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Atluri S, De DR, Shih T, Dagenet CB, Masson R, Tran KA, Ng V, Hsiao JL, Shi VY. Perspectives of Emergency Medicine Physicians on Hidradenitis Suppurativa Care. Skin Appendage Disord 2024; 10:133-136. [PMID: 38572194 PMCID: PMC10987174 DOI: 10.1159/000535189] [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: 09/11/2023] [Accepted: 10/30/2023] [Indexed: 04/05/2024] Open
Abstract
Introduction Hidradenitis suppurativa (HS) is a chronic skin condition that often requires acute care during periods of flares, with many patients visiting the emergency department over 5 times before receiving a proper diagnosis. However, little is known about emergency medicine (EM) providers' experiences and knowledge of HS management. Methods In this study, an anonymous survey was distributed to EM providers to identify knowledge and practice gaps in HS care. Results The results showed that most respondents lacked confidence in HS diagnosis and management, especially in knowing available treatment options and managing patients with moderate to severe HS. Attendings were more confident than non-attendings in diagnosing and managing HS, and providers who saw more HS patients per month were more confident in referring patients to appropriate specialists. Over 80% of respondents referred HS patients to dermatology, which is an important initial step in HS management. Conclusion The study highlights the importance of educating EM providers in HS recognition, timely referral to dermatology, and initial management to improve quality of life among patients and mitigate disease progression.
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Affiliation(s)
- Swetha Atluri
- College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Rahul Masson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Khiem A. Tran
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Vivienne Ng
- Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Jennifer L. Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Atluri S, De DR, Shih T, Masson R, Tran KA, Partha I, Hsiao JL, Shi VY. Perspectives and experiences of primary care providers on hidradenitis suppurativa care. Int J Dermatol 2024; 63:e60-e62. [PMID: 37691008 DOI: 10.1111/ijd.16835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/19/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Swetha Atluri
- University of Arizona College of Medicine, Tucson, AZ, USA
| | - Devea R De
- University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Rahul Masson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Khiem A Tran
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Indu Partha
- Department of Internal Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Atluri S, Jeong C, Rick JW, Dagenet C, Tran KA, De DR, Masson R, Hsiao JL, Shi VY. Allergens and Marketing Claims of Popular Baby Washes. Dermatitis 2023. [PMID: 37890118 DOI: 10.1089/derm.2023.0175] [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: 10/29/2023]
Affiliation(s)
- Swetha Atluri
- University of Arizona College of Medicine Tucson, AZ USA
| | - Charlotte Jeong
- College of Medicine University of Arkansas for Medical Sciences Little Rock, AR USA
| | - Jonathan W Rick
- Department of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA
| | | | - Khiem A Tran
- Department of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo, NY USA
| | - Rahul Masson
- Keck School of Medicine University of Southern California Los Angeles, CA USA
| | - Jennifer L Hsiao
- Department of Dermatology University of Southern California Los Angeles, CA USA
| | - Vivian Y Shi
- Department of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA
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Masson R, Shih T, Park S, De DR, Gierbolini A, Alavi A, Garg A, Micheletti RG, Shi VY, Hsiao JL. Patient Perspectives on Hidradenitis Suppurativa and Infertility: A Survey Study. Dermatology 2023; 239:732-737. [PMID: 37385230 PMCID: PMC10614271 DOI: 10.1159/000531727] [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: 11/19/2022] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is an inflammatory skin condition which predominantly affects women of childbearing age in the USA. There is a lack of research on the association between HS and fertility. OBJECTIVES The aim of this study was to understand the perspectives of females with HS regarding the impact of their disease on reproductive health, the impact of fertility treatments on HS, and the impact of HS treatments on fertility. METHODS An anonymous, online survey was disseminated through HS support groups from June to July 2022. Respondents aged 18-50 who were assigned female sex at birth were eligible for participation. Comparative statistics were performed using t tests/χ2 tests to assess associations between respondents' demographics and survey responses. RESULTS Among the 312 respondents (80.8% White, mean age 35.7 ± 7.4 [range 18-50]), two-thirds of respondents (66.6%, 207/311) had been pregnant before and 79.5% (248/312) had ever tried to conceive. 