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Kaposi's sarcoma, epidemiology and clinical characteristics in a tertiary hospital, a cross-sectional study. 一家三级医院的卡波西肉瘤、流行病学和临床特征横断面研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-11 DOI: 10.1159/000545022
Fanny Carolina López Jiménez, Jorge Alberto González Torres, Sirenia Castro Molina, Andrea Malagón Liceaga, Linda García Hidalgo

Introduction: Kaposi's Sarcoma (KS) is a rare soft tissue tumor linked to human herpesvirus 8 (HHV-8), a recognized oncogenic virus. Five distinct clinical presentations have been identified, with the epidemic type being the most prevalent and notably associated with Human Immunodeficiency Virus (HIV). A delayed diagnosis significantly compromises patient prognosis and survival rates.

Methods: This article aims to describe the epidemiological and clinical characteristics of KS cases diagnosed through histological examination between 2007 and 2023 in our dermatology department, after a comprehensive review of electronic medical records.

Results: A total of 52 cases were identified, with 51 cases corresponding to the epidemic type (associated with HIV infection) and only one to the classic type. Men were predominantly affected, all cases being of the epidemic type. The most prevalent topography was the lower extremities, with nodular lesions being the most frequent morphology. Half of the cases presented as a disseminated form, while the remaining half exhibited localized manifestations. In both groups, 50% had previously undergone combined antiretroviral therapy. Gastrointestinal involvement occurred in 8 cases. No deaths were associated with KS.

Conclusions: Due to its often asymptomatic nature, KS can easily go unnoticed. Recognizing the significance of early detection is crucial, emphasizing the necessity for prompt intervention, accurate staging, and vigilant follow-up protocols.

简介卡波西肉瘤(KS)是一种罕见的软组织肿瘤,与人类疱疹病毒 8(HHV-8)这种公认的致癌病毒有关。目前已发现有五种不同的临床表现,其中流行型最为普遍,且主要与人类免疫缺陷病毒(HIV)有关。延误诊断会严重影响患者的预后和存活率:本文旨在通过全面查阅电子病历,描述 2007 年至 2023 年期间我院皮肤科通过组织学检查确诊的 KS 病例的流行病学和临床特征:结果:共发现 52 例病例,其中 51 例属于流行型(与 HIV 感染有关),只有 1 例属于典型型。男性患者居多,所有病例均为流行型。最常见的部位是下肢,最常见的形态是结节性病变。半数病例表现为播散型,其余半数表现为局部症状。两组病例中均有50%曾接受过联合抗逆转录病毒治疗。胃肠道受累的病例有 8 例。没有人因KS而死亡:结论:由于 KS 通常无症状,因此很容易被忽视。认识到早期发现的重要性至关重要,强调及时干预、准确分期和警惕随访方案的必要性。
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引用次数: 0
From the Cochrane Library: Interventions for nail psoriasis.
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-03 DOI: 10.1159/000545021
Michael J Diaz, Kaya L Curtis, Jasmine T Tran, Phyllis I Spuls, Marjorie E Montanez-Wiscovich, Shari R Lipner
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引用次数: 0
Validity of Diagnosis Codes to Identify a Dermatomyositis Cohort from Electronic Health Records.
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-25 DOI: 10.1159/000543803
Alex Silberzweig, Andrew Strunk, Elizabeth Flatley, Anthony P Fernandez, Amit Garg

Introduction: Dermatomyositis (DM) is an uncommon idiopathic inflammatory myopathy resulting in characteristic patterns of cutaneous lesions and myositis. Observational evidence related to the disease is limited by small case cohorts. We aimed to evaluate the validity of specialist-specific diagnostic coding for DM in an outpatient clinical database.

Methods: Adults having an outpatient encounter between January 1, 2010, and June 30, 2023, at a US regional health system with ICD-9/-10 coding for DM were identified. We randomly sampled 156 patients with ≥1 code applied by a dermatologist or rheumatologist. The primary reference standard for case adjudication was a confirmed diagnosis of DM by the treating physician in the medical chart. Fulfilment of the 2017 European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) criteria for "probable" or "definite" DM was used as a secondary, more stringent reference standard. Positive predictive values (PPVs) for several case definitions were calculated with 95% confidence intervals.

