To review current knowledge on how patients with hidradenitis suppurativa (HS) experience stigmatization, as well as on its associations with clinical and psychosocial characteristics of the disease. ...A better understanding of these may help dermatologists improve screening and management for the benefit of HS patients.
A MEDLINE search using the terms stigmatization, perceived stigma, self-stigma, and HS/acne inversa.
Stigmatization is common among HS patients and has a strong psychosocial impact, which is often disproportional to the extent and severity of skin involvement. Stigmatization in HS has many faces and it is more prevalent and more severe than most other skin diseases. Stigmatization of HS patients is due not only to the distressing symptoms of pain, itch malodorous discharge, and disfiguring scars but also to the lack of knowledge about HS on part of the general public.
Stigma is a significant contributor to the impairment of quality of life and psychiatric co-morbidities commonly seen in patients with HS. Therefore, evaluation for stigma and formulation of strategies to prevent stigmatization and treat its consequences, in the context of a multidisciplinary approach, may ameliorate considerably the lives of HS patients.
Objectives
To evaluate the prevalence and its clinical characteristics of psoriatic arthritis (PsA) in a specialized psoriasis clinic of a University Hospital.
Methods
In this retrospective study, ...278 patients with psoriasis were evaluated between 2011 and 2013.
Results
The study included 278 patients with psoriasis: 144 (52%) were male and 134 (48%) female. Their median age was 51.41 with median psoriasis presenting age of 34.52 years. Referring to the type of psoriasis, 86% presented with plaque psoriasis, 5% guttate, 2% palms and soles, 2% inverse, 1% pustular and 4% with psoriasis of more than one type. Nail disease appeared in 121 patients (43.5%) and scalp disease in 175 (63%). Of these patients, 85 (30%) had PsA, whereas 51% of patients with PsA had psoriatic nail disease. With reference to the PsA type, 43 (51%) patients presented with polyarthritis, 10 (12%) with oligoarthritis, 7 (8%) with axial arthritis, whereas the rest 25 of them (31%) had PsA of more than one type. The subgroup of patients with PsA had significantly higher rates of comorbidities including arterial hypertension, diabetes and hypercholesterolaemia compared to non‐PsA patients with 41% vs. 17% (P = 0.001), 20% vs. 8% (P = 0.021) and 41% vs. 19% (P = 0.004), respectively.
Conclusion
The prevalence of PsA among patients with psoriasis was relatively higher in Greece compared to other ethnic‐based studies. Comorbidities related to life expectancy were more frequent. As there is a high percentage of undiagnosed cases with active arthritis among patients with psoriasis, dermatologists should be aware of PsA clinical signs in order to recognize it earlier and provide successful treatment.
Background
Photodynamic therapy (PDT) is used to treat cutaneous cancers. It may induce cell death through direct and indirect means, including apoptosis, inflammation and certain immune mechanisms, ...with the depth of penetration as a potential modifying factor.
Objectives
To examine the pathways of apoptosis in the intralesional PDT of basal cell carcinoma (BCC) and intraepidermal squamous cell carcinoma (Bowen's disease).
Methods
Sixteen patients with superficial or nodular BCC and Bowen's disease were treated with intralesional aminolevulinic acid‐PDT. Biopsies were taken at baseline and 24 h post‐PDT, and sections were examined by immunohistochemistry for the expression of markers of apoptosis, such as caspase 3, involved in the intrinsic apoptotic pathway, granzyme B, a caspase‐independent apoptotic mediator, and the proapoptotic markers BAX and BAK.
Results
Apoptotic cells stained with TUNEL showed statistically significant staining at 24 h post PDT (p < 0.01 in both BCC and Bowen's lesions). Caspase 3 (p < 0.01 in BCC and p < 0.05 in Bowen's) and granzyme B (p < 0.01 in BCC and p < 0.01 in Bowen's) were significantly increased at 24 h post‐PDT. BAX expression was apparently increased compared to baseline in Bowen's lesions at 24 h post‐PDT, whereas Bak was upregulated both in BCC and Bowen's disease at baseline and at 24 h post‐PDT.
Conclusion
Intralesional PDT induces apoptosis in BCC and Bowen's disease via common and alternative apoptotic pathways involving granzyme B. Proapoptotic factors Bak in both BCC and Bowen and Bax in Bowen's disease appear to increase by intralesional PDT at 24 h.
Abstract The European Academy of Dermatology and Venereology (EADV) Task Forces on quality of life (QoL) and patient‐oriented outcomes and on urticaria and angioedema recommendations for the ...assessment of Health‐related (HR) QoL in all patients with urticaria in research and practice are as follows: to use the DLQI for adults and the CDLQI for children as dermatology‐specific and the CU‐Q2oL as a disease‐specific HRQoL instruments in urticaria; to use generic instruments to provide comparison of data on urticaria with non‐dermatologic diseases, or to compare with healthy volunteers or the general population; to select validated HRQoL instruments with appropriate age limits; to present exact numeric data for HRQoL results; correct title of any HRQoL instrument should be used, along with its correct abbreviation and the reference to its original publication, where possible. The EADV TFs discourage the use of non‐validated HRQoL instruments and modified HRQoL instruments that have not undergone standard validation.
Bullying in persons with skin diseases Chernyshov, P. V.; Tomas‐Aragones, L.; Manolache, L. ...
Journal of the European Academy of Dermatology and Venereology,
April 2024, 2024-Apr, 2024-04-00, 20240401, Letnik:
38, Številka:
4
Journal Article
Recenzirano
Background
There are few studies on bullying in skin diseases. Persons with skin diseases are especially prone to bullying.
Objectives
This component of the project ‘Bullying among Dermatologic ...Patients’ aimed to study the prevalence and nature of bullying in patients with skin diseases from different countries and age groups.
Methods
Data were collected from participants of international social media groups for patients with skin diseases, in‐patients and out‐patients with skin diseases, and parents of children with skin diseases from six European countries. School and university students from Poland and Ukraine were asked to answer the question: Have you been bullied because of skin problems?
Results
Bullying was reported in 1016 patients with 36 different skin diseases. Prevalence of self‐reported and parental‐reported bullying was quite heterogeneous among different countries In total, self‐reported bullying was noted by 25.6% of patients with skin diseases during face‐to‐face consultations, by 63.7% of respondents from international patients' groups and by 12.2% of school and university students. Parental‐reported bullying was detected in 34.5% of 3–4 years old children with skin diseases. The peak of bullying prevalence occurred between the ages of 13 and 15. The most prevalent forms of bullying were verbal abuse and social isolation. Physical abuse was the least often reported form of bullying. Only 33.2% of participants talked to anyone about being bullied. Negative long‐term effects of bullying were reported by 63% of respondents.
Conclusions
Skin disease‐related bullying was reported by patients in all centres of the project. The main manifestations of bullying were similar in different countries and among patients with different skin diseases. International activities aimed to decrease or prevent skin disease‐related bullying in different age groups are needed. These activities should be multidirectional and target teachers, parents of classmates and classmates of children with skin diseases, patients' parents and patients themselves.
Many events, including the COVID‐19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) ...assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient‐oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health‐related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face‐to‐face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face‐to‐face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology‐specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease‐specific instruments.
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