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Cranwell W, Meah N, Wall D, Bevin B, Laita B, Sinclair RD. Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients. Australas J Dermatol 2024. [PMID: 38831704 DOI: 10.1111/ajd.14325] [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: 09/02/2023] [Revised: 12/14/2023] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is implicated in the pathogenesis of AA and Janus Kinase inhibitor (JAKi) medications are promising emerging treatments for AA. OBJECTIVES We evaluated the safety and effectiveness of tofacitinib in a real-world setting over 18 months of treatment. METHODS A retrospective cohort study of all patients with scalp AA commenced on tofacitinib between 1 November 2016 and 31 May 2019. The primary endpoint was the percent change in Severity of Alopecia Tool (SALT) score at 18 months. RESULTS Two hundred and two patients were included. After 18 months of treatment, 55.9%, 42.6% and 29.2% achieved 50%, 75% and 90% reductions in their SALT scores respectively. Increased duration of AA was a negative predictor of hair regrowth. Males and patients with baseline SALT ≥90 were slower to respond to treatment in the first 12 months. One hundred and twenty-four patients and 168 patients received concomitant systemic corticosteroids or low-dose oral minoxidil during tofacitinib therapy respectively. There were no serious adverse events. CONCLUSION Tofacitinib was a safe and effective treatment for patients with moderate-to-severe AA. Further randomised controlled studies are needed to establish the optimal treatment regimen.
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Affiliation(s)
| | - Nekma Meah
- St Helens & Knowsley NHS Trust, Prescot, UK
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - Dmitri Wall
- National and International Skin Registry Solutions (NISR), Dublin, Ireland
- Hair Restoration Blackrock, Dublin, Ireland
- Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Bhoyrul Bevin
- Sinclair Dermatology, Melbourne, Victoria, Australia
| | - Bokhari Laita
- Sinclair Dermatology, Melbourne, Victoria, Australia
| | - Rodney D Sinclair
- Sinclair Dermatology, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
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2
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Scope A, Liopyris K, Weber J, Barnhill RL, Braun RP, Curiel-Lewandrowski CN, Elder DE, Ferrara G, Grant-Kels JM, Jeunon T, Lallas A, Lin JY, Marchetti MA, Marghoob AA, Navarrete-Dechent C, Pellacani G, Soyer HP, Stratigos A, Thomas L, Kittler H, Rotemberg V, Halpern AC. International Skin Imaging Collaboration-Designated Diagnoses (ISIC-DX): Consensus terminology for lesion diagnostic labeling. J Eur Acad Dermatol Venereol 2024. [PMID: 38733254 DOI: 10.1111/jdv.20055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/16/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND A common terminology for diagnosis is critically important for clinical communication, education, research and artificial intelligence. Prevailing lexicons are limited in fully representing skin neoplasms. OBJECTIVES To achieve expert consensus on diagnostic terms for skin neoplasms and their hierarchical mapping. METHODS Diagnostic terms were extracted from textbooks, publications and extant diagnostic codes. Terms were hierarchically mapped to super-categories (e.g. 'benign') and cellular/tissue-differentiation categories (e.g. 'melanocytic'), and appended with pertinent-modifiers and synonyms. These terms were evaluated using a modified-Delphi consensus approach. Experts from the International-Skin-Imaging-Collaboration (ISIC) were surveyed on agreement with terms and their hierarchical mapping; they could suggest modifying, deleting or adding terms. Consensus threshold was >75% for the initial rounds and >50% for the final round. RESULTS Eighteen experts completed all Delphi rounds. Of 379 terms, 356 (94%) reached consensus in round one. Eleven of 226 (5%) benign-category terms, 6/140 (4%) malignant-category terms and 6/13 (46%) indeterminate-category terms did not reach initial agreement. Following three rounds, final consensus consisted of 362 terms mapped to 3 super-categories and 41 cellular/tissue-differentiation categories. CONCLUSIONS We have created, agreed upon, and made public a taxonomy for skin neoplasms and their hierarchical mapping. Further study will be needed to evaluate the utility and completeness of the lexicon.
