Quality of life in persons living with psoriasis patients Martínez-García, Eliseo, MD; Arias-Santiago, Salvador, MD, PhD; Valenzuela-Salas, Ignacio, MD ...
Journal of the American Academy of Dermatology,
08/2014, Letnik:
71, Številka:
2
Journal Article
Recenzirano
Background Numerous studies have analyzed the influence of psoriasis on the quality of life and psychosocial health of patients. However, few studies have addressed the effect of this disease on ...individuals living with these patients (cohabitants). Objective To analyze the influence of psoriasis on the levels of anxiety, depression, and quality of life of the cohabitants of psoriatic patients. Methods The study included patients, cohabitants, and controls, a total of 130 participants. Their quality of life was measured with the Dermatology Life Quality Index (DLQI) and Family Dermatology Life Quality Index (FDLQI), and their psychological state with the Hospital Anxiety and Depression Scale (HADS). Demographic data of participants and clinical characteristics of patients were also gathered. Results The presence of psoriasis impaired the quality of life of 87.8% of the cohabitants. FDLQI scores of cohabitants were significantly associated with the DLQI scores of the patients ( rs = 0.554; P < .001). Anxiety and depression levels did not differ between patients and cohabitants, but were significantly higher than in the controls ( P < .001). Limitations Additional studies with larger numbers of patients and cohabitants are required to analyze differences between groups according to psoriasis severity. Conclusion Psoriasis markedly worsens the global well-being of patients and their cohabitants, who experienced an impairment of their quality of life and higher levels of anxiety and depression.
Background Some autoimmune conditions have been associated with reduced vitamin D levels, including systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, and multiple sclerosis. ...Objective The main objective of this study was to analyze the 25-hydroxyvitamin D (OHD) status of patients with psoriasis in comparison with control subjects without this disease. Methods This case-control study included 86 patients (43 with psoriasis and 43 age- and sex-matched control subjects) from the outpatient clinic of our hospital dermatology department in Granada, Spain. All patients and control subjects were studied during one 4-week period to avoid seasonal variations in vitamin D levels. Results Serum 25-OHD levels were significantly lower in psoriatic patients than in control subjects even after adjusting for confounding factors in a multivariate analysis (odds ratio 2.89, 95% confidence interval 1.02-7.64, P < .03 for vitamin D insufficiency). Low 25-OHD levels were negatively associated with C-reactive protein (inflammatory activation marker) and body mass index in multiple linear regression analysis. Psoriatic patients with body mass index greater than or equal to 27 kg/m2 had a higher risk of 25-OHD insufficiency (sensitivity of 82.3% and specificity of 51.7%). Limitations Further studies with larger numbers of patients are required to analyze the pathogenic mechanisms underlying the relationship between 25-OHD deficiency and psoriasis. Conclusions The 25-OHD values are significantly lower in psoriatic patients than in control subjects. Low 25-OHD levels are negatively associated with C-reactive protein, an inflammatory activation marker, and with obesity. Psoriatic patients with a body mass index of 27 or more are likely to have vitamin D insufficiency.
Psoriasis is associated with an increased risk of cardiovascular disease (CVD) at younger ages that is not identifiable by traditional risk factors. Screening for subclinical atherosclerosis with ...ultrasound has only been investigated in carotid arteries. Femoral artery ultrasound has never been considered for this purpose. The link between psoriasis and accelerated atherosclerosis has not yet been established.
To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis in psoriasis. We also investigated its possible relationship with changes in insulin resistance.
We conducted a cross-sectional study in 140 participants, 70 patients with moderate-to-severe psoriasis and 70 healthy controls, matched 1:1 for age, sex, and BMI. Femoral and carotid atherosclerotic plaques were evaluated by ultrasonography. Insulin resistance was assessed by the homeostasis model assessment method (HOMA-IR).
Femoral atherosclerotic plaque prevalence was significantly higher in patients with psoriasis (44.64%) than in controls (19.07%) (p<0.005), but no significant difference was found in carotid plaque prevalence (p<0.3). Femoral plaques were significantly more prevalent than carotid plaques (21.42%) among patients with psoriasis (p<0.001). In the regression analysis, insulin resistance was the most influential determinant of atherosclerosis in psoriasis and C-reactive protein the most significant predictor of insulin resistance.
