Pub Date : 2024-01-01Epub Date: 2023-11-08DOI: 10.1159/000535043
Wen-Rong Luo, Gan Shen, Li-Hua Yang, Xiao-Hai Zhu
Background: Alopecia areata (AA) is an autoimmune disorder characterized by hair loss on the scalp, face, and other body areas. Despite affecting approximately 2% of the global population, there has been no previous bibliometric analysis specifically focusing on AA treatment that can guide researchers in exploring promising treatment options and directing future research efforts.
Summary: This study conducted a bibliometric analysis of AA treatment research, encompassing publications from 2003 to 2022. A total of 1,323 papers from 65 countries, predominantly led by the USA and China, were included in the analysis. The number of publications related to AA treatment showed a notable increase over the years. Prominent research institutions included the University of Manchester, Icahn School of Medicine at Mount Sinai, University of Miami, and Columbia University. Among the journals, Dermatologic Therapy stood out as the most popular, while the Journal of the American Academy of Dermatology appeared as the most frequently co-cited publication.
{"title":"A Bibliometrics of the Treatment of Alopecia Areata in the Past Twenty Years.","authors":"Wen-Rong Luo, Gan Shen, Li-Hua Yang, Xiao-Hai Zhu","doi":"10.1159/000535043","DOIUrl":"10.1159/000535043","url":null,"abstract":"<p><strong>Background: </strong>Alopecia areata (AA) is an autoimmune disorder characterized by hair loss on the scalp, face, and other body areas. Despite affecting approximately 2% of the global population, there has been no previous bibliometric analysis specifically focusing on AA treatment that can guide researchers in exploring promising treatment options and directing future research efforts.</p><p><strong>Summary: </strong>This study conducted a bibliometric analysis of AA treatment research, encompassing publications from 2003 to 2022. A total of 1,323 papers from 65 countries, predominantly led by the USA and China, were included in the analysis. The number of publications related to AA treatment showed a notable increase over the years. Prominent research institutions included the University of Manchester, Icahn School of Medicine at Mount Sinai, University of Miami, and Columbia University. Among the journals, Dermatologic Therapy stood out as the most popular, while the Journal of the American Academy of Dermatology appeared as the most frequently co-cited publication.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"42-58"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520793","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}
Pub Date : 2024-01-01Epub Date: 2023-11-04DOI: 10.1159/000535027
Zarqa Ali, Jennifer Astrup Sørensen, Ditte Georgina Zhang, Misbah Noshela Ghazanfar, Johan Anker Chrom Allerup, Marcus Maurer, Emek Kocatürk, Christian Vestergaard, Simon Francis Thomsen
Background: Chronic urticaria (CU) is characterized by transient wheals and angioedema, which are often not present when patients see their treating physician.
Objective: The objective of this study was to evaluate the diagnostic value of smartphone photographs captured by patients prior to their first visit at an urticaria outpatient clinic.
Methods: A survey regarding the quality and utility of smartphone photographs of urticarial skin lesions in patients with CU attending the outpatient clinic for the first time was conducted. Up to three random patient-selected photographs of skin lesions were evaluated by a physician.
Results: Of 148 patients, 118 (79.7%) had taken photographs of their skin lesions prior to the consultation, and 75% took photographs with the intention of presenting it to their physician. The photographs were of wheals in 90% of the cases and angioedema in 8%. In total, 72% of the smartphone photographs had the skin lesion in focus, 64% had good resolution, and 48% had good lighting. Only 9% of the smartphone photographs were blurred, 10% had bad lighting, 4% had bad resolution, and 8% did not have the lesion in focus. Moreover, 86% of the smartphone photographs were found to be useful for clinical evaluation. At least one photograph of good/very good quality was presented by 86% of the patients, and 97% had at least one photograph that was useful for clinical evaluation.
Conclusion: Patients with CU often take smartphone photographs of their skin lesions on their own initiative prior to their first consultation to present the photographs to their physician. These smartphone photographs are very often of good quality and suitable for clinical evaluation.
