| 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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| 11. |
- Hjalte, Frida, et al.
(författare)
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Real-world outcome analysis of continuously and intermittently treated patients with moderate to severe psoriasis after switching to a biologic agent
- 2015
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 230:4, s. 347-353
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical studies of continuous versus intermittent biologic therapy for moderate to severe psoriasis demonstrate improved efficacy with continuous treatment. Objective: To analyse Swedish real-world data of continuously and intermittently treated biologic-naive patients after switching to a biologic agent. Methods: This is an observational study based on PsoReg, the Swedish registry for systemic psoriasis treatment. Outcome effects in biologic-naive patients who switched to a biologic agent (n = 351) were analysed in groups of continuous, intermittent and terminated treatment. Results: Intermittently treated patients (n = 50) reported higher Psoriasis Area and Severity Index and Dermatology Life Quality Index values after switching than patients with continuous (n = 260) or terminated treatment (n = 41). Study Limitations:The reason for intermittent treatment was not recorded. The intermittently treated patients may be a heterogeneous group and a limitation is that it cannot be determined whether less than continuous use was offered to handle negative aspects. Conclusion: Patients with continuous biologic treatment tend to achieve better outcomes compared to intermittently treated patients.
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| 12. |
- Kallionpaa, R. A., et al.
(författare)
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Mast Cells in Human Cutaneous Neurofibromas: Density, Subtypes, and Association with Clinical Features in Neurofibromatosis 1
- 2022
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 238:2, s. 329-339
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cutaneous neurofibromas (cNFs) are hallmarks of neurofibromatosis 1 (NF1) and cause the main disease burden in adults with NF1. Mast cells are a known component of cNFs. However, no comprehensive characterization of mast cells in cNFs is available, and their contributions to cNF growth and symptoms such as itch are not known. Methods: We collected 60 cNFs from ten individuals with NF1, studied their mast cell proteinase content, and compared the mast cell numbers to selected clinical features of the tumors and patients. The tumors were immunolabeled for the mast cell markers CD117, tryptase, and chymase, and the percentage of immunopositive cells was determined using computer-assisted methods. Results: The median proportions of positive cells were 5.5% (range 0.1-14.4) for CD117, 4.0% (1.2-7.0) for tryptase, and 5.0% (1.1-15.9) for chymase. The median densities of cells immunopositive for CD117, tryptase, and chymase were 280, 243, and 250 cells/mm(2), respectively. Small tumors, growing tumors, and tumors from patients below the median age of 33 years displayed a high proportion of mast cells. Cells expressing both tryptase and chymase were the predominant mast cell type in cNFs, followed by cells expressing chymase only. Conclusion: The results highlight the abundance of mast cells in cNFs and that their number and subtypes clearly differ from those previously reported in unaffected skin.
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| 13. |
- Killasli, Hassan, et al.
(författare)
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Hidradenitis Suppurativa in Sweden : A Registry-Based Cross-Sectional Study of 13,538 Patients
- 2020
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 236:4, s. 281-288
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition with nodules and fistula formation and scarring. It is a debilitating disease with a severe negative impact on quality of life. There is a need for increased knowledge about the social and lifestyle characteristics of patients with HS in general, and pregnant women in particular. Objectives: The aims of this study were to investigate and describe social characteristics and comorbidity in all HS patients in Sweden as well as to study the prevalence of lifestyle factors associated with negative impact on health and pregnancy in Swedish pregnant women with HS. Methods: A registry-based cross-sectional study was performed by record linkage between Swedish registers covering the entire population. A cohort of 13,538 HS patients diagnosed with HS in specialised care during the years 2001-2014 and a subgroup of 1,368 HS patients who had undergone pregnancy during 2010-2015 were defined and described. Aggregated public data on the entire Swedish population and all pregnancies in 2014 were described for reference. Results: The HS population had an average age of 44 years on December 31, 2014. The prevalence of HS was 0.14%. In comparison to the Swedish reference population the HS patients were more often women, unmarried (36 vs. 44% married), and had lower education (68 vs. 82% with an upper-secondary school degree or higher) and lower income (39 vs. 16% made SEK <100,000 a year). Comorbidity was 3% for inflammatory bowel disease and 8% for type 2 diabetes. The subgroup analysis showed high prevalence of overweight, obesity, and smoking in pregnant women with HS. Conclusions: The results from this comprehensive characterisation of Swedish HS patients may be used to improve preventive measures, information, and care for this vulnerable group.
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| 14. |
- Knipping, Sofie, et al.