Ultrasound screening for femoral atherosclerotic plaques improves the detection of subclinical atherosclerosis in patients with psoriasis, whereas the study of carotid arteries is not sufficiently accurate. Insulin resistance appears to play a greater role in the development of atherosclerosis in these patients in comparison to other classical CVD risk factors.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Mesenchymal Stromal Cells (MSCs) are of great interest in cellular therapy. Different routes of administration of MSCs have been described both in pre-clinical and clinical reports. Knowledge about ...the fate of the administered cells is critical for developing MSC-based therapies. The aim of this review is to describe how MSCs are distributed after injection, using different administration routes in animal models and humans. A literature search was performed in order to consider how MSCs distribute after intravenous, intraarterial, intramuscular, intraarticular and intralesional injection into both animal models and humans. Studies addressing the biodistribution of MSCs in “in vivo” animal models and humans were included. After the search, 109 articles were included in the review. Intravenous administration of MSCs is widely used; it leads to an initial accumulation of cells in the lungs with later redistribution to the liver, spleen and kidneys. Intraarterial infusion bypasses the lungs, so MSCs distribute widely throughout the rest of the body. Intramuscular, intraarticular and intradermal administration lack systemic biodistribution. Injection into various specific organs is also described. Biodistribution of MSCs in animal models and humans appears to be similar and depends on the route of administration. More studies with standardized protocols of MSC administration could be useful in order to make results homogeneous and more comparable.
The impact of dupilumab on skin barrier function: A systematic review Montero‐Vilchez, Trinidad; Sanabria‐de‐la‐Torre, Raquel; Sanchez‐Diaz, Manuel ...
Journal of the European Academy of Dermatology and Venereology,
July 2023, 2023-Jul, 2023-07-00, 20230701, Letnik:
37, Številka:
7
Journal Article
Recenzirano
Skin barrier dysfunction plays an important role in atopic dermatitis (AD) aetiopathogenesis. Dupilumab, a drug that inhibits IL‐4 and IL‐13, is an effective treatment for AD but there is scarce ...evidence about its impact on epidermal barrier. The objective of this systematic review is to evaluate the influence of dupilumab on skin barrier in patients with AD using non‐invasive tools. A systematic review was designed following PRISMA guidelines. The literature search identified 73 references and, finally, only 6 were selected, including a total of 233 participants. All the studies were prospective observational studies. Dupilumab improved clinical scores in all the research. Skin barrier function parameters were mainly measured on the volar forearm. Transepidermal water loss (TEWL) was the parameter most frequently measured, evaluated in all the studies. Dupilumab decreased TEWL on eczematous lesions and non‐involved skin. About 33.6% (2/6) studies reported that dupilumab also increased stratum corneum hydration (SCH) on eczematous lesions while one study did not report any changes in this parameter. This drug also decreased temperature and improved ceramide composition. In conclusion, dupilumab improved skin barrier function in AD patients, mainly reflected in a decreased in TEWL values.
Coral-Red Fluorescence of Erythrasma Plaque Pérez-López , Israel; Arias-Santiago , Salvador; Martínez-López , Antonio ...
Sultan Qaboos University medical journal,
08/2016, Letnik:
16, Številka:
3
Journal Article
Recenzirano
Odprti dostop
A potassium hydroxide preparation of tissue scrapings was negative for fungal elements or cultures. Comment Erythrasma is a localised and chronic skin infection caused by Corynebacterium ...minutissimum.1–3 It appears as patches that are either asymptomatic and well-defined or irregular in shape and size and red/ brown in colour.3–5 The diagnosis is usually clinical, but a WL examination can show characteristic fluorescence due to coproporphyrin III produced by the bacteria.2,3 The WL emits ultraviolet A radiation with wavelengths between 320–400 nm and is useful in the diagnosis of disorders of pigmentation, skin infections (such as erythrasma) and porphyrias. 2 However, microscopic examinations (e.g. Gram staining of an epidermis scraping to reveal Gram-positive filaments and rods) and cultures on different types of media (e.g. 20% fetal bovine serum, 2% agar and 78% tissue culture medium #199) may be required in certain cases.4,5 A potassium hydroxide preparation of tissue scrapings can rule out concomitant infections, especially in patients with interdigital involvement.4 The differential diagnosis of erythrasma includes candidiasis, psoriasis and dermatophytosis.1–5 The most effective treatment is 500 mg of erythromycin twice daily for 14 days, with cure rates as high as 100%; however, other treatments with topical antibiotics and antifungals have also demonstrated good responses.1–5 1.
