OCT and RCM assessment of skin rejuvenation was demonstrated in this study. Importantly, image-based improvements corresponded to favorable clinical skin scores and fewer photoaging characteristics in dermoscopy. Importantly, most changes did not reach statistical significance, prompting further studies and emphasizing the modest value of non-randomized, non-blinded anti-aging trials.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"422-429"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39410711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Characteristics of Hidradenitis Suppurativa Phenotypes in a Large Dutch Cohort.","authors":"Koen Dudink,&nbsp;Pim Aarts,&nbsp;Christine B Ardon,&nbsp;Allard R J V Vossen,&nbsp;Sterre B L Koster,&nbsp;Jonathan F Van den Bosch,&nbsp;Errol P Prens,&nbsp;Hessel H van der Zee","doi":"10.1159/000518965","DOIUrl":"https://doi.org/10.1159/000518965","url":null,"abstract":"Dear Editor, Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating inflammatory skin disease. It has a heterogeneous clinical presentation regardless of disease severity [1]. Therefore, different phenotypes are thought to exist which might differ in their pathogenesis and prognosis and which will likely benefit from different treatment modalities. Based on clinical experience, a set of six phenotypes has been proposed in this journal: regular, frictional furunculoid, scarring folliculitis, conglobata, ectopic and syndromic [2]. However, our continued clinical experience suggested that the ectopic and syndromic types do not have specific clinical features and could be categorized as one of the other phenotypes. Here, we present the prevalence and patient characteristics of these phenotypes in a population of 935 Dutch HS patients participating in our HS registry at the Department of Dermatology of the Erasmus University Medical Center and its affiliated DermaHaven. All patients included in the study were diagnosed with HS according to the criteria of the European S1 guideline [3]. To help the phenotype designation in daily practice, we included a flowchart (Fig. 1) and prototypical clinical pictures of the phenotypes (available at www.karger.com/doi/10.1159/000518965). The need for ethical approval was waived by the Medical Research Eth-","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"600-602"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39520475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Adherence and Persistence of Patients with Moderate to Severe Psoriasis Treated with Biologic Medications in a US Commercially Insured Population.","authors":"Chang Xu,&nbsp;Amanda Teeple,&nbsp;Bingcao Wu,&nbsp;Timothy Fitzgerald,&nbsp;Steven R Feldman","doi":"10.1159/000519176","DOIUrl":"https://doi.org/10.1159/000519176","url":null,"abstract":"<p><strong>Background: </strong>Adalimumab (ADA), certolizumab pegol (CER), etanercept (ETA), guselkumab (GUS), ixekizumab (IXE), secukinumab (SEC), and ustekinumab (UST) are biologic medications approved in the USA for the treatment of moderate to severe psoriasis. We examined drug adherence and persistence of patients with moderate to severe psoriasis who initiated these seven biologic medications.</p><p><strong>Methods: </strong>Adult patients with ≥1 pharmacy/medical claim for any of the seven psoriasis medications and ≥1 diagnosis of psoriasis in the previous 6 months between July 1, 2014 and June 30, 2019 were selected from the IBM MarketScan® Commercial Claims and Encounters Database. The index date was defined as the date of the first prescription fill. Patients were required to have continuous health plan enrollment during the 6 months prior to their index date and ≥9 months after. Patients were grouped into seven study cohorts based upon their index biologic medication. Adherence was measured using the proportion of days covered (PDC) and defined by a PDC ≥80%. Adherence and persistence with index biologic medications were examined during fixed follow-up periods of 3, 6, and 9 months, with a subpopulation analysis carried out among patients with 12 months of follow-up.