41.5% (103/248) had unsuccessfully tried to conceive for 12 months or more. Of the 59 respondents who had never attempted to conceive, 39% reported that HS had impacted this decision. Amongst respondents who experienced fertility challenges but did not pursue fertility treatments, top barriers to fertility treatments include concerns about financial support/insurance coverage (47.5%, 29/61) and fertility treatments worsening HS (21.3%, 13/61). Most respondents who used fertility treatments reported either no change (73.7%, 28/38 or 77.8%, 14/18) or improvement (15.8%, 6/38 or 11.1%, 2/18) in their HS symptoms with oral or injectable medications. Respondents were most concerned about the effects of oral antibiotics (44.9%, 140/312), followed by hormonal medications (38.8%, 121/312) and biologics (35.9%, 112/312) on fertility. CONCLUSION Females with HS reported high rates of infertility compared to the general population. The majority reported no change in HS symptoms with fertility treatments, and clinicians can use this finding to help counsel patients during family planning discussions. Further research in the field of HS and fertility is needed.
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Affiliation(s)
- Rahul Masson
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sarah Park
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Amit Garg
- Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Robert G. Micheletti
- Departments of Dermatology and Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer L. Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
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Shih T, De DR, Fixsen D, Brooks B, Shi VY, Hsiao JL. Hidradenitis suppurativa surgery: patient perspectives and barriers. Int J Dermatol 2023; 62:e270-e272. [PMID: 35933652 DOI: 10.1111/ijd.16371] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/21/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | | | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
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De DR, Rick JW, Shih T, Hsiao JL, Hamzavi I, Shi VY. COVID-19 Infection in Hidradenitis Suppurativa Patients: A Retrospective Study. Skin Appendage Disord 2023. [DOI: 10.1159/000529462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
<b><i>Introduction:</i></b> Hidradenitis suppurativa (HS) is associated with comorbidities that are risk factors for severe COVID-19 infection. We evaluated demographics and COVID-19 outcomes in HS patients. <b><i>Methods:</i></b> HS patients with COVID-19 (HS+/COVID+) and a randomized age-, race-, and sex-matched control population of patients without HS with COVID-19 (HS−/COVID+) were selected through a retrospective chart review. Data were collected on demographics, medications, comorbidities, vaccination status, and COVID-19 treatment/outcomes. Fisher’s exact test was used to analyze the relationship between risk factors and COVID-19 outcomes. A <i>p</i> value of <0.05 was considered statistically significant. <b><i>Results:</i></b> There were 58 HS+/COVID+ patients, primarily African American (83%, <i>n</i> = 48) and female (88%, <i>n</i> = 51). Compared to HS+/COVID+ patients, HS−/COVID+ patients were significantly more likely to have cardiovascular disease (51% vs. 24%; <i>p</i> = 0.0029) and be pregnant (23% vs. 4%; <i>p</i> = 0.0093). HS+/COVID+ and HS−/COVID+ patients did not vary significantly in vaccination rate at time of COVID-19 diagnosis (6% vs. 5%; <i>p</i> = 0.78). HS−/COVID+ patients were significantly more likely to have COVID-19 complications (35% vs. 7%; <i>p</i> = 0.001) and receive COVID-19 treatment (37% vs. 7%; <i>p</i> = 0.0001) when compared to HS+/COVID+ patients. <b><i>Conclusion:</i></b> Our findings support the growing evidence that having HS itself may not be a risk factor for severe COVID-19 outcomes.
