Dermatology Life Quality Index Scores Research Articles

An Individualised Homoeopathic Approach to Chronic Atopic Dermatitis: A Case Report

AbstractAtopic dermatitis is a chronic inflammatory skin disease affecting about one-fifth of all individuals during their lifetime. It has substantial impact on the quality of life of the affected individual. Not only patient is affected by the social stigma of a visible skin condition but also the characteristic itch-scratch cycle often leads to skin trauma and significant sleep disruption. Though there is multitude of treatment options in modern medicine, the recurrence, and adverse effects of medications cannot be ruled out. Therefore, an alternative approach is required. The case presented here reported with the complaint of severe generalised itching eruptions for the last 8 years with a history of atopy. After thorough evaluation from the clinical and homoeopathic standpoint, a single homoeopathic medicine Arsenicum iodatum was prescribed in different potencies at different timepoints as the symptomatology corresponds. Following the administration of individualised homoeopathic (IH) medicine, there was gradual improvement in the case with disappearance of skin lesions which was also evaluated through reduction in SCORing Atopic Dermatitis and Dermatology Life Quality Index scores. During the treatment, old symptoms also reappeared indicating improvement in accordance with Hering's law of cure and Kent's 11th observation. The modified Naranjo criteria score after the treatment course was 10 which exclusively shows positive causal attribution of the IH in this case.

A cross‐sectional study on quality of life in adult indolent systemic mastocytosis and its association with cutaneous involvement

AbstractBackgroundSystemic mastocytosis (SM) is characterized by abnormal mast cell accumulation in various tissues, including the skin, and encompasses several clinical variants, ranging from less aggressive to more severe forms. ISM, the most common variant, often presents with cutaneous manifestations, causing significant impairment in QoL due to mediator‐release symptoms and stigma associated with typical cutaneous lesions.ObjectivesThe study aimed to assess QoL impairment in ISM patients and its correlation with demographic and clinical data.MethodsA cohort of 52 adult ISM patients was evaluated using the Dermatology Life Quality Index (DLQI) and the mastocytosis QoL questionnaire (MC‐QoL). Questionnaire scores were then analyzed in relation to the clinical and demographic characteristics of the patients.ResultsOver half of the patients experienced mild or higher levels of impairment in QoL, with female patients showing greater impairment than males. Patients with recent symptom onset reported higher MC‐QoL scores, possibly due to psychological factors and lack of disease knowledge. Cutaneous symptoms significantly impacted QoL, and the visibility of lesions affected DLQI scores more than MC‐QoL scores. A moderately strong correlation was observed between DLQI and MC‐QoL scores, particularly in the Skin and Social Life domains. The study highlights gender differences in QoL impairment, suggesting the need for further investigation into potential social or cultural factors.ConclusionsWhile the study provides valuable insights into QoL impairment in ISM patients, its monocentric nature and small sample size are notable limitations. Further research is warranted to better understand the impact of SM on patients' well‐being and to identify effective strategies for managing symptoms and improving overall QoL in this population.

Sexual Distress and Quality of Life in Women With Genital Erosive Lichen Planus-A Cross-sectional Study.

The study aimed to assess sexual distress and quality of life in women with moderate-to-severe genital erosive lichen planus (GELP). Thirty-six women with GELP were recruited at the Oslo University Hospital in Norway. The diagnosis was confirmed by a dermatologist with experience in vulvovaginal disease and based on characteristic clinical changes in the vulva and/or vagina, and biopsy results if available. Clinical severity was measured using the GELP score with a score ≥5 required for inclusion. Sexual distress was measured using the revised Female Sexual Distress Scale (FSDS-R), and quality of life was measured using the Dermatology Life Quality Index (DLQI). Topical steroid treatment was allowed. The mean FSDS-R score was 22.7 (range 0-45) with 27 women reporting high scores for sexual distress (FSDS-R score >15). The mean DLQI score was 8.8 (range 1-19) with 15 women reporting a moderate impact (DLQI score 6-10), and 12 women reporting a very large impact (DLQI score 11-20) of GELP on their quality of life. No clear correlations were found between disease severity assessed by GELP scores and FSDS-R or DLQI scores. Age was not correlated with FSDS-R or DLQI scores. These results demonstrate that a substantial number of women with GELP experience sexual distress and a reduced quality of life.