{"title":"Smartphone Photographs of Chronic Urticaria Taken by Patients Are of Good Quality and Useful in the Clinic.","authors":"Zarqa Ali, Jennifer Astrup Sørensen, Ditte Georgina Zhang, Misbah Noshela Ghazanfar, Johan Anker Chrom Allerup, Marcus Maurer, Emek Kocatürk, Christian Vestergaard, Simon Francis Thomsen","doi":"10.1159/000535027","DOIUrl":"10.1159/000535027","url":null,"abstract":"<p><strong>Background: </strong>Chronic urticaria (CU) is characterized by transient wheals and angioedema, which are often not present when patients see their treating physician.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the diagnostic value of smartphone photographs captured by patients prior to their first visit at an urticaria outpatient clinic.</p><p><strong>Methods: </strong>A survey regarding the quality and utility of smartphone photographs of urticarial skin lesions in patients with CU attending the outpatient clinic for the first time was conducted. Up to three random patient-selected photographs of skin lesions were evaluated by a physician.</p><p><strong>Results: </strong>Of 148 patients, 118 (79.7%) had taken photographs of their skin lesions prior to the consultation, and 75% took photographs with the intention of presenting it to their physician. The photographs were of wheals in 90% of the cases and angioedema in 8%. In total, 72% of the smartphone photographs had the skin lesion in focus, 64% had good resolution, and 48% had good lighting. Only 9% of the smartphone photographs were blurred, 10% had bad lighting, 4% had bad resolution, and 8% did not have the lesion in focus. Moreover, 86% of the smartphone photographs were found to be useful for clinical evaluation. At least one photograph of good/very good quality was presented by 86% of the patients, and 97% had at least one photograph that was useful for clinical evaluation.</p><p><strong>Conclusion: </strong>Patients with CU often take smartphone photographs of their skin lesions on their own initiative prior to their first consultation to present the photographs to their physician. These smartphone photographs are very often of good quality and suitable for clinical evaluation.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"357-361"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479305","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}
Pub Date : 2024-01-01Epub Date: 2023-10-18DOI: 10.1159/000534364
Husein Husein-ElAhmed, Sara Husein-ElAhmed
Background: Lichen planopilaris (LPP) is a primary chronic lymphocytic cutaneous disorder that selectively destroys the hair follicles, resulting in scarring alopecia. Unfortunately, current available treatments are not fully effective to stop hair loss, and the level of evidence for medical interventions is weak.
Objectives: The present article aimed to determine the efficacy of the different medical interventions in LPP through a network meta-analysis (NMA).
Methods: A systematic review and meta-analysis were performed including randomized trials that report the outcomes of lichen planopilaris activity index (LPPAI). These articles were pooled and a NMA was conducted.
Results: A total of seven studies were identified and included in meta-analysis, comprising 251 LPP patients. The NMA showed the mean difference in LLPAI was significantly superior with the combination of clobetasol plus N-acetylcysteine (mean difference: -2.0, 95% CI = -3.43 to -0.51) and the combination of clobetasol plus pentoxifylline (mean difference: -1.62, 95% CI = -3.0 to -0.25) compared to the treatment of reference (clobetasol). The NMA showed cyclosporine (mean difference: 2.05 95% CI = 0.68-3.49), methotrexate (mean difference: 1.95 95% CI = 1.23-3.17), the combination of methotrexate plus prednisolone (mean difference: 1.56 95% CI = 0.25-2.96) were significantly worse than hydroxychloroquine according to the differences in LLPAI.
Conclusion: This work is the first NMA in LPP and hence, it can be helpful in serving as an initial step toward better evidence-based decisions in the treatment of this challenging condition. We propose a triple-combined approach consisting of topical clobetasol, hydroxychloroquine, and N-acetylcysteine as resulted in the most effective approach. Considering the poor outcomes observed with pioglitazone, mycophenolate mofetil, and cyclosporine, it is advisable to contemplate the use of these medications in patients who have not responded adequately to more efficacious alternatives.
