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Ehlers-Danlos Syndromes and Related Disorders: Diagnostic Challenges and the Need for an Interdisciplinary Patient Care in Germany. 埃勒-丹洛斯综合征和相关疾病:诊断挑战和需要跨学科的病人护理在德国。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-12-10 DOI: 10.1159/000542026
Nikolaus Kernich, Franziska Peters, Julia Schreml, Oliver Semler, Manuel Koch, Eckhard Schönau, Michael Huntgeburth, Peer Eysel, Thomas Krieg, Esther von Stebut-Borschitz, Iliana Tantcheva-Poór

Introduction: Ehlers-Danlos syndromes (EDS) represent a group of heritable connective tissue disorders characterized by skin hyperelasticity, joint hypermobility and generalized tissue fragility. Many patients remain undiagnosed years after initial symptoms and an accurate diagnosis is difficult despite all efforts. Currently, Germany lacks a patient registry and a specialized EDS centre.

Methods: In early 2020, a dermatological-orthopaedic EDS outpatient service was established at the University Hospital of Cologne. Medical records of all patients presenting in 2020 were retrospectively analysed.

Results: Forty-three adults were examined. Fifteen patients were diagnosed with EDS (different types), 13 with hypermobility spectrum disorder, and 1 with likely Loeys-Dietz syndrome (LDS) based on patient history and a suspicious variant in the gene TGFBR1. Excluding hypermobile EDS (6 patients), molecular confirmation was achieved in a total of 4 of 9 patients. The combination of symptomatic generalized hypermobility and skin manifestations was diagnostic in more than two-thirds of the EDS patients. Arterial involvement (aneurysms, dissection and rupture) and distinctive cutaneous signs (thin translucent skin with haematomas) indicated vascular EDS and LDS in altogether 3 patients.

Conclusion: With the present analysis, we discuss our diagnostic approach in patients with a suspected diagnosis of EDS in order to raise awareness of this rare group of genodermatoses and review recent developments in EDS nosology.

简介:ehers - danlos综合征(EDS)是一组遗传性结缔组织疾病,其特征是皮肤过度弹性、关节过度活动和全身组织脆弱。许多患者在出现最初症状数年后仍未得到诊断,尽管做出了所有努力,但准确诊断仍很困难。目前,德国缺乏患者登记和专门的EDS中心。方法:2020年初,在科隆大学医院建立了皮肤科骨科EDS门诊。回顾性分析2020年所有患者的医疗记录。结果:共检查43例成人。根据患者病史和TGFBR1和TGFBR1基因的可疑变异,15例患者被诊断为EDS(不同类型),13例患有多动谱系障碍(HSD), 1例可能患有Loeys-Dietz综合征(LDS)。排除过度移动EDS(6例),9例患者中有4例获得分子确证。在超过三分之二的EDS患者中,症状性全身性多动和皮肤表现的结合是诊断性的。动脉受累(动脉瘤,夹层和破裂)和独特的皮肤征象(薄半透明的皮肤有血肿)表明血管性EDS和LDS共3例。结论:通过本文的分析,我们讨论了疑似EDS患者的诊断方法,以提高人们对这一罕见的遗传性皮肤病的认识,并回顾了EDS分类学的最新进展。
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引用次数: 0
Perineural Invasion for Risk Stratification in Cutaneous Squamous Cell Carcinoma: A Scoping Review. 用于皮肤鳞状细胞癌风险分层的神经周围侵犯:范围界定综述。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-27 DOI: 10.1159/000542772
Emmy C Crüts, Myrthe M G Moermans, Myrurgia Abdul Hamid, Patty J Nelemans, Klara Mosterd

Background: Microscopic perineural invasion (mPNI) is a histopathological characteristic that can be found in cutaneous squamous cell carcinoma (cSCC). In the eighth edition of the American Joint Committee on Cancer (AJCC), mPNI defined as the involvement of nerves ≥0.1 mm and nerves deeper than the dermis is included in risk stratification of cSCC. The question remains whether other mPNI features are important for optimal cSCC staging. We aimed to summarize the evidence from published studies on the independent association between various mPNI features and the risk of recurrence, metastasis and disease-specific death in patients with cSCC.

Summary: Embase, PubMed, and Web of Science were searched from January 2023 to February 2024 to identify studies that reported the prognostic impact of mPNI features in patients ≥18 years with histopathologically verified cSCC. Data on study and tumour characteristics were extracted. Nineteen studies met the inclusion criteria and evaluated one or more mPNI features in cSCC including nerve diameter, the extent of mPNI, the number of affected nerves, and depth of mPNI. Two studies provided evidence that "mPNI ≥0.1 mm" and "mPNI deeper than the dermis" are significantly and independently associated with poor prognosis after correction for other mPNI features and high-risk factors. One of these studies additionally identified "involvement of ≥3 nerves" as an independent and significant predictor of higher risk of local recurrence (HR, 2.17; 95% CI: 1.03-4.56; p = 0.04).

Key messages: Besides "nerve diameter of ≥0.1 mm" and "depth of mPNI involvement," "involvement of multiple nerves" was found to be an independent risk factor for poor prognosis and should also be considered for appropriate risk stratification.