</p><p><strong>Results: </strong>Among psoriasis patients with ≥9 months of continuous enrollment included in the study population, the number of those who initiated each biologic medication was 10,324 for ADA, 431 for CER, 3,092 for ETA, 821 for GUS, 1,766 for IXE, 4,132 for SEC, and 5,441 for UST. The mean age at the time of initiating biologic treatment was 46.9 years. During the 9-month follow-up period, the proportions of adherent patients (i.e., PDC ≥80%) were numerically higher among those treated with UST (59.9%) and GUS (56.9%), followed by those treated with SEC (46.1%), IXE (45.5%), ADA (44.7%), ETA (33.9%), and CER (22.0%). The proportions of patients who were persistent with their index biologic medication during the 9-month follow-up period were numerically higher among those treated with UST (70.1%) and GUS (67.8%), followed by those treated with IXE (47.3%), SEC (46.9%), ADA (28.7%), CER (14.8%), and ETA (10.7%).</p><p><strong>Conclusions: </strong>In this large healthcare claims database analysis of psoriasis patients treated with seven different biologic medications, adherence was numerically higher among those treated with UST or GUS. UST and GUS were also associated with numerically greater persistence.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"438-447"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post hoc Analysis of a Randomized, Controlled, Phase 2 Study to Assess Response Rates with Chlormethine/Mechlorethamine Gel in Patients with Stage IA-IIA Mycosis Fungoides.","authors":"Christiane Querfeld,&nbsp;Julia J Scarisbrick,&nbsp;Chalid Assaf,&nbsp;Emmanuella Guenova,&nbsp;Martine Bagot,&nbsp;Pablo Luis Ortiz-Romero,&nbsp;Pietro Quaglino,&nbsp;Erminio Bonizzoni,&nbsp;Emmilia Hodak","doi":"10.1159/000516138","DOIUrl":"https://doi.org/10.1159/000516138","url":null,"abstract":"<p><strong>Background: </strong>Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. Patients can be treated using chlormethine gel, a skin-directed therapy developed and approved for MF. In the randomized, controlled 201 trial, chlormethine gel was found to be noninferior to equal-strength chlormethine ointment. However, there remains a need to gain more insight into outcome measures after treatment.</p><p><strong>Objective: </strong>The aim of this study was to further investigate the potential of chlormethine gel treatment through a novel post hoc analysis of the 201 trial data (NCT00168064).</p><p><strong>Methods: </strong>Patients were randomized to chlormethine gel or ointment; response assessments included Composite Assessment of Index Lesion Severity (CAILS) and total body surface area (BSA). In this post hoc analysis, additional subgroup response analyses were performed for stage IA/IB-IIA MF. Very good partial response (75 to <100% improvement) was included as an additional response category. Time to response and overall response trends were determined. Finally, multivariate time-to-event analyses were performed to determine whether associations were observed between treatment frequency, response, and adverse events.</p><p><strong>Results: </strong>Response rates were significantly higher for patients with stage IA MF for CAILS (intent-to-treat [p = 0.0014] and efficacy-evaluable [EE; p = 0.0036] populations) and BSA (EE population [p = 0.0488]) treated with gel versus ointment. Time to first CAILS response and response trends were better for all-stage gel-treated patients overall. No association was seen between treatment frequency and response or occurrence of adverse events at the following visit. An association was observed between the occurrence of contact dermatitis and improved clinical response at the next visit (p = 0.0001).</p><p><strong>Conclusion: </strong>This post hoc analysis shows that treatment with chlormethine gel may result in higher and faster response rates compared with chlormethine ointment, which confirms and expands results reported in the original analysis. The incidence of contact dermatitis may potentially be a prognostic indicator for clinical response; this needs to be confirmed in a larger population.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"347-357"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000516138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38996814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-SeboSkin Model for Human ex vivo Studies of Hidradenitis Suppurativa/Acne Inversa.","authors":"Xiaoxiao Hou,&nbsp;Amir M Hossini,&nbsp;Georgios Nikolakis,&nbsp;Ottfried Balthasar,&nbsp;Andreas Kurtz,&nbsp;Christos C Zouboulis","doi":"10.1159/000515955","DOIUrl":"https://doi.org/10.1159/000515955","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa/acne inversa (HS) is a chronic, recurrent inflammatory skin disease. Its pivotal pathogenetic event is believed to be the occlusion of the hair follicle generating a perifollicular lympho-histiocytic inflammation. However, knowledge of the exact HS pathogenesis requires further research.