1
|
Kong Y, Xing P, Huai P, Zhang F. The burden of skin diseases in China: global burden of Disease Study 2019. Arch Dermatol Res 2024; 316:277. [PMID: 38796625 DOI: 10.1007/s00403-024-03046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/28/2024]
Abstract
Skin diseases continue to affect human health and cause a significant disease burden on the healthcare system.We aimed to report the changing trends in the burden of skin disease in China from 1990 to 2019, Which has an important role in developing targeted prevention strategies. We applied Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 analytical tools to calculate the age-standardized Prevalence and Incidence in 2019, number of years lived with disability (YLDs) and age-standardized YLDs from 1990 to 2019 of skin and subcutaneous diseases, notifiable infectious skin diseases and skin tumors in China. Among the skin and subcutaneous diseases in China in 2019, dermatitis contributed to the greatest YLD (2.17 million, 95% uncertainty interval[UI]: 1.28-3.36). Age-standardized YLD rates for leprosy decreased from 0.09 (95%UI: 0.06-0.13) in 1990 to 0.04 (95%UI: 0.03-0.06) in 2019; the proportional decrease was 55.56% over 30 years. Age-standardized YLDs for HIV and sexually transmitted infections increased by 26% during the same time period. Age-standardized YLDs for non-melanoma skin cancer increased at a much higher rate than melanoma between 1990 and 2019. Dermatitis and scabies continue to have an important role in the burden of skin and subcutaneous disease burden in China. The burden of non-melanoma cell cancer has increased most significantly over the past three decades.
Collapse
Affiliation(s)
- Yaoyao Kong
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
| | - Peiye Xing
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
| | - Pengcheng Huai
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China.
| | - Furen Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
| |
Collapse
|
2
|
Du Plessis LH, Gouws C, Nieto D. The influence of viscosity of hydrogels on the spreading and migration of cells in 3D bioprinted skin cancer models. Front Cell Dev Biol 2024; 12:1391259. [PMID: 38835508 PMCID: PMC11148284 DOI: 10.3389/fcell.2024.1391259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Various in vitro three-dimensional (3D) tissue culture models of human and diseased skin exist. Nevertheless, there is still room for the development and improvement of 3D bioprinted skin cancer models. The need for reproducible bioprinting methods, cell samples, biomaterial inks, and bioinks is becoming increasingly important. The influence of the viscosity of hydrogels on the spreading and migration of most types of cancer cells is well studied. There are however limited studies on the influence of viscosity on the spreading and migration of cells in 3D bioprinted skin cancer models. In this review, we will outline the importance of studying the various types of skin cancers by using 3D cell culture models. We will provide an overview of the advantages and disadvantages of the various 3D bioprinting technologies. We will emphasize how the viscosity of hydrogels relates to the spreading and migration of cancer cells. Lastly, we will give an overview of the specific studies on cell migration and spreading in 3D bioprinted skin cancer models.
Collapse
Affiliation(s)
- Lissinda H Du Plessis
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Chrisna Gouws
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Daniel Nieto
- Advanced Biofabrication for Tissue and Organ Engineering Group, Interdisciplinary Centre of Chemistry and Biology (CICA), Faculty of Health Sciences, University of Coruña, Campus de A Coruna, Coruna, Spain
| |
Collapse
|
3
|
Belgrad J, Fakih HH, Khvorova A. Nucleic Acid Therapeutics: Successes, Milestones, and Upcoming Innovation. Nucleic Acid Ther 2024; 34:52-72. [PMID: 38507678 DOI: 10.1089/nat.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Nucleic acid-based therapies have become the third major drug class after small molecules and antibodies. The role of nucleic acid-based therapies has been strengthened by recent regulatory approvals and tremendous clinical success. In this review, we look at the major obstacles that have hindered the field, the historical milestones that have been achieved, and what is yet to be resolved and anticipated soon. This review provides a view of the key innovations that are expanding nucleic acid capabilities, setting the stage for the future of nucleic acid therapeutics.
Collapse
Affiliation(s)
- Jillian Belgrad
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Hassan H Fakih
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Anastasia Khvorova
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
4
|
Brickley S, Barrolle S, Pentland A. Implementation of a postgraduate dermatology fellowship program for nurse practitioners. J Am Assoc Nurse Pract 2024; 36:180-186. [PMID: 37906505 PMCID: PMC10898538 DOI: 10.1097/jxx.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 11/02/2023]
Abstract
ABSTRACT Transition to practice programs (also referred to as fellowship, residency, or postgraduate training programs) for nurse practitioners (NPs) are becoming more popular, especially in specialties such as dermatology. A nationwide shortage of dermatology clinicians, which had led to long appointment wait times and inadequate patient access to care, has led to more NPs practicing dermatology to help meet the demand for care. New graduate NPs may struggle in their transition to practice, and fellowship programs have been shown to support NPs as they transition from novice to expert. In this article, the University of Rochester Medical Center shares its experience in developing, implementing, and managing a postgraduate dermatology fellowship program for NPs.
Collapse
Affiliation(s)
- Sylvana Brickley
- Department of Dermatology, Beth Israel Lahey Health, Burlington, Massachusetts
| | - Shimika Barrolle
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | - Alice Pentland
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
5
|
Li Q, Patrick MT, Sreeskandarajan S, Kang J, Kahlenberg JM, Gudjonsson JE, He Z, Tsoi LC. Large-scale epidemiological analysis of common skin diseases to identify shared and unique comorbidities and demographic factors. Front Immunol 2024; 14:1309549. [PMID: 38259463 PMCID: PMC10800546 DOI: 10.3389/fimmu.2023.1309549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The utilization of large-scale claims databases has greatly improved the management, accessibility, and integration of extensive medical data. However, its potential for systematically identifying comorbidities in the context of skin diseases remains unexplored. Methods This study aims to assess the capability of a comprehensive claims database in identifying comorbidities linked to 14 specific skin and skin-related conditions and examining temporal changes in their association patterns. This study employed a retrospective case-control cohort design utilizing 13 million skin/skin-related patients and 2 million randomly sampled controls from Optum's de-identified Clinformatics® Data Mart Database spanning the period from 2001 to 2018. A broad spectrum of comorbidities encompassing cancer, diabetes, respiratory, mental, immunity, gastrointestinal, and cardiovascular conditions were examined for each of the 14 skin and skin-related disorders in the study. Results Using the established type-2 diabetes (T2D) and psoriasis comorbidity as example, we demonstrated the association is significant (P-values<1x10-15) and stable across years (OR=1.15-1.31). Analysis of the 2014-2018 data reveals that celiac disease, Crohn's disease, and ulcerative colitis exhibit the strongest associations with the 14 skin/skin-related conditions. Systemic lupus erythematosus (SLE), leprosy, and hidradenitis suppurativa show the strongest associations with 30 different comorbidities. Particularly notable associations include Crohn's disease with leprosy (odds ratio [OR]=6.60, 95% confidence interval [CI]: 3.09-14.08), primary biliary cirrhosis with SLE (OR=6.07, 95% CI: 4.93-7.46), and celiac disease with SLE (OR=6.06, 95% CI: 5.49-6.69). In addition, changes in associations were observed over time. For instance, the association between atopic dermatitis and lung cancer demonstrates a marked decrease over the past decade, with the odds ratio decreasing from 1.75 (95% CI: 1.47-2.07) to 1.02 (95% CI: 0.97-1.07). The identification of skin-associated comorbidities contributes to individualized healthcare and improved clinical management, while also enhancing our understanding of shared pathophysiology. Moreover, tracking these associations over time aids in evaluating the progression of clinical diagnosis and treatment. Discussion The findings highlight the potential of utilizing comprehensive claims databases in advancing research and improving patient care in dermatology.
