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Baumann K, Jørgensen AHR, Sørensen JA, Zhang DG, Ghazanfar MN, Skov PS, Woetmann A, Vestergaard C, Maurer M, Thomsen SF. Positive basophil histamine release assay predicts insufficient response to standard-dosed omalizumab in patients with chronic spontaneous urticaria. Clin Exp Allergy 2023; 53:1318-1321. [PMID: 37771063 DOI: 10.1111/cea.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Katrine Baumann
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- RefLab ApS, Copenhagen, Denmark
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Astrid-Helene Ravn Jørgensen
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jennifer Astrup Sørensen
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Ditte Georgina Zhang
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Misbah Noshela Ghazanfar
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Anders Woetmann
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Christian Vestergaard
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology and Venerology, Aarhus University Hospital, Aarhus, Denmark
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Simon Francis Thomsen
- Urticaria Center of Reference and Excellence (UCARE), Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ali Z, Robert Zibert J, Dahiya P, Bachdal Johansen C, Grønlund Holm J, Ravn Jørgensen AH, Manole I, Suru A, Egeberg A, Francis Thomsen S, Andersen AD. Mild to moderate severity of psoriasis may be assessed remotely based on photographs and self-reported extent of skin involvement. JAAD Int 2023; 11:129-136. [PMID: 37128265 PMCID: PMC10148150 DOI: 10.1016/j.jdin.2023.02.004] [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] [Accepted: 02/12/2023] [Indexed: 02/24/2023] Open
Abstract
Background Remote monitoring was used to assess and manage skin diseases. Objective To investigate to what extent smartphone photographs along with a self-reported body region (BR) score can be used to evaluate psoriasis severity. Methods Psoriasis severity was assessed in the clinic using the psoriasis area and severity index and the physician's global assessment. On the same day, the patients took a photograph of a representative lesion from 4 BR (head/neck, upper limbs, trunk, and lower limbs) and completed a questionnaire about BR score. The photographs were rated by 5 dermatologists. Intraclass correlation coefficients with 95% CIs were calculated. Results Overall, 32 were included, of which 6% had almost clear, 69% had mild, and 25% had moderate psoriasis. Perfect agreement between the self-reported and the doctors' BR score was observed for 59%, and near-perfect agreement (deviation of maximum 1 score) was 92%. The intraclass correlation coefficient between clinical and photographic psoriasis area and severity index was 0.78 (95% CI, 0.55-0.90), and for physician's global assessment, perfect agreement was 53%. Conclusions The agreement between psoriasis severity assessed clinically and by photographs was good in a study setting. This gives the opportunity to remotely assess psoriasis severity by combining photographs with self-reported BR scores.
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Affiliation(s)
- Zarqa Ali
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
- Correspondence to: Zarqa Ali, MD, PhD, Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.
| | - John Robert Zibert
- Studies&Me A/S, Copenhagen, Denmark
- Future-Brain Aps, Copenhagen, Denmark
| | | | - Cæcilie Bachdal Johansen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - Jesper Grønlund Holm
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | | | - Ionela Manole
- Studies&Me A/S, Copenhagen, Denmark
- Department of Dermatology, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - Alina Suru
- Studies&Me A/S, Copenhagen, Denmark
- Paediatric Dermatology Discipline, Dermatology Research Unit, Colentina Clinical Hospital; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexander Egeberg
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Holm Nielsen S, Groen SS, Yao Y, Jørgensen AHR, Nielsen VW, Karsdal M, Gehring K, Bay-Jensen AC, Thomsen SF. Biomarkers of Tissue Turnover and Systemic Inflammation Are Associated with Disease Severity and Activity in Patients with Hidradenitis Suppurativa. J Invest Dermatol 2023; 143:328-331.e3. [PMID: 36108804 DOI: 10.1016/j.jid.2022.08.049] [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: 04/21/2022] [Revised: 08/05/2022] [Accepted: 08/16/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Signe Holm Nielsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark; ImmunoScience, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - Solveig Skovlund Groen
- ImmunoScience, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yiqiu Yao
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | | | - Morten Karsdal
- ImmunoScience, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | - Kristoffer Gehring
- ImmunoScience, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | | | - Simon Francis Thomsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
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4
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Yao Y, Ghazanfar MN, Ravn Jørgensen AH, Ring HC, Thomsen SF. Adalimumab for the Treatment of Periodontitis in a 35-Year-Old Woman with Hidradenitis Suppurativa. Case Rep Dermatol 2023; 15:5-9. [PMID: 36619701 PMCID: PMC9818680 DOI: 10.1159/000528139] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/06/2022] [Indexed: 01/07/2023] Open
Abstract
Increasing evidence suggests an association between chronic inflammatory conditions and oral health. Herein, we present a case of a 35-year-old woman with concomitant hidradenitis suppurativa (HS) and periodontitis, who was treated successfully with adalimumab. After 3 months of treatment, a marked improvement was observed in her clinical scores of HS, quality of life, as well as her gingival pain and signs of inflammation. This finding calls for a closer collaboration between dermatologists and dentists to further explore the possible beneficial role of biologic therapy for chronic inflammatory skin conditions as well as periodontitis.