{"title":"A Systematic Review and Bayesian Network Meta-Analysis of Medical Therapies for Lichen Planopilaris.","authors":"Husein Husein-ElAhmed, Sara Husein-ElAhmed","doi":"10.1159/000534364","DOIUrl":"10.1159/000534364","url":null,"abstract":"<p><strong>Background: </strong>Lichen planopilaris (LPP) is a primary chronic lymphocytic cutaneous disorder that selectively destroys the hair follicles, resulting in scarring alopecia. Unfortunately, current available treatments are not fully effective to stop hair loss, and the level of evidence for medical interventions is weak.</p><p><strong>Objectives: </strong>The present article aimed to determine the efficacy of the different medical interventions in LPP through a network meta-analysis (NMA).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed including randomized trials that report the outcomes of lichen planopilaris activity index (LPPAI). These articles were pooled and a NMA was conducted.</p><p><strong>Results: </strong>A total of seven studies were identified and included in meta-analysis, comprising 251 LPP patients. The NMA showed the mean difference in LLPAI was significantly superior with the combination of clobetasol plus N-acetylcysteine (mean difference: -2.0, 95% CI = -3.43 to -0.51) and the combination of clobetasol plus pentoxifylline (mean difference: -1.62, 95% CI = -3.0 to -0.25) compared to the treatment of reference (clobetasol). The NMA showed cyclosporine (mean difference: 2.05 95% CI = 0.68-3.49), methotrexate (mean difference: 1.95 95% CI = 1.23-3.17), the combination of methotrexate plus prednisolone (mean difference: 1.56 95% CI = 0.25-2.96) were significantly worse than hydroxychloroquine according to the differences in LLPAI.</p><p><strong>Conclusion: </strong>This work is the first NMA in LPP and hence, it can be helpful in serving as an initial step toward better evidence-based decisions in the treatment of this challenging condition. We propose a triple-combined approach consisting of topical clobetasol, hydroxychloroquine, and N-acetylcysteine as resulted in the most effective approach. Considering the poor outcomes observed with pioglitazone, mycophenolate mofetil, and cyclosporine, it is advisable to contemplate the use of these medications in patients who have not responded adequately to more efficacious alternatives.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"103-110"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675476","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}
Pub Date : 2024-01-01Epub Date: 2024-01-30DOI: 10.1159/000536481
Anna Wolinska, Gregg Murray, Madonna Andrawis, Paula Beatty, Marta Costa Blasco, Claire Doyle, Orla Mc Feely, Lisa Murphy, Anne-Marie Tobin
{"title":"Response to \"Letter to the Editor on \"Comparison of Social Media Content on Hidradenitis Suppurativa: A Cross-Sectional Study\".","authors":"Anna Wolinska, Gregg Murray, Madonna Andrawis, Paula Beatty, Marta Costa Blasco, Claire Doyle, Orla Mc Feely, Lisa Murphy, Anne-Marie Tobin","doi":"10.1159/000536481","DOIUrl":"10.1159/000536481","url":null,"abstract":"","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"519-520"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641779","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}
Pub Date : 2024-01-01Epub Date: 2023-12-11DOI: 10.1159/000535285
Jacob P Thyssen, Anthony Bewley, Sonja Ständer, Carla Castro, Laurent Misery, Brian S Kim, Pinaki Biswas, Gary Chan, Daniela E Myers, Melissa Watkins, Justine Alderfer, Erman Güler, Jonathan I Silverberg
Background: Skin pain in atopic dermatitis (AD) increases with disease severity and is associated with substantial quality of life (QoL) burden.
Objectives: The aim of the study was to evaluate abrocitinib efficacy on skin pain and QoL in adults and adolescents with moderate-to-severe AD.
Methods: This post hoc analysis included data with abrocitinib administered as monotherapy (pooled phase 2b [NCT02780167] and phase 3 JADE MONO-1 [NCT03349060] and JADE MONO-2 [NCT03575871]) or in combination with topical therapy (phase 3 JADE COMPARE [NCT03720470] and JADE TEEN [NCT03796676]). Patients received oral, once-daily abrocitinib 200 mg, abrocitinib 100 mg, or placebo for 12 or 16 weeks (JADE COMPARE). Skin pain was rated using the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) skin pain Numerical Rating Scale (NRS) item ("How painful was your skin over the past 24 h?") on a scale from 0 (not painful) to 10 (extremely painful). Itch (Peak Pruritus NRS) and QoL (Dermatology Life Quality Index or Children's Dermatology Life Quality Index) were assessed. Least squares mean (LSM) change from baseline was analyzed using mixed-effects repeated measures modeling.
Results: A total of 1,822 patients (monotherapy pool, n = 942; JADE COMPARE, n = 595; and JADE TEEN, n = 285) were analyzed. LSM change from baseline in PSAAD skin pain score was significantly greater with abrocitinib versus placebo from week 2 through week 12 or 16 across all 3 study populations and occurred in a dose-dependent manner. A greater proportion of patients achieved a ≥4-point improvement from baseline in PSAAD skin pain score with abrocitinib (200 mg and 100 mg) versus placebo in the monotherapy pool (56% and 38% vs. 12%; week 12), JADE COMPARE (72% and 52% vs. 26%; week 16), and JADE TEEN (51% and 60% vs. 31%; week 12). Additionally, a greater proportion of patients achieved a stringent threshold of skin pain improvement (PSAAD skin pain score <2) with abrocitinib versus placebo. Adults and adolescents who achieved a ≥4-point improvement in skin pain reported greater QoL improvement than those who did not achieve a ≥4-point improvement. A positive correlation (≥0.3) was observed between skin pain and QoL and separately between skin pain and itch across the 3 study populations.
Conclusion: Abrocitinib as monotherapy or in combination with topical therapy improved skin pain and was associated with improved QoL in both adults and adolescents with moderate-to-severe AD across all evaluated studies.
