Acta dermato-venereologica最新文献

Actinic keratosis is a common, chronic, and potentially pre-cancerous skin disease that can negatively impact patients' health-related quality of life. This systematic review aimed to identify and describe the questionnaires used to assess health-related quality of life in patients with actinic keratosis and summarize reported impacts. Four databases (EMBASE, PsycINFO, PubMed, and Cochrane Library) were searched up to February 2025. Two reviewers independently screened articles, and risk of bias was assessed using tools appropriate to study design. Of 639 records, 37 studies including 9,326 patients met inclusion criteria. Most studies were interventional (59%) and of moderate to high quality (64%). Health-related quality of life was assessed using 3 disease-specific, 3 dermatology-specific, and 2 generic questionnaires. The most frequently used instruments were the Actinic Keratosis Quality of Life (n = 13) and the Dermatology Life Quality Index (n = 16). All questionnaires detected health-related quality of life impairment, especially during treatment. Actinic Keratosis Quality of Life identified patient subgroups with greater health-related quality of life reduction, including females, younger individuals, patients with comorbidities, and those with a history of skin cancer. All health-related quality of life questionnaires captured impairment in patients with actinic keratosis. The Actinic Keratosis Quality of Life and Dermatology Life Quality Index questionnaires were widely used. Actinic Keratosis Quality of Life identified subpopulations with health-related quality of life impairment. Among studies reporting mean health-related quality of life scores, the Dermatology Life Quality Index ranged from 1.55 to 24 and the Actinic Keratosis Quality of Life from 4.22 to 17, reflecting very broad variability and underlying differences in actinic keratosis severity across study populations.

Dermatophyte infections are common in general practice and occur more often in individuals with type 2 diabetes (T2D), but whether they signal undiagnosed T2D remains unclear. We conducted a register-based cohort study including positive PCR tests for dermatophyte infection from the feet or nails, matched 1:3 to individuals from the same geographic area in Denmark. Those with known diabetes, type 1 diabetes or aged under 20 were excluded. Incidence rates (IRs) and incidence rate ratios (IRRs) for new-onset T2D were estimated using Poisson regression. The final cohort comprised 78,140 individuals, with a median age of 51 years, and 60.8% were male. The IR for T2D was 9.23 per 100 person-years in the exposed group and 9.00 in the unexposed group, with an adjusted IRR of 1.00 (0.91-1.11, p=0.94), indicating no significant association. In a sensitivity analysis excluding unexposed individuals with prior topical antifungal treatment, the IRR increased to 1.15 (1.08-1.23, p=0.001). While the primary analysis showed no significant association, the sensitivity analysis suggested a modest increased risk when exposure misclassification was reduced, supporting dermatophyte infection as a possible early signal of undiagnosed T2D in selected populations.

Body modifications such as tattoos and piercings are increasingly popular, yet their psychological implications in dermatology patients remain understudied. This study examined the prevalence of body modifications, their association with body dysmorphic disorder (BDD) symptom tendencies and their relationship with illness acceptance. A cross-sectional survey was conducted among 333 consecutive dermatology outpatients in Wrocław, Poland. Participants provided demographic data, chronic skin disease status and information on tattoos and piercings. BDD symptoms were assessed with the Appearance Anxiety Inventory (AAI; score≥20 indicating high BDD risk), while the Acceptance of Illness Scale (AIS) measured psychological adaptation. Statistical analyses included t-tests, χ2 tests, ANOVA and Spearman's correlation. Overall, 29.4% of participants reported body modifications - 20.7% tattoos and 15.9%piercings. BDD symptom tendencies were present in 15.9% of patients but were significantly more frequent among those with tattoos (26.1%) and piercings (34%). Individuals with body modifications were younger and more often female. AIS and AAI scores showed a significant negative correlation, suggesting that lower illness acceptance was linked to higher BDD symptomatology. Body modifications among dermatology patients are associated with increased risk of screening positive for BDD tendencies and reduced acceptance of illness. These findings emphasize the need for psychological screening in dermatological practice and training dermatologists to recognize and address underlying mental health concerns.

Catastrophizing, defined as an overly negative evaluation of one's situation, is associated with worse disease outcomes in patients with chronic pain but remains unexplored in pruritus medicine. In this cross-sectional study, we included patients with chronic prurigo (CPG, n=50), chronic pruritus on nonlesional skin (CPNL, n=50) and chronic spontaneous urticaria (CSU, n=50) to investigate catastrophizing and determine possible associations with demographic and clinical factors. Patients completed validated questionnaires assessing catastrophizing (Itch-Cognition-Questionnaire), itch intensity, disease control, quality of life, anxiety, depression, stress and attention to itch. We recorded median [interquartile range] catastrophizing scores of 19.0 [11.0; 29.0] for CPG, 17.0 [11.8; 24.3] for CPNL and 10.0 [5.0; 18.3] for CSU patients. Catastrophizing correlated positively with itch intensity (r=0.382-0.678, p<0.001-0.006), quality of life impairment (r=0.554-0.716, p<0.001) and vigilance and awareness to itch (r=0.407-0.591, p<0.001-0.003) across patient groups. Linear regression analysis revealed a lower likelihood of catastrophizing in CSU patients (CSU: β=-5.905, p<0.001; CPG: reference), a positive association of catastrophizing with average itch intensity (β=1.119, p=0.008) and attention to itch (β=0.150, p<0.001), and a negative association with age (β=-0.095, p=0.004) and short disease duration (β=-5.797, p=0.049). Catastrophizing represents a pivotal cognitive process, which is associated with worse clinical outcomes in chronic itch patients.