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Affiliation(s)
- Yiqiu Yao
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Misbah Noshela Ghazanfar
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Hans Christian Ring
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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5
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Jørgensen AHR, Nielsen VW, Yao Y, Ring HC, Thomsen SF. Anemia in Patients with Hidradenitis Suppurativa: Prevalence and Risk Factors in a Hospital-Based Cohort. Skinmed 2021; 19:432-437. [PMID: 35022114] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We examined the prevalence and risk factors of anemia in patients with hidradenitis suppurativa (HS). The presence of anemia and information on risk factors was obtained through interview, clinical examination, and blood samples in a cohort of 367 consecutive patients with HS. The overall prevalence of anemia was 9.3% (11.4% in men and 8.1% in women). Altogether 7.9%, 7.0%, and 20.4% of patients with Hurley stage I, II, and III were anemic, respectively. Risk factors for anemia included increasing age, nonwhite ethnicity, sporadic (nonfamilial) HS, concomitant inflammatory bowel disease (IBD), absence of hypertension, and absence of infected lesions in the preceding month. We found significant inverse correlations between hemoglobin level and inflammatory markers in the blood. There were significant correlations between hemoglobin and lipid levels, and between lipid levels and inflammatory markers. Hemoglobin levels are lower in patients with more severe HS and with more chronic inflammatory burden compared to those with less disease severity. Older age, nonwhite ethnicity, sporadic (nonfamilial) HS, and IBD are the risk factors of anemia.
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Affiliation(s)
| | | | - Yiqiu Yao
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Jørgensen AHR, Yao Y, Thomsen SF, Ring HC. Treatment of hidradenitis suppurativa with tetracycline, doxycycline, or lymecycline: a prospective study. Int J Dermatol 2021; 60:785-791. [PMID: 33660281 DOI: 10.1111/ijd.15459] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/09/2020] [Accepted: 01/20/2021] [Indexed: 02/06/2023]
Abstract
AIM To evaluate the clinical efficacy of tetracycline, doxycycline, and lymecycline in patients with hidradenitis suppurativa (HS). METHODS A prospective study of three different treatment regimens in patients with HS; oral tetracycline 500 mg twice daily, oral doxycycline 100 mg twice daily, and oral lymecycline 300 mg twice daily were administered in patients with HS. Outcomes were change in Hidradenitis Suppurativa Score (HSS), Dermatology Life Quality Life index (DLQI), overall disease-related distress, boil-related pain, number of boils in the preceding month, fraction of patients with no boils in the preceding month, and Physician's Global Assessment (PGA) score at follow-up. RESULTS In total, 108 patients, 73 (67.6%) women and 35 (32.4%) men, were included. Mean duration of treatment was 4.3 months. The mean HSS at baseline was 26.10 (SD 20.18) points, improving to 17.97 (SD 17.88) at follow-up, difference is 8.13 (95% CI 5.21-10.93), P < 0.0001. Highest improvement in HSS was observed in the tetracycline group. After multivariate adjustment, higher reduction in HSS was significantly associated with lower BMI, Hurley stage III, higher HSS at baseline, and higher number of boils in the preceding month at baseline. CONCLUSION Oral treatment with tetracycline, doxycycline, and lymecycline appears effective and safe in HS patients. Tetracycline provided the greatest clinical improvement measured by HSS.