背景:特应性皮炎(AD)患者的皮肤疼痛会随着疾病严重程度的增加而加剧,并且与严重的生活质量(QoL)负担相关:评估阿昔替尼对中重度特应性皮炎成人和青少年患者皮肤疼痛和 QoL 的疗效:这项事后分析纳入了阿罗西替尼单药治疗(2b期[NCT02780167]和3期JADE MONO-1[NCT03349060]和MONO-2[NCT03575871]合并治疗)或与局部治疗(3期JADE COMPARE[NCT03720470]和JADE TEEN[NCT03796676]合并治疗)的数据。患者每天口服一次阿罗西替尼 200 毫克、阿罗西替尼 100 毫克或安慰剂,疗程为 12 或 16 周(JADE COMPARE)。皮肤疼痛采用特应性皮炎瘙痒和症状评估(PSAAD)皮肤疼痛数字评定量表(NRS)项目("过去24小时内您的皮肤有多疼痛?")进行评定,评分范围从0(不痛)到10(极度疼痛)。瘙痒(瘙痒峰值 NRS)和 QoL(皮肤科生活质量指数或儿童皮肤科生活质量指数)也得到了评估。使用混合效应重复测量模型分析了与基线相比的最小平方均值(LSM)变化:共分析了1822名患者(单药治疗组,942人;JADE COMPARE,595人;JADE TEEN,285人)。在所有3个研究人群中,从第2周到第12周或第16周,阿罗西替尼与安慰剂相比,PSAAD皮肤疼痛评分从基线开始的LSM变化显著增大,且呈剂量依赖性。在单药治疗组(56%和38% vs 12%;第12周)、JADE COMPARE(72%和52% vs 26%;第16周)和JADE TEEN(51%和60% vs 31%;第12周)中,阿罗西替尼(200毫克和100毫克)与安慰剂相比,PSAAD皮肤疼痛评分较基线改善≥4分的患者比例更高。此外,更多患者达到了严格的皮肤疼痛改善阈值(PSAAD 皮肤疼痛评分结论):在所有接受评估的研究中,阿罗西替尼单药治疗或联合外用疗法均可改善中重度AD成人和青少年患者的皮肤疼痛,并与QoL的改善相关。
{"title":"Abrocitinib Provides Rapid and Sustained Improvement in Skin Pain and Is Associated with Improved Quality of Life Outcomes in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis.","authors":"Jacob P Thyssen, Anthony Bewley, Sonja Ständer, Carla Castro, Laurent Misery, Brian S Kim, Pinaki Biswas, Gary Chan, Daniela E Myers, Melissa Watkins, Justine Alderfer, Erman Güler, Jonathan I Silverberg","doi":"10.1159/000535285","DOIUrl":"10.1159/000535285","url":null,"abstract":"<p><strong>Background: </strong>Skin pain in atopic dermatitis (AD) increases with disease severity and is associated with substantial quality of life (QoL) burden.</p><p><strong>Objectives: </strong>The aim of the study was to evaluate abrocitinib efficacy on skin pain and QoL in adults and adolescents with moderate-to-severe AD.</p><p><strong>Methods: </strong>This post hoc analysis included data with abrocitinib administered as monotherapy (pooled phase 2b [NCT02780167] and phase 3 JADE MONO-1 [NCT03349060] and JADE MONO-2 [NCT03575871]) or in combination with topical therapy (phase 3 JADE COMPARE [NCT03720470] and JADE TEEN [NCT03796676]). Patients received oral, once-daily abrocitinib 200 mg, abrocitinib 100 mg, or placebo for 12 or 16 weeks (JADE COMPARE). Skin pain was rated using the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) skin pain Numerical Rating Scale (NRS) item (\"How painful was your skin over the past 24 h?\") on a scale from 0 (not painful) to 10 (extremely painful). Itch (Peak Pruritus NRS) and QoL (Dermatology Life Quality Index or Children's Dermatology Life Quality Index) were assessed. Least squares mean (LSM) change from baseline was analyzed using mixed-effects repeated measures modeling.</p><p><strong>Results: </strong>A total of 1,822 patients (monotherapy pool, n = 942; JADE COMPARE, n = 595; and JADE TEEN, n = 285) were analyzed. LSM change from baseline in PSAAD skin pain score was significantly greater with abrocitinib versus placebo from week 2 through week 12 or 16 across all 3 study populations and occurred in a dose-dependent manner. A greater proportion of patients achieved a ≥4-point improvement from baseline in PSAAD skin pain score with abrocitinib (200 mg and 100 mg) versus placebo in the monotherapy pool (56% and 38% vs. 12%; week 12), JADE COMPARE (72% and 52% vs. 26%; week 16), and JADE TEEN (51% and 60% vs. 31%; week 12). Additionally, a greater proportion of patients achieved a stringent threshold of skin pain improvement (PSAAD skin pain score <2) with abrocitinib versus placebo. Adults and adolescents who achieved a ≥4-point improvement in skin pain reported greater QoL improvement than those who did not achieve a ≥4-point improvement. A positive correlation (≥0.3) was observed between skin pain and QoL and separately between skin pain and itch across the 3 study populations.</p><p><strong>Conclusion: </strong>Abrocitinib as monotherapy or in combination with topical therapy improved skin pain and was associated with improved QoL in both adults and adolescents with moderate-to-severe AD across all evaluated studies.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"243-253"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800639","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}
Pub Date : 2024-01-01Epub Date: 2024-06-18DOI: 10.1159/000539685
Giacomo Caldarola, Eleonora De Luca, Angelina Barini, Umberto Basile, Valeria Carnazzo, Andrea Chiricozzi, Barbara Tolusso, Elisa Gremese, Lucia Di Nardo, Ketty Peris, Clara De Simone
Introduction: Night shift work disrupts circadian rhythms and has been associated with immune system alterations and various health conditions. However, there is limited data regarding its impact on psoriasis. The aim of our study was to compare psoriasis severity and the hormonal and immunological profile in patients with a night shift work to those with a daytime occupation.