Unveiling the Impact of Moderate and Severe Atopic Dermatitis: Insights on Burden, Clinical Characteristics, and Healthcare Resource Utilization in Adult Greek Patients from the APOLO Cross-Sectional Study

Background: Moderate to severe (M2S) atopic dermatitis (AD) is a chronic condition impacting individuals, society, and healthcare systems. Considering the changing M2S-AD treatment landscape, this study assesses the M2S-AD burden in patients reaching referral centers in Greece. Methods: This was a multicenter, cross-sectional study. Patients aged 12 years or older with clinically diagnosed M2S-AD were enrolled. Data collected included clinical practice assessments and the following validated patient-reported instruments: Dermatology Life Quality Index (DLQI); EuroQol-5 Dimensions-3 Level scale (EQ-5D-3L); Patient Oriented Eczema Measure (POEM); Peak Pruritus Numerical Rating Scale (PP-NRS); and Work Productivity and Activity Impairment: General Health (WPAI:GH). A pain frequency/intensity/cause questionnaire and a sleep disturbance scale were also used. Results: Outcomes of 184 adults (51.1% female) with M2S-AD based on the Eczema Area and Severity Index (EASI) are presented (n = 117 moderate; n = 67 severe). Among the patients, 14.8% were obese, 59.2% had allergic comorbidities, and 88.0% were receiving AD-specific therapy (systemic: 38.6%). The median age, disease duration, body surface area, and total EASI scores were 38.8 years, 11.8 years, 30.0%, and 16.9, respectively. The median DLQI score was 12.0, with ‘symptoms/feelings’ being the most affected domain. EQ-5D dimensions ‘anxiety/depression’ and ‘pain/discomfort’ were also affected (65.2% and 64.1% reporting problems, respectively). The median POEM score was 17.0. Pain, severe pruritus (PP-NRS ≥ 7), and sleep disturbance were reported by 80.4%, 62.0%, and 88.5%, respectively. The median WPAI:GH ‘work productivity loss’ and ‘activity impairment’ scores were 23.8% and 30.0%, respectively. Conclusions: Both moderate and severe AD patients reaching Greek specialized centers experience significant symptom burden and impairments in quality of life, sleep, work, and daily activities.

Validation of the Real-World Application of the Hidradenitis Suppurativa Quality of Life (HiSQOL) Score to Adults with Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) has unique symptoms and physical features among skin diseases. Patient reported outcome measures (PROMs) agnostic to specific skin diseases may not fully characterise the influence of HS on quality of life (QoL). A HS-specific PROM is needed to capture the impact of HS on QoL in the real-world setting. To validate the Hidradenitis Suppurativa Quality of Life Questionnaire (HiSQOL) as a HS-specific PROM by comparing it to the Dermatology Life Quality Index (DLQI) in clinical practice. Data were drawn from the Adelphi HS Disease Specific Programme™, a cross-sectional survey of physicians and patients conducted in France, Germany, Italy, Spain, and the United States between November, 2020 and April, 2021. Practicing physicians each provided demographic and clinical data for 5-7 consecutively evaluated HS patients aged at least 10 years receiving any treatment for HS, and an additional 3 patients undergoing biologic treatment; only patients aged at least 18 years were included in this study. Patients completed the DLQI and HiSQOL. Construct validity was assessed by Pearson's correlation between DLQI and HiSQOL scores. The HiSQOL item discrimination was assessed by comparing differences in item responses between the highest and lowest 25% of HiSQOL scores. Multivariable linear regressions assessed relationships between individual PROM item responses and the total score of the other PROM. In total, 677 patients [mean age of 34.3 (11.3) years; female (57.3%, n=388)] completed both the HiSQOL and DLQI. There was strong correlation between HiSQOL and DLQI total scores (Pearson's correlation 0.87 [95% confidence interval: 0.85-0.89, p<0.001]). The HiSQOL items that had the biggest impact on QoL related to "Embarrassment", "Depression" and "Anxiety", items that also had among the lowest relationship to total DLQI score. The HiSQOL is a valid tool for assessing QoL in HS patients in the real-world setting. Furthermore, the HiSQOL better captures those aspects of HS that have the highest impact on QoL, including depression and anxiety, which are not captured by the DLQI.

