Cutaneous delayed drug hypersensitivity reactions (DHRs) are common iatrogenic events with potentially life-threatening consequences. Delayed DHRs encompass diverse phenotypes and can be classified by their distinct T-cell responses to drug antigens. Interaction between the immune receptors, human leukocyte antigen (HLA) and T-cell receptor (TCR), and the complementary antigenic peptide is required for the development of delayed DHRs. These idiosyncratic interactions can be elicited by the formation of antigenic drug-protein adducts (hapten hypothesis) or from direct interactions of drugs with the immune receptors (pharmacological interaction of drugs with immune receptors concept, altered peptide repertoire model, and altered TCR model). In addition, viral infections may play a role by providing co-stimulatory signals or enhancing TCR/HLA expression on T-cells. The associations of HLA allele polymorphisms and DHRs are phenotype and ethnicityspecific. The discovery of genetic polymorphisms associated with DHRs has provided a strategy to prevent and diagnose potentially life-threatening reactions. Recently, advances in next-generation sequencing technologies, such as the incorporation of whole-exome or whole-genome sequencing, enabled the comprehensive detection of susceptibility loci. Several HLA associations have shown clinical utility and cost-effectiveness, such as HLA-B*15:02 (carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in Han Chinese), HLA-B*58:01 (allopurinol-induced severe cutaneous adverse reactions in Han Chinese), HLA-B*57:01 (abacavir hypersensitivity reactions in Caucasians), and HLA-B*13:01 (dapsone-induced drug reaction with eosinophilia and systemic symptoms in Han Chinese). Herein, we summarize the current knowledge of the pathogenesis, antigen presentation models, and HLA associations of cutaneous delayed DHRs.
皮肤迟发性药物超敏反应（DHRs）是一种常见的先天性疾病，其后果可能危及生命。迟发性药物过敏反应包括多种表型，可根据其对药物抗原的不同 T 细胞反应进行分类。免疫受体、人类白细胞抗原（HLA）和 T 细胞受体（TCR）与互补抗原肽之间的相互作用是延迟性 DHRs 发生的必要条件。这些特异性相互作用可通过抗原药物-蛋白质加合物的形成（合体假说）或药物与免疫受体的直接相互作用（药物与免疫受体的药理相互作用概念、改变的肽库模型和改变的 TCR 模型）引起。此外，病毒感染也可能通过提供协同刺激信号或增强 T 细胞上 TCR/HLA 的表达发挥作用。HLA 等位基因多态性与 DHRs 的关联具有表型和种族特异性。发现与 DHRs 相关的基因多态性为预防和诊断可能危及生命的反应提供了一种策略。最近，下一代测序技术的进步，如全外显子组或全基因组测序的应用，使得对易感基因位点的全面检测成为可能。一些 HLA 关联已显示出临床实用性和成本效益，如 HLA-B*15:02（卡马西平诱发的 Stevens-Johnson 综合征/汉族中毒性表皮坏死）、HLA-B*58：01（在汉族人中由别嘌呤醇诱发的严重皮肤不良反应）、HLA-B*57:01（在白种人中阿巴卡韦超敏反应）和 HLA-B*13:01（在汉族人中由地塞米松诱发的伴有嗜酸性粒细胞增多和全身症状的药物反应）。在此，我们总结了目前关于皮肤迟发性 DHR 的发病机制、抗原递呈模型和 HLA 相关性的知识。
{"title":"Genetic associations of human leukocyte antigen alleles in cutaneous delayed drug hypersensitivity reactions: An updated review","authors":"Chun-Bing Chen, Chih-Chun Lee, Chuang-Wei Wang, Wei-Kai Hung, Wen-Hung Chung","doi":"10.4103/ds.ds-d-23-00082","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00082","url":null,"abstract":"<p>Cutaneous delayed drug hypersensitivity reactions (DHRs) are common iatrogenic events with potentially life-threatening consequences. Delayed DHRs encompass diverse phenotypes and can be classified by their distinct T-cell responses to drug antigens. Interaction between the immune receptors, human leukocyte antigen (HLA) and T-cell receptor (TCR), and the complementary antigenic peptide is required for the development of delayed DHRs. These idiosyncratic interactions can be elicited by the formation of antigenic drug-protein adducts (hapten hypothesis) or from direct interactions of drugs with the immune receptors (pharmacological interaction of drugs with immune receptors concept, altered peptide repertoire model, and altered TCR model). In addition, viral infections may play a role by providing co-stimulatory signals or enhancing TCR/HLA expression on T-cells. The associations of HLA allele polymorphisms and DHRs are phenotype and ethnicityspecific. The discovery of genetic polymorphisms associated with DHRs has provided a strategy to prevent and diagnose potentially life-threatening reactions. Recently, advances in next-generation sequencing technologies, such as the incorporation of whole-exome or whole-genome sequencing, enabled the comprehensive detection of susceptibility loci. Several HLA associations have shown clinical utility and cost-effectiveness, such as HLA-B*15:02 (carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in Han Chinese), HLA-B*58:01 (allopurinol-induced severe cutaneous adverse reactions in Han Chinese), HLA-B*57:01 (abacavir hypersensitivity reactions in Caucasians), and HLA-B*13:01 (dapsone-induced drug reaction with eosinophilia and systemic symptoms in Han Chinese). Herein, we summarize the current knowledge of the pathogenesis, antigen presentation models, and HLA associations of cutaneous delayed DHRs.