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Shih T, De DR, Rick J, Shi VY, Hsiao JL. Low Rates of Psychosocial Screening and Lifestyle Counseling in Hidradenitis Suppurativa Patients in the USA. Skin Appendage Disord 2023; 9:94-98. [PMID: 36937161 PMCID: PMC10015644 DOI: 10.1159/000528253] [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: 06/21/2022] [Accepted: 11/07/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Although hidradenitis suppurativa (HS) is associated with psychosocial comorbidities such as depression as well as modifiable comorbidities such as obesity, rates of psychosocial screening and lifestyle counseling in the USA have not been characterized. Methods This cross-sectional study utilized publicly available data from the National Ambulatory Medical Care Survey (NAMCS) between 2008 and 2018 to identify visits with a diagnosis of HS (ICD-9 code 705.83, ICD-10 code L73.2). T tests and multivariate logistic regressions analyzed trends in rates of screening and counseling while controlling for race, sex, and age. Survey weights are applied to each visit to represent a national sample. Results Depression screening was completed in only 2% of reported visits. No visits reported screening for alcohol misuse, substance abuse, or domestic violence. There were low rates of counseling for weight reduction (7.8%), diet and nutrition (3.3%), exercise (2.4%), smoking (1.0%), and substance abuse (0.7%). Black patients and individuals with public health insurance received less screening and counseling overall. Conclusion Rates of psychosocial screening and counseling on lifestyle modifications are low in ambulatory clinic visits for HS patients, and there are disparities based on race and insurance status. Implementing strategies to incorporate routine psychosocial screening and lifestyle counseling into visits may improve HS patient outcomes.
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Affiliation(s)
- Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Devea R. De
- University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Jonathan Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jennifer L. Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
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Rick JW, Morgan A, De DR, Hsiao JL, Shi VY. Allergens and marketing claims of the most popular baby moisturizers: A product analysis. J Am Acad Dermatol 2023; 88:205-207. [PMID: 35487334 DOI: 10.1016/j.jaad.2022.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan W Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Austin Morgan
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Jennifer L Hsiao
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Thompson AM, Rick JW, De DR, Fernandez JM, Maarouf M, Seivright JR, Hsiao JL, Shi VY. Relationship Disturbances in Hidradenitis Suppurativa: A Patient Perspective. Skin Appendage Disord 2022; 8:448-453. [PMID: 36407648 PMCID: PMC9672867 DOI: 10.1159/000525131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/06/2022] [Accepted: 05/12/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction Hidradenitis suppurativa (HS) can significantly impact patients' relationships. Methods Using an anonymous electronic survey, we aimed to determine what aspects of sexual relationships are affected by HS discomfort and patients' reluctance to discuss HS with their partner. Results Among the 873 participants, 60.9% reported that some aspect of their relationship was affected by HS discomfort, with the greatest being their sexual encounters with spouse (49.1%). Furthermore, 43.0% (320) of participants reported feeling reluctant to discuss HS with their spouse/significant other, with the more common reason being fear of partner seeing boils and scars (84.7%). Multiple aspects of relationships can be affected by HS such as sexual encounters, overall relationship, and finding a relationship. Additionally, several communication barriers are present, such as fear of partner seeing boils and scars, partner thinking they had an infection such as a sexually transmitted disease, and fear of bloody or malodorous drainage, among others. The presence of anogenital pain, Hurley stage, gender, and age significantly affect these findings. Conclusion Addressing HS-related relationship disturbances should be included in HS management.
