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Stölzl D, Sander N, Siegels D, Harder I, Kind B, Fonfara M, Heinrich L, Abraham S, Neustädter I, Kleinheinz A, Gerdes S, Wollenberg A, Lau S, Nemat K, Heratizadeh A, Gellhaus I, Werfel T, Schmitt J, Weidinger S. Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry. Allergy 2024. [PMID: 38712730 DOI: 10.1111/all.16147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/08/2024]
Affiliation(s)
- D Stölzl
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - N Sander
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - D Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - I Harder
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - B Kind
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - M Fonfara
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - L Heinrich
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - I Neustädter
- Cnopfsche Children's Hospital/Neonatology, Pediatrics, DIAKONEO KdöR, Nuremberg, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - S Gerdes
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany
| | - S Lau
- Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Nemat
- Praxis für Kinderpneumologie/Allergologie, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
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Symanzik C, Heratizadeh A, Skudlik C, John SM. [Prevention and health promotion in dermatology]. Dermatologie (Heidelb) 2024; 75:377-385. [PMID: 38600365 DOI: 10.1007/s00105-024-05329-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/12/2024]
Abstract
The term prevention includes measures that are used to avoid illnesses or damage to health as well as to reduce the risk of illness or to delay its occurrence. Preventive measures can be classified based on various criteria: temporal differentiation (primary, secondary, and tertiary prevention), context (behavioral and relational prevention), and recipient (general and individual prevention). Health promotion is used when appropriate measures are intended to strengthen and increase human health potential and resources. This includes, among other things, measures to develop health-promoting behavior (empowerment) and measures regarding the planning and implementation of health-promoting behavior (participation). One goal of these measures is generally to increase health literacy. This article describes examples of prevention and health promotion measures for occupational skin cancer (counseling approach for individual sun protection for outdoor workers; "individuelle Lichtschutzberatung" [ILB]) as well as occupational hand eczema within the meaning of German occupational disease number 5101 (outpatient and inpatient individual prevention measures). These are supplemented by the example of outpatient age-adapted small group trainings for patients with atopic dermatitis according to the multicenter evaluated concept of AGNES e. V. ("Arbeitsgemeinschaft Neurodermitisschulung") and ARNE ("Arbeitsgemeinschaft Neurodermitisschulung im Erwachsenenalter"). These examples also address aspects of sustainability and digitalization (eHealth, eLearning) in the areas of prevention and health promotion.
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Affiliation(s)
- Cara Symanzik
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland
- Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland
| | - Annice Heratizadeh
- Niedersächsisches Institut für Berufsdermatologie (NIB), Osnabrück, Deutschland
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
| | - Christoph Skudlik
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland
- Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland
- Niedersächsisches Institut für Berufsdermatologie (NIB), Osnabrück, Deutschland
| | - Swen Malte John
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland.
- Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland.
- Niedersächsisches Institut für Berufsdermatologie (NIB), Osnabrück, Deutschland.
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Traidl S, Hollstein MM, Kroeger N, Fischer S, Heratizadeh A, Heinrich L, Kind B, Siegels D, Abraham S, Schäfer T, Augustin M, Harder I, Pinter A, Schäkel K, Wollenberg A, Ertner K, Ramaker-Brunke J, Bong A, Quist S, Gorriahn-Maiterth H, Schenck F, Sticherling M, Effendy I, Schwarz B, Handrick C, Asmussen A, Weidinger S, Schmitt J, Werfel T. Obesity is linked to disease severity in moderate to severe atopic dermatitis-Data from the prospective observational TREATgermany registry. J Eur Acad Dermatol Venereol 2024. [PMID: 38661511 DOI: 10.1111/jdv.20042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND There are conflicting data on a potential association between obesity and atopic dermatitis (AD). The purpose of this study was to investigate the relationship between obesity and AD disease severity. METHODS Patients from the TREATgermany registry cohort were divided into three groups according to their body mass index (BMI). Due to low numbers, underweight patients (BMI <18.5 kg/m2) were excluded from the analysis. Physician- and patient-reported disease severity scores as well as additional phenotypic characteristics were evaluated for association with BMI. Generalized linear mixed models and multinomial logit models, respectively, were applied to investigate the association of BMI, age, sex and current systemic AD treatment with disease severity. RESULTS This study encompassed 1416 patients, of which 234 (16.5%) were obese (BMI ≥30 kg/m2). Obesity was associated with lower educational background and smoking. Otherwise, obese and non-obese AD patients had similar baseline characteristics. Increased BMI was associated with higher oSCORAD (adjusted β: 1.24, 95% CI: 1.05-1.46, p = 0.013) and Patient-oriented eczema measure (POEM) (adjusted β: 1.09, 95% CI: 1.01-1.17, p = 0.038). However, the absolute difference in the overall oSCORAD was small between obese and non-obese AD patients (Δ oSCORAD = 2.5). Allergic comorbidity was comparable between all three groups, with the exception of asthma which was more pronounced in obese patients (p < 0.001). DISCUSSION In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance. The overall prevalence of obesity among the German AD patients was lower than in studies on other AD cohorts from different countries, which confirms previous research on the German population and suggests regional differences in the interdependence of AD and obesity prevalence.
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Affiliation(s)
- Stephan Traidl
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Moritz M Hollstein
- Department of Dermatology, Venereology and Allergology, University Medical Centre Göttingen, Göttingen, Germany
| | - Nadine Kroeger
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Sascha Fischer
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Luise Heinrich
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Barbara Kind
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Thomas Schäfer
- Practice Dr. med. Thomas Schaefer/Dr. med. Doreen Belz, Derma Koeln, Koeln, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital, Frankfurt am Main, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany
- Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, Germany
| | | | | | - Anne Bong
- Practice Dr. med. Anne Bong, Emmerich, Germany
| | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | | | | | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | - Isaak Effendy
- Department of Dermatology Venereology and Allergology, University Hospital - Medical School OWL - University of Bielefeld, Rosenhoehe, Bielefeld, Germany
| | | | | | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Werfel T, Heratizadeh A, Aberer W, Augustin M, Biedermann T, Bauer A, Fölster-Holst R, Kahle J, Kinberger M, Nemat K, Neustädter I, Peters E, von Kiedrowski R, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Simon D, Spindler T, Traidl-Hoffmann C, Werner RN, Wollenberg A, Worm M, Ott H. S3 guideline Atopic dermatitis: Part 2 - Systemic treatment. J Dtsch Dermatol Ges 2024; 22:307-320. [PMID: 38161245 DOI: 10.1111/ddg.15229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 01/03/2024]
Abstract
The present S3 guideline was created based on the European English-language S3 guideline, with special consideration given to the medical conditions in the German-speaking region, and with additions from the previous German-language version, in accordance with the criteria of the AWMF. This second part of the guideline addresses the systemic therapy of atopic dermatitis (AD). It covers topics such as the indication for systemic therapy in children, adolescents, and adult patients with AD. Furthermore, it addresses all medications approved for AD, such as the biologics dupilumab and tralokinumab, the Janus kinase inhibitors abrocitinib, baricitinib, and upadacitinib, as well as conventional immunosuppressive therapies with systemic glucocorticosteroids and ciclosporin. Additionally, it discusses systemic off-label therapies. The first part of the guideline, published separately, includes the definition and diagnostic aspects of AD, describes topical therapy, non-drug therapy approaches, and addresses aspects related to special patient groups.
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Affiliation(s)
- Thomas Werfel
- Department of Dermatology, Allergology and Venereology, Hannover Medical School, Hannover, Germany
| | - Annice Heratizadeh
- Department of Dermatology, Allergology and Venereology, Hannover Medical School, Hannover, Germany
| | - Werner Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Matthias Augustin
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, University Medical Center Munich, Technical University of Munich, Munich, Germany
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Regina Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Julia Kahle
- German Allergy and Asthma Association (DAAB), Mönchengladbach, Germany
| | - Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Nemat
- Office for Pediatric Pneumology and Allergology, Pediatric Center Dresden-Friedrichstadt (Kid), Dresden, Germany
| | - Irena Neustädter
- Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg, Germany
| | - Eva Peters
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen, Germany
| | | | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), Medical Faculty Gustav Carus, Technical University Dresden, Dresden, Germany
| | | | - Dagmar Simon
- Department of Dermatology, Inselspital Bern, Bern, Switzerland
| | - Thomas Spindler
- Specialized Clinic for Pediatric Pneumology and Allergology, Wangen, Germany
| | | | - Ricardo Niklas Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
- Department of Dermatology and Allergy, Ludwig Maximilian University Munich, Munich, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hagen Ott
- Department of Pediatric Dermatology and Allergology, Children's and Adolescents' Hospital Auf der Bult, Hannover, Germany
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Werfel T, Heratizadeh A, Aberer W, Augustin M, Biedermann T, Bauer A, Fölster-Holst R, Kahle J, Kinberger M, Nemat K, Neustädter I, Peters E, von Kiedrowski R, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Simon D, Spindler T, Traidl-Hoffmann C, Werner RN, Wollenberg A, Worm M, Ott H. S3-Leitlinie Atopische Dermatitis: Teil 2 - Systemische Therapie: S3 guideline Atopic dermatitis: Part 2 - Systemic treatment. J Dtsch Dermatol Ges 2024; 22:307-322. [PMID: 38361206 DOI: 10.1111/ddg.15229_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 02/17/2024]
Abstract
ZusammenfassungDie vorliegende S3‐Leitlinie wurde auf der Basis der europäischen englischsprachigen S3‐Leitlinie unter besonderer Berücksichtigung der medizinischen Gegebenheiten im deutschsprachigen Raum und mit Ergänzungen der deutschsprachigen Vorgängerversion, entsprechend den Kriterien der AWMF, erstellt. Dieser zweite Teil der Leitlinie behandelt die systemische Therapie der atopischen Dermatitis (AD). Eingegangen wird unter anderem auf die Indikationsstellung für eine Systemtherapie bei Kindern, Jugendlichen und erwachsenen Patienten mit AD. Darüber hinaus werden alle für die AD zugelassenen Medikamente wie die Biologika Dupilumab und Tralokinumab, die Januskinase‐Inhibitoren Abrocitinib, Baricitinib und Upadacitinib sowie die konventionellen immunsuppressiven Therapien mit systemischen Glukokortikosteroiden und Ciclosporin adressiert. Systemische Off‐Label‐Therapien werden ebenfalls behandelt. Der separat publizierte erste Teil der Leitlinie umfasst die Definition und diagnostischen Aspekte der AD, beschreibt die topische Therapie sowie nichtmedikamentöse Therapieverfahren und geht auf Aspekte bei besonderen Patientengruppen ein.
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Affiliation(s)
- Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Deutschland
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Deutschland
| | - Werner Aberer
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Matthias Augustin
- Kompetenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Eppendorf, Hamburg, Deutschland
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Deutschland
| | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Deutschland
| | - Regina Fölster-Holst
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
| | - Julia Kahle
- Deutscher Allergie- und Asthmabund (DAAB) e. V., Mönchengladbach, Deutschland
| | - Maria Kinberger
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Katja Nemat
- Praxis für Kinderpneumologie und Allergologie, Kinderzentrum Dresden-Friedrichstadt (Kid), Dresden, Deutschland
| | - Irena Neustädter
- Klinik Hallerwiese, Cnopfsche Kinderklinik, Nürnberg, Deutschland
| | - Eva Peters
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen (UKGM), Gießen, Deutschland
| | | | | | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Gustav Carus, Technische Universität Dresden, Deutschland
| | | | - Dagmar Simon
- Universitätsklinik für Dermatologie, Inselspital Bern, Bern, Schweiz
| | - Thomas Spindler
- Fachklinik für Pädiatrische Pneumologie und Allergologie, Wangen, Deutschland
| | | | - Ricardo Niklas Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Andreas Wollenberg
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwigs-Maximilians-Universität, München, Deutschland
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Hagen Ott
- Fachbereich Pädiatrische Dermatologie und Allergologie, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Deutschland
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6
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Werfel T, Heratizadeh A, Aberer W, Augustin M, Biedermann T, Bauer A, Fölster-Holst R, Kahle J, Kinberger M, Nemat K, Neustädter I, Peters E, von Kiedrowski R, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Simon D, Spindler T, Traidl-Hoffmann C, Werner RN, Wollenberg A, Worm M, Ott H. S3 Guideline Atopic dermatitis: Part 1 - General aspects, topical and non-drug therapies, special patient groups. J Dtsch Dermatol Ges 2024; 22:137-153. [PMID: 38171719 DOI: 10.1111/ddg.15230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 01/05/2024]
Abstract
This S3 guideline was created based on the European S3 guideline, with special consideration of the medical conditions in the German-speaking region and incorporating additions from the previous German-language version. The interdisciplinary guideline commission consisted of representatives from the German Dermatological Society, the Professional Association of German Dermatologists, the Austrian Society of Dermatology and Venereology, the Swiss Society of Dermatology and Venereology, the German Society for Allergology and Clinical Immunology, the German Society for Pediatric and Adolescent Medicine, the Professional Association of Pediatricians and Adolescent Medicine, the Society for Pediatric Allergology and Environmental Medicine, the German Society for Pediatric Rehabilitation and Prevention, the German Society for Psychosomatic Medicine and Medical Psychotherapy, the German Network for Health Services Research, the German Eczema Association and the German Allergy and Asthma Association. This first part of the guideline focuses on the definition and diagnostic aspects of atopic dermatitis (AD), addressing topical therapy as well as non-pharmacological treatment approaches such as UV therapy, psychoeducational therapy, dietary interventions for AD, allergen immunotherapy for AD, and complementary medicine. This part of the guideline also covers specific aspects of AD in children and adolescents, during pregnancy and lactation, and in the context of family planning. Additionally, it addresses occupational aspects of AD and highlights the perspective of the patients. The second part of the guideline, published separately, addresses the systemic therapy of AD.