Research in dermatology in the COVID‐19 era Martinez‐Lopez, Antonio; Montero‐Vilchez, Trinidad; Arias‐Santiago, Salvador
Dermatologic therapy,
November/December 2020, Letnik:
33, Številka:
6
Journal Article
Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to ...summarise the pandemic's impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (January-July 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval -0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22-1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Frontal fibrosing alopecia has been related to some autoimmune diseases, but the association with rosacea is not clear. The objective of this study was to analyse the prevalence of rosacea in a group ...of patients with frontal fibrosing alopecia. A cross-sectional study, including 99 women with frontal fibrosing alopecia and 40 controls, was performed, in which clinical, dermoscopic and hormonal data were analysed. Women with frontal fibrosing alopecia presented a higher prevalence of rosacea than the controls did (61.6% vs. 30%, p = 0.001), especially those with severe grades of alopecia (77.8% in grade V vs. 33.3% in grade I, p = 0.02). Binary logistic multivariate analysis showed that perifollicular erythema (odds ratio (OR) 8.5; 95% confidence interval (95% CI) 1.73-42.30), higher body mass index (OR 1.16; 95% CI 1.01-1.34) and lower progesterone levels (OR 0.15; 95% CI 0.028-0.89) were associated with a higher risk of rosacea in patients with frontal fibrosing alopecia. In conclusion, patients with frontal fibrosing alopecia presented a higher prevalence of rosacea than did controls. Perifollicular erythema, higher body mass index and lower progesterone levels were associated with a higher risk of rosacea in the group with frontal fibrosing alopecia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The Effect of Sunscreens on the Skin Barrier Gonzalez-Bravo, Alicia; Montero-Vilchez, Trinidad; Arias-Santiago, Salvador ...
Life,
12/2022, Letnik:
12, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Transepidermal water-loss (TEWL), stratum-corneum hydration (SCH), erythema, elasticity, pH and melanin, are parameters of the epidermal barrier function and skin homeostasis that objectively ...indicate the integrity of the skin barrier. Sunscreens are necessary to protect people from skin cancer, but could modify the skin barrier function. Nevertheless, there are not many studies on their impact on skin homeostasis. The aim of this study is to evaluate the impact of sunscreens on the epidermal-barrier function and skin homeostasis of healthy individuals. A prospective observational study was designed. TEWL, SCH, erythema, elasticity, pH and melanin were measured on the cheek and volar region of the forearm, using non-invasive methods before and after applying sunscreen. Four different sunscreens were tested, one full-body sunscreen and three facial sunscreens. The study included 51 healthy volunteers, 72.5% (37/51) women, with a mean age of 41.63 years. After full-body sunscreen application, temperature increased by 0.68 °C (p < 0.001), pH by 0.16 units (p < 0.001), and elasticity by 0.22% (p = 0.039), while melanin decreased by 10.95 AU (p < 0.001), erythema by 28.79 AU (p < 0.001) and TEWL by 0.66 g·m−2·h−1 (p = 0.019). On the cheek, facial sunscreen 1 increased temperature by 0.51 °C, TEWL 0.7 g·m−2·h−1 (p < 0.05), pH by 0.12 units (p < 0.001) and elasticity by 0.059% (p < 0.001), but decreased erythema by 19.87 AU (p < 0.05) and SCH by 5.63 AU (p < 0.001). Facial sunscreen 2 increased temperature by 0.67 °C, TEWL by 1.93 g·m−2·h−1 (p < 0.001), pH by 0.42 units (p < 0.001) and elasticity by 0.12% (p < 0.01), but decreased melanin by 15.2 AU (p = 0.000), erythema by 38.61 AU (p < 0.05) and SCH by 10.80 AU (p < 0.01). Facial sunscreen 3 increased temperature by 1.15 °C, TEWL by 2.29 g·m−2·h−1 (p < 0.001), pH by 0.46 units (p < 0.001) and elasticity by 0.15% (p < 0.01), but decreased erythema by 35.7 (p < 0.05) and SCH by 10.80 AU (p < 0.01). In conclusion, sunscreen could slightly modify the skin-barrier function. All of them decreased erythema, likely in relation to anti-inflammatory power.
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