Actas dermo-sifiliograficas最新文献

Background: Psoriasis is a chronic disease with a prevalence of 3% in the general population. The high prevalence of psoriasis has prompted the study of its comorbidities in recent decades. However, no studies have ever analyzed comorbidity patterns including all chronic diseases in psoriatic patients.

Objectives: To identify comorbidity patterns in psoriatic patients using network analysis and describe them from a clinical point of view.

Methods: We conducted an observational and retrospective study with individuals of the EpiChron Cohort (Aragón, Spain) diagnosed with psoriasis from January 1st, 2010 through December 31st, 2019. The population was stratified by sex and age intervals (0-11, 12-17, 18-44, 45-64 > 65). We built a network for each stratum (ie, 5 for each sex), calculating the tetrachoric correlations of each pair of diseases. We used a cut-off threshold for statistical significance of p-value < 0.01. We applied the Louvain community detection algorithm to identify clusters of diseases.

Results: The prevalence of psoriasis in Aragón was found to be 2.84%. We identified a total of 31,178 psoriatic patients (54% men, 61% from metropolitan areas). The most common comorbidities were respiratory diseases, cardiometabolic conditions (such as hypertension and dyslipidemia), and mental health disorders (including anxiety and mood disorders). A total of 21 comorbidity patterns were identified, varying by sex and age group.

Conclusions: This is the first study ever conducted with a comprehensive analysis of the disease patterns of psoriatic patients. Our results are a comprehensive map of possible psoriasis-related comorbidities. Further studies should confirm these associations and their pathophysiological relationship with psoriasis, which could help to detect and prevent comorbidities and modifiable risk factors.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease affecting all age groups, particularly children. This systematic review provides an overview of the humanistic and economic disease burden in the pediatric population with AD in Spain. The evidence, collected from 11 observational studies published over the past 10 years, exhibits the most common characteristics of the patients, disease burden, patient-reported outcomes, use of resources, and treatment patterns. The burden of AD extends beyond physical symptoms, with associated comorbidities such as asthma and impaired health-related quality of life and mental health disorders, particularly in severe cases. Traditional therapies, primarily topical corticosteroids, face adherence and efficacy challenges. Despite promising innovative treatments and available biological therapies, their use is still limited in the pediatric population. The findings of the present review highlight the scarce scientific evidence on the economic burden of pediatric AD, as well as the most updated humanistic evidence on this disease. At the same time, the need for individualized care and innovative therapeutic interventions to address the multifaceted challenges of pediatric AD in Spain is evident.

Background: Biosynthetic porcine type I collagen dressing is useful to close ulcers and secondary intention healing of surgical cancer wounds.

Objective: To identify factors associated with the healing time of such wounds.

Methods: We conducted a retrospective observational study of patients on oncological dermatological surgery in a cancer center. Healing time was studied based on age, sex, personal history of comorbidities, usual medication, anatomical location, type of surgery performed and size of the defect. Statistical analysis was performed using the ANOVA test and logistic regression.

Results: A total of 306 patients were included with a median age of 73 years (62.4%, men). The statistically significantly characteristics associated with a healing time ≤ 66 days were location-auricle, nose, inner canthus, hand, retroauricular region and nail bed-use of the Mohs technique and defect sizes ≤ 5.28 cm².

Limitations: This is a retrospective study from a single center.

Conclusion: The use of biosynthetic porcine type I collagen dressings for the definitive closure of dermatological surgical cancer wounds seems particularly suitable for small defects of the inner canthus of the eye, hand, auricle, nose, forehead, retroauricular region, and nail bed.

Background: Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor.

Objectives: To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients.

Methods: We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 through December 2019.

Results: A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; p = 0.003), stages III and IV at diagnosis (24.8% vs 11.7%; p < 0.001), thicker Breslow depth (2.8 mm vs 2.0 mm; p = 0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; p = 0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12-1.87] vs 2.14 years [IQR, 1.68-2.70]; p = 0.015).

Conclusion: This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasise the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses.

UV radiation is the main etiological agent of skin cancer. Other factors such as pollution, diet and lifestyle are also contributing factors. Our aim was to investigate the association between melanoma and exposome factors in the Spanish population with a prospective multicenter case-control study. Case group included patients with melanoma while the control group included people who attended the consultations as companions without a past medical history of skin cancer. A total of 73 melanoma patients and 126 controls were included. The former group included more outdoor workers, a history of skin cancer, drug use (acetylsalicylic acid, antidepressants and ACE inhibitors, p<0.05), more sun exposure (p<0.001) and more sunburns (p=0.04). Controls used shade (p=0.04) or clothing (p<0.001) and the sun protection factor (SPF) used 15 years earlier was higher (p=0.04). Melanoma-related exposome factors are associated with sun exposure, drug intake and food. Prevention strategies should target specific populations, such as outdoor workers by promoting sun-safe behaviors and healthy lifestyle habits since childhood.