(författare)
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Translation and Validation of the Dutch Version of the Sun Exposure and Protection Index (SEPI)
- 2024
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Ingår i: Dermatology. - : KARGER. - 1018-8665 .- 1421-9832. ; 240:2, s. 282-290
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Skin cancer is currently the most common cancer type worldwide, and numbers are rapidly increasing. To improve primary prevention, individualised prevention strategies may be of interest as this enhances the chance of long-term behavioural change. The Sun Exposure and Protection Index (SEPI), previously validated in multiple languages, is a tool that could help identify individuals with risky behaviour and tailor interventions to the persons propensity to change. The aim of the present study was to investigate the reliability and validity of a Dutch version of the SEPI for both usage in daily clinical practice and research. Methods: Patients were included at primary care settings and dermatology outpatient settings in a 1:1 ratio. Participants were asked to fill out the SEPI together with some baseline characteristics and the previously validated FACE-Q Skin Cancer - Sun Protection module. Construct validity was tested by comparing SEPI part I and the FACE-Q module using Spearmans Rho. Internal consistency was assessed with Cronbachs Alpha for both SEPI parts separately. To assess test-retest reliability, the SEPI was again filled out three weeks later, and scores were compared with Cohens weighted Kappa. Results: Of the 171 participants completing the first questionnaire, 147 (86.0%) participants also completed the follow-up questionnaire. Comparison between the corresponding SEPI part I and FACE-Q module questions showed good correlations regarding sun exposure habits (correlation coefficients ranging from 0.61 to 0.85). Internal consistency of SEPI part I was 0.63 and SEPI part II was 0.65. The test-retest analysis indicated reproducibility over time (weighted Kappa ranging from 0.38 to 0.76). Conclusion: In conclusion, the Dutch version of the SEPI is shown to be a valid and reliable tool for both usage in daily clinical practice and research to evaluate individual UV exposure and measure a persons propensity to limit it.
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| 15. |
- Koreck, A, et al.
(författare)
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The role of innate immunity in the pathogenesis of acne.
- 2003
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 206:2, s. 96-105
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Tidskriftsartikel (refereegranskat)abstract
- Acne is a multifactorial disease of the pilosebaceous follicle. The most significant pathogenetic factors of acne are: abnormal ductal keratinization, increased sebum secretion, abnormalities of the microbial flora and inflammation. The pilosebaceous unit is an immunocompetent organ. Keratinocytes and sebocytes may act as immune cells capable of pathogen recognition and abnormal lipid presentation, and they might have an important role in initiating and perpetuating the activation of both innate and adaptive immune responses. The elements of the skin immune system are involved in the development of both noninflammatory and inflammatory acne lesions.
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| 16. |
- Kragballe, K., et al.
(författare)
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Efficacy results of a 52-week, randomised, double-blind, safety study of a calcipotriol/betamethasone dipropionate two-compound product (Daivobet (R)/Dovobet (R)/Taclonex (R)) in the treatment of psoriasis vulgaris
- 2006
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Ingår i: Dermatology. - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 213:4, s. 319-326
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Tidskriftsartikel (refereegranskat)abstract
- Background: The calcipotriol/betamethasone dipropionate two-compound product is safe and effective in the short-term treatment of psoriasis. Objective: The primary objective was to investigate the safety of two treatment regimens involving use of the two-compound product over 52 weeks. The efficacy results are presented here. Methods: Six hundred and thirty-four patients were randomised double-blind to treatment (once daily, when required) with either: 52 weeks of two-compound product (two-compound group), 52 weeks of alternating 4-week periods of two-compound product and calcipotriol (alternating group), or 4 weeks of two-compound product followed by 48 weeks of calcipotriol (calcipotriol group). Results: There was a trend towards a difference between treatments from the overall treatment effect for the percentage of satisfactory responses for each patient during the study (p = 0.071). This appeared to be due to the comparison of the two-compound and calcipotriol groups (p = 0.025). Conclusion: There was a trend towards the efficacy of the two-compound product used for up to 52 weeks being better than that of 4 weeks of the two-compound product followed by 48 weeks of calcipotriol.
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| 17. |
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| 18. |
- Laskowski, Marta, 1991, et al.
(författare)
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Translation and validation of the Self-Assessment Psoriasis Area Severity Index (SAPASI).
- 2023
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 239:5, s. 794-801
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Tidskriftsartikel (refereegranskat)abstract
- The Self-Assessment Psoriasis Area Severity Index (SAPASI) is a patient-administered psoriasis assessment tool for which we present a validated translation from English to Swedish.Validity was evaluated in this single-centre study using the Psoriasis Area Severity Index (PASI) as the standard. Test-retest reliability was assessed using repeated SAPASI measurements.Significant correlations (P<0.0001) using Spearman's correlation coefficient (r) were found between PASI and SAPASI scores (r=0.60) for 51 participants (median baseline PASI 4.4, interquartile range [IQR] 1.8-5.6) and repeated SAPASI measurements (r=0.70) among 38 participants (median baseline SAPASI 4.0, IQR 2.5-6.1). Bland-Altman plots showed generally higher SAPASI scores than PASI scores.The translated version of SAPASI is valid and reliable, although patients generally tend to overrate their disease severity compared to PASI. Keeping this limitation in mind, SAPASI has the potential of being implemented as a time- and cost-efficient assessment tool in a Scandinavian context.
