Dermatology最新文献

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicles in the apocrine gland-bearing areas of the body. The global HS prevalence has been reported in the range of 0.00033-4.1%. It is reportedly rarer in Asia.

Methods: The study aimed to establish the prevalence of hidradenitis suppurativa (HS) in a Sri Lankan hospital setting. An explorative, cross-sectional, descriptive study was done on a sample of accompanying healthy persons to patients at Base Hospital, Balangoda, Sri Lanka. The study was conducted over a 6-month period (November 1st, 2022, to April 30th, 2023) and was a part of the Global Hidradenitis Suppurativa Atlas (GHiSA) initiative. The data were collected using validated self-administered questionnaire. When the questionnaire indicated HS (screen-positive), the study participant was referred to the consultant dermatologist, who examined the individual and confirmed the final diagnosis based on three obligatory diagnostic criteria (i.e., typical lesion, typical topography, and the chronicity and recurrence).

Results: Of 993 participants, the prevalence of HS was 0.2 (95% confidence interval 0.06%-0.73%). The difference in median age between two groups (i.e., individuals with HS - positive group and the control group) was statistically significant (p = 0.01802). The HS group was relatively younger with a median age of 26.5 (23.8-29.3) years, while that of the control group was 54.0 (48.0-59.0).

Conclusion: Hidradenitis suppurativa is rare in Sri Lanka as in other Asia-pacific countries.

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent and debilitating skin disease, with a poorly understood global burden. The prevalence of HS in Belgium is not yet known. We aimed to determine the prevalence of the disease in the Belgian context and validate a screening questionnaire.

Materials and methods: Conducted as part of the Global Hidradenitis Suppurativa Atlas (GHiSA) initiative, this monocenter cross-sectional study involved 500 healthy adults accompanying patients at the Erasme Hospital in Brussels. Participants gave their consent and completed a screening questionnaire. All screen-positive and a subset of some screen-negative participants underwent clinical examination by a dermatologist. The severity of the disease was assessed using the Hurley staging.

Results: The prevalence of HS in the sample was 1.6% (8/500; 95% Cl: 0.81%-3.13%). There were no statistically significant demographic differences between the group control and the HS group. The screening questionnaire demonstrated a sensitivity of 100%, a specificity of 89%, a positive predictive value of 56% and a negative predictive value of 100%. Most of the patients diagnosed with HS were Hurley I (6/8) and the axilla was the most affected area.

Conclusion: The study uncovered a 1.6% prevalence of HS among a cohort of 500 Belgian participants and contributed to the GHiSA project. The high sensitivity and specificity of the screening questionnaire suggests it is an effective tool for detecting HS in the general population.

Introduction: The knowledge of the epidemiology of hidradenitis suppurativa (HS) in Germany is currently insufficient. This study aimed to determine the prevalence of HS in Darmstadt, Germany, and contribute to the Global Hidradenitis Suppurativa Atlas (GHiSA).

Methods: This monocentric, cross-sectional study was conducted at the Klinikum Darmstadt, Germany, from January to February 2024. Data from 519 healthy accompanying adults were included after obtaining oral and written consent. A validated screening questionnaire, used as an index test before clinical examination, was performed on screening-positive and randomly selected screening-negative participants as a reference test.

Results: The prevalence of HS in Darmstadt, Germany, was 1.16% (6/519; confidence interval: 0.95: 0.53%-2.50%). The HS group had a median age of 37.5 years and a median BMI of 32.5. No predominance of sex or smoking status could be found in the HS group and there were no statistical differences between the groups in sex, age, or smoking status. However, the median BMI was significantly higher in the HS group.

Conclusion: The study found the prevalence of HS in Darmstadt, Germany, to be 1.16%, which is significantly higher than previously reported rates in Germany. This study found an association between BMI and HS. However, it did not observe the previously reported association between HS and sex or smoking status. The questionnaire used is a valid screening tool for HS in the assessment of the general population.

Introduction: Hidradenitis suppurativa (HS) is a chronic, debilitating condition that is underrecognized and poorly managed in South Africa. Hence, this study aimed to determine the prevalence of HS in KwaZulu-Natal, South Africa.

Methods: This multicenter, explorative, cross-sectional, and descriptive study was conducted on 500 persons accompanied by patients in a tertiary and private hospital in Ethekwini, KZN, South Africa, from 6th February to 16th March 2023. After obtaining consent, they were screened by a physician for HS on a validated questionnaire comprising questions for the presence of recurrent painful deep-seated boils in the axillae, breasts, groins, or perineum. Screened positive and selected (10%) negative persons were re-examined by a dermatologist. Relevant data on demographics, smoking, and body mass index (BMI) were also collected.

Results: From 500 participants, 9 were confirmed as HS and the point prevalence was 1.8%. The HS group comprised 8 females and 1 male, with a median interquartile range age of 36 years (IQR 29-42) and BMI of 27.3 kg/m2 (IQR 26.8-29.9). Four HS patients were of African ethnic origin (44.4%), and 5 were of Asian ethnic origin (55.6%). The majority of HS cases were graded as Hurley stage I (7/9 cases) and 2 were Hurley stage III. The sensitivity from the HS questionnaire was 100% and the specificity was 80%. The positive predictive value was 0.4 while the negative predictive value was 1.0.

Conclusion: The prevalence of HS in KwaZulu-Natal South Africa is 1.8%, with those of African and Indian ethnicity being more predisposed.

Introduction: Oral isotretinoin is the only effective treatment for severe acne without an alternative. Isotretinoin has been linked to the occurrence of acute psychiatric disorders outside suicidal behaviors. There are few large-scale epidemiological studies in this area, and the putative associations are unclear. Our objective was to determine whether adolescents and young adults have an elevated risk of acute-onset psychiatric disorder requiring hospital treatment within 2 months of starting isotretinoin treatment.