导言:显微镜下神经周围侵犯(mPNI)是皮肤鳞状细胞癌(cSCC)的一种组织病理学特征。在第八版美国癌症联合委员会(AJCC)中,mPNI 被定义为神经受累≥0.1 毫米且神经深度超过真皮层,被纳入 cSCC 的风险分层中。问题是,mPNI 的其他特征对于 cSCC 的最佳分期是否重要。我们旨在总结已发表研究的证据,这些研究涉及各种 mPNI 特征与 cSCC 患者的复发、转移和疾病特异性死亡风险之间的独立关联:方法:在2023年1月至2024年2月期间,对Embase、PubMed和Web of Science进行检索,以确定报道了mPNI特征对组织病理学确诊的≥18岁cSCC患者预后影响的研究。结果:19 项研究符合纳入标准:19项研究符合纳入标准,并评估了cSCC的一个或多个mPNI特征,包括神经直径、mPNI范围、受累神经数量和mPNI深度。两项研究证明,在校正了其他mPNI特征和高危因素后,"mPNI≥0.1毫米 "和 "mPNI深度超过真皮层 "与预后不良有显著的独立相关性。其中一项研究还发现,"累及≥3条神经 "是局部复发风险较高的独立重要预测因素(HR,2.17;95% CI,1.03-4.56;P=0.04):结论:除了 "神经直径≥0.1毫米 "和 "mPNI受累深度 "外,"多条神经受累 "也是预后不良的独立风险因素,在进行适当的风险分层时也应加以考虑。
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引用次数: 0
Using Smartphone Data to Frequently Measure Atopic Dermatitis Severity and Understand Triggers: A Decentralized 12-Week Observational Study. 利用智能手机数据频繁测量特应性皮炎的严重程度并了解诱发因素:一项为期 12 周的分散观察研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-25 DOI: 10.1159/000542771
Zarqa Ali, Johan Anker Chrom Allerup, Anders Daniel Andersen, Justin M Ko, John R Zibert, Simon Francis Thomsen

Introduction: Atopic dermatitis (AD) severity is traditionally evaluated during in-office consultations; however, this does not provide continuous monitoring and any intermittent flare/remission cycles are usually not recorded. The aim was to apply smartphone technology to evaluate AD severity, to explore if severity based on highly frequent sampling of photographs is associated with patient reported outcomes, and to investigate disease fluctuations and trigger associations based on passively collected environmental data.

Methods: In this 12-week decentralized observational study, adult patients with AD were recruited online and used a tailored remote clinical trial platform app to perform all study tasks including capturing photographs and completing the Patient-Oriented Eczema Measure (POEM) weekly. AD severity was assessed based on photographs using the Eczema Area and Severity Index (EASI) and Scoring Atopic Dermatitis (SCORAD). Geographical location collected in the app was used to retrieve data on ambient temperature and carbon monoxide (CO), a common air pollutant.

Results: A total of 42 patients (35 women) were recruited online. A total of 712 photographs were taken, with an average of 17 photographs per participant. Photographic SCORAD (r = 0.450) and EASI (r = 0.206) were significantly associated with subjective severity POEM. Patients experiencing AD fluctuation (n = 10) based on SCORAD had significantly higher risk of also having a psychiatric disorder (60 vs. 17%, p = 0.008). Anxiety was significantly associated with disease fluctuation based on EASI (40 vs. 7%, p = 0.01), and a tendency was observed for depression (40 vs. 13%, p = 0.06). Decreasing temperature was significantly associated with higher POEM (estimate -0.18, p = 0.012) and EASI score (estimate -0.14, p = 0.007), but not with SCORAD. High levels of CO were significantly associated with higher SCORAD (estimate 15.9, p < 0.001).

Conclusion: In this small study with a predominance of young adults, primarily women, we were able to recruit patients and monitor AD entirely remotely via smartphone-enabled photographic assessments; patients reported outcomes and passively collected environmental data without physical contact between patient and investigator.

导言:特应性皮炎(AD)的严重程度传统上在诊室咨询时进行评估;但是,这并不能提供连续监测,而且通常不会记录任何间歇性发作/缓解周期。我们的目的是应用智能手机技术评估过敏性皮炎的严重程度;探讨基于高频率照片采样的严重程度是否与患者报告的结果相关,并根据被动收集的环境数据调查疾病波动和诱发因素的关联。方法 在这项为期 12 周的分散式观察研究中,我们在线招募了患有注意力缺失症的成年患者,他们使用定制的远程临床试验平台应用程序来完成所有研究任务,包括每周拍摄照片和完成以患者为导向的湿疹测量(POEM)。根据照片,使用湿疹面积和严重程度指数(EASI)和SCORing特应性皮炎(SCORAD)评估特应性皮炎的严重程度。应用中收集的地理位置信息用于检索环境温度和常见空气污染物一氧化碳 (CO) 的数据。结果 共在线招募了 42 名患者(35 名女性)。共拍摄了 712 张照片,平均每位参与者拍摄 17 张照片。照片 SCORAD(r=0.450)和 EASI(r=0.206)与主观严重程度 POEM 显著相关。根据 SCORAD,出现注意力缺失症波动的患者(10 人)同时患有精神障碍的风险明显更高(60% 对 17%,P=0.008)。根据 EASI,焦虑与疾病波动明显相关(40 对 7%,P=0.01),抑郁也有相关趋势(40 对 13%,P=0.06)。体温下降与较高的 POEM(估计值-0.18,p=0.012)和 EASI 评分(估计值-0.14,p=0.007)明显相关,但与 SCORAD 无关。高浓度 CO 与较高的 SCORAD 有明显相关性(估计值为 15.9,p=0.012)。
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引用次数: 0
Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study. 土耳其化脓性扁桃体炎的临床特征和自然病程:一项多中心研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-21 DOI: 10.1159/000542670
Erkan Alpsoy, Bilge Fettahlıoglu Karaman, Duriye Deniz Demirseren, S Levent Cınar, Nida Kacar, Aylin Türel Ermertcan, Emel Bulbul Baskan, Derya Ucmak, Kifayet Mammadli, Fadime Kılınc, Serkan Yazici, Selami Aykut Temiz, Tugba Özkök Akbulut, Arzu Ataseven, Aysun Şikar Aktürk, Hayriye Sarıcaoğlu, Meltem Türkmen, Fatmagül Gülbaşaran, Burhan Engin, Hatice Kaya Özden, Koray Durmaz, Müge Güler Özden, Hilal Özdemir, Bengü Çevirgen Cemil, Sezgi Sarıkaya Solak, Serap Günes Bilgili, İbrahim Halil Yavuz, Göknur Özaydın Yavuz, Münevver Güven, Algün Polat Ekinci, Tuğba Atcı, Didem Didar Balci, Aylin Oztürk, İlknur Kıvanç Altunay, Ezgi Özkur, Ece Ugurer, Ayse Serap Karadag, Göknur Kalkan, Sevilay Kılıc, Bilgen Erdoğan, Savas Yayli, Leyla Baykal Selçuk, Levent Dönmez, Aslı Bilgic

