| 1. |
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| 2. |
- Bjarnason, B, et al.
(författare)
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Reactivity at edges of corticosteroid patch tests may be an indicator of a strong positive test response
- 1999
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 199:2, s. 130-134
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Tidskriftsartikel (refereegranskat)abstract
- <b>Background:</b> The importance of the reactivity at the edges of corticosteroid patch tests is unknown. <b>Objective:</b> To study the clinical importance of edge reactivity in budesonide patch tests. <b>Methods:</b> Ten subjects previously positive for budesonide patch tests were retested with 0.1% budesonide in Finn Chambers<sup>®</sup> and with budesonide-printed polyester squares in serial doses (150–0.074 μg/cm<sup>2</sup>). Six exposure periods were used for each polyester square dose (3 h to 4 days). Tests were followed up to 11 days. Doubtful or weakly visible reactivity at the test edges was assessed additionally by test perfusion assessments. <b>Results:</b> Nine of 10 subjects reacted with some edge reactivity and later exhibited positive reactions. Perfusion assessments helped to confirm early edge reactivity. Some allergic subjects showed edge reactivity only at high doses, while longer applications were required for weaker doses. <b>Conclusion:</b> Edge reactivity may be an indicator of a strong suppressed test response.
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| 3. |
- Bykov, VJ, et al.
(författare)
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Protective effects of tanning on cutaneous DNA damage in situ
- 2001
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 202:1, s. 22-26
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The incidence of skin cancer, the most common type of cancer in the Western world, has been shown to be associated with the degree of exposure to solar radiation. However, little is known on how human skin can be protected against UV-induced DNA damage by constitutive and induced pigmentation. <i>Objective:</i> To study the effect of skin pigmentation induced by a sunbed-type of treatment on the formation of UV-induced DNA damage in human skin in situ. <i>Methods:</i> A photoproduct assay was performed in untanned and tanned skin of healthy volunteers. <i>Results:</i> There is no significant difference in the induction of photoproducts between untanned and tanned skin. <i>Conclusion:</i> Our data demonstrate that constitutive skin pigmentation is more efficient than the induced one in protection against formation of photoproducts.
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| 4. |
- de Rie, MA, et al.
(författare)
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Pharmacoeconomic evaluation of calcipotriol (Daivonex/Dovonex) and UVB phototherapy in the treatment of psoriasis: a Markov model for The Netherlands
- 2001
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 202:1, s. 38-43
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The high prevalence and chronic nature of psoriasis leads to high costs in relation to the treatment and control of the disease. A number of clinical trials have shown that a combination therapy of calcipotriol cream (Daivonex<sup>®</sup>/Dovonex<sup>®</sup>, Leo Pharmaceutical Products) and ultraviolet B phototherapy (UVB) decreases the total number of UVB exposures required compared to UVB treatment alone. From a societal point of view, the addition of calcipotriol to UVB therapy could achieve cost savings due to the fewer UVB treatments needed and the reduced travelling and time off work for patients. Fewer UVB exposures may also have other beneficial effects, i.e., shortened waiting lists and less risk to patients of developing cancer or photoaging of the skin. <i>Objective:</i> To compare the cost-effectiveness of treating psoriatic patients in the Netherlands with calcipotriol cream used daily combined with twice weekly UVB treatments to emollient used daily combined with UVB given 3 times weekly. <i>Methods:</i> Based on the clinical results from a Canadian trial, a decision-analytical model was constructed to simulate treatment outcomes and estimate the costs of managing psoriatic patients in the Netherlands over a period of 20 weeks from initiation of therapy. Unit costs and details of standard treatment protocols were collected from Dutch dermatology centres in hospitals and the community for use in the model. Other therapies, such as topical corticosteroids, tar or dithranol were not investigated in this analysis. <i>Results:</i> The total cost of managing psoriatic patients in the Netherlands over a 20-week period is estimated as EUR 1,175.90 for those treated with calcipotriol and UVB and EUR 1,212.14 for patients treated with emollient and UVB. Thus, the former treatment, adding calcipotriol to UVB phototherapy, provides a minor cost saving of EUR 36.24 (3%) compared to the cost of UVB treatment alone. Sensitivity analyses demonstrated that these results are sensitive to changes in the cost of UVB treatment. <i>Conclusion:</i> Calcipotriol treatment combined with UVB phototherapy is a cost-neutral alternative to UVB phototherapy used with an emollient. The patients achieve treatment success in the same time on both treatments but the former, with calcipotriol, requires less exposure to UVB radiation. The additional drug costs from using calcipotriol are offset by savings from the fewer UVB sessions required. Essential beneficial effects for patients are less inconvenience, less risk of developing photoaging of the skin and less exposure to potentially carcinogenic radiations.
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| 5. |
- Duvetorp, Albert, 1980-, et al.