</p>","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070223","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}
Pub Date : 2023-12-15DOI: 10.4103/ds.ds-d-23-00159
Yen-Ning Chen, Ching-Chi Chi*
Levels of evidence (LOE), also known as hierarchies of evidence, are determined primarily by the inherent bias and validity of the study designs. Understanding LOE is a crucial preliminary step in practicing evidence-based medicine (EBM) or evidence-based dermatology. These hierarchies facilitate the efficient acquisition of the best available evidence for clinicians in decision-making, as well as guiding researchers in conducting new studies with appropriate designs while considering the next higher LOE necessary to improve the quality of currently available evidence. This article provides a concise overview of LOE and study designs based on the 2011 Oxford Centre for Evidence-Based Medicine LOE for treatment benefits. We utilize examples from medical literature to elucidate the strengths and limitations of various study designs. Furthermore, we shed light on the key concepts of the updated evidence pyramid and how the EBM research roadmap functions to bridge the gap between current best evidence and clinical practice.
证据等级（LOE）又称证据层次，主要由研究设计的内在偏差和有效性决定。了解 LOE 是实践循证医学（EBM）或循证皮肤病学的重要第一步。这些分级有助于临床医生在决策过程中有效地获取最佳可用证据，并指导研究人员以适当的设计开展新的研究，同时考虑提高现有证据质量所需的下一个更高的LOE。本文以2011年牛津循证医学中心（Oxford Centre for Evidence-Based Medicine）的治疗效益LOE为基础，简要概述了LOE和研究设计。我们利用医学文献中的实例来阐明各种研究设计的优势和局限性。此外，我们还阐明了最新证据金字塔的关键概念，以及循证医学研究路线图如何发挥弥合当前最佳证据与临床实践之间差距的作用。
{"title":"Levels of evidence and study designs: A brief introduction to dermato-epidemiologic research methodology","authors":"Yen-Ning Chen, Ching-Chi Chi*","doi":"10.4103/ds.ds-d-23-00159","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00159","url":null,"abstract":"\u0000 Levels of evidence (LOE), also known as hierarchies of evidence, are determined primarily by the inherent bias and validity of the study designs. Understanding LOE is a crucial preliminary step in practicing evidence-based medicine (EBM) or evidence-based dermatology. These hierarchies facilitate the efficient acquisition of the best available evidence for clinicians in decision-making, as well as guiding researchers in conducting new studies with appropriate designs while considering the next higher LOE necessary to improve the quality of currently available evidence. This article provides a concise overview of LOE and study designs based on the 2011 Oxford Centre for Evidence-Based Medicine LOE for treatment benefits. We utilize examples from medical literature to elucidate the strengths and limitations of various study designs. Furthermore, we shed light on the key concepts of the updated evidence pyramid and how the EBM research roadmap functions to bridge the gap between current best evidence and clinical practice.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998559","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}
Pub Date : 2023-12-15DOI: 10.4103/ds.ds-d-23-00070
Nattan Stalin, Dongyup Lee, Amitesh Sharma, Shivani Devi, Jiwon Choi, Yunbhin Hwang, Young Sil Kim, Tae-Sik Park*
