Dermatitis Diseases Research Articles

Atopic dermatitis disease control and age: A cohort study

Atopic dermatitis disease control and age: A cohort study

Patient-centered, direct-access online care for management of atopic dermatitis: a randomized clinical trial.

New models of health care delivery for dermatological care have the potential to increase access and improve patient-centered outcomes. To compare effectiveness of a direct-access, online model for follow-up dermatologic care in pediatric and adult patients with atopic dermatitis with that of in-person office visits. This was a 1-year, randomized controlled equivalency clinical trial in medically underserved areas, outpatient clinics, and the general community. Participants included children and adults with atopic dermatitis with access to the Internet, computers, and digital cameras. After an initial in-person visit, patients were randomized 1:1 to direct-access online or usual in-person care for follow-up management of atopic dermatitis. In the direct-access online group, patients captured and transmitted clinical images and history asynchronously to dermatologists online; dermatologists evaluated the clinical information, provided recommendations and education, and prescribed medications online asynchronously. In the in-person group, patients visited dermatologists in their offices for follow-up care. Atopic dermatitis disease severity as assessed by patient-oriented eczema measure (POEM) and investigator global assessment (IGA). A total of 156 children and adults were randomized. Between baseline and 12 months, the mean (SD) within-group difference in POEM score in patients in the direct-access online group was -5.1 (5.48) (95% CI, -6.32 to -3.88); in the in-person group, the within-group difference was -4.86 (4.87) (95% CI, -6.27 to -3.46). The difference in the change in POEM scores between the 2 groups was 0.24 (6.59) (90% CI, -1.70 to 1.23), which was contained within the predetermined 2.5 equivalence margin. The percentage of patients achieving clearance or near-clearance of their disease (IGA score of 0 or 1) was 38.4% (95% CI, 27.7% to 49.3%) in the direct-access online group and 43.6% (95% CI, 32.6%-54.6%) in the in-person group. The difference in the percent of patients achieving clearance or near-clearance between the 2 groups was 5.1% (90% CI, 1.7%-8.6%), which was contained within the predetermined 10% equivalence margin. The direct-access online model results in equivalent improvements in atopic dermatitis clinical outcomes as in-person care. Direct-access online care may represent an innovative model of delivering dermatological services to patients with chronic skin diseases. clinicaltrials.gov Identifier: NCT00985894.

Clinical Features And Clinicopathological Correlation of The Skin Biopsies in Adult Patients

OBJECTIVE: In this study, we aimed to determine sex, age, number of preliminary diagnosis and histopathological correlation between pathological diagnosis and preliminary diagnosis in the skin biopsies from adult patients in dermatology outpatient clinic of our university.METHODS: In the study, 774 adult patients’ skin biopsy reports who con¬sulted to dermatology outpatient clinic of our university from January 2008-December 2013 were analyzed retrospectively. Two hundred thirty nine patients whose information were reached fully were included in the study. The obtained results were evaluated statistically according to preliminary diagnosis and diagnosis correlation. Correlation was considered positive if there is an overlap between preliminary diagnosis and diagnosis.RESULTS: A total of total 239 patients, 122 female 51% and 117 male 49% , between ages of 17 to 102 years were investigated. The frequency of biopsy was found most often in the 17-29 29.3% age group. When the patients were evaluated in terms of the correlation between preliminary diagnosis-diagnosis, first preliminary diagnosis and pathology correlation was positive in 94 39.3% patients, 46 19.2% patients for second preliminary diagnosis and 22 9.2% patients for third diagnosis. In contrast, there was present mismatch between the pathologic diagnose and preliminary diagnosis in 61 patients 25.5% . In our study, there was a clinicopathological correlation in 178 patients 74.4% . The most common diseases were dermatitis and allergic diseases 22.2%, n = 53 according to biopsy results.CONCLUSION: Pathologists and clinicians may share their informations to increase clinicopathological correlation. In case of need both specialties should evaluate patients together, in this way we think that we get better results.

