The underlying mechanisms mycosis fungoides (MF)‐related pruritus remain unclear, and the link between pruritus and systemic inflammation in MF is unexplored. We aimed to investigate systemic ...inflammation in MF patients and its potential connection to pruritus. In this retrospective study, demographic characteristics, MF stage, clinical and laboratory findings, and neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio (PLR), monocyte‐lymphocyte ratio (MLR), systemic immune‐inflammation index (SII), systemic inflammation response index (SIRI) and pan‐immune inflammation value (PIV) were assessed for all participants. Additionally, mSWAT scores, Dermatology Life Quality Index (DLQI), and pruritus presence and intensity via Visual Analogue Scale (VAS) scoring were recorded for MF patients. A total of 81 patients with early‐stage MF and 50 controls were enrolled. Itching was present in 41 patients (50.6%). NLR, PLR, SII, SIRI and CRP values in the MF group were significantly higher. CRP, NLR, mSWAT and DLQI score were significantly higher in MF patients with pruritus than those without. Pruritus was positively correlated with DLQI, mSWAT, CRP, NLR, MLR and SIRI. VAS score was positively correlated with eosinophil count and DLQI. In the multivariate logistic regression model, only NLR was an independent and significant associate of pruritus in patients with MF. This study provides evidence of enhanced systemic inflammation in early‐stage MF patients. Additionally, the correlation between pruritus with mSWAT scores and systemic inflammation parameters suggests a potential link between pruritus and the inflammatory milieu in MF.
Omalizumab has high treatment efficacy in patients with chronic spontaneous urticaria (CSU) who do not respond to high doses of antihistamines. Systemic immune‐inflammation index (SII) and systemic ...inflammation response index (SIRI) were described as novel inflammatory and prognostic biomarkers. The present study aimed to evaluate the effectiveness of SII and SIRI in patients with CSU who receive omalizumab therapy. A total of 124 patients with severe urticaria who had an urticaria activity score over 7 days (UAS‐7) ≥28 were included in the study. UAS‐7, C‐reactive protein (CRP), SII, and SIRI values were recorded before and after omalizumab treatment. Patients with UAS‐7 ≤6 at week 12 and/or week 24 of omalizumab treatment were considered responders. Three months after omalizumab treatment, significant decreases were observed in SII, SIRI, CRP, and UAS‐7 compared to pre‐treatment values (p = 0.003, p < 0.001, p = 0.006, and p < 0.001, respectively). At the third and sixth months of treatment, baseline SII and SIRI levels of the omalizumab responder group were significantly higher than the non‐responder group (p < 0.001). However, there was no difference in baseline CRP and UAS‐7 levels between responders and non‐responders (p ˃ 0.05). After adjusting for confounding factors, only pre‐treatment SII (OR: 1.002, 95% CI: 1.000–1.004, p = 0.036) and SIRI (OR: 4.334, 95% CI: 1.751–10.726, p = 0.002) values were independently associated with response to omalizumab at 3 months in multivariate regression analysis. SII and SIRI could be effectively used to predict the response to omalizumab therapy. More comprehensive studies are needed to validate and elaborate on this relationship.
Aim The aim of the study was to investigate data from patients suffering from chronic spontaneous urticaria refractory to conventional therapy, and to document outcomes of omalizumab use. Material ...and methods We conducted a single-centre retrospective study with 175 chronic spontaneous urticaria patients who were treated with 300 mg omalizumab subcutaneously every 4 weeks for at least 6 months. Efficacy, factors affecting outcome, and complications were examined. Results The complete response rate was 70.9%. Minor complications were observed in 12% of our patients. Anaphylaxis occurred in 1 patient as a major complication. We did not notice any clinical or laboratory factors predicting response to omalizumab treatment. Conclusions The findings show that omalizumab is effective and safe for the treatment of chronic spontaneous urticaria with a dosing of 300 mg/month subcutaneously. However, due to 1 case of anaphylaxis in this small group, we must still remind practitioners to be alert for this possible complication.
Superficial cutaneous vascular lesions (SCVLs) are quite common. Several types of lasers have been used to treat these lesions; however, there are no dedicated treatment guidelines and few studies in ...the literature addressed their treatment.
In this paper, we aimed to report our clinical experience with potassium titanyl phosphate (KTP) laser treatment on different types of facial SCVLs including telangiectasia, spider angioma, and erythema.