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Affiliation(s)
- Thomas Werfel
- Department of Dermatology, Allergology and Venereology, Hannover Medical School, Hannover, Germany
| | - Annice Heratizadeh
- Department of Dermatology, Allergology and Venereology, Hannover Medical School, Hannover, Germany
| | - Werner Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Matthias Augustin
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, University Medical Center, Technical University of Munich, Munich, Germany
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Regina Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Julia Kahle
- German Allergy and Asthma Association (DAAB), Mönchengladbach, Germany
| | - Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Nemat
- Office for Pediatric Pneumology and Allergology, Pediatric Center Dresden-Friedrichstadt (Kid), Dresden, Germany
| | - Irena Neustädter
- Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg, Germany
| | - Eva Peters
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen, Germany
| | | | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), Medical Faculty Gustav Carus, Technical University Dresden, Dresden, Germany
| | | | - Dagmar Simon
- Department of Dermatology, Inselspital Bern, Bern, Switzerland
| | - Thomas Spindler
- Specialized Clinic for Pediatric Pneumology and Allergology, Wangen, Germany
| | | | - Ricardo Niklas Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
- Department of Dermatology and Allergy, Ludwig Maximilian University Munich, Munich, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hagen Ott
- Department of Pediatric Dermatology and Allergology, Children's and Adolescents' Hospital Auf der Bult, Hannover, Germany
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Heratizadeh A, Mempel M, von Kiedrowski R, Hagl S, Mosch T, Fritz B, Werfel T. Checklist identification of candidates for systemic therapy in adult patients with atopic dermatitis in Germany: A multicentre study. J Eur Acad Dermatol Venereol 2024; 38:157-166. [PMID: 37611262 DOI: 10.1111/jdv.19465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The German S2k guideline is the first to include a checklist that captures atopic dermatitis (AD) signs and symptoms as well as the lack of treatment response to identify patients eligible for systemic therapy. OBJECTIVES Identifying candidates for a start/switch of systemic therapy in adult AD patients in Germany by applying the S2k guideline's checklist. METHODS In this German multicentre, cross-sectional, non-interventional study (German Clinical Trials Register number: DRKS00023296), adult patients with mild to severe AD were enrolled at dermatological outpatient clinics and offices between April and October 2021. Demographics, clinical characteristics and quality of life were collected using questionnaires during one single visit. Eligibility for a start/switch of systemic AD therapy was evaluated according to the criteria of the German S2k guideline's checklist. RESULTS Atopic dermatitis patients (575) were included in the analysis. One hundred and sixty-four patients (28.5%) received systemic (SYS) AD therapy and 411 patients (71.5%) did not (TOP). Of the TOP therapy patients, 38.7% were eligible to start systemic AD therapy, and about half of those (49.1%), were scheduled to start systemic AD therapy. The most frequent reason deciding against a systemic therapy was the patient's wish. Although 29.3% of SYS patients were eligible for a switch according to the criteria of the German S2k guideline's checklist, the majority (81.3%) did not switch AD therapy. CONCLUSIONS This is the first study on the implementation of the German S2k guideline's checklist in everyday care of AD patients in Germany. More than one-third of the TOP patients were identified as eligible for systemic treatment. By applying the guideline's checklist criteria, another one-third of SYS patients may have benefited from a change of current systemic therapy. The use of the German S2k guideline's checklist in routine care represents an important tool to ensure effective patient care and identify inadequately treated patients.
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Affiliation(s)
- A Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - M Mempel
- Hautarztpraxis Elmshorn, Elmshorn, Germany
| | - R von Kiedrowski
- Company for Medical Study & Service Selters GmbH (CMS), Selters, Germany
| | - S Hagl
- formerly AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - T Mosch
- AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - B Fritz
- AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Werfel T, Heratizadeh A, Aberer W, Augustin M, Biedermann T, Bauer A, Fölster-Holst R, Kahle J, Kinberger M, Nemat K, Neustädter I, Peters E, von Kiedrowski R, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Simon D, Spindler T, Traidl-Hoffmann C, Werner RN, Wollenberg A, Worm M, Ott H. S3-Leitlinie Atopische Dermatitis: Teil 1- Allgemeine Aspekte, topische und nichtmedikamentöse Therapien, besondere Patientengruppen: S3 guideline Atopic dermatitis: Part 1- General aspects, topical and non-drug therapies, special patient groups. J Dtsch Dermatol Ges 2024; 22:137-155. [PMID: 38212907 DOI: 10.1111/ddg.15230_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 01/13/2024]
Abstract
ZusammenfassungDiese S3‐Leitlinie wurde auf der Basis der europäischen S3‐Leitlinie unter besonderer Berücksichtigung der medizinischen Gegebenheiten im deutschsprachigen Raum und mit Ergänzungen der deutschsprachigen Vorgängerversion erstellt. Die interdisziplinäre Leitlinienkommission bestand aus Vertretern der Deutschen Dermatologischen Gesellschaft, dem Berufsverband der Deutschen Dermatologen, der Österreichischen Gesellschaft für Dermatologie und Venerologie, der Schweizerischen Gesellschaft für Dermatologie und Venerologie, der Deutschen Gesellschaft für Allergologie und Klinische Immunologie, der Deutschen Gesellschaft für Kinder‐ und Jugendmedizin, dem Berufsverband der Kinder‐ und Jugendärzte, der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin, der Deutschen Gesellschaft für Pädiatrische Rehabilitation und Prävention, der Deutschen Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie, dem Deutschen Netzwerk Versorgungsforschung, dem Deutschen Neurodermitis Bund und dem Deutschen Allergie‐ und Asthmabund. Dieser erste Teil der Leitlinie geht auf die Definition und die diagnostischen Aspekte der atopischen Dermatitis (AD) ein, behandelt die topische Therapie sowie die nichtmedikamentösen Therapieverfahren wie die UV‐Therapie, die psychoedukative Therapie, diätische Interventionen bei AD, die Allergen‐spezifische Immuntherapie bei AD und die Komplementärmedizin. Auch behandelt dieser Teil der Leitlinie die besonderen Aspekte der AD bei Kindern und Jugendlichen, in der Schwangerschaft und in der Stillzeit sowie bei Kinderwunsch. Außerdem wird auf berufsbezogene Aspekte der AD eingegangen und die Perspektive der Patienten hervorgehoben. Der zweite, separat publizierte Teil der Leitlinie adressiert die systemische Therapie der AD.
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Affiliation(s)
- Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Deutschland
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Deutschland
| | - Werner Aberer
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Matthias Augustin
- Kompetenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Eppendorf, Hamburg, Deutschland
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Deutschland
| | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Deutschland
| | - Regina Fölster-Holst
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
| | - Julia Kahle
- Deutscher Allergie- und Asthmabund (DAAB) e. V., Mönchengladbach, Deutschland
| | - Maria Kinberger
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Katja Nemat
- Praxis für Kinderpneumologie und Allergologie, Kinderzentrum Dresden-Friedrichstadt (Kid), Dresden, Deutschland
| | - Irena Neustädter
- Klinik Hallerwiese, Cnopfsche Kinderklinik, Nürnberg, Deutschland
| | - Eva Peters
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen (UKGM), Gießen, Deutschland
| | | | | | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Gustav Carus, Technische Universität Dresden, Deutschland
| | | | - Dagmar Simon
- Universitätsklinik für Dermatologie, Inselspital Bern, Bern, Schweiz
| | - Thomas Spindler
- Fachklinik für Pädiatrische Pneumologie und Allergologie, Wangen, Deutschland
| | | | - Ricardo Niklas Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Andreas Wollenberg
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwigs-Maximilians-Universität, München, Deutschland
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Hagen Ott
- Fachbereich Pädiatrische Dermatologie und Allergologie, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Deutschland
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Forkel S, Schubert S, Corvin L, Heine G, Lang CCV, Oppel E, Pföhler C, Treudler R, Bauer A, Sulk M, Kränke B, Schäkel K, Heratizadeh A, Worm M, Witte J, Geier J, Buhl T. Contact allergies to dental materials in patients. Br J Dermatol 2023:ljad525. [PMID: 38123140 DOI: 10.1093/bjd/ljad525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy. OBJECTIVE This study was aimed at analysing current sensitization patterns to dental materials in patients with suspected contact allergy. METHODS This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected patients among 169,834 patients tested in 2005-2019, and registered with (i) an affected area of 'mouth' (and 'lips'/'perioral'), (ii) with the dental material in question belonging to three groups: dental filling materials, oral implants, or dentures or equivalents, and (iii) were patch-tested in parallel with the German baseline series, (dental) metal series, and dental technician series. RESULTS A total of 2,730 of 169,834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) and 40 years or older (92.8%). The sensitization rates with confirmed allergic contact stomatitis in female patients (n=444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates (HEMA 4.8%), and the substances propolis (6.8%) and 'balsam of Peru' (11.4%). The most relevant acrylates were HEMA, HPMA, MMA, EGDMA, and PETA. Few male patients were diagnosed with allergic contact stomatitis (n=68), and their sensitization rates were highest for propolis (14.9%) and amalgam (13.6%), but not (meth)acrylates. CONCLUSION Allergic contact stomatitis to dental materials is rare. Patch testing should focus on metals such as nickel, palladium, amalgam, and gold, but also (meth)acrylates and the natural substances propolis and 'balsam of Peru'.
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Affiliation(s)
- Susann Forkel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology, Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Lisa Corvin
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Guido Heine
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claudia C V Lang
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Eva Oppel
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical School, Homburg, Germany
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology, University Medical Center, Leipzig, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Mathias Sulk
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Birger Kränke
- Department of Dermatology and Venereology, Medical University of Graz, Austria
| | - Knut Schäkel
- Department of Dermatology, Ruprecht Karls University, Heidelberg, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Witte
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology, Institute at the University Medical Center Göttingen, Göttingen, Germany
- Lower Saxony Institute of Occupational Dermatology, University of Göttingen, Göttingen, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
- Lower Saxony Institute of Occupational Dermatology, University of Göttingen, Göttingen, Germany
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Birkner T, Siegels D, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Bell M, Fell I, Worm M, Handrick C, Effendy I, Asmussen A, Kleinheinz A, Homey B, Sticherling M, Hong-Weldemann SH, Augustin M, Weisshaar E, Schäkel K, Schaefer T, Schwarz B, Wiemers F, Brücher JJ, Quist S, Wollenberg A, Biedermann T, Ertner K, von Kiedrowski R, Werfel T, Weidinger S, Schmitt J. Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate-to-severe atopic dermatitis: Analyses of TREATgermany registry data. J Dtsch Dermatol Ges 2023; 21:1157-1168. [PMID: 37485573 DOI: 10.1111/ddg.15159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND TREATgermany is a multicenter registry including patients with moderate-to-severe atopic dermatitis (AD) from currently 74 study centers (university clinics, hospitals and practices) in Germany. As of August 31, 2021, 1,230 adult patients were enrolled. METHODS In TREATgermany, patients and physicians fill in questionnaires pertaining to symptoms, disease severity, quality of life, depressiveness, and fatigue. In particular, limitations in work performance are assessed using the Work Limitations Questionnaire (WLQ). To assess associations between occupational performance/work limitations and symptoms, correlations and regression models were calculated. RESULTS The examined sample of 228 employed patients reported an average of 6% at-work productivity loss within the past two weeks prior to enrolment in the registry. The WLQ productivity loss score was moderately associated with itch (r = 0.32) and sleep loss (r = 0.39) and strongly associated with depressive symptoms (r = 0.68) and fatigue (r = 0.60). CONCLUSIONS The analyses of the registry data show that moderate-to-severe atopic dermatitis has a negative impact on the work productivity of the patients. The analyses further point out the relevant associations between work productivity, depressive symptoms, and fatigue highlighting the disease burden caused by the psychological components of AD.