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| 19. |
- Lipsker, D, et al.
(författare)
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The ABC of Hidradenitis Suppurativa: A Validated Glossary on how to Name Lesions
- 2016
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 232:2, s. 137-142
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> The precise clinical description of skin lesions observed in some patients with hidradenitis suppurativa (HS) can be extremely difficult. <b><i>Objective:</i></b> Establishing a validated glossary of terms allowing the best possible description of lesions observed in HS patients. <b><i>Material and Methods:</i></b> Five international experts of HS were to assess a series of 25 photos representing typical lesions of this disorder. For each photo, the experts were asked whether naming of the lesions was possible or not and, if yes, by using which noun. Agreement of their responses was calculated using Fleiss's kappa index. Using a Delphi strategy, photos with disagreement were discussed, and photos were reevaluated on the next day. In case of agreement on the impossibility of naming some clinical situations, new terms, to be included into the glossary, were agreed upon. <b><i>Results:</i></b> After the first round of photos, agreement between the experts was poor with a kappa index of only 0.33 (95% CI 0.22-0.46). After extensive discussion of cases with disagreement, the kappa index increased on day 2 to 0.75 (95% CI 0.60-0.87), allowing to conclude on good interobserver agreement on terminology. Furthermore, a few clinical situations were identified in which naming with established semantics is so far not possible. For these situations, the terms ‘multicord', ‘multipore', ‘multitunnel' and ‘retraction' were defined. <b><i>Discussion:</i></b> This is the first validation of clinical terms used to describe lesions in patients with HS. This should be helpful in better defining the clinical phenotypes observed in this disorder.
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| 20. |
- Lossius, AH, et al.
(författare)
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Shifts in the Skin Microbiota after UVB Treatment in Adult Atopic Dermatitis
- 2022
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 238:1, s. 109-120
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> The pathophysiology in atopic dermatitis (AD) is not fully understood, but immune dysfunction, skin barrier defects, and alterations of the skin microbiota are thought to play important roles. AD skin is frequently colonized with <i>Staphylococcus aureus</i> (<i>S. aureus</i>) and microbial diversity on lesional skin (LS) is reduced compared to on healthy skin. Treatment with narrow-band ultraviolet B (nb-UVB) leads to clinical improvement of the eczema and reduced abundance of <i>S. aureus</i>. However, in-depth knowledge of the temporal dynamics of the skin microbiota in AD in response to nb-UVB treatment is lacking and could provide important clues to decipher whether the microbial changes are primary drivers of the disease, or secondary to the inflammatory process. <b><i>Objectives:</i></b> To map the temporal shifts in the microbiota of the skin, nose, and throat in adult AD patients after nb-UVB treatment. <b><i>Methods:</i></b> Skin swabs were taken from lesional AD skin (<i>n</i> = 16) before and after 3 treatments of nb-UVB, and after 6–8 weeks of full-body treatment. We also obtained samples from non-lesional skin (NLS) and from the nose and throat. All samples were characterized by 16S rRNA gene sequencing. <b><i>Results:</i></b> We observed shifts towards higher diversity in the microbiota of lesional AD skin after 6–8 weeks of treatment, while the microbiota of NLS and of the nose/throat remained unchanged. After only 3 treatments with nb-UVB, there were no significant changes in the microbiota. <b><i>Conclusion:</i></b> Nb-UVB induces changes in the skin microbiota towards higher diversity, but the microbiota of the nose and throat are not altered.
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| 21. |
- Mitteldorf, C., et al.
(författare)
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Galectin-3 Expression in Primary Cutaneous CD30-Positive Lymphoproliferative Disorders and Transformed Mycosis Fungoides
- 2015
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 231:2, s. 164-170
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Tidskriftsartikel (refereegranskat)abstract
- Background: In nodal anaplastic large cell lymphoma, strong expression of galectin-3 (Gal-3) has been found, but only very few cases of primary cutaneous lymphoma have so far been examined. Objectives: To investigate 11 primary cutaneous anaplastic large cell lymphomas (PCALCL), 47 lymphomatoid papuloses (LYP) and 14 cases of transformed mycosis fungoides with CD30 expression (MF-T) for Gal-3 expression. Methods: A Gal-3 score was applied using a photo-based morphometric evaluation program. Double staining for CD30 and Gal-3 was performed. Furthermore, we recorded the cellular and extracellular sublocalization of the signal. Results: The Gal-3 expression in CD30+ tumor cells was significantly lower in MF-T in contrast to CD30+ lymphoproliferative disorders (CD30 LPD; p < 0.001), but we found no differences between PCALCL and LYP (p = 0.42). In PCALCL Gal-3 was more often localized in the cytoplasm in contrast to LYP, in which an equal distribution in the cytoplasm and the nucleus was more common (p = 0.9). Conclusions: The lower Gal-3 expression in MF-T in comparison to CD30 LPD might be an additional criterion to differentiate both entities. The different sublocalization of the Gal-3 signal might reflect a different biological function and behavior. © 2015 S. Karger AG, Basel.