Introduction: The natural history, the progression of a disease process in an individual over time, has not yet been fully elucidated in hidradenitis suppurativa (HS). In this large multicenter study, we aimed to investigate the natural history of HS and its gender differences.

Methods: This cross-sectional study included 827 patients. The chronological order of the clinical manifestations for each patient was recorded retrospectively. Sociodemographic characteristics, triggering factors, clinical, treatment, and prognostic features were also evaluated.

Results: The mean age of disease onset was significantly younger in women than in men (22.42 ± 9.28 vs. 27.06 ± 20.56, p < 0.001) and those with a family history (p < 0.0001). The mean disease duration was 91.17 ± 83.64 months. The most common symptom was purulent discharge (81%). The mean duration of abscess was shorter in women than in men (3.11 ± 2.65 vs. 3.75 ± 3.75, p = 0.01). The axilla was the most common onset area followed by the inguinal and gluteal regions. The disease ran a more severe course in men. Abscess/inflammatory nodule was defined in the last 6 months in 88.6% of the patients; however, the first 5 years of the disease were the most active disease period in 67.5% of the patients. Multivariate analysis revealed being male, older age, family history, involvement of the axillary, inguinal, and perianal regions independently associated with HS severity. While antibiotic use was the most important factor in improving the disease symptoms, stress was the most common aggravating factor. Biological therapy in men, laser epilation and pregnancy in women were significant alleviating factors, whereas weight gain was a more common aggravating factor for women.

Conclusion: HS shows a relentlessly progressive course with inflammatory attacks, but the first years of the disease are the most active period. This study confirms that environmental and hormonal factors may play an important role in the disease course, probably with other endogenous or exogenous factors.

导言:化脓性扁桃体炎(HS)的自然病史,即疾病在个体身上随时间推移而发展的过程,尚未完全阐明。在这项大型多中心研究中,我们旨在调查化脓性扁桃体炎的自然病史及其性别差异:这项横断面研究包括 827 名患者。回顾性记录了每位患者临床表现的时间顺序。研究还评估了社会人口学特征、诱发因素、临床、治疗和预后特征:结果:女性的平均发病年龄明显小于男性(22.42±9.28 vs. 27.06±20.56,p):HS的病程呈无情的进行性发展,并伴有炎症发作,但疾病的最初几年是最活跃的时期。这项研究证实,环境和激素因素可能在病程中起着重要作用,可能还有其他内源性或外源性因素。
{"title":"Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study.","authors":"Erkan Alpsoy, Bilge Fettahlıoglu Karaman, Duriye Deniz Demirseren, S Levent Cınar, Nida Kacar, Aylin Türel Ermertcan, Emel Bulbul Baskan, Derya Ucmak, Kifayet Mammadli, Fadime Kılınc, Serkan Yazici, Selami Aykut Temiz, Tugba Özkök Akbulut, Arzu Ataseven, Aysun Şikar Aktürk, Hayriye Sarıcaoğlu, Meltem Türkmen, Fatmagül Gülbaşaran, Burhan Engin, Hatice Kaya Özden, Koray Durmaz, Müge Güler Özden, Hilal Özdemir, Bengü Çevirgen Cemil, Sezgi Sarıkaya Solak, Serap Günes Bilgili, İbrahim Halil Yavuz, Göknur Özaydın Yavuz, Münevver Güven, Algün Polat Ekinci, Tuğba Atcı, Didem Didar Balci, Aylin Oztürk, İlknur Kıvanç Altunay, Ezgi Özkur, Ece Ugurer, Ayse Serap Karadag, Göknur Kalkan, Sevilay Kılıc, Bilgen Erdoğan, Savas Yayli, Leyla Baykal Selçuk, Levent Dönmez, Aslı Bilgic","doi":"10.1159/000542670","DOIUrl":"10.1159/000542670","url":null,"abstract":"<p><strong>Introduction: </strong>The natural history, the progression of a disease process in an individual over time, has not yet been fully elucidated in hidradenitis suppurativa (HS). In this large multicenter study, we aimed to investigate the natural history of HS and its gender differences.</p><p><strong>Methods: </strong>This cross-sectional study included 827 patients. The chronological order of the clinical manifestations for each patient was recorded retrospectively. Sociodemographic characteristics, triggering factors, clinical, treatment, and prognostic features were also evaluated.</p><p><strong>Results: </strong>The mean age of disease onset was significantly younger in women than in men (22.42 ± 9.28 vs. 27.06 ± 20.56, p < 0.001) and those with a family history (p < 0.0001). The mean disease duration was 91.17 ± 83.64 months. The most common symptom was purulent discharge (81%). The mean duration of abscess was shorter in women than in men (3.11 ± 2.65 vs. 3.75 ± 3.75, p = 0.01). The axilla was the most common onset area followed by the inguinal and gluteal regions. The disease ran a more severe course in men. Abscess/inflammatory nodule was defined in the last 6 months in 88.6% of the patients; however, the first 5 years of the disease were the most active disease period in 67.5% of the patients. Multivariate analysis revealed being male, older age, family history, involvement of the axillary, inguinal, and perianal regions independently associated with HS severity. While antibiotic use was the most important factor in improving the disease symptoms, stress was the most common aggravating factor. Biological therapy in men, laser epilation and pregnancy in women were significant alleviating factors, whereas weight gain was a more common aggravating factor for women.</p><p><strong>Conclusion: </strong>HS shows a relentlessly progressive course with inflammatory attacks, but the first years of the disease are the most active period. This study confirms that environmental and hormonal factors may play an important role in the disease course, probably with other endogenous or exogenous factors.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686324","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
Squamous Metaplasia of Lactiferous Ducts (Zuska's Disease) of the Breast: Clinical and Histopathologic Manifestations. 乳腺导管鳞状增生(祖斯卡病):临床和组织病理学表现。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-14 DOI: 10.1159/000542622
Rewan M Abdelwahab, Nessa Aghazadeh Mohandesi, Charles D Sturgis, Afsaneh Alavi