Results: Among eligible patients, the median age was 51.5 years, and 81% were female. Using the treating physician's diagnosis as reference, PPVs of ≥1 and ≥2 codes applied by a dermatologist were 93.2% (95% CI 82.0-98.3%) and 96.4% (82.2-99.8%), respectively. The PPVs of ≥1 and ≥2 codes from a rheumatologist were 82.0% (77.1-86.9%) and 85.8% (80.6-91.1%), respectively. At least one and at least two codes from a rheumatologist or dermatologist had PPVs of 82.1% (77.3-86.8%) and 85.7% (80.7-90.8%), respectively. The rate of confirmed cases based on EULAR/ACR criteria ranged from 44.9% to 57.1%.

Conclusion: All tested algorithms yielded an accurate case cohort with high PPV. Studies prioritizing sensitivity may use ≥1 code by dermatology or rheumatology to identify patients with DM.

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引用次数: 0
Tattoo Ink Products and Pigments 2018-2019 Upfront the New EU-REACH Regulation: Danish Golden Benchmark Study of 108 Studios and 39,687 Clients Tattooed with Inks from 109,720 Ink Bottles. 纹身油墨产品和颜料2018-19年前期EUREACH新法规:丹麦黄金基准对108个工作室和39687个客户进行了研究,他们使用了109720个墨水瓶中的墨水。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-10 DOI: 10.1159/000543455
Jørgen Serup, Bjørn Christian Severin, Esben Hammershøy

Introduction: The new EU regulation on tattoo inks in force January 2022 in a hitherto unregulated market marks a historical change. The study aim was to register tattoo inks de facto used in studios before the new EU regulation and establish a historical reference to tattoo customer exposure, ink toxicology assessment, clinical complications, and the impact on tattooing businesses.

Method: A tattooist-operated electronic system (InkBase) for ink registration required by law is used in Denmark since 2018. A local database in studios refers to a central database. Clients, sessions, ink bottles, brand name, and pigment color index (CI) are registered. Person's data protection is respected. Tracing harmful inks is possible, with public warning.

Results: Registrations from 108 studios employing about 700 tattooists were collected from March 2018 to 2019. 39,687 clients were tattooed in 50,604 sessions, using colors from 109,720 ink bottles. 10,833 were CI-labelled identifying the pigment. 98.1% of inks originated from USA. Detailed statistics on inks and pigments used are provided as a benchmark showing the spontaneous use and preference of "old" tattoo inks before the EU regulation compulsory to member states introduced dramatic restrictions difficult to follow.

Conclusions: Denmark can, having detailed ink registration enforced by law and having a commonly used electronic registration system reporting to a central server, function as an index country in future surveillance of use of tattoo inks in studios, toxicology aspects and the impact of regulatory intervention on the tattooing industry, with a large sample of data collected in 2018-2019.

背景:欧盟关于纹身墨水的新法规将于 2022 年 1 月生效,这标志着迄今为止尚无监管的市场发生了历史性变化:绘制欧盟新法规实施前工作室实际使用的数千种纹身墨水的图谱,并为纹身顾客的纹身接触、墨水毒理学评估、临床并发症以及对纹身行业的影响建立历史参考:自 2018 年起,丹麦使用由纹身师操作的电子系统(InkBase)进行法律规定的油墨登记。工作室的本地数据库与中央数据库相互参照。客户、疗程、墨水瓶、品牌名称和颜料颜色指数(CI)都会被登记。个人数据保护得到尊重。可追溯有害油墨,并向公众发出警告:从 2018 年 3 月到 2019 年,共收集了 108 家工作室约 700 名纹身师的注册信息。在 50604 个疗程中为 39687 名顾客进行了纹身,使用了 109720 瓶墨水中的颜色。其中 10833 瓶带有识别颜料的 CI 标签。98.1%的墨水来自美国。我们提供了所使用墨水和颜料的详细统计数据,以此作为基准,显示在欧盟强制成员国引入难以遵循的严格限制之前,"老式 "纹身墨水的自发使用和偏好情况:丹麦通过法律强制执行详细的墨水登记,并拥有一个向中央服务器报告的常用电子登记系统,可作为未来监测工作室纹身墨水使用情况、毒理学方面以及监管干预对纹身行业影响的指标国家,并在 2018-19 年收集大量数据样本。字数 249。
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引用次数: 0
Development and External Validation of the Hidradenitis Suppurativa Cutaneous Abscess Prediction Score-2: A Clinical Decision Support Tool for Diagnosis of Hidradenitis Suppurativa over Cutaneous Abscess. 化脓性汗腺炎皮肤脓肿预测评分-2 (HSCAPS-2)的开发和外部验证:化脓性汗腺炎皮肤脓肿诊断的临床决策支持工具。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-09 DOI: 10.1159/000543130
Amit Garg, Jonathan Koptyev, Melissa Butt, Joslyn Kirby, Andrew Strunk