The Case for Doxycycline in Our Battle against Filariasis

Lymphatic filariasis and onchocerciasis are filarial diseases with potentially debilitating health outcomes as they collectively account for the loss of about 7.2 million disability adjusted life years in both men and women annually. Ivermectin, the major player in the mass drug administration (MDA) programme, has been effective at clearing microfilaria and halting transmission of these infections in some endemic communities. It is however unable to ameliorate the chronic conditions associated with the infections. When anti wolbachial therapy was discovered, an important milestone in the control of filariasis was chalked. Several investigators have since screened many anti wolbachial agents in varied combinations and regimes in order to find a drug/regime that could deplete Wolbachia, kill adult worms, deplete baby worms and ameliorate pathologies associated with these filarial diseases. This scoping review takes a critical look at the literature on anti wolbachial therapy and argues that doxycycline is by far the most promising of the current anti wolbachial drugs under investigation. This is in view of the fact that doxycycline depletes Wolbachia, kills adult worms and indirectly depletes baby worms. Doxycycline also ameliorates chronic pathologies such as lymphedema, hydrocele, dilation in scrotal lymphatics, thickening of the scrotal skin (associated with lymphatic filariasis) as well as dermatitis and ocular diseases (associated with onchocerciasis). Barring a few logistical challenges arising from contraindication in pregnant women and children below 8, doxycycline is relatively safe and does not generate adverse effects associated with rapid killing of worms as with some MDA drugs.

Autoimmune Diseases of the Innate and Adaptive Immune System including Atopic Dermatitis, Psoriasis, Chronic Arthritis, Lyme Disease, and Alzheimers Disease

In atopic dermatitis, we have recently shown the innate immune system is activated by biofilm-forming staphylococci that occlude sweat ducts. Toll-like receptor 2 (TLR 2) is activated and moves from its epidermal control location in the basal zone to the proximal stratum corneum (surrounding the occluded duct). There it likely initiates the MyD88 and the PAR 2 pathways in an effort to inactivate the staphylococci; these efforts are fruitless because of the biofilms and lead to the prime pathological finding of spongiosis and to the prime symptom of pruritus which leads to the disease. If the pruritus is intense enough to cause excoriations severe enough to disrupt the epidermis, the involvement of the dermis likely causes the activation of the adaptive immune system leading to the documented appearance of IL 31, another even more potent pruritogen. We have also shown that the innate system is involved in psoriasis, again with TLR 2. This time it was present in the dilated upper dermal capillaries; TLR 2 has been shown to lead to TNFa, IL 12/23, and IL 17 which have all been shown to be involved in the production of psoriatic lesions. In this instance, the streptococcus is most likely the organism involved; it is not recoverable because it internalizes or makes biofilms, so TLR 2 instead of combating the bacterium attacks host cells. Anti-streptococcal IgG is markedly elevated in plaque psoriasis in one half the patients; it is of interest to postulate these patients were those who would develop the systemic findings of arthritis, uveitis, and the metabolic syndrome which develop in 40% of patients. In chronic arthritis, Lyme disease, and Alzheimer’s disease where the disease has been shown to be caused by Borrelia and dental spirochetes, TLR 2 is activated because of the presence of the microbes and their biofilms and leads to the chronic course noted in osteoarthritis, Lyme neuroborreliosis and Alzheimer’s disease. When the adaptive immune system is involved, as in rheumatoid arthritis and after a stroke, it is curious that the disease occurs more rapidly and is much more destructive.

Immunological Reactions in Atopic Dermatitis and Possible Improvement of Probiotics

Allergic diseases are common hyper-immune disorders. Atopic dermatitis (AD) has a higher prevalence in industrialized countries. It has been suggested that association between genetic factors, environmental factors and gut microbiota would be major triggering factors for the development of atopic dermatitis. Hygiene hypothesis by a lack of early childhood exposure to diverse microorganism increases susceptibility to atopic dermatitis and other allergic diseases. Recent studies have demonstrated the complex interrelationship between skin barrier, genetic, environmental, pharmacologic, psychological and immunologic factors that contribute to the development and severity of AD. The current review will examine the immunological mechanism that contributes to AD as well as immunologic triggers involved in the pathogenesis.

