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Maul JT, Maul LW, Didaskalu JA, Valenzuela F, Romiti R, Peterson H, Korouri E, Novoa F, Oon HH, Zheng M, Wu JJ, Thyssen JP, Egeberg A, Armstrong AW, Nielsen ML. Correlation between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis: A Cross-sectional Global Healthcare Study on Psoriasis. Acta Derm Venereol 2024; 104:adv20329. [PMID: 38470165 PMCID: PMC10949083 DOI: 10.2340/actadv.v104.20329] [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: 10/05/2023] [Accepted: 12/26/2023] [Indexed: 03/13/2024] Open
Abstract
Quality of life impairment in dermatology patients and severity of psoriasis are quantified by the Dermatology Life Quality Index (DLQI) and the Psoriasis Area and Severity Index (PASI), respectively. The aim of this study is to compare the correlation between PASI and DLQI in patients from different geographical areas and to identify predictors of high DLQI across geographical regions. Correlations between PASI and DLQI were evaluated using Spearman's rank correlation tests and quantile regression. The study included 1,158 patients with psoriasis, with a median (interquartile range) PASI and DLQI of 6.0 (3.0-12.0) and 8.0 (4.0-15.0), respectively. Correlations were demonstrated between PASI and DLQI, both overall and stratified by geographical region. Quantile (median) regression yielded coefficients of 0.75 (95% confidence interval (95% CI) 0.62, 0.88) for Switzerland, 0.50 (95% CI 0.42, 0.58) for Latin America, 0.34 (95% CI 0.16, 0.51) for Asia, and 0.31 (95% CI 0.08, 0.53) for the USA. Current age, age at diagnosis, sex, body mass index, and psoriasis arthritis affected DLQI in Latin America, while education had an impact among patients treated in Switzerland. Few countries were included within each continent; hence, more data from different countries are necessary for generalizability. The study showed correlations between PASI and DLQI among patients in all included geographical regions. The patients' characteristics affecting DLQI vary worldwide.
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Affiliation(s)
- Julia-Tatjana Maul
- Faculty of Medicine, University of Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
| | - Lara W Maul
- Faculty of Medicine, University of Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | | | | | - Ricardo Romiti
- Department of Dermatology, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Edwin Korouri
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA
| | - Farah Novoa
- Department of Dermatology, Jockey Salud Medical Center, Lima, Peru
| | - Hazel H Oon
- Department of Dermatology, National Skin Centre, Singapore
| | - Min Zheng
- 10) Dermatology Department, Second Affiliated Hospital, Zhejiang University, School of Medicine, Zhejiang, China
| | - Jashin J Wu
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, USA
| | - Jacob P Thyssen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. jacob.pontoppidan
| | - Alexander Egeberg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - April W Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mia-Louise Nielsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Peterson H, Kingston P, Lee K, Yee D, Huang MY, Korouri E, Aguero R, Armstrong AW. Complementary and Alternative Medicine for Hidradenitis Suppurativa Discussed on TikTok: A Cross-Sectional Analysis. J Drugs Dermatol 2024; 23:e93-e96. [PMID: 38443128 DOI: 10.36849/jdd.7738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a painful, chronic inflammatory skin disease that negatively affects patient quality of life, and conventional treatments are variably effective. As a result, patients often turn to complementary and alternative medicine (CAM) for pain relief. Social media enables HS patients to share treatment recommendations. TikTok is a popular social media platform, but little is known about the HS treatments discussed in TikTok videos. Objective: To evaluate the content and quality of information on TikTok regarding CAM HS therapies. Methods: A cross-sectional analysis was conducted by performing a search in TikTok using the terms #hidradenitissuppurativa, #hswarrior, #naturalremedy, #complementarymedicine, #alternativemedicine, and #HStreatment. Two independent reviewers evaluated video quality using the DISCERN and AVA instruments. Linear regressions compared the engagement, DISCERN, and AVA scores among different uploader types. RESULTS In total, 91 TikTok videos were analyzed. Videos were uploaded by non-physicians (82.4), dermatologists (6.6%), and private companies (11.0%). The average DISCERN and AVA scores were 36.2 and 1.6, respectively (poor quality). Common CAM therapies were natural salves, turmeric, Epsom salts, elimination diets, and zinc supplements. Physician-uploaded videos were of significantly higher quality than videos by other uploader types, with an average DISCERN and AVA score of 44.3 (P<0.009) and 2.6 (P<0.001), respectively (fair quality). CONCLUSION TikTok videos were poor quality (low DISCERN and AVA scores); physician-uploaded videos were fair quality. Dermatologists can improve video quality by adequately discussing the supporting evidence, mechanisms of action, and remaining questions for HS treatments. J Drugs Dermatol. 2024;23(3):e93-96. doi:10.36849/JDD.7738e.