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| 22. |
- Moreno-Arrones, O. M., et al.
(författare)
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Folliculitis decalvans has a heterogeneous microbiological signature and impaired immunological response
- 2023
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 239:3, s. 454-461
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Tidskriftsartikel (refereegranskat)abstract
- Background: Folliculitis decalvans (FD) is a rare primary neutrophilic scarring alopecia whose etiology has not been completely elucidated yet.Objective: To determine if the follicular microbiota residing in FD-affected hair follicles had a distinct microbiological signature and if an aberrant immune response was present in the pathogenesis of FD.Methods: We conducted a cross-sectional study of ten patients affected by FD. Trichoscopy-guided follicular biopsies were taken from affected and healthy scalp to identify the follicular microbiome using next-generation sequencing. We searched for microbiological biomarkers of FD-affected follicles using the linear discriminant analysis (LDA) effect size (LEfSe) tool. Additionally, peripheral blood mononuclear cells were obtained, and their cytokine production was quantified after incubation with pathogen-associated molecular patterns isolated from patients' biopsies and compared with healthy controls.Results: beta-diversity analysis showed statistically significant differences regarding bacteria comparing follicular microbiota of healthy and FD-affected hairs. Ruminococcaceae, Agathobacter sp., Tyzzerella sp. and Bacteriodales vadin HA21 family were good predictors of disease status. IL-10, TNF-alpha and IL-6 levels were significantly decreased in patients after incubation with various strains of bacteria compared with controls.Conclusion: FD hair follicles have a specific heterogenous follicular bacterial microbiota signature. Additionally, these patients seem to have an impaired immunological response.
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| 23. |
- Norlin, Jenny M, 1982-, et al.
(författare)
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Switch to Biological Agent in Psoriasis Significantly Improved Clinical and Patient-Reported Outcomes in Real-World Practice
- 2012
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Ingår i: Dermatology. - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 225:4, s. 326-332
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although clinical studies have shown efficacy of biological agents in moderate to severe psoriasis, observational studies of real-world effectiveness are rare. Objective: To analyse the psoriasis area and severity index (PASI) and quality of life by the EQ-5D questionnaire and dermatology quality of life index (DLQI) in psoriasis patients who switched from conventional systemic treatment to biological agents in clinical practice. Furthermore, to analyse patient groups with the highest benefit of biological agents. Methods: Longitudinal, observational study based on the Swedish National Registry for Systemic Treatment of Psoriasis, PsoReg. Outcomes of biological-naive patients who switched to a biological agent (n = 267) were analysed before switch and at the first follow-up. Results: Patients significantly improved in EQ-5D, DLQI and PASI (p < 0.001). Patients with DLQI >= 10 and/or PASI >= 10 had the greatest benefits from biological agents in terms of EQ-5D. Conclusions: Patients with moderate to severe psoriasis benefit from biological agents in clinical practice; the patients with the highest benefits were those with high pretreatment PASI and DLQI scores. Copyright (c) 2013 S. Karger AG, Basel
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| 24. |
- Norlin, Jenny M., et al.
(författare)
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The use of IL-17 and IL-23 inhibitors in Swedish clinical practice : a register-based analysis
- 2023
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 239:2, s. 262-266
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Interleukin (IL) inhibitors have made completely cleared skin achievable for many patients with moderate to severe psoriasis in clinical trial settings. Few observational studies assess treatment response in accordance with treatment goals in guidelines.OBJECTIVES: The aim of the study was to analyze the treatment response of IL-17/IL-23 inhibitors in clinical practice and the proportions of patients that reach the treatment target of the Psoriasis Area and Severity Index (PASI) < 3 and the Dermatology Life Quality Index (DLQI) ≤5.METHODS: A longitudinal, observational study based on the Swedish National Registry for Systemic Treatment of Psoriasis, PsoReg. Patients using IL-17/IL-23 inhibitors with assessments of PASI, DLQI, and EQ-5D before (maximum 6 months) and after (3-12 months) initiation of IL-17/IL-23 were included.RESULTS: In total, 333 patients using IL-17/IL-23 inhibitors were included. Eighty percent (n = 266) received IL-17 inhibitors, and 20% (n = 67) received IL-23 inhibitors. Sixty-six percent of patients reached both PASI <3 and DLQI ≤5, 23% reached one target, and 11% reached none. The mean (SD) PASI, DLQI, and EQ-5D improvements were 6.75 (6.99), 7.14 (7.97), and 0.126 (0.296), respectively. There was no statistically significant difference in outcomes between IL-17 and IL-23 inhibitor treatment groups.CONCLUSIONS: IL-17/IL-23 inhibitors are effective in clinical practice, but there is still an unmet therapeutic need in moderate to severe psoriasis.