</p><p><strong>Objective: </strong>To develop a human HS model applicable in preclinical research which could help to understand the pathophysiology of HS and to determine the action of therapeutic candidates.</p><p><strong>Methods: </strong>The 3D-SeboSkin technology was applied to maintain explants of involved and uninvolved skin of HS patients ex vivo for 3 days. Detection of differential expression of previously detected HS biomarkers was performed by immunohistochemistry in a group of female patients (n = 9, mean age 37.2 ± 8.4 years).</p><p><strong>Results: </strong>The application of the 3D-SeboSkin model preserved the structural integrity of lesional and perilesional HS skin ex vivo, as previously described for healthy skin. Moreover, the HS 3D-SeboSkin setting maintained the differential expression and pattern of several HS biomarkers (S100A9, KRT16, SERPINB3) in epidermal and dermal tissue and the appendages.</p><p><strong>Conclusion: </strong>We have validated HS 3D-SeboSkin as a reproducible, human model, which is appropriate for preclinical lesional and perilesional HS skin studies ex vivo.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"236-243"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39069894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaching Treatment Goals in Psoriasis with Conventional Systemic Drugs: How Long Are We Willing to Wait?","authors":"Arnd Jacobi,&nbsp;Birgit Weidemann-Röver,&nbsp;Sebastian Barbus,&nbsp;Ulrich Mrowietz","doi":"10.1159/000515765","DOIUrl":"https://doi.org/10.1159/000515765","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to investigate the attainment of treatment goals according to the European Consensus Programme (ECP-TGs) from 2011 in patients with moderate to severe psoriasis (Pso) treated with the first conventional systemic therapy and to identify factors that might compromise the attainment of these treatment goals.</p><p><strong>Methods: </strong>In a multicenter, prospective observational study, patients with moderate to severe Pso, defined as either body surface area (BSA) >10% or psoriasis area severity index (PASI) >10 and dermatology life quality index (DLQI) >10, received a conventional systemic therapy that could be modified at each follow-up visit over the course of 18 months. All subjects signed an informed consent form, were ≥18 years of age as well as systemic therapy naïve, and had regular study visits at months 3, 6, 9, 12, and 18 after baseline. Among others and in addition to demographic and disease-related characteristics at baseline, we documented BSA, PASI, DLQI, and the physician-reported attainment of treatment goals at each follow-up visit. Factors related to a failure in achieving the ECP-TGs (i.e., either Δ PASI ≥75 or Δ PASI ≥50 and <75 with a DLQI ≤5) at month 18 were investigated by multiple logistic regression. Descriptive results are presented as the mean ± SD for interval data, and absolute as well as relative frequencies for nominal data. For this part of the analysis, data at baseline and months 6, 12, and 18 are presented.</p><p><strong>Results: </strong>A total of 133 Pso patients with a mean age and disease duration of 49.5 ± 14.4 and 15.6 ± 12.8 years, respectively, were included in the analysis; 54.1% (n = 72) were male. The mean baseline disease-related outcomes were: BSA: 21.5 ± 15.8%, PASI: 13.7 ± 7.14, and DLQI: 12.0 ± 6.11. The most common conventional systemic therapies initiated at baseline were fumaric acid esters (n = 74, 55.6%), methotrexate (n = 46, 34,6%), and ciclosporin (n = 6, 4.5%). The ECP-TGs were achieved by 58 patients (43.6%) at month 6, 86 patients (64.7%) at month 12, and 97 patients (72.9%) at month 18. An optimized reduced logistic regression model identified the presence of onycholysis/nail dystrophy at two or more digits to be associated with failing to attain the ECP-TGs (OR 10.7, 95% CI 2.5-46.7, p = 0.002).