Acta dermato-venereologica最新文献

The Atopic Dermatitis Control Tool (ADCT) has not been validated in the Dutch population, and comparisons with the Recap of atopic eczema (RECAP) questionnaire are still lacking. This prospective study was conducted at a Dutch tertiary hospital between June 2021 and December 2022, to assess measurement properties of the Dutch ADCT in adults with atopic dermatitis (AD) and compare it with RECAP. Participants completed the ADCT, RECAP, and reference instruments including Patient's Global Assessment (PtGA), Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), quality-of-life questionnaire of the EuroQol Group (EQ-5D-5L), Numeric Rating Scale (NRS) peak itch/sleep disturbance, Skindex-29, and Global Rating of Change (GRC), at baseline, 1-3 days, and 4-12 weeks. Construct validity was assessed through a priori hypotheses, whilst reliability was evaluated with standard error of measurement (SEMagreement) and intraclass correlation coefficient (ICCagreement). Interpretability was examined using anchor-based approaches. In total, 196 adults with AD were included. Among a priori hypotheses, 82% (single-score validity) and 59% (responsiveness) were confirmed. The SEMagreement was 1.15, and the ICCagreement was 0.983. The final bandings for the ADCT were established, with a binary cutoff of ≥ 6 indicating uncontrolled AD. The smallest detectable change (SDC) was 3.2, and the minimally important change (MIC) value from predictive modelling was 2.9. Furthermore, the ADCT exhibited high correlations with RECAP at all levels (most correlations being above 0.80). These results demonstrated the Dutch ADCT as a valid, reliable, and responsive tool, and have important clinical implications.

Atopic dermatitis is a chronic skin disease affecting quality of life, sleep, and mental health. Traditional evaluation methods focus on clinical assessments, but there is a growing need for tools that incorporate patient-reported outcomes (PROs). To evaluate the effectiveness of the Atopic Dermatitis Control Tool (ADCT) in assessing disease severity in patients with moderate to severe atopic dermatitis and to compare the efficacy of systemic immunosuppressants and dupilumab in patients with moderate to severe atopic dermatitis. A prospective, observational study was conducted across seven centres in Korea, involving 112 patients with moderate to severe atopic dermatitis. The ADCT, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were used for assessing atopic dermatitis severity. In addition, the study assessed the effectiveness of immunosuppressants and dupilumab over the course of one year. The study found significant correlations between ADCT scores and other severity measures (EASI, DLQI). The correlation coefficients were 0.54 (p < 0.0001) for ADCT vs EASI and 0.83 (p < 0.0001) for ADCT vs DLQI. Furthermore, patients treated with dupilumab exhibited greater improvement compared with those on cyclosporine, as measured by the ADCT (adjusted OR [95% CI]); 6.98 [2.49, 19.58]). The ADCT effectively captures subjective aspects compared with the EASI and can be used practically and effectively in clinical settings of atopic dermatitis.

The high prevalence of basal cell carcinoma (BCC) entails a substantial burden on healthcare systems. Interest in non-surgical treatment methods for low-risk BCCs, including destructive treatments, is increasing. Dermatologists often highlight suboptimal cosmetic outcomes as drawbacks of destructive treatments, also for non-facial lesions. Patient perspectives regarding scarring and cosmetic outcomes in relation to other relevant factors are largely unknown, yet important to consider in shared decision-making when choosing treatment. This study investigates patient perceptions of scarring following destructive treatments and explores important factors in treatment decisions for non-facial BCCs. Through a mixed-methods design, cosmetic outcomes, patient satisfaction, scarring concerns, and treatment preferences were evaluated within an ongoing randomized clinical trial on destructive treatments for low-risk BCCs. Overall, 157 patients with 425 non-facial scars were assessed. Most patients were not concerned about scar appearance, highlighting a discrepancy compared with dermatologists' general concerns regarding inferior cosmetic outcome. Instead, when opting for specific treatments, patients listed clearance rates as the most important factor, followed by convenience and time consumption. We believe the results are important both in the context of patient-centred care and in "choosing wisely" when deciding between BCC treatments.

Atopic dermatitis (AD) is the most common skin condition among pregnant women. However, there is limited information on the safety of biologicals during pregnancy. A systematic review and meta-analysis was conducted following the PRISMA guidelines to evaluate the effects of exposure to biologicals during pregnancy and/or preconception in women with AD, and to estimate the pooled prevalence of spontaneous abortions and congenital malformations in their newborns. MEDLINE, Embase, Scopus, and Web of Science to 31 May 2024 were searched to identify randomized controlled trials and non-randomized studies. To test the robustness of our findings, sensitivity analyses were performed. Fifteen observational studies involving 115 pregnant women with a mean age of 33.46 years (standard deviation [SD] 3.02 were included). All studies evaluated dupilumab. The mean duration of exposure to dupilumab during pregnancy was 27.52 weeks (SD 11.16). The weighted prevalence of spontaneous abortions was 18.9% (95% confidence interval 5.3 to 38.2). There were no reports of congenital malformations. The sensitivity analyses showed no significant differences in weighted prevalences. In conclusion, the current scientific evidence suggests that dupilumab is probably safe during pregnancy and preconception in women with AD, with no significant increase in the risk of miscarriage or congenital malformations compared to the general population. However, the results of this review are inconclusive due to the limited number of large, well-designed clinical studies.