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Affiliation(s)
- Alon Scope
- The Kittner Skin Cancer Screening & Research Institute, Sheba Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Konstantinos Liopyris
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Dermatology-Venereology, University of Athens Medical School, Athens, Greece
| | - Jochen Weber
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Raymond L Barnhill
- Department of Translational Research, Institut Curie, and UFR de Médecine, Université de Paris, Paris, France
| | - Ralph P Braun
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Clara N Curiel-Lewandrowski
- Department of Dermatology, University of Arizona College of Medicine, and the University of Arizona Cancer Center Skin Cancer Institute, Tucson, Arizona, USA
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gerardo Ferrara
- Anatomic Pathology and Cytopathology Unit, Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Naples, Italy
| | - Jane M Grant-Kels
- Department of Dermatology, UConn Health, Farmington, Connecticut, USA
- Department of Dermatology, University of Florida, Gainesville, Florida, USA
| | - Thiago Jeunon
- Departments of Dermatology and Pathology, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Jennifer Y Lin
- Department of Dermatology, Brigham and Women's Hospital and Melanoma Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cristian Navarrete-Dechent
- Melanoma and Skin Cancer Unit and Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena and Dermatology Clinic, University of Rome, Rome, Italy
| | - Hans Peter Soyer
- The University of Queensland Diamantina Institute, University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Luc Thomas
- Dermatology Department, Hôpital Universitaire Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Veronica Rotemberg
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Allan C Halpern
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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3
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Moussa A, Bennett M, Wall D, Meah N, York K, Bokhari L, Asfour L, Rees H, Abraham LS, Asz-Sigall D, Basmanav FB, Bergfeld W, Betz RC, Bhoyrul B, Blume-Peytavi U, Callender V, Chitreddy V, Combalia A, Cotsarelis G, Craiglow B, Dhurat R, Donovan J, Doroshkevich A, Eisman S, Farrant P, Ferrando J, Gadzhigoroeva A, Green J, Grimalt R, Harries M, Hordinsky M, Irvine A, Jolliffe V, Kaiumov S, King B, Lee J, Lee WS, Li J, Lortkipanidze N, McMichael A, Mesinkovska NA, Messenger A, Mirmirani P, Olsen E, Orlow SJ, Ovcharenko Y, Piraccini BM, Pirmez R, Rakowska A, Reygagne P, Rudnicka L, Corralo DS, Senna M, Shapiro J, Sharma P, Siliuk T, Starace M, Suchonwanit P, Takwale A, Tosti A, Vañó-Galván S, Visser WI, Vogt A, Wade M, Yip L, Zhou C, Sinclair R. The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results From a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity. JAMA Dermatol 2024; 160:341-350. [PMID: 38324292 DOI: 10.1001/jamadermatol.2023.5869] [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: 02/08/2024]
Abstract
Importance Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact. Objective To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI). Evidence Review A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022. Findings Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss. Conclusions and Relevance This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity.
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Affiliation(s)
- Anthony Moussa
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | | - Dmitri Wall
- Hair Restoration Blackrock, Dublin, Ireland
- National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Nekma Meah
- St Helens & Knowsley National Health Service Trust, St Helens, United Kingdom
- Manchester University, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Katherine York
- Netcare Greenacres Hospital, Port Elizabeth, South Africa
| | - Laita Bokhari
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Leila Asfour
- Salford Royal Foundation Trust, Northern Care Alliance, Manchester, United Kingdom
| | - Huw Rees
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | | - Daniel Asz-Sigall
- Trichology Clinic, Dermatology Department, Dr Manuel Gea Gonzalez General Hospital, Mexico City, Mexico
| | - Fitnat Buket Basmanav
- Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany
| | | | - Regina C Betz
- Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany
| | - Bevin Bhoyrul
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Andrea Combalia
- Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - George Cotsarelis
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Brittany Craiglow
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | | | - Jeff Donovan
- Donovan Hair Clinic, University of British Columbia, Whistler, British Columbia, Canada
| | | | - Samantha Eisman
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia
| | - Paul Farrant
- Brighton and Sussex University Hospitals National Health Service Trust, Brighton, United Kingdom
| | - Juan Ferrando
- Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Aida Gadzhigoroeva
- Moscow Scientific & Practical Center of Dermatology, Venereology and Cosmetology, Russian Federation
| | - Jack Green
- Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia
| | - Ramon Grimalt
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Matthew Harries
- Salford Royal Hospital, Northern Care Alliance National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Centre for Dermatology Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Maria Hordinsky
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Alan Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Victoria Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Spartak Kaiumov
- Clinic of Trichology and Cosmetology Nautilus, Saint-Petersburg, Russia
| | - Brett King
- Yale School of Medicine, New Haven, Connecticut
| | | | - Won-Soo Lee
- Department of Dermatology, Yonsei University, Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea
| | - Jane Li
- Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, Eastern Health, Melbourne, Victoria, Australia
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia
| | | | - Amy McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Andrew Messenger
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | | | - Elise Olsen
- Duke Dermatology Clinic, Durham, North Carolina
| | - Seth J Orlow
