Acta dermato-venereologica最新文献

The objective of this retrospective observational study was to estimate the prevalence of actinic keratosis (AK) in individuals aged ≥ 40 years in France, to describe the characteristics of affected patients, and to describe treatments. A representative panel of 20,000 households with ≥ 1 member aged ≥ 40 years were invited to participate. Participants who reported AK lesions diagnosed by a physician were eligible. The study questionnaire collected data on demographics, lesion characteristics, Fitzpatrick phototype, diagnosis, and treatments. In total, 15,246 questionnaires (78.5%) were returned and 639 responders were eligible. The adjusted prevalence of AK was 4.03% (95% CI: 3.73-4.35). Prevalence is probably underestimated due to data collection by self-report and low awareness of AK. 177 participants (27.7%) were aged < 65 years. AK was diagnosed by a dermatologist for 521 participants (81.6%). Some 200 participants (31.3%) had no lesions at the time of the survey and 243 (37.9%) had never been treated; 312 participants (78.6%) were prescribed physical treatment, principally cryotherapy; and 125 (31.5%) were prescribed topical treatment, principally 5-fluorouracil or imiquimod. In conclusion, improving diagnosis of AK in everyday clinical practice is important to ensure that all individuals with AK are treated optimally and encouraged to take sun protection measures to prevent progression to SCC.

Itching tends to worsen at night in patients with itchy skin diseases, such as atopic dermatitis. Unconscious scratching during sleep can exacerbate symptoms, cause sleep disturbances, or reduce quality of life. Therefore, evaluating nocturnal scratching behaviour is important for better patient care. However, no report exists on the specific detection of overnight scratching behaviour of patients with atopic dermatitis using a non-wearable sensor. A novel algorithm was developed to specifically detect scratching behaviour using a non-wearable sheet-shaped body vibrometer placed under the mattress. To evaluate the algorithm, the sleep of 7 patients with atopic dermatitis and 3 healthy participants was simultaneously measured using an infrared camera and the sheet-shaped body vibrometer. Scratching time was then used as the gold standard, which was determined visually from the infrared video. The proposed method of detecting vibration was compared with the conventional method using the activity score measured by a sheet-shaped body vibrometer. Spearman's correlation coefficients of the conventional and proposed methods were 0.72 and 0.89, respectively. The Bland-Altman plot results confirmed that the proposed method avoided overestimation of scratching time in patients with short scratching times because it excluded activities other than scratching behaviour, such as turning over.

Gain-of-function variants in the voltage-gated sodium channel Nav1.7, encoded by the SCN9A gene, have previously been identified in patients with erythromelalgia, a clinical diagnosis defined by intermittent attacks of painful, hot, swollen, and red skin, predominantly involving the hands and feet. Symptoms are induced or aggravated by warming and relieved by cooling. In primary erythromelalgia there is no known underlying disease. This study investigated the frequency of SCN9A variants in a cohort of primary erythromelalgia patients collected at a single centre, and examined the clinical signs and symptoms associated with identified variants. One hundred patients with possible erythromelalgia were collected prospectively and evaluated by clinical examination. Thirty-five patients fulfilling the clinical criteria of primary erythromelalgia were screened for variants in SCN9A. Five were found to carry likely causal variants, including a variant found in 2 related individuals and a variant not previously described in patients with erythromelalgia. The clinical findings differed significantly between the patients. Overall, in this cohort only 4/34 (11.7%) of unrelated patients had erythromelalgia likely caused by gain-of-function variants in SCN9A. Variants in SCN9A are therefore likely to cause or contribute to primary erythromelalgia in only a small proportion of patients.