The Impact of Disease Severity on the Serum Levels of Significant Neutrophil Extracellular Trap (NET) Proteins in Patients with Psoriasis.

Psoriasis is an inflammatory skin disease with various symptoms of differing severities and with the reported prominent involvement of neutrophil extracellular traps (NETs). The excitation of neutrophils, e.g., by interleukin 8 (IL-8) or lipopolysaccharide (LPS), leads to the citrullination of histones and the release of protein-DNA complexes into the extracellular space, where they are digested by DNases. Our aim was to explore data on the levels of protein-complexed DNAs neutrophil elastase-DNA (NE-DNA) and myeloperoxidase-DNA (MPO-DNA), citrullinated histones (citH2, citH3, citH4), and NET-degrading enzyme DNase I in the serum of psoriatic patients with varying severities of clinical symptoms assessed with the Psoriasis Area Severity Index (PASI), Body Surface Area (BSA), and Dermatology Life Quality Index (DLQI) scores. The levels of factors were detected in 52 patients with psoriasis and 22 healthy volunteers by the enzyme-linked immunosorbent assay (ELISA). The results showed the elevated levels of NE-DNA, MPO-DNA, citH3, and DNase I in the patients with psoriasis compared to healthy volunteers (p < 0.05). Additionally, changes were noticed in the levels of NE-DNA, citH3, and DNase I, depending on the severity of symptoms (p < 0.05). In mild psoriasis (PASI < 10, BSA < 10, DLQI < 10), the suppressing activity of the enzyme caused the impaired ability to remove the physiological level of NETs, whereas in moderate to severe psoriasis (PASI ≥ 10, BSA ≥ 10, DLQI ≥ 10), the enhanced activity of DNase I failed to remove NETs due to the observed overexpression. It may, thus, be concluded that the mechanism of action of NETs, which play an undeniable role in psoriatic diseases, seem to follow two different paths depending on the severity of disease, which may be crucial in selecting potential anti-NET treatment methods.

[Artículo traducido] Un nuevo paradigma en el tratamiento del prurito del cuero cabelludo: Hallazgos del estudio SCALP-PR

PurposeThe “Impact of scalp pruritus in dermatological consultations in Spain: The SCALP-PR trial” was initiated to address the common yet often insufficiently examined issue of scalp pruritus in dermatology. This condition leads to an uncontrollable urge to scratch, affecting the patients’ quality of life and potentially causing scalp damage. This study aimed to explore the prevalence, patient profile, underlying conditions, and therapeutic approaches for scalp pruritus in Spain, and to assess the safety and efficacy profile, as well as the tolerability of a non-pharmacologic treatment. MethodsFrom 2021 through 2022, 75 dermatologists enrolled a total of 359 patients in a study on scalp pruritus, approved by the Bellvitge University Hospital Research Ethics Committee, Barcelona, Spain. This evidence-based research combined a meta-analysis with observational study techniques focused on real-world evidence to examine the therapeutic impact on quality of life (QoL). Utilizing the Dermatology Life Quality Index (DLQI) for QoL assessments, the study evaluated the effectiveness of the topical product over 15 days. Data collection was conducted via an eCRF and analyzed with statistical methods to provide reliable insights into the management of scalp pruritus. ResultsThe prevalence of scalp pruritus in Spain was found to be 6.9%, predominantly among women with a mean age of 52.5 years. The leading causes identified were seborrheic dermatitis and pruritus of undetermined etiology or sensitive scalp. Stress was noted as a key factor, with corticosteroids and hygienic measures being common therapies. The topical product demonstrated significant reductions in pruritus and scratching in more than 90% of patients after 15 days. Improvements were also seen in dermatological quality of life, with 87.1% of patients showing enhancements in DLQI scores. The product was well-received thanks to its cosmetic properties, with high ratings in texture, ease of application, and fragrance. ConclusionThe topical product studied is a safe, effective, and cosmetically appealing treatment, improving scalp pruritus in various etiologies for most patients. The results highlight the need for patient-center treatments in dermatology, providing important insights for clinical practice and future research.

