Acta dermato-venereologica最新文献

Chronic pruritus is a burdensome condition that frequently affects older adults, yet its epidemiology and impact on quality of life in the ageing population remain underexplored. This cross-sectional study examined the prevalence of chronic pruritus, its associated factors, and pruritus-specific quality of life in 4,474 participants (median age: 72 years; range: 48-99, 58.8% female) from the population-based Rotterdam Study. Questionnaires assessed current, 12-month, and lifetime chronic pruritus, along with the ItchyQoL. Multivariable logistic regression identified factors associated with chronic pruritus, and linear regression assessed factors linked to pruritus-specific quality of life. Principal component analysis explored the ItchyQoL's dimensional structure in this older population. Chronic pruritus prevalence was 8.6% (current), 10.5% (12-month), and 18.6% (lifetime). Female sex, older age, smoking, atopic dermatitis, psoriasis, self-reported dry skin, asthma, steatotic liver disease, polyneuropathy, depressive symptoms, anxiety, and poor sleep were associated with higher odds of chronic pruritus. Among those with current chronic pruritus, pruritus-specific quality of life was moderately impaired, with the greatest impairment associated with atopic dermatitis and psychological symptoms. Principal component analysis identified 4 ItchyQoL dimensions, extending beyond the original 3 domains. Given the cross-sectional design, directionality cannot be inferred. These findings highlight chronic pruritus as a prevalent, multifactorial condition in older adults, with significant psychological impact and implications for multidisciplinary management.

Increasing life expectancy will lead to more elderly people with atopic dermatitis; however, analyses of the impact of atopic dermatitis therapy on the elderly are lacking. This prospective, multicentre observational study assessed the effect of treatment choice on the efficacy of atopic dermatitis therapies in patients with atopic dermatitis aged ≥ 65 years vs < 65 years in France. Clinical endpoints assessed included changes in Eczema Area and Severity Index scores, atopic dermatitis-related hospitalizations, and quality of life. Between December 2020 and October 2024, 679 patients were included in the study (≥65 years: n = 83; < 65 years: n = 596). At baseline, most patients had moderate/severe atopic dermatitis. Biological therapy was the most common treatment initiated at the enrollment visit (≥ 65 years: 72.3%; < 65 years: 54.0%). At 12 months, the mean Eczema Area and Severity Index score decreased similarly in both groups (p = 0.845), from 17.6 ±9.6 to 3.7 ± 5.2 for patients aged ≥ 65 years and from 18.4 ±12.3 to 4.3 ± 5.5 for those aged < 65 years. The reduction in number of atopic dermatitis-related hospitalizations was significant and similar in both groups, and quality of life improved across all areas. Overall, results suggest that therapeutic choices made by dermatologists have a positive impact on elderly patients with atopic dermatitis.

Teledermatology has become increasingly relevant for skin cancer diagnosis, particularly following the COVID-19 pandemic. This retrospective study assessed whether teledermatology enables earlier diagnosis of cutaneous squamous cell carcinoma (cSCC) compared with conventional face-to-face consultation. Clinical and histopathological data from 224 patients (101 in 2019; 123 in 2022) were analysed. Referral delays decreased from 55 to 3 days and surgical wait times from 28.7 to 12.3 days. Tumours diagnosed via teledermatology had significantly smaller minor diameters (0.56 ± 0.3 cm vs 1.09 ± 0.5 cm; p < 0.001). Al-though maximum diameter and tumour depth did not differ significantly, the smaller tumour surface area in the teledermatology group suggests diagnosis at an earlier clinical stage. In multivariate analysis, minor diameter was the strongest independent predictor of teledermatology-based diagnosis (OR = 0.01, 95% CI: 0.001-0.02). These findings suggest that teledermatology facilitates earlier diagnosis of cSCC, allowing timely treatment and potentially reducing the need for extensive surgical procedures. Teledermatology should be considered a valuable triage tool for skin cancer detection, particularly in health systems with limited access to dermatological care.

This study evaluated the diagnostic value and therapeutic efficacy assessment potential of the interferon-γ release assay T-SPOT.TB in cutaneous Mycobacterium marinum infections. A total of 145 patients diagnosed at the Institute of Dermatology, Chinese Academy of Medical Sciences (2020-2024), excluding tuberculosis cases, were retrospectively analysed. Clinical data including demographics, underlying diseases, pathology, microbiological culture, molecular identification, T-SPOT.TB results, treatment regimens, and outcomes were collected. T-SPOT.TB results before treatment, and at 3 and 6 months post-treatment, were compared to assess its diagnostic and monitoring utility. The baseline T-SPOT.TB positivity rate was 71% (95% CI: 63.2-77.8%). Among 17 patients retested at 3 months, positivity was 64.7% (p = 0.125), with median spot-forming cells (SFCs) significantly decreasing from 20.0 (IQR 8.5-41.0) to 8.0 (IQR 2.5-28.0) (p = 0.0007). Among 27 patients retested at 6 months, positivity was 59.3% (p = 0.344), with median SFCs decreasing from 12.0 (IQR 5.0-30.0) to 8.0 (IQR 3.0-13.0) (p = 0.0006). No significant difference in positivity rates was observed between 3 and 6 months post-treatment. The T-SPOT.TB assay shows significant diagnostic value for cutaneous M. marinum infections and facilitates early diagnosis. Declining SFC counts post-treatment provide useful reference for evaluating therapeutic response.

A mainstay treatment of head and neck basal cell carcinoma (BCC) is excision with a fixed surgical margin. Large-scale evaluation of post-surgical margin status is necessary to improve outcomes. This cross-sectional study assessed margin outcomes following excision of head and neck BCCs across Danish healthcare settings, including risk factors for tumour-positive margins. Histopathology records on BCCs excised by all medical specialities between 1 January-31 December 2022 were retrieved from The Danish Pathology Bank. Cases with intraoperative microscopic margin assessment were excluded. Descriptive analyses and multivariable logistic regression determined complete excision proportions and risk factors for positive margins. Including 9,291 BCC excisions in 7,741 patients, the tumour-free proportion was 80.0% (95% CI: 79.2-80.8%). Significant variation occurred by histologic subtype, with tumour-free margins ranging from 60.6% in morpheaform to 83.6% in nodular BCCs. Multivariable analyses also identified morpheaform, micronodular, infiltrating, and superficial subtypes, auricular/postauricular locations, small specimen size, and advancing age as risk factors for tumour-positive margins. The nose was a risk factor in univariable analysis. Simple excision of head and neck BCCs shows notable variation in margin outcomes by patient, tumour, and specimen profile. To minimise recurrence and optimise resources, increased awareness of positive margins is essential.