- Grossman School of Medicine, New York University, New York, New York
| | - Yuliya Ovcharenko
- Department of Infectious Diseases and Clinical Immunology, V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Bologna, Italy
| | - Rodrigo Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Pascal Reygagne
- Centre de Santé Sabouraud, Hopital Saint Louis, Vellefaux, Paris, France
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - David Saceda Corralo
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maryanne Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Jerry Shapiro
- Disorders of the Hair and Scalp, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Pooja Sharma
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Tatiana Siliuk
- Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anita Takwale
- Editorial Advisory Board, Indian Journal of Dermatology Venereology Leprosy
| | - Antonella Tosti
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Sergio Vañó-Galván
- Dermatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Universidad de Alcalá, Madrid, Spain
- Trichology Unit, #TricoHRC Research Group, Madrid, Spain
| | - Willem I Visser
- Division of Dermatology, Stellenbosch University, Cape Town, South Africa
| | - Annika Vogt
- Department of Dermatology, Venerology and Allergology, Clinical Research Center for Hair and Skin Science, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Martin Wade
- The London Skin and Hair Clinic, London, United Kingdom
| | - Leona Yip
- Skin Partners Specialist Dermatologists, Brisbane, Australia
| | - Cheng Zhou
- Department of Dermatology, Peking University People's Hospital, Xicheng District, Beijing, China
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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4
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Dainichi T, Iwata M, Kaku Y. Alopecia areata: What's new in the diagnosis and treatment with JAK inhibitors? J Dermatol 2024; 51:196-209. [PMID: 38087654 DOI: 10.1111/1346-8138.17064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/11/2023] [Accepted: 11/15/2023] [Indexed: 02/04/2024]
Abstract
Alopecia areata (AA) affects individuals of all ages and is intractable in severe relapsing cases. Dermatologists and other healthcare providers should consider AA in the medical context and prioritize treatment. Several randomized controlled clinical studies on Janus kinase (JAK) inhibitors with different specificities for the treatment of AA are ongoing. These studies have encouraged us to appreciate the importance of a definitive diagnosis and accurate evaluation of AA before and during treatment. Following our previous review article in 2017, here we provide the second part of this two-review series on the recent progress in the multidisciplinary approaches to AA from more than 1800 articles published between July 2016 and December 2022. This review focuses on the evaluation, diagnosis, and treatment of AA. We also provide the latest information on the safety and efficacy of JAK inhibitors for the treatment of AA and describe their mechanisms of action.
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Affiliation(s)
- Teruki Dainichi
- Department of Dermatology, Kagawa University Faculty of Medicine, Miki-cho, Kita-gun, Japan
| | - Masashi Iwata
- Department of Dermatology, Kagawa University Faculty of Medicine, Miki-cho, Kita-gun, Japan
| | - Yo Kaku
- Department of Dermatology, Kagawa University Faculty of Medicine, Miki-cho, Kita-gun, Japan
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
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Haddadin OM, Jacobson ME, Chen DM, Croitoru DO, Dissemond J, Gontijo JRV, Hampton PJ, Kelly RI, Marzano AV, Tada Y, Gerbens LAA, Ortega-Loayza AG. Minimum data set for treatment effectiveness in pyoderma gangrenosum (MIDSTEP): an international protocol of an e-Delphi study to develop a clinical physician-driven treatment effectiveness registry on behalf of the UPGRADE initiative. Arch Dermatol Res 2023; 315:2913-2919. [PMID: 37755505 DOI: 10.1007/s00403-023-02729-9] [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: 08/02/2023] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
Pyoderma gangrenosum (PG) is a rare inflammatory condition with an immense disease burden that remains understudied. With limited approved treatments and low-quality clinical evidence, PG continues to have poor patient outcomes. Unfortunately, improvement in PG treatments and patient care is based on additional research endeavors that can only be developed from existing high-quality data. The following protocol outlines the development of the Minimum Data Set for Treatment Effectiveness in Pyoderma gangrenosum (MIDSTEP), a core set of domains and domain items for the Pyoderma Gangrenosum Treatment Effectiveness (PyGaTE) international registry. The outcomes and benefits are focused on providing real-world data for physicians to improve their clinical decisions on PG treatment and inform clinical trial design, promoting clinical research among the international scientific community. MIDSTEP is a multi-phase project. The first phase will produce a domain item list from a literature review to take into the second phase which would finalize the core data set by an e-Delphi exercise. There will be a single stakeholder group participating together in the e-Delphi consisting of PG experts (healthcare providers, researchers, methodologists, industry representatives, and regulators), ulcerative PG patients, and PG patient advocates. The methodology outlined in the protocol is a systematic method based on several guidelines through COMET and established dermatologic registries and outcome sets with systematic methodologies of their own. The third phase will identify the instruments for the items, the 'when to measure' the items, and the platform for the registry. The last phase is the implementation and continued maintenance of the international registry PyGaTE. By solidifying a consensus on standardized outcomes and collecting information on PG treatment effectiveness in a centralized database, existing treatments can be compared more systematically and analyzed with increased evidence. MIDSTEP and the PyGaTE international registry will have the ambitious goal to generate and disseminate real-world data that can be used by all stakeholders to improve health outcomes for PG patients. Future potential for the outcome of this project includes the development of a gold-standard PG treatment.