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Affiliation(s)
- Thomas Birkner
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Magnus Bell
- Practice Dr. med. Magnus Bell, Andernach, Germany
| | - Isabell Fell
- Hautmedizin Bad Soden Studienzentrum, Bad Soden, Germany
| | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Bielefeld, Germany
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | | | - Bernhard Homey
- Department of Dermatology and Allergology, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Germany
| | - Thomas Schaefer
- Practice Dr. med. Thomas Schaefer/ Dr. med. Doreen Belz, Derma Koeln, Köln, Germany
| | | | | | - Jens-Joachim Brücher
- Practice Dr. med. Jens-Joachim Brücher, Hautambulatorium Magdeburg, Magdeburg, Germany
| | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, München, Germany and Vrije Universiteit Brussel, Universitair Ziekenhuis, Department of Dermatology, Brussels, Belgium
| | - Tilo Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, München, Germany
| | | | - Ralph von Kiedrowski
- Focus Practice for chronic inflammatory dermatoses, skin cancer and allergology and also Study Center CMS3 (Company for Medical Study and Service), Selters/Westerwald, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Birkner T, Siegels D, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Bell M, Fell I, Worm M, Handrick C, Effendy I, Asmussen A, Kleinheinz A, Homey B, Sticherling M, Hong-Weldemann SH, Augustin M, Weisshaar E, Schäkel K, Schaefer T, Schwarz B, Wiemers F, Brücher JJ, Quist S, Wollenberg A, Biedermann T, Ertner K, von Kiedrowski R, Werfel T, Weidinger S, Schmitt J. Juckreiz, Schlafstörungen, depressive Symptome, Fatigue und Einschränkungen der Arbeitsproduktivität bei Patienten mit moderater bis schwerer atopischer Dermatitis: Daten aus dem TREATgermany-Register. J Dtsch Dermatol Ges 2023; 21:1157-1169. [PMID: 37845075 DOI: 10.1111/ddg.15159_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/28/2023] [Indexed: 10/18/2023]
Abstract
ZusammenfassungHintergrundTREATgermany ist ein multizentrisches Register, das Patienten mit moderater bis schwerer atopischer Dermatitis (AD) aus derzeit 74 Studienzentren (Universitätskliniken, Krankenhäuser und Praxen) in Deutschland umfasst. Bis zum 31. August 2021 wurden 1.230 erwachsene Patienten eingeschlossen.MethodenIn TREATgermany füllen Patienten und Ärzte Fragebögen zu Symptomen, Krankheitsschwere, Lebensqualität, Depressivität und Fatigue aus. Die Einschränkungen der Arbeitsleistung werden insbesondere mit dem Work Limitations Questionnaire (WLQ) erfasst. Um Assoziationen zwischen beruflicher Leistung/Arbeitseinschränkungen und Symptomen zu bestimmen, wurden Korrelationen und Regressionsmodelle berechnet.ErgebnisseDie untersuchte Stichprobe von 228 berufstätigen Patienten beschrieb einen durchschnittlichen Produktivitätsverlust von 6% bei der Arbeit innerhalb der letzten zwei Wochen vor der Aufnahme in das Register. Der WLQ‐Wert für den Produktivitätsverlust war moderat mit Juckreiz (r = 0,32) und Schlafstörungen (r = 0,39) und stark mit depressiven Symptomen (r = 0,68) und Fatigue (r = 0,60) korreliert.SchlussfolgerungenDie Analysen der Registerdaten zeigen, dass eine moderate bis schwere AD einen negativen Einfluss auf die Arbeitsproduktivität der Patienten hat. Die Analysen weisen außerdem auf die relevanten Zusammenhänge zwischen Arbeitsproduktivität, depressiven Symptomen und Fatigue hin, was die durch die psychologischen Komponenten der AD verursachte Krankheitslast verdeutlicht.
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Affiliation(s)
- Thomas Birkner
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Luise Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Eva Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Inken Harder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | | | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie am Campus Mitte (CCM), Charité - Universitätsmedizin Berlin
| | | | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | - Andrea Asmussen
- Praxis Dr. med. Andrea Asmussen, Dermatologie an der Lesum, Bremen
| | - Andreas Kleinheinz
- Klinik für Dermatologie, Allergologische Ambulanz, Elbe Klinikum Buxtehude
| | - Bernhard Homey
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf
| | | | | | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Elke Weisshaar
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
| | - Knut Schäkel
- Universitäts-Hautklinik, Universitätsklinikum Heidelberg
| | - Thomas Schaefer
- Praxis Dr. med. Thomas Schaefer/ Dr. med. Doreen Belz, Derma Köln
| | - Beate Schwarz
- Praxis Dr. med. Beate Schwarz, Dermatologie und Allergologie, Langenau
| | | | | | - Sven Quist
- Dermatologische Klinik, Helix Medical Excellence Center, Mainz
| | - Andreas Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München und Hautklinik, Vrije Universiteit Brussel, Universitair Ziekenhuis, Brüssel, Belgien
| | - Tilo Biedermann
- Klinik für Dermatologie und Allergologie, Klinikum rechts der Isar, Technischen Universität München
| | | | - Ralph von Kiedrowski
- Spezialpraxis für chronisch-entzündliche Dermatosen, Hautkrebs und Allergologie/Berufsdermatologie und Studienzentrums CMS3 (Company for Medical Study and Service), Selters/Westerwald
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Stephan Weidinger
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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Hartmann J, Moitinho-Silva L, Sander N, Harder I, Häsler R, Rodriguez E, Haufe E, Kleinheinz A, Abraham S, Heratizadeh A, Weisshaar E, Schäkel K, Handrick C, Augustin M, Wollenberg A, Staubach-Renz P, Ertner K, Sticherling M, Schwarz B, Quist S, Wiemers F, Schenck F, Wildberger J, Tittmann L, Lieb W, Schmitt J, Werfel T, Weidinger S. Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis. Allergy 2023; 78:2290-2300. [PMID: 37032440 DOI: 10.1111/all.15742] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be an indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' skin microbiome, clinical data, and response to systemic therapy in patients of the TREATgermany registry. METHODS Skin swabs of 157 patients were profiled with 16S rRNA gene amplicon sequencing before and after 3 months of treatment with dupilumab or cyclosporine. For comparison, 16s microbiome data from 258 population-based healthy controls were used. Disease severity was assessed using established instruments such as the Eczema Area and Severity Index (EASI). RESULTS We confirmed the previously shown correlation of Staphylococcus aureus abundance and bacterial alpha diversity with AD severity as measured by EASI. Therapy with Dupilumab shifted the bacterial community toward the pattern seen in healthy controls. The relative abundance of Staphylococci and in particular S. aureus significantly decreased on both lesional and non-lesional skin, whereas the abundance of Staphylococcus hominis increased. These changes were largely independent from the degree of clinical improvement and were not observed for cyclosporine. CONCLUSIONS Systemic treatment with dupilumab but not cyclosporine tends to restore a healthy skin microbiome largely independent of the clinical response indicating potential effects of IL-4RA blockade on the microbiome.
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Affiliation(s)
- Jan Hartmann
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lucas Moitinho-Silva
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Nicole Sander
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Robert Häsler
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Elke Rodriguez
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Eva Haufe
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Susanne Abraham
- Department of Dermatology, Medical Faculty Carl Gustav Carus, University Allergy Center, TU Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | | | - Michael Sticherling
- Department of Dermatology, University Hospital, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | | | | | - Julia Wildberger
- Practice Dr. med. Julia Wildberger, Hautmedizin Bad Soden, Bad Soden, Germany
| | - Lukas Tittmann
- Biobank PopGen and Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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13
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Schubert S, Geier J, Brans R, Heratizadeh A, Kränke B, Schnuch A, Bauer A, Dickel H, Buhl T, Vieluf D, Wagner N, Worm M. Patch testing hydroperoxides of limonene and linalool in consecutive patients-Results of the IVDK 2018-2020. Contact Dermatitis 2023. [PMID: 37177844 DOI: 10.1111/cod.14332] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Hydroperoxides of limonene (Lim-OOHs) and linalool (Lin-OOHs) are potent contact sensitizers. OBJECTIVES To investigate the prevalence of positive patch test (PT) reactions to Lim-OOHs and Lin-OOHs in consecutive patients, their demographic factors and concomitant reactions. METHODS Between 7/2018 and 12/2020, Lim-OOHs 0.3% pet. and Lin-OOHs 1% pet. were patch tested in 5511 consecutive patients. We assessed PT reactivity and analysed data from patients with either positive or negative PTs to Lim-OOHs and Lin-OOHs. RESULTS Positive PT results to Lim-OOHs (n = 170, 3.1%) and Lin-OOHs (n = 483, 8.8%) were frequent. Most of the positive reactions were weak (LimOOHs n = 134/LinOOHs n = 429), and even more frequently, doubtful (n = 252/n = 578) or irritant reactions (n = 81/n = 178) were documented. PT reactivity to Lim-OOHs and Lin-OOHs was increased in patients with irritant reactions to sodium lauryl sulphate (SLS). The proportion of leg dermatitis and concomitant positive reactions to fragrances and essential oils was increased in patients with reactivity to these hydroperoxides. CONCLUSION The observed reaction pattern suggests that both test preparations display an irritant potential with an increased risk of false positive reactions. Preparations should be chemically monitored in order to reduce irritancy. Mindful interpretation of PT results and aimed patch testing of lower concentrations is recommended.
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Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Birger Kränke
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Dieter Vieluf
- Department of Allergology, Photodermatology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany
| | - Nicola Wagner
- Department of Dermatology, Erlangen University Hospital, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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14
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Geier J, Brans R, Weisshaar E, Wagner N, Szliska C, Heratizadeh A, Schubert S. Contact sensitization to benzisothiazolinone: IVDK-data of the years 2002 to 2021. Contact Dermatitis 2023; 88:446-455. [PMID: 36861774 DOI: 10.1111/cod.14300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Benzisothiazolinone (BIT; CAS no. 2634-33-5) is used as a biocide in various products, including water-based paints, metalworking fluids, and household products. In recent years, increasing sensitization rates have been observed in Europe. OBJECTIVE To describe a time trend of sensitization to BIT, analyse concomitant reactions, and identify patients with increased risk of BIT sensitization. METHODS Retrospective analysis of data from 26 739 patients patch tested with BIT, sodium salt, 0.1% petrolatum as part of several special test series within the Information Network of Departments of Dermatology (IVDK), 2002 to 2021. RESULTS Positive reactions to BIT were noted in 771 patients (2.9%). Sensitization frequency varied over time and increased in recent years, peaking at 6.5% in 2020. Painters and metalworkers handling metalworking fluids, but not cleaners, had a significantly increased risk of BIT sensitization. From our data, there is no evidence of immunological cross-reactivity between BIT and other isothiazolinones. CONCLUSION The increasing frequency of sensitization justifies adding BIT to the baseline series. More research on the clinical relevance of positive patch test reactions to BIT and the cause for the rising numbers of BIT sensitization is needed. HIGHLIGHTS Frequency of sensitization to BIT has increased in recent years. The increasing frequency of sensitization justifies adding BIT to the baseline series. Painters and metalworkers handling metalworking fluids, but not cleaners, has a significantly increased risk of BIT sensitization. We found no evidence of immunological cross-reactivity between BIT and other isothiazolinones.