Prevalence of occupational contact dermatitis, knowledge and adaption of preventive measures by chemical industries workers of Pune: An observational study

Objective: To study the prevalence of occupational contact dermatitis (OCD), knowledge and adaption of preventive measures by chemical industries workers in Pimpri Chinchwad, Pune. Materials and methods: Across sectional study was conducted from August 2010 to July 2011 on five hundred randomly selected participants from varnish, cement, nickel salt and oil paint industries. A semi-structured interview questionnaire was used to record details regarding socio-demographic data, knowledge and preventive measures adapted towards occupational hazards. Nordic occupational skin questionnaire and Occupational Contact Dermatitis Disease Severity Index (ODDI) were used to record the data related to the disease. Results: Overall prevalence of OCD was 5.20% (n=26/500).The prevalence in varnish, oil paint, nickel salt and cement exposed workers was 9.82% (n=11/112), 6.42%(n=7/109), 3.72%(n=6/161) and 1.69%(n=2/118) respectively. The ODDI mean(SD) score of severity index was 4.2(1.44). The prevalence regarding poor, average and good knowledge of occupational hazards was 7.22%(n=12/166), 4.24%(n=12/283) and 3.92%(n=2/51) respectively. The prevalence regarding not at all, irregularly and regularly adapting preventive measures was 11.11%(n=13/117), 4.67% (n=10/214) and 1.78% (n= 3/169)respectively. Conclusion:The workers involved in varnish chemical industry are more susceptible to OCD than workers involved in nickel salt, cement, and oil paint industries. This study clearly indicates that knowledge regarding the occupational hazards and adaption of preventive measures are prerequisite to lower the prevalence of OCD in chemical industries workers as prevalence was higher in poor knowledge workers and workers who had not adapted any preventive measures.

Unusual food allergy: Alioidea allergic reactions overview.

Allergic reactions can cause by several aliments and foods. Symptoms usually appear after ingestion, several hours after consumption or even almost immediately. Various food allergies can lead to serious diseases and in some cases to death, so the priority for people suffering from them should be prevention and completely avoiding foods that cause this kind of reactions. Allergy to Alioidea is one of the probable causes of contact dermatitis, gingival and oculonasal diseases and asthma. In this review, we will focus on the increasing incidence of allergy to foods of common use like onions and garlic. In the last ten years, the world production of onions and garlic has increased of at least 25%. People make large use of them, not only in cookery but also from a therapeutic point of view. Their growing use is producing more and more specific, insidious and sometimes serious medical conditions, which highly influence the quality of life of patients. Medical practitioners should be able to recognize immediately these disorders in order to diagnose them quickly and accurately, avoiding unnecessary tests and treatments. We will also describe new patents for detecting food allergens.

Severity and functional disability of patients with occupational contact dermatitis: validation of the German version of the Occupational Contact Dermatitis Disease Severity Index.

The Occupational Contact Dermatitis Disease Severity Index (ODDI) was designed in Australia to measure severity and functional disability in patients with occupational contact dermatitis (OCD) of the hands. The ODDI was translated into the German language with a linguistic validation process. The psychometric properties of the German version of the ODDI are still unclear. To report the linguistic validation procedure and to perform a psychometric validation by investigating the validity and reliability of the German ODDI version in a sample of patients with OCD. Data were drawn from the baseline assessment (T0) and first follow-up (T1) of the German chronic hand eczema (CHE) registry (CARPE). Spearman correlations of the ODDI with reference measures were computed to assess validity. Cronbach's alpha was calculated as a measure of internal consistency, and the intraclass correlation coefficient (ICC) was calculated to assess retest reliability. The smallest real difference (SRD) and minimal clinically important difference (MCID) were calculated to assess sensitivity to change. Physician Global Assessment (PGA) was used as an anchor for the MCID. Four hundred and twenty-two patients (54.5% female, mean age 45.1 years) were included for analysis. Cronbach's alpha was found to be 0.73. The ICC was 0.79. Correlations between the ODDI total and the Dermatology Life Quality Index (rho = 0.36), and between PGA (rho = 0.48) and patient-assessed disease severity (rho = 0.40), were of moderate strength. The MCID (1.29) was found to be smaller than the SRD (1.87). The German ODDI version is reliable and valid for the measurement of functional impairment and disease severity in patients suffering from OCD.