Atopic dermatitis (AD) is a prevalent inflammatory skin disorder characterized by skin barrier dysfunction, thymic stromal lymphopoietin (TSLP) production and an imbalance in the Th1/Th2 immune response. While numerous studies have examined the therapeutic potential of adipose-derived stem cells (ADSC) in repairing and regenerating damaged skin tissues caused by AD, the effects of membrane-free stem cell components derived from ADSC extract (ADSCE) on AD have not been investigated. The objective of this study was to investigate the alleviating effects of ADSCE on AD in mice and validate the therapeutic application of ADSCE on AD. An AD-like lesion was induced by the administration of 2,4-dinitrochlorobenzene (DNCB) on the dorsal skin of NC/Nga mice. Then, ADSCE was administered subcutaneously for 3 weeks. Dermatitis score, epidermal thickness, transepidermal water loss (TEWL), and serum levels of immunoglobulin E (IgE) were measured. Expression of the skin barrier proteins and inflammatory cytokines were measured by western blotting and quantitative real-time polymerase chain reaction. The administration of ADSCE demonstrated a significant amelioration in several skin diseases, as indicated by improvements in dermatitis score, epidermal thickness, TEWL, and total blood levels of IgE. ADSCE treatment led to an upregulation in the expression of various skin barrier proteins, including involucrin, loricrin, occludin, and zonula occludens-1. In addition, ADSCE inhibited the infiltration of mast cells and the expression of TSLP. Expression of inflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1 β, IL-4, and inducible nitric oxide synthase, was also lowered by ADSCE. The use of ADSCE resulted in enhanced skin features and exerted anti-inflammatory properties on AD-like lesions in mice.
{"title":"Membrane-free stem cell components ameliorate atopic dermatitis in 2,4-dinitrochlorobenzene-induced NC/Nga mice","authors":"Nattan Stalin, Dongyup Lee, Amitesh Sharma, Shivani Devi, Jiwon Choi, Yunbhin Hwang, Young Sil Kim, Tae-Sik Park*","doi":"10.4103/ds.ds-d-23-00070","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00070","url":null,"abstract":"\u0000 \u0000 \u0000 Atopic dermatitis (AD) is a prevalent inflammatory skin disorder characterized by skin barrier dysfunction, thymic stromal lymphopoietin (TSLP) production and an imbalance in the Th1/Th2 immune response. While numerous studies have examined the therapeutic potential of adipose-derived stem cells (ADSC) in repairing and regenerating damaged skin tissues caused by AD, the effects of membrane-free stem cell components derived from ADSC extract (ADSCE) on AD have not been investigated.\u0000 \u0000 \u0000 \u0000 The objective of this study was to investigate the alleviating effects of ADSCE on AD in mice and validate the therapeutic application of ADSCE on AD.\u0000 \u0000 \u0000 \u0000 An AD-like lesion was induced by the administration of 2,4-dinitrochlorobenzene (DNCB) on the dorsal skin of NC/Nga mice. Then, ADSCE was administered subcutaneously for 3 weeks. Dermatitis score, epidermal thickness, transepidermal water loss (TEWL), and serum levels of immunoglobulin E (IgE) were measured. Expression of the skin barrier proteins and inflammatory cytokines were measured by western blotting and quantitative real-time polymerase chain reaction.\u0000 \u0000 \u0000 \u0000 The administration of ADSCE demonstrated a significant amelioration in several skin diseases, as indicated by improvements in dermatitis score, epidermal thickness, TEWL, and total blood levels of IgE. ADSCE treatment led to an upregulation in the expression of various skin barrier proteins, including involucrin, loricrin, occludin, and zonula occludens-1. In addition, ADSCE inhibited the infiltration of mast cells and the expression of TSLP. Expression of inflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1 β, IL-4, and inducible nitric oxide synthase, was also lowered by ADSCE.\u0000 \u0000 \u0000 \u0000 The use of ADSCE resulted in enhanced skin features and exerted anti-inflammatory properties on AD-like lesions in mice.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996600","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}
Pub Date : 2023-12-15DOI: 10.4103/ds.ds-d-23-00143
Caroline Oktarina, R. Astriningrum, Aida S. D. Hoemardani, W. Budianti, Sandra Widaty, Dewi Friska