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Affiliation(s)
- Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Elke Weisshaar
- Unit for Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Nicola Wagner
- Department of Dermatology, University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Annice Heratizadeh
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
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15
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Weisshaar E, Bentz P, Haufe E, Heinrich L, Apfelbacher C, Heratizadeh A, Abraham S, Harder I, Kleinheinz A, Wollenberg A, Schäkel K, Wiemers F, Ertner K, Augustin M, Wildberger J, von Kiedrowski R, Worm M, Zink A, Effendy I, Asmussen A, Pawlak M, Sticherling M, Hilgers M, Handrick C, Quist S, Schwarz B, Bell M, Staubach-Renz P, Hong-Weldemann SH, Homey B, Bruecher J, Weidinger S, Werfel T, Schmitt J. Itching and treatments in atopic dermatitis (AD): results from the German AD registry TREATgermany. Br J Dermatol 2023; 188:430-432. [PMID: 36763757 DOI: 10.1093/bjd/ljac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/21/2022] [Accepted: 11/15/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Philipp Bentz
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Eva Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Christian Apfelbacher
- Institute for Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg, Regensburg, Germany.,Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Annice Heratizadeh
- Department of Dermatology, Allergy and Venerology, Hannover Medical School, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Andreas Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Germany.,Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Knut Schäkel
- Department of Dermatology, University of Heidelberg, Germany
| | | | | | - Matthias Augustin
- Institute for Health Research in Dermatology, University Medical Center Hamburg, Germany
| | | | | | - Margitta Worm
- Clinics for Dermatology, Venerology and Allergy, Charité Berlin, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, Germany
| | - Isaak Effendy
- Department of Dermatology and Allergology, Campus Bielefeld, University OWL, Germany
| | | | - Mario Pawlak
- Private Practice Dr. Anika Hünermund, Mario Pawlak, Heilbad Heiligenstadt, Germany
| | | | - Melanie Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Ecellence Center, Mainz, Germany
| | - Beate Schwarz
- Private Practice Dr. Beate Schwarz, Langenau, Germany
| | - Magnus Bell
- Private Practice Dr. Magnus Bell, Andernach, Germany
| | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Germany
| | | | - Bernhard Homey
- Department of Dermatology, University of Duesseldorf, Germany
| | | | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Thomas Werfel
- Department of Dermatology, Allergy and Venerology, Hannover Medical School, Germany
| | - Jochen Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
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16
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Weisshaar E, Bentz P, Apfelbacher C, Haufe E, Heinrich L, Heratizadeh A, Abraham S, Harder I, Kleinheinz A, Wollenberg A, Schäkel K, Wiemers F, Ertner J, Augustin M, Wildberger J, Von Kiedrowski R, Worm M, Zink A, Effendy I, Asmussen A, Pawlak M, Sticherling M, Hilgers M, Handrick C, Quist S, Schwarz B, Bell M, Staubach-Renz P, Hong-Weldemann SH, Homey B, Brücher JJ, Weidinger S, Werfel T, Schmitt J. Itching in Atopic Dermatitis: Patient- and Physician-reported Outcomes in the German Atopic Dermatitis Registry TREATgermany. Acta Derm Venereol 2023; 103:adv00854. [PMID: 36688701 PMCID: PMC10391776 DOI: 10.2340/actadv.v103.4426] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
TREATgermany is an investigator-initiated prospective disease registry. It investigates physician- and patient-reported disease severity (Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis (oSCORAD), Investigator Global Assessment, Patient-Oriented Eczema Measure (POEM), Patient Global Assessment (PGA)), patient-reported symptoms (itch, sleep loss, depressive symptoms), therapy courses and dermatological quality of life (DLQI) in moderate-to-severe atopic dermatitis with SCORAD > 20. 1,134 atopic dermatitis patients (mean age 41.0 ± 14.7 years, 42.5% females) were enrolled by 40 German recruiting sites (dermatological clinics and practices) between June 2016 and April 2021. The current analysis focuses on itch scores obtained with a numerical rating scale (NRS)) documented for the previous 3 days prior to baseline visit. The results show that 97.2% (1,090 of 1,121) patients experienced itch. Itch severity correlated moderately with severity of atopic dermatitis oSCORAD (rho = 0.44 (0.39-0.48)) and EASI score (rho = 0.41 (0.36-0.46)). A strong correlation was found with self-reported disease severity as PGA (rho = 0.68 (0.65-0.71)), POEM sum score (rho = 0.66 (0.63-0.69)) and dermatological quality of life impairment DLQI (rho = 0.61 (0.57-0.65)). Itch as a subjective complaint is more closely correlated with patient-reported outcomes than with objective assessments by the physician.
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Affiliation(s)
- Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg.
| | - Philipp Bentz
- Occupational Dermatology, Department of Dermatology, University of Heidelberg
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany; Institute for Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Eva Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden
| | - Luise Heinrich
- 4. Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | | | | | - Knut Schäkel
- Department of Dermatology, University of Heidelberg
| | | | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology, University Medical Center Hamburg Eppendorf
| | | | - Ralph Von Kiedrowski
- Focus Practice for chronic inflammatory dermatoses, skin cancer and allergology and also Study Center CMS3 (Company for Medical Study and Service), Selters/Westerwald
| | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité Berlin
| | | | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen.
| | - Mario Pawlak
- Practice Dr. med. Anika Hünermund and Mario Pawlak, Heiligenstadt
| | - Michael Sticherling
- 21. Department of Dermatology, German Center for Immunotherapy, University of Erlangen
| | - Melanie Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center, Mainz
| | | | | | | | | | - Bernhard Homey
- Department of Dermatology and Allergology, University Hospital Duesseldorf
| | | | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - Jochen Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden
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17
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Stölzl D, Sander N, Heratizadeh A, Haufe E, Harder I, Abraham S, Heinrich L, Kleinheinz A, Wollenberg A, Weisshaar E, Schäkel K, Ertner K, Wiemers F, Wildberger J, Worm M, von Kiedrowski R, Effendy I, Asmussen A, Augustin M, Pawlak M, Sticherling M, Zink A, Hilgers M, Handrick C, Quist S, Schwarz B, Staubach-Renz P, Bell M, Hong-Weldemann SH, Homey B, Brücher JJ, Schmitt J, Werfel T, Weidinger S. Real-world data on the effectiveness, safety and drug survival of dupilumab: an analysis from the TREATgermany registry. Br J Dermatol 2022; 187:1022-1024. [PMID: 35895855 DOI: 10.1111/bjd.21794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
This interim analysis from the atopic dermatitis registry TREATgermany shows robust long-term efficacy, favourable safety and high persistence of dupilumab under real life conditions.
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Affiliation(s)
- Dora Stölzl
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicole Sander
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Eva Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Germany
| | | | | | - Julia Wildberger
- Practice Dr. med. Julia Wildberger, Hautmedizin, Bad Soden, Germany
| | - Margitta Worm
- Clinics for Dermatology, Venerology and Allergy, Charité Berlin, Germany
| | | | - Isaak Effendy
- Department of Dermatology, Hospital Rosenhoehe, Bielefeld, Germany
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg-Eppendorf, Germany
| | - Mario Pawlak
- Practice Dr. med. Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - Michael Sticherling
- Department of Dermatology, University Hospital, Friedrich-Alexander-University Erlangen-Nuernberg, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich and Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Germany
| | - Melanie Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Germany
| | | | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Germany
| | - Magnus Bell
- Practice Dr. med. Magnus Bell, Thomas Kaiser, Andernach, Germany
| | | | - Bernhard Homey
- Department of Dermatology, Heinrich-Heine-University Duesseldorf, Germany
| | | | - Jochen Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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18
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Traidl S, Heratizadeh A. [Modern systemic therapies for atopic dermatitis : Which factors determine the choice of therapy?]. Hautarzt 2022; 73:529-537. [PMID: 35648139 DOI: 10.1007/s00105-022-05003-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
For the treatment of moderate to severe atopic dermatitis (AD), two groups of modern systemic therapies with a total of five drugs are currently approved in Germany: biologics (dupilumab, tralokinumab) and "small molecules" (abrocitinib, baricitinib, upadacitinib). The growing armamentarium of therapy options, especially with more than one drug per substance group, makes it challenging for practitioners to select the appropriate treatment for the individual patient. In this review article, the preconditions and requirements of each drug group as well as the corresponding substances are presented comparatively. On the one hand, direct therapeutic effects on the severity of the disease are considered and, on the other hand, the spectrum of potential adverse drug reactions are discussed. In particular, short- and long-term effects, the safety profile and the patient's concomitant diseases represent key factors for shared decision-making with regard to select the optimum personalized therapy option.
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Affiliation(s)
- Stephan Traidl
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Wassmann-Otto A, Heratizadeh A, Wichmann K, Werfel T. Microarray Analysis Confirms ImmunoCAP-Fluorescence Enzyme Immunoassay Results on Specific IgE in Patients with Atopic Dermatitis and Suspected Birch Pollen-Related Food Allergy. Int Arch Allergy Immunol 2022; 183:814-823. [PMID: 35378542 PMCID: PMC9533431 DOI: 10.1159/000522525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies demonstrated that birch pollen-related foods can cause late eczematous responses in birch pollen-sensitized patients with atopic dermatitis (AD). However, suitable markers to predict birch pollen-related food allergy in patients with AD are still lacking. Objective We evaluated the correlation of the results from ImmunoCAP® fluorescence enzyme immunoassay (FEIA) singleplex and ImmunoCAP® immuno solid-phase allergen chip (ISAC) multiplex system in AD patients and investigated the diagnostic validity of allergen microarray analysis, measuring specific IgE (sIgE) with ImmunoCAP® ISAC to predict birch pollen-related food allergy in patients with AD. Methods A total of 19 children and adults with AD, existing IgE-mediated birch pollen sensitization, and suspected birch pollen-related food allergy underwent a double-blind placebo-controlled food challenge (DBPCFC) in the clinical routine. Total and sIgE levels to birch pollen, Bet v 1, Bet v 2, and birch pollen-related foods (apple, carrot, celery, and hazelnut) were determined prior to the DBPCFC by ImmunoCAP®-FEIA. Additionally, allergen microarray ImmunoCAP® ISAC analysis was performed. Data were analyzed retrospectively. Results Twelve out of 19 patients (63% responders) experienced an allergic reaction upon DBPCFC. Overall, 7 patients (37%) developed a significant deterioration of AD with a median increase of 12.4 points in the scoring of atopic dermatitis (SCORAD) index (range 10.0–15.7). Oral allergy syndrome was the predominant immediate-type symptom (n = 11/12 responders). There were no differences in sensitization frequencies regarding allergens of the pathogenesis-related protein family 10 between responders and non-responders. In all patients, correlation of IgE levels determined with ImmunoCAP® ISAC and ImmunoCAP®-FEIA, respectively, was significant with high correlation coefficients regarding birch pollen allergen extract, rBet v 1, and rBet v 2 (r<sub>s</sub> > 0.8, p < 0.001) and lower but also significant correlation coefficients regarding food allergens (r<sub>s</sub> < 0.8, p < 0.05–<0.001). Conclusion ImmunoCAP® ISAC microarray allows displaying a differentiated sensitization profile in birch pollen-sensitized patients with AD. However, IgE-mediated sensitization against birch pollen-related allergens revealed by the allergen multiplex system does not predict late eczematous reactions upon DBPCFC with birch pollen-related foods.
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Affiliation(s)
- Anja Wassmann-Otto
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Katja Wichmann
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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20
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Farag AK, Roesner LM, Wieschowski S, Heratizadeh A, Eiz‐Vesper B, Kwok WW, Valenta R, Werfel T. Specific T cells targeting Staphylococcus aureus fibronectin-binding protein 1 induce a type 2/type 1 inflammatory response in sensitized atopic dermatitis patients. Allergy 2022; 77:1245-1253. [PMID: 34601735 DOI: 10.1111/all.15120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 08/13/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is one of the most common inflammatory skin diseases worldwide and Staphylococcus aureus colonization and secondary infections occur in the majority of AD patients. Allergic sensitizations against microbial antigens have been discussed as possible trigger factors of AD. Recently, we reported IgE sensitization against fibronectin-binding protein 1 (FBP1), an essential virulence component in S. aureus, in a subgroup of patients suffering from AD. To expand these findings by investigating delayed-type immune reactions, the objective of this study was to detect and phenotypically characterize FBP1-specific T cells as possible trigger factors in AD. METHODS Immunodominant T-cell epitopes were mapped by proliferation testing of patient-derived FBP1-specific T-cell lines after stimulation with single 15mer peptides, which were derived from different functional domains of the FBP1 sequence. Major histocompatibility complex class II tetramers carrying immunodominant epitopes successfully stained T helper cells in 8 out of 8 HLA-matched, IgE-sensitized AD patients. RESULTS Cytokine profiling of multimer-sorted cells revealed that predominantly the type 2 cytokines IL-13 and IL-4 were secreted by these cells. In contrast, IL-17, the marker cytokine for response to extracellular pathogens, was scarcely detectable. CONCLUSIONS We demonstrate that FBP1 contains immunodominant peptides that induce a specific pro-inflammatory T helper cell response with increased Th2 levels that can drive an allergic inflammation in sensitized AD patients.