</p><p><strong>Conclusion: </strong>Patients with onycholysis/nail dystrophy at two or more digits were identified as having a higher risk of not achieving ECP-TGs under conventional systemic therapy. The ECP-TGs from 2011 were attained by 43.6% of our patients 6 months after starting conventional systemic therapies. In the era of safe, fast, and efficacious Pso therapies, much higher treatment goals might be achieved during therapy. New treatment goals are only of use if patients and dermatologists strive to attain them.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"292-300"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39078757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Disorders/Obesity Is a Primary Risk Factor in Hidradenitis Suppurativa: An Immunohistochemical Real-World Approach.","authors":"Katarzyna P Kaleta,&nbsp;Georgios Nikolakis,&nbsp;Amir M Hossini,&nbsp;Ottfried Balthasar,&nbsp;Daifallah Almansouri,&nbsp;Aristeidis Vaiopoulos,&nbsp;Jürgen Knolle,&nbsp;Anna Boguslawska,&nbsp;Anna Wojas-Pelc,&nbsp;Christos C Zouboulis","doi":"10.1159/000517017","DOIUrl":"https://doi.org/10.1159/000517017","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa (HS) is an inflammatory, potentially scarring disease of the hair follicle, affecting the apocrine gland-bearing skin areas. The major comorbid disorders associated with the occurrence or the aggravation of the disease are obesity and smoking. Numerous efforts to dissociate these factors led to controversial results.</p><p><strong>Objectives: </strong>To assess the importance of metabolic disorders/obesity, smoking/environmental toxins, and inflammation in HS by utilizing the differential expression of major relevant protein markers in lesional skin of obese/smoking versus non-obese/non-smoking HS patients.</p><p><strong>Methods: </strong>Lesional skin specimens deriving from two groups of HS patients (BMI >30 and smokers, n = 12 vs. BMI <30 and non-smokers, n = 10) were stained with antibodies raised against irisin, PPARγ, and IGF-1R, which correlate with metabolic disorders/obesity, EGFR and AhR, associated with smoking, and IL-17, IL-17R, and S100A8, as markers of inflammation.</p><p><strong>Results: </strong>Metabolic disorders/obesity-related markers exhibited marked differential expression between the two groups, while smoking-associated markers a limited one. IL-17R expression was stronger in obese/smokers, and S100A8 staining exhibited intense strong immunoreactivity in both groups without significant difference.</p><p><strong>Conclusions: </strong>The notion that obesity plays a role in HS development appears to be supported by the prominent regulation of the associated lesional biomarkers. Tobacco smoking might contribute less to HS than previously suspected.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"251-259"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39209417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy Assessment of the High-Frequency High-Intensity Focused Ultrasound as a New Treatment for Actinic Keratosis.","authors":"S Morteza Seyed Jafari,&nbsp;Simone Cazzaniga,&nbsp;Simon Bossart,&nbsp;Laurence Feldmeyer,&nbsp;Lorenzo Pelloni,&nbsp;Maja van Rhyn,&nbsp;Sarina Angermeier,&nbsp;Maurice Adatto,&nbsp;Robert E Hunger,&nbsp;Kristine Heidemeyer","doi":"10.1159/000520536","DOIUrl":"https://doi.org/10.1159/000520536","url":null,"abstract":"<p><strong>Background: </strong>Actinic keratosis (AK) is the most common precancerous cutaneous lesion, with risk of progression to cutaneous squamous cell carcinoma. In the current study, we evaluated the efficacy of 20-MHz high-intensity focused ultrasound (HIFU), as a new treatment modality for AK.</p><p><strong>Materials and methods: </strong>Patients with AK lesions (grades I-III) treated with HIFU were included in the study. The clinical assessment was performed 3 months after therapy.</p><p><strong>Results: </strong>Twenty-one patients (14 men, 7 women) with 108 AK lesions (grades I-III) were included in the current study. Ages ranged from 62 to 85 years (mean 72.6 years). Clinically complete resolution of the actinic damage in the treated area was detected in 72.2% of lesions. Furthermore, 28 lesions (26%) showed a reduction of the AK grade, or partial response, after the therapy. Most of the patients experienced annoying but short pain during the procedure. However, late adverse effects of the therapy, such as hypopigmentation, hyperpigmentation and erythema were reported only in a small portion of the lesions.