An increased frequency of hand sanitizer use and washing hands with soap seems to increase the incidence of hand eczema (HE). The aim was to analyze HE in nonmedical personnel, its severity, and the effect of hand sanitizer use on transepidermal water loss (TEWL) and skin capacitance. This observational cross-sectional study was conducted from July to September 2022. Subjects were recruited based on the study criteria with cluster random sampling method. Each subject’s identity, data related to hand sanitizer use and handwashing, atopic stigmata, and duration of HE were documented. The severity of HE was assessed with the HE Severity Index (HECSI). TEWL and skin capacitance were measured with the Tewameter® TM 300 and Corneometer® CM 825 instruments. Out of 240 subjects who were selected randomly, 24 normal subjects and 24 subjects with HE were recruited. The incidence of HE in nonmedical personnel using hand sanitizer was 10%, with a median disease duration of 22 weeks and a mean HECSI score of 9.25 ± 6.33. There was no significant difference in TEWL and skin capacitance between the groups (P > 0.05). There was no significant correlation between TEWL and skin capacitance with the HECSI score (P > 0.05). Subjects with HE washed their hands more frequently than subjects without HE (6 vs. 4.5 times per day; P 0.005). Most nonmedical personnel with HE had a mild form of the condition. There were no significant barrier function and skin hydration differences between the groups.
使用洗手液和用肥皂洗手的频率增加似乎会增加手部湿疹（HE）的发病率。 本研究旨在分析非医务人员手部湿疹的发病率、严重程度以及使用洗手液对经表皮失水（TEWL）和皮肤电容的影响。 这项横断面观察研究于 2022 年 7 月至 9 月进行。受试者是根据研究标准以整群随机抽样方法招募的。研究人员记录了每位受试者的身份、洗手液使用和洗手相关数据、特应性症状和 HE 持续时间。HE 严重性指数（HECSI）用于评估 HE 的严重程度。使用 Tewameter® TM 300 和 Corneometer® CM 825 仪器测量 TEWL 和皮肤电容。 在随机抽取的 240 名受试者中，有 24 名正常受试者和 24 名 HE 受试者。使用洗手液的非医务人员的 HE 发病率为 10%，中位病程为 22 周，HECSI 平均得分为 9.25 ± 6.33。各组之间的 TEWL 和皮肤电容无明显差异（P > 0.05）。TEWL和皮肤电容与HECSI评分无明显相关性（P > 0.05）。患有 HE 的受试者比没有 HE 的受试者洗手更频繁（每天 6 次对 4.5 次；P 0.005）。 大多数患有 HE 的非医务人员病情较轻。各组之间在屏障功能和皮肤水合作用方面没有明显差异。
{"title":"Hand eczema and its severity in nonmedical personnel: A study of the use of hand sanitizer on transepidermal water loss and skin capacitance","authors":"Caroline Oktarina, R. Astriningrum, Aida S. D. Hoemardani, W. Budianti, Sandra Widaty, Dewi Friska","doi":"10.4103/ds.ds-d-23-00143","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00143","url":null,"abstract":"\u0000 \u0000 \u0000 An increased frequency of hand sanitizer use and washing hands with soap seems to increase the incidence of hand eczema (HE).\u0000 \u0000 \u0000 \u0000 The aim was to analyze HE in nonmedical personnel, its severity, and the effect of hand sanitizer use on transepidermal water loss (TEWL) and skin capacitance.\u0000 \u0000 \u0000 \u0000 This observational cross-sectional study was conducted from July to September 2022. Subjects were recruited based on the study criteria with cluster random sampling method. Each subject’s identity, data related to hand sanitizer use and handwashing, atopic stigmata, and duration of HE were documented. The severity of HE was assessed with the HE Severity Index (HECSI). TEWL and skin capacitance were measured with the Tewameter® TM 300 and Corneometer® CM 825 instruments.\u0000 \u0000 \u0000 \u0000 Out of 240 subjects who were selected randomly, 24 normal subjects and 24 subjects with HE were recruited. The incidence of HE in nonmedical personnel using hand sanitizer was 10%, with a median disease duration of 22 weeks and a mean HECSI score of 9.25 ± 6.33. There was no significant difference in TEWL and skin capacitance between the groups (P > 0.05). There was no significant correlation between TEWL and skin capacitance with the HECSI score (P > 0.05). Subjects with HE washed their hands more frequently than subjects without HE (6 vs. 4.5 times per day; P 0.005).\u0000 \u0000 \u0000 \u0000 Most nonmedical personnel with HE had a mild form of the condition. There were no significant barrier function and skin hydration differences between the groups.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998591","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}
Pub Date : 2023-12-07DOI: 10.4103/ds.ds-d-23-00145
Yukari Woo, Suyeun Kim, Sang Hyun Cho, Hei Sung Kim