Methods: In this case-control study, we enrolled psoriatic patients aged >18 years engaged in night shift work and a control group of psoriatic patients with a daytime occupation. A further categorization was performed by the duration of night shift work: < or ≥7 days a month and < or ≥8 years. Disease severity was evaluated by PASI, BSA, and DLQI, and blood samples were taken to measure various hormonal and immunological markers. Univariable and multivariable analysis were performed to assess differences between the two groups.
Results: A total of 40 night shift workers were included, along with 36 patients in the control group. Patients who worked night shifts at least 7 days a month had significantly higher PASI scores (11.2 ± 6.6 vs. 8.5 ± 6.6; p = 0.04) and higher IL-8 serum (115.33 ± 463.65 pg/mL vs. 19.98 ± 29.78 pg/mL; p = 0.006) compared to patients who did not. Night shifts workers for at least 8 years had higher BMI (28.65 ± 4.56 vs. 25.32 ± 5.50, p = 0.010), and females had higher testosterone levels (0.46 ± 0.53 ng/mL vs. 0.23 ± 0.13 ng/mL; p = 0.055).
Conclusion: Night shift might increase psoriasis severity and have an impact on chronic inflammation, obesity, and hormonal imbalances.
{"title":"Evaluation of the Impact of Night Shift Work on Disease Severity in Psoriatic Patients: A Case-Control Study with Clinical, Hormonal, and Immunological Evaluation.","authors":"Giacomo Caldarola, Eleonora De Luca, Angelina Barini, Umberto Basile, Valeria Carnazzo, Andrea Chiricozzi, Barbara Tolusso, Elisa Gremese, Lucia Di Nardo, Ketty Peris, Clara De Simone","doi":"10.1159/000539685","DOIUrl":"10.1159/000539685","url":null,"abstract":"<p><strong>Introduction: </strong>Night shift work disrupts circadian rhythms and has been associated with immune system alterations and various health conditions. However, there is limited data regarding its impact on psoriasis. The aim of our study was to compare psoriasis severity and the hormonal and immunological profile in patients with a night shift work to those with a daytime occupation.</p><p><strong>Methods: </strong>In this case-control study, we enrolled psoriatic patients aged >18 years engaged in night shift work and a control group of psoriatic patients with a daytime occupation. A further categorization was performed by the duration of night shift work: < or ≥7 days a month and < or ≥8 years. Disease severity was evaluated by PASI, BSA, and DLQI, and blood samples were taken to measure various hormonal and immunological markers. Univariable and multivariable analysis were performed to assess differences between the two groups.</p><p><strong>Results: </strong>A total of 40 night shift workers were included, along with 36 patients in the control group. Patients who worked night shifts at least 7 days a month had significantly higher PASI scores (11.2 ± 6.6 vs. 8.5 ± 6.6; p = 0.04) and higher IL-8 serum (115.33 ± 463.65 pg/mL vs. 19.98 ± 29.78 pg/mL; p = 0.006) compared to patients who did not. Night shifts workers for at least 8 years had higher BMI (28.65 ± 4.56 vs. 25.32 ± 5.50, p = 0.010), and females had higher testosterone levels (0.46 ± 0.53 ng/mL vs. 0.23 ± 0.13 ng/mL; p = 0.055).</p><p><strong>Conclusion: </strong>Night shift might increase psoriasis severity and have an impact on chronic inflammation, obesity, and hormonal imbalances.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"665-670"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418299","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}
Pub Date : 2024-01-01Epub Date: 2024-10-11DOI: 10.1159/000540359
Raghu P Metpally, Sangeetha Vishweswaraiah, Sarathbabu Krishnamurthy, Nazia Saiyed, Richard C Stahl, Alicia Golden, Andrew Denisenko, Jeffrey Staples, Claudia Gonzaga-Jauregui, David J Carey, Falk Bechara, Gregor B E Jemec, Heinric Williams, Uppala Radhakrishna
Introduction: Hidradenitis suppurativa (HS) is a prevalent and persistent inflammatory skin disorder, lacking a known cure or effective biomarkers for early diagnosis at present. The genetic determinants of HS have not been fully documented, but it is believed to result from a combination of genetic and environmental factors.