Efficacy of photodynamic therapy combined with cross-punch technique for the treatment of keloid

ObjectiveKeloids are characterized by abnormal activation of fibroblasts and excessive collagen deposition. Keloids are notoriously difficult to treat effectively due to their high recurrence rate after therapy. Our study explored the use of the punch technique in conjunction with photodynamic therapy, a novel approach that may swiftly reduce keloid volume, promote collagen remodeling, mitigate inflammation and enhance the wound healing process. MethodsIn our study, we conducted a retrospective analysis of 47 keloid patients who were treated with cross-punch technique combined with photodynamic therapy (punch+PDT group), compared them with a control group of 42 patients who received cross-punch therapy alone (punch group). The visual Analog Scale (VAS) scoring system, the Dermatology Life Quality Index (DLQI) questionnaire and the subjective scoring of patients were implemented to assess the improvement rate at baseline (month 0) and 12-month follow-up (month 12). ResultsThe results demonstrated significant enhancements in both VAS scores and DLQI scores on month 12 when compared with those on month 0. Notably, the subjective scoring indicated a marked difference, with 93.62 % of patients in the punch+PDT group and 59.52 % in the punch group reporting good or excellent improvement. ConclusionPatients in the punch+PDT group had a significant improvement rate than those in the punch group.

Understanding Perceptions and Experiences on Acceptability of Oral Ivermectin, Topical Permethrin, and their Combination in the Treatment of Adult Filipino Patients with Scabies: A Multiple Case Study.

Oral ivermectin, a broad-spectrum anti-parasitic drug, alone or in combination with permethrin, may be a cheaper and more convenient alternative drug to topical permethrin alone in the treatment of classic scabies. There are no previous studies on the treatment acceptability of the three interventions among individual patients with scabies in the Philippines.The purpose of this study was to understand the experiences and perceptions on treatment acceptability for oral ivermectin, topical permethrin or combination treatment among patients with scabies using the multiple-case study approach. We conducted a qualitative multiple case study among adult Filipino patients with classic scabies who were prescribed oral ivermectin, topical permethrin or its combination at a government tertiary hospital dermatology outpatient clinic from December 2022 to September 2023. Semi-structured interviews were used as the primary source of data and analyzed together with chart reviews, Dermatology Life Quality Index (DLQI) scores, and clinical images. Interviews were transcribed, coded, and triangulated with other secondary data. A three-person research team employed a reflexive and iterative process of familiarization, coding, and thematic analysis using a modified Theoretical Framework of Acceptability (TFA) to generate case descriptions, within-case analyses, and cross-case syntheses. The acceptability of scabies treatments (permethrin, ivermectin, and combination therapy) was generally positive. Permethrin, used in three patient cases, was generally perceived as effective but itch relief varied. The burden of whole-body application of permethrin was context-dependent, influenced by living arrangements and family support. Perceived affordability of permethrin was linked to socioeconomic status. Ivermectin, used by one patient case, was perceived as highly effective with no side effects. Its single dose use did not interfere with patient routine. Combination therapy was also considered effective but potential antagonistic effects and the cost of adding permethrin made it less preferred. Reluctance in taking oral pills was noted. All patients valued medical advice and deferred to their physicians for treatment decisions. All three treatment options were considered effective and safe. Patients generally preferred permethrin over oral ivermectin due to its topical nature and perceived lower side effects. However, affordability and logistical challenges, especially for large households and low-income families, were noted with permethrin. Oral ivermectin elicited hesitation due to its controversial role in COVID-19 and veterinary use. Concerns about added costs and potential antagonism in combination therapy were raised. Despite these considerations, patients ultimately relied on physicians for treatment decisions. This study underscores the importance of understanding patient perspectives, experiences, and the patient-physician relationship in choosing scabies interventions. Addressing patient concerns, providing education, and ensuring ease of use and affordability can enhance treatment acceptability and adherence for better outcomes.