Data were retrospectively collected from 146 patients with SCVLs, who had been treated with the 532-nm wavelength laser at our outpatient dermatology clinic. Treatment responses were graded as four groups: clearance (> 75% improvement compared with the previous session), marked improvement (50-75%), partial improvement (25-50%), and no response (< 25%).
The rate of clearance plus marked improvement (favorable outcome) was 66.1% for telangiectasia group, 93.5% for spider angioma group, and 26.7% for erythema group. Mean number of treatments was 2.9 ± 1.4 for telangiectasia group, 1.4 ± 0.8 for spider angioma group, and 2.9 ± 1.7 for facial erythema group. Only minimal adverse effects related to treatment procedure were detected in 5 out of 146 (3.4%) patients.
Our results demonstrated that KTP laser might be a safe and effective laser modality for SCVLs, which may be associated with physiological problems due to cosmetic concerns.
Background
Determination of control level in recurrent angioedema (RAE) is necessary to guide management. Here, we validated a Turkish version of the angioedema control test (AECT) for 4‐week ...(AECT‐4wk) and for 3‐month (AECT‐3mth) and assessed their utility in monitoring RAE.
Method
The recommended structured translation process for patient‐reported outcome measures was completed. The final versions were administered to 51 patients with mast cell‐mediated angioedema (MMAE) and 38 patients with hereditary angioedema, and the minimal clinically important difference (MCID) was determined. Additionally, anchor surveys comprising angioedema activity score for 28 days (AAS‐28 day), visual analog score for angioedema control, Likert scale for the control level from the patient's perspective (LS‐AEC), angioedema quality of life, short form‐12 (SF‐12) and patients' assessment of treatment sufficiency were applied.
Results
The Turkish AECT versions showed good convergent validity with a substantial correlation with anchor tools and known‐group validity. Excellent internal consistency and reproducibility were observed. Equal or more than 10 of 16 points scored with the AECT‐4wk and AECT‐3mth identified patients with well‐controlled disease. The disease activity, control and burden parameters were consistent with the disease control level defined depending on the cut‐off point 10 of AECT. Three‐point changes in AECT‐4wk and ‐3 mt could detect MCID in disease control in all patients.
Conclusions
Turkish AECT versions are valid and reliable tools for assessing and monitoring disease control in patients with RAE. The use of the Turkish versions of the AECT in routine patient care, clinical trials and angioedema research is recommended.
Although acute urticaria (AU) and urticaria-like rash are commonly reported with COVID-19 infection, chronic spontaneous urticaria (CSU) triggered by COVID-19 is rare. The authors compared the ...features of COVID-19 infection-induced chronic CSU and AU to determine which patients' COVID-19 infection leads to CSU and possible indicators of chronicity.
The authors retrieved the charts of patients diagnosed with AU or CSU following COVID-19 at the Urticaria Centers of Reference and Excellence and compared patients in terms of demographic characteristics, length of time between infection and onset of urticaria, duration of urticaria, COVID-19 disease severity, laboratory test results, vaccination, and treatment status.
A total of 92 patients were included in the study: 7 with CSU following COVID-19 and 85 with AU after COVID-19. The mean duration of urticaria for CSU and AU following COVID-19 was 13.0 ± 6.0 months and 7.1 ± 3.4 days, respectively. The average time between COVID-19 and the start of urticaria was longer in the CSU group (20.7 ± 3.9 days vs 4.5 ± 2.8 days, respectively; P = .000). No between-group differences were found for any other parameters.
The onset of urticaria more than 2 weeks after COVID-19 infection may serve as an indicator for urticaria chronicity beyond 6 weeks and may help physicians predict the possible course of urticaria associated with COVID-19 infection. The relevance of basopenia and eosinopenia needs to be determined.
There are only a few case reports about nail changes due to valproic acid in the literature despite its widespread use. We present a 50-year-old man who had onycholysis, roughness of the nail surface ...and brownish-yellow discoloration of both fingernails and toenails, which remarkably ameliorated upon cessation of valproic acid.
Background
Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user‐friendly platform to complete ...patient‐reported outcome measures (PROMs) on their mobile devices. CRUSE®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need.
Methods
CRUSE® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real‐time insights. Additionally, CRUSE® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations.
Results
CRUSE® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country‐specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second‐generation antihistamines were used in 74.0% of days.
Conclusions
The initial data from CRUSE® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.
