| 1. |
- Albadri, Zeyad, et al.
(författare)
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Increased Risk of Squamous Cell Carcinoma of the Skin and Lymphoma Among 5,739 Patients with Bullous Pemphigoid: A Swedish Nationwide Cohort Study
- 2020
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Ingår i: Acta Dermato-Venereologica. - : ACTA DERMATO-VENEREOLOGICA. - 0001-5555 .- 1651-2057. ; 100
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Tidskriftsartikel (refereegranskat)abstract
- Evidence about the association of bullous pemphigoid and the risk of cancer is conflicting. Patients diagnosed with bullous pemphigoid (n = 5,739) between 2005 and 2016 were matched with a control cohort from the general population (n = 17,168) to estimate their overall and specific risk of cancer. The risk of squamous cell cancer of the skin (cSCC) was increased in patients with bullous pemphigoid (hazard ratio (HR) 1.3; 95% confidence interval (CI) 1.1-1.6). The risk of lymphoma within one year after bullous pemphigoid diagnosis was also increased (HR 3.1; 95% CI 1.3-7.6). While overall cancer risk prior to diagnosis of bullous pemphigoid was similar in cases and controls (prevalence odds ratio (POR) 1.0; 95% CI 0.9-1.0), the risk of male genital cancer within one year prior to diagnosis of bullous pemphigoid was lower in cases (POR 0.4; 95% CI 0.2-0.8). Clinicians must be aware of the increased risk of cSCC and lymphoma in patients with bullous pemphigoid.
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| 2. |
- Thorslund, Kristofer, et al.
(författare)
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Incidence of bullous pemphigoid in Sweden 2005–2012 : a nationwide population-based cohort study of 3761 patients
- 2017
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Ingår i: Archives of Dermatological Research. - : Springer Science and Business Media LLC. - 0340-3696 .- 1432-069X. ; 309:9, s. 721-727
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Tidskriftsartikel (refereegranskat)abstract
- Studies that report the incidence of bullous pemphigoid from validated nationwide population-based registries are rare. The aim of this study was to estimate the incidence of bullous pemphigoid in Sweden 2005–2012. A population-based open cohort study was designed including all patients diagnosed by a dermatologist with bullous pemphigoid (BP) in Sweden from 2005 to 2012 (n = 3761), identified from the National Patient Register (NPR). The diagnosis of bullous pemphigoid in the NPR was recently validated from medical records, histopathological and immunopathological data by our group in a previous study. The average annual incidence of bullous pemphigoid was 7.1/100,000 (95% CI 6.5–7.7). Female to male ratio was 1.2:1, mean age at diagnosis was 78.9 years. The age-specific incidence rate increased markedly after 80 years of age with an incidence peak between 90 and 99 years of age, 81.9/100,000 (95% CI 75.0–89.2). This large nationwide cohort study presents an adjusted incidence of BP of 7.1/100,000 (95% CI 6.5–7.7) in Sweden. The incidence of bullous pemphigoid is higher than expected and bullous pemphigoid is a common disease in the elderly population.
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| 3. |
- Thorslund, Kristofer
(författare)
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Serotonergic mechanisms in psoriasis
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psoriasis is a chronic inflammatory disease with a prevalence in Sweden of 2-3%. Stress worsens psoriasis. Serotonin, a monoamine and a neurotransmitter, is a well-documented signal substance in situations like stress and in regulation of inflammatory processes. Serotonin produces its effects via about 21 receptors (R), of which the most characterized are 5-HT1AR and 5-HT2AR. The amplitude and duration of activation of the serotonergic system is determined by the serotonin transporter protein (SERT). The aim of the thesis is to elucidate the serotonergic mechanisms involved in psoriasis. In the first study there was a decreased expression of 5-HT1AR and an increased 5-HT2AR expression in the involved skin as compared to normal skin. This differential expression concord with their antagonistic effects, 5-HT1AR inhibiting inflammation and 5-HT2AR promoting inflammation. These two receptors could be potential targets for anti-inflammatory therapies in psoriasis. The expression of 5-HT3R was absent in involved skin and evident in the basal epidermis of the non-involved skin. In Study II the expression of SERT was increased in involved skin as compared to non-involved and normal skin and there was co-localization with caspase-3, a key regulator of apoptosis. This indicates that SERT might play a role in regulating apoptosis in inflammatory cells in psoriasis. SERT might thus constitute a valuable therapeutic target. In Study III an increased SERT expression in inflammatory cells in the epidermis was positively correlated to psoriasis severity and to chronic stress. This implicates that SERT expression could be of importance for psoriasis severity and chronic stress. In the last study, a broad population-based cohort study, SSRI use among patients with plaque psoriasis was associated with a decreased need for systemic psoriasis treatment. SSRI may have a protective effect in psoriasis. In conclusion, a role for the serotonergic system was implicated for the chronic inflammation in psoriasis.
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