Introduction: Patients with hidradenitis suppurativa (HS) experience a 10-year diagnosis delay, on average. Accordingly, time to diagnosis represents one of the greatest unmet needs in HS, which to date has not been adequately addressed. A general lack of awareness about HS in the medical community and a notable heterogeneity in clinical presentation, which is most often confused with cutaneous abscess (CA), forms the basis of poor disease recognition and diagnosis delay. Our objective was to develop and validate a prediction model for diagnosis of HS versus site-specific CA.

Methods: We performed a cross-sectional study in which the model was developed using a large clinical database and externally validated using a sample of clinical records at Penn State Health. Prediction model discrimination and calibration were evaluated using the c-statistic, calibration intercept/slope, and a flexible calibration curve.

Results: Variable selection identified 15 predictors, 7 of which remained after model simplification. The following characteristics were predictive of HS relative to site-specific CA: female sex, increasing age up to 44 years, African American race, race other than white or African American, increasing body mass index, polycystic ovarian syndrome, and acne. The c-statistic of the 7-variable model in validation was 0.77 (95% CI: 0.73-0.80). Calibration intercept and slope were 0.29 (95% CI: 0.14, 0.43) and 1.09 (95% CI: 0.90, 1.28).

Conclusion: Clinical characteristics can predict diagnosis of HS over CA in practice without reliance on a specialty-specific examination to identify disease and potentially reduce diagnosis delay.

化脓性汗腺炎(HS)患者平均诊断延迟10年。因此,诊断时间是卫生系统中最大的未满足需求之一,这一需求迄今尚未得到充分解决。医学界普遍缺乏对HS的认识,临床表现也存在明显的异质性,最常与皮肤脓肿(CA)混淆,这构成了疾病认识不佳和诊断延误的基础。我们的目的是建立和验证一个预测模型来诊断HS与部位特异性皮肤脓肿(CA)。方法:我们进行了一项横断面研究,其中使用大型临床数据库开发模型,并使用宾夕法尼亚州立大学健康中心的临床记录样本进行外部验证。采用c-统计量、校正截距/斜率和柔性校正曲线对预测模型判别和校正进行评价。结果:变量选择确定了15个预测因子,模型简化后保留了7个。与特定部位的CA相比,以下特征可预测HS:女性、年龄≥44岁、非裔美国人种族、非白人或非裔美国人种族、体重指数增加、多囊卵巢综合征和痤疮。7变量模型验证的c统计量为0.77 (95% CI 0.73 ~ 0.80)。校正截距和斜率分别为0.29 (95% CI 0.14, 0.43)和1.09 (95% CI 0.90, 1.28)。结论:临床特征可以在实践中预测HS而不是CA的诊断,而不依赖于专门的检查来识别疾病,并可能减少诊断延误。
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引用次数: 0
Exploring Health Literacy among Adults with Hidradenitis Suppurativa. 探讨成人化脓性汗腺炎患者的健康素养。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-03 DOI: 10.1159/000543286
Nicole D K Koerts, Barbara Horváth

Introduction: Health literacy plays an important role in the management of chronic and debilitating skin diseases like hidradenitis suppurativa (HS). Adequate health literacy empowers patients to understand their disease, manage it effectively, and make informed decisions about their health. Exploring the interplay between health literacy and HS is essential to improve healthcare outcomes in this population. This study aimed to assess the prevalence of limited health literacy among HS patients and its associated factors which has never been studied before.