Introduction: Squamous metaplasia of lactiferous duct (SMOLD), also known as Zuska's disease, is an uncommon, recurrent inflammatory fistulizing disease of the breast that strongly correlates with smoking in premenopausal patients. Clinical and imaging findings may overlap with other breast conditions. SMOLD is well recognized by breast pathologists; however, the dermatology literature on this condition remains scarce.

Methods: In this retrospective study, we reviewed 29 patients with SMOLD diagnosed at Mayo Clinic.

Results: The mean age of the patient cohort is 50.3 with a range of 30 to 81 years. One patient (3.7%) had hidradenitis suppurativa of the retroareolar area. Patient smoking history demonstrated prior/current smokers of 37.9% (11/29), lifetime nonsmokers with significant secondhand exposure 6.9% (2/29), and unknown smoking status 3.4% (1/29). One patient had a personal history of invasive ductal carcinoma, and 10.3% (3/29) had a history of breast cancer in a first-degree relative. The clinical presentation of the patient cohort includes areolar papules, nodules, and draining tract/fistula 13.7% (4/29); pustular cyst/abscess on the breast 13.7% (4/29); breast mass 3.4% (1/29); pain breast discomfort/pain 13.7% (4/29); nipple retraction 3.4% (1/29); and asymptomatic with nipple calcifications on mammogram 3.4% (1/29). A total of 77.8% (7/9) of patients with bacterial cultures demonstrated polymicrobial growth. Overall, 37.9% (11/29) of patients received at least one round of antibiotic therapy. In total, 27.6% (8/29) of patients underwent invasive intervention. Staphylococcus, Streptococcus, and Cutibacterium species were the most frequent causes of infection in our patient cohort.

Conclusions: We confirm previous findings of strong association between SMOLD and current/former smoking status and a potential, novel correlation between extensive secondhand exposure and SMOLD development. While both medical and surgical interventions are employed in patient management, many patients ultimately require complete excision of the involved duct(s). Dermatologists should consider SMOLD in the differential diagnosis of patients presenting with breast abscess, fistulizing tracts with mass, and breast pain.

乳腺导管鳞状上皮增生症(SMOLD)又称祖斯卡病,是一种不常见的乳腺复发性炎症性瘘管病,与绝经前患者吸烟密切相关。在这项回顾性研究中,我们回顾了梅奥诊所确诊的 29 例 SMOLD 患者。患者的平均年龄为 50.3 岁,从 30 岁到 81 岁不等。一名患者(3.7%)患有乳晕后区域化脓性扁桃体炎。患者的吸烟史显示,37.9%(11/29)曾经/现在吸烟,6.9%(2/29)终生不吸烟,3.4%(1/29)吸烟状况不明。一名患者曾患浸润性导管癌,10.3%(3/29)的患者一级亲属曾患乳腺癌。患者群的临床表现包括乳晕丘疹、结节和引流道/瘘管 13.7% (4/29),乳房脓囊肿/脓肿 13.7% (4/29),乳房肿块 3.4% (1/29),乳房不适/疼痛 13.7% (4/29),乳头回缩 3.4% (1/29),乳房 X 光检查乳头钙化无症状 3.4% (1/29)。77.8%(7/9)的患者细菌培养显示有多微生物生长。37.9%(11/29)的患者接受了至少一轮抗生素治疗。27.6%(8/29)的患者接受了侵入性干预。葡萄球菌、链球菌和 Cutibacterium 菌种是患者群中最常见的感染原因。我们证实了之前的研究结果,即 SMOLD 和amp、当前/曾经的吸烟状况以及大量二手烟暴露与 SMOLD 的形成之间存在密切联系。在对患者进行治疗时,我们采用了药物和手术两种干预方法,但许多患者最终需要对受累的导管进行彻底切除。皮肤科医生在鉴别诊断乳腺脓肿、伴有肿块的瘘道和乳房疼痛的患者时,应考虑 SMOLD。
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引用次数: 0
Treatment Satisfaction in Patients with Hidradenitis Suppurativa: A Real-World Survey from the EU5 and USA. 化脓性扁桃体炎患者的治疗满意度:来自欧盟5国和美国的真实世界调查。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-05 DOI: 10.1159/000542343
John R Ingram, Vincenzo Bettoli, Jasmine I Espy, Georgios Kokolakis, Antonio Martorell, Axel P Villani, Hayley Wallinger, Isabel Truman, Emily Coak, Torben Kasparek, Elisa Muscianisi, Craig Richardson, Alexa B Kimball

Introduction: Hidradenitis suppurativa (HS) is a debilitating, inflammatory skin disorder. Treatment strategies in patients with HS are challenging; real-world evidence in a HS population is warranted for greater disease understanding. The objective of this analysis was to describe real-world treatment patterns and treatment satisfaction in patients with HS.