Collapse
Affiliation(s)
- Qinmengge Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Matthew T Patrick
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Sutharzan Sreeskandarajan
- The Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - J Michelle Kahlenberg
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
- Rheumatology, Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Zhi He
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Lam C Tsoi
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
6
|
Yuan J, Li X, Yu S. Global, Regional, and National Incidence Trend Analysis of Malignant Skin Melanoma Between 1990 and 2019, and Projections Until 2034. Cancer Control 2024; 31:10732748241227340. [PMID: 38227397 DOI: 10.1177/10732748241227340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The goal of this study was to evaluate the global burden of malignant skin melanoma (MSM) from 1990 to 2019 using MSM-related data from the Global Burden of Disease study. METHODS The incidences' relationships with the social-demographic index (SDI) and human developmental index (HDI) were investigated. To determine significant changes in incidence trends, the joinpoint regression model was used. To demonstrate trends in MSM mortality rates, an Age-Period-Cohort framework was conducted. For the projection of new cases and the age-standardized incidence rate (ASR) of MSM incidence to 2034, the Nordpred method was used. RESULTS In 2019, the ASR incidence per 100, 000 people for MSM was 3.6 (95% UI, 2.6-4.2). MSM prevalence increased in most countries between 1990 and 2019 (average annual percentage change >0). HDI and annual percentage change (APC) (ρ = .63, P < .001), as well as SDI and ASR, had a positive correlation. The total MSM mortality rate declined globally, with an APC of -.61%. Likewise, the mortality rate for the age group of people with ages <77.5 years declined. Predictive analysis demonstrated a declining trend in ASR incidence and a growing number of MSM. CONCLUSION There are significant differences in ASR incidence among regions and countries. Despite decreases in ASR incidence and fatality, MSM remains one of the leading sources of cancer mortality and morbidity globally. MSM necessitates more primary prevention measures and screening in high-risk areas.
Collapse
Affiliation(s)
- Jin Yuan
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyang Li
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shengji Yu
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
7
|
Prameswari FU, Muharram FR, Setyaningrum T, Prakoeswa CRS. Burden of Skin and Subcutaneous Diseases in Indonesia 1990 to 2019. Acta Derm Venereol 2023; 103:adv18291. [PMID: 38112210 PMCID: PMC10753593 DOI: 10.2340/actadv.v103.18291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/24/2023] [Indexed: 12/21/2023] Open
Abstract
is missing (Short communication).
Collapse
Affiliation(s)
- Faida Ufaira Prameswari
- Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | - Trisniartami Setyaningrum
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
| |
Collapse
|
8
|
Misery L, Schut C, Balieva F, Bobko S, Reich A, Sampogna F, Altunay I, Dalgard F, Gieler U, Kupfer J, Lvov A, Poot F, Szepietowski JC, Tomas-Aragones L, Vulink N, Zalewska-Janowska A, Bewley A. White paper on psychodermatology in Europe: A position paper from the EADV Psychodermatology Task Force and the European Society for Dermatology and Psychiatry (ESDaP). J Eur Acad Dermatol Venereol 2023; 37:2419-2427. [PMID: 37615377 DOI: 10.1111/jdv.19427] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
Psychodermatology is a subspecialty of dermatology that is of increasing interest to dermatologists and patients. The case for the provision of at least regional psychodermatology services across Europe is robust. Psychodermatology services have been shown to have better, quicker and more cost-efficient clinical outcomes for patients with psychodermatological conditions. Despite this, psychodermatology services are not uniformly available across Europe. In fact many countries have yet to establish dedicated psychodermatology services. In other countries psychodermatology services are in development. Even in countries where psychodermatolgy units have been established, the services are not available across the whole country. This is especially true for the provision of paediatric psychodermatology services. Also whilst most states across Europe are keen to develop psychodermatology services, the rate at which this development is being implemented is very slow. Our paper maps the current provision of psychodermatology services across Europe and indicates that there is still very much more work to be done in order to develop the comprehensive psychodermatology services across Europe, which are so crucial for our patients.
Collapse
Affiliation(s)
- Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
- Univ Brest, LIEN, Brest, France
| | - Christina Schut
- Institute of Medical Psychology, University of Giessen, Giessen, Germany
| | - Flora Balieva
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Svetlana Bobko
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
| | - Ilknur Altunay
- Şişli Hamidiye Etfal Training and Research Hospital, Dermatology and Venereology Clinic, University of Health Sciences, Insatnbul, Turkey
| | - Florence Dalgard
- Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Lund, Sweden
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Uwe Gieler
- Department of Dermatology, Justus Liebig University of Giessen, Giessen, Germany
| | - Jörg Kupfer
- Institute of Medical Psychology, University of Giessen, Giessen, Germany
| | - Andrey Lvov
- Department of Dermatovenereology and Cosmetology, Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
- Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Françoise Poot
- ULB-Erasme Hospital Department Dermatology, Brussels, Belgium
- IFTS, Charleroi, Belgium
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Nienke Vulink
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Anna Zalewska-Janowska
- Psychodermatology Department, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, Poland
| | - Anthony Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
| |
Collapse
|
9
|
Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, Trakatelli M, Puig L, Stratigos A. Public perception of dermatologists in Europe: Results from a population-based survey. J Eur Acad Dermatol Venereol 2023; 37 Suppl 7:27-37. [PMID: 37806001 DOI: 10.1111/jdv.18988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/15/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The public perception of dermatology has been poorly investigated in Europe. OBJECTIVE To determine the general public's perception of dermatologists in Europe. METHODS This multinational, cross-sectional study was conducted within the framework of the EADV population-based survey on the 'Burden of skin diseases in Europe'. Data were collected using a web-based online survey on a representative sample of the general populations aged 18 years or more of 27 European countries. Proportional quota sampling with replacement design was used for each country. RESULTS A total of 44,689 adult participants responded to the questionnaire, of whom 18,004 visited a dermatologist in the preceding 3 years. The dermatologist was the second most often visited specialist among all medical specialties, with 69.7%, 72.1%, 42.1% and 78.1% of participants in Western Europe (WE), Eastern Europe (EE), Northern Europe (NE) and Southern Europe (SE), respectively, having consulted a dermatologist over the past 24 months. Most participants across all regions agreed that the dermatologist was the first healthcare provider for chronic skin diseases (61.9% in WE, 69.8% in EE, 45.7% in NE and 60.4% in SE) and for skin cancers (65.5% in WE, 67.6% in EE, 42.4% in NE and 63.0% in SE). The five most common reasons for visiting a dermatologist among all participants were: naevi check-up or skin cancer screening (20.2%), chronic skin diseases (16.5%), acute skin diseases (12.4%), cosmetic advice or procedure (10.2%), hyperpigmentation or congenital lesions (9.1%) and hair or nail disorder (7.7%). Most participants (84.6% in WE, 82.5% in EE, 78.3% in NE and 82.8% in SE) were very swatisfied/somewhat satisfied with the service provided. CONCLUSION Our study findings underscore the central role of dermatologists in skin health and highlights them as valued and trusted care providers across Europe. Understanding the perceived position of the dermatologist is the first step in improving health policy development and implementation. Notably, access to a dermatologist was lowest in NE, probably reflecting differences in healthcare organizational structures or possibly cultural differences in healthcare seeking behaviour.
Collapse
Affiliation(s)
- Marie Aleth Richard
- CEReSS-EA 3279, Research Centre in Health Services and Quality of Life Aix Marseille University, Dermatology Department, Assistance Publique Hôpitaux de Marseille, APHM, University Hospital Timone, Marseille, France
| | - Carle Paul
- Service de Dermatologie, Université de Toulouse et CHU, Toulouse, France
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | | | - Myrto Trakatelli
- Second Department of Dermatology and Venerology of Aristotle School of Medicine Papageorgiou Hospital, Thessaloniki, Greece
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alex Stratigos
- Department of Dermatology, Andreas Syggros Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
10
|
Mahfouz MS, Alqassim AY, Hakami FA, Alhazmi AK, Ashiri AM, Hakami AM, Khormi LM, Adawi YM, Jabrah AA. Common Skin Diseases and Their Psychosocial Impact among Jazan Population, Saudi Arabia: A Cross-Sectional Survey during 2023. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1753. [PMID: 37893471 PMCID: PMC10608052 DOI: 10.3390/medicina59101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Skin problems are a widespread issue that affects people in both developing and wealthy countries, posing significant public health concerns. These disorders can profoundly impact individuals' social and psychological well-being. In this study, we aimed to determine the prevalence of the most common skin diseases in the Jazan region of southwestern Saudi Arabia and investigate their impact on patients' quality of life and psychological and social well-being. Materials and Methods: An observational cross-sectional survey conducted among a random sample of 940 adults ≥ 18 years in the Jazan region, Saudi Arabia. Four standardized questionnaires were used for data collection: Patient Health Questionnaire (PHQ-9), a five-dimension questionnaire (EQ-5D), Rosenberg Self-Esteem Scale, and Loneliness Scale (ULS-8). Results: The most prevalent skin conditions involved hair loss, which was reported by (61.1%) of the study population. These disorders significantly affected a higher percentage of females (71.9%) compared to males (46.3%) (p < 0.001). Melasma was more common in females (14.1%) than in males (4.3%) p < 0.001. The lowest prevalence was found for urticaria. Those with acne and hair loss reported higher mean scores on the PHQ-9 Scale than the group without these conditions (p < 0.05 for all). Patients with alopecia, acne, and melasma also reported significantly lower self-esteem scores compared to those without these skin conditions (p < 0.05 for all). Regarding the activity domain of QoL, participants with skin conditions reported no problems doing usual activities, compared to those without skin problems (p < 0.001). Conclusions: In conclusion, research revealed that the most prevalent skin condition was hair loss. Further, an association was found between skin diseases and the mental and social well-being of those affected, resulting in a negative impact on their quality of life. The results call for improving the condition of patients with skin diseases, improving their quality of life, and providing appropriate interventions.