Dupilumab Treatment in Adults with Moderate-to-Severe Atopic Dermatitis

BackgroundDupilumab, a fully human monoclonal antibody that blocks interleukin-4 and interleukin-13, has shown efficacy in patients with asthma and elevated eosinophil levels. The blockade by dupilumab of these key drivers of type 2 helper T-cell (Th2)–mediated inflammation could help in the treatment of related diseases, including atopic dermatitis.MethodsWe performed randomized, double-blind, placebo-controlled trials involving adults who had moderate-to-severe atopic dermatitis despite treatment with topical glucocorticoids and calcineurin inhibitors. Dupilumab was evaluated as monotherapy in two 4-week trials and in one 12-week trial and in combination with topical glucocorticoids in another 4-week study. End points included the Eczema Area and Severity Index (EASI) score, the investigator's global assessment score, pruritus, safety assessments, serum biomarker levels, and disease transcriptome.ResultsIn the 4-week monotherapy studies, dupilumab resulted in rapid and dose-dependent improvements in clinical indexes, biomarker levels, and the transcriptome. The results of the 12-week study of dupilumab monotherapy reproduced and extended the 4-week findings: 85% of patients in the dupilumab group, as compared with 35% of those in the placebo group, had a 50% reduction in the EASI score (EASI-50, with higher scores in the EASI indicating greater severity of eczema) (P<0.001); 40% of patients in the dupilumab group, as compared with 7% in the placebo group, had a score of 0 to 1 (indicating clearing or near-clearing of skin lesions) on the investigator's global assessment (P<0.001); and pruritus scores decreased (indicating a reduction in itch) by 55.7% in the dupilumab group versus 15.1% in the placebo group (P<0.001). In the combination study, 100% of the patients in the dupilumab group, as compared with 50% of those who received topical glucocorticoids with placebo injection, met the criterion for EASI-50 (P=0.002), despite the fact that patients who received dupilumab plus glucocorticoids used less than half the amount of topical glucocorticoids used by those who received placebo plus the topical medication (P=0.16). Adverse events, such as skin infection, occurred more frequently with placebo; nasopharyngitis and headache were the most frequent adverse events with dupilumab.ConclusionsPatients treated with dupilumab had marked and rapid improvement in all the evaluated measures of atopic dermatitis disease activity. Side-effect profiles were not dose-limiting. (Funded by Regeneron Pharmaceuticals and Sanofi; ClinicalTrials.gov numbers, NCT01259323, NCT01385657, NCT01639040, and NCT01548404.)

530Extracellular ATP induces atherosclerosis and vascular inflammation via purinergic receptor 2 (P2Y2) in mice