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Affiliation(s)
- Olivia M Haddadin
- School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Michael E Jacobson
- Department of Dermatology, Center for Health and Healing, Oregon Health and Science University, Portland, OR, USA
| | | | - David O Croitoru
- Division of Dermatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | - Joao Renato V Gontijo
- Professor of Dermatology, Medical School of Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Philip J Hampton
- Department of Dermatology, The Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Robert I Kelly
- Department of Dermatology, St Vincent's Hospital, Melbourne, Australia
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Louise A A Gerbens
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, The Netherlands
| | - Alex G Ortega-Loayza
- Department of Dermatology, Center for Health and Healing, Oregon Health and Science University, Portland, OR, USA.
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6
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Al Hammadi A, Parmar NV, Aljefri K, Al Sharif O, Abdallah M, Ahmed HM, Ammoury A. Review on Alopecia Areata in the Middle East and Africa: Landscape and Unmet Needs. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00946-8. [PMID: 37338721 DOI: 10.1007/s13555-023-00946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disease characterized by non-scarring hair loss in adults and children. Clinical manifestations range from hair loss in small, well-circumscribed patches to total hair loss on the scalp or any other hair-bearing areas. Although the exact pathogenesis of AA is not fully understood, it is thought that loss of immune privilege caused by immunological dysregulation of the hair follicle is key. Genetic susceptibility also plays a role. Response to currently available treatments is widely variable, causing patient dissatisfaction and creating an unmet need. AA is frequently associated with multiple comorbidities, further affecting patient quality of life. AIMS AND FINDINGS AA causes a significant burden on dermatologists and healthcare systems in the Middle East and Africa. There is a lack of data registries, local consensus, and treatment guidelines in the region. Limited public awareness, availability of treatments, and patient support need to be addressed to improve disease management in the region. A literature review was conducted to identify relevant publications and highlight regional data on prevalence rates, diagnosis, quality of life, treatment modalities, and unmet needs for AA in the Middle East and Africa.
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Affiliation(s)
| | - Nisha V Parmar
- Department of Dermatology, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | | | - Osama Al Sharif
- King Fahad General Hospital, Medina, Kingdom of Saudi Arabia
| | | | | | - Alfred Ammoury
- Division of Dermatology, St George University Medical Center, Beirut, Lebanon
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7
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Fagan N, Doherty GA, Meah N, Sinclair R, Wall D. Cross-specialty identification of the JAK1 inhibitor trial agent filgotinib as a potential therapy for alopecia areata. Br J Dermatol 2023; 188:442-443. [PMID: 36680304 DOI: 10.1093/bjd/ljac103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Abstract
First report of alopecia areata responding to the selective JAK1 inhibitor filgotinib. This case is a patient with coinciding Crohn’s disease that had failed multiple biologics. It serves as a real-world example of how shared decision making between physicians can greatly improve patient outcomes. It highlights that sharing patient registry datasets between specialties will have great benefits, for example in repurposing of JAK inhibitors for other conditions.