Collapse
Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Fanan Adel Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Abrar Khalid Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Amjad Mohammed Ashiri
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Alaa Marwei Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Linan Mohammed Khormi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Yara Mohammed Adawi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Asmaa Ahmed Jabrah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| |
Collapse
|
11
|
Slodownik D, Bar J, Solomon M, Lavy Y, Baum S, Mordechai Galed O, Cnaan R, Solomon-Cohen E, Horev L, Daniely D. Pediatric Contact Dermatitis: A 10-Year Multicenter Retrospective Study. Dermatitis 2023; 34:399-404. [PMID: 37192492 DOI: 10.1089/derm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Background: Although allergic contact dermatitis (ACD) is relatively common in the adult and pediatric populations alike, few studies describe the special features of contact sensitization among the Israeli pediatric populations, none of them is multicenter. Our study aims to describe and analyze patch test results and trends in 4 tertiary care centers between 2012 and 2022. Methods: We assessed the results of 357 patch tests performed on children 0-18 years old between 2012 and 2022 in designated clinics in 4 tertiary medical centers. All patients were tested using the European baseline series and additional series as clinically indicated. We assessed the demographic features, atopic features, and influence, as well as the main allergens to cause sensitization and allergic contact dermatitis among the pediatric population. Results: In total 69% of the study population were females, mainly 12-18 years old, 35% of the study population were previously diagnosed with atopic dermatitis, and 57% had an atopic diathesis. Females were more commonly sensitized (P < 0.05). Patients without atopic dermatitis were more commonly diagnosed with ACD and had more reactions on patch test (P < 0.05). The most common allergens to cause ACD are preservatives and metals, as previously described, however, acrylate sensitivity is an emerging group that has not been described among the Israeli pediatric population in previous studies. Fragrance mix 2 and Mroxylon pereirae are relatively rare allergens among the Israeli pediatric population, whereas linalool hyperoxide might be considered an emerging allergen. Methylisothiazolinone causes ACD more frequently among patients without atopic dermatitis (P < 0.05). Conclusions: Among the Israeli pediatric population, ACD is more common in females without atopic dermatitis. Acrylates become a common culprit and should be included in baseline series. Patients with atopic dermatitis are less frequently sensitized by methylisothiazolinone.
Collapse
Affiliation(s)
- Dan Slodownik
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Solomon
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Yaron Lavy
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Sharon Baum
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Roten Cnaan
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Liran Horev
- Department of Dermatology, Hadassah University Medical Center, Jerusalem, Israel; and
- Shamir Medical Center, Zerifin, Israel
| | - Danny Daniely
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
12
|
Yan W, Qin C, Tao L, Guo X, Liu Q, Du M, Zhu L, Chen Z, Liang W, Liu M, Liu J. Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990-2019: observational study. BMJ 2023; 381:e073043. [PMID: 37164365 PMCID: PMC10170610 DOI: 10.1136/bmj-2022-073043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To explore inequalities in human resources for health (HRH) in relation to all cause and cause specific mortality globally in 1990-2019. DESIGN Observational study. SETTING 172 countries and territories. DATA SOURCES Databases of the Global Burden of Disease Study 2019, United Nations Statistics, and Our World in Data. MAIN OUTCOME MEASURES The main outcome was age standardized all cause mortality per 100 000 population in relation to HRH density per 10 000 population, and secondary outcome was age standardized cause specific mortality. The Lorenz curve and the concentration index (CCI) were used to assess trends and inequalities in HRH. RESULTS Globally, the total HRH density per 10 000 population increased, from 56.0 in 1990 to 142.5 in 2019, whereas age standardized all cause mortality per 100 000 population decreased, from 995.5 in 1990 to 743.8 in 2019. The Lorenz curve lay below the equality line and CCI was 0.43 (P<0.05), indicating that the health workforce was more concentrated among countries and territories ranked high on the human development index. The CCI for HRH was stable, at about 0.42-0.43 between 1990 and 2001 and continued to decline (narrowed inequality), from 0.43 in 2001 to 0.38 in 2019 (P<0.001). In the multivariable generalized estimating equation model, a negative association was found between total HRH level and all cause mortality, with the highest levels of HRH as reference (low: incidence risk ratio 1.15, 95% confidence interval 1.00 to 1.32; middle: 1.14, 1.01 to 1.29; high: 1.18, 1.08 to 1.28). A negative association between total HRH density and mortality rate was more pronounced for some types of cause specific mortality, including neglected tropical diseases and malaria, enteric infections, maternal and neonatal disorders, and diabetes and kidney diseases. The risk of death was more likely to be higher in people from countries and territories with a lower density of doctors, dentistry staff, pharmaceutical staff, aides and emergency medical workers, optometrists, psychologists, personal care workers, physiotherapists, and radiographers. CONCLUSIONS Inequalities in HRH have been decreasing over the past 30 years globally but persist. All cause mortality and most types of cause specific mortality were relatively higher in countries and territories with a limited health workforce, especially for several specific HRH types among priority diseases. The findings highlight the importance of strengthening political commitment to develop equity oriented health workforce policies, expanding health financing, and implementing targeted measures to reduce deaths related to inadequate HRH to achieve universal health coverage by 2030.
Collapse
Affiliation(s)
- Wenxin Yan
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Chenyuan Qin
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Beijing, China
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Xin Guo
- Department of Institutional Reform, National Health Commission of the People's Republic of China, Xicheng District, Beijing, China
| | - Qiao Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Min Du
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Lin Zhu
- Department of Health Policy, School of Medicine, Stanford University, Stanford, CA, USA
| | - Zhongdan Chen
- World Health Organization Representative Office for China, Chaoyang District, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing, China
- Institute for Healthy China, Tsinghua University, Haidian District, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, Haidian District, Beijing, China
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Peking University, Haidian District, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Haidian District, Beijing, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
13
|
Ezzedine K, Shourick J, Bergqvist C, Misery L, Chuberre B, Kerob D, Halioua B, Le Fur G, Paul C, Richard MA, Taieb C. Patient Unique Stigmatization Holistic tool in dermatology (PUSH-D): Development and validation of a dermatology-specific stigmatization assessment tool. J Eur Acad Dermatol Venereol 2023; 37:443-450. [PMID: 36201355 PMCID: PMC10092236 DOI: 10.1111/jdv.18641] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The skin plays an important role in establishing interpersonal relationships, and thus visible skin disorders, which have a significant impact on physical appearance, influence other people's behaviours and attitudes. OBJECTIVE To develop and validate a dermatologic-specific questionnaire to evaluate stigmatization in individuals with visible skin conditions. METHODS Items were generated by a verbatim report based on qualitative interviews with patients with various dermatologic conditions. Subsequently, a study was implemented for psychometric analysis. A dermatology-specific stigmatization questionnaire (PUSH-D) was refined via item reduction according to inter-question correlations, consensus among experts and exploratory factor analysis. Internal consistency was determined by calculating Cronbach's α. Concurrent validity was determined by calculating the correlation between PUSH-D and the Dermatology Life Quality Index (DLQI) and the Rosenberg Self-Esteem Scale (RSES). RESULTS From a primary list of 22 items, PUSH-D was reduced to a 17-item questionnaire, covering two pertinent dimensions based on the exploratory factor analysis. Construct validity was demonstrated, and PUSH-D showed good internal consistency (Cronbach's α = 0.9). PUSH-D correlated strongly with the DLQI 0.72 (p < 0.001) and moderately with the RSES 0.49 (p < 0.001). CONCLUSION PUSH-D allows a comprehensive view of the degree of stigmatization in visible skin disorders, as well as the comparability of stigmatization levels across various skin conditions.