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Peterson H, Huang MY, Lee K, Kingston P, Yee D, Korouri E, Agüero R, Armstrong AW. Comorbidity Burden in Psoriasis Patients with Skin of Color. J Psoriasis Psoriatic Arthritis 2024; 9:16-22. [PMID: 38516030 PMCID: PMC10957134 DOI: 10.1177/24755303231198482] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Background Psoriasis is a chronic disease with increased risk of numerous comorbidities. Known differences exist regarding treatment outcomes for psoriasis patients with skin of color (SOC). However, factors contributing to these differences are relatively unknown. Objectives This study aims to compare the comorbidity burden in SOC psoriasis patients vs. White patients, as measured by the Charlson Comorbidity Index (CCI) score. Methods We utilized the National Ambulatory Medical Care Survey (NAMCS) to identify visits for adult psoriasis patients occurring in the years 2002-2016 and 2018. The CCI was used to objectively measure comorbidity burden. Patients were identified by race, and SOC was defined as any reported race besides White Only. A multiple linear regression was run to compare the CCI among adult psoriasis patients based on race and ethnicity, controlling for age, sex, insurance status, and geographic region. Results A total of 39,176,928 weighted visits were analyzed. Compared to White patients, patients with SOC did not have statistically significant differences in comorbidity burden, as measured by CCI score (p=0.073 for Black/African American Only vs. White Only, p=0.073 for American Indian/Alaska Native Only vs. White Only, p=0.435 for Asian Only vs. White Only, p=0.403 for Native Hawaiian/Pacific Islander Only vs. White Only, p=0.195 for Other vs. White Only). Conclusion Patients with SOC were not found to have differences in comorbidity burden compared to White patients. These results highlight that social factors such as socioeconomic status and access to healthcare may contribute more directly to psoriasis treatment outcomes than patient race.
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Affiliation(s)
- Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Margaret Y. Huang
- Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Kathryn Lee
- Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Paige Kingston
- Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Danielle Yee
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Edwin Korouri
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA
| | - Rosario Agüero
- Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - April W. Armstrong
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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Yee D, Lee K, Huang MY, Kingston P, Korouri E, Peterson H, Armstrong AW. Assessing the Quality, Comprehensiveness, and Readability of Online Patient Health Resources About Psoriasis in Skin of Color. J Clin Aesthet Dermatol 2023; 16:52-54. [PMID: 38125673 PMCID: PMC10729803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Danielle Yee
- Dr. Yee and Dr. Armstrong are with the Division of Dermatology, University of California in Los Angeles, Los Angeles, California
| | - Kathryn Lee
- Ms. Lee is with Saint Louis University School of Medicine in Saint Louis, Missouri
| | - Margaret Y. Huang
- Ms. Huang and Ms. Kingston are with Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Paige Kingston
- Ms. Huang and Ms. Kingston are with Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Edwin Korouri
- Mr. Korouri is with Chicago Medical School in North Chicago, Illinois
| | - Hannah Peterson
- Ms. Peterson is with Loma Linda University School of Medicine in Loma Linda, California
| | - April W. Armstrong
- Dr. Yee and Dr. Armstrong are with the Division of Dermatology, University of California in Los Angeles, Los Angeles, California