Methods: In this epidemiological cross-sectional study, data were collected via a population-wide survey within the Lifelines Cohort Study in the Netherlands. Health literacy of participants with HS was compared to non-HS controls. The health literacy was measured using six validated questions covering functional, communicative, and critical health literacy. Associations between the characteristics of the HS group and limited health literacy were examined.

Results: Out of 56,084 adult respondents, 1,156 participants with HS were identified. The prevalence of limited functional health literacy was 24.5% in the non-HS group and 26.4% in the HS group. Our findings indicate that limited health literacy among HS patients is associated with higher body mass index (BMI) (26.9 vs. 25.8) (OR: 0.969, 95% CI: 0.941-0.998), lower education level (34.5% vs. 19.9%) (OR: 0.495, 95% CI: 0.350-0.701), lower socioeconomic status (-0.68 vs. -0.58) (OR: 1.194, 95% CI: 1.029-1.386), and more severe disease stage according to the Hurley stage (33.0% vs. 25.8%) (OR: 1.400, 95% CI: 1.005-1.952).

Conclusions: Our study highlights the importance of addressing health literacy in HS patients, given the high prevalence of limited health literacy among this group and associations with higher BMI and more severe disease stage. Limited health literacy may contribute to poorer health outcomes, suboptimal healthcare utilization, elevated healthcare costs, and health disparities. Targeted interventions to improve health literacy could enhance care quality and outcomes for HS patients.

背景:健康素养在慢性和衰弱性皮肤病如化脓性汗腺炎(HS)的管理中起着重要作用。充分的卫生知识使患者能够了解自己的疾病,有效地管理疾病,并就自己的健康做出知情决定。探索健康素养与卫生保健之间的相互作用对于改善这一人群的卫生保健结果至关重要。目的:本研究旨在评估HS患者有限健康素养的流行程度及其相关因素,这是以前从未研究过的。方法:在这项流行病学横断面研究中,通过荷兰生命线队列研究中的一项基于人口调查的研究收集了数据。将HS参与者的健康素养与非HS对照进行比较。健康素养采用六个有效问题进行测量,包括功能性、交际性和批判性健康素养。研究了HS组特征与有限健康素养之间的关系。结果:在56084名成年受访者中,有1156名参与者被确定患有HS。非HS组和HS组的有限功能健康素养患病率分别为24.5%和26.4%。我们的研究结果表明,HS患者健康知识有限与较高的BMI (26.9 vs 25.8) [OR 0.969, 95% CI 0.941-0.998]、较低的受教育程度(34.5% vs 19.9%) [OR 0.495, 95% CI 0.350-0.701]、较低的社会经济地位(-0.68 vs -0.58) [OR 1.194, 95% CI 1.029-1.386]、较严重的疾病分期(33.0% vs 25.8%) [OR 1.400, 95% CI 1.005-1.952]相关。结论:我们的研究强调了解决HS患者健康素养问题的重要性,因为这一群体中有限的健康素养非常普遍,并且与较高的BMI和更严重的疾病阶段有关。有限的健康素养可能导致较差的健康结果、次优的医疗保健利用、较高的医疗保健成本和健康差异。提高健康素养的有针对性的干预措施可以提高HS患者的护理质量和结果。
{"title":"Exploring Health Literacy among Adults with Hidradenitis Suppurativa.","authors":"Nicole D K Koerts, Barbara Horváth","doi":"10.1159/000543286","DOIUrl":"10.1159/000543286","url":null,"abstract":"<p><strong>Introduction: </strong>Health literacy plays an important role in the management of chronic and debilitating skin diseases like hidradenitis suppurativa (HS). Adequate health literacy empowers patients to understand their disease, manage it effectively, and make informed decisions about their health. Exploring the interplay between health literacy and HS is essential to improve healthcare outcomes in this population. This study aimed to assess the prevalence of limited health literacy among HS patients and its associated factors which has never been studied before.</p><p><strong>Methods: </strong>In this epidemiological cross-sectional study, data were collected via a population-wide survey within the Lifelines Cohort Study in the Netherlands. Health literacy of participants with HS was compared to non-HS controls. The health literacy was measured using six validated questions covering functional, communicative, and critical health literacy. Associations between the characteristics of the HS group and limited health literacy were examined.</p><p><strong>Results: </strong>Out of 56,084 adult respondents, 1,156 participants with HS were identified. The prevalence of limited functional health literacy was 24.5% in the non-HS group and 26.4% in the HS group. Our findings indicate that limited health literacy among HS patients is associated with higher body mass index (BMI) (26.9 vs. 25.8) (OR: 0.969, 95% CI: 0.941-0.998), lower education level (34.5% vs. 19.9%) (OR: 0.495, 95% CI: 0.350-0.701), lower socioeconomic status (-0.68 vs. -0.58) (OR: 1.194, 95% CI: 1.029-1.386), and more severe disease stage according to the Hurley stage (33.0% vs. 25.8%) (OR: 1.400, 95% CI: 1.005-1.952).</p><p><strong>Conclusions: </strong>Our study highlights the importance of addressing health literacy in HS patients, given the high prevalence of limited health literacy among this group and associations with higher BMI and more severe disease stage. Limited health literacy may contribute to poorer health outcomes, suboptimal healthcare utilization, elevated healthcare costs, and health disparities. Targeted interventions to improve health literacy could enhance care quality and outcomes for HS patients.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930877","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}
引用次数: 0
Identification of Risk Factors Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease in Psoriatic Patients. 确定与银屑病患者代谢功能障碍相关的脂肪肝风险因素。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-13 DOI: 10.1159/000541796
Kirley Küçük, Christophe Moreno, Hassane Nijmi, Mathieu Daoud, Dillon Mintoff, Fabienne Willaert, Farida Benhadou

