| 1. |
- Elmelid, Andrea, 1986, et al.
(author)
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Effects of Phototherapy on Free Vitamin D Levels in Ten Patients with Atopic Dermatitis
- 2022
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In: International Journal of Translational Medicine. - : MDPI AG. - 2673-8937. ; 2:4, s. 586-596
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Journal article (peer-reviewed)abstract
- The role of vitamin D in atopic dermatitis (AD) is controversial. Conflicting data could be due to the use of inadequate markers for assessing vitamin D status. So far, directly measured free 25(OH)D concentrations have not been reported in AD patients. Ten adults with AD were treated with narrow band ultraviolet light B (NB-UVB) for 10–12 weeks. SCORing atopic dermatitis (SCORAD) and the visual analogue scale (VAS) were used to assess disease severity before and after NB-UVB therapy. Total and free 25(OH)D and 1,25(OH)2D serum levels were analyzed before and after treatment. Free 25(OH)D concentrations were measured with a two-step immunosorbent assay (ELISA). The majority of patients had sufficient levels of 25(OH)D before treatment (mean 76.4 nmol/L). Mean free 25(OH)D was 11.9 pmol/L and mean 1,25(OH)2D was 108.9 pmol/L. Median SCORAD decreased from 37.1 to 19.8 and VAS improved significantly after phototherapy. Total and free 25(OH)D increased in all subjects. No correlations between disease severity and vitamin D levels were found. There was no correlation between total and free 25(OH)D levels. Larger studies are needed to test the applicability of the free hormone hypothesis in AD pathogenesis.
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| 2. |
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| 3. |
- Stenman, Caroline, et al.
(author)
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Sun protection behaviour in organ transplant recipients and non-transplant patients attending a dermatology outpatient clinic in Sweden: A questionnaire survey
- 2022
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In: Photodermatology Photoimmunology & Photomedicine. - : Wiley. - 0905-4383 .- 1600-0781. ; 38:2, s. 132-140
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Journal article (peer-reviewed)abstract
- Background/purpose Organ transplant recipients (OTRs) are at high risk of developing skin cancer and are therefore advised to protect their skin against ultraviolet radiation from the sun. Specialized OTR clinics with dermatological follow-up may improve sun habits among OTRs. In this study, we compared self-reported sun exposure and sun protection behaviour between OTRs and non-transplant patients (non-TPs) and between OTRs with and without special dermatological follow-up. Methods Patients from Sahlgrenska University Hospital, Gothenburg, Sweden, completed a sun exposure questionnaire. Between 2011 and 2015, 282 OTRs transplanted in the period 1976-2014 and 414 non-TPs were recruited among dermatological outpatients. Participants were stratified into five groups by their status as OTRs or non-TPs and by attendance to dermatological follow-up. Results More non-TPs than OTRs reported one or more sunburns in the past year, 46% vs. 20%, P < .0001). More OTRs with than OTRs without dermatological follow-up reported frequent use of sunscreens (63% vs 44%, P = .006). More OTRs with follow-up used one or more sun protection measure such as covering clothes, than other OTRs (54% vs 34%, P = .016). Conclusion In this study, OTRs reported less sun exposure than non-TPs. Specialized dermatological follow-up seems to improve sun protection behaviour among OTRs. We suggest that specialized OTR clinics should be more broadly implemented.
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| 4. |
- Andersch-Björkman, Ylva, et al.
(author)
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Effects of brodalumab on psoriasis and depressive symptoms in patients with insufficient response to TNF-α inhibitors
- 2023
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In: Journal of Dermatology. - : WILEY. - 0385-2407 .- 1346-8138. ; 50:11, s. 1401-1414
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Journal article (peer-reviewed)abstract
- The objective of this study was to evaluate emotions of depression and anxiety in psoriatic patients that due to insufficient response to tumor necrosis factor-alpha inhibition (TNF-alpha), underwent a treatment switch from TNF-alpha to interleukin 17 inhibition using brodalumab. The Self-rated Montgomery-Asberg Depression Rating Scale and the Hospital Anxiety and Depression Scale were used to assess depression and anxiety. A total of 20 patients with psoriasis were enrolled in the study. They were monitored for a period of 3 months following the transition to brodalumab treatment. The results showed a significant improvement in both the Psoriasis Area and Severity Index as well as symptoms of depression; anxiety symptoms showed a reduction, though not statistically significant. Perhaps of more interest, the positive effects on depression and anxiety seem to be independent of the reduction in skin related psoriatic lesions. These findings highlight the importance of addressing depressive and anxiety symptoms, together with psoriasis severity and quality of life, when managing patients with psoriasis.