Methods: This was a cross-sectional market research survey with retrospective data collection in patients with HS from the USA and five European countries (France, Germany, Italy, Spain, and the UK) between November 2020 and April 2021, using physician- and patient-reported surveys. Eligible physicians were general dermatologists actively managing patients with HS; dermatologists were required to have consulted with ≥2 patients with HS in the previous 12 months. Adult (≥18 years) and adolescent (10-17 years) HS patients visiting a participating dermatologist were included. Outcomes included treatment patterns, flare status, treatments prescribed in response to flares, previous surgeries, barriers to biologics, and patient- and physician-reported satisfaction with the disease control provided by treatment.

Results: Survey data from 1,787 patients were collected from 312 dermatologists. The most frequently prescribed treatments were topicals, oral antibiotics, and antiseptic washes/creams at diagnosis and sampling. At sampling, biologics were more frequently prescribed in patients with more severe disease (prescribed in 26.6%, 31.0%, and 52.4% of patients with mild, moderate, and severe disease, respectively); oral antibiotics (48.8%), topicals (37.4%), and biologics (34.3%) were the most frequently prescribed treatment classes in response to a flare. Of patients currently not receiving a biologic, dermatologists reported that 18.9% of patients' condition warranted their use. Approximately one quarter of dermatologists (24.5%) and patients (27.4%) were not satisfied with current treatment; of patients who were dissatisfied, 12.8% reported they would never raise their dissatisfaction with their doctor.

Conclusion: These real-world data suggest a high disease burden and potential undertreatment in patients with HS. Patients received multiple treatments, and a notable proportion underwent surgery. Robustly integrating the patient voice in HS treatment decisions may lead to better outcomes and improved treatment satisfaction.

导言:化脓性扁平湿疹(HS)是一种使人衰弱的炎症性皮肤病。HS患者的治疗策略极具挑战性;为了更好地了解疾病,我们需要在HS患者中收集真实世界的证据。本分析旨在描述 HS 患者的实际治疗模式和治疗满意度。方法 这是一项横断面市场研究调查,在 2020 年 11 月至 2021 年 4 月期间对美国和五个欧洲国家(法国、德国、意大利、西班牙、英国)的 HS 患者进行回顾性数据收集,采用医生和患者报告调查的方式。符合条件的医生是积极管理 HS 患者的普通皮肤科医生;要求皮肤科医生在过去 12 个月内诊治过的 HS 患者≥2 人。在参与调查的皮肤科医生处就诊的成人(≥18 岁)和青少年(10-17 岁)HS 患者也包括在内。研究结果包括治疗模式、复发状况、针对复发的处方治疗、既往手术、使用生物制剂的障碍以及患者和医生对治疗所提供的疾病控制的满意度。结果 从 312 位皮肤科医生处收集到了 1787 名患者的调查数据。在诊断和取样时,最常用的处方治疗是局部用药、口服抗生素和消毒洗剂/药膏。在抽样调查中,病情较重的患者更常使用生物制剂(轻度、中度和重度患者的处方比例分别为 26.6%、31.0% 和 52.4%);口服抗生素(48.8%)、局部用药(37.4%)和生物制剂(34.3%)是病情发作时最常使用的治疗类别。皮肤科医生报告说,在目前没有接受生物制剂治疗的患者中,有 18.9% 的患者的病情需要使用生物制剂。约四分之一的皮肤科医生(24.5%)和患者(27.4%)对目前的治疗不满意;在不满意的患者中,12.8%的人表示他们永远不会向医生提出不满。结论 这些真实世界的数据表明,HS 患者的疾病负担较重,可能存在治疗不足的情况。患者接受了多种治疗,其中相当一部分接受了手术治疗。在HS治疗决策中充分考虑患者的意见可能会带来更好的治疗效果并提高治疗满意度。
{"title":"Treatment Satisfaction in Patients with Hidradenitis Suppurativa: A Real-World Survey from the EU5 and USA.","authors":"John R Ingram, Vincenzo Bettoli, Jasmine I Espy, Georgios Kokolakis, Antonio Martorell, Axel P Villani, Hayley Wallinger, Isabel Truman, Emily Coak, Torben Kasparek, Elisa Muscianisi, Craig Richardson, Alexa B Kimball","doi":"10.1159/000542343","DOIUrl":"10.1159/000542343","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a debilitating, inflammatory skin disorder. Treatment strategies in patients with HS are challenging; real-world evidence in a HS population is warranted for greater disease understanding. The objective of this analysis was to describe real-world treatment patterns and treatment satisfaction in patients with HS.</p><p><strong>Methods: </strong>This was a cross-sectional market research survey with retrospective data collection in patients with HS from the USA and five European countries (France, Germany, Italy, Spain, and the UK) between November 2020 and April 2021, using physician- and patient-reported surveys. Eligible physicians were general dermatologists actively managing patients with HS; dermatologists were required to have consulted with ≥2 patients with HS in the previous 12 months. Adult (≥18 years) and adolescent (10-17 years) HS patients visiting a participating dermatologist were included. Outcomes included treatment patterns, flare status, treatments prescribed in response to flares, previous surgeries, barriers to biologics, and patient- and physician-reported satisfaction with the disease control provided by treatment.</p><p><strong>Results: </strong>Survey data from 1,787 patients were collected from 312 dermatologists. The most frequently prescribed treatments were topicals, oral antibiotics, and antiseptic washes/creams at diagnosis and sampling. At sampling, biologics were more frequently prescribed in patients with more severe disease (prescribed in 26.6%, 31.0%, and 52.4% of patients with mild, moderate, and severe disease, respectively); oral antibiotics (48.8%), topicals (37.4%), and biologics (34.3%) were the most frequently prescribed treatment classes in response to a flare. Of patients currently not receiving a biologic, dermatologists reported that 18.9% of patients' condition warranted their use. Approximately one quarter of dermatologists (24.5%) and patients (27.4%) were not satisfied with current treatment; of patients who were dissatisfied, 12.8% reported they would never raise their dissatisfaction with their doctor.</p><p><strong>Conclusion: </strong>These real-world data suggest a high disease burden and potential undertreatment in patients with HS. Patients received multiple treatments, and a notable proportion underwent surgery. Robustly integrating the patient voice in HS treatment decisions may lead to better outcomes and improved treatment satisfaction.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581484","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
Management Strategies and Corticophobia among Healthcare Professionals Involved in the Care for Atopic Dermatitis: A Dutch Survey. 参与特应性皮炎护理的医护人员的管理策略和皮质恐惧症:荷兰调查。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-11-04 DOI: 10.1159/000542421
Aviël Ragamin, Karlijn F van Halewijn, Renske Schappin, Willemijn C A M Witkam, Nicolette J T Arends, Jaap Hoogeterp, Arthur M Bohnen, Gijs Elshout, Marie L A Schuttelaar, Suzanne G M A Pasmans