Introduction: A solid body of basic evidence support a role for extracellular ATP and its receptors as danger signals in various chronic inflammatory diseases including asthma, chronic obstructive pulmonary disease (COPD), arthritis, allergic dermatitis, graft versus host disease and other entities. The ATP- binding P2Y2- receptor is involved in inflammatory cell recruitment and chronic inflammatory diseases like COPD. Hypothesis: Atherosclerosis represents a chronic inflammatory disease and several lines of evidence suggest that extracellular ATP and the P2Y2- receptor may contribute to atherogenesis. Methods: The expression of P2Y2 was determinded by realtime PCR and immune histology in aortas after feeding LDLR- deficient mice (LDLR-/-) a high (HCD) or low (LCD) cholesterol diet for 16 weeks. To gain into the functional role of extracellular ATP in atherogenesis, LDLR-/- mice on HCD for 18 weeks received either ATP or PBS intraperitoneally 3 times per week. Furthermore, P2Y2 knockout mice (P2Y2-/-) were crossed with LDLR-/- and fed a HCD for 18 weeks. LDLR-/- served as control group. Atherosclerosis was determined histologically. To evaluate the role of ATP and P2Y2 in vascular inflammation, intravital microscopy was performed in P2Y2-/- and LDLR-/- mice stimulated with ATP or vehicle. Results: P2Y2 is overexpressed in murine atherosclerotic aortas compared to healthy vessels indicating a relevant role in atherosclerosis. Stimulation of the P2Y2- receptor by ATP increases atherosclerotic lesions in aortic arches (N=15, control: 0.30mm2, ATP- group: 0.35 mm2, p=0.04) and abdominal aortas (N=15, control: 0, 0.34mm2, ATP- group: 0.18mm2, p<0.01) significantly. However, the knockout of the ATP- binding P2Y2- receptor reduces atherosclerosis in aortic arches compared to the LDLR-/- control group (N= 10, LDLR-/- :0.26mm2, P2Y2-/-/LDLR-/-: 0.14mm2, p = 0.03). Since leukocyte recruitment to the vessel wall is the crucial step in atherogenesis, we examined ATP and its P2Y2- receptor in vascular inflammation. Stimulating mice with ATP intraperitoneally induces leukocyte adhesion and rolling in wildtype mice. In P2Y2-/- mice this effect of ATP is reduced indicating a relevant role of P2Y2 in ATP dependent vascular inflammation. Conclusion: Extracellular ATP acts as a danger signal in vascular inflammation and induces atherosclerosis in mice via purinergic receptor 2. The ATP- P2Y2 axis represents a potential new pathway in pathogenesis of atherosclerosis.

Measure of Atopic Dermatitis Disease Severity Using Actigraphy

Analyzing adherence to treatment and outcomes in atopic dermatitis is limited by methods to assess continual disease severity. Atopic dermatitis significantly impacts sleep quality, and monitoring sleep through actigraphy may capture disease burden. To assess if actigraphy monitors provide continuous measures of atopic dermatitis disease severity and to preliminarily evaluate the impact of a short-course, high-potency topical corticosteroid regimen on sleep quality. Ten patients with mild to moderate atopic dermatitis applied topical fluocinonide 0.1% cream twice daily for 5 days. Sleep data were captured over 14 days using wrist actigraphy monitors. Investigator Global Assessment (IGA) and secondary measures of disease severity were recorded. Changes in quantity of in-bed time sleep were estimated with random effects models. The mean daily in-bed time, total sleep time, and wake after sleep onset (WASO) were 543.7 minutes (SEM 9.4), 466.0 minutes (SEM 7.7), and 75.0 minutes (SEM 3.4), respectively. WASO, a marker of disrupted sleep, correlated with baseline (ρ = .75) and end of treatment IGA (ρ = .70). Most patients did not have marked changes in sleep. IGA scores declined by a median change of 1 point at days 7 (p = .02) and 14 (p = .008). Using actigraphy, atopic dermatitis disease severity positively correlated with sleep disturbances. Actigraphy monitors were well tolerated by this cohort of atopic dermatitis subjects.

The Vitiligo in Senegal

The aim of our study was to determine the epidemiological and clinical aspects of vitiligo in the largest dermatology department of Senegal. A cross-sectional and descriptive study in a period of 5 months was performed covering all the vitiligo cases. Fifty patients were identified (26 women and 24 men). The mean age was 26.5 years. A family history of vitiligo was found in 11 cases and a psychoaffective disturbance in 6 cases. The clinical forms distinguished were generalized vitiligo (n = 33), localized vitiligo (n = 16), vitiligo universalis (n = 4), and segmental vitiligo (n = 1). The Koebner phenomenon was found in 7 cases. Associated diseases were atopic dermatitis (n = 2), contact dermatitis (n = 1), diabetes (n = 1), and Graves' disease (n = 1). The disgraceful character of Vitiligo was the predominance of generalized forms and the elective localization in sun-exposed areas. The family character, the psychoaffective disturbances, the Koebner phenomenon increased by the lifestyle and the itching dermatosis were the aggravating factors.

