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Yang Z, Jin Y, Wang M, Li R, Li WQ, Li H. Enhanced impact of psoriasis severity on the treatment demands of patients during the COVID-19 pandemic: a cross-sectional study based on a national psoriasis registry in China. BMJ Open 2024; 14:e079627. [PMID: 38367975 PMCID: PMC10875510 DOI: 10.1136/bmjopen-2023-079627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/17/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES The personalised treatment demands of patients with psoriasis did not get significant attention during the pandemic lockdown. This study aimed to investigate the treatment demands of patients with psoriasis with different severities, stratified by COVID-19 pandemic conditions. DESIGN Cross-sectional study design. SETTING Multicentre study based on a national psoriasis registry in China. PARTICIPANTS A total of 22 425 adult patients with psoriasis were enrolled between August 2020 and September 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were patient demands for quick healing of skin lesions and improving mental health, which were collected by questionnaires. Multivariable logistic models were used to examine the impact of disease severity, as measured by Psoriasis Area and Severity Index (PASI), body surface area (BSA) and Investigator's Global Assessment (IGA), on treatment demands, as stratified by COVID-19 pandemic conditions (lockdown vs non-lockdown). RESULTS Increasing PASI score significantly increased patient demands for rapid healing of skin lesions and improving mental health during non-lockdown periods. The magnitude of both associations further increased during the COVID-19 lockdown from an OR of 1.45 (95% CI 1.27 to 1.65) to 2.19 (95% CI 1.57 to 3.05) and 2.21 (95% CI 2.03 to 2.40) to 2.82 (95% CI 2.24 to 3.55), respectively. The skin lesion healing demand was more triggered by the overall irritation level (measured by IGA, OR 1.64, 95% CI 1.35 to 1.99 during non-lockdown periods vs OR 2.70, 95% CI 1.63 to 4.49 during lockdowns), while the mental health improving demand was more triggered by lesion coverage (measured by BSA, OR 2.01, 95% CI 1.85 to 2.19 vs OR 3.27, 95% CI 2.57 to 4.15). CONCLUSIONS Psoriasis aggravation significantly increased patients' treatment demands, especially during lockdowns. The used psoriasis severity measures highlighted patients' treatment demands differently. This suggests more accessible and personalised healthcare for patients with psoriasis should be available during future pandemics.
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Affiliation(s)
- Zhihui Yang
- Department of Dermatology and Venerology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, and NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
| | - Yu Jin
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, and Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Mingyue Wang
- Department of Dermatology and Venerology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, and NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
| | - Ruoyu Li
- Department of Dermatology and Venerology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, and NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
| | - Wen-Qing Li
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, and Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Hang Li
- Department of Dermatology and Venerology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, and NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
- Peking University - Yunnan Baiyao International Medical Research Center, Peking University, Beijing, China
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Raheel MFS, Snoubar Y, Mosbah WS. Being female with vitiligo disease in traditional societies within North Africa. Biopsychosoc Med 2024; 18:1. [PMID: 38200533 PMCID: PMC10777494 DOI: 10.1186/s13030-024-00299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study aims to assess the influence of vitiligo illness on the quality of life of female individuals residing in Ajdabiya, Libya. Through this investigation, we aim to enhance our comprehension of the potential impact of cultural norms and conventional gender roles on managing and caring for skin disorders within a North African society. Over a 20-week period, 65 female participants diagnosed with vitiligo were recruited. The participants' quality of life was assessed using the Skindex-16 scale. This validated tool measures the impact of skin disease on several aspects of an individual's life, including physical, emotional, and social well-being. The findings of this study indicate that the quality of life of women with vitiligo significantly differed with age, social and functional status, and economic status. However, the illness profoundly impacted patients' lives emotionally, with clear consequences, including diminished emotional satisfaction and reduced social participation. The results of this study highlight the negative effects that vitiligo disease can have on women's quality of life within traditional Libyan society. This investigation also indicates that cultural norms and traditional gender patterns may contribute to these effects.
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Affiliation(s)
| | - Yaser Snoubar
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, 2713, Qatar.