Association between Inflammatory Markers and Psychometric Scores in Patients with Hidradenitis Suppurativa

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such as the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and the UCLA Loneliness Scale. Methods: A pilot observational study including 37 patients with HS was conducted. Inflammatory serum markers, including C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), were evaluated at baseline, 3 months, and 6 months later. Psychometric scores were also evaluated at the same study intervals. Results: DLQI was correlated with ESR at baseline (Spearman’s rho = 0.35, p = 0.03), indicating that poorer quality of life is associated with changes in this serum marker. Disease activity, as reflected by inflammatory markers, was associated with significant psychological burden. Specifically, a worse DLQI score was associated with higher ESR (estimate β = 0.14, 95% confidence interval [CI]: 0.05–0.22; p = 0.001) and higher CRP level (estimate β = 0.25, 95% CI: 0.02–0.48; p = 0.02). Similarly, a worse UCLA score was associated with higher ESR (estimate β = 0.11, 95% CI: 0.02–0.20, p = 0.01). Conclusions: Our study results underline the close relation between systemic inflammatory markers and clinical severity together with psychological burden in HS patients, as indicated by the significant association that was revealed between ESR/CRP and poorer psychometric scores. However, further research is warranted to validate these findings.

Treatment efficacy and patient satisfaction of ustekinumab compared with tumor necrosis factor-alpha inhibitors in Chinese patients with moderate-to-severe psoriasis: a real-world study

Background Ustekinumab is an interleukin (IL)-12/IL-23 inhibitor for the treatment of moderate-to-severe psoriasis. Objective This real-world study compared ustekinumab and tumor necrosis factor-alpha inhibitors (TNFis) in Chinese moderate-to-severe psoriasis patients. Methods Patient health records of 110 moderate-to-severe psoriasis patients initiating or switching biologics were reviewed, with 31 patients receiving ustekinumab (ustekinumab group) and 79 patients receiving TNFis (TNFi group). Results Compared with TNFi group, psoriasis area and severity index (PASI)-75 response rate at month 6 (M6) were elevated (87.1% versus 65.8%, p = 0.026) in the ustekinumab group, whereas the rates at month 1 (M1) and month 3 (M3) and PASI-90 response rates at M1, M3, and M6 only showed an increasing trend (all p > 0.050) in the ustekinumab group than the TNFi group. By subgroup analyses, ustekinumab (versus TNFi) was more effective in patients with biologics therapy history than those without. Compared with the TNFi group, the ustekinumab group had lower dermatology life quality index scores and higher patient satisfaction scores at M3 and M6 (all p < 0.050). Conclusion Chinese moderate-to-severe psoriasis patients treated with ustekinumab have a better treatment response at 6 months with improved quality of life and patient satisfaction after 3–6 months of treatment when compared to TNFi.