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| 25. |
- Nyren, M, et al.
(författare)
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Instrumental measurement of the Mantoux test: differential effects of tuberculin and sodium lauryl sulphate on impedance response patterns in human skin
- 2000
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 201:3, s. 212-217
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background and Objective:</i> The tuberculin (PPD) test is a model reaction for the cell-mediated immune system of the skin. The aim of this study is to compare the non-invasive technique based on electrical impedance for investigation of the tuberculin test with an irritant contact reaction induced by sodium lauryl sulphate, which has already been carefully evaluated using this method. <i>Methods:</i> 0.1 ml of PPD (2 TU) was injected intracutaneously into the volar forearms of 20 adult healthy subjects, all known to be tuberculin sensitized. Assessments were performed 3 and 7 days after the injections, using visual scoring, a new electrical impedance technique and transepidermal water loss (TEWL). <i>Results:</i> In the 16 cases that completed the study, compared to relevant controls and reactions induced by sodium lauryl sulphate statistically significant changes in 3 of the 4 impedance indices were found: both the means of index MIX and index IMIX increased (p ≤ 0.01) and the mean of index PIX decreased (p ≤ 0.05). Furthermore, similar impedance response patterns occurred in another cell- mediated immune reaction that we have studied previously – namely, the allergic contact reaction induced by nickel sulphate. Unlike the irritant reactions, no significant increase in TEWL values in tuberculin reactions were found. This can be explained by the fact that the epidermis is little affected, since the inflammatory process in the tuberculin reaction is located more deeply in the dermis than with the irritant reaction. <i>Conclusion:</i> The current study strongly indicates that electrical impedance in the described version, besides contact dermatitis, also seems suitable for studies of the tuberculin reaction. This will add a new indication for the technique, and studies of further clinical applications are in progress.
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| 26. |
- Ormerod, AD, et al.
(författare)
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Challenges for synthesising data in a network of registries for systemic Psoriasis therapies
- 2012
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 224:3, s. 236-243
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Tidskriftsartikel (refereegranskat)abstract
- Background: Large disease registries are the preferred method to assess long-term treatment safety. If psoriasis registries collaborate in a network, their power to assess safety is increased.Objective: To identify heterogeneity in psoriasis registries and methodological challenges for synthesising the data they provide.Methods: We surveyed the registries in PSONET and identified and addressed the challenges to collaborative analysis for the network in several round table meetings.Results: Eight out of 10 registries had a prospective comparator cohort with similar disease characteristics but not on biologics. Registries differed in the coding and validation or follow-up of adverse events and in the way they sampled their population. Fifteen challenges to registries collaborating were identified in the areas of operational governance, structural conduct, bias and analysis.Conclusions: Participation in PSONET, a network of psoriasis registries, helps identify and solve common issues, enhancing the individual registries, and provides larger sets of more powerful safety data in a diverse population. Challenges to interpreting data collectively include heterogeneity in sampling, variable penetration of biologics and compatibility of different datasets.Copyright (c) 2012 S. Karger AG, Basel
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| 27. |
- Rossi, Marta, et al.
(författare)
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Design and Feasibility of an International Study Assessing the Prevalence of Contact Allergy to Fragrances in the General Population: The European Dermato-Epidemiology Network Fragrance Study
- 2010
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Ingår i: Dermatology. - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 221:3, s. 267-275
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on the prevalence of contact allergy to fragrances and other sensitizers of the European baseline series, in the general population of different geographical areas of Europe. We report the methodology and the reliability of instruments adopted and discuss the feasibility based on a pilot phase. Methods: Descriptive epidemiology survey. A random sample from the general population is selected and interviewed, and is offered patch testing in a randomized way. We specifically enquire about any skin rash reported during the previous year, and any history of reactions to products that may contain the sensitizer and/or a history of avoidance of the same products. Patch test data are linked to the questionnaire information to define clinical relevance. Results: The questionnaire showed high test-retest reliability in 94 individuals. Patch test reading also showed a high level of interrater reliability. During the pilot phase, a total of 589 participants were recruited. Conclusions: The EDEN Fragrance Study is feasible and able to provide useful data on fragrance allergy. Copyright (C) 2010 S. Karger AG, Basel
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| 28. |
- Sartorius, Karin, et al.
(författare)
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Bacteraemia in patients with hidradenitis suppurativa undergoing carbon dioxide laser surgery: detection and quantification of bacteria by lysis-filtration.