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Affiliation(s)
- Ahmed K. Farag
- Division of Dermatology and Allergy Department of Immunodermatology and Allergy Research Hannover Medical School Hannover Germany
| | - Lennart M. Roesner
- Division of Dermatology and Allergy Department of Immunodermatology and Allergy Research Hannover Medical School Hannover Germany
- Cluster of Excellence RESIST (EXC 2155) Hannover Medical School Hannover Germany
| | - Susanne Wieschowski
- Division of Dermatology and Allergy Department of Immunodermatology and Allergy Research Hannover Medical School Hannover Germany
| | - Annice Heratizadeh
- Division of Dermatology and Allergy Department of Immunodermatology and Allergy Research Hannover Medical School Hannover Germany
| | - Britta Eiz‐Vesper
- Institute of Transfusion Medicine and Transplant Engineering Hannover Medical School Hannover Germany
| | - William W. Kwok
- Benaroya Research Institute at Virginia Mason Seattle Washington USA
- Department of Medicine University of Washington Seattle Washington USA
| | - Rudolf Valenta
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- NRC Institute of Immunology FMBA of Russia Moscow Russia
- Department of Clinical Immunology and Allergy Sechenov First Moscow State Medical University Moscow Russia
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Thomas Werfel
- Division of Dermatology and Allergy Department of Immunodermatology and Allergy Research Hannover Medical School Hannover Germany
- Cluster of Excellence RESIST (EXC 2155) Hannover Medical School Hannover Germany
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21
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Heratizadeh A, Roesner LM, Traidl S, Moitinho‐Silva L, Ellinghusen B, Rodriguez E, Harder I, Sapak M, Weidinger S, Badorrek P, Hohlfeld JM, Werfel T. Basic skin therapy effects on skin inflammation and microbiome composition in patients with atopic dermatitis after challenges with grass pollen. J Eur Acad Dermatol Venereol 2022; 36:e480-e483. [DOI: 10.1111/jdv.17966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/10/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- A Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - LM Roesner
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - S Traidl
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - L Moitinho‐Silva
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
- Institute of Clinical Molecular Biology Kiel University Kiel Germany
| | - B Ellinghusen
- Fraunhofer Institute of Toxicology and Experimental Medicine Hannover Germany
| | - E Rodriguez
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - I Harder
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - M Sapak
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
- Institute of Immunology Faculty of Medicine Comenius University in Bratislava, Bratislava Slovakia
| | - S Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - P Badorrek
- Fraunhofer Institute of Toxicology and Experimental Medicine Hannover Germany
| | - JM Hohlfeld
- Fraunhofer Institute of Toxicology and Experimental Medicine Hannover Germany
- Department of Respiratory Medicine Hannover Medical School Hannover Germany
- Biomedical Research in End‐Stage and Obstructive Lung Disease (BREATH) German Center for Lung Research (DZL)
| | - T Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
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22
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Wahrnehmung der Corona‐Pandemie durch Neurodermitispatienten – Ergebnisse aus dem Neurodermitisregister TREATgermany. J Dtsch Dermatol Ges 2022; 20:45-58. [PMID: 35040570 DOI: 10.1111/ddg.14655_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Claudia Helmert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Eva Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Annice Heratizadeh
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | | | - Inken Harder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Knut Schäkel
- Hautklinik, Universitätsklinikum Heidelberg, Ruprecht-Karls Universität Heidelberg
| | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | | | | | | | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie am Campus Mitte (CCM), Charité - Universitätsmedizin Berlin
| | - Uwe Schwichtenberg
- Hautpraxen Derma-nord, Derma-nord Hautarztpraxen Dr. Schwichtenberg, Bremen-Nord
| | | | | | | | | | - Thomas Werfel
- Exzellenzcluster RESIST (EXC 2155), Hannover Medizinische Hochschule Hannover
| | - Stephan Weidinger
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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23
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Perception of the coronavirus pandemic by patients with atopic dermatitis - Results from the TREATgermany registry. J Dtsch Dermatol Ges 2021; 20:45-57. [PMID: 34958179 DOI: 10.1111/ddg.14655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND TREATgermany, a registry for patients with moderate to severe atopic dermatitis (AD), established an additional questionnaire in spring 2020 to investigate the effects of the coronavirus pandemic on the daily life of patients with AD. MATERIAL AND METHODS A questionnaire was used to analyze general information regarding a patient's experience of the coronavirus pandemic and, using the Inventory of Life-Changing Events, the resulting personal burden. To analyze possible associations between disease severity (EASI score, oSCORAD, IGA, PGA, POEM), quality of life (DLQI) and personal burden, t-tests, analyses of variance and correlations were evaluated, controlled for sex and age. RESULTS 58 % (n = 233) of the included 400 registry patients reported high burden scores caused by the coronavirus pandemic, regardless of an actual infection. Men showed significantly higher burden scores than women, and younger than older respondents (both P = 0.03). There were no differences in burden scores related to the physician's assessment of disease severity. However, patients with higher quality of life impairments and higher disease severity perceived the burden of the coronavirus pandemic as less severe (DLQI P = 0.019, PGA P = 0.044). CONCLUSIONS Our data show that registry patients considered the coronavirus pandemic as a life-changing event and perceived the burden differently. This should be taken into account in the treatment of patients with moderate to severe AD as well as in further studies.
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Affiliation(s)
- Claudia Helmert
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Haufe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | | | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité Berlin, Berlin, Germany
| | | | | | - Jens Rossbacher
- Practice Jens Rossbacher/Dr. med. Klaus Spickermann, Hautzentrum, Friedrichshain, Germany
| | | | | | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Helmert C, Haufe E, Heinrich L, Siegels D, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Zink A, Pawlak M, Schäkel K, Wildberger J, Weidinger S, Werfel T, Schmitt J. Atopic dermatitis and depressive symptoms. Results of the German national AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2021; 36:e279-e282. [PMID: 34779054 DOI: 10.1111/jdv.17812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Helmert
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - D Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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25
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Pilz AC, Schielein MC, Schuster B, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Pawlak M, Schäkel K, Wildberger J, Hilgers M, Werfel T, Weidinger S, Schmitt J, Biedermann T, Zink A. Atopic Dermatitis: Disease Characteristics and Comorbidities in Smoking and Nonsmoking Patients from the TREATgermany Registry. J Eur Acad Dermatol Venereol 2021; 36:413-421. [PMID: 34743344 DOI: 10.1111/jdv.17789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/15/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. OBJECTIVES In this study AD characteristics and its atopic comorbidities are compared in smoking and nonsmoking AD patients. METHODS TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included into TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analyzed comparing AD disease characteristics and comorbidities in smokers versus non-smokers. RESULTS Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n=352; 38.8%) and nonsmokers, however lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to nonsmoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than nonsmokers. Total IgE levels were more elevated in smokers and they displayed a younger age at initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to nonsmokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet. CONCLUSIONS German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
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Affiliation(s)
- A C Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf
| | | | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg
| | | | - M Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Weisshaar E, Wiemers F, Ertner K, Schäkel K, Augustin M, Wildberger J, von Kiedrowski R, Zink A, Pawlak M, Worm M, Sticherling M, Effendy I, Hilgers M, Quist S, Asmussen A, Handrick C, Bell M, Staubauch-Renz P, Schwarz B, Hong-Weldemann SH, Homey B, Werfel T, Weidinger S, Schmitt J. Einschätzung der Erkrankungsschwere der Neurodermitis durch Ärzte und Patienten in Abhängigkeit vom Geschlecht: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany+. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- Universitäts AllergieCentrum Dresden, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitäts-klinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München
| | - E Weisshaar
- Berufsdermatologie, Klinik für Dermatologie, Universität Heidelberg
| | - F Wiemers
- Praxis Dr. Ulrike Wiemers/Dr. Franca Wiemers
| | | | - K Schäkel
- Klinik für Dermatologie, Universität Heidelberg
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf
| | | | | | - A Zink
- Klinik für Dermatologie und Allergologie, TU München & Zentrum für Umweltmedizin GmbH
| | - M Pawlak
- Praxis Dr. Anika Hünermund, Mario Pawlak
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Berlin
| | - M Sticherling
- Klinik für Dermatologie, Universität Erlangen-Nürnberg
| | - I Effendy
- Klinik für Dermatologie, Klinikum Rosenhöhe
| | - M Hilgers
- Universitätsklinikum Aachen, Uniklinik RWTH Aachen
| | | | - A Asmussen
- Praxis Dr. Andrea Asmussen, Dermatologie an der Lesum
| | | | - M Bell
- Praxis Dr. Magnus Bell, Thomas Kaiser
| | - P Staubauch-Renz
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Mainz
| | | | | | - B Homey
- Klinik für Dermatologie, Universität Düsseldorf
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Helmert C, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Wildberg J, Pawlak M, Hilgers M, Worm M, Schäkel K, Sticherling M, Effendy I, Staubach-Renz P, Handrick C, Bell M, Asmussen A, Schwarz B, Werfel T, Weidinger S, Schmitt J. Fatigue und Neurodermitis: Ergebnisse aus dem deutschen Neurodermitisregister TREATgermany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C Helmert
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- UniversitätsAllergieZentrum, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | | | - E Weisshaar
- Berufsdermatologie, Universitätsklinikum Heidelberg
| | - M Augustin
- Institut für Versorgugnsforschung in der Dermatologie und Pflegeberufe, Universitätsklinikum Hamburg-Eppendorf
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service Selters, Dermatologische Spezialpraxis
| | | | | | - M Hilgers
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Aachen
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin
| | | | | | - I Effendy
- Hautklinik, Klinikum Bielefeld Rosenhöhe
| | - P Staubach-Renz
- Universitätshautklinik und poliklinik, Universitätsmedizin Mainz
| | - C Handrick
- Praxis, für Haut- und Geschlechtskrankheiten
| | | | | | - B Schwarz
- Praxis, Dermatologie und Allergologie
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
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28
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Thormann K, Aubert H, Barbarot S, Britsch-Yilmaz A, Chernyshov P, Deleuran M, El-Hachem M, de Groot J, Heratizadeh A, Raymakers F, Stalder JF, Wollenberg A, Simon D. Position statement on the role of nurses in therapeutic patient education in atopic dermatitis. J Eur Acad Dermatol Venereol 2021; 35:2143-2148. [PMID: 34289187 DOI: 10.1111/jdv.17487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/28/2021] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
Abstract
In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased disease severity and improved quality of life in AD patients. Various healthcare professionals (dermatologists, nurses, psychologists, dieticians) have been involved. TPE performed by trained dermatology nurses are highly efficient and improve various health-related outcomes. The aim of this position paper is to analyse the aims, modalities and efficacy of TPE in AD, to identify specific roles of dermatology nurses, to assess qualification requirements, and to propose practical recommendations. Potential activities of nurses in ongoing and future TPE programmes for AD patients will be discussed.
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Affiliation(s)
- K Thormann
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - H Aubert
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - S Barbarot
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - A Britsch-Yilmaz
- Department of Paediatric Dermatology, Children's Hospital Wilhelmstift, Hamburg, Germany
| | - P Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital- IRCCS, Rome, Italy
| | - J de Groot
- National Expertise Center Constitutioneel Eczeem, University Medical Center Utrecht, Utrecht, Netherlands
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - F Raymakers
- National Expertise Center Constitutioneel Eczeem, University Medical Center Utrecht, Utrecht, Netherlands
| | - J F Stalder
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - A Wollenberg
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian University of Munich, Munich, Germany
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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29
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Traidl S, Roesner LM, Kienlin P, Begemann G, Schreiber A, Werfel T, Heratizadeh A. Temperature-controlled laminar airflow in adult atopic dermatitis patients - an observational study. J Eur Acad Dermatol Venereol 2021; 35:e812-e815. [PMID: 34242453 PMCID: PMC9292141 DOI: 10.1111/jdv.17507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/09/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- S Traidl
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - L M Roesner
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - P Kienlin
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - G Begemann
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Schreiber
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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30
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Nast A, Werner RN, Dressler C, Zidane M, Heratizadeh A, Gaskins M. [Current dermatology guidelines in Germany and Europe : A selection of clinically relevant recommendations]. Hautarzt 2021; 72:600-606. [PMID: 33666670 PMCID: PMC8238738 DOI: 10.1007/s00105-021-04775-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 12/18/2022]
Abstract
Clinical practice guidelines are systematically developed decision aids for specific medical conditions. In Germany, national dermatology guidelines are developed chiefly under the aegis of the German Dermatological Society in collaboration with the Professional Association of German Dermatologists. European and international dermatological guidelines also exist and are developed by a range of organisations, such as the European Centre for Guidelines Development, which was founded by the European Dermatology Forum in 2018. In the years 2019 and 2020, new or updated German national guidelines were published on topics such as pathological scars (hypertrophic scars and keloids), cutaneous lupus erythematosus, pyoderma grangrenosum, anal pruritus, anal eczema, anal canal and anal rim carcinomas, as well as the prevention of HPV-associated neoplasms through vaccination, syphilis and the systemic treatment of neurodermitis. A new European guideline on lichen planus closes a gap in the spectrum of guidelines available in Germany. Key recommendations and relevant changes in the guidelines are presented in this article.