Methods: To identify relevant HS gene variants in sporadic HS patients, this study utilized longitudinal electronic health records (EHRs) and whole-exome sequencing. DNA exome sequencing data from 92,455 participant samples in the MyCode biobank, linked to Geisinger's EHR, were analyzed. This cohort included 1,092 HS cases and 91,363 healthy controls. The MyCode EHR has a median longitudinal follow-up of 15 years per participant, with an average of 87 clinical encounters, 687 laboratory tests, and 7 procedures.
Results: There were 1,092 (901 females and 191 males) participants aged 14-89 years (median 47 years) with HS (L73.2), indicating a 1.18% prevalence and accounting for a 4.7:1 female-to-male ratio among the individuals presenting for clinical care. γ-secretase complex, syndromic, and autoinflammatory gene variants were assessed. Potential pathogenic variants were identified among 66 individuals in the HS genes studied. Molecularly, the estimated HS variant prevalence was 1:1,400 in the cohort, 12.3% of variant carriers had HS diagnosis in EHR.
Conclusions: Using longitudinal EHR data, genomic screening identified HS-associated gene variants in a defined group of sporadic HS patients to augment the clinical diagnosis, particularly in cases of ambiguity. Based on this study, the field of skin disorders can benefit from a personalized approach to HS diagnosis using large-scale sequencing.
{"title":"Identification of Novel Genetic Risk Variants Associated with Hidradenitis Suppurativa in an Exome Sequencing Cohort of 92,455 Individuals.","authors":"Raghu P Metpally, Sangeetha Vishweswaraiah, Sarathbabu Krishnamurthy, Nazia Saiyed, Richard C Stahl, Alicia Golden, Andrew Denisenko, Jeffrey Staples, Claudia Gonzaga-Jauregui, David J Carey, Falk Bechara, Gregor B E Jemec, Heinric Williams, Uppala Radhakrishna","doi":"10.1159/000540359","DOIUrl":"10.1159/000540359","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a prevalent and persistent inflammatory skin disorder, lacking a known cure or effective biomarkers for early diagnosis at present. The genetic determinants of HS have not been fully documented, but it is believed to result from a combination of genetic and environmental factors.</p><p><strong>Methods: </strong>To identify relevant HS gene variants in sporadic HS patients, this study utilized longitudinal electronic health records (EHRs) and whole-exome sequencing. DNA exome sequencing data from 92,455 participant samples in the MyCode biobank, linked to Geisinger's EHR, were analyzed. This cohort included 1,092 HS cases and 91,363 healthy controls. The MyCode EHR has a median longitudinal follow-up of 15 years per participant, with an average of 87 clinical encounters, 687 laboratory tests, and 7 procedures.</p><p><strong>Results: </strong>There were 1,092 (901 females and 191 males) participants aged 14-89 years (median 47 years) with HS (L73.2), indicating a 1.18% prevalence and accounting for a 4.7:1 female-to-male ratio among the individuals presenting for clinical care. γ-secretase complex, syndromic, and autoinflammatory gene variants were assessed. Potential pathogenic variants were identified among 66 individuals in the HS genes studied. Molecularly, the estimated HS variant prevalence was 1:1,400 in the cohort, 12.3% of variant carriers had HS diagnosis in EHR.</p><p><strong>Conclusions: </strong>Using longitudinal EHR data, genomic screening identified HS-associated gene variants in a defined group of sporadic HS patients to augment the clinical diagnosis, particularly in cases of ambiguity. Based on this study, the field of skin disorders can benefit from a personalized approach to HS diagnosis using large-scale sequencing.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"739-749"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460189","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}
Pub Date : 2024-01-01Epub Date: 2024-10-11DOI: 10.1159/000541052
Mathieu Daoud, Mariano Suppa, Farida Benhadou, Stéphanie Heudens, Anne-Sophie Sarkis, Hassane Njimi, Sara K Saunte, Lila Desmarest, Carmen Orte Cano, Céline Dandoy, Laura Nobile, Margot Fontaine, Mathilde Daxhelet, Jalila Karama, Jonathan M White, Gregor B E Jemec, Véronique Del Marmol
Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate. Our study aims to determine the clinical factors associated with severe HS using several severity scores.