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Affiliation(s)
| | - Glen A Doherty
- St. Vincent's University Hospital, Dublin, Ireland.,Department of Medicine, University College Dublin, Ireland
| | - Nekma Meah
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, UK.,Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Dmitri Wall
- Charles Institute of Dermatology, UCD School of Medicine, University College Dublin, Dublin, Ireland.,Hair Restoration Blackrock, Blackrock, Dublin, Ireland
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8
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Asfour L, Narayan B. Shared Decision-making, Therapeutic Choice, and Decisional Regret in Alopecia Areata-Where Narrative Ethics Meets the Unconscious Bias of Clinicians. JAMA Dermatol 2023; 159:462. [PMID: 36811883 DOI: 10.1001/jamadermatol.2022.6534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Leila Asfour
- Salford Royal Foundation Trust, Manchester, England
| | - Bhaskar Narayan
- Monash Health, Melbourne, Victoria, Australia.,Manchester University National Health Service Foundation Trust, Manchester, England
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9
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Asfour L, Raja H, Harries MJ. What is the role of a specialist hair clinic? The impact and patient experience from a regional NHS specialist hair clinic. Clin Exp Dermatol 2023; 48:36-38. [PMID: 36669178 DOI: 10.1093/ced/llac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/21/2022] [Accepted: 10/13/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Leila Asfour
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, Greater Manchester, UK
| | - Hussain Raja
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, Greater Manchester, UK
| | - Matthew J Harries
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, Greater Manchester, UK
- Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester, Biomedical Research Centre, Manchester, UK
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10
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Signposts to the Promised Land in Alopecia Areata. J Invest Dermatol 2023; 143:9-10. [PMID: 36123183 DOI: 10.1016/j.jid.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022]
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11
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Arabkermani Z, Sheikhtaheri A, Aryanian Z, Bastani P, Esmaeli N, Bashiri A, Mehralian G, Sharifian R. Developing a minimum data set required to create a registry system for patients with vitiligo. Heliyon 2022; 8:e12641. [PMID: 36619402 PMCID: PMC9812701 DOI: 10.1016/j.heliyon.2022.e12641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/22/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Background Vitiligo can be psychologically devastating and stigmatizing, with significant impacts on patients. As such, the early treatment and understanding of the profound psychosocial impact of this skin disease cannot be overstated. A standardized method of data collection with consistent definitions is a prerequisite for vitiligo management. Against this background, this study aimed to develop a minimum data set (MDS) for the vitiligo registry system. Materials and methods The study was conducted in four steps in 2020 in Iran. After a comprehensive literature review to find relevant resources in English, medical records of patients with vitiligo were examined to assess the status quo of the country. Then, a model was developed from the data obtained in the previous step and through interviews. To reach a consensus on the data items, the Delphi technique was applied using a questionnaire, and the mean of expert judgments on each data item was calculated. Results A total of 127 data elements were developed through two rounds of the Delphi technique. The MDS was divided into an administrative part with three sections and 18 data items, and a clinical part with seven sections and 109 data items. Conclusion This study is the first step towards establishing a registry system for patients with vitiligo. Accurate identification of data items, such as MDSs, can be useful in establishing a vitiligo registry, planning, and improving the quality of patient care.
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Affiliation(s)
- Zahra Arabkermani
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Peivand Bastani
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nafiseh Esmaeli
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Bashiri
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Roxana Sharifian
- Department of Health Information Management, School of Health Management and Information Sciences, Health Human Resources Research Center, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Corresponding author.
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12
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Neale H, Schrandt S, Abbott BM, Austin J, Brand C, Camp K, Devenport K, Hall M, Isbell L, Miciano C, Pry S, Quinn P, Rittle J, Tenconi F, Terrell J, Weiss M, Zavitz S, Siegel M. Defining patient-centered research priorities in pediatric dermatology. Pediatr Dermatol 2022; 40:250-257. [PMID: 36443263 DOI: 10.1111/pde.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Patient and caregiver perspectives are critical in understanding dermatologic disease impact, presentation, and management in children. The Pediatric Dermatology Research Alliance (PeDRA) Patient Advisory Committee (PtAC), a group of patient representatives and parents of children with cutaneous disease, pursued a multistep, iterative, consensus-building process to identify comprehensive, high-priority research needs. METHODS Building on discussions at the 2020 PeDRA Annual Conference, a research prioritization survey was developed and completed by PtAC members. Survey themes were aggregated and workshopped by the PtAC through a series of facilitated calls. Emerging priorities were refined in collaboration with additional PeDRA patient community members at the 2021 PeDRA Annual Conference. Subsequently, a final actionable list was agreed upon. RESULTS Fourteen PtAC members (86.7% female) representing patients with alopecia areata, atopic dermatitis, vascular birthmarks, congenital melanocytic nevi, ectodermal dysplasias, epidermolysis bullosa, Gorlin syndrome, hidradenitis suppurativa, ichthyosis, pemphigus, psoriasis, Sturge-Weber syndrome, and pachyonychia congenita completed the survey. Following serial PtAC meetings, 60 research needs were identified from five domains: psychosocial challenges, health care navigation/disease management, causes/triggers, treatments to preserve or save life, and treatments to preserve or save quality of life. CONCLUSIONS Many pediatric dermatology research priorities align across affected communities and may drive meaningful, patient-centric initiatives and investigations.