</p><p><strong>Conclusions: </strong>20-MHz HIFU could be an effective and safe alternative treatment for AK.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"662-667"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39746059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Utilization and Treatment Patterns in Patients with Chronic Prurigo and Chronic Pruritus in Germany.","authors":"Sonja Ständer,&nbsp;Claudia Garbe,&nbsp;Kristina Hagenström,&nbsp;Jana Petersen,&nbsp;Claudia Zeidler,&nbsp;Matthias Augustin","doi":"10.1159/000520863","DOIUrl":"https://doi.org/10.1159/000520863","url":null,"abstract":"<p><strong>Background: </strong>To date, there have been no large studies describing real-world treatment of chronic prurigo (CPG) and pruritus (CPR) in Germany.</p><p><strong>Objective: </strong>To determine the healthcare utilization, treatment patterns, and costs associated with CPG and CPR in Germany.</p><p><strong>Methods: </strong>Retrospective analysis using anonymized claims data (German DAK-Gesundheit), based on a 40% sample of all insured adults of the DAK-Gesundheit on December 31, 2010 (N = 2,006,003).</p><p><strong>Results: </strong>Patients with CPR (prevalence 2.2%) most commonly visited general medicine/general practitioners (GPs, 80.1%), followed by gynecologists (66.1%) and dermatologists (51.1%). Patients with CPG (prevalence 0.2%) most commonly visited dermatologists (85.7%), GPs (78.1%), and ophthalmologists (47.2%). Of adult patients, 44% received at least one drug prescription. Two thirds of patients with a drug prescription received ≥1 topical drug (66.2%), and 54.3% ≥1 systemic drug (total costs of approximately EUR 550,000 and 2,500,000, respectively). Of patients with CPG, 33.8% received ≥1 systemic and 45.1% ≥1 topical drug prescription (costs of approximately EUR 360,000 vs. 105,000). Of patients with CPR, 23.5% received ≥1 systemic and 28.6% ≥1 topical drug prescription (costs of approximately EUR 2,000,000 vs. 500,000). Of patients with CPG, 5.8% received ≥1 phototherapy application vs. 1.2% of patients with CPR.</p><p><strong>Conclusions: </strong>These findings reflect the reality of care and can form a basis for the identification of overuse, underuse, and misuse in order to design CPG and CPR healthcare more effectively and efficiently.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"753-761"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Histological Effects of Topical Epidermal Growth Factor on Acne and Acne Scars.","authors":"Dong Hyo Kim,&nbsp;Ji Hoon Yang,&nbsp;Soo Ick Cho,&nbsp;Ji Young Yoon,&nbsp;Ji Won Kim,&nbsp;Sungjun Choi,&nbsp;Dae Hun Suh","doi":"10.1159/000521294","DOIUrl":"https://doi.org/10.1159/000521294","url":null,"abstract":"<p><strong>Background: </strong>The inflammatory lesions of acne leave scars which greatly affect patients' quality of life. Treatment options targeting both acne and acne scars are still lacking.</p><p><strong>Objectives: </strong>To evaluate the clinical efficacy of epidermal growth factor ointment (EGFO) on acne and acne scars.</p><p><strong>Methods: </strong>The study design was 12-week, prospective, split-face, single-blinded. The 36 patients with mild to moderate acne vulgaris applied EGFO on one side of the face and the vehicle ointment on the other side twice daily. The patients were assessed every 4 weeks by acne lesion and scar counts, investigator's global assessment for acne (IGA) and scar (SGA), and the ECCA scar grading scale. Biopsies were performed before and after treatment.</p><p><strong>Results: </strong>Acne and acne scars were significantly improved on EGFO-treated sides, while control sides were not. Acne lesion and scar counts were significantly reduced after 4 weeks, while IGA, SGA, and ECCA grade significantly decreased after 8 weeks. Immunohistochemistry showed decreased expression of keratin 16, NF-κB p65, IL-1α, and IL-8, and increased expression of TGF-β1, elastin, and collagen type 1, 3 after treatment.</p><p><strong>Conclusions: </strong>EGFO can be a treatment option targeting acne and acne scars.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"837-845"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39948675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}