(författare)
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Sex and Age Influence the Associated Risk of Depression in Patients with Psoriasis : A Retrospective Population Study Based on Diagnosis and Drug-Use
- 2021
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Ingår i: Dermatology. - : KARGER. - 1018-8665 .- 1421-9832. ; 237:4, s. 595-602
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Tidskriftsartikel (refereegranskat)abstract
- Background:The reported prevalence of depression among individuals with psoriasis varies substantially, and the effect of gender on depression distribution has revealed conflicting results. In addition, using medication to identify cases is uncommon. Objective: To study the prevalence of pharmacologically treated depression among individuals with and without psoriasis in a Swedish population using ICD-10 codes and data from the Swedish Prescribed Drug Register. Methods: A retrospective case-control population-based study was performed including all living individuals (age ≥18 years) in Region Jönköping, southern Sweden (n = 273,536). ICD-10 codes for the diagnosis of psoriasis (L40.*) and depression (F32.* and F33.*), and data on pharmacological treatment from the Swedish Prescribed Drug Register, were extracted from electronic medical records between April 9, 2008 and January 1, 2016. The extraction date was January 1, 2016. Results: The risk of pharmacologically treated depression was increased in individuals with psoriasis (age- and sex-adjusted OR 1.55; CI 1.43–1.68); 21.1% of women with psoriasis received pharmacological treatment for depression during the study period compared to 14.2% in the control population. Prevalence figures for depression were significantly higher in women with psoriasis compared to men. The risk of suffering from depression was highest among male and female patients with psoriasis under the age of 31 years. Conclusions: Depression is common among patients with psoriasis. The results of the current study underline the need for dermatologists to adopt a holistic approach, looking beyond the skin, when handling patients with psoriasis in every-day clinical practice.
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| 6. |
- Ekbäck, Maria Palmetun, et al.
(författare)
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Health-Related Quality of Life, Depression and Anxiety Correlate with the Degree of Hirsutism
- 2013
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Ingår i: Dermatology. - : Karger. - 1018-8665 .- 1421-9832. ; 227:3, s. 278-284
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hirsutism has a negative impact on womens quality of life. The relation between quality of life, anxiety, depression and the level of hairiness has not been described. Aims: To investigate the correlations between the levels of hairiness, quality of life, anxiety and depression. Methods: 200 patients from Malmo, Orebro and Uppsala, who had been in contact with the clinics for problems with excessive hair growth, were invited to answer a self-administered questionnaire including sociodemographic questions, EQ-5D index score, Dermatology Life Quality Index (DLOI), Hospital Anxiety and Depression Scale (HADS) and Ferriman-Gallwey scale (F-G); of these, 127 women participated in the study. Results: The mean values were: EQ-5D index 0.73 (SD = 0.27), EQ visual analogue scale 61.0 (SD = 22.6), HADS-anxiety 9.5 +/- 5.3 and HADS-depression 6.5 +/- 4.6. The mean DLQI was 11.8 +/- 8.4, indicating a very large effect on patients lives. All were significantly correlated with the amount of hairiness. Conclusions: Higher levels of hair growth were significantly correlated with a lower level of quality of life and symptoms of both anxiety and depression.
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| 7. |
- Emtestam, L, et al.
(författare)
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Electrical impedance of nodular basal cell carcinoma: a pilot study
- 1998
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 197:4, s. 313-316
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previously, we have explored the use of measurements of electrical impedance and devised 4 physically distinct indices named magnitude index (MIX), phase index, real part index and imaginary part index (IMIX) from the impedance data. Our results indicated that these indices could characterize contact reactions. Objective: The goal of the present study was to use the electrical impedance method for the preoperative assessment of nodular basal cell carcinoma (BCC). Methods: We included 11 patients with a total of 12 nodular BCC, diagnosed clinically and histologically. The noninvasive measurements were performed by transepidermal water loss (TEWL) and electrical impedance. For reference, normal looking contralateral or ipsilateral skin was used. Results: Compared to controls, the mean TEWL of BCC was increased, but this finding was not statistically significant. The electrical impedance measurements of BCC tissue revealed statistically significant changes of the impedance indices MIX and IMIX (p ≤0.001). Conclusion: The results suggest that the measurement of electrical impedance might become useful for investigations of BCC.
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| 8. |
- Feldreich, N, et al.