Collapse
Affiliation(s)
- Khaled Ezzedine
- EA 7379 EpidermE, Université Paris-Est Créteil (UPEC), Créteil, France.,Department of Dermatology, Henri Mondor University Hospital, AP-HP, Créteil, France
| | - Jason Shourick
- Department of Clinical Epidemiology and Public Health, CHU Toulouse, Toulouse, France
| | - Christina Bergqvist
- Department of Dermatology, Henri Mondor University Hospital, AP-HP, Créteil, France
| | - Laurent Misery
- Department of Dermatology, Brest University Hospital, Brest, France.,French Society of Human Skin Sciences [SFSHP], Maison de la Dermatologie, Paris, France
| | | | | | - Bruno Halioua
- French Society of Human Skin Sciences [SFSHP], Maison de la Dermatologie, Paris, France.,Private Practice, Paris, France
| | | | - Carle Paul
- Department of Dermatology, University of Toulouse, Toulouse, France
| | - Marie-Aleth Richard
- Department of Dermatology, Assistance Publique des Hôpitaux de Marseille, Aix Marseille University, UMR 911, INSERM CRO2, Marseille, France
| | - Charles Taieb
- French Society of Human Skin Sciences [SFSHP], Maison de la Dermatologie, Paris, France.,Patient Priority Department, EMMA, Paris, France
| |
Collapse
|
14
|
Gao W, Mostaghimi A, Gandhi K, Done N, Ray M, Signorovitch J, Swallow E, Carley C, Wang T, Sikirica V. Patient characteristics associated with all-cause healthcare costs of alopecia areata in the United States. J Med Econ 2023; 26:441-444. [PMID: 36896625 DOI: 10.1080/13696998.2023.2188843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Wei Gao
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | | | - Kavita Gandhi
- Immunology & Inflamation, Pfizer Inc., Collegeville, PA, USA
| | - Nicolae Done
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | - Markqayne Ray
- Immunology & Inflamation, Pfizer Inc., Collegeville, PA, USA
| | - James Signorovitch
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | - Elyse Swallow
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | - Christopher Carley
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | - Travis Wang
- Health Economics and Outcomes Research, Analysis Group, Inc., Boston, MA, USA
| | - Vanja Sikirica
- Immunology & Inflamation, Pfizer Inc., Collegeville, PA, USA
| |
Collapse
|
15
|
Yakupu A, Aimaier R, Yuan B, Chen B, Cheng J, Zhao Y, Peng Y, Dong J, Lu S. The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019. Front Public Health 2023; 11:1145513. [PMID: 37139398 PMCID: PMC10149786 DOI: 10.3389/fpubh.2023.1145513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
Background The small number of existing integrative studies on the global distribution and burden of all types of skin and subcutaneous diseases hinders relevant comparisons. Objective This study aimed to determine the latest distribution, epidemiological differences, and factors potentially influencing each skin and subcutaneous disease and the policy implications. Methods Data on the skin and subcutaneous diseases were obtained from the Global Burden of Disease Study 2019. The incidence, disability-adjusted life years (DALYs), and deaths due to skin and subcutaneous diseases in 204 countries and regions from 1990 to 2019 were analyzed and stratified by sex, age, geographical location, and sociodemographic index (SDI). The annual age-standardized rate of change in the incidence was obtained to evaluate temporal trends. Results Of 4,859,267,654 (95% uncertainty interval [UI], 4,680,693,440-5,060,498,767) new skin and subcutaneous disease cases that were identified, most were fungal (34.0%) and bacterial (23.0%) skin diseases, which accounted for 98,522 (95% UI 75,116-123,949) deaths. The burden of skin and subcutaneous diseases measured in DALYs was 42,883,695.48 (95%UI, 28,626,691.71-63,438,210.22) in 2019, 5.26% of which were years of life lost, and 94.74% of which were years lived with disability. The highest number of new cases and deaths from skin and subcutaneous diseases was in South Asia. Globally, most new cases were in the 0-4-year age group, with skin and subcutaneous disease incidence slightly higher in men than in women. Conclusion Fungal infections are major contributors to skin and subcutaneous diseases worldwide. Low-middle SDI states had the highest burden of skin and subcutaneous diseases, and this burden has increased globally. Targeted and effective management strategies based on the distribution characteristics of each country are, thus, required to reduce the burden of skin and subcutaneous diseases.
Collapse
Affiliation(s)
- Aobuliaximu Yakupu
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rehanguli Aimaier
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bo Yuan
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Chen
- Department of Burn and Plastic Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jia Cheng
- Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yaohua Zhao
- Department of Burn and Plastic Surgery, Jiangyin Hospital Affiliated to Medical College of Southeast University, Jiangyin, China
| | - Yinbo Peng
- Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyun Dong
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jiaoyun Dong
| | - Shuliang Lu
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shuliang Lu
| |
Collapse
|
16
|
Sivesind T, D'Angelo J, Khazova T, Hassan S, Kamara M, Wallace E, Dunnick C, Dellavalle R. Participation in Clinical Trials Among Academic Dermatologists Affiliated With Veterans Affairs Hospitals: Survey Study. JMIR DERMATOLOGY 2022; 5:e35379. [PMID: 36187494 PMCID: PMC9511003 DOI: 10.2196/35379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Clinical trials have led to the development of new and effective therapies for many dermatologic conditions. To our knowledge, there is no published study that has quantified and described the degree of involvement in clinical trials among academic dermatologists and their university affiliates. Objective The purpose of this study was to characterize the involvement of academic dermatology departments in clinical trials research. Methods An online survey was sent to 211 Veterans Affairs (VA)–employed dermatologists. It comprised 20 questions related to the number of clinical trials, support staff dedicated to clinical research, skin diseases studied, and the effect of the COVID-19 pandemic on conducting clinical research. Three rounds of survey invitations were sent over a 3-month period (March to May 2021). Data from all survey responses were reviewed for quantitative and descriptive analyses of the key outcome measures. Results A total of 48 dermatologists completed the survey and provided their university affiliations and details of involvement in clinical trials research. Over half of participants (n=25, 58.1%) with a university affiliate reported that their affiliated dermatology department had a dedicated clinical trials unit. Basal cell carcinoma was the most frequently studied skin condition (n=9, 18.8%), followed by atopic dermatitis and psoriasis (n=4, 8.3% each); 66.7% of participants reported no current clinical trials participation. Of those conducting clinical trials, 87% (n=18) noted that COVID-19 was a barrier to conducting trials, with 52.2% (n=11) citing disrupted or decreased trials due to the pandemic. Conclusions Although many dermatologists with university affiliations reported having a dedicated clinical trials unit at their institution, a majority of those surveyed reported not taking part in any active trials. Overall, the diseases investigated in academic clinical trials appear to follow national trends, though some of the top dermatological diseases are underrepresented in clinical trials research. A key limitation of our study was the low response rate (~23%) and that the survey responses from the sample of VA-based dermatologists may not be generalizable to all academic dermatology departments in the United States. The effect of the COVID-19 pandemic appeared to play a significant role in disrupting active trials.
