| 1. |
- Diepgen, T. L., et al.
(författare)
-
Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema
- 2009
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 160:2, s. 353-358
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Tidskriftsartikel (refereegranskat)abstract
- Hand eczema is a long-lasting disease with a high prevalence in the background population. The disease has severe, negative effects on quality of life and sometimes on social status. Epidemiological studies have identified risk factors for onset and prognosis, but treatment of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system for hand eczema is needed. The present study attempts to characterize subdiagnoses of hand eczema with respect to basic demographics, medical history and morphology. Clinical data from 416 patients with hand eczema from 10 European patch test clinics were assessed. A classification system for hand eczema is proposed. It is suggested that this classification be used in clinical work and in clinical trials.
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| 2. |
- Ruzicka, T, et al.
(författare)
-
Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial
- 2008
-
Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 158:4, s. 808-817
-
Tidskriftsartikel (refereegranskat)abstract
- Background Patients with severe chronic hand eczema (CHE) refractory to topical corticosteroids currently have limited treatment options suited for chronic use, and few controlled clinical studies have investigated new therapies in this setting. Objectives To assess the efficacy and safety of oral alitretinoin (9-cis retinoic acid) taken at 10 mg or 30 mg once daily for up to 24 weeks, compared with placebo control, in the treatment of severe CHE refractory to topical corticosteroids. Methods A randomized, double-blind, placebo-controlled, prospective, multicentre trial was conducted in 111 dermatology outpatient clinics in Europe and Canada. A total of 1032 patients with severe refractory CHE were randomized in a 1 : 2 : 2 ratio to placebo, or 10 mg or 30 mg of oral alitretinoin once daily for up to 24 weeks. Safety was assessed for all patients during a follow-up period of 4 weeks, and responders were observed for relapse for 24 weeks after the end of therapy. The primary efficacy parameter was Physician Global Assessment of overall CHE severity, with response defined as clear or almost clear hands. Results Responses, defined as clear or almost clear hands, were achieved in up to 48% of patients treated with alitretinoin, compared with 17% for placebo (P < 0.001), with up to 75% median reduction in disease signs and symptoms. Treatment was well tolerated, with dose-dependent adverse effects comprising headache, mucocutaneous events, hyperlipidaemia, and decreased free thyroxine and thyroid-stimulating hormone. The median time to relapse, defined as recurrence of 75% of initial signs and symptoms, was 5.5-6.2 months in the absence of anti-eczema medication. Conclusions Alitretinoin given at well-tolerated doses induced clearing of CHE in a substantial proportion of patients with severe disease refractory to standard therapy.
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| 3. |
- Bruynzeel, DP, et al.
(författare)
-
Monitoring the European standard series in 10 centres 1996-2000
- 2005
-
Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 53:3, s. 146-149
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Tidskriftsartikel (refereegranskat)abstract
- A 5-year retrospective study of the frequency of sensitization to the 25 allergens of the European standard series (ESS) was conducted in 10 centres in 8 European countries. Included were the results of 26 210 patients. The range in sensitivities differed moderately between the centres. Combining results of different centres and drawing conclusions on incidences can be done only with great care. The information on the ranking of the allergens and their sensitization incidence in the clinics are useful for decisions on the future composition of the standard series. The ESS is still a valid screening tool, and no substances should be deleted.
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| 4. |
- Diepgen, TL, et al.
(författare)
-
Mercaptobenzothiazole or the mercapto-mix: which should be in the standard series?
- 2006
-
Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 55:1, s. 36-38
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Tidskriftsartikel (refereegranskat)abstract
- Mercaptobenzothiazole (MBT) compounds are well known contact allergens. To detect rubber allergic patients we use both MBT (2% in petrolatum) and a mercapto-mix with 4 constituents of 0.5% each in our standard series. In this article the EECDRG presents data of in total 32 475 consecutive tested patients attending the respective contact dermatitis clinics from 11 centres in Europe to determine if the mix and MBT detected the same allergic patients. We found 327 patients positive to the mix or MBT, or to both. 261 were positive to the mix and 254 to MBT. MBT was negative in 73 patients who were positive to the mix. If the mix had not been in the standard series, on average 22% of patients allergic to a mercapto-compound would have been missed, for MBT this would have been on average 20%. All clinics would have missed a significant number of positive reactions if both compounds had not been tested. We conclude, that both the mercapto mix and MBT are required in the standard series.
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| 5. |
- Diepgen, T, et al.
(författare)
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Therapie von handekzemen. Was können wir von publizierten klinischen Studien lernen?
- 2005
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Ingår i: Hautarzt. - : Springer Science and Business Media LLC. - 0017-8470. ; 56:3, s. 224-231
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in German Handekzeme sind sehr häufig, können verschiedene Ursachen haben und trotz einer Vielzahl von Behandlungsoptionen, die von topischen Kortikosteroiden über Phototherapie bis zur oralen Gabe von Ciclosporin und Retinoiden reichen, eine therapeutische Herausforderung darstellen. In den führenden Literaturdatenbanken (ldquorCochraneldquo, ldquorMEDLINEldquo, ldquorEmbaseldquo, ldquorPascalldquo, ldquorJicst-Eplusldquo, ldquorAmedldquo) wurden systematisch publizierte Studien zur Therapie des Handekzems recherchiert und nach Qualitätskriterien bewertet. Zusätzlich wurden vier führende medizinische Zeitschriften (BMJ, JAMA, Lancet, NEJM) und 17 dermatologische Zeitschriften ab 1977 per Hand durchsucht. Eingeschlossen wurden alle Studien, die sich auf alle möglichen Varianten von ärztlich diagnostizierten Handekzemen bezogen. Dabei konnten von insgesamt 100 klinischen Untersuchungen 31 als randomisierte klinische Studien (RCT) identifiziert werden. Diese RCTs weisen teilweise erhebliche methodische Mängel auf und untersuchen sehr unterschiedliche Therapieoptionen. Es besteht ein großer Bedarf an guten RCTs zur Therapie des Handekzems, wobei nicht nur neue, sondern auch etablierte Therapieoptionen untersucht werden sollten und die verschiedenen Handekzemtypen Berücksichtigung finden müssen.
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| 6. |
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| 7. |
- Larsen, F S, et al.
(författare)
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The occurrence of atopic dermatitis in Greenland
- 2005
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 85:2, s. 140-143
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Tidskriftsartikel (refereegranskat)abstract
- Until recently there was no information available on the prevalence of atopic dermatitis in Greenland. Our objective was to determine the prevalence of atopic dermatitis in younger schoolchildren in Greenland. In the autumn of 2000 we used our previously elaborated questionnaire in a cross-sectional study of 954 schoolchildren aged 7 - 8 years, who lived in five Greenlandic towns. The findings were compared to data on atopic dermatitis from Denmark. The response rate was 65% ( 622). The lifetime prevalence of atopic dermatitis was calculated to be 14.0% (95% confidence interval 11.3 - 16.7) using our standard score criteria with an absolute lower limit estimate of 4.5%. Taking the response rate of 65% into consideration this study indicates that in 2000 the lifetime prevalence of atopic dermatitis among younger schoolchildren in Greenland was in the range of 10 - 15%.
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| 8. |
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