Quality of life of patients with dyshidrotic eczema: a cross-sectional study

Introduction. Dyshidrotic eczema (DE) is a type of true eczema, prone to chronic recurrent course, which has a negative impact on the quality of life of patients. In the domestic literature, insufficient attention is paid to the study of the role and nature of the course of the disease on the daily life of patients with DE.Aim. To study the quality of life in patients of DE. Provide a description of a clinical cases of DE and experience with external therapy.Materials and methods. 105 patients with DE aged 18 to 52 years were included in the study, the mean age was 31.3 ± 8.1 years. The quality of life was assessed using the Dermatology Life Quality Index (DLQI). The Dyshidrotic Eczema Area and Severity Index (DASI) was used to clinically assess the severity of DE.Results. All patients suffering from DE noted a negative impact of the skin process on the quality of life. At the same time, the average DLQI score in all patients was 6.99 ± 4.6, which indicates a moderate undesirable effect of DE on the quality of life, without statistically significant differences by gender. The average DASI score was 12.6 ± 8.8, which indicates a predominance of mild DE in the sample. In women, a process of moderate severity was more often diagnosed and the DASI index was 13.2 ± 8.5. The study demonstrated that the female gender is more susceptible to the influence of DE symptoms on the quality of life, regardless of the severity and extent of the skin process, and minimal changes in the skin can have a negative impact on the quality of life. The article presents clinical examples of successful treatment of DE localized on the skin of the hands with an external preparation containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole.Conclusion. DE is a common condition and affects quality of life. Proper diagnosis is essential for effective and efficient treatment. External therapy with the inclusion of a cream (ointment) containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole gives better results and increases satisfaction with the treatment of patients with DE.

A 14-year registry review (2007-2020) on nail involvement among patients with psoriasis in Malaysia

Nail psoriasis affects 20 to 30% of psoriasis patients and is an early predictor of psoriatic arthropathy (PsA). We have evaluated the prevalence, clinical characteristics, and impact on quality of life of patients with nail psoriasis.We conducted a multicenter retrospective cohort study was of patients registered with The Malaysian Psoriasis Registry (MPR) from 1 January 1, 2007 through 31 December 31, 2020.Of the 24147 patients, 13081 (54.2%) had nail psoriasis. Patients with nail psoriasis had la ater onset of psoriasis (34.0±16.6 vs 32.9±17.6 years, p<0.001) and longer disease duration (11.4±10.5 vs 8.5±9.4 years, p<0.01), with a male to female ratio of 1.2:1. They were more likely to have a family history of psoriasis, cardiometabolic diseases, smoking history, higher body mass index, severe disease, PsA, face and scalp involvement and higher mean Dermatology Life Quality Index scores (9.36±6.84 vs 8.87±6.60). Systemic treatment and biologics were more commonly prescribed in this cohort (25.0% vs 13.2%, p<0.001).Overall, 54.2% of the MPR patients had nail involvement. Nail psoriasis was associated with longer duration of psoriasis, older age of onset, male gender, and a family history of psoriasis. It proved to be an important predictor for PsA, severe psoriasis, face and scalp involvement, increased cardiometabolic risk, and a greater impairment of quality of life.

Perspectives of Japanese patients on psoriatic disease burden: Results from "Psoriasis and Beyond," the Global Psoriatic Disease Survey.

Psoriatic disease (PsD) is a chronic disease affecting skin (psoriasis) and joints (psoriatic arthritis, PsA) that has a significant impact on patients' quality of life (QOL). We report findings from the Japanese subgroup of patients included in Psoriasis and Beyond: The Global Psoriatic Disease Survey, a cross-sectional, quantitative online survey of patients with self-reported, healthcare professional (HCP)-diagnosed, moderate-to-severe plaque psoriasis, with or without PsA. Eligible patients who were recruited online completed a 25-min internet-based survey in Japanese. We assessed patients' understanding of the systemic nature of PsD, disease burden, perception towards their HCPs, treatment expectations, and satisfaction with care. Of the 148 patients, 74% were females. In total, 65% of patients were aware of the systemic nature of their disease. A minority of patients (27%) were aware that PsA was related to their psoriasis, and 30% and 42% of patients were unaware of any manifestations and comorbidities, respectively, related to PsD. Overall, 21% of patients reported that their disease has a "very large" to "extremely large" impact on their QOL (assessed by Dermatology Life Quality Index score), while the majority (61%) reported a "small" effect or "no effect" at all on QOL. Patients experienced stigma and discrimination and had a negative impact on relationships due to PsD. More patients with psoriasis and concomitant PsA (66%) were satisfied with their current treatment than those with psoriasis alone (46%). Overall, 41% of patients were not involved in deciding their treatment goals. These results suggest that Japanese patients may not be fully aware of the systemic nature of PsD, its manifestations and comorbidities. While these patients were somewhat satisfied with their current treatment, they were only occasionally consulted in deciding treatment goals. Policy measures are required to address the stigma and discrimination experienced by patients. Increased patient participation in their care supports shared decision-making and enhanced treatment outcomes.