Collapse
Affiliation(s)
- Torunn Sivesind
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Josephine D'Angelo
- Department of Dermatology University of Rochester Rochester, NY United States
| | - Tatyana Khazova
- College of Osteopathic Medicine Rocky Vista University Parker, CO United States
| | - Shahzeb Hassan
- Feinberg School of Medicine Northwestern University Chicago, IL United States
| | - Michael Kamara
- School of Medicine University of Missouri Columbia, MO United States
| | - Elizabeth Wallace
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Cory Dunnick
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Robert Dellavalle
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center US Department of Veterans Affairs Eastern Colorado Health Care System Aurora, CO United States
| |
Collapse
|
17
|
Williams J, Lowery Z, Bowers N, Jorizzo J. Single-Institution Retrospective Chart Review of Prurigo Nodularis With a Focus on Etiology. J Cutan Med Surg 2022; 26:626-627. [PMID: 35971953 DOI: 10.1177/12034754221119501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Josiah Williams
- 12279 Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Zachary Lowery
- 12279 Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nathan Bowers
- 12279 Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joseph Jorizzo
- 12279 Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
18
|
Igarashi A, Yuasa A, Yonemoto N, Kamei K, LoPresti M, Murofushi T, Ikeda S. A Systematic Literature Review of Economic Evaluations and Cost Studies of the Treatment of Psoriasis, Atopic Dermatitis, and Chronic Urticaria. Dermatol Ther (Heidelb) 2022; 12:1729-1751. [PMID: 35909186 PMCID: PMC9357586 DOI: 10.1007/s13555-022-00774-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Psoriasis (PSO), atopic dermatitis (AD), and chronic urticaria (CU) are common manifestations of immunological skin and subcutaneous conditions and have been shown to have a substantial impact on the quality of life of patients. The cost of treating those conditions can also be high, as the use of biologic treatments has become more common for moderate to severe patients. In this review, we examine characteristics of economic evaluations and cost studies conducted for the three conditions. Methods A literature search was conducted using PubMed, Embase, and the Cochrane Library from January 1, 2016 to October 26, 2020 to identify economic evaluations where the cost of one or more drug treatment was evaluated and cost studies covering any intervention type. Each database was searched using keyword and MeSH terms related to treatment costs (e.g., health care cost, drug cost, etc.) and each condition (e.g., PSO, AD, eczema, CU, etc.). Results A total of 123 studies were reviewed, including 104 studies (85%) of PSO (including psoriasis, plaque psoriasis, psoriatic arthritis, and psoriasis vulgaris), 14 studies (11%) of AD, and 5 studies (4%) of CU. Seventy-two studies (59%) reviewed reported the inclusion of biologic treatments, 10 studies (8%) did not include biologic treatments, and 41 studies (33%) did not report whether or not a biologic treatment was included. While nearly all studies (98%) included direct costs, only 22 studies (18%) included indirect costs. Conclusions Economic evaluations for AD and CU may be needed in order to better understand the value of new treatments. Moreover, a clearer delineation for biologic treatments and indirect costs (i.e., productivity losses and gains) may be required. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00774-2.
Collapse
Affiliation(s)
| | - Akira Yuasa
- Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan.
| | - Naohiro Yonemoto
- Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | - Kazumasa Kamei
- Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | | | | | - Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
| |
Collapse
|
19
|
Chao L, Lu M, Gao W, An Z, Li J, Liu Y, Wu W, Song J. Ambient temperature exposure and risk of outpatient visits for dermatologic diseases in Xinxiang, China: a time-series analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1487-1493. [PMID: 35522347 DOI: 10.1007/s00484-022-02297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/06/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
The effect of ambient temperature on dermatologic diseases has received widespread attention. Previous studies have shown that ambient temperature might affect specific dermatologic diseases, but results were inconsistent. This study aims to assess the short-term effect of ambient temperature on outpatient visits due to dermatologic diseases (DMs) in Xinxiang, China. Daily DMs outpatient visits, mean temperature, mean relative humidity, and air pollution data of Xinxiang were retrieved from January 1, 2015, to December 31, 2018. A distributed lag nonlinear model (DLNM) was applied to analyze the effect of ambient temperature on DMs outpatients. We controlled several potential confounding factors such as the long-term trend, public holiday, day of the week, humidity, and air pollutants (NO2, PM2.5). Finally, two more stratification analysis was conducted by age and gender. A total of 164,270 outpatients of DMs were enrolled during our study, and the daily mean visits were 113. The estimated effect of temperature on DMs was nonlinear. Heat temperature would exacerbate outpatients of dermatologic diseases. With a reference median temperature (17 °C), the effect of temperature on DMs was most pronounced at lag0-14; exposure to heat (32 °C, 99th) was associated with 1.565 (95% CI: 1.266-1.934) increased risk of outpatients for DMs. Stratification analysis showed that citizens of young ages were susceptive to heat; both genders had a similar relationship between temperature and DMs risk. This study highlights that ambient temperature was associated with DMs outpatients; heat temperature might aggravate DMs risk. The health hazards of heat temperature required more attention, and more effective prevention measurements should be designed and implemented to curb global warming.
Collapse
Affiliation(s)
- Ling Chao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Mengxue Lu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Wenshan Gao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.
| |
Collapse
|
20
|
Moura IB, Grada A, Spittal W, Clark E, Ewin D, Altringham J, Fumero E, Wilcox MH, Buckley AM. Profiling the Effects of Systemic Antibiotics for Acne, Including the Narrow-Spectrum Antibiotic Sarecycline, on the Human Gut Microbiota. Front Microbiol 2022; 13:901911. [PMID: 35711781 PMCID: PMC9194605 DOI: 10.3389/fmicb.2022.901911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Treatment for moderate-to-severe acne vulgaris relies on prolonged use of oral tetracycline-class antibiotics; however, these broad-spectrum antibiotics are often associated with off-target effects and negative gastrointestinal sequelae. Sarecycline is a narrow-spectrum antibiotic treatment option. Here, we investigated the effect of prolonged sarecycline exposure, compared with broad-spectrum tetracyclines (doxycycline and minocycline) upon the colonic microbiota. Three in vitro models of the human colon were instilled with either minocycline, doxycycline or sarecycline, and we measured microbiota abundance and diversity changes during and after antibiotic exposure. Significant reductions in microbial diversity were observed following minocycline and doxycycline exposure, which failed to recover post antibiotic withdrawal. Specifically, minocycline caused a ~10% decline in Lactobacillaceae and Bifidobacteriaceae abundances, while doxycycline caused a ~7% decline in Lactobacillaceae and Bacteroidaceae abundances. Both minocycline and doxycycline were associated with a large expansion (>10%) of Enterobacteriaceae. Sarecycline caused a slight decline in bacterial diversity at the start of treatment, but abundances of most families remained stable during treatment. Ruminococcaceae and Desulfovibrionaceae decreased 9% and 4%, respectively, and a transient increased in Enterobacteriaceae abundance was observed during sarecycline administration. All populations recovered to pre-antibiotic levels after sarecycline exposure. Overall, sarecycline had minimal and transient impact on the gut microbiota composition and diversity, when compared to minocycline and doxycycline.
Collapse
Affiliation(s)
- Ines B Moura
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | - William Spittal
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Emma Clark
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Duncan Ewin
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - James Altringham
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | - Mark H Wilcox
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom.,Department of Microbiology, Leeds Teaching Hospital NHS Trust, Old Medical School, Leeds General Infirmary, Leeds, United Kingdom
| | - Anthony M Buckley
- Healthcare-Associated Infections Group, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom.,Microbiome and Nutritional Science Group, School of Food Science, Faculty of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| |
Collapse
|
21
|
Paolino G, Stabile G, Guerriero A, Rongioletti F. Paradoxical inflammatory reaction to terbinafine in the setting of Majocchi's granuloma due to Trichophyton interdigitale. Dermatol Ther 2022; 35:e15632. [PMID: 35686811 DOI: 10.1111/dth.15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Giovanni Paolino
- IRCCS Ospedale San Raffaele, Milan, Italy.,Università Vita-Salute San Raffaele, Milan, Italy
| | | | | | - Franco Rongioletti
- IRCCS Ospedale San Raffaele, Milan, Italy.,Università Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
22
|
Lee J, van der Valk WH, Serdy SA, Deakin C, Kim J, Le AP, Koehler KR. Generation and characterization of hair-bearing skin organoids from human pluripotent stem cells. Nat Protoc 2022; 17:1266-1305. [PMID: 35322210 PMCID: PMC10461778 DOI: 10.1038/s41596-022-00681-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/04/2022] [Indexed: 12/28/2022]
Abstract
Human skin uses millions of hairs and glands distributed across the body surface to function as an external barrier, thermoregulator and stimuli sensor. The large-scale generation of human skin with these appendages would be beneficial, but is challenging. Here, we describe a detailed protocol for generating hair-bearing skin tissue entirely from a homogeneous population of human pluripotent stem cells in a three-dimensional in vitro culture system. Defined culture conditions are used over a 2-week period to induce differentiation of pluripotent stem cells to surface ectoderm and cranial neural crest cells, which give rise to the epidermis and dermis, respectively, in each organoid unit. After 60 d of incubation, the skin organoids produce hair follicles. By day ~130, the skin organoids reach full complexity and contain stratified skin layers, pigmented hair follicles, sebaceous glands, Merkel cells and sensory neurons, recapitulating the cell composition and architecture of fetal skin tissue at week 18 of gestation. Skin organoids can be maintained in culture using this protocol for up to 150 d, enabling the organoids to be used to investigate basic skin biology, model disease and, further, reconstruct or regenerate skin tissue.