Autoimmune Disease Genetics

Autoimmune Disease Genetics

Berberine inhibits the production of thymic stromal lymphopoietin by the blockade of caspase-1/NF-κB pathway in mast cells

Thymic stromal lymphopoietin (TSLP) plays a pivotal role in allergic diseases such as atopic dermatitis, asthma, and chronic obstructive pulmonary disease. However, it has not been clarified the effect of berberine (BER) on the production of TSLP yet. Thus, we investigated how BER inhibits the production of TSLP in the human mast cell line (HMC-1) cells. We used enzyme-linked immunosorbent assay, reverse transcription-polymerase chain reaction, luciferase assay, and Western blot analysis to investigate the effects of BER. BER inhibited the production and mRNA expression of TSLP in HMC-1 cells. BER also inhibited the nuclear factor-κB luciferase activity induced by phorbol myristate acetate plus A23187. BER inhibited the activation of caspase-1 in HMC-1 cells. Furthermore, BER inhibited the production of TSLP in primary mast cells. These results provide evidence that BER can help to treat inflammatory and atopic diseases through the inhibition of TSLP.

Epigallocatechin-3-O-gallate inhibits the production of thymic stromal lymphopoietin by the blockade of caspase-1/NF-κB pathway in mast cells

The cytokine thymic stromal lymphopoietin (TSLP) has been implicated in the development and progression of allergic diseases such as atopic dermatitis, asthma, and chronic obstructive pulmonary disease. However, it has not yet been clarified the effect of epigallocatechin-3-O-gallate (EGCG) on the production of TSLP. Thus, we investigated how EGCG inhibits the production of TSLP in the human mast cell line (HMC-1) cells. Enzyme-linked immunosorbent assay, reverse transcription-polymerase chain reaction, luciferase assay, and Western blot analysis were used to investigate the effects of EGCG. EGCG inhibited the production and mRNA expression of TSLP in HMC-1 cells. EGCG also inhibited the nuclear factor-κB luciferase activity induced by phorbol myristate acetate plus A23187. Furthermore, EGCG inhibited the activation of caspase-1 in HMC-1 cells. These results provide evidence that EGCG can help us to treat inflammatory and atopic diseases through the inhibition of TSLP.

3,4,5-Tricaffeoylquinic acid inhibits tumor necrosis factor-α-stimulated production of inflammatory mediators in keratinocytes via suppression of Akt- and NF-κB-pathways

Keratinocytes may play an important role in the pathogenesis of skin disease in atopic dermatitis. Caffeoyl derivatives are demonstrated to have anti-inflammatory and anti-oxidant effects. However, the effect of 3,4,5-tricaffeoylquinic acid prepared from Aconium koreanum on the pro-inflammatory cytokine-stimulated keratinocyte responses remains uncertain. In human keratinocytes, we investigated the effect of 3,4,5-tricaffeoylquinic acid on the tumor necrosis factor (TNF)-α-stimulated production of inflammatory mediators in relation to the nuclear factor (NF)-κB and cell signaling Akt, which regulates the transcription genes involved in immune and inflammatory responses. 3,4,5-Tricaffeoylquinic acid inhibited the TNF-α-stimulated production of cytokines (IL-1β and IL-8) and chemokine (CCL17 and CCL27) in keratinocytes. Bay 11-7085 (an inhibitor of NF-κB activation) and Akt inhibitor attenuated the TNF-α-induced formation of inflammatory mediators. 3,4,5-Tricaffeoylquinic acid, Bay 11-7085, Akt inhibitor and N-acetylcysteine inhibited the TNF-α-induced activation of NF-κB, activation of Akt, and formation of reactive oxygen and nitrogen species. The results show that 3,4,5-tricaffeoylquinic acid seems to attenuate the TNF-α-stimulated inflammatory mediator production in keratinocytes by suppressing the activation of Akt and NF-κB pathways which may be mediated by reactive oxygen species. The findings suggest that 3,4,5-tricaffeoylquinic acid may exert an inhibitory effect against the pro-inflammatory mediator-induced skin disease.