Investigation of the effect of oral ivermectin on systemic inflammatory response and quality of life in scabies patients.

Scabies is a prevalent ectoparasitic infectious disease, caused by the mite Sarcoptes scabiei. As a consequence of the infestation, localised cutaneous inflammation, pruritus and polymorphic skin lesions develop. The primary symptoms of scabies manifest as hypersensitivity-like reactions and immune responses, the precise mechanisms of which remain poorly defined. The objective of this study was to evaluate the effects of oral ivermectin treatment in patients with scabies on the systemic immune response and the patient's quality of life (QoL). Patients admitted to the dermatology outpatient clinic and diagnosed with scabies were administered oral ivermectin treatment following diagnosis at week 0 and 2. Laboratory tests were conducted to measure complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels before treatment and at week 4. The systemic immune-inflammation index (SII) was calculated using the platelet, neutrophil and lymphocyte counts. Additionally, data pertaining to the Dermatological Life Quality Index (DLQI) were recorded. In 119 patients (51 males) diagnosed with scabies, increases in ESR, CRP, and SII values and decreases in inflammatory cell counts and DLQI scores were observed one month after treatment with oral ivermectin. The results of the study showed that the use of oral ivermectin, a scabicidal agent, triggered the inflammatory response and improved the QoL of the patients.

Efficacy of a Multi-lamellar Emulsion Containing a Synthetic Sphingosine Kinase 1 Activator and Pseudoceramide in Patients with Atopic Dermatitis: A Randomized Controlled Trial.

Patients with atopic dermatitis(AD) have impaired barrier function, which decreases skin hydration, weakens their defense against microorganisms, and culminates in increased inflammatory responses. Here, we conducted a clinical trial to evaluate the efficacy of a multi-lamellar emulsion (MLE) containing the pseudoceramide PC-9S and a synthetic sphingosine kinase 1 (SPHK1) activator, Defensamide™, in improving mild-to-moderate atopic dermatitis. Forty patients aged ≥ 2years were randomized into a combined-therapy group treated with the MLE containing PC-9S and Defensamide™ plus a topical corticosteroid and a topical-corticosteroid-only group. Assessments based on therapeutic methods included the Eczema Area and Severity Index (EASI), the Investigator Global Assessment (IGA), transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin dryness, a visual analogue scale (VAS) of itchiness, a VAS of sleep disturbance, patientsatisfaction, and the Dermatology Life Quality Index (DLQI). Thirty-eight patients completed this study. In the combined-therapy group, significant improvements in clinical and instrumental measures such as EASI scores, skin hydration, and skin dryness were noted at 4weeks compared to baseline, but such improvements were not noted in the topical corticosteroid-only group. Subjective assessments of itching and sleep disturbance and DLQI scores also showed significant improvements in the combined-therapy group. Combined therapy with the MLE containing Defensamide™ and PC-9S and with topical corticosteroid demonstrated superior clinical outcomes compared with topical corticosteroid monotherapy. Our findings underscore the potential of MLE-containing formulations as effective adjunctive therapies for AD, offering both objective and subjective symptomatic relief and enhancing patients' quality of life.

51782 Generalized pustular psoriasis (GPP) continues to adversely impact quality of life between flares, as per Dermatology Life Quality Index scores: Baseline data from the Effisayil 2 trial

51782 Generalized pustular psoriasis (GPP) continues to adversely impact quality of life between flares, as per Dermatology Life Quality Index scores: Baseline data from the Effisayil 2 trial

51856 Spesolimab rapidly improves quality of life in patients with generalized pustular psoriasis, as per Dermatology Life Quality Index scores: Data from the Effisayil 2 trial

51856 Spesolimab rapidly improves quality of life in patients with generalized pustular psoriasis, as per Dermatology Life Quality Index scores: Data from the Effisayil 2 trial