Collapse
Affiliation(s)
- Jiyoon Lee
- Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA.
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA.
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
- Department of Surgery, Harvard Medical School, Boston, MA, USA.
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
| | - Wouter H van der Valk
- Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Sara A Serdy
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
| | - CiCi Deakin
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
- Department of Biological Engineering, Wentworth Institute of Technology, Boston, MA, USA
| | - Jin Kim
- Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
| | - Anh Phuong Le
- Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
| | - Karl R Koehler
- Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA.
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA.
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
23
|
González S, Aguilera J, Berman B, Calzavara-Pinton P, Gilaberte Y, Goh CL, Lim HW, Schalka S, Stengel F, Wolf P, Xiang F. Expert Recommendations on the Evaluation of Sunscreen Efficacy and the Beneficial Role of Non-filtering Ingredients. Front Med (Lausanne) 2022; 9:790207. [PMID: 35433750 PMCID: PMC9008233 DOI: 10.3389/fmed.2022.790207] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
A variety of non-filtering agents have been introduced to enhance sunscreen photoprotection. Most of those agents have only weak erythema protective properties but may be valuable and beneficial in supporting protection against other effects of UV radiation, such as photoimmunosuppression, skin aging, and carcinogenesis, as well as photodermatoses. The question arises how to measure and evaluate this efficacy since standard SPF testing is not appropriate. In this perspective, we aim to provide a position statement regarding the actual value of SPF and UVA-PF to measure photoprotection. We argue whether new or additional parameters and scales can be used to better indicate the protection conferred by these products against the detrimental effects of natural/artificial, UV/visible light beyond sunburn, including DNA damage, photoimmunosuppression and pigmentation, and the potential benefits of the addition of other ingredients beyond traditional inorganic and organic filters to existing sunscreens. Also, we debate the overall usefulness of adding novel parameters that measure photoprotection to reach two tiers of users, that is, the general public and the medical community; and how this can be communicated to convey the presence of additional beneficial effects deriving from non-filtering agents, e.g., biological extracts. Finally, we provide a perspective on new challenges stemming from environmental factors, focusing on the role of the skin microbiome and the role of air pollutants and resulting needs for photoprotection.
Collapse
Affiliation(s)
- Salvador González
- Medicine and Medical Specialties Department, University of Alcalá de Henares, Madrid, Spain
- *Correspondence: Salvador González,
| | - José Aguilera
- Dermatological Photobiology Laboratory, Medical Research Center, School of Medicine, University of Málaga, Málaga, Spain
| | - Brian Berman
- Department of Dermatology and Cutaneous Surgery, University of Miami-Florida, Miami, FL, United States
| | | | - Yolanda Gilaberte
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | | | - Henry W. Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, United States
| | - Sergio Schalka
- Photoprotection Laboratory, Medicine Skin Research Center, São Paulo, Brazil
| | | | - Peter Wolf
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Flora Xiang
- Department of Dermatology, Shanghai Medical College, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
24
|
Sturm B, Creytens D, Smits J, Ooms AHAG, Eijken E, Kurpershoek E, Küsters-Vandevelde HVN, Wauters C, Blokx WAM, van der Laak JAWM. Computer-Aided Assessment of Melanocytic Lesions by Means of a Mitosis Algorithm. Diagnostics (Basel) 2022; 12:diagnostics12020436. [PMID: 35204526 PMCID: PMC8871065 DOI: 10.3390/diagnostics12020436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 11/16/2022] Open
Abstract
An increasing number of pathology laboratories are now fully digitised, using whole slide imaging (WSI) for routine diagnostics. WSI paves the road to use artificial intelligence (AI) that will play an increasing role in computer-aided diagnosis (CAD). In melanocytic skin lesions, the presence of a dermal mitosis may be an important clue for an intermediate or a malignant lesion and may indicate worse prognosis. In this study a mitosis algorithm primarily developed for breast carcinoma is applied to melanocytic skin lesions. This study aimed to assess whether the algorithm could be used in diagnosing melanocytic lesions, and to study the added value in diagnosing melanocytic lesions in a practical setting. WSI’s of a set of hematoxylin and eosin (H&E) stained slides of 99 melanocytic lesions (35 nevi, 4 intermediate melanocytic lesions, and 60 malignant melanomas, including 10 nevoid melanomas), for which a consensus diagnosis was reached by three academic pathologists, were subjected to a mitosis algorithm based on AI. Two academic and six general pathologists specialized in dermatopathology examined the WSI cases two times, first without mitosis annotations and after a washout period of at least 2 months with mitosis annotations based on the algorithm. The algorithm indicated true mitosis in lesional cells, i.e., melanocytes, and non-lesional cells, i.e., mainly keratinocytes and inflammatory cells. A high number of false positive mitosis was indicated as well, comprising melanin pigment, sebaceous glands nuclei, and spindle cell nuclei such as stromal cells and neuroid differentiated melanocytes. All but one pathologist reported more often a dermal mitosis with the mitosis algorithm, which on a regular basis, was incorrectly attributed to mitoses from mainly inflammatory cells. The overall concordance of the pathologists with the consensus diagnosis for all cases excluding nevoid melanoma (n = 89) appeared to be comparable with and without the use of AI (89% vs. 90%). However, the concordance increased by using AI in nevoid melanoma cases (n = 10) (75% vs. 68%). This study showed that in general cases, pathologists perform similarly with the aid of a mitosis algorithm developed primarily for breast cancer. In nevoid melanoma cases, pathologists perform better with the algorithm. From this study, it can be learned that pathologists need to be aware of potential pitfalls using CAD on H&E slides, e.g., misinterpreting dermal mitoses in non-melanotic cells.
Collapse
Affiliation(s)
- Bart Sturm
- Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | - David Creytens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Jan Smits
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | | | - Erik Eijken
- Laboratory for Pathology Oost Nederland (LabPON), 7550 AM Hengelo, The Netherlands;
| | - Eline Kurpershoek
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | | | - Carla Wauters
- Department of Pathology, Canisius Wilhelmina Hospital, 6500 GS Nijmegen, The Netherlands; (H.V.N.K.-V.); (C.W.)
| | - Willeke A. M. Blokx
- Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands;
| | - Jeroen A. W. M. van der Laak
- Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Center for Medical Image Science and Visualization, Linköping University, 581 83 Linköping, Sweden
- Correspondence: ; Tel.: +31-638-814-869
| |
Collapse
|
25
|
Blauvelt A, Shi N, Murage MJ, Kern SA, Somani N, Burge R, Ridenour TL, Lew CR, Zimmerman NM, Zhu B. Healthcare resource utilization and costs among patients with psoriasis treated with ixekizumab or adalimumab over 2 years of follow-up in real-world settings. J Med Econ 2022; 25:741-749. [PMID: 35615978 DOI: 10.1080/13696998.2022.2081417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS To compare long-term healthcare resource utilization (HCRU) and costs among patients who initiated ixekizumab (IXE) or adalimumab (ADA) for treatment of psoriasis in the United States. METHODS Adult patients with psoriasis who had ≥1 claim for IXE or ADA were identified from IBM MarketScan claims databases prior to the COVID-19 pandemic (1 March 2016-31 October 2019). The index date was the date of first claim for the index drug of interest. Inverse probability of treatment weighting was employed to balance treatment cohorts. All-cause and psoriasis-related HCRU and costs were examined for 24 months of follow-up. Costs were reported as per patient per month. Costs of psoriasis-related biologics were adjusted using published Institute for Clinical and Economic Review (ICER) discount factors. Index drug costs were adjusted for adherence and ICER discount rates. RESULTS The analyses included 407 IXE and 2,702 ADA users. IXE users had significantly higher inpatient admission rate (all-cause HCRU: 14.9% vs. 11.0%; p =0.012) and greater mean length of stay per admission (days, 6.6 vs. 4.1; p =0.004) than ADA users. ICER-adjusted costs were significantly higher in IXE than ADA users (all-cause costs: $4,132 vs. $3,610; p <0.001; psoriasis-related costs $3,077 vs. $2,700; p <0.001). After adjusting for ICER and adherence, IXE and ADA drug costs were comparable ($3,636 vs. $3,677; p =0.714). LIMITATIONS Study relied on administrative claims data, subjected to data coding limitations and data entry errors. Rebates, patient assistance programs, and commission to wholesalers are not always captured in claims. Adjustment made by ICER discount factors may lead to double-discounting if the discounts have been applied in claim payments. CONCLUSIONS All-cause HCRU was higher in IXE than ADA users. Healthcare costs were also higher in IXE than ADA users after ICER adjustment, over 24 months. Cost differences were largely driven by higher treatment adherence associated with IXE. Index drug costs were comparable after ICER and adherence adjustments.