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Mangini CSM, Vasconcelos RCFD, Rodriguez EVR, Oliveira IRLD. Social isolation: main dermatosis and the impact of stress during the COVID-19 pandemic. EINSTEIN-SAO PAULO 2022; 20:eAO6320. [PMID: 35352765 PMCID: PMC8932822 DOI: 10.31744/einstein_journal/2022ao6320] [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: 11/19/2020] [Accepted: 01/19/2021] [Indexed: 12/01/2022] Open
Abstract
Objective To analyze the pattern of triggering and exacerbation of dermatological diseases between March and July 2020 and to compare this pattern to the corresponding period of 2019. Methods This was a quantitative, descriptive, comparative and documentary study that was carried out through the retrospective analysis of medical records (March to July 2019 and 2020) of individuals assisted at a private dermatology practice service located in the southern area of the city of São Paulo (SP). Results We evaluated 992 medical consultations in 2019 and 1,176 in 2020. In 2020, we observed a significant increase in cases of telogen effluvium (276%), psoriasis (1,400%), atopic dermatitis (178%), seborrheic dermatitis (200%), herpes zoster (1,200%) and vitiligo (433%). All diseases had stress as a possible initial trigger. In addition, fragile nail syndrome and contact dermatitis, pathologies associated with behavioral measures, also had an important increase in the prevalence (6,400% and 5,500%, respectively). However, the number of aesthetic procedures decreased by approximately 54% during the pandemic period. Conclusion During the pandemic period, the pattern of incidence of dermatoses had changed compared with the previous year. An emphasis was observed on diseases triggered by a psychological component, as well as those pathologies that have behavioral measures as the main cause. For this reason, the impacts of COVID-19 is greater than only among those infected.
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Blackstone B, Patel R, Bewley A. Assessing and Improving Psychological Well-Being in Psoriasis: Considerations for the Clinician. Psoriasis (Auckl) 2022; 12:25-33. [PMID: 35371967 PMCID: PMC8965012 DOI: 10.2147/ptt.s328447] [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: 11/23/2021] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
Psoriasis is a common chronic, systemic inflammatory disease, affecting approximately 2% of the population worldwide. Psoriasis is associated with profound psychosocial comorbidity with a burden that extends well beyond the physical signs and symptoms. Psychosocial comorbidities strongly associated with psoriasis include anxiety and depression, suicidal ideation, and substance misuse. There is a substantial unmet need for access to psychological support for people with skin disease in the UK. Recent reports found that while up to 98% of patients felt that their skin disease had affected their emotional or psychological well-being, only 18% sought help. This care gap is largely due to a lack of awareness about the limited available services alongside poor recognition, diagnosis, and triaging. Addressing psychosocial support needs starts with early identification, which can be complex and challenging. Once patients who need further support are identified, outcomes can be improved through prompt and effective treatment of inflammation, cognitive behavioural therapy, meditation and mindfulness-based therapy (including motivational interviewing), and to some extent psychotropic medication. Finally, resources for mental health support are notoriously limited, with dire consequences for patients. It is imperative that a proportion of the new funding promised for mental health services is bookmarked for dermatology patients and adequate provision of multidisciplinary psychodermatology teams to best serve the needs of this population. Ultimately, psoriasis is a complex condition with multifactorial psychological and biological drivers. Psoriasis is associated with high levels of distress, which is often under-recognized. Fully addressing this condition requires a holistic approach to the physical and psychosocial aspects to maximise adherence, efficacy, and optimise patient quality of life.
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Affiliation(s)
- Brittany Blackstone
- Bart’s Health NHS Foundation Trust, London, UK
- Correspondence: Brittany Blackstone, Department of General Internal Medicine, The Royal London Hospital, Whitechapel Road, London, E1 1FR, UK, Email ; Radhika Patel, Bart's Health NHS Foundation Trust, London, UK, Email
| | - Radhika Patel
- Bart’s Health NHS Foundation Trust, London, UK
- Correspondence: Brittany Blackstone, Department of General Internal Medicine, The Royal London Hospital, Whitechapel Road, London, E1 1FR, UK, Email ; Radhika Patel, Bart's Health NHS Foundation Trust, London, UK, Email
| | - Anthony Bewley
- Barts Health NHS Trust, Queen Mary University London, London, UK
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Aktas N, Güray T, Alyanak A, Bağcı B. Anxiety, depression, COVID-19 anxiety, and the effects of hospital environment on patients presenting to dermatology outpatient clinic during the pandemic. TURKISH JOURNAL OF DERMATOLOGY 2022. [DOI: 10.4103/tjd.tjd_36_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mustafa SS, Shaker MS, Munblit D, Greenhawt M. Paediatric allergy practice in the era of coronavirus disease 2019. Curr Opin Allergy Clin Immunol 2021; 21:159-165. [PMID: 33534416 DOI: 10.1097/aci.0000000000000727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy. RECENT FINDINGS Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care. SUMMARY Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.
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Affiliation(s)
- S Shahzad Mustafa
- Department of Allergy, Immunology, & Rheumatology, Rochester Regional Health, University of Rochester School of Medicine and Dentistry
| | - Marcus S Shaker
- Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology, Lebanon
- Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Daniel Munblit
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Matthew Greenhawt
- Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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