Acta dermato-venereologica最新文献

COVID-19 can affect the skin, with rosacea flare-ups reported after infection or vaccination. This study compared rosacea patients with and without post-COVID-19 exacerbation to identify contributing factors. A customized electronic questionnaire was administered to rosacea patients, gathering COVID-19 infection/vaccination status, demographics, and rosacea features. Participants were classified by post-COVID-19 rosacea exacerbation vs none. Multivariable logistic regression identified risk factors. Finally, a total of 104 patients were analysed; 15.4% experienced rosacea exacerbation after COVID-19 vaccination and 28.8% after infection. Comorbidities such as metabolic diseases or allergic diseases were associated with a higher risk of rosacea exacerbation after vaccination or infection (OR = 11.083, 95% CI: 1.136-108.135). Burning and stinging symptoms predicted higher exacerbation risk after vaccination (OR = 8.978, 95% CI 1.968-40.969). Papulopustular rosacea was associated with lower risk (OR = 0.276, 95% CI: 0.066-1.160). Higher body mass index (BMI) was associated with lower exacerbation risk after vaccination (OR = 0.646, 95% CI 0.450-0.928) and infection (OR = 0.731, 95% CI: 0.572-0.933). Frequent rosacea episodes increased exacerbation risk after infection (OR = 8.288, 95% CI: 2.044-33.608). In conclusion, lower BMI was associated with higher risk of rosacea exacerbation after COVID-19 vaccination or infection. Patients with burning and stinging symptoms or a non-papulopustular subtype were more likely to experience exacerbation after vaccination.

Prurigo nodularis (PN) has been associated with autoimmune diseases, though longitudinal data are limited. This study investigates the risk of autoimmune disease development in PN patients using a global electronic health record database. This retrospective cohort study analysed data from the Global Collaborative Network within the TriNetX research network. Adults (≥ 18 years) with PN were compared with propensity score-matched controls without PN. Matching considered age, sex, comorbidities, race, and socioeconomic status. Patients with prior autoimmune diseases or cancers were excluded. Incident autoimmune diseases, including systemic lupus erythematosus (SLE), Sjögren's syndrome, psoriasis, ankylosing spondylitis (AS), rheumatoid arthritis (RA), Crohn's disease (CD), and ulcerative colitis (UC), were evaluated using hazard ratios (HR). Among 17,963 PN patients and the same amount of matched pairs, PN patients had higher risks for SLE (HR: 2.16, 95% CI: 1.44-3.24), Sjögren's syndrome (HR: 1.86, 95% CI: 1.33-2.59), and psoriasis (HR: 3.20, 95% CI: 2.58-3.97). Stratified analysis revealed that female PN patients had higher risks for SLE and Sjögren's syndrome, while psoriasis risk was elevated in both sexes, especially in males. Risks for AS, RA, CD, and UC were not significant. Sensitivity analyses validated these findings. In conclusion, PN is linked to increased risks for SLE, Sjögren's syndrome, and psoriasis, highlighting the need for proactive screening and management of autoimmune diseases in PN patients.

Lichen simplex chronicus is a chronic pruritic skin condition that significantly impacts quality of life. This retrospective study analysed 125 patients with clinically confirmed lichen simplex chronicus seen at a tertiary academic centre to characterize itch severity, anatomical distribution, and associated comorbidities. Itch intensity was assessed using the Numerical Rating Scale (NRS), and clinical data were stratified by demographics and disease extent. Most patients (75%) reported moderate-to-severe itch (NRS 4-10), with nearly 90% experiencing daily pruritus and half reporting both daytime and nocturnal symptoms. The limbs were the most commonly affected sites. Comorbid conditions were frequent, including generalized anxiety disorder (50% vs ~3% in the US adult population), major depressive disorder (44% vs ~8%), hypertension (61% vs ~45%), and type 2 diabetes (30% vs ~11%). Patients with multiple-lesion lichen simplex chronicus had significantly higher itch severity (mean NRS 7.81 vs 7.08, p = 0.001) and were more likely to be female (81% vs 46%, p = 0.002) compared with those with localized disease. These findings highlight the high symptom burden and frequent co-occurrence of psychiatric and metabolic comorbidities in lichen simplex chronicus. Thus, early identification and management of psychiatric, neurological, and metabolic conditions may improve outcomes for patients with lichen simplex chronicus.

Pruritus is a frequent symptom in medicine. Population-based studies show that one in five persons in the general population has suffered from chronic pruritus (CP) at least once in their lifetime, with a 12-month incidence of 7%. CP, which can affect all age groups, is associated with numerous, often interdisciplinary medical conditions. It needs a precise diagnostic work-up to identify causes and relevant comorbidities. Management of CP comprises treatment of the underlying disease as well as topical and systemic therapies. Treating CP needs to be targeted, multimodal and performed in a step-wise procedure requiring an interdisciplinary approach. In recent years, novel on-label therapies have been approved for CP, including therapies for chronic prurigo and cholestatic pruritus. We present the updated European guideline on chronic pruritus by a team of European pruritus experts from different disciplines.