- 2006
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Ingår i: Dermatology. - : S. Karger AG. ; 213:4, s. 305-312
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- BACKGROUND: Hidradenitis suppurativa (HS) is a cicatrising and persistent disease of apocrine gland-bearing areas in adults. The severity of this condition varies from a few suppurating lesions to widespread, disabling disease. The aetiology is obscure, but suggested contributory factors include a genetic predisposition, comedones occluding the pilosebaceous apparatus, bacterial infections, and hormonal factors. Treatment consists mainly of surgery, while medical therapies serve principally as adjunct therapy. OBJECTIVES: The aim of the study was to determine the number and type of bacteria circulating in the bloodstream in patients with HS undergoing surgical treatment with a carbon dioxide laser stripping-secondary intention technique. METHODS: Twenty-one patients (20 females and 1 male, mean age 36, range 20-55 years) were included in the study. One blood sample (8.3 ml) was taken before surgery, one during the operation and the last one 10 min after surgery. Five healthy persons (all females, mean age 36, range 23-48 years) not undergoing any operation were used as the controls. The blood was cultured by a lysis-filtration technique which had been shown to be very sensitive. Since the filter catches the microorganisms and colonies are formed during culturing, the number of bacteria in the samples is easily determined. RESULTS: In 6 patients, all samples were negative, which indicates that the method of surgery itself caused no spread of bacteria from the lesions. Bacterial growth in the first blood sample was found in 9 patients, from the second sample in 10 and from the third one in 6. In 1 patient, bacteria were detected in three samples. At least 12 bacterial species were identified. The dominating bacteria were coagulase-negative staphylococci of which most were subtyped as Staphylococcus warneri. Among the anaerobic microorganisms, Propionibacterium acnes and P.granulosum were the most frequently isolated bacteria. The bacterial findings in the blood samples accord well with the results from a previous study in which cultures were taken from the deep parts of the HS lesions. In the 5 controls, no microbial growth was detected. CONCLUSION: The carbon dioxide laser stripping technique caused no additional spread of bacteria into the bloodstream. The evaluation of cultures containing microorganisms from normal skin flora is controversial. Since the bacteria encountered in this study are in close agreement with the findings in cultures from the deeper parts of HS lesions they seem to be relevant. The growth of bacteria in the first blood sample taken before surgery may indicate that some of these patients have bacteria continuously circulating in their blood.
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| 29. |
- Schmitt-Egenolf, Marcus
(författare)
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PsoReg : the Swedish registry for systemic psoriasis treatment. The registry's design and objectives.
- 2007
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 214:2, s. 112-117
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Tidskriftsartikel (refereegranskat)abstract
- With the introduction of new systemic drugs for the management of psoriasis, we felt an obligation in Sweden to establish a trusted tool to monitor their use. We formed PsoReg to create a solid, long-term database in order to analyze safety and effectiveness of different systemic psoriasis treatment regimens. PsoReg will provide information to help clinicians individualize therapy on a rational basis through evaluation of effectiveness and adverse effects in specific patient subgroups. Designed and managed by specialized health care professionals, PsoReg will enroll all psoriasis patients on systemic treatment to allow a fair comparison of old versus new-generation psoriasis treatments. PsoReg will even create benchmark data for quality assurance of the medical service. A web-based design allows real-time pharmacovigilance and enables the registry to assist clinicians in their day-to-day management of psoriasis patients. In this way PsoReg can become an integrated part of tomorrow’s dermatology.
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| 30. |
- Schmitt-Egenolf, Marcus
(författare)
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Psoriasis therapy in real life : the need for registries
- 2006
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 213:4, s. 327-330
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Tidskriftsartikel (refereegranskat)abstract
- The introduction of new therapeutic options for the management of psoriasis is a challenge for the dermatology community, and new tools are needed to face this challenge. This article argues for the establishment of profession-based registries to collect solid, long-term data on the safety and effectiveness of different psoriasis treatment regimens. Managed by health care professionals, registries will be most successful if they enroll patients based on indications for treatment rather than on drugs given. This protects the evaluation process from commercial influences and allows a fair comparison of old- versus new-generation psoriasis treatments. In contrast to the patients in a registry who receive care in the natural clinical setting, subjects in randomized clinical trials (RCTs) are selected according to study criteria and may therefore not reflect the experience of patients in clinical practice. It is possible that particular risks and opportunities in the real patient population may therefore go undetected in RCTs.Copyright © 2006 S. Karger AG, Basel
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| 31. |
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| 32. |
- Shayesteh, Alexander, et al.
