| 1. |
- Alsterholm, Mikael, 1977, et al.
(author)
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Establishment and utility of SwedAD : a nationwide Swedish registry for patients with atopic dermatitis receiving systemic pharmacotherapy
- 2023
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 103
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Journal article (peer-reviewed)abstract
- SwedAD, a Swedish nationwide registry for patients with atopic dermatitis receiving systemic pharmacotherapy, was launched on 1 September 2019. We describe here the establishment of a user-friendly registry to the benefit of patients with atopic dermatitis. By 5 November 2022, 38 clinics had recorded 931 treatment episodes in 850 patients with an approximate national coverage rate of 40%. Characteristics at enrolment included median Eczema Area and Severity Index (EASI) 10.2 (interquartile range 4.0, 19.4), Patient-Oriented Eczema Measure (POEM) 18.0 (10.0, 24.0), Dermatology Life Quality Index (DLQI) 11.0 (5.0, 19.0) and Peak Itch Numerical Rating Scale-11 (NRS-11) 6.0 (3.0, 8.0). At 3 months, median EASI was 3.2 (1.0, 7.3) and POEM, DLQI, and NRS-11 were improved. Regional coverage varied, reflecting the distribution of dermatologists, the ratio of public to private healthcare, and difficulties in recruiting certain clinics. This study highlights the importance of a nationwide registry when managing systemic pharmacotherapy of atopic dermatitis.
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| 2. |
- Sigurdardottir, Gunnthorunn, et al.
(author)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden. - 0001-5555 .- 1651-2057. ; 104
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Journal article (peer-reviewed)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p < 0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p < 0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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| 3. |
- Sandström Falk, Mari Helen, 1958, et al.
(author)
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Atopic dermatitis in adults: does it disappear with age?
- 2006
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In: Acta Derm Venereol. ; 86:2, s. 135-9
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Journal article (peer-reviewed)abstract
- There is limited knowledge of the prognosis in adult atopic dermatitis. We previously published a long-term follow-up questionnaire study of adults with atopic dermatitis. This study is a clinical examination of 79 adults (mean age 57 years) recruited 3 years after that study. Most patients (68%) still reported that they had atopic dermatitis and 53% had ongoing eczema at examination, mainly located on the head and neck. Severity was mainly mild to moderate, but 12% had severe atopic dermatitis. IgE antibodies to Malassezia (m70) were more common in patients with ongoing atopic dermatitis, while positive Malassezia culture was seen mainly in patients with no ongoing atopic dermatitis. M. obtusa and M. globosa were the most commonly cultured Malassezia species. In conclusion, considering increased prevalence of atopic dermatitis in children in recent decades and the fact that atopic dermatitis in most adults continues for many years, we should expect to see more adults with atopic dermatitis in the future.
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| 4. |
- Sandström Falk, Mari Helen, 1958
(author)
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Atopic dermatitis in adults: prognosis and factors of importance for persistence
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Atopic dermatitis (AD) is a common skin disease with multifactorial aetiology. Elevatedlevels of serum IgE are common in AD patients and IgE antibodies to the yeast Malassezia, amember of the cutaneous microflora, are also common. Many investigations concerning thelong-term prognosis of AD have been performed in children but only a few studies amongadults.The overall aim of the study was to obtain more knowledge about the prognosis of AD inadults and factors of importance for persistence of the disease.Adults with AD examined at 20 years of age or older at the outpatient clinic in theDepartment of Dermatology 25-38 years ago were followed up by a postal questionnairewhen the patients were 45 years of age or older. Analysis of the answers from 833 patientsshowed that the majority of adults with AD continue to have AD as they age. Theprognostically unfavourable factors regarding clearance of AD were, in a logistic regressionanalysis, head and neck AD, siblings with atopic disease, allergy to furred animals, pollenallergy, oral allergy syndrome (OAS), and nickel sensitivity.At clinical examination of randomly selected patients recruited from the questionnaire studythe severity of AD was mainly mild to moderate. The majority had ongoing AD and morethan half had head and neck dermatitis with or without other AD locations. Specific serum-IgE to