The Correlation Between Atopic Dermatitis Disease Severity and Quality of Life is Complex

S A T U R D A Y 153 The Correlation Between Atopic Dermatitis Disease Severity and Quality of Life is Complex F. C. Lewer, K. Keat, P. K. Burton, B. S. Frankum, B. Wainstein, C. H. Katelaris; University of Western Sydney, Sydney, AUSTRALIA, Sydney South West Area Health Service, Sydney, AUSTRALIA, Sydney Children’s Hospital, Sydney, AUSTRALIA. RATIONALE:This study aims to assess whether atopic dermatitis disease severity (as assessed by the SCORing Atopic Dermatitis [SCORAD] assessment tool) is a good indicator of the impact on quality of life (QOL) in the paediatric population. METHODS: Children aged between 2 and 17 years of age that present to the Paediatric Immunology Clinic at Campbelltown Hospital in Sydney, Australia, with atopic dermatitis are assessed using the SCORAD and the PedsQL QOL survey as part of clinical practice. The PedsQL is a general non disease-specific QOL assessment tool. Children are reassessed at subsequent visits and tracked longitudinally. This study is an audit of this data. RESULTS: Preliminary findings for 31 children suggest there is not a strong correlation between disease severity and QOL. Overall correlation between SCORAD and QOL is lower than expected (r5-0.382, p50.11). Visits with children under the age of 5 (n512) have a greater correlation between their SCORAD and QOL scores (r5-0.624, p50.03) than visits of children aged 5 years old or above (n532) (r5-0.304, p50.09, not statistically significant). Surprisingly, there was a trend for visits of children with a SCORAD of 40 or less (n522) to have an almost absent correlation between SCORAD and QOL (r50.059) although this was not statistically significant (p50.795). Those with a SCORAD over 40 (n522) have a strong negative correlation (r5-0.516, p50.014). CONCLUSIONS: This preliminary data indicates a complex relationship between disease severity and effects on QOL, in the setting of atopic dermatitis. This relationshipmay becomemore evident as we examine a larger sample size.

The Self-Administered Eczema Area and Severity Index in Children with Moderate to Severe Atopic Dermatitis: Better Estimation of AD Body Surface Area Than Severity

The Self-Administered Eczema Area and Severity Index (SA-EASI) is one of the few patient based atopic dermatitis (AD) disease activity scores and was found to be highly correlated with the EASI. Correlation with other frequently used scoring methods has not been investigated. The aim of this study was to evaluate the relation of the SA-EASI with two physician-based disease activity scores (objective SCORAD and SASSAD score) and with a serum marker for AD (Thymus and Activation-Regulated Cytokine [TARC]) in children with AD. Sixty children with moderate to severe AD were included. The SA-EASI was completed by caregivers, and the objective SCORAD and SASSAD scores were measured successively on the same day by a trained investigator. Blood for serum TARC measurement was drawn. The correlation between the SA-EASI and the objective SCORAD was high (ρ = 0.61, p = <0.001), mainly based on high correlation between the body surface area (BSA) measurements of both scores (ρ = 0.50, p = <0.001). The correlation with the SASSAD score (only severity measurement) was 0.43 (p = <0.001). The correlation with serum TARC levels was 0.46; p = <0.001, mainly based on the BSA score of the SA-EASI (ρ = 0.42, p = <0.001). Parents may have more difficulty in scoring severity of AD than scoring BSA involved. Educating parents in severity scoring of AD may improve agreement of the SA-EASI and the objective SCORAD, TARC, and SASSAD score. Additional use of the SA-EASI in routine clinical practice or in trials may then facilitate more frequent but still accurate assessment of AD.

Does the Occupational Contact Dermatitis Disease Severity Index correlate with quality of life in patients with occupational contact dermatitis of the hands?

Does the Occupational Contact Dermatitis Disease Severity Index correlate with quality of life in patients with occupational contact dermatitis of the hands?