(författare)
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Hyperhidrosis – Sweating Sites Matter : Quality of Life in Primary Hyperhidrosis according to the Sweating Sites Measured by SF-36
- 2017
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 233:6, s. 441-445
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Primary hyperhidrosis has negative impacts on quality of life. The aim of this study was to investigate whether the impacts of primary hyperhidrosis on quality of life are different depending on the localisation of the sweating.METHOD: We compiled background data, Hyperhidrosis Disease Severity Scale (HDSS), and Short-Form Health Survey (SF-36) post hoc results from 2 previous studies. Cases who described only 1 site as their most problematic area of sweating were included (n = 160/188) while individuals with multifocal primary sites of hyperhidrosis were excluded (n = 28/188).RESULTS: Individuals included were 11-62 years old with a mean age of 30.2 ± 10.4 years, and axillary hyperhidrosis (65.6%) was the most common type of hyperhidrosis. Comorbidities were more common when hyperhidrosis was reported in other than the axillary, palmar, and plantar regions. Excluding comorbidities showed the lowest SF-36 mental component summary scores for axillary (41.6 ± 11.6), palmar (40.0 ± 9.4), and plantar hyperhidrosis (41.1 ± 13.7). The HDSS showed the highest proportion of severe cases in axillary (60.6%) and palmar (51.5%) hyperhidrosis (p < 0.01) while mild cases were more often observed in plantar (60%), facial (83.3%), and other sites (85.7%) in primary hyperhidrosis (p < 0.01).CONCLUSION: Our results indicate that impairments in quality of life can be different depending on the manifestation of primary hyperhidrosis on the body. This can have an influence on how patients with hyperhidrosis could be prioritised in health care. Subgroup samples affected by facial hyperhidrosis and other sites of primary hyperhidrosis were however small, and more research is required to verify our findings.
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| 33. |
- Shayesteh, Alexander, et al.
(författare)
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Prevalence and Characteristics of Hyperhidrosis in Sweden : A Cross-Sectional Study in the General Population
- 2016
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Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 232:5, s. 586-591
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hyperhidrosis is defined as excessive sweating which can be primary or secondary. Data about the prevalence of primary hyperhidrosis are scarce for northern Europe.OBJECTIVE: Our aim was to investigate the prevalence of hyperhidrosis focusing on its primary form and describe the quality of life impairments for the affected individuals.METHODS: Five thousand random individuals aged 18-60 years in Sweden were investigated. The individuals' addresses were obtained from Statens personadressregister, SPAR, which includes all persons who are registered as resident in Sweden. A validated questionnaire regarding hyperhidrosis including the Hyperhidrosis Disease Severity Scale (HDSS) and 36-item Short Form (SF-36) health survey was sent to each individual. The participants were asked to return the coded questionnaire within 1 week.RESULTS: A total of 1,353 individuals (564 male, 747 female and 42 with unspecified gender) with a mean age of 43.1 ± 11.2 years responded. The prevalence of primary hyperhidrosis was 5.5%, and severe primary hyperhidrosis (HDSS 3-4 points) occurred in 1.4%. Secondary hyperhidrosis was observed in 14.8% of the participants. Our SF-36 results showed that secondary hyperhidrosis causes a significant (p < 0.001) impairment of both mental and physical abilities while primary hyperhidrosis impairs primarily the mental health (p < 0.001).CONCLUSION: Hyperhidrosis affects individuals in adolescence as a focal form while occurring as a generalised form with increasing age. Further, the prevalence of primary hyperhidrosis described in our study is comparable to other studies from the western hemisphere. While secondary, generalised hyperhidrosis impairs both physical and mental aspects of life, primary hyperhidrosis, with the exception of severe cases, mainly affects the mental health.
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| 34. |
- Sigurdardottir, Gunnthorunn, 1975-, et al.
(författare)
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Decreased Systemic Levels of Endocan-1 and CXCL16 in Psoriasis Are Restored following Narrowband UVB Treatment.
- 2018
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Ingår i: Dermatology. - Basel : S. Karger. - 1018-8665 .- 1421-9832. ; 234:5-6, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In psoriasis, a common immune-mediated disease affecting 2-3% of the population worldwide, there is an increased prevalence of extracutaneous diseases including obesity, the metabolic syndrome, and cardiovascular disease. This is believed to be linked to systemic inflammation. In previous studies, we have explored various markers in plasma and serum to characterize the ongoing systemic inflammation in psoriasis patients compared to controls. We have identified several markers that were altered in psoriasis patients, but which all were unresponsive to narrowband UVB (NB-UVB) treatment.OBJECTIVE: The objective of the study was to evaluate the effect of NB-UVB treatment on markers of cardiovascular risk and systemic inflammation in psoriasis.METHODS: The levels of 17 potential biomarkers with an association with cardiovascular risk were quantitated in plasma from 37 age- and gender-matched psoriasis patients and controls at baseline and in 21 psoriasis patients after 12 weeks of NB-UVB treatment to identify a systemic treatment response.RESULTS: We identified the mediators endocan-1, CXCL16, and sVEGFR1, which were systemically decreased in psoriasis at baseline, as well as FABP3, FABP4, and sIL-1R1, which showed normal baseline levels. After 10-12 weeks of NB-UVB treatment, endocan-1 and CXCL16 were restored to normal levels, while sVEGFR1, FABP3, FABP4, and sIL-1R1 showed a significant reduction.CONCLUSION: The current study expands the number of potential biomarkers in psoriasis by including a greater number and variety of mediators, approaching the systemic inflammation from additional vantage points, including soluble immune receptors and adipocyte contribution, to provide a more complete picture of the systemic inflammatory state in psoriasis.