Malassezia was commonest in those with ongoing AD and head and neck dermatitis.The occurrence of reactivity to Malassezia extract and three recombinant Malasseziaallergens (rMala s1, rMala s5, rMala s6) was measured as specific serum IgE, positive skinprick test (SPT) and atopy patch test (APT) reactions in 132 AD patients in a multicentrestudy. Sixty-seven percent of the AD patients and none of healthy controls (HCs) reacted to atleast one of the Malassezia allergens in at least one of the tests. APT added to the test batteryrevealed a previously overlooked impact of Malassezia hypersensitivity in subgroups of ADpatients without head and neck dermatitis or high total serum IgE. A positive Malasseziaculture was less commonly found in AD patients than HCs. M. sympodialis was the dominantMalassezia species found. No correlation was seen between AD severity, head and neckdermatitis or positive APT reaction and the occurrence of positive Malassezia culture. Noassociation was seen between the Malassezia species cultured from individual patients andtheir serum IgE antibodies to the various Malassezia species.In conclusion, AD persists in a majority of adults with AD. This applies particularly ifunfavourable prognostic factors exist such as head and neck dermatitis and occurrence ofallergies (IgE associated AD). A positive Malassezia culture does not seem to correlate withthe severity of the AD, while the occurrence of IgE antibodies to the yeast Malassezia mightcontribute to the chronicity of AD.
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| 5. |
- Sandström Falk, Mari Helen, 1958, et al.
(author)
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Prognosis and prognostic factors in adult patients with atopic dermatitis: a long-term follow-up questionnaire study
- 2004
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In: Br J Dermatol. ; 150:1, s. 103-10
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Journal article (peer-reviewed)abstract
- BACKGROUND: Atopic dermatitis (AD) is a chronic relapsing skin disease. Several investigations concerning the long-term prognosis of AD among children and teenagers have been performed but there are only few data among adults. OBJECTIVES: To investigate the prognosis and prognostic factors in adult patients with AD by a long-term follow-up (25-38 years). The prognostic factors were defined as those factors of importance for the persistence of AD. PATIENTS AND METHODS: A follow-up questionnaire was sent in November/December 1998 to 922 AD patients examined in our outpatient clinic between 1960 and 1973 among 1366 registered patients with AD. The patients were aged 20 years or older when they visited the clinic and 45 years or older when they answered the follow-up questionnaire. RESULTS: The response rate was 90.4%. The age range at the time of follow-up was 45-86 years (mean 55 years). Of the 833 patients who responded, 59% reported AD at some time during the last 12 months, which we defined as persistent AD. The mean value of clearance rate per person-years was 18%. One of the most important factors associated with persistence of AD was a head and neck dermatitis with or without other AD locations at the time of examination according to the old patient records. CONCLUSIONS: This study showed that the majority of adults with AD still had AD when they became older. This applies particularly if negative prognostic factors existed.
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| 6. |
- Sandström Falk, Mari Helen, 1958, et al.
(author)
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The prevalence of Malassezia yeasts in patients with atopic dermatitis, seborrhoeic dermatitis and healthy controls
- 2005
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In: Acta Derm Venereol. - : Medical Journals Sweden AB. ; 85:1, s. 17-23
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Journal article (peer-reviewed)abstract
- Cultures for Malassezia yeasts were taken from both normal-looking skin and lesional skin in 124 patients with atopic dermatitis, 16 patients with seborrhoeic dermatitis and from normal skin of 31 healthy controls. Positive Malassezia growth was found in fewer patients with atopic dermatitis (56%) than in patients with seborrhoeic dermatitis (88%) or in healthy controls (84%, p<0.01). In the patients with atopic dermatitis, fewer positive cultures were found in lesional (28%) than in non-lesional skin (44%, p<0.05), while positive cultures were found in 75% of both lesional and non-lesional skin of patients with seborrhoeic dermatitis (not significant). M. sympodialis dominated in patients with atopic dermatitis (46%) and in healthy controls (69%). In patients with seborrhoeic dermatitis both M. sympodialis and M. obtusa were cultured in 43%. A Malassezia species extract mixture would increase the possibility of detecting IgE sensitization to Malassezia in patients with atopic dermatitis.
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