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Affiliation(s)
| | - Jonathan W. Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Jennifer M. Fernandez
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Melody Maarouf
- Division of Dermatology, Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Justine R. Seivright
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Jennifer L. Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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De DR, Shih T, Hsiao JL, Shi VY. 32128 Hand dermatitis: Readability, quality, and comprehensiveness of online patient health resources. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.712] [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: 10/14/2022]
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Rick JW, Morgan AG, De DR. 32853 Baby moisturizers: Prices, allergens, and marketing claims. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.122] [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: 10/14/2022]
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Shih T, De DR, Tran KA, Hsiao JL, Shi VY. Health Literacy in Dermatology Patients: How to Level the Playing Field. Cutis 2022; 110:119-120. [PMID: 36446108 DOI: 10.12788/cutis.0608] [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: 11/07/2022]
Affiliation(s)
- Terri Shih
- Ms. Shih is from the David Geffen School of Medicine, University of California, Los Angeles. Ms. De is from the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York. Drs. Tran and Shi are from the Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock. Dr. Hsiao is from the Department of Dermatology, University of Southern California, Los Angeles
| | - Devea R De
- Ms. Shih is from the David Geffen School of Medicine, University of California, Los Angeles. Ms. De is from the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York. Drs. Tran and Shi are from the Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock. Dr. Hsiao is from the Department of Dermatology, University of Southern California, Los Angeles
| | - Khiem A Tran
- Ms. Shih is from the David Geffen School of Medicine, University of California, Los Angeles. Ms. De is from the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York. Drs. Tran and Shi are from the Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock. Dr. Hsiao is from the Department of Dermatology, University of Southern California, Los Angeles
| | - Jennifer L Hsiao
- Ms. Shih is from the David Geffen School of Medicine, University of California, Los Angeles. Ms. De is from the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York. Drs. Tran and Shi are from the Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock. Dr. Hsiao is from the Department of Dermatology, University of Southern California, Los Angeles
| | - Vivian Y Shi
- Ms. Shih is from the David Geffen School of Medicine, University of California, Los Angeles. Ms. De is from the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York. Drs. Tran and Shi are from the Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock. Dr. Hsiao is from the Department of Dermatology, University of Southern California, Los Angeles
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Rick JW, Nair N, De DR. 32877 Dermatology clinical trials: Analysis of investments by the top 10 pharmaceutical companies. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.188] [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: 10/14/2022]
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Rick JW, Brannon M, De DR, Shih T, Hsiao JL, Shi VY. 34516 Top selling pediatric sunscreens: An analysis of prices, claims, and allergens. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.885] [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: 11/16/2022]
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Shih T, Lee K, Grogan T, De DR, Shi VY, Hsiao JL. Infliximab in Hidradenitis Suppurativa: A Systematic Review and Meta‐analysis. Dermatol Ther 2022; 35:e15691. [PMID: 35790062 PMCID: PMC9539481 DOI: 10.1111/dth.15691] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory often recalcitrant to treatment. There is a lack of an updated systematic data review for infliximab use in HS. We conducted a systematic review and meta‐analysis of literature on infliximab in HS. This study was performed following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and was pre‐registered on PROSPERO (CRD42021283596). In 9/2021, MEDLINE and EMBASE were systematically searched for articles on infliximab in HS. Non‐English, duplicate, and studies with <5 HS patients were excluded. Study quality was assessed utilizing Cochrane Risk of Bias for prospective trials and Newcastle‐Ottawa Scale for cohort studies. Random effects meta‐analytical model, Cochran's Q statistic, and I squared index were performed. Nineteen articles (314 patients) met inclusion criteria (six prospective, 13 retrospective studies). All patients with HS severity data available (n = 299) had moderate‐to‐severe disease. Outcome measures used for meta‐analysis of the pooled response rate were largely based on clinician reported outcomes (16 studies). One utilized both clinician and patient assessment. Two utilized patient‐reported response alone. The pooled response rate of HS patients to infliximab was 83% (95% CI, 0.71–0.91). The most common adverse events (AEs) included non‐serious infections (13.2%) and infusion reaction (2.9%). The rate of serious AEs was 2.9%. Study limitations include the small number of prospective studies and heterogeneity between studies. Overall, infliximab is an effective treatment for moderate‐to‐severe HS. Efficacy of infliximab in HS should be compared to other biologics in larger, randomized controlled trials.