Methods: Our data source was the French national health insurance database (Système National des Données de Santé, SNDS), 2010-2015. We performed a case-time-control study nested in an exhaustive, nationwide cohort of all French adolescents and young adults aged 10-25 years treated with isotretinoin. The outcome was an acute-onset psychiatric disorder requiring hospitalization (including anxiety, depressive, mood, adjustment, and psychotic disorders). A conditional logistic model was used to estimate odds ratios (ORs) with their 95% confidence interval (CI) for acute psychiatric events.

Results: 2,284 acute-onset psychiatric disorder requiring hospitalization were recorded for the study population of 262,786 patients. Among the patients with at least one psychiatric event, 88 had started taking isotretinoin in the risk period (0-2 months before the date of the event), versus 81 in the reference period (2-4 months before the event). A comparison with the 383 and 355 time-trend matched controls who started taking isotretinoin in the risk and reference periods, respectively, yielded a case-time-control OR (95% CI) of 1.01 (0.72-1.41).

Conclusion: Psychiatric events managed outside the hospital system were not recorded. Our findings are reassuring for clinicians concerning the risk of severe acute-onset psychiatric events after isotretinoin initiation.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent boils or abscesses. Its prevalence varies globally, yet specific data from Poland are limited. This study aimed to determine the prevalence of HS among adults in Poland, utilizing standardized methods as part of the Global Hidradenitis Suppurativa Atlas (GHiSA) initiative.

Methods: This monocenter study was conducted at the Internal Medicine Departments of University Hospital of Wroclaw. In the study, participants were individuals accompanying patients administered to the hospital, excluding individuals under 18 years old, pregnant women, and those deemed incapable of participating. A self-administered screening questionnaire for HS diagnosis was utilized. Physical examinations and Hurley score assessments were conducted for participants reporting HS symptoms. In addition, approximately 10% of participants who did not report any HS symptoms were tested to determine the false-negative response rate. Statistical analysis was performed using R Project for Statistical Computing and Statistica 13.3 software.

Results: Out of 940 adults approached, 932 participated in the study. 21 participants reported HS symptoms, with 14 individuals diagnosed with HS upon examination. Additionally, 1 participant without reported symptoms was diagnosed with HS. The estimated prevalence of HS among the Polish adult population was 1.61% (95% CI: 0.90-2.50%). The screening questionnaire exhibited a sensitivity and specificity of 93%, with a positive predictive value of 67% and a negative predictive value of 99%.

Conclusion: This study shed some light on the prevalence of HS in Poland, indicating that it is a more common condition than previously reported in the literature. It can contribute to understanding the epidemiology of HS in Poland and may aid in improving diagnosis and management strategies for affected individuals.

Introduction: Migration is an increasing phenomenon and associated with a physical and psychosocial burden on individuals. Little is known about migration and skin health. The objective of this study was to describe the characteristics of patients regarding migration background and dermatological morbidity among adults seen in a dermatological out-patient clinic in Malmö, Sweden.

Methods: An observational cross-sectional study was performed in 2017. Dermatological out-patients completed questionnaires and were examined by a dermatologist. Sociodemographic variables including ethnicity and migration status were assessed by self-report. Ethnicity was assessed with country of birth. General and physical health and details about skin disease were self-reported. Stress was assessed by the Perceived Stress Scale (PSS) and with items assessing stressful life events and economic difficulties. Depression and anxiety were assessed with the Patient Health Questionnaire-2 (PHQ-2) and the General Anxiety Disorder Assessment-2 (GAD-2).

Results: 250 patients were included. 24% were foreign-born (FB) reporting 41 different countries of birth. Mean duration of living in Sweden was 24.4 years. Compared to non-foreign-born (NFB) patients, FB patients were more stressed (PSS mean 17.5 vs. 15.3, p = 0.044), had more economic difficulties (31.0% vs. 14.6%, p = 0.005) and more anxiety (39.7% vs. 24.9%, p = 0.03). There were significantly fewer patients with psoriasis in FB and more with connective tissue disease. FB rated skin disease severity significantly higher than NFB patients.

Conclusion: This study reports the multi-ethnic population in an out-patient dermatological clinic in Malmö, Sweden and the difference in distribution of dermatological conditions among FB patients and NFB patients as well as the burden of disease, with higher levels of stress and anxiety in FB patients. These issues will be investigated further by our group in a larger multicentre study.

Introduction: Psoriasis is associated with lung diseases, but there have been no studies on full pulmonary function tests (PFTs) in patients with psoriasis. The aim of this study was to compare pulmonary function measurements in patients with psoriasis and controls.

Methods: Sixty-eight patients with psoriasis and sixty-eight sex- and age-matched controls fulfilling the inclusion criteria were included in this study. Spirometric PFT, body plethysmography, and diffusion capacity for carbon monoxide (DLCO) testing were performed on all study participants.

Results: The mean forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio was significantly lower in the psoriasis patients than in the controls (98 ± 6.6 vs. 100.3 ± 3.2, p < 0.05). In the subgroup analysis, the FEV1/FVC ratio in non-smoking and non-obese subjects was significantly lower in psoriasis patients than controls (98.2 ± 5 vs. 100.6 ± 2.7; p < 0.05 and 98 ± 6.8 vs. 100 ± 3.1; p < 0.05, respectively). There was no statistically significant difference in body plethysmography or the DLCO test parameters between groups.

Conclusion: Psoriasis patients had a lower mean FEV1/FVC ratio compared to the control subjects. The FEV1/FVC ratio was independently associated with the presence of psoriasis.