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Affiliation(s)
| | - Yiqiu Yao
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
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Jørgensen AHR, Aarestrup J, Baker JL, Thomsen SF. Association of Birth Weight, Childhood Body Mass Index, and Height With Risk of Hidradenitis Suppurativa. JAMA Dermatol 2021; 156:746-753. [PMID: 32347905 DOI: 10.1001/jamadermatol.2020.1047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance There is a lack of evidence on the association of birth weight, childhood body mass index (BMI), change in BMI during childhood, and childhood height with subsequent risks of hidradenitis suppurativa (HS) in adulthood. Objective To investigate the association of birth weight, childhood BMI, change in BMI during childhood, and childhood height with subsequent risks of HS in adulthood in a large Danish population-based cohort. Design, Setting, and Participants This cohort study included 347 200 schoolchildren from the Copenhagen School Health Records Register born from 1930 to 1996 who were linked to the Danish National Patient Register of hospital discharge diagnoses to identify cases of HS. Birth weight was reported by parents or guardians, whereas childhood weight and height were measured by school physicians or nurses at ages 7 through 13 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% CIs. Statistical analysis was performed from February 20, 2019, to May 15, 2019. Main Outcomes and Measures A diagnosis of HS as recorded in the Danish National Patient Register. Results Among the 347 200 children included in the study (175 750 boys) during the follow-up period from 1977 to 2017, 1037 individuals (677 females; median age at diagnosis, 39 years [range, 15-73 years]) received a diagnosis of HS. A nonlinear (U-shaped) association was found between birth weight and HS, such that both the lightest (2.00-2.75 kg; HR, 1.36 [95% CI, 1.10-1.68]) and the heaviest babies (4.26-5.50 kg; HR, 1.39 [95% CI, 1.01-1.93]) had increased risks of HS compared with normal-weight babies (3.26-3.75 kg; P = .04 for deviation from linearity). The risk of HS increased significantly with increasing BMI z score at each age from 7 to 13 years, from an HR of 1.32 (95% CI, 1.24-1.40) per BMI z score at 7 years of age to an HR of 1.50 (95% CI, 1.40-1.61) per BMI z score at 13 years of age. Compared with children with a normal weight at 7 and 13 years of age, those with a normal weight at 7 years of age and overweight at 13 years of age had a significantly increased risk of HS (HR, 2.11 [95% CI, 1.63-2.74]) and children with persistent overweight at both ages also had an increased risk of HS (HR, 2.61 [95% CI, 2.02-3.38]). Children with overweight at 7 years of age but with normal weight at 13 years of age did not have a significantly increased risk of HS (HR, 1.05 [95% CI, 0.67-1.67]). Childhood height at all ages was not associated with risk of HS (children at 7 years had an HR of 1.00 [95% CI, 0.94-1.07], and those 13 years had an HR of 1.06 [95% CI, 0.99-1.13], per z score). Conclusions and Relevance This cohort study found that both the lightest and heaviest babies had increased risks of HS. Childhood BMI was positively and significantly associated with risk of HS development in adulthood. These findings suggest that returning to normal weight before puberty reduces risks of HS to levels observed in children who were never overweight. Childhood height was not associated with risk of HS.