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Affiliation(s)
- Terri Shih
- David Geffen School of Medicine University of California Los Angeles Los Angeles CA USA
| | - Katrina Lee
- Department of Dermatology University of California Los Angeles Los Angeles CA USA
| | - Tristan Grogan
- Department of Medicine Statistics Core, David Geffen School of Medicine University of California Los Angeles CA USA
| | - Devea R. De
- University at Buffalo, Jacobs School of Medicine and Biomedical Sciences Buffalo NY USA
| | - Vivian Y. Shi
- Department of Dermatology University of Arkansas for Medical Sciences Little Rock AR USA
| | - Jennifer L. Hsiao
- Department of Dermatology University of Southern California Los Angeles CA USA
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De DR, Shih T, Fixsen D, Brooks B, Hsiao JL, Shi VY. Biologic Use in Hidradenitis Suppurativa: Patient Perspectives and Barriers. J DERMATOL TREAT 2022; 33:3060-3062. [PMID: 35737883 DOI: 10.1080/09546634.2022.2089336] [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] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is an inflammatory dermatosis for which the treatment paradigm is rapidly expanding. We aimed to identify HS patient perspectives and barriers on biologics. METHODS An anonymous survey was distributed between 10/2021 to 1/2022 through HS support groups. Data regarding demographics and perspectives on biologics were collected and analyzed. RESULTS Of the 196 respondents, 92% were female (180/196) and 75% were white (147/196). 89.3% had Hurley stage 2/3 HS (102/195). The primary healthcare provider (HCP) for HS in 65% (128/196) of patients was a dermatologist, with 12% (23/196) seen at an HS specialty clinic. Most respondents never tried a biologic medicine (62%, 118/192). The top barriers to biologics were fear of side effects (61%, 109/179), high cost/lack of insurance coverage (46%, 83/179), frequency of weekly injections (32%, 58/179). Respondents reporting their main HCP as a non-dermatologist (4.11 vs 3.0, p < 0.0001) and not seen at a HS specialty clinic (3.5 vs 2.7, 0.039) were significantly more likely to agree "I do not know enough about how biologics work to help my HS". CONCLUSION Our results highlight the importance of specialty care in the education and implementation of biologics. Patients may benefit from comprehensive discussion prior to starting biologics.
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Affiliation(s)
- Devea R De
- University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | | | - Jennifer L Hsiao
- University of Southern California, Department of Dermatology, Los Angeles, CA, USA
| | - Vivian Y Shi
- University of Arkansas for Medical Sciences, Department of Dermatology, Little Rock, AR, USA
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De DR, Shih T, Hsiao JL, Shi VY. Readability, Quality, and Comprehensiveness of Patient Online Health Resources for Hand Dermatitis. Dermatitis 2022; 33:e31-e33. [PMID: 35594459 DOI: 10.1097/der.0000000000000896] [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: 11/25/2022]
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De DR, Goldenberg A, Bogner PN, Pei S. Urticarial rash with leukocytosis and monoclonal gammopathy. JAAD Case Rep 2022; 22:114-115. [PMID: 35495098 PMCID: PMC9044094 DOI: 10.1016/j.jdcr.2022.03.022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Alicia Goldenberg
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Paul N Bogner
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.,Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Susan Pei
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.,Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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19
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Rick JW, De DR, Shih T, Alavi A, Kirby JS, Naik HB, Frew JW, Sayed CJ, Hsiao JL, Shi VY. Guidance on COVID-19 Vaccination in Hidradenitis Suppurativa Patients: A Modified Delphi Consensus of Experts. Skin Appendage Disord 2022; 8:287-290. [PMID: 35979524 PMCID: PMC9274824 DOI: 10.1159/000521268] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Hidradenitis suppurativa (HS) patients may be at increased risk of COVID-19 infection and complications from their medications and comorbidities. There is a lack of expert consensus on recommendations for the COVID-19 vaccine for HS patients. Herein, we aim to provide expert-driven consensus recommendations regarding COVID-19 vaccinations in HS patients. Methods A modified Delphi consensus survey developed by a core committee of 7 dermatologist HS experts consisting of 4 demographic questions and 12 practice statements was distributed to the US HS Foundation-sponsored provider listserv. Participants were attending physician HS experts. Survey results were to be reviewed by the core group and revised and resubmitted until consensus (≥70% agreement) was achieved. Results Among the 33 survey participants, there were 30 (87%) dermatologists, 1 general surgeon, 1 plastic surgeon, and 1 rheumatologist. Consensus for all 12 statements on vaccine counseling and HS treatment counseling was achieved after the first round. Discussion/Conclusion For now, this consensus can serve as a resource for clinicians discussing COVID-19 vaccination with their HS patients. These recommendations will need to be updated as new evidence on COVID-19 emerges.