Introduction: Various healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs.

Methods: Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCSs). Higher scores reflect a more negative attitude.

Results: A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists, other HCPs showed greater reluctance to TCS. This difference was highlighted by the finding that half of GPs reported to prescribed only TCS of mild potency for infants with severe AD, while few dermatologists (9%) reported a similar approach. Dermatologists had lowest TOPICOP-P scores (median: 19, IQR: 12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR: 31-44, pharmacy assistants: median: 36, IQR: 31-42). More corticophobia was significantly associated with prescription of a lower TC potency class in prescribing HCPs (B -0.04, 95% CI: -0.07 to 0.01, p = 0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube.

Conclusions: This study shows the differences in management of AD and reluctance toward TCS in HCPs. Furthermore, corticophobia among HCPs and its influence on the selection of TCS potency class and recommendations were demonstrated. To reduce corticophobia and improve care for AD, more education is needed.

背景:许多医疗保健专业人员(HCPs)为特应性皮炎(AD)患者提供护理服务。尽管管理策略至关重要,但尚未对医护人员的管理策略及其与恐皮质症的关系进行调查。本研究旨在调查特应性皮炎的管理策略及其与卫生保健人员恐皮质症的关系:荷兰全科医生(GPs)、青年保健医生(YHPs)、儿科医生、皮肤科医生、药剂师和药剂助理参与了一项关于管理策略和皮质恐惧症的调查。专业人员外用皮质类固醇恐惧症问卷(TOPICOP-P)用于测量对外用皮质类固醇(TCS)的态度。得分越高,说明态度越消极:共有 407 名高级保健医生(124 名全科医生、33 名青年保健医生、51 名儿科医生、56 名皮肤科医生、58 名药剂师和 85 名药房助理)参加了调查。与皮肤科医生相比,其他高级保健医生更不愿意使用TCS,这体现在全科医生(50%)与皮肤科医生(9%)相比,只为患有严重AD的婴儿开具温和药效的TCS处方。皮肤科医生的 TOPICOP-P 得分最低(中位数:19,IQR:12-28)。全科医生和药房助理的得分最高(全科医生中位数:36,IQR:31-44;药房助理中位数:36,IQR:31-42)。更多的皮质恐惧症与处方较低的三氯化碳效力等级明显相关(B -0.04,95%CI:-0.07-0.01,P=0.01),并且发现更多的皮质恐惧症与一个三氯化碳管的感知持久性更长之间存在趋势:本研究显示了HCP在管理AD和不愿使用TCS方面的差异。此外,HCPs 中的皮质恐惧症及其对 AD 管理的影响也得到了证实。为了减少恐皮质症并改善对 AD 的护理,需要开展更多的教育。
{"title":"Management Strategies and Corticophobia among Healthcare Professionals Involved in the Care for Atopic Dermatitis: A Dutch Survey.","authors":"Aviël Ragamin, Karlijn F van Halewijn, Renske Schappin, Willemijn C A M Witkam, Nicolette J T Arends, Jaap Hoogeterp, Arthur M Bohnen, Gijs Elshout, Marie L A Schuttelaar, Suzanne G M A Pasmans","doi":"10.1159/000542421","DOIUrl":"10.1159/000542421","url":null,"abstract":"<p><strong>Introduction: </strong>Various healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs.</p><p><strong>Methods: </strong>Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCSs). Higher scores reflect a more negative attitude.</p><p><strong>Results: </strong>A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists, other HCPs showed greater reluctance to TCS. This difference was highlighted by the finding that half of GPs reported to prescribed only TCS of mild potency for infants with severe AD, while few dermatologists (9%) reported a similar approach. Dermatologists had lowest TOPICOP-P scores (median: 19, IQR: 12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR: 31-44, pharmacy assistants: median: 36, IQR: 31-42). More corticophobia was significantly associated with prescription of a lower TC potency class in prescribing HCPs (B -0.04, 95% CI: -0.07 to 0.01, p = 0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube.</p><p><strong>Conclusions: </strong>This study shows the differences in management of AD and reluctance toward TCS in HCPs. Furthermore, corticophobia among HCPs and its influence on the selection of TCS potency class and recommendations were demonstrated. To reduce corticophobia and improve care for AD, more education is needed.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575394","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
Hidradenitis suppurativa prevalence in Algeria: A multicenter cross-sectional study. 阿尔及利亚的化脓性扁平湿疹发病率:一项多中心横断面研究。
IF 3.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-06-01 DOI: 10.1159/000539599
Ahmed Samaouel Chehad, Samira Zobiri, Dorra Bouazzi, Cecilia E Medianfar, Robin Christensen, Gregor B E Jemec, Amina Serradj