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Affiliation(s)
- A Nast
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - R N Werner
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - C Dressler
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - M Zidane
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - A Heratizadeh
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - M Gaskins
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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31
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Ring J, Worm M, Wollenberg A, Thyssen JP, Jakob T, Klimek L, Bangert C, Barbarot S, Bieber T, de Bruin-Weller MS, Chernyshov PV, Christen-Zaech S, Cork M, Darsow U, Flohr C, Fölster-Holst R, Gelmetti C, Gieler U, Gutermuth J, Heratizadeh A, Hijnen DJ, von Kobyletzki LB, Kunz B, Paul C, De Raeve L, Seneschal J, Simon D, Spuls PI, Stalder JF, Svensson A, Szalai Z, Taieb A, Torrelo A, Trzeciak M, Vestergaard C, Werfel T, Weidinger S, Deleuran M. Risk of severe allergic reactions to COVID-19 vaccines among patients with allergic skin diseases - practical recommendations. A position statement of ETFAD with external experts. J Eur Acad Dermatol Venereol 2021; 35:e362-e365. [PMID: 33752263 PMCID: PMC8250791 DOI: 10.1111/jdv.17237] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Affiliation(s)
- J Ring
- Department Dermatology Allergy Biederstein, Technical University Munich, Munich, Germany
| | - M Worm
- Divison Allergy and Immunology, Department of Dermatology and Allergology, Charité University Hospital, Berlin, Germany
| | - A Wollenberg
- Department of Dermatology and Allergology, Ludwig Maximilian University Munich, Munich, Germany
| | - J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, Copenhagen, Denmark
| | - T Jakob
- Department of Dermatology, University Hospital Giessen-Marburg, Marburg, Germany
| | - L Klimek
- Allergy Center Wiesbaden, Wiesbaden, Germany
| | - C Bangert
- Department of Dermatology University, Vienna, Austria
| | - S Barbarot
- Department of Dermatology, Nantes Université, CHU Nantes UMR 1280 PhAN, INRAE, Nantes, France
| | - T Bieber
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - M S de Bruin-Weller
- National Expertise Center of Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Cork
- Sheffield Dermatology Research. Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - U Darsow
- Department Dermatology Allergy Biederstein, Technical University Munich, Munich, Germany
| | - C Flohr
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - R Fölster-Holst
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Venereology and Allergology, Kiel, Germany
| | - C Gelmetti
- Unit of Pediatric Dermatology, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - U Gieler
- Department of Dermatology, University Hospital Giessen-Marburg, Marburg, Germany
| | - J Gutermuth
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - A Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D J Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - L B von Kobyletzki
- Faculty of Medicine, University Healthcare Research Center, Lund University, Lund, Sweden.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - B Kunz
- Dermatologikum Hamburg, Hamburg, Germany
| | - C Paul
- Department of Dermatology, Toulouse University, Toulouse, France
| | - L De Raeve
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - J Seneschal
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - P I Spuls
- Department of Dermatology. Amsterdam Public Health/Infection and Immunology, Location AMC, Amsterdam, The Netherlands
| | - J F Stalder
- Department of Dermatology, Nantes Université, CHU Nantes UMR 1280 PhAN, INRAE, Nantes, France
| | - A Svensson
- Department of Dermatology, Skane University Hospital, Malmö, Sweden
| | - Z Szalai
- Department of Dermatology of Heim, Pál National Children's Institute Budapest, Budapest, Hungary
| | - A Taieb
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain
| | - M Trzeciak
- Department of Dermatology, Venereology and Allergology Medical, University of Gdansk, Gdansk, Poland
| | - C Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Venereology and Allergology, Kiel, Germany
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
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32
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Siegels D, Heratizadeh A, Abraham S, Binnmyr J, Brockow K, Irvine AD, Halken S, Mortz CG, Flohr C, Schmid‐Grendelmeier P, Poel L, Muraro A, Weidinger S, Werfel T, Schmitt J. Systemic treatments in the management of atopic dermatitis: A systematic review and meta-analysis. Allergy 2021; 76:1053-1076. [PMID: 33074565 DOI: 10.1111/all.14631] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/14/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND As an evidence resource for the currently planned European Academy of Allergy and Clinical Immunology (EAACI) clinical practice guideline "systemic treatment of atopic dermatitis (AD)," we critically appraised evidence on systemic treatments for moderate-to-severe AD. METHODS We systematically identified randomized controlled trials (RCTs) investigating the safety and efficacy of systemic treatments for AD up to February 2020. Primary efficacy outcomes were clinical signs, AD symptoms and health-related quality of life. Primary safety outcomes included cumulative incidence rates for (serious) adverse events. Trial quality was assessed applying the Cochrane Risk of Bias Tool 2.0. Meta-analyses were conducted where appropriate. RESULTS 50 RCTs totalling 6681 patients were included. Trial evidence was identified for apremilast, azathioprine (AZA), baricitinib, ciclosporin A (CSA), corticosteroids, dupilumab, interferon-gamma, intravenous immunoglobulins (IVIG), mepolizumab, methotrexate (MTX), omalizumab, upadacitinib and ustekinumab. Meta-analyses were indicated for the efficacy of baricitinib [EASI75 RD 0.16, 95% CI (0.10;0.23)] and dupilumab [EASI75, RD 0.37, 95% CI (0.32;0.42)] indicating short-term (ie 16-week treatment) superiority over placebo. Furthermore, efficacy analyses of AZA and CSA indicated short-term superiority over placebo; however, nonvalidated scores were used and can therefore not be compared to EASI. CONCLUSION The most robust, replicated high-quality trial evidence is present for the efficacy and safety of dupilumab for up to 1 year in adults. Robust trial evidence was further revealed for AZA, baricitinib and CSA. Methodological restrictions led to limited evidence-based conclusions for all other systemic treatments. Head-to-head trials with novel systemic treatments are required to clarify the future role of conventional therapies.
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Affiliation(s)
- Doreen Siegels
- Center for Evidence‐Based Healthcare University Hospital Dresden Dresden Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - Susanne Abraham
- Center for Evidence‐Based Healthcare University Hospital Dresden Dresden Germany
- Department of Dermatology Medical Faculty Carl Gustav Carus University Allergy Center TU DresdenDresden Germany
| | - Jonas Binnmyr
- The Swedish Asthma‐ and Allergy Association Stockholm Sweden
- The Swedish Asthma‐ and Allergy Research Foundation Stockholm Sweden
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich Munich Germany
| | - Alan D. Irvine
- Department of Clinical Medicine Trinity College Dublin Ireland
- Dermatology, Children’s Health Ireland National Children’s Research Centre Dublin Ireland
| | - Susanne Halken
- Hans Christian Andersen Children’s Hospital Odense University Hospital Odense Denmark
| | - Charlotte G Mortz
- Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Carsten Flohr
- Unit for Population‐Based Dermatology Research St John's Institute of Dermatology Guy’s & St Thomas' NHS Foundation Trust and King’s College London London UK
| | - Peter Schmid‐Grendelmeier
- Allergy Unit Department of Dermatology University Hospital of Zurich Zurich
- Christine‐Kuehne Center for Allergy Research and Education CK_CARE Davos Switzerland
| | - Lauri‐Ann Poel
- Department of Paediatric Allergy Guy's and St Thomas' NHS Foundation Trust UK
| | - Antonella Muraro
- Department of Woman and Child Health Food Allergy Referral Centre Padua University Hospital Padua Italy
| | - Stephan Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - Jochen Schmitt
- Center for Evidence‐Based Healthcare University Hospital Dresden Dresden Germany
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33
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Thyssen JP, Vestergaard C, Barbarot S, de Bruin-Weller MS, Bieber T, Taieb A, Seneschal J, Cork MJ, Paul C, Flohr C, Weidinger S, Trzeciak M, Werfel T, Heratizadeh A, Darsow U, Simon D, Torrelo A, Chernyshov PV, Stalder JF, Gelmetti C, Szalai Z, Svensson Å, von Kobyletzki LB, De Raeve L, Fölster-Holst R, Christen-Zaech S, Hijnen DJ, Gieler U, Gutermuth J, Bangert C, Spuls PI, Kunz B, Ring J, Wollenberg A, Deleuran M. European Task Force on Atopic Dermatitis: position on vaccination of adult patients with atopic dermatitis against COVID-19 (SARS-CoV-2) being treated with systemic medication and biologics. J Eur Acad Dermatol Venereol 2021; 35:e308-e311. [PMID: 33587756 PMCID: PMC8014632 DOI: 10.1111/jdv.17167] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, Copenhagen, Denmark
| | - C Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - S Barbarot
- Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN, INRAE, Nantes, France
| | - M S de Bruin-Weller
- National Expertise Center of Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T Bieber
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - A Taieb
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - J Seneschal
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - M J Cork
- Sheffield Dermatology Research. Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - C Paul
- Department of Dermatology, Toulouse University, Toulouse, France
| | - C Flohr
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Trzeciak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - U Darsow
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - J-F Stalder
- Department of Dermatology, CHU, Nantes, France
| | - C Gelmetti
- Department of Pathophysiology and Transplantation, University of Milan, Head, Unit of Pediatric Dermatology, Milan, Italy
| | - Z Szalai
- Department of Dermatology of Heim, Pál National Children's Institute Budapest, Budapest, Hungary
| | - Å Svensson
- Department of Dermatology, Skane University hospital, Malmö, Sweden
| | - L B von Kobyletzki
- University Healthcare Research Center, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - L De Raeve
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - R Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University clinics of Schleswig-Holstein, Kiel, Germany
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - D J Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - U Gieler
- Department of Dermatology and Allergology, University of Giessen, Giessen, Germany
| | - J Gutermuth
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - C Bangert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P I Spuls
- Department of Dermatology. Amsterdam Public Health/Infection and Immunology, Location AMC, Amsterdam, The Netherlands
| | - B Kunz
- Dermatologikum Hamburg, Hamburg, Germany
| | - J Ring
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.,Department of Dermatology I, München Klinik Thalkirchner Strasse, Munich, Germany
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
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Werfel T, Heratizadeh A, Aberer W, Ahrens F, Augustin M, Biedermann T, Diepgen T, Fölster-Holst R, Kahle J, Kapp A, Nemat K, Peters E, Schlaeger M, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Staab D, Traidl-Hoffmann C, Werner R, Wollenberg A, Worm M, Ott H. Aktualisierung„ Systemtherapie bei Neurodermitis“ zur S2k‐Leitlinie Neurodermitis. J Dtsch Dermatol Ges 2021; 19:151-169. [PMID: 33491881 DOI: 10.1111/ddg.14371_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas Werfel
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Annice Heratizadeh
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Werner Aberer
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Austria
| | | | - Matthias Augustin
- Kompetenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Eppendorf, Hamburg
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
| | - Thomas Diepgen
- Institut für Klinische Sozialmedizin, Hautklinik, Universitätsklinikum Heidelberg
| | - Regina Fölster-Holst
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Julia Kahle
- Deutscher Allergie- und Asthmabund (DAAB) e.V., Mönchengladbach
| | - Alexander Kapp
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Katja Nemat
- Praxis für Kinderpneumologie und Allergologie, Kinderzentrum Dresden-Friedrichstadt (Kid), Dresden
| | - Eva Peters
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen (UKGM), Gießen
| | | | | | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Gustav Carus, Technische Universität Dresden
| | | | - Doris Staab
- Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Charité Campus Virchow-Klinikum, Berlin
| | | | - Ricardo Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin
| | - Andreas Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwigs-Maximilians-Universität, München
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - Hagen Ott
- Fachbereich Pädiatrische Dermatologie und Allergologie, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
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35
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Werfel T, Heratizadeh A, Aberer W, Ahrens F, Augustin M, Biedermann T, Diepgen T, Fölster-Holst R, Kahle J, Kapp A, Nemat K, Peters E, Schlaeger M, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Staab D, Traidl-Hoffmann C, Werner R, Wollenberg A, Worm M, Ott H. Update "Systemic treatment of atopic dermatitis" of the S2k-guideline on atopic dermatitis. J Dtsch Dermatol Ges 2021; 19:151-168. [PMID: 33491884 DOI: 10.1111/ddg.14371] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This guideline is an update from August 2020 the S2k-guideline "Atopic dermatitis" published in 2015. The reason for updating this chapter of the guideline were the current developments in the field of systemic therapy of atopic dermatitis. The agreed recommendations for systemic treatment in atopic dermatitis of the present guideline are based on current scientific data. Due to the approval of dupilumab for the treatment of moderate to severe atopic dermatitis, which cannot be treated sufficiently with topical drugs alone, this part of the guideline has now been adapted and newly consented. The indication for systemic therapy and the therapeutic response to topical and systemic treatment should be recorded and documented in a suitable form in clinic and practice. A standardized documentation of the indication for system therapy in atopic dermatitis can be recommended and is also part of the updated chapter of this guideline.
