Clinical and Experimental Dermatology最新文献

Background: Pediatric psoriasis is a chronic inflammatory skin disease that poses unique challenges in diagnosis and management. While studies from high-income countries have reported rising incidence trends, global data on the incidence of pediatric psoriasis remain scarce.

Objective: To provide a comprehensive description of pediatric psoriasis incidence at the global, regional, and national levels.

Method: We analyzed data from the Global Burden of Disease Study 2021 to evaluate the incidence trends of pediatric psoriasis from 1990 to 2021. Incidence rates were stratified by age, sex, and sociodemographic index (SDI). Estimated annual percentage change (EAPC) was used to quantify the temporal trends.

Results: In 2021, there were 664,100 cases of pediatric psoriasis globally, with an incidence rate of 33.0 per 100,000 children. Over the study period, the global incidence increased by 0.21% (95% CI 0.18-0.25%) per year, with more pronounced rises observed in low- and middle-SDI regions. The highest incidence rates were recorded in high-SDI regions, such as High-income North America (70.5 per 100,000) and Western Europe (67.5 per 100,000). Notably, the largest increases in incidence occurred in regions like Sub-Saharan Africa. At the national level, 189 countries/territories experienced significant increases in pediatric psoriasis incidence, while only five countries saw a decline. Incidence was higher in girls across all age groups, with the most pronounced rise in children under 5 years old.

Conclusions: The incidence of pediatric psoriasis has significantly increased, particularly in low- and middle-SDI regions, underscoring the need for improved diagnosis, early intervention, and targeted public health strategies.

Lichen nitidus (LN) is a rare inflammatory skin condition characterized by small, shiny, flat-topped papules, commonly affecting children and young adults. Its etiology remains unclear, though immune-mediated pathways are suspected. LN is often asymptomatic, with papules primarily on the trunk, upper limbs, and genitalia. Diagnosis relies on characteristic histopathology, notably a "claw clutching a ball" pattern. Though it often resolves spontaneously, LN may present persistently, sometimes requiring topical treatment. This review highlights LN's clinical, histological, and dermoscopic features, discusses variants and associated systemic conditions, and offers guidance for dermatologists in managing this distinct dermatosis.

Background: Sensitive skin (SS) is a common condition reported by many people worldwide. Patient interviews reveal that individuals with SS experience diminished quality of life, anxiety, and depression. Nonetheless, the impact of SS on mental health remains unclear.

Objective: To assess whether SS affects mental health and the relationship between symptom severity and its impact.

Methods: A cross-sectional study was conducted at Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea, between June 2022 and March 2023. The Sensitive-Scale 10 (SS-10) was used for SS diagnosis and severity scoring; the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) assessed mental health. Participants were categorized as 'non-sensitive' (<20), 'sensitive' (20-49), and 'extremely sensitive'(≥50) based on SS-10 scores. Objective measurements included transepidermal water loss (TEWL), stratum corneum hydration (SCH), erythema, and demodex density.

Results: Of 200 participants, 146 completed the study. Participants were predominantly female (79.45%) with a mean age of 36.86 years (SD = 12.25). DLQI scores were higher in more sensitive groups (non-sensitive: 6.25, sensitive: 14.46, extremely sensitive: 18.86; P <.001). HADS-A and HADS-D scores also increased with severity (HADS-A: 4.94 in non-sensitive to 7.80 in extremely sensitive, HADS-D: 3.88 to 8.54; P <.05 for HADS-A, P <.001 for HADS-D). DLQI was significantly influenced by discomfort and redness, HADS-A by TEWL (negatively) and flushes, and HADS-D by flushes.

Conclusion: SS is associated with lower quality of life and increased anxiety and depression. Symptoms of sensitive skin substantially impact patients' psychological well-being.

Background: In recessive dystrophic epidermolysis bullosa (RDEB), complications like oesophageal strictures, hand contractures, cardiomyopathy and cutaneous squamous cell carcinoma (SCC) may develop, necessitating procedures such as oesophageal dilatation (OD), gastrostomy tube placement and hand surgery.

Objectives: To determine prevalence and age of onset of milestone events by RDEB subtype, specifically dysphagia, first OD, first gastrostomy tube, first hand surgery, cardiomyopathy, first SCC and death.

Methods: The Prospective Epidermolysis Bullosa Longitudinal Evaluation Study (PEBLES) is a register study of individuals with RDEB which records comprehensive EB- and non-EB-related health information. Age of onset and prevalence of milestone events was analysed as all RDEB and by RDEB subtype.

Results: Dysphagia occurred in 89% of 62 total participants including all with severe (RDEB-S) and inversa (RDEB-Inv) subtypes, and OD was also frequent, in 69% overall (92% RDEB-S, 89% RDEB-Inv). All events were most frequent and occurred earliest in RDEB-S (except cardiomyopathy) with median age of dysphagia, OD and gastrostomy tube placement in the first decade. Frequent and early dysphagia and OD in RDEB-Inv may suggest this subtype before characteristic flexural skin changes manifest. Thirty-five percent of RDEB-S participants had a first SCC at median age 27.8 years. Seven participants died in the 10-year study; median age for the 6 with RDEB-S was 36 years and causes included sepsis, metastatic SCC and complications of refeeding syndrome.

Conclusions: Our results detail the frequency and prevalence of important milestone events by RDEB subtype, informing prognostication, increasing understanding of RDEB natural history to help inform study endpoints, and potentially serving as proxy control data for future clinical trials.