(författare)
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Photochemotherapy and Graft-versus-Leukemia Reaction in Acute Leukemia: Tumor Immunity and Survival Are Dependent on Timing of Photochemotherapy of the Skin
- 2017
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 233:4, s. 303-313
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Cure of acute leukemia after transplantation is mediated by the grafted cells. We investigated the graft-versus-leukemia effect (GVL) in patients with cutaneous acute graft-versus-host disease (GVHD) treated with photochemotherapy (psoralen and ultraviolet light type A). <b><i>Method:</i></b> Forty-seven patients with acute leukemia were followed 5,000 days after transplantation to assess survival and GVL by multivariate analysis. The primary predictor was time to treatment of cutaneous acute GVHD by photochemotherapy separated into treatment start during the first week of acute GVHD versus after the first week of acute GVHD. <b><i>Results:</i></b> Photochemotherapy started after the first week of acute GVHD predicted GVL with a hazard ratio (HR) of 3.94 (95% confidence interval, CI, 1.67-9.33, <i>p</i> = 0.0018) and survival with preserved GVL with an HR of 2.63 (95% CI 1.30-5.32, <i>p</i> = 0.007). The effects on GVL and survival with preserved GVL were present regardless of whether the patients were transplanted in remission or relapse (<i>p</i> < 0.05). Chronic GVHD came earlier in the group that started photochemotherapy after 1 week of acute GHVD, but chronic GVHD did not increase the GVL. <b><i>Conclusion:</i></b> The timing of photochemotherapy after cutaneous acute GVHD may direct the GVL and predict long-term leukemia-free survival.
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| 9. |
- Feldreich, N, et al.
(författare)
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Photochemotherapy of Cutaneous Graft-versus-Host Disease May Reduce Concomitant Visceral Disease
- 2016
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 232:4, s. 453-463
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Photochemotherapy may be used to treat cutaneous graft-versus-host disease (GvHD). Animal models show that in the days after photochemotherapy and antigen provocation, cells with an antigen-specific suppressive phenotype are elicited in the lymphoid organs. In GvHD, host antigens are present not only in the skin treated by photochemotherapy but also in the visceral tissues. <b><i>Objective:</i></b> The aim of this paper was to evaluate the effect on visceral acute GvHD (aGvHD) of photochemotherapy of the skin. <b><i>Methods:</i></b> We retrospectively evaluated 33 patients with aGvHD of the skin, the liver, and/or the gastrointestinal tract treated with photochemotherapy for their aGvHD of the skin and did a long-term follow-up of 10 years on survival. <b><i>Results:</i></b> The complete response (CR) to photochemotherapy was 39%, the complete and partial response was 64% and the 6-month survival was 64%. Total body irradiation (TBI) before hematopoietic stem cell transplantation predisposed for CR of aGvHD of the liver and the gastrointestinal tract (p = 0.045). In the TBI group, the accumulated dose (numbers of treatments) for CR of visceral aGvHD increased with the body surface area affected by disease, from 8 (min-max: 5-14) for skin disease stage 1 to 10.5 (6-33) for stage 2 and 13 (11-21) for stage 3 (p = 0.04). Skin disease stage 1 showed a trend to be associated with CR in visceral disease at 28, 56, and 100 days (p = 0.07). Overall CR in visceral disease predicted a better 10-year overall survival (p = 0.0036). Finally, after TBI aGvHD of the gastrointestinal tract without anti-thymocyte globulin (ATG), clearance of T cells and dendritic cells responded better than aGvHD of the liver and aGvHD of the gastrointestinal tract with ATG (p = 0.01). <b><i>Conclusion:</i></b> Photochemotherapy after ionizing irradiation regulates the cell-mediated immunity in the viscera, and the systemic efficacy increases when the skin itself is less affected by disease. ATG modulates the regulatory effect of the gastrointestinal tract.
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| 10. |
- Gross, B., et al.
(författare)
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New Findings in PiZZ alpha(1)-Antitrypsin Deficiency-Related Panniculitis Demonstration of Skin Polymers and High Dosing Requirements of Intravenous Augmentation Therapy
- 2009
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Ingår i: Dermatology. - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 218:4, s. 370-375
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Tidskriftsartikel (refereegranskat)abstract
- Panniculitis is a recognized but unusual complication of a severe deficiency of alpha(1)-antitrypsin (AAT), with fewer than 100 cases described to date. Like the pathogenesis of emphysema in severe PiZZ deficiency of AAT, panniculitis has been hypothesized to be an inflammatory process, possibly related to Z AAT polymer formation and to an unopposed anti-inflammatory screen in the context of deficient serum levels of AAT. The current report presents a 31-year-old woman with PiZZ AAT deficiency-associated panniculitis. Our case extends current knowledge of AAT-associated panniculitis in 2 ways: (1) we demonstrate Z-type AAT polymers in the skin, which supports the inflammatory pathogenesis of panniculitis and the potential pro-inflammatory role of polymers; (2) we show that a high dose and long- term use of intravenous augmentation therapy (90 mg/kg body weight once weekly during 3 years) can ameliorate the frequency and severity of panniculitis associated with AAT deficiency. Copyright (C) 2009 S. Karger AG, Basel
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