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Affiliation(s)
- Thomas Werfel
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Annice Heratizadeh
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Werner Aberer
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Austria
| | | | - Matthias Augustin
- Kompetenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Eppendorf, Hamburg
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
| | - Thomas Diepgen
- Institut für Klinische Sozialmedizin, Hautklinik, Universitätsklinikum Heidelberg
| | - Regina Fölster-Holst
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Julia Kahle
- Deutscher Allergie- und Asthmabund (DAAB) e.V., Mönchengladbach
| | - Alexander Kapp
- Abteilung für Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Katja Nemat
- Praxis für Kinderpneumologie und Allergologie, Kinderzentrum Dresden-Friedrichstadt (Kid), Dresden
| | - Eva Peters
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen (UKGM), Gießen
| | | | | | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsforschung, Technische Universität Dresden
| | | | - Doris Staab
- Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Charité Campus Virchow-Klinikum, Berlin
| | | | - Ricardo Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin
| | - Andreas Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwigs-Maximilians-Universität, München
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - Hagen Ott
- Fachbereich Pädiatrische Dermatologie und Allergologie, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
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Wollenberg A, Christen‐Zäch S, Taieb A, Paul C, Thyssen J, Bruin‐Weller M, Vestergaard C, Seneschal J, Werfel T, Cork M, Kunz B, Fölster‐Holst R, Trzeciak M, Darsow U, Szalai Z, Deleuran M, Kobyletzki L, Barbarot S, Heratizadeh A, Gieler U, Hijnen D, Weidinger S, De Raeve L, Svensson Å, Simon D, Stalder J, Ring J. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol 2020; 34:2717-2744. [DOI: 10.1111/jdv.16892] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023]
Affiliation(s)
- A. Wollenberg
- Department of Dermatology and Allergy Ludwig‐Maximilian‐University Munich Germany
| | - S. Christen‐Zäch
- Pediatric Dermatology Unit Departments of Dermatology and Pediatrics Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
| | - A. Taieb
- University of Bordeaux Bordeaux France
| | - C. Paul
- Department of Dermatology and Allergy Toulouse University and CHU Toulouse France
| | - J.P. Thyssen
- Department of Dermatology and Allergy Herlev‐Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - M. Bruin‐Weller
- National Expertise Center for Atopic Dermatitis Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands
| | - C. Vestergaard
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - J. Seneschal
- Department of Dermatology National Reference Center for Rare Skin Diseases Bordeaux University Hospitals Bordeaux France
| | - T. Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - M.J. Cork
- Sheffield Dermatology Research IICDUniversity of Sheffield UK
| | - B. Kunz
- Dermatologikum Hamburg Hamburg Germany
| | - R. Fölster‐Holst
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - M. Trzeciak
- Department of Dermatology, Venereology and Allergology Medical University of Gdansk Gdansk Poland
| | - U. Darsow
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- ZAUM – Center of Allergy & Environment Munich Germany
| | - Z. Szalai
- Department of Dermatology Heim Pál National Children’s Institute Budapest Hungary
| | - M. Deleuran
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Kobyletzki
- School of Medical Sciences Lund University Malmö Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - S. Barbarot
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRA, F‐44000 Nantes Université Nantes France
| | - A. Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - U. Gieler
- Department of Dermatology University of Gießen and Marburg GmbH Gießen Germany
| | - D.J. Hijnen
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - S. Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - L. De Raeve
- Department of Dermatology Universitair Ziekenhuis Brussel (UZB)Free University of Brussels (VUB) Brussels Belgium
| | - Å. Svensson
- Department of Dermatology Skane University Hospital Malmö Sweden
| | - D. Simon
- Department of Dermatology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - J.F. Stalder
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRAE, F‐44000 Nantes Université Nantes France
| | - J. Ring
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- Christiane‐Kühne Center for Allergy Research and Education (CK‐Care) Davos Switzerland
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Misery L, Belloni Fortina A, El Hachem M, Chernyshov P, Kobyletzki L, Heratizadeh A, Marcoux D, Aoki V, Zaniboni M, Stalder J, Eichenfield L. A position paper on the management of itch and pain in atopic dermatitis from the International Society of Atopic Dermatitis (ISAD)/Oriented Patient‐Education Network in Dermatology (OPENED) task force. J Eur Acad Dermatol Venereol 2020; 35:787-796. [DOI: 10.1111/jdv.16916] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/21/2020] [Indexed: 02/06/2023]
Affiliation(s)
- L. Misery
- Department of Dermatology and Expert Center on Pruritus University Hospital of Brest Brest France
| | | | - M. El Hachem
- Dermatology Unit Bambino Gesù Children's HospitalIRCCS Rome Italy
| | - P. Chernyshov
- Department of Dermatology and Venereology National Medical University Kiev Ukraine
| | - L. Kobyletzki
- Department of Medical Research Lund University Malmö Sweden
- Centre for Clinical Research Örebro University Örebro Sweden
| | - A. Heratizadeh
- Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - D. Marcoux
- Division of Dermatology Department of Pediatrics University of MontrealSte‐Justine Hospital Montreal QC Canada
| | - V. Aoki
- Department of Dermatology University of Sao Paulo Medical School Sao Paulo Brazil
| | - M.C. Zaniboni
- Department of Dermatology University of Sao Paulo Medical School Sao Paulo Brazil
| | - J.‐F. Stalder
- Department of Dermatology University Hospital of Nantes Nantes France
| | - L.F. Eichenfield
- Departments of Dermatology and Pediatrics University of California San Diego CA USA
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Thyssen J, Vestergaard C, Deleuran M, Bruin‐Weller M, Bieber T, Taieb A, Seneschal J, Cork M, Paul C, Flohr C, Weidinger S, Trzeciak M, Werfel T, Heratizadeh A, Barbarot S, Darsow U, Simon D, Torrelo A, Chernyshov P, Stalder J, Gelmetti C, Szalai Z, Svensson Å, Kobyletzki L, De Raeve L, Fölster‐Holst R, Cristen‐Zaech S, Hijnen D, Gieler U, Ring J, Wollenberg A. European Task Force on Atopic Dermatitis (ETFAD): treatment targets and treatable traits in atopic dermatitis. J Eur Acad Dermatol Venereol 2020; 34:e839-e842. [DOI: 10.1111/jdv.16716] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- J.P. Thyssen
- Department of Dermatology and Allergy Herlev and Gentofte Hospital Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS) Hellerup Denmark
| | - C. Vestergaard
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - M. Deleuran
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - M.S. Bruin‐Weller
- Department of Dermatology and Allergology National Expertise Center of Atopic Dermatitis University Medical Center Utrecht Utrecht The Netherlands
| | - T. Bieber
- Department of Dermatology and Allergy University Hospital of Bonn Bonn Germany
| | - A. Taieb
- Department of Adult and Pediatric Dermatology CHU Bordeaux University of Bordeaux Bordeaux France
| | - J. Seneschal
- Department of Adult and Pediatric Dermatology CHU Bordeaux University of Bordeaux Bordeaux France
| | - M.J. Cork
- Department of Infection, Immunity and Cardiovascular Disease Sheffield Dermatology Research The University of Sheffield Sheffield UK
| | - C. Paul
- Department of Dermatology Toulouse University Toulouse France
| | - C. Flohr
- St John’s Institute of Dermatology King’s College London and Guy’s & St Thomas’ NHS Foundation Trust London UK
| | - S. Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - M. Trzeciak
- Department of Dermatology, Venereology and Allergology Medical University of Gdansk Gdansk Poland
| | - T. Werfel
- Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - A. Heratizadeh
- Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - S. Barbarot
- Department of Dermatology UMR 1280 PhAN INRAE CHU Nantes Nantes Université Nantes France
| | - U. Darsow
- Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich Germany
| | - D. Simon
- Department of Dermatology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - A. Torrelo
- Department of Dermatology Hospital Infantil Niño Jesús Madrid Spain
| | - P.V. Chernyshov
- Department of Dermatology and Venereology National Medical University Kiev Ukraine
| | | | - C. Gelmetti
- Unit of Pediatric Dermatology Department of Pathophysiology and Transplantation University of Milan Milan Italy
| | - Z. Szalai
- Department of Dermatology of Heim Pál National Children’s Institute Budapest Budapest Hungary
| | - Å. Svensson
- Department of Dermatology Skane University Hospital Malmö Sweden
| | - L.B. Kobyletzki
- Faculty of Medicine University Healthcare Research Center Lund University Lund Sweden
- Department of Occupational and Environmental Dermatology Lund University Skåne University Hospital Malmö Sweden
| | - L. De Raeve
- Department of Dermatology Universitair Ziekenhuis Brussel (UZB) Free University of Brussels (VUB) Brussels Belgium
| | - R. Fölster‐Holst
- University Clinics of Schleswig‐Holstein Campus Kiel Dermatology, Venereology and Allergology Kiel Germany
| | - S. Cristen‐Zaech
- Pediatric Dermatology Unit Departments of Dermatology and Pediatrics Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
| | - D. Hijnen
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - U. Gieler
- Department of Dermatology and Allergology University of Giessen Giessen Germany
| | - J. Ring
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - A. Wollenberg
- Department of Dermatology and Allergy Ludwig‐Maximilian University Munich Germany
- Department of Dermatology I München Klinik Thalkirchner Strasse Munich Germany
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Möbus L, Rodriguez E, Harder I, Stölzl D, Boraczynski N, Gerdes S, Kleinheinz A, Abraham S, Heratizadeh A, Handrick C, Haufe E, Werfel T, Schmitt J, Weidinger S. Atopic dermatitis displays stable and dynamic skin transcriptome signatures. J Allergy Clin Immunol 2020; 147:213-223. [PMID: 32615169 DOI: 10.1016/j.jaci.2020.06.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Skin transcriptome studies in atopic dermatitis (AD) showed broad dysregulation as well as "improvement" under therapy. These observations were mainly made in trials and based on microarray data. OBJECTIVES Our aim was to explore the skin transcriptome and the impact of systemic treatment in patients of the TREATgermany registry. METHODS Biopsy specimens from 59 patients with moderate-to-severe AD before and 30 patients 12 weeks after start of systemic treatment (dupilumab [n = 22] or cyclosporine [n = 8]) and from 31 healthy controls were subjected to mRNA sequencing. Differential expression, pathway enrichment, correlation, and coexpression network analysis were conducted. RESULTS Both lesional and nonlesional skin showed a stable "core" signature characterized by disturbed epidermal differentiation and activation of IL-31/IL-1 signaling. A second dynamic signature showed progressive enrichment for type 2 inflammation, TH17 signaling, and natural killer cell function. Markers correlated with disease activity have functions in epidermal barrier properties and immune modulation. IL4RA was among the top 3 central dysregulated genes. Cyclosporine led to a more pronounced global transcriptome reversion and normalized TH17 cell/IL23 signaling, whereas dupilumab led to a stronger increase in level of epidermal differentiation markers. Both treatments strongly decreased levels of type 2 markers, but overall the residual profile was still profoundly different from that of healthy skin. Lower levels of IL4RA and IL13 and high IL36A expression were related to a stronger clinical response to dupilumab. CONCLUSION The AD core signature is characterized by dysregulation of genes related to keratinocyte differentiation and itch signaling. A dynamic signature reflects progressive immune responses dominated by type 2 cytokines with an additional role of TH17 and natural killer cell signaling.
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Affiliation(s)
- Lena Möbus
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Elke Rodriguez
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Inken Harder
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dora Stölzl
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicole Boraczynski
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sascha Gerdes
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Susanne Abraham
- University Allergy Centre, Carl Gustav Carus University Medical Centre, TU Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology, Allergy, and Venereology, Hannover Medical School, Hannover, Germany
| | - Christiane Handrick
- Practice for Dermatology and Venereology, Christiane Handrick, MD, Berlin, Germany
| | - Eva Haufe
- Center for Evidence-Based Health Care, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology, Allergy, and Venereology, Hannover Medical School, Hannover, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Health Care, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
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40
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Fricke D, Becker A, Heratizadeh A, Knigge S, Jütte L, Wollweber M, Werfel T, Roth BW, Glasmacher B. Mueller Matrix Analysis of Collagen and Gelatin Containing Samples Towards More Objective Skin Tissue Diagnostics. Polymers (Basel) 2020; 12:polym12061400. [PMID: 32580462 PMCID: PMC7361993 DOI: 10.3390/polym12061400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 11/19/2022] Open
Abstract
Electrospun polycaprolactone:gelatin (PCL:GT) fibre scaffolds are widely employed in the field of tissue implants. Here, the orientation of fibres plays an important role in regard to implantation due to the impact on the mechanical properties. Likewise, the orientation of collagen fibres in skin tissue is relevant for dermatology. State-of-the-art fibre orientation measurement methods like electron microscopy are time consuming and destructive. In this work, we demonstrate polarimetry as a non-invasive approach and evaluate its potential by measuring the Mueller matrix (MM) of gelatin and collagen containing samples as simple skin tissue phantoms. We demonstrate that it is possible to determine the orientation of PCL:GT fibre scaffolds within one MM measurement. Furthermore, we determine the structural orientation in collagen film samples. Currently, the diagnosis of skin diseases is often performed by image analysis or histopathology respectively, which are either subjective or invasive. The method presented, here, provides an interesting alternative approach for such investigations. Our findings indicate that the orientation of collagen fibres within skin lesions might be detectable by MM measurements in the future, which is of interest for skin diagnostics, and will be further investigated during the next step.