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Affiliation(s)
| | - Julie Aarestrup
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Ghazanfar MN, Jørgensen AHR, Thomsen SF. Biological treatment of palmoplantar pustulosis: Long-term experience in 10 patients. Dermatol Ther 2021; 34:e14780. [PMID: 33449416 DOI: 10.1111/dth.14780] [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: 09/04/2020] [Revised: 11/17/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Misbah Noshela Ghazanfar
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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9
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Jørgensen AHR, Holm JG, Ghazanfar MN, Yao Y, Ring HC, Thomsen SF. Factors affecting quality of life in patients with hidradenitis suppurativa. Arch Dermatol Res 2019; 312:427-436. [PMID: 31848682 DOI: 10.1007/s00403-019-02025-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 08/28/2019] [Revised: 11/26/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
Hidradenitis suppurativa (HS) has a substantial impact on patients' lives. We identified factors associated with decreased quality of life (QoL) in patients with HS. Consecutive newly referred patients with HS attending a tertiary referral centre for HS were evaluated with the dermatology life quality index (DLQI). Clinical evaluation was performed according to the Hurley stage. Furthermore, disease duration, number of boils in the past month, boil-associated pain score, overall disease-related distress score, smoking status, employment status and comorbidities were recorded. A total of 339 patients with a mean age of 39.4 years were included; 218 (64.3%) females and 121 (35.7%) males. Of these, 96 (28.3%) had Hurley stage I, whereas 195 (57.5%) and 48 (14.2%) had Hurley II and III, respectively. The mean BMI was 29.0 (SD 7.1) kg/m2 and 75.2% of patients were current or former smokers. The mean overall DLQI score was 11.9 (SD 7.6). After mutual adjustment for clinical characteristics a significant difference in mean overall DLQI score was observed between severity groups (8.6 vs. 12.6 vs. 16.1, adjusted p < 0.001, for Hurley I, II and III, respectively), age group (12.1 vs. 12.1 vs. 12.5 vs. 7.1, adjusted p = 0.002, for ≤ 20, 21-40, 41-60 and > 60 years, respectively), employment status (11.0 vs. 14.6, adjusted p = 0.003, for employed and unemployed, respectively), presence of boils in the preceding month (8.3 vs. 13.6, adjusted p = 0.001, for no boils and presence of boils, respectively), higher overall disease-related distress score (6.3 vs. 13.9, adjusted p < 0.001, for low and high score, respectively), involvement of the groins (8.7 vs. 13.0, adjusted p = 0.035 for no and involvement, respectively), high number of anatomical regions involved (9.8 vs. 12.4 vs. 14.5, adjusted p = 0.007 for 0-1, 2 and ≥ 3 anatomical regions involved, respectively) and diabetes (11.5 vs. 15.2, adjusted p = 0.043, for no and diabetes, respectively). All ten individual DLQI question scores increased significantly with increasing Hurley stage. Patients with HS referred for specialized hospital care report substantial impact on the quality of life. Disease severity (Hurley stage), younger age, diabetes, recent and increasing disease activity and specific anogenital localization are major aggravating factors.
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Affiliation(s)
- Astrid-Helene Ravn Jørgensen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
| | - Jesper Grønlund Holm
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Misbah Noshela Ghazanfar
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Yiqiu Yao
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Hans Christian Ring
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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10
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Yao Y, Jørgensen AHR, Thomsen SF. Work productivity and activity impairment in patients with hidradenitis suppurativa: a cross-sectional study. Int J Dermatol 2019; 59:333-340. [PMID: 31736064 DOI: 10.1111/ijd.14706] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The understanding of absenteeism, presenteeism, and impairments in daily activities among patients with hidradenitis suppurativa (HS) is limited. We examined the impact of disease-specific factors of HS on work and daily life among a cohort of outpatients in a tertiary hospital setting. METHODS Consecutive patients with HS were clinically evaluated and completed the Work Productivity and Activity Impairment (WPAI) questionnaire modified for HS. RESULTS A total of 100 patients were included. Among 57 (57.0%) patients who were employed, 21.2% reported missing work, and 60.4% reported loss of work productivity during the preceding week as a result of HS. The overall work productivity was reduced by 26.6%. Seventy-two percent reported daily activity impairment, averaging 32.7% reduction in daily activities. Moderate to strong correlations were observed between reduction in quality of life and the WPAI outcomes; presenteeism, overall work impairment, and activity impairment (r = 0.50-0.77). There were moderate correlations between disease severity and the same outcomes (r = 0.35-0.46). The mean rank of activity impairment among patients with Hurley stage I was 34.8, 60.1 for Hurley stage II, and 64.0 for Hurley stage III, P < 0.0001. Unemployed patients had higher activity impairment compared with employed patients (mean rank: 61.0 vs. 42.6, P = 0.001). CONCLUSION There are considerable rates of presenteeism, overall work impairment, and activity impairment in HS patients. Presenteeism, loss of overall work productivity, and activity impairment are positively correlated with greater disease severity and reduction in quality of life.