Rosacea is a common chronic skin condition. To manage rosacea long-term and prevent further flare-ups, patients need to be aware of the disease and have sound knowledge of the condition. However, few related studies have been conducted on this subject. The aim of this study was to identify rosacea awareness and knowledge among Korean rosacea patients and their means of gathering information on the disease. A prospective multicenter cross-sectional study recruited a total of 201 outpatients who were diagnosed with rosacea by a dermatologist. All were asked to complete a questionnaire asking about their demographic characteristics, rosacea awareness, and knowledge. Among 201 rosacea patients, 146 (72.6%) were unaware of the disease before their diagnosis. The median number of questions the patients correctly answered was 6 of a total of 13 questions (46%) on rosacea knowledge, implying relatively shallow knowledge on rosacea. Better understanding of rosacea was negatively associated with age (odds ratio [OR] 0.965; 95% confidence interval [CI]: 0.941 – 0.989) and positively associated with a higher education level (OR = 2.896; 95% CI: 1.379–6.082). Individuals with rosacea felt that they were getting reliable information from doctors (n = 189, 94%), followed by the Internet (n = 38, 18.9%). Overall, rosacea awareness and knowledge among Korean rosacea patients were relatively low. Detailed education, especially targeting elderly patients and those with low education levels, is necessary for better disease outcomes.
{"title":"Rosacea understanding among Korean patients: A multi-center questionnaire study","authors":"Yukari Woo, Suyeun Kim, Sang Hyun Cho, Hei Sung Kim","doi":"10.4103/ds.ds-d-23-00145","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00145","url":null,"abstract":"\u0000 \u0000 \u0000 Rosacea is a common chronic skin condition. To manage rosacea long-term and prevent further flare-ups, patients need to be aware of the disease and have sound knowledge of the condition. However, few related studies have been conducted on this subject.\u0000 \u0000 \u0000 \u0000 The aim of this study was to identify rosacea awareness and knowledge among Korean rosacea patients and their means of gathering information on the disease.\u0000 \u0000 \u0000 \u0000 A prospective multicenter cross-sectional study recruited a total of 201 outpatients who were diagnosed with rosacea by a dermatologist. All were asked to complete a questionnaire asking about their demographic characteristics, rosacea awareness, and knowledge.\u0000 \u0000 \u0000 \u0000 Among 201 rosacea patients, 146 (72.6%) were unaware of the disease before their diagnosis. The median number of questions the patients correctly answered was 6 of a total of 13 questions (46%) on rosacea knowledge, implying relatively shallow knowledge on rosacea. Better understanding of rosacea was negatively associated with age (odds ratio [OR] 0.965; 95% confidence interval [CI]: 0.941 – 0.989) and positively associated with a higher education level (OR = 2.896; 95% CI: 1.379–6.082). Individuals with rosacea felt that they were getting reliable information from doctors (n = 189, 94%), followed by the Internet (n = 38, 18.9%).\u0000 \u0000 \u0000 \u0000 Overall, rosacea awareness and knowledge among Korean rosacea patients were relatively low. Detailed education, especially targeting elderly patients and those with low education levels, is necessary for better disease outcomes.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590662","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}
Pub Date : 2023-11-30DOI: 10.4103/ds.ds-d-23-00110
Jui-Wen Yeh, Chao-Chun Yang
{"title":"Upadacitinib for the treatment of alopecia areata – A case report","authors":"Jui-Wen Yeh, Chao-Chun Yang","doi":"10.4103/ds.ds-d-23-00110","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00110","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139199777","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}
Whether patients with vitiligo have an increased risk of thyroid cancer remained controversial.