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Conclusion: This study highlights the importance of screening patients with psoriasis for MASLD to prevent the progression to liver fibrosis.

简介代谢功能障碍相关性脂肪性肝病(MASLD)是慢性肝病的常见病因。银屑病患者罹患代谢性脂肪肝的风险增加。银屑病和脂肪性肝病具有共同的促炎细胞因子环境,但目前还不清楚这两种疾病是否通过共同的变态反应过程或共同的合并症(如肥胖、糖尿病、胰岛素抵抗和代谢综合征)而相互关联。我们的研究旨在更好地描述 MASLD 银屑病患者的人体测量和代谢特征:我们在 2014 年 6 月至 2017 年 8 月期间开展了一项前瞻性、单中心、横断面研究。招募对象仅限于成年银屑病患者。进行了血液分析、肝脏超声波检查和纤维扫描。对血液检查、基线人体测量和脂肪肝的组成部分(肝脏超声波、纤维扫描)进行了评估:结果:共招募了 100 名患者。结果:共招募了 100 名患者,其中 43%(65.1% 为男性,n=28)被确诊为 MASLD。MASLD患者的平均体重指数(BMI)明显高于非MASLD患者(27.7kg/m2 vs 30.1kg/m2,p=讨论:我们发现了在患有银屑病的 MASLD 患者中更为普遍的参数,特别是高体重指数、甘油三酯水平升高、高密度脂蛋白水平降低和 C 肽水平升高。银屑病患者和MASLD患者更有可能同时患有银屑病关节炎,尽管根据PASI衡量的银屑病病情严重程度相似:本研究强调了对银屑病患者进行MASLD筛查以防止其发展为肝纤维化的重要性。
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引用次数: 0
A Territory-Wide Follow-Up of Primary and Secondary Extramammary Paget Disease of 2 Decades: Effects of Local Disease on Survival. 二十年来对原发性和继发性乳腺外 Paget 病的全境随访--局部疾病对存活率的影响。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-01 DOI: 10.1159/000541394
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
<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><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 marg
导言:乳腺外Paget病(EMPD)是一种不常见的恶性皮肤肿瘤,分为原发性和继发性两种。在这项多中心研究中,对经组织学证实的原发性和继发性 EMPD 病例进行了临床结果回顾,并对继发性 EMPD 进行了亚组分析。方法 从相关机构二十多年来的病理报告中找出 EMPD 病例。通过病例记录、放射学和病理学报告确定继发性 EMPD 病例。检索临床病理和结果数据以进行统计分析。结果 共检索到109个病例,其中包括19个继发性EMPD病例,最常见的是与结直肠癌(6个)、肛门癌(5个)和前列腺癌(3个)相关的病例。年龄较大与继发性(相对于原发性)EMPD之间存在差异(p=0.016),但其他临床病历参数没有差异。男性(p=0.018)、60 岁以上(p=0.004)和边缘受累(可切除)(p=0.018)与较短的 OS 相关。就DSS而言,边缘受累(p=0.009)是一个不利的预测因素。继发性 EMPD 的 DSS 比原发性 EMPD 短(p=0.005)。多变量分析证实了上述所有关联(p
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引用次数: 0
Association between Hidradenitis Suppurativa and Gout: A Propensity Score-Matched Cohort Study. 化脓性扁桃体炎与痛风之间的关系:倾向分数匹配队列研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1159/000541969
Hui-Chin Chang, Tsu-Man Chiu, Ru-Yin Tsai, Chen-Pi Li, Yu-Lun Wu, Shiu-Jau Chen, Shuo-Yan Gau