Lactiplantibacillus plantarum IS-10506 Supplementation Improves Clinical Outcome and Immunology Markers in Psoriasis Vulgaris Patients: A Randomized Controlled Trial

BACKGROUND: Probiotics may modify the gut microbiome and have been proven to improve psoriasis vulgaris. Lactiplantibacillus plantarum IS-10506 is a probiotic strain of Indonesian origin. It offers a safe and effective probiotic for psoriasis patients in Indonesia. This study was conducted to evaluate the effect of L. plantarum IS-10506 on clinical and immunology markers in psoriasis vulgaris.METHODS: This randomized, placebo-controlled, and double-blind trial compared L. plantarum IS-10506 (2×1010 CFU/day) and placebo in 49 patients mild-moderate psoriasis vulgaris, which were divided into intervention (n=24) and control groups (n=25). The interventions were given twice daily for 12 weeks. Both groups received topical corticosteroid and emollient as standard treatment. Psoriasis area and severity index (PASI), dermatology life quality index (DLQI), interleukin (IL)-10, IL-17, and forkhead box protein (Foxp3) were then assessed.RESULTS: Mean PASI score for the the subjects in probiotic group was significantly reduced compared to placebo at week-6 (p=0.024), and was sustained until week-12 (p=0.049). At week-12, DLQI scores in the probiotic group were lower than placebo (7.57±5.77 vs. 7.79±5.48). IL-17 level was significantly decreased (p=0.013), while the IL-10 and Foxp3 were significantly increased (p≤0.001 and p=0.048, respectively) in probiotic group. Six months after the completion of study, subjects in probiotic group had a lower probability of flares (52.2%) compared to placebo (79.2%). Two subjects receiving probiotics and one receiving placebo noticed changes in defecation frequency, while another subject in the placebo group complained of mild nausea.CONCLUSION: L. plantarum IS-10506 might effectively improve clinical outcomes and immune biomarkers in psoriasis vulgaris patients, potentially acting as an adjuvant therapy.KEYWORDS: psoriasis, probiotic, clinical severity, immune marker, human and health

Clinical study of vitiligo with assessment of quality of life and comparison with Vitiligo Area Severity Index score in a tertiary care center in northern India

Introduction: Vitiligo is a common, chronic, and idiopathic pigmentary disorder of the skin, characterized by well-defined depigmented macules. It has a significant negative impact on psychological health of patients. Patients report having low self-esteem and a negative body image, which may result in a reduced quality of life for them. Vitiligo also has considerable potential for social stigma and cosmetic impairment, which are aspects of the disease that are often overlooked. Aims and Objective: The aim of this study was to describe the demographic characteristics of the rural population of Uttar Pradesh, India, diagnosed with vitiligo, and to study the association of the Vitiligo Area Scoring Index (VASI) score with the quality of life in patients having vitiligo. Material and Methods: An observational study was conducted on 121 patients diagnosed with vitiligo at a tertiary care hospital for 6 months after receiving ethical approval. The patients’ demographic details were recorded, and the severity of their condition was assessed using the VASI. This information was then compared with the Dermatology Life Quality Index (DLQI) using a standard questionnaire. Statistical analysis was performed using SPSS software. Results: The study included a total of 121 patients, with 67 (55.4%) females and 54 (44.6%) males. Their ages ranged from 15 to 65 years, with a mean age of 32.28 years. The DLQI scores ranged from 3 to 21, with a mean of 11.49. There was no statistically significant difference in scores between males and females. Out of the total, 21 patients (12 males and 9 females) reported a small effect of the disease on their life, while 29 patients (comprising 9 males and 20 females) revealed a moderate effect. Additionally, 32 (59.3%) males and 35 (52.2%) females showed a very large effect on their life. Significant variations were observed between the DLQI score grades in relation to the VASI score. There was a statistically significant positive correlation between the VASI score and the DLQI score (P &lt; 0.001). The DLQI score also showed a statistically significant association with increased body surface area. Conclusion: The severity of vitiligo should be evaluated not only based on the disease itself but also on its impact on the patients’ quality of life.