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Affiliation(s)
- Jonathan W. Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joslyn S. Kirby
- Department of Dermatology Hershey, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Haley B. Naik
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - John W. Frew
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Christopher J. Sayed
- Department of Dermatology Chapel Hill, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer L. Hsiao
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- *Vivian Y. Shi,
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20
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De DR, Thompson AM, Seivright J, Atluri S, Ederle A, Swigert A, Jaros J, Hsiao JL, Shi VY. Bibliometric Analysis of Hidradenitis Suppurativa Publication Trends from Asia and Australasia. Skin Appendage Disord 2022; 8:20-23. [PMID: 35118124 PMCID: PMC8787547 DOI: 10.1159/000518045] [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: 04/21/2021] [Accepted: 06/21/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS), once an orphan disease, has gained increased interest world-wide. The most highly cited works in HS are from North America and Europe despite known phenotypic and epidemiological differences globally. Herein, we perform a bibliometric analysis to characterize HS publication trends in Asia and Australasia (AA) over the last decade. METHODS PubMed database was searched to identify HS-related articles and were analyzed for senior authorship, country of origin, article topic, and study design. RESULTS The search criteria yielded 163 articles from AA. Rapid increase in publications started in 2015 with 75% (123/163) of total articles published in the last half of the decade. Case reports/series were consistently the most published study type yearly and overall (49%, 80/163). Efforts were made to increase high level of evidence publications with both randomized controlled trials from Japan and Turkey including all Asian patients. China, Japan, and India were the leading publishing countries with Australia, Israel, and Turkey increasingly contributing in the last half of the decade. CONCLUSIONS Advancements in HS research are encouraging with increases in publication numbers and diversity; however, more geographical diversity is needed in order to garner a better understanding of the disease and treatment options.
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Affiliation(s)
- Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | | | - Justine Seivright
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Swetha Atluri
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Amanda Ederle
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Anna Swigert
- School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Joanna Jaros
- Division of Dermatology, Cook County Hospitals and Health System, Chicago, Illinois, USA
| | - Jennifer L. Hsiao
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA,*Vivian Y. Shi,
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21
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Seivright JR, Villa NM, De DR, Hsiao JL, Shi VY. Intralesional biologics for inflammatory dermatoses: A systematic review. Dermatol Ther 2021; 35:e15234. [PMID: 34825744 DOI: 10.1111/dth.15234] [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: 09/06/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
Biologic medications are systemic therapeutic options for inflammatory dermatoses. Local forms of administration are less well-studied. To provide a summary of intralesional (IL) administration of biologics for various non-malignant inflammatory dermatologic conditions reported in the literature. A systematic review was performed in the PubMed and Embase databases from 2000 to 2020. Inclusion criteria included the local use of biologic medications for non-malignant cutaneous conditions. Quality was assessed with the modified Oxford Centre for Evidence-Based Medicine ratings. A total of 19 articles describing the use of 5 biologic medications in 9 dermatologic conditions were identified, comprising 172 patients. Conditions successfully treated with intralesional biologics included pemphigus vulgaris (rituximab), granuloma faciale (rituximab), perianal Crohn's disease (infliximab), lichen sclerosus (adalimumab), and necrobiosis lipoidica (etanercept and infliximab). Intralesional etanercept reduced pruritus associated with keloids. A case report of the use of infliximab for pyoderma gangrenosum did not demonstrate any efficacy. There was no consistent effect noted with treatments for sarcoidosis (infliximab) or cutaneous lymphoid hyperplasia (rituximab). Local administration of biologic medications may offer an additional method of treating refractory inflammatory dermatoses, but further study is needed to develop standardized dosing protocols, clarify efficacy rates, and identify optimal treatment candidates.