Methods: The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS, and DLQI. Univariable and multivariable analyses were performed.
Results: Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (odds ratio [OR] = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated body mass index was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of nonsteroidal anti-inflammatory drugs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001).
Conclusion: HS seems to be more severe in men; smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.
{"title":"Factors Associated with Severe Hidradenitis Suppurativa, Using Hurley Staging and Metascore.","authors":"Mathieu Daoud, Mariano Suppa, Farida Benhadou, Stéphanie Heudens, Anne-Sophie Sarkis, Hassane Njimi, Sara K Saunte, Lila Desmarest, Carmen Orte Cano, Céline Dandoy, Laura Nobile, Margot Fontaine, Mathilde Daxhelet, Jalila Karama, Jonathan M White, Gregor B E Jemec, Véronique Del Marmol","doi":"10.1159/000541052","DOIUrl":"10.1159/000541052","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate. Our study aims to determine the clinical factors associated with severe HS using several severity scores.</p><p><strong>Methods: </strong>The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS, and DLQI. Univariable and multivariable analyses were performed.</p><p><strong>Results: </strong>Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (odds ratio [OR] = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated body mass index was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of nonsteroidal anti-inflammatory drugs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001).</p><p><strong>Conclusion: </strong>HS seems to be more severe in men; smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"713-731"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460187","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}
Pub Date : 2024-01-01Epub Date: 2024-06-27DOI: 10.1159/000539536
Rodney Sinclair, Ernest H Law, Xingqi Zhang, Fan Zhang, Lynne Napatalung, Samuel H Zwillich, Brett King, Natasha Mesinkovska
Introduction: Patients with alopecia areata (AA) report high levels of dissatisfaction with commonly used treatments. Patient-reported outcomes are essential to understanding patients' experiences with AA treatments. The objective of this study was to evaluate patient-reported satisfaction with hair growth among patients with AA receiving ritlecitinib or placebo and the correlation between clinician-assessed efficacy and patient-reported satisfaction.
Methods: In the ALLEGRO-2b/3 (NCT03732807) trial, patients with AA and ≥50% scalp hair loss were randomized to daily ritlecitinib or placebo for 24 weeks, with a 24-week extension of continued ritlecitinib or switch from placebo to ritlecitinib. The Patient Satisfaction with Hair Growth (P-Sat) measure evaluated patients' satisfaction with hair growth in 3 domains: amount, quality, and overall satisfaction with hair growth. The prespecified analysis evaluated the proportion of patients who were slightly, moderately, or very satisfied with hair growth. Several post hoc analyses assessed the proportion of patients who were moderately/very satisfied and moderately/very dissatisfied and calculated polyserial correlations between change from baseline (CFB) in Severity of Alopecia Tool (SALT) and P-Sat scores at weeks 24 and 48.
Results: At week 24, the proportion of patients (N = 718) reporting satisfaction (slightly, moderately, or very satisfied) overall with their hair growth ranged from 36.4% in the ritlecitinib 10-mg group (evaluated for dose ranging only) to 67.5% in the 200/50-mg group versus 22.6% in the placebo groups. In patients randomized to ritlecitinib, the proportion who were satisfied increased or was maintained at week 48. A substantially greater proportion of placebo patients who switched to ritlecitinib reported satisfaction at week 48 than at week 24. Similar results were observed for patient satisfaction with the amount and quality of hair growth. In the post hoc analyses defining satisfaction as moderately/very satisfied and dissatisfaction as moderately/very dissatisfied, the benefit of ritlecitinib was also observed. All P-Sat domain scores strongly correlated with CFB-SALT scores at weeks 24 (range 0.73-0.76; p < 0.05) and 48 (0.74-0.77; p < 0.05).
Conclusions: Patients receiving active ritlecitinib doses reported favorable results versus placebo in satisfaction with hair growth up to week 48. High concordance was observed between improvement in scalp hair growth evaluated by clinicians and patient-reported satisfaction.