Collapse
Affiliation(s)
- Andrew Blauvelt
- Research Excellence & Personalized Patient Care, Oregon Medical Research Center, Portland, OR, USA
| | - Nianwen Shi
- Truven Health Analytics, Truven Health Analytics, IBM Watson Health, Cambridge, MA, USA
| | | | | | | | - Russel Burge
- Eli Lilly and Company, Indianapolis, IN, USA
- University of Cincinnati, Cincinnati, OH, USA
| | | | - Carolyn R Lew
- Truven Health Analytics, Truven Health Analytics, IBM Watson Health, Cambridge, MA, USA
| | - Nicole M Zimmerman
- Truven Health Analytics, Truven Health Analytics, IBM Watson Health, Cambridge, MA, USA
| | - Baojin Zhu
- Eli Lilly and Company, Indianapolis, IN, USA
| |
Collapse
|
26
|
Silva FALS, Costa-Almeida R, Timochenco L, Amaral SI, Pinto S, Gonçalves IC, Fernandes JR, Magalhães FD, Sarmento B, Pinto AM. Graphene Oxide Topical Administration: Skin Permeability Studies. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2810. [PMID: 34070414 PMCID: PMC8197561 DOI: 10.3390/ma14112810] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
Nanostructured carriers have been widely used in pharmaceutical formulations for dermatological treatment. They offer targeted drug delivery, sustained release, improved biostability, and low toxicity, usually presenting advantages over conventional formulations. Due to its large surface area, small size and photothermal properties, graphene oxide (GO) has the potential to be used for such applications. Nanographene oxide (GOn) presented average sizes of 197.6 ± 11.8 nm, and a surface charge of -39.4 ± 1.8 mV, being stable in water for over 6 months. 55.5% of the mass of GOn dispersion (at a concentration of 1000 µg mL-1) permeated the skin after 6 h of exposure. GOn dispersions have been shown to absorb near-infrared radiation, reaching temperatures up to 45.7 °C, within mild the photothermal therapy temperature range. Furthermore, GOn in amounts superior to those which could permeate the skin were shown not to affect human skin fibroblasts (HFF-1) morphology or viability, after 24 h of incubation. Due to its large size, no skin permeation was observed for graphite particles in aqueous dispersions stabilized with Pluronic P-123 (Gt-P-123). Altogether, for the first time, Gon's potential as a topic administration agent and for delivery of photothermal therapy has been demonstrated.
Collapse
Affiliation(s)
- Filipa A. L. S. Silva
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
| | - Raquel Costa-Almeida
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
| | - Licínia Timochenco
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculdade de Engenharia, Universidade do Porto, 4200-180 Porto, Portugal; (L.T.); (F.D.M.)
| | - Sara I. Amaral
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculdade de Engenharia, Universidade do Porto, 4200-180 Porto, Portugal; (L.T.); (F.D.M.)
| | - Soraia Pinto
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
- ICBAS–Instituto de Ciencias Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Inês C. Gonçalves
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
| | - José R. Fernandes
- CQVR–Centro de Química Vila Real, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal;
- Physical Department, University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Fernão D. Magalhães
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculdade de Engenharia, Universidade do Porto, 4200-180 Porto, Portugal; (L.T.); (F.D.M.)
| | - Bruno Sarmento
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
- CESPU, IINFACTS–Institute for Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Artur M. Pinto
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal; (F.A.L.S.S.); (R.C.-A.); (S.I.A.); (S.P.); (I.C.G.); (B.S.)
- INEB—Instituto de Engénharia Biomedica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-180 Porto, Portugal
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculdade de Engenharia, Universidade do Porto, 4200-180 Porto, Portugal; (L.T.); (F.D.M.)
| |
Collapse
|
27
|
Gronbeck C, Feng H. Annual Trends in Medicare Part D Prescription Claims for Vismodegib, 2013-2018. J Am Acad Dermatol 2021; 86:1356-1359. [PMID: 34000293 DOI: 10.1016/j.jaad.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Hao Feng
- Department of Dermatology, University of Connecticut, Farmington, Connecticut.
| |
Collapse
|
28
|
United States burden of melanoma and non-melanoma skin cancer from 1990 to 2019. J Am Acad Dermatol 2021; 85:388-395. [PMID: 33852922 DOI: 10.1016/j.jaad.2021.03.109] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Skin cancer is the most common cancer worldwide. OBJECTIVE To evaluate the burden of skin cancer in the US from 1990 to 2019. METHODS Age-standardized incidence, prevalence, disability-adjusted life years (DALY), and mortality rates from skin cancer in the US were evaluated from the Global Burden of Disease 2019. RESULTS Incidence, prevalence, DALY, and mortality rates for melanoma per 100,000 persons in 2019 were 17.0, 138, 64.8, and 2.2, respectively; for squamous cell carcinoma, rates were 262, 314, 26.6, and 0.8, respectively; and for basal cell carcinoma, rates were 525, 51.2, 0.2, and zero, respectively. Incidence and prevalence rates of melanoma and non-melanoma skin cancer (NMSC) have increased since 1990, while mortality rates have remained fairly stable. Males have had higher incidence, prevalence, DALY, and mortality rates from melanoma and NMSC every year since 1990. Incidence and prevalence of melanoma was relatively higher in the northern half of the US than in the southern half. LIMITATIONS Global Burden of Disease is derived from estimation and mathematical modeling. CONCLUSIONS Health care professionals can utilize differences and trends noted in this study to guide allocation of resources to reduce incidence and morbidity from skin cancer.
Collapse
|
29
|
Piquero-Casals J, Carrascosa JM, Morgado-Carrasco D, Narda M, Trullas C, Granger C, Fabbrocini G. The Role of Photoprotection in Optimizing the Treatment of Atopic Dermatitis. Dermatol Ther (Heidelb) 2021; 11:315-325. [PMID: 33582977 PMCID: PMC8019014 DOI: 10.1007/s13555-021-00495-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/23/2021] [Indexed: 01/31/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with an estimated prevalence of 10-15% in children and 2-10% in adults. Clinically, there is notable phenotypic variability driven by a complex interaction between genetics, immune function, and the environment. Impairment of the skin barrier plays a significant role in the pathogenesis of AD. The apparent beneficial effect of sunlight in patients with atopic eczema is questioned due to its capacity to disrupt the skin barrier and generate free radicals that can damage proteins, lipids, and DNA. The sum of the external factors that an individual is exposed to throughout their lifetime is termed the exposome. Environmental factors such as sun exposure, temperature, and humidity contribute to both AD flares and regional prevalence variation. Literature on photoprotection in atopic dermatitis is very scarce. The use of adequate sunscreens in atopic dermatitis can ensure the level of photoprotection required to prevent skin photoaging and skin cancer and to mitigate skin barrier dysfunction, decrease inflammation, and neutralize facial redness. Herein we discuss and review the role of UV radiation and the exposome in the etiology of AD, as well as the role of adequate photoprotection.