Introduction: While an association between hidradenitis suppurativa (HS) and inflammatory arthritis has been reported in clinical studies, the potential link between HS and gout remains uncertain. As HS and gout share common immunological pathways, we conducted a retrospective cohort study to determine whether HS patients are at an increased risk of developing gout in the future.

Methods: This retrospective multicenter cohort study obtained information through the US collaborative network, a subset of the TriNetX research network. Patients diagnosed with HS between January 01, 2005, and December 31, 2017, were recruited, and a 1:1 propensity score matching was conducted to identify appropriate controls. The hazard ratio (HR) for the new-onset gout in HS patients was subsequently calculated.

Results: Compared to individuals without HS, those with HS were associated with a 1.39-fold higher risk (95% confidence interval [CI], 1.20, 1.62) of developing new-onset gout within 5 years after the index date. This association remained significant in shorter follow-up times and sensitivity analyses utilizing different matching models. For both male and female HS patients, the risk of developing new-onset gout within 5 years after the index date was statistically significant, with respective HRs of 1.61 (95% CI, 1.28, 2.02) for males and 1.41 (95% CI, 1.11,1.78) for females.

Conclusion: HS patients are at a high risk of developing gout within 5 years after an HS diagnosis while comparing with non-HS controls.

导言:虽然临床研究已报道化脓性扁桃体炎(HS)与炎性关节炎之间存在关联,但HS与痛风之间的潜在联系仍不确定。由于HS和痛风有共同的免疫途径,我们进行了一项回顾性队列研究,以确定HS患者将来患痛风的风险是否会增加。方法 这项回顾性多中心队列研究通过美国协作网络(TriNetX 研究网络的一个子集)获取信息。研究人员招募了2005年1月1日至2017年12月31日期间确诊为HS的患者,并进行了1:1倾向得分匹配以确定适当的对照组。随后计算了HS患者新发痛风的危险比。结果 与非HS患者相比,HS患者在指数日期后五年内新发痛风的风险高出1.39倍(95% CI,1.20,1.62)。这种关联在较短的随访时间和利用不同匹配模型进行的敏感性分析中仍然显著。对于男性和女性 HS 患者而言,在发病日期后 5 年内罹患新发痛风的风险均具有统计学意义,男性的危险比分别为 1.61(95% CI,1.28,2.02),女性的危险比分别为 1.41(95% CI,1.11,1.78)。结论 与非 HS 对照组相比,HS 患者在确诊 HS 后五年内患痛风的风险较高。
{"title":"Association between Hidradenitis Suppurativa and Gout: A Propensity Score-Matched Cohort Study.","authors":"Hui-Chin Chang, Tsu-Man Chiu, Ru-Yin Tsai, Chen-Pi Li, Yu-Lun Wu, Shiu-Jau Chen, Shuo-Yan Gau","doi":"10.1159/000541969","DOIUrl":"10.1159/000541969","url":null,"abstract":"<p><strong>Introduction: </strong>While an association between hidradenitis suppurativa (HS) and inflammatory arthritis has been reported in clinical studies, the potential link between HS and gout remains uncertain. As HS and gout share common immunological pathways, we conducted a retrospective cohort study to determine whether HS patients are at an increased risk of developing gout in the future.