导言:斑秃(AA)患者对常用治疗方法的不满意度很高。患者报告的结果对于了解患者对 AA 治疗的体验至关重要。本研究旨在评估接受利特西替尼或安慰剂治疗的 AA 患者报告的头发生长满意度,以及临床医生评估的疗效与患者报告的满意度之间的相关性:在ALLEGRO-2b/3 (NCT03732807)试验中,头皮脱发≥50%的AA患者被随机分配到每日服用瑞替西替尼或安慰剂,为期24周,延长24周后继续服用瑞替西替尼或从安慰剂换成瑞替西替尼。患者对毛发生长的满意度(P-Sat)测量从3个方面评估患者对毛发生长的满意度:毛发生长的数量、质量和总体满意度。预设分析评估了对头发生长略微满意、比较满意或非常满意的患者比例。几项事后分析评估了中度/非常满意和中度/非常不满意患者的比例,并计算了第24周和第48周脱发严重程度工具(SALT)和P-Sat评分与基线相比的变化(CFB)之间的多序列相关性:第24周时,对头发生长总体表示满意(略微满意、比较满意或非常满意)的患者比例(718人)从利特西替尼10毫克组的36.4%(仅评估剂量范围)到200/50毫克组的67.5%,而安慰剂组为22.6%。在随机接受利特西替尼治疗的患者中,满意的比例在第48周时有所增加或保持不变。改用利特西替尼治疗的安慰剂患者中,第48周满意的比例大大高于第24周。在患者对毛发生长数量和质量的满意度方面也观察到了类似的结果。在将满意度定义为 "中度/非常满意 "和将不满意度定义为 "中度/非常不满意 "的事后分析中,也观察到了利特西替尼的益处。在第24周(范围为0.73-0.76;P<0.05)和第48周(0.74-0.77;P<0.05),所有P-Sat域得分均与CFB-SALT得分密切相关:结论:与安慰剂相比,接受瑞替尼有效剂量治疗的患者在第48周之前对毛发生长的满意度表现良好。临床医生评估的头皮毛发生长改善情况与患者报告的满意度高度一致:试验注册:Clinicaltrials.gov NCT0373280。
{"title":"Patient-Reported Satisfaction with Hair Regrowth in a Study of Ritlecitinib in Alopecia Areata: Results from ALLEGRO-2b/3.","authors":"Rodney Sinclair, Ernest H Law, Xingqi Zhang, Fan Zhang, Lynne Napatalung, Samuel H Zwillich, Brett King, Natasha Mesinkovska","doi":"10.1159/000539536","DOIUrl":"10.1159/000539536","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with alopecia areata (AA) report high levels of dissatisfaction with commonly used treatments. Patient-reported outcomes are essential to understanding patients' experiences with AA treatments. The objective of this study was to evaluate patient-reported satisfaction with hair growth among patients with AA receiving ritlecitinib or placebo and the correlation between clinician-assessed efficacy and patient-reported satisfaction.</p><p><strong>Methods: </strong>In the ALLEGRO-2b/3 (NCT03732807) trial, patients with AA and ≥50% scalp hair loss were randomized to daily ritlecitinib or placebo for 24 weeks, with a 24-week extension of continued ritlecitinib or switch from placebo to ritlecitinib. The Patient Satisfaction with Hair Growth (P-Sat) measure evaluated patients' satisfaction with hair growth in 3 domains: amount, quality, and overall satisfaction with hair growth. The prespecified analysis evaluated the proportion of patients who were slightly, moderately, or very satisfied with hair growth. Several post hoc analyses assessed the proportion of patients who were moderately/very satisfied and moderately/very dissatisfied and calculated polyserial correlations between change from baseline (CFB) in Severity of Alopecia Tool (SALT) and P-Sat scores at weeks 24 and 48.</p><p><strong>Results: </strong>At week 24, the proportion of patients (N = 718) reporting satisfaction (slightly, moderately, or very satisfied) overall with their hair growth ranged from 36.4% in the ritlecitinib 10-mg group (evaluated for dose ranging only) to 67.5% in the 200/50-mg group versus 22.6% in the placebo groups. In patients randomized to ritlecitinib, the proportion who were satisfied increased or was maintained at week 48. A substantially greater proportion of placebo patients who switched to ritlecitinib reported satisfaction at week 48 than at week 24. Similar results were observed for patient satisfaction with the amount and quality of hair growth. In the post hoc analyses defining satisfaction as moderately/very satisfied and dissatisfaction as moderately/very dissatisfied, the benefit of ritlecitinib was also observed. All P-Sat domain scores strongly correlated with CFB-SALT scores at weeks 24 (range 0.73-0.76; p < 0.05) and 48 (0.74-0.77; p < 0.05).</p><p><strong>Conclusions: </strong>Patients receiving active ritlecitinib doses reported favorable results versus placebo in satisfaction with hair growth up to week 48. High concordance was observed between improvement in scalp hair growth evaluated by clinicians and patient-reported satisfaction.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"767-777"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455829","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}