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Affiliation(s)
- Holly Neale
- Pediatric Dermatology Research Alliance, Portland, Oregon, USA.,University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Becky M Abbott
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Foundation for Ectodermal Dysplasias, Fairview Heights, Illinois, USA
| | - Jennifer Austin
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,International Alliance of Dermatology Patient Organizations, Ottawa, Ontario, Canada
| | - Callista Brand
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,HS Foundation, Santa Monica, California, USA
| | - Karen Camp
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA
| | | | - Michelle Hall
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,EB Research Partnership, New York, New York, USA
| | - Lauren Isbell
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Nevus Outreach, Jonesboro, Arkansas, USA
| | - Charlene Miciano
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Eczema Association, San Rafael, California, USA
| | - Sarah Pry
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Global Parents for Eczema Research, Santa Barbara, California, USA
| | - Paula Quinn
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Alopecia Areata Foundation, San Rafael, California, USA
| | - James Rittle
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Pachyonychia Congenita Project, Holladay, Utah, USA
| | - Francesca Tenconi
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Children's Skin Disease Foundation, Walnut Creek, California, USA
| | - Julia Terrell
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,The Sturge-Weber Foundation, Randolph, New Jersey, USA
| | - Meredith Weiss
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Gorlin Syndrome Alliance, Reading, Pennsylvania, USA
| | - Sam Zavitz
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Foundation for Ichthyosis and Related Skin Types, Colmar, Pennsylvania, USA
| | - Michael Siegel
- Pediatric Dermatology Research Alliance, Portland, Oregon, USA
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13
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Predictors of QOL in Patients with Alopecia Areata. J Invest Dermatol 2022; 142:2646-2650.e3. [PMID: 35331716 DOI: 10.1016/j.jid.2022.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 02/08/2023]
Abstract
Although alopecia areata (AA) severity is often defined by the degree of scalp hair loss, its impact on QOL can also be a defining measure of severity. In this cross-sectional study (AA Disease Specific Program), 259 patients were surveyed for demographics, AA illness characteristics, QOL (Skindex-16 AA), and daily impairment (Work Productivity and Activity Impairment). The association between patient demographics and illness variables, the Skindex-16 AA scores, and the Work Productivity and Activity Impairment scores were analyzed using regression analyses. The mean age of patients was 39 years (51% female). Self-reported severity of current AA was rated as mild (21%), moderate (54%), and severe (25%). The highest impairment was observed for the Skindex-16 AA emotions and the Work Productivity and Activity Impairment daily activity performance scores. Although the degree of scalp hair loss (physician Severity of Alopecia Tool score) was not predictive of QOL, patients' self-report of moderate or severe disease, sex (females more impacted), and eyebrow and eyelash involvement were predictors of diminished QOL, consistently and incrementally. The present results suggest patients' perception of severity as well as the presence of eyelash and eyebrow hair loss are also impactful and should be considered in defining the severity of disease.