Objectives:
To study the risk of developing thyroid cancer among vitiligo patients using meta-analysis.
Methods:
This meta-analysis was performed via a literature review of four databases (Web of Science, Embase, PubMed, and Cochrane Library) from their respective inception till February 17, 2023. Relevant reviews and the bibliographies of eligible studies were also scrutinized. During searching in databases, no filter was placed regarding the language or geography of the study. Only observational studies presenting with adjusted risk estimates were eligible for meta-analysis. The random-effects model was employed for performing this meta-analysis.
Results:
Four studies with 200,629 vitiligo patients and 404,124 nonvitiligo controls were included in this meta-analysis, and patients with vitiligo were found to have an elevated risk of thyroid cancer (pooled relative risk, 1.341; 95% confidence interval, 1.083–1.661).
Conclusion:
Our systematic review and meta-analysis found that vitiligo patients are at a slightly elevated risk of thyroid cancer, although the exact underlying mechanisms remain unclear. Even though the evidence is limited, clinicians should not ignore the possible susceptibility of developing thyroid malignancy among vitiligo patients.
{"title":"Risk of thyroid cancer among patients with vitiligo: A systematic review and meta-analysis","authors":"Yi-Rong Li, Ting-An Chang, Jen-Hung Wang, Li-Yu Chen, Jing-Wun Lu, Ching-Hui Loh, Tai-Li Chen","doi":"10.4103/ds.ds-d-23-00089","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00089","url":null,"abstract":"<h3>Background: </h3>\u0000<p>Whether patients with vitiligo have an increased risk of thyroid cancer remained controversial.</p>\u0000<h3>Objectives: </h3>\u0000<p>To study the risk of developing thyroid cancer among vitiligo patients using meta-analysis.</p>\u0000<h3>Methods: </h3>\u0000<p>This meta-analysis was performed via a literature review of four databases (Web of Science, Embase, PubMed, and Cochrane Library) from their respective inception till February 17, 2023. Relevant reviews and the bibliographies of eligible studies were also scrutinized. During searching in databases, no filter was placed regarding the language or geography of the study. Only observational studies presenting with adjusted risk estimates were eligible for meta-analysis. The random-effects model was employed for performing this meta-analysis.</p>\u0000<h3>Results: </h3>\u0000<p>Four studies with 200,629 vitiligo patients and 404,124 nonvitiligo controls were included in this meta-analysis, and patients with vitiligo were found to have an elevated risk of thyroid cancer (pooled relative risk, 1.341; 95% confidence interval, 1.083–1.661).</p>\u0000<h3>Conclusion: </h3>\u0000<p>Our systematic review and meta-analysis found that vitiligo patients are at a slightly elevated risk of thyroid cancer, although the exact underlying mechanisms remain unclear. Even though the evidence is limited, clinicians should not ignore the possible susceptibility of developing thyroid malignancy among vitiligo patients.</p>","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070019","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}
Pub Date : 2023-11-22DOI: 10.4103/ds.ds-d-23-00107
Chang-Yu Hsieh, Tsen-Fang Tsai
{"title":"Treatment responses of four different biologics in a patient with recurrent generalized pustular psoriasis harboring IL36RN mutation","authors":"Chang-Yu Hsieh, Tsen-Fang Tsai","doi":"10.4103/ds.ds-d-23-00107","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00107","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247218","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}
Pub Date : 2023-11-20DOI: 10.4103/ds.ds-d-23-00075
Hsin-Yu Huang, Chao-Chun Yang
{"title":"Anatomical distribution of basal cell carcinoma and squamous cell carcinoma in the Taiwanese population","authors":"Hsin-Yu Huang, Chao-Chun Yang","doi":"10.4103/ds.ds-d-23-00075","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00075","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256119","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}
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