Introduction Although there has been an expansion of knowledge on hidradenitis suppurativa (HS), data about the disease is largely based on Western population and no relevant African or Asian studies are available. Methods We conducted a descriptive, cross-sectional, multicenter study, as part of GHiSA (Global HS Atlas) initiative, to assess the epidemiologic profile of HS in Algerian population. Healthy adults accompanying patients undergoing care in a non-dermatological wards were approached and invited to complete a self-administered questionnaire. Subsequently, a clinical assessment was performed by an in-person dermatologists for all screen-positive participants and ten percent of the screen-negative ones. Results A total of 1434 participants were included in this study. The prevalence of HS among Algerian adults was 0.78%. Compared to non HS group, no significant difference was found regarding gender, age, body mass index and smoker status. Both the sensitivity (100%) and the specificity (97%) of the HS screening questionnaire were excellent. Conclusion The prevalence of HS in Algeria is very close to that of Australia (0.8%) and Europe (0.7%) and almost the same prevalence found by Ghanaian study (other GHiSA study from Africa). The results of this study demonstrate also the reliability and validity of GHiSA questionnaire as HS data collection instrument.

导言:尽管人们对化脓性扁桃体炎(HS)的了解在不断增加,但有关该疾病的数据主要基于西方人群,目前尚无相关的非洲或亚洲研究。方法 我们进行了一项描述性横断面多中心研究,作为 GHiSA(全球化脓性扁桃体炎图谱)计划的一部分,以评估阿尔及利亚人群中化脓性扁桃体炎的流行病学概况。研究人员接触了在非皮肤科病房接受治疗的患者的随行健康成年人,并邀请他们填写一份自填问卷。随后,由皮肤科医生对所有筛查呈阳性的参与者和10%筛查呈阴性的参与者进行临床评估。结果 共有 1434 人参与了这项研究。阿尔及利亚成年人的 HS 患病率为 0.78%。与非 HS 组相比,性别、年龄、体重指数和吸烟状况均无明显差异。HS筛查问卷的灵敏度(100%)和特异度(97%)都非常高。结论 阿尔及利亚的 HS 患病率与澳大利亚(0.8%)和欧洲(0.7%)的患病率非常接近,几乎与加纳研究(非洲的其他 GHiSA 研究)发现的患病率相同。本研究结果还证明了 GHiSA 问卷作为 HS 数据收集工具的可靠性和有效性。
{"title":"Hidradenitis suppurativa prevalence in Algeria: A multicenter cross-sectional study.","authors":"Ahmed Samaouel Chehad, Samira Zobiri, Dorra Bouazzi, Cecilia E Medianfar, Robin Christensen, Gregor B E Jemec, Amina Serradj","doi":"10.1159/000539599","DOIUrl":"https://doi.org/10.1159/000539599","url":null,"abstract":"<p><p>Introduction Although there has been an expansion of knowledge on hidradenitis suppurativa (HS), data about the disease is largely based on Western population and no relevant African or Asian studies are available. Methods We conducted a descriptive, cross-sectional, multicenter study, as part of GHiSA (Global HS Atlas) initiative, to assess the epidemiologic profile of HS in Algerian population. Healthy adults accompanying patients undergoing care in a non-dermatological wards were approached and invited to complete a self-administered questionnaire. Subsequently, a clinical assessment was performed by an in-person dermatologists for all screen-positive participants and ten percent of the screen-negative ones. Results A total of 1434 participants were included in this study. The prevalence of HS among Algerian adults was 0.78%. Compared to non HS group, no significant difference was found regarding gender, age, body mass index and smoker status. Both the sensitivity (100%) and the specificity (97%) of the HS screening questionnaire were excellent. Conclusion The prevalence of HS in Algeria is very close to that of Australia (0.8%) and Europe (0.7%) and almost the same prevalence found by Ghanaian study (other GHiSA study from Africa). The results of this study demonstrate also the reliability and validity of GHiSA questionnaire as HS data collection instrument.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199430","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
Hidradenitis suppurativa prevalence in Algeria: A multicenter cross-sectional study. 阿尔及利亚的化脓性扁平湿疹发病率:一项多中心横断面研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-06-01 DOI: 10.1159/000539599
Ahmed Samaouel Chehad, Samira Zobiri, Dorra Bouazzi, Cecilia E Medianfar, Robin Christensen, Gregor B E Jemec, Amina Serradj

Introduction Although there has been an expansion of knowledge on hidradenitis suppurativa (HS), data about the disease is largely based on Western population and no relevant African or Asian studies are available. Methods We conducted a descriptive, cross-sectional, multicenter study, as part of GHiSA (Global HS Atlas) initiative, to assess the epidemiologic profile of HS in Algerian population. Healthy adults accompanying patients undergoing care in a non-dermatological wards were approached and invited to complete a self-administered questionnaire. Subsequently, a clinical assessment was performed by an in-person dermatologists for all screen-positive participants and ten percent of the screen-negative ones. Results A total of 1434 participants were included in this study. The prevalence of HS among Algerian adults was 0.78%. Compared to non HS group, no significant difference was found regarding gender, age, body mass index and smoker status. Both the sensitivity (100%) and the specificity (97%) of the HS screening questionnaire were excellent. Conclusion The prevalence of HS in Algeria is very close to that of Australia (0.8%) and Europe (0.7%) and almost the same prevalence found by Ghanaian study (other GHiSA study from Africa). The results of this study demonstrate also the reliability and validity of GHiSA questionnaire as HS data collection instrument.