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14
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Freeman EE, Chamberlin GC, McMahon DE, Hruza GJ, Wall D, Meah N, Sinclair R, Balogh EA, Feldman SR, Lowes MA, Marzano AV, Naik HB, Castelo-Soccio L, Lara-Corrales I, Cordoro KM, Mahil SK, Griffiths CEM, Smith CH, Irvine AD, Spuls PI, Flohr C, French LE. Dermatology COVID-19 Registries: Updates and Future Directions. Dermatol Clin 2021; 39:575-585. [PMID: 34556247 PMCID: PMC8165090 DOI: 10.1016/j.det.2021.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA; Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
| | - Grace C Chamberlin
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Devon E McMahon
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - George J Hruza
- Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Dmitri Wall
- Hair Restoration Blackrock, Dublin, Ireland; National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Nekma Meah
- St Helens & Knowsley NHS Trust, Marshalls Cross Road, St. Helens WA9 3DA, UK; Manchester University, Faculty of Biology, Medicine and Health, Oxford Road, Manchester, UK
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, Victoria 3002, Australia
| | - Esther A Balogh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | | | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Haley B Naik
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Leslie Castelo-Soccio
- Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Irene Lara-Corrales
- Section of Pediatric Dermatology, Hospital for Sick Children, Toronto, Canada
| | - Kelly M Cordoro
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Satveer K Mahil
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Christopher E M Griffiths
- Dermatology Centre, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - Catherine H Smith
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Alan D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Phyllis I Spuls
- Department of Dermatology, Public Health and Epidemiology; Immunity and Infections, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Lars E French
- Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany; Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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15
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Wall D, Alhusayen R, Arents B, Apfelbacher C, Balogh EA, Bokhari L, Bloem M, Bosma AL, Burton T, Castelo-Soccio L, Fagan N, Feldman SR, Fletcher G, Flohr C, Freeman E, French LE, Griffiths CEM, Hruza GJ, Ingram JR, Kappelman MD, Lara-Corrales I, Lim HW, Meah N, McMahon DE, Mahil SK, McNicoll I, Musters A, Naik HB, Sinclair R, Smith CH, Spuls P, Tobin DJ, York K, Irvine AD. Learning from disease registries during a pandemic: Moving toward an international federation of patient registries. Clin Dermatol 2021; 39:467-478. [PMID: 34518006 PMCID: PMC8432911 DOI: 10.1016/j.clindermatol.2021.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
High-quality dermatology patient registries often require considerable time to develop and produce meaningful data. Development time is influenced by registry complexity and regulatory hurdles that vary significantly nationally and institutionally. The rapid emergence of the coronavirus disease 2019 (COVID-19) global pandemic has challenged health services in an unprecedented manner. Mobilization of the dermatology community in response has included rapid development and deployment of multiple, partially harmonized, international patient registries, reinventing established patient registry timelines. Partnership with patient organizations has demonstrated the critical nature of inclusive patient involvement. This global effort has demonstrated the value, capacity, and necessity for the dermatology community to adopt a more cohesive approach to patient registry development and data sharing that can lead to myriad benefits. These include improved utilization of limited resources, increased data interoperability, improved ability to rapidly collect meaningful data, and shortened response times to generate real-world evidence. We call on the global dermatology community to support the development of an international federation of patient registries to consolidate and operationalize the lessons learned during this pandemic. This will provide an enduring means of applying this knowledge to the maintenance and development of sustainable, coherent, and impactful patient registries of benefit now and in the future.
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Affiliation(s)
- Dmitri Wall
- Hair Restoration Blackrock, Dublin, Ireland; National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
| | - Raed Alhusayen
- Division of Dermatology and Sunnybrook Research Institute, University of Toronto, Ontario, Canada
| | - Bernd Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Esther A Balogh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | | | - Manja Bloem
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | - Angela L Bosma
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | | | - Leslie Castelo-Soccio
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicole Fagan
- University of Dublin, Trinity College, Dublin, Ireland
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Godfrey Fletcher
- National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Esther Freeman
- Massachusetts General Hospital Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
| | - Lars E French
- Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany
| | - Christopher E M Griffiths
- Dermatology Centre, The University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - George J Hruza
- St. Louis University Department of Dermatology, St. Louis, Missouri, USA
| | - John R Ingram
- Department of Dermatology, Division of Infection & Immunity, Cardiff University, Cardiff, UK
| | - Michael D Kappelman
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Irene Lara-Corrales
- Section of Dermatology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Nekma Meah
- Sinclair Dermatology, Melbourne, Australia
| | - Devon E McMahon
- Massachusetts General Hospital Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
| | - Satveer K Mahil
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Ian McNicoll
- Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK
| | - Annelie Musters
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | - Haley B Naik
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | | | - Catherine H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Phyllis Spuls
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | - Desmond J Tobin
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Katherine York
- Netcare Greenacres Hospital, Port Elizabeth, South Africa
| | - Alan D Irvine
- National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland; Clinical Medicine, Trinity College, Dublin, Ireland
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