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| 5. |
- Berglund, Sofia, et al.
(author)
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Incomplete Excisions of Melanocytic Lesions: Rates and Risk Factors.
- 2021
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In: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057. ; 101:3
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Journal article (peer-reviewed)abstract
- Incomplete excisions of melanocytic lesions occur despite the intention of complete removal. The aim of this study was to determine the incomplete excision rates for benign and malignant melanocytic lesions and the associated risk factors. Demographic, clinical, and histo-pathological data possibly associated with incomplete excision were collected from 2,782 consecutive excisions between 2014 and 2015. Of these, 269 melanocytic lesions (9.7%) were incompletely excised. Multivariate analysis revealed the following risk factors for significantly higher incomplete excision rates: lesions located in the head and neck area (odds ratio (OR) 3.95, 95% confidence interval (95% CI) 2.35-6.65), surgery performed by general practitioners (OR 3.01, 95% CI 2.16-4.19), the use of a punch excision technique (OR 2.83, 95% CI 1.96-4.08), and excision of non-dysplastic naevi (OR 1.58, 95% CI 1.11-2.23). In conclusion, more caution should be taken when excising melanocytic lesions in the head and neck area, general practitioners require more surgical training, and punch excisions of melanocytic lesions should be avoided.
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| 6. |
- Bieliauskiene, Giedre, et al.
(author)
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Incidence of Kaposi Sarcoma in Sweden is Decreasing.
- 2020
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In: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057. ; 100:17
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Journal article (peer-reviewed)abstract
- Kaposi sarcoma is a rare skin cancer, and epidemiological research into Kaposi sarcoma is therefore scarce. The current epidemiological situation for Kaposi sarcoma in Sweden is unknown. The authors hypothesized that the incidence of Kaposi sarcoma should have decreased after the introduction of antiretroviral therapy in 1996. Using data from the Swedish Cancer Registry, this study aimed to determine the incidence rates and survival for Kaposi sarcoma in Sweden from 1993 to 2016. The results showed that a total of 657 patients (74.0% men, 26.0% women) were diagnosed with Kaposi sarcoma in Sweden during 1993 to 2016. The overall incidence per 100,000, age-standardized to the world population, decreased from 0.40 to 0.10 (p=0.003) for both sexes combined, from 0.76 to 0.14 (p=0.003) for men, and from 0.07 to 0.06 (p=0.86) for women. The 10-year overall survival rate was significantly lower for the study population (30%) compared with the age- and sex-matched Swedish population (56%) (p<0.00001). Over the study period, incidence rates of Kaposi sarcoma decreased significantly in men, especially during the late 1990s.
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| 7. |
- Gente-Lidholm, Anette, et al.
(author)
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Long-term clinical course and prognosis of vaccine-related persistent itching nodules (1997-2019): An observational study
- 2022
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In: Vaccine: X. - : Elsevier BV. - 2590-1362. ; 11
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Journal article (peer-reviewed)abstract
- Background: Vaccines adsorbed to aluminium can induce long-lasting intensely itching subcutaneous nodules (granulomas) at the injection site as well as contact allergy to aluminium. In clinical trials of a new acellular pertussis vaccine performed in the 1990s (Gothenburg, Sweden) with 76 000 participants, itching nodules were reported in 745 children. A positive patch test to aluminium was verified in 77% of the tested children with itchy nodules. Aim: To describe the long-term clinical course and prognosis of vaccine-related itching nodules caused by aluminium-containing pediatric vaccines and to estimate the risk for new symptoms after future vaccination with aluminium-containing vaccines. Methods: 745 children with vaccine-related itching nodules were followed by regular interviews/questionnaires for more than 20 years. 723 of them received a booster dose of diphtheria/tetanus vaccine either with or without aluminium adjuvant during the follow-up time. Results: Most study participants (86%) reported a full recovery from their itching nodules after a median duration of 6.6 years. Only a few of the diphtheria/tetanus-booster-vaccinated children (3%) reported mild transient itching and swelling at the new injection site. Conclusion: Vaccine-induced itching granulomas caused by an aluminium-adsorbed acellular pertussis toxoid vaccine seem to disappear over time. Future vaccinations with aluminium-adsorbed vaccines can be performed with little risk for new itching nodules later in life. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
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| 8. |
- Gente-Lidholm, Anette, et al.