导言:尽管人们对化脓性扁桃体炎(HS)的了解在不断增加,但有关该疾病的数据主要基于西方人群,目前尚无相关的非洲或亚洲研究。方法 我们进行了一项描述性横断面多中心研究,作为 GHiSA(全球化脓性扁桃体炎图谱)计划的一部分,以评估阿尔及利亚人群中化脓性扁桃体炎的流行病学概况。研究人员接触了在非皮肤科病房接受治疗的患者的随行健康成年人,并邀请他们填写一份自填问卷。随后,由皮肤科医生对所有筛查呈阳性的参与者和10%筛查呈阴性的参与者进行临床评估。结果 共有 1434 人参与了这项研究。阿尔及利亚成年人的 HS 患病率为 0.78%。与非 HS 组相比,性别、年龄、体重指数和吸烟状况均无明显差异。HS筛查问卷的灵敏度(100%)和特异度(97%)都非常高。结论 阿尔及利亚的 HS 患病率与澳大利亚(0.8%)和欧洲(0.7%)的患病率非常接近,几乎与加纳研究(非洲的其他 GHiSA 研究)发现的患病率相同。本研究结果还证明了 GHiSA 问卷作为 HS 数据收集工具的可靠性和有效性。
{"title":"Hidradenitis suppurativa prevalence in Algeria: A multicenter cross-sectional study.","authors":"Ahmed Samaouel Chehad, Samira Zobiri, Dorra Bouazzi, Cecilia E Medianfar, Robin Christensen, Gregor B E Jemec, Amina Serradj","doi":"10.1159/000539599","DOIUrl":"https://doi.org/10.1159/000539599","url":null,"abstract":"<p><p>Introduction Although there has been an expansion of knowledge on hidradenitis suppurativa (HS), data about the disease is largely based on Western population and no relevant African or Asian studies are available. Methods We conducted a descriptive, cross-sectional, multicenter study, as part of GHiSA (Global HS Atlas) initiative, to assess the epidemiologic profile of HS in Algerian population. Healthy adults accompanying patients undergoing care in a non-dermatological wards were approached and invited to complete a self-administered questionnaire. Subsequently, a clinical assessment was performed by an in-person dermatologists for all screen-positive participants and ten percent of the screen-negative ones. Results A total of 1434 participants were included in this study. The prevalence of HS among Algerian adults was 0.78%. Compared to non HS group, no significant difference was found regarding gender, age, body mass index and smoker status. Both the sensitivity (100%) and the specificity (97%) of the HS screening questionnaire were excellent. Conclusion The prevalence of HS in Algeria is very close to that of Australia (0.8%) and Europe (0.7%) and almost the same prevalence found by Ghanaian study (other GHiSA study from Africa). The results of this study demonstrate also the reliability and validity of GHiSA questionnaire as HS data collection instrument.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460188","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
Update in diagnosis, treatment, and prevention of osteochondritis dissecans of the capitellum. 帽状腱膜骨软骨炎的诊断、治疗和预防的最新进展。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-03-01 Epub Date: 2023-07-25 DOI: 10.1177/17585732231190011
Michel Pj van den Bekerom, Huub H de Klerk, Roger van Riet

Osteochondritis dissecans of the capitellum is debilitating and is a potentially sports career-ending injury in a young and athletic population. Osteochondritis dissecans typically occurs in patients between the ages of 10 and 24 years, and boys are more commonly affected than girls. Conventional radiographs have low diagnostic accuracy, and magnetic resonance imaging (with or without contrast) or computed tomography may aid in accurate diagnosis. The primary indication for non-operative treatment is the presence of an intact cartilage cap on magnetic resonance imaging, indicating a "stable lesion." However, if operative treatment is necessary, various surgical procedures are available when operative treatment for an osteochondritis dissecans of the capitellum is considered, including open or arthroscopic removal of loose bodies, with or without microfracturing, fragment fixation, osteochondral autograft transplantation, and osteochondral allograft transplantation. The decision-making process for selecting the appropriate treatment considers factors such as the patient's characteristics, functional limitations, and lesion morphology.

帽状腱膜骨软骨炎是一种使人衰弱的疾病,对于年轻运动员来说,它可能会导致运动生涯的终结。骨软骨软化症通常发生在 10 到 24 岁的患者身上,男孩比女孩更常见。传统的X光片诊断准确率较低,而磁共振成像(有或无造影剂)或计算机断层扫描可能有助于准确诊断。非手术治疗的主要指征是磁共振成像显示软骨帽完好无损,表明病变 "稳定"。然而,如果有必要进行手术治疗,在考虑对髌骨软骨软化症进行手术治疗时,可采用多种手术方法,包括开放式或关节镜下松动体切除术,伴有或不伴有微骨折、碎片固定术、骨软骨自体移植术和骨软骨异体移植术。选择适当治疗方法的决策过程要考虑患者的特点、功能限制和病变形态等因素。
{"title":"Update in diagnosis, treatment, and prevention of osteochondritis dissecans of the capitellum.","authors":"Michel Pj van den Bekerom, Huub H de Klerk, Roger van Riet","doi":"10.1177/17585732231190011","DOIUrl":"10.1177/17585732231190011","url":null,"abstract":"<p><p>Osteochondritis dissecans of the capitellum is debilitating and is a potentially sports career-ending injury in a young and athletic population. Osteochondritis dissecans typically occurs in patients between the ages of 10 and 24 years, and boys are more commonly affected than girls. Conventional radiographs have low diagnostic accuracy, and magnetic resonance imaging (with or without contrast) or computed tomography may aid in accurate diagnosis. The primary indication for non-operative treatment is the presence of an intact cartilage cap on magnetic resonance imaging, indicating a \"stable lesion.\" However, if operative treatment is necessary, various surgical procedures are available when operative treatment for an osteochondritis dissecans of the capitellum is considered, including open or arthroscopic removal of loose bodies, with or without microfracturing, fragment fixation, osteochondral autograft transplantation, and osteochondral allograft transplantation. The decision-making process for selecting the appropriate treatment considers factors such as the patient's characteristics, functional limitations, and lesion morphology.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":"118 1","pages":"24-34"},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86855911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Dermatology
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