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| 35. |
- Sondermann, W, et al.
(författare)
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Effects of Patients' Expectation in Dermatology: Evidence from Experimental and Clinical Placebo Studies and Implications for Dermatologic Practice and Research
- 2021
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 237:6, s. 857-871
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Tidskriftsartikel (refereegranskat)abstract
- Patients’ expectations towards the benefit of a treatment are key determinants of placebo responses and can affect the development and course of medical conditions and the efficacy and tolerability of active medical treatment. The mechanisms mediating these placebo and nocebo effects have been best described in the field of experimental pain and placebo analgesia. However, also in dermatology experimental and clinical studies demonstrate that various skin diseases such as inflammatory dermatoses and allergic reactions can be modulated by patients’ expectations. Dermatologists should consider the important modulatory role of patients’ expectations on the efficacy and tolerability of specific treatments and the key role of verbal information, patients’ prior treatment experiences (associative learning), and the quality and quantity of doctor-patient communication in shaping treatment expectation. As a consequence, techniques aiming at maximizing patients’ expectation effects should be implemented into daily clinical routine. By contrast, in clinical studies expectation effects should be maximally controlled and harmonized to improve the “assay sensitivity” to detect new compounds. Further translational studies, also in dermatoses that have not been investigated yet, are needed to better characterize the mechanisms underlying patients’ expectation and to gain further insights into potential clinical implications of these effects in dermatologic conditions. Therefore, in this review, we provide a brief overview on the concept of expectation effects on treatment outcome in general, summarize what is already known about this topic for dermatologic diseases, and finally present the relevance of this topic in clinical dermatology.
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| 36. |
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| 37. |
- von Kobyletzki, Laura, et al.
(författare)
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Validation of a parental questionnaire to identify atopic dermatitis in a population-based sample of children up to 2 years of age
- 2013
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Ingår i: Dermatology. - Basel, Switzerland : S. Karger. - 1018-8665 .- 1421-9832. ; 226:3, s. 222-226
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Tidskriftsartikel (refereegranskat)abstract
- Background: Validated eczema questionnaires have been available for schoolchildren only, but the incidence of atopic dermatitis (AD) is highest during infancy. Objective: To validate a parental questionnaire to identify AD in children up to 2 years of age.Methods: Parents of 476 children answered a written questionnaire prior to an examination by a physician. Sensitivity, specificity, predictive values and test-retest reliability of the questionnaire were assessed.Results: A total of 245 (51%) girls and 231 (49%) boys, aged 1-24 months, with and without physician-diagnosed AD participated. Seventy-one children (15%) had physician-diagnosed AD. Validation of the questionnaire by comparisons with physicians' diagnoses showed a sensitivity of 0.87 (95% confidence interval, CI, 0.77-0.94) and a specificity of 0.98 (95% CI, 0.96-0.99). The positive predictive value was 0.90 (95% CI, 0.80-0.96) and the negative predictive value was 0.98 (95% CI, 0.96-0.99). Conclusion: The questionnaire identified AD in children aged 0-2 years with high accuracy.
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| 38. |
- Zou, L, et al.
(författare)
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Alcohol intake measured by phosphatidylethanol in blood and the lifetime drinking history interview are correlated with the extent of psoriasis
- 2015
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Ingår i: Dermatology (Basel, Switzerland). - : S. Karger AG. - 1421-9832 .- 1018-8665. ; 230:4, s. 375-380
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Psoriasis has been reported to be associated with alcohol consumption. <b><i>Objective:</i></b> To investigate the level of alcohol intake in individuals with psoriasis and correlate intake with the extent of disease and pruritus. <b><i>Methods:</i></b> Twenty-nine outpatients (15 females and 14 males) with stable chronic plaque psoriasis of moderate severity were recruited. The Psoriasis Area and Severity Index (PASI) and the degree of pruritus (visual analogue scale) were compared with measures of drinking habits as determined by the Lifetime Drinking History (LDH), the Alcohol Use Disorders Identification Test and whole-blood phosphatidylethanol (PEth), an alcohol-specific biomarker. <b><i>Results:</i></b> The majority of patients were social drinkers with moderate alcohol consumption as determined by PEth and LDH. Alcohol consumption correlated significantly with the PASI score. There was no correlation between alcohol use and pruritus. <b><i>Conclusion:</i></b> The level of alcohol consumption is correlated with the extent of psoriasis.
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| 39. |
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