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Affiliation(s)
- Justine R Seivright
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Natalie M Villa
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Jennifer L Hsiao
- Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, California, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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22
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Shih T, Lee K, Seivright JR, De DR, Shi VY, Hsiao JL. Hyperhidrosis treatments in hidradenitis suppurativa: A systematic review. Dermatol Ther 2021; 35:e15210. [PMID: 34796606 DOI: 10.1111/dth.15210] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/27/2021] [Accepted: 11/13/2021] [Indexed: 11/30/2022]
Abstract
Hyperhidrosis impairs quality of life (QOL) in hidradenitis suppurativa (HS) patients and may exacerbate HS. However, there is limited literature on whether hyperhidrosis treatments improve HS disease. To systematically review literature on efficacy and tolerability of hyperhidrosis treatments in HS patients. In May 2021, MEDLINE and EMBASE databases were systematically searched by two reviewers per PRISMA guidelines for articles on hyperhidrosis and HS. Sixteen articles met inclusion criteria (2 randomized controlled trials [RCTs], one case-control study, three cross-sectional studies, 10 case-studies/series), encompassing 252 HS patients across studies. They examined botulinum toxin A (BTX-A) (n = 6) and B (BTX-B) (n = 1), suction-curettage (n = 1), diode laser (n = 1), and microwave-based energy device (MED) (n = 3). Overall, BTX treatments improve HS severity, QOL, hyperhidrosis, and were well-tolerated. Suction-curettage did not improve disease. One HS patient tolerated diode laser well, with improvement in sweating and HS. One RCT studying MED was discontinued due to adverse events. Two studies reported MED-induced HS. BTX was overall helpful in HS patients, including in patients without concomitant hyperhidrosis. However, more prospective studies are needed to examine its utility in HS. There is potential harm of MEDs in HS. Most studies examining hyperhidrosis treatments in HS patients are low level of evidence. Larger RCTs should examine the efficacy and tolerability of hyperhidrosis treatments in HS.
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Affiliation(s)
- Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Katrina Lee
- Division of Dermatology, University of California Los Angeles, Los Angeles, California, USA
| | - Justine R Seivright
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
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23
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Shih T, De DR, Thompson AM, Seivright JR, Atluri S, Ederle A, Swigert A, Jaros JA, Hsiao JL, Shi VY. Global geographic bibliometric analysis of hidradenitis suppurativa publications. Int J Dermatol 2021; 61:e453-e455. [PMID: 34658018 DOI: 10.1111/ijd.15945] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Justine R Seivright
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Swetha Atluri
- College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Amanda Ederle
- Department of Internal Medicine, Baptist Health, North Little Rock, AR, USA
| | - Anna Swigert
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Joanna A Jaros
- Division of Dermatology, Cook County Hospitals and Health System, Chicago, Illinois, USA
| | - Jennifer L Hsiao
- Division of Dermatology, University of California Los Angeles, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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24
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De DR, Seivright J, Yee D, Hsiao JL, Shi VY. Readability, quality, and timeliness of patient online health resources for urticaria. J Am Acad Dermatol 2021; 86:1182-1185. [PMID: 33951494 DOI: 10.1016/j.jaad.2021.04.089] [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: 03/20/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Devea R De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Justine Seivright
- David Geffen School of Medicine, University of California, Los Angeles, California
| | - Danielle Yee
- Department of Medicine, University of California Los Angeles, Sylmar, California
| | - Jennifer L Hsiao
- Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, California
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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