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study obtained information through the US collaborative network, a subset of the TriNetX research network. Patients diagnosed with HS between January 01, 2005, and December 31, 2017, were recruited, and a 1:1 propensity score matching was conducted to identify appropriate controls. The hazard ratio (HR) for the new-onset gout in HS patients was subsequently calculated.</p><p><strong>Results: </strong>Compared to individuals without HS, those with HS were associated with a 1.39-fold higher risk (95% confidence interval [CI], 1.20, 1.62) of developing new-onset gout within 5 years after the index date. This association remained significant in shorter follow-up times and sensitivity analyses utilizing different matching models. For both male and female HS patients, the risk of developing new-onset gout within 5 years after the index date was statistically significant, with respective HRs of 1.61 (95% CI, 1.28, 2.02) for males and 1.41 (95% CI, 1.11,1.78) for females.</p><p><strong>Conclusion: </strong>HS patients are at a high risk of developing gout within 5 years after an HS diagnosis while comparing with non-HS controls.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"19-26"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521338","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}
引用次数: 0
Brodalumab Is Effective for Psoriasis Patients with Difficult-To-Treat Body Regions: Results from an Observational Clinical Study. 布达鲁单抗对难以治疗身体部位的银屑病患者有效:一项观察性临床研究的结果。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-06 DOI: 10.1159/000542348
Stephanie Dauth, Ann Christina Foldenauer, Konstantin Hallmann, Christina Kunz, Anke König, Isabel Haferland, Christine Möser, Michaela Koehm, Andreas Pinter
<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><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 Psor
简介Brodalumab是一种选择性抑制白细胞介素(IL)-17受体亚基A的人类单克隆抗体,已被批准用于治疗中重度斑块状银屑病。多项临床研究已明确证实了布达鲁单抗的治疗效果。然而,对于难以治疗的身体部位,尤其是日常临床实践中的疗效数据仍然有限:在这项探索性观察临床研究中,德国的 7 个中心招募了在常规临床治疗中接受过布达鲁单抗治疗的指甲和头皮受累银屑病患者。对患者进行了 60 周的观察。共同主要终点是第12周时头皮银屑病严重程度指数(PSSI75)改善75%,第24周时指甲银屑病严重程度指数(NAPSI75)改善75%。次要终点包括一般皮肤和疾病结果评估、生活质量以及患者对治疗的满意度:结果:共纳入 87 名患者。平均年龄为 46.8 岁,70.1% 的患者为男性,平均体重指数为 28.9 kg/m²。90%以上符合疗效分析标准的患者(62 人)达到了共同主要终点:93.6%的患者在第12周达到了PSSI75,90.3%的患者在第24周达到了NAPSI75。受累体表面积中位数从基线时的14%分别降至第12周和第24周时的1.5%和1%。皮肤病生活质量指数中位数从基线时的16分分别降至第12周和第24周时的2分和1分。在为期60周的研究中,大多数患者的病情都得到了改善。布达鲁单抗的耐受性良好,患者对治疗非常满意:结论:本研究评估的结果,包括头皮和指甲症状的评估,在开始使用布达鲁单抗治疗后都有所改善。这项针对真实世界中银屑病患者的研究证明,布洛达单抗对难以治疗的身体部位具有长期临床疗效。
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