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Affiliation(s)
- Yiqiu Yao
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Jørgensen AHR, Thomsen SF, Karmisholt KE, Ring HC. Clinical, microbiological, immunological and imaging characteristics of tunnels and fistulas in hidradenitis suppurativa and Crohn's disease. Exp Dermatol 2019; 29:118-123. [PMID: 31519056 DOI: 10.1111/exd.14036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 06/27/2019] [Revised: 08/19/2019] [Accepted: 09/09/2019] [Indexed: 12/20/2022]
Abstract
Hidradenitis suppurativa (HS) tunnels and Crohn's disease (CD) fistulas are a challenge to treat. Although pathogenic similarities have been described between HS and CD, recent studies indicate that clinical, microbiological, immunological and imaging characteristics differ between these diseases. This review highlights the differences between HS tunnels and CD fistulas. Next-generation sequencing studies demonstrate a microbiome in HS tunnels dominated by Porphyromonas spp., Prevotella spp. whereas no specific bacteria have been associated with cutaneous CD. Immunologically, TNF has been found upregulated in HS tunnels along with various interleukins (IL-8, IL-16, IL-1α and IL-1β). In CD fistulas, Th1, Th17, IL-17, IFN-ɤ, TNF and IL-23 are increased. US imaging is an important tool in HS. US of HS tunnels depict hypoechoic band-like structure across skin layers in the dermis and/or hypodermis connected to the base of a widened hair follicle. In CD, MR imaging of simple perianal fistulas illustrates a linear, non-branching inflammatory tract relating to an internal opening in the anus or low rectum and an external opening to the skin surface. An increased awareness of the immediate potential differences between HS tunnels and CD fistulas may optimize treatment regimens of these intractable skin manifestations.
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Affiliation(s)
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
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12
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Jørgensen AHR, Zarchi K. Pronounced larva migrans with secondary MRSA infection. Lancet Infect Dis 2019; 19:1034. [PMID: 31478509 DOI: 10.1016/s1473-3099(19)30302-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/18/2019] [Accepted: 04/18/2019] [Indexed: 06/10/2023]
Affiliation(s)
| | - Kian Zarchi
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
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13
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Affiliation(s)
- Yiqiu Yao
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Simon Francis Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Munch IC, Jørgensen AHR, Radner W. The Danish version of the Radner Reading Chart: design and empirical testing of sentence optotypes in subjects of varying educational background. Acta Ophthalmol 2016; 94:182-6. [PMID: 26408429 DOI: 10.1111/aos.12845] [Citation(s) in RCA: 8] [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: 03/01/2015] [Accepted: 08/03/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To develop 28 short texts to be used as sentence optotypes in a Danish version of the Radner Reading Chart for the measurement of reading acuity and speed. METHOD Forty-six short texts of comparable lexical and grammatical difficulty were constructed. The short texts were tested together with two longer reference texts in 100 persons with visual acuity 6/6, of which 50 were university students (age: 24.7 ± 3.1 years, 36% males) and 50 were blue-collar workers (37.2 ± 13.4 years, 54% males). Study parameters were mean reading speed and error rate per participant, and mean reading time, variance and number of errors per short text. RESULTS The students read the short texts faster than the blue-collar workers (184 ± 21.4 words per minute (wpm) versus 163 ± 26.3 wpm, p < 0.0001). There was a high correlation between the reference texts and the short texts [Pearson's correlation coefficient = 0.89 (95% CI 0.83-0.92)]. The mean reading time for each of the short texts ranged from 4.4 s to 5.8 s with a mean of 4.96 ± 0.35 s, and the median number of errors was eight. Twenty-eight short texts were selected for sentence optotypes with mean reading times between 4.6 s and 5.2 s, a mean standard deviation of 1.2 s or less and a number of errors of 17 per 100 persons or less. CONCLUSION Reading time uniformity in the Danish version of the Radner Reading Chart was comparable to that of the original German version. Education had an influence on reading performance that may warrant stratification for this parameter when reading tests are used in clinical trials.
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Affiliation(s)
- Inger Christine Munch
- Department of Ophthalmology; Roskilde Hospital; Roskilde Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | | | - Wolfgang Radner
- Austrian Academy of Ophthalmology and Optometry; Vienna Austria
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