Clinical and Experimental Dermatology最新文献

Granulomatous inflammation is usually described in association with tertiary syphilis up till recent years where there are emerging cases reporting its presence in secondary syphilis. Herein we present two patients who presented with erythematous infiltrated papules and nodules and were eventually diagnosed with granulomatous secondary syphilis, with clearance of their rashes after treatment. In this article, we highlight the important clues that point clinicians and histopathologists towards the diagnosis of syphilis compared to other similar differentials such as leprosy in reaction, cutaneous histiocytosis and lymphoma. Additionally, from literature review and own experiences, we wish to highlight that granulomatous syphilis is often palmoplantar sparing and its presence may not necessarily be a feature of immunocompromised states (e.g. human immunodeficiency virus) In this increasingly connected world, the recognition of an atypical presentation of an age-old disease in patients with different skin types needs to be underscored with close clinicopathological correlation.

Background: SunSmart is the National Cancer Control Programme's annual skin cancer prevention awareness campaign.

Objectives: This study aimed to assess sun protection attitudes following the 2023 campaign, and compare findings to 2022.

Methods: An online survey was conducted in September 2023, a repeat of the 2022 survey. Data were collated and analysed in Excel.

Results: In 2023, 48% (n=480) adults reported being sunburnt that summer. Younger adults were more likely than older adults to report sunburn (62% v 28% p<0.001). In assessing the "SunSmart 5s": 94% rated sunscreen, 88% rated shade, 84% rated hats, 71% rated long sleeves, and 70% rated sunglasses as important. Older adults were more likely than younger adults to rate each factor as important. A higher proportion reported each factor as important compared to 2022. Awareness of the campaign increased, 32% having heard of SunSmart, compared to 21% in 2022 (p<0.001). Awareness was higher in older adults (39% v 21% p<0.001), and in those who reported no sunburn (34% v 30% p=0.023).

Conclusions: Awareness of SunSmart and perceived importance of the sun protection factors have improved since 2022, with perceived importance of the "SunSmart 5s" reasonably high. Reaching younger adults and improving their sun protection behaviours remain areas for progress.

Backgrounds: Acne vulgaris is one of the most common skin conditions worldwide among adolescents. Beyond its physical manifestations, acne can leave invisible psychological scars.

Objectives: We aimed to examine the protective and risk factors of acne-related quality of life, and its association with mental health outcomes.

Methods: The analysis included data collected in 2023 from adolescents enrolled in the SEROCoV-KIDS population-based cohort. By combining the Acne Severity and Acne-Quality of Life (Acne-QoL) scales, three groups were established: Acne-LowAQoL (adolescents with acne and low Acne-related Quality of Life), Acne-HighAQoL, and NoAcne-HighAQoL. We used multinomial and logistic regression to assess the association between health behaviours, these groups, and mental health outcomes.

Results: Among 335 adolescents (mean age 16.1 years [SD 1.8], 56% female), 65 (19.4%) reported experiencing acne while maintaining a high Acne-QoL, 26 (7.7%) reported having acne and a low Acne-QoL and 244 (72.9%) reported having nearly no acne. Low engagement in physical activity (aOR: 0.30, 95% CI: 0.12-0.77), addictive use of social media (aOR: 3.78, 95%CI: 1.60-8.96), and prolonged screen time (aOR: 2.99, 95%CI: 1.26-7.08) were independently associated with Acne-LowAQoL. Conversely, those from the group Acne-HighAQoL reported higher social support (aOR: 1.95, 95%CI: 1.07-3.54). Adolescents with Acne-LowAQoL showed lower levels of self-esteem, resilience, and increased psychological distress.

Conclusions: Among adolescents with acne, physical activity and social support were positively associated with good acne-related quality of life, which translated into better mental health. In contrast, screen time and social media use notably reduced it. Dermatologists should incorporate these considerations into clinical practice to ensure effective patient care.

Background: Atopic dermatitis (AD) has been associated with psychiatric comorbidities.

Objectives: To characterize the association between AD and bipolar disorder (BPD) with a case-control study of the NIH All of Us Research Program.

Methods: Utilizing Systemized Nomenclature of Medicine diagnostic codes, we identified cases of AD. Four age, sex, and race/ethnicity matched controls were found for each case using propensity score matching. After controlling for age, sex, race/ethnicity, income, smoking status, and depression, the relationship between AD and BPD was evaluated using logistic regression.

Results: We identified 13,431 AD cases with 53,724 matched controls. Participants with AD were more likely than controls to have BPD (7.8% vs. 4.6%, P<.001). After adjusting for demographics and comorbidities, we observed a significant association (OR 1.49, 95%CI 1.37-1.62, P<.001).

Conclusion: Compared to individuals without AD, individuals with AD have 1.49-fold increased odds of having BPD. Further investigation is needed to further understand this association.

Background: Psoriasis is associated with poor mental health and reduced quality of life. Although the high risk for depression in patients with psoriasis is well-established, their suicidality risk is uncertain. Previous studies provide contrasting results and have not included patients with clinically-confirmed severe disease.

Objectives: Our aim was to determine risk of suicide among patients with moderate to severe psoriasis compared with the general population, and investigate if psychiatric comorbidity or history of suicidality increases future suicidality risk in psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients.

Methods: Analysis was performed using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). As controls, general population mortality and suicide data were used.

Results: There were 9 suicides in BADBIR. The incidence rate of suicide was 12.5 per 100,000 person-years (95% CI 6.53, 24.11) in BADBIR versus 11.0 per 100,000 person-years (95% CI 10.7, 11.3) in the general population in England and Wales. Among patients, psychiatric comorbidity or past suicidality was associated with higher risk for suicidal ideation, suicide attempts and self-injurious behaviours.

Conclusions: Suicide rates among patients with moderate to severe psoriasis were not significantly higher compared with the general population. Suicide is a rare event and our results are limited by the uncertainty in the estimate reliability. However, considering the high depression prevalence in psoriasis, our findings support the need for prompt assessment of patients for psychiatric comorbidities and suicidality history. Further research is required on suicidal behaviours and the role of psoriasis severity.