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Affiliation(s)
- Dierk Fricke
- Hannover Centre for Optical Technologies (HOT), Leibniz University Hannover, 30167 Hannover, Germany; (L.J.); (M.W.); (B.W.R.)
- Correspondence:
| | - Alexander Becker
- Institute for Multiphase Processes (IMP), Leibniz University Hannover, 30167 Hannover, Germany; (A.B.); (S.K.); (B.G.)
- Implant Research and Development (NIFE), Lower Saxony Centre for Biomedical Engineering, 30625 Hannover, Germany
| | - Annice Heratizadeh
- Hannover Medical School, Department of Dermatology and Allergy, 30625 Hannover, Germany; (A.H.); (T.W.)
| | - Sara Knigge
- Institute for Multiphase Processes (IMP), Leibniz University Hannover, 30167 Hannover, Germany; (A.B.); (S.K.); (B.G.)
- Implant Research and Development (NIFE), Lower Saxony Centre for Biomedical Engineering, 30625 Hannover, Germany
| | - Lennart Jütte
- Hannover Centre for Optical Technologies (HOT), Leibniz University Hannover, 30167 Hannover, Germany; (L.J.); (M.W.); (B.W.R.)
| | - Merve Wollweber
- Hannover Centre for Optical Technologies (HOT), Leibniz University Hannover, 30167 Hannover, Germany; (L.J.); (M.W.); (B.W.R.)
- Laser Zentrum Hannover e.V., 30419 Hannover, Germany
| | - Thomas Werfel
- Hannover Medical School, Department of Dermatology and Allergy, 30625 Hannover, Germany; (A.H.); (T.W.)
| | - Bernhard Wilhelm Roth
- Hannover Centre for Optical Technologies (HOT), Leibniz University Hannover, 30167 Hannover, Germany; (L.J.); (M.W.); (B.W.R.)
- Cluster of Excellence PhoenixD, Leibniz University Hannover, 30167 Hannover, Germany
| | - Birgit Glasmacher
- Institute for Multiphase Processes (IMP), Leibniz University Hannover, 30167 Hannover, Germany; (A.B.); (S.K.); (B.G.)
- Implant Research and Development (NIFE), Lower Saxony Centre for Biomedical Engineering, 30625 Hannover, Germany
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Wollenberg A, Flohr C, Simon D, Cork M, Thyssen J, Bieber T, Bruin‐Weller M, Weidinger S, Deleuran M, Taieb A, Paul C, Trzeciak M, Werfel T, Seneschal J, Barbarot S, Darsow U, Torrelo A, Stalder J, Svensson Å, Hijnen D, Gelmetti C, Szalai Z, Gieler U, De Raeve L, Kunz B, Spuls P, Kobyletzki L, Fölster‐Holst R, Chernyshov P, Christen‐Zaech S, Heratizadeh A, Ring J, Vestergaard C. European Task Force on Atopic Dermatitis statement on severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2) infection and atopic dermatitis. J Eur Acad Dermatol Venereol 2020; 34:e241-e242. [DOI: 10.1111/jdv.16411] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Heratizadeh A, Haufe E, Stölzl D, Abraham S, Heinrich L, Kleinheinz A, Wollenberg A, Weisshaar E, Augustin M, Wiemers F, Zink A, von Kiedrowski R, Hilgers M, Worm M, Pawlak M, Sticherling M, Fell I, Handrick C, Schäkel K, Staubach-Renz P, Asmussen A, Schwarz B, Bell M, Effendy I, Bieber T, Homey B, Gerlach B, Tchitcherina E, Stahl M, Schwichtenberg U, Rossbacher J, Buck P, Mempel M, Beissert S, Biedermann T, Weidinger S, Schmitt J, Werfel T. Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2020; 34:1263-1272. [PMID: 31721316 DOI: 10.1111/jdv.16078] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/17/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND The Atopic Dermatitis (AD) TREATgermany registry was initiated by the German Society for Dermatology (DDG) in 2011 to evaluate the 'real-life' situation of health care for patients with AD. OBJECTIVES Interim data analysis on baseline characteristics as well as current and prescribed systemic treatments of the TREATgermany registry patients. METHODS Patients (≥18 years) with moderate-to-severe AD [objective (o)SCORAD > 20], or with current or previous anti-inflammatory systemic treatment for AD within 24 months, were included and are followed up over at least 24 months. To assess clinical signs, the eczema area severity index (EASI, 0-72), the oSCORAD (0-83) and the Investigator Global Assessment (IGA; 6-point scale) were used. The disease severity was globally scored by the patients [Patient Global Assessment (PGA); six-step Likert scale]. Disease symptoms were assessed by the patient-oriented eczema measure (POEM, 0-28) and numeric rating scales (NRS, 0-10). Health-related quality of life was measured using the dermatological life quality index (DLQI, 0-30). RESULTS A total of 612 patients were recruited across 32 sites between 06/2016 and 01/2019 (mean age: 42.6 ± 14.2 years; mean oSCORAD: 40.8 ± 16.3). The mean POEM score was 16.3 ± 7.5. Pruritus was rated highest among subjective symptoms (NRS: 5.4 ± 2.7). The mean DLQI value was 11.3 ± 7.5. The frequency of arterial hypertension was lower (20.8%) compared with the general population, whilst this was higher for depression (10%). More than 60% of the patients had received systemic glucocorticosteroids, and 36.8% had received cyclosporine A prior to inclusion. Dupilumab was the leading substance documented as either 'current' (12.1%) or 'prescribed' (31.4%) at baseline. CONCLUSIONS These 'real-life' data clearly demonstrate the substantial disease burden. Most of TREATgermany patients were already treated with or prescribed dupilumab at baseline. Moreover, current findings indicate the urgent need for further alternative agents in order to achieve a perceptible improvement of quality of life of patients with moderate-to-severe AD.
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Affiliation(s)
- A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - E Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - D Stölzl
- Department of Dermatology and Allergy, Center for Inflammatory Skin Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Augustin
- Insitute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Munich, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - M Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Aachen, Germany
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Pawlak
- Practice Dr. med. Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital, Friedrich Alexander University Erlangen-Nurnberg, Erlangen, Germany
| | - I Fell
- Hautmedizin Bad Soden, Bad Soden, Germany
| | - C Handrick
- Practice Dr. med. Christiane Handrick, Berlin, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - P Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | - A Asmussen
- Practice Dermatologie an der Lesum, Bremen, Germany
| | - B Schwarz
- Practice Dr. med. Beate Schwarz, Langenau, Germany
| | - M Bell
- Practice Dr. Magnus Bell, Thomas Kaiser, Andernach, Germany
| | - I Effendy
- Department of Dermatology, Hospital Rosenhoehe, Bielefeld, Germany
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - B Homey
- Department of Dermatology, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany
| | - B Gerlach
- Practice Dr. med. Beatrice Gerlach, Dresden, Germany
| | - E Tchitcherina
- Practice Dr. med. Ekaterina Tchitcherina, Friedberg/Hessen, Germany
| | - M Stahl
- Practice Dr. med. Maren Stahl, Osterode, Germany
| | | | | | - P Buck
- Goldbek Medical, Hamburg, Germany
| | - M Mempel
- Practice Prof. Dr. med. Martin Mempel, Elmshorn, Germany
| | - S Beissert
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Munich, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, Center for Inflammatory Skin Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Abraham S, Haufe E, Harder I, Heratizadeh A, Kleinheinz A, Wollenberg A, Weisshaar E, Augustin M, Wiemers F, Zink A, Biedermann T, von Kiedrowski R, Hilgers M, Worm M, Pawlak M, Sticherling M, Fell I, Handrick C, Schäkel K, Staubach P, Asmussen A, Schwarz B, Bell M, Neubert K, Effendy I, Bieber T, Homey B, Gerlach B, Tchitcherina E, Stahl M, Schwichtenberg U, Rossbacher J, Buck P, Mempel M, Beissert S, Werfel T, Weidinger S, Schmitt J. Implementation of dupilumab in routine care of atopic eczema: results from the German national registry TREATgermany. Br J Dermatol 2020; 183:382-384. [PMID: 32068242 DOI: 10.1111/bjd.18958] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- S Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Beissert
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Heratizadeh A, Werfel T. Der Wahrheit auf der Spur: Atopische Dermatitis und psychosoziale Komorbidität. J Dtsch Dermatol Ges 2020; 18:87-88. [DOI: 10.1111/ddg.14025_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Heratizadeh A, Fricke D, Meinhardt-Wollweber M, Roth B, Werfel T. Non-contact remote digital dermoscopy - new perspectives on differential diagnosis of inflammatory skin diseases. J Eur Acad Dermatol Venereol 2019; 34:e125-e126. [PMID: 31710132 DOI: 10.1111/jdv.16056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D Fricke
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - M Meinhardt-Wollweber
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - B Roth
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Weidinger S, Stölzl D, Abraham S, Haufe E, Heratizadeh A, Werfel T, Schmitt J. 127 TREATGermany registry: “real-world effectiveness” of dupilumab in atopic dermatitis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wassmann‐Otto A, Heratizadeh A, Wichmann K, Werfel T. Birch pollen-related foods can cause late eczematous reactions in patients with atopic dermatitis. Allergy 2018; 73:2046-2054. [PMID: 29654628 DOI: 10.1111/all.13454] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have indicated that in patients with atopic dermatitis (AD) and birch pollen allergy pollen-related foods are able to cause late eczematous response. However, the relevance of AD worsening by ingestion of birch pollen-related foods is still a matter of debate. OBJECTIVE The purpose of this retrospective study was to determine how frequently birch pollen-related foods induce a deterioration of eczema. Additionally, the diagnostic value of specific IgE (sIgE) determination was evaluated. METHODS A total of 182 children and adults with AD and suspected birch pollen-related food allergy underwent 261 double-blind placebo-controlled food challenges (DBPCFC). Total and sIgE levels were determined prior to DBPCFC. RESULTS Sixty-five patients developed allergic reactions (responders) upon DBPCFC with birch pollen-related foods (n = 103 DBPCFC). Of these, 32 patients exhibited significant deterioration of AD defined as a median increase of 15.4 severity scoring of atopic dermatitis index points (95% CI 12.4-16.3) from baseline making up 37% of all positive reactions. Responders showed significantly higher sIgE levels to birch pollen and apple as well as a higher prevalence of allergic rhinoconjunctivitis compared to nonresponders (P < .05). However, patients with late eczematous response could not be differentiated from those with isolated immediate-type reactions by sIgE levels. CONCLUSION In a subpopulation of patients with AD and birch pollen sensitization, related foods should be considered as a trigger for an aggravation of eczema. As sufficient markers for prediction of late eczematous reactions are still lacking, DBPCFC cannot be replaced in diagnosis of birch pollen-related foods in patients with AD. CLINICAL IMPLICATIONS In patients with AD and birch pollen allergy, birch pollen-related foods should be considered as a provocation factor for an aggravation of disease signs and symptoms.
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Affiliation(s)
- A. Wassmann‐Otto
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - A. Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - K. Wichmann
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - T. Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
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Haufe E, Abraham S, Heratizadeh A, Harder I, Zink A, Weisshaar E, Kleinheinz A, von Kiedrowski R, Worm M, Bell M, Wollenberg A, Neubert K, Staubach-Renz P, Hilgers M, Bieber T, Fell I, Homey B, Effendy I, Mempel M, Schäkel K, Beissert S, Weidinger S, Werfel T, Schmitt J. Verminderte berufliche Leistungsfähigkeit und Lebensqualität bei Patienten mit moderater bis schwerer Neurodermitis. Hautarzt 2018; 69:815-824. [DOI: 10.1007/s00105-018-4261-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Haufe E, Heratizadeh A, Weidinger S, Werfel T, Schmitt J. Gesundheitsökonomische Aspekte des Atopischen Ekzems: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- E Haufe
- Medizinische Fakultät und Universitätsklinikum der TU Dresden, Zentrum für Evidenzbasierte Gesundheitsversorgung, Dresden, Deutschland
| | - A Heratizadeh
- Medizinische Hochschule Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Hannover, Deutschland
| | - S Weidinger
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Zentrum für entzündliche Hauterkrankungen, Kiel, Deutschland
| | - T Werfel
- Medizinische Hochschule Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Hannover, Deutschland
| | - J Schmitt
- Medizinische Fakultät und Universitätsklinikum der TU Dresden, Zentrum für Evidenzbasierte Gesundheitsversorgung, Dresden, Deutschland
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Heratizadeh A, Werfel T, Gieler U, Kupfer J. Neurodermitis-Erwachsenenschulung nach dem Konzept der „Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene“ (ARNE). Hautarzt 2018; 69:225-231. [DOI: 10.1007/s00105-018-4125-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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