Collapse
Affiliation(s)
| | - José Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, IGTP, Badalona, Spain
| | - Daniel Morgado-Carrasco
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| |
Collapse
|
30
|
Zhou S, Qi F, Gong Y, Zhang J, Zhu B. Biological Therapies for Atopic Dermatitis: A Systematic Review. Dermatology 2021; 237:542-552. [PMID: 33735876 DOI: 10.1159/000514535] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a widely acquired, relapsing inflammatory skin disease. Biologics are now widely used in patients with moderate-to-severe AD. OBJECTIVE This work aims to summarize both label and off-label biologics on AD treatment in phase II and phase III stages, and compile evidence on the efficacy of the most-studied biologics. METHODS We conducted a comprehensive literature search through PubMed, EMBASE, and ClinicalTrials.gov to identify all documented biological therapies for AD. The criteria were further refined to focus on those treatments with the highest evidence level for AD with at least one randomized clinical trial supporting their use. Only studies or articles published in English were enrolled in this study. FINDINGS Primary searches identified 525 relevant articles and 27 trials. Duplicated articles and papers without a full text were excluded. Only completed trials were enrolled. We included 28 randomized controlled trials, 4 unpublished trials, 2 observational studies, and 1 meta-analysis. Eight kinds of biologics, including IL-4/IL-13 inhibitors, JAK inhibitors, anti-IL-13 antibodies, anti-IL-22 antibodies, anti-IL-33 antibodies, thymic stromal lymphopoietin inhibitor (TSLP), OX40 antibodies, and H4R-antagonists were included in this work. Dupliumab, as the most widely used and investigated biologic, was reported in 1 meta-analysis and 4 trials exploring its long-term use and application in both adults and pediatric patients. Besides dupilumab, four other IL-4/IL-13 inhibitors recruited were all randomized, clinical trials at phase 2-3 stage. Six different kinds of JAK inhibitors were summarized with strong evidence revealing their significant therapeutic effects on AD. There were 3 trials for nemolizumab, an anti-IL-13 antibody, all of which were in the phase 2 clinical trial stage. Results showed nemolizumab could be another alternative therapy for moderate-to-severe AD with long-term efficiency and safety. CONCLUSION The biological therapies with the most robust evidence on efficacy and long-term safety for AD treatment include dupilumab, barcitinib, abrocitinib, and delgocitinib. Most of the biologics mentioned in this review were still at the exploratory stage. This review will help practitioners advise patients seeking suitable biological therapies and offer experimental study directions for treatment.
Collapse
Affiliation(s)
- Shuying Zhou
- Department of Dermatology, The 305 Hospital of PLA, Beijing, China
| | - Fei Qi
- Capital Medical University Affiliated with Beijing Chaoyang Hospital, Beijing, China,
| | - Yue Gong
- Department of Dermatology, The 305 Hospital of PLA, Beijing, China
| | - Jinping Zhang
- Department of Dermatology, The 305 Hospital of PLA, Beijing, China
| | - Binghua Zhu
- Department of Dermatology, The 305 Hospital of PLA, Beijing, China
| |
Collapse
|
31
|
Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spalkowska M, Pigatto PDM, Santus P, Savoia P. Mask-induced Koebner phenomenon and its clinical phenotypes: A multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics. Dermatol Ther 2021; 34:e14823. [PMID: 33527560 PMCID: PMC7995036 DOI: 10.1111/dth.14823] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022]
Abstract
During COVID-19 pandemic, wearing masks for prevention became mandatory but evidence suggest that is also detrimental for skin. Although facial dermatoses due to masks increase in both healthcare workers and general population, a pathogenetic hypothesis remains still elusive. We aimed to evaluate the prevalence of dermatological consultations due to Koebner triggered dermatoses In this prospective, multicenter, real life study carried out in Italy from March 11th to December 11th 2020 during COVID-19 pandemics, dermatological consultations (in-person and telemedicine) to study the prevalence of Koebner (KB) phenomenon due to masks were evaluated. Boyd and Nelder classification was adopted for Koebner phenomenon and Bizzozero's for KB intensity. A total of 229/873 (26.2%) dermatological consultations were KB triggered dermatoses and lesions were located in mask-covered ear area (76 [33.2%]), malar area (73 [31.8%]), perioral area (53 [23.1%]), and nose (27 [11.8%]). The first KB category grouped 142 patients (psoriasis, vitiligo, maskne, and mask rosacea), the second one 24 (warts, molluscum contagiosum, and impetigo), the third one 46 (atopic dermatitis), and the fourth one 17 (eczema). Among previously KB negative psoriatic patients that became KB positive, 9/13 (69.2%) had discontinued or modified the prescribed antipsoriatic treatment. Mask-related Koebner phenomenon is an important clinical sign to orient clinician's therapeutic protocols during COVID-19 pandemic, especially in patients with psoriasis.
Collapse
Affiliation(s)
- Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.,Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | | | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Alessia Pacifico
- Clinical Dermatology Department, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Magdalena Spalkowska
- Faculty of Medicine, Department of Dermatology, Jagellonian University Medical College, Krakow, Poland.,Department of Rheumatology and Immunology, University Hospital of Krakow, Krakow, Poland
| | - Paolo Daniele Maria Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milano, Italy
| | | | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| |
Collapse
|
32
|
Boismal F, Serror K, Dobos G, Zuelgaray E, Bensussan A, Michel L. [Skin aging: Pathophysiology and innovative therapies]. Med Sci (Paris) 2020; 36:1163-1172. [PMID: 33296633 DOI: 10.1051/medsci/2020232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
One of the major challenges of the 21st century is the fight against aging, defined as a set of physiological mechanisms altering the physical and intellectual capacities of human beings. Aging of the skin is only one visible part of this process. It is associated with major healing defects linked in part to the alteration of the biomechanical properties of skin cells, mainly dermal fibroblasts. The immune system, another key component in maintaining skin homeostasis and the efficient healing of wounds, also suffers the effects of time: the consequent skin immunosenescence would limit the anti-infectious and vaccine response, while promoting a pro-tumor environment. The main skin damages due to aging, whether intrinsic or extrinsic, will be detailed before listing the effective anti-aging strategies to combat age-related dermal and epidermal stigmas.
Collapse
Affiliation(s)
- Françoise Boismal
- Inserm U976 ; Centre de recherche sur la peau ; hôpital Saint-Louis, Paris, France
| | - Kevin Serror
- Service de chirurgie plastique et reconstructrice, hôpital Saint-Louis, Paris, France
| | - Gabor Dobos
- Inserm U976 ; Centre de recherche sur la peau ; hôpital Saint-Louis, Paris, France - Service de dermatologie, hôpital Saint Louis, Paris, France
| | - Elina Zuelgaray
- Inserm U976 ; Centre de recherche sur la peau ; hôpital Saint-Louis, Paris, France - Service de dermatologie, hôpital Saint Louis, Paris, France
| | - Armand Bensussan
- Inserm U976 ; Centre de recherche sur la peau ; hôpital Saint-Louis, Paris, France
| | - Laurence Michel
- Inserm U976 ; Centre de recherche sur la peau ; hôpital Saint-Louis, Paris, France - Service de dermatologie, hôpital Saint Louis, Paris, France
| |
Collapse
|
33
|
Gene Delivery to the Skin - How Far Have We Come? Trends Biotechnol 2020; 39:474-487. [PMID: 32873394 PMCID: PMC7456264 DOI: 10.1016/j.tibtech.2020.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/19/2022]
Abstract
Gene therapies are powerful tools to prevent, treat, and cure human diseases. The application of gene therapies for skin diseases received little attention so far, despite the easy accessibility of skin and the urgent medical need. A major obstacle is the unique barrier properties of human skin, which significantly limits the absorption of biomacromolecules, and thus hampers the efficient delivery of nucleic acid payloads. In this review, we discuss current approaches, successes, and failures of cutaneous gene therapy and provide guidance toward the development of next-generation concepts. We specifically allude to the delivery strategies as the major obstacle that prevents the full potential of gene therapies – not only for skin disorders but also for almost any other human disease. Gene therapies are powerful tools for the treatment of inflammatory, genetic, and cancer-related skin diseases. The skin barrier function and the low number of cells that get transfected are the main hurdles for cutaneous gene therapy and contribute to the fact that gene therapies for skin diseases are an underexplored area. Gene editing provides an approach to cure rare and severe genodermatoses-like epidermolysis bullosa. First studies demonstrate the potential and invaluable impact these treatments may have even if only a small percentage of the gene function can be restored. Recent advancements demonstrate the power of non-viral delivery systems for the delivery of gene therapeutics to the skin. They may prove superior to viral vectors, the current gold standard, because their use is not limited by packaging size, serious safety concerns, or manufacturing issues.
Collapse
|