(author)
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Long-term prognosis of vaccine-induced contact allergy to aluminium: Third patch-test with additional test preparations
- 2023
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In: Contact Dermatitis. - 0105-1873. ; 89:5, s. 359-367
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Journal article (peer-reviewed)abstract
- Background A high incidence of local itching subcutaneous nodules and aluminium allergy was observed in clinical trials of a new aluminium adsorbed pertussis vaccine in Gothenburg, Sweden, in the 1990s. A total of 495 children with itching nodules were patch tested with aluminium chloride hexahydrate 2% and an empty Finn Chamber (R), 377 (76%) with positive reactions. When 241 of them were re-tested some years later 186 (3 out of 4) had unexpectedly lost their patch test reactivity.Aim To investigate the long-term prognosis of vaccine-induced contact allergy to aluminium by a third patch test about 20 years after Patch test I.Methods Twenty individuals with positive and 11 with negative results in Patch test II were tested a third time with the same sensitisers as in in the first two tests. Three additional aluminium preparations were also tested.Results A total 15 out of 20 persons with positive results in the second test had lost their patch test reactivity. Two of 11 with negative tests had turned positive again. The addition of the preparations gave no conclusive results.Conclusion Contact allergy to aluminium caused by vaccination with aluminium-adsorbed vaccines in childhood seems to fade away with time as measured by loss of patch test reactivity.
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| 9. |
- Giannopoulos, Filippos, et al.
(author)
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Methotrexate Use for Patients with Psoriasis and Risk of Cutaneous Squamous Cell Carcinoma: A Nested Case-control Study.
- 2021
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In: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057. ; 101:1
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Journal article (peer-reviewed)abstract
- An association between methotrexate use and risk of cutaneous squamous cell carcinoma has been reported in patients with rheumatoid and psoriatic arthritis. A nested case-control study was performed to investigate if methotrexate use among patients with psoriasis was associated with increased risk of cutaneous squamous cell carcinoma. Data were obtained from Swedish egisters and included 623 patients with psoriasis and a first cutaneous squamous cell carcinoma from 2010 to 2016. Ten randomly selected patients with psoriasis were matched on age and sex to each case. Among cases, 160 (26%) were ever-users of metho-trexate. The corresponding number among the controls was 1,370 (22%), yielding an unadjusted odds ratio (OR) of 1.23 (95% confidence interval (95% CI) 1.02-1.49); p=0.034. After adjusting for use of other immunosuppressive drugs the association was close to unity (OR 1.09; 95% CI 0.89-1.34); p=0.39. The slightly increased risk of cutaneous squamous cell carcinoma associated with methotrexate-exposure in patients with psoriasis does not seem to be associated with metho-trexate, but rather with disease severity, other anti-psoriatic treatments, and ultraviolet (UV) exposure.
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| 10. |
- Gillstedt, Martin, 1977, et al.
(author)
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Ability to Predict Melanoma Within 5 Years Using Registry Data and a Convolutional Neural Network: A Proof of Concept Study
- 2022
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 102
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Journal article (peer-reviewed)abstract
- Research relating to machine learning algorithms, including convolutional neural networks, has increased during the past 5 years. The aim of this pilot study was to investigate how accurately a convolutional neural network, trained on Swedish registry data, could perform in predicting cutaneous invasive and in situ melanoma (CMM) within 5 years. A cohort of 1,208,393 individuals was used. Registry data ranged from 4 July 2005 to 31 December 2011, predicting CMM between 1 January 2012 and 31 December 2016. A convolutional neural network with one-dimensional convolutions with respect to time was trained using healthcare databases and registers. The algorithm was trained on 23,886 individuals. Validation was performed on a hold out validation set including 6,000 individuals. After training and validation, the convolutional neural network was evaluated on a test set (1,000 individuals with an CMM occurring within 5 years and 5,000 without). The area under the receiver-operating characteristic curve was 0.59 (95% confidence interval (95% CI) 0.57???0.61). The point on the receiver-operating characteristic curve where sensitivity equalled specificity had a value of 56% (sensitivity 95% CI 53???60% and specificity 95% CI 55???58%). Albeit at an early stage, this pilot investigation demonstrates potential usefulness for machine learning algorithms in predicting melanoma risk.
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