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Yee D, Kingston P, Lee K, Huang M, Peterson H, Korouri E, Armstrong AW. Shared decision-making and satisfaction with care in patients with psoriasis: A population-based study in the United States. J Am Acad Dermatol 2023; 89:920-926. [PMID: 37011814 DOI: 10.1016/j.jaad.2023.03.039] [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: 10/13/2022] [Revised: 02/19/2023] [Accepted: 03/12/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Shared decision-making (SDM) is a critical component of the patient-physician relationship. Although SDM has been reported to improve patient knowledge in other fields, it is still relatively unknown in dermatology. OBJECTIVE To determine the association between SDM and satisfaction with care among patients with psoriasis. METHODS Cross-sectional study using data from the 2014 to 2017 and 2019 Medical Expenditure Panel Survey. RESULTS A weighted total of 3,715,027 patients with psoriasis were identified. The average SDM score was 3.6 (of 4), and the average satisfaction with care score was 8.6 (of 10). Approximately 42% of the cohort reported having a high SDM (score, ≥3.9). Patients who had high SDM had, on average, 85% higher satisfaction with care (P < .001) after adjusting for covariates. LIMITATIONS The results of our study should be interpreted within the context of the Medical Expenditure Panel Survey database. The ability to measure SDM was limited by the 7 items from Medical Expenditure Panel Survey, which may not fully capture active participation in shared decision-making. CONCLUSION A majority of patients with psoriasis are not participating in highly SDM. It is important to construct a framework for carrying out SDM efficiently to enhance physician-patient communication and improve patient outcomes.
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Affiliation(s)
- Danielle Yee
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Paige Kingston
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kathryn Lee
- Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Margaret Huang
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, California
| | | | - April W Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, California.
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Kingston P, Huang MY, Lee K, Peterson H, Korouri E, Agüero R, Yee D, Armstrong AW. The impact of race on mental health outcomes among patients with hidradenitis suppurativa: A population-based study in the United States. J Eur Acad Dermatol Venereol 2023; 37:e1280-e1282. [PMID: 37328920 DOI: 10.1111/jdv.19268] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Paige Kingston
- Keck School of Medicine of USC, Los Angeles, California, USA
| | | | - Kathryn Lee
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Edwin Korouri
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA
| | - Rosario Agüero
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Danielle Yee
- Keck School of Medicine of USC, Los Angeles, California, USA
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Huang MY, Peterson H, Yee D, Lee K, Korouri E, Kingston P, Agüero R, Lung K, Armstrong AW. Atopic Dermatitis and the Risk of Actinic Keratosis Development: A Population-Based Study. Dermatitis 2023. [PMID: 37792323 DOI: 10.1089/derm.2023.0141] [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: 10/05/2023]
Affiliation(s)
- Margaret Y Huang
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Danielle Yee
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Kathryn Lee
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Edwin Korouri
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Paige Kingston
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Rosario Agüero
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Khristina Lung
- Keck-Shaeffer Initiative for Population Health Policy, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
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Lee K, Yee D, Peterson H, Huang MY, Kingston P, Agüero R, Korouri E, Armstrong AW. Readability, quality, and comprehensiveness of online health resources for skin cancer in skin of color. Int J Dermatol 2023; 62:e532-e534. [PMID: 37039526 DOI: 10.1111/ijd.16674] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/22/2023] [Indexed: 04/12/2023]
Affiliation(s)
- Kathryn Lee
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Danielle Yee
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Margaret Y Huang
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Paige Kingston
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Rosario Agüero
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Edwin Korouri
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
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Kingston P, Yee D, Huang MY, Korouri E, Peterson H, Lee K, Agüero R, Armstrong AW. Shared decision-making and satisfaction with care: a population-based study in patients with acne with skin of colour in the USA. Clin Exp Dermatol 2023; 48:1032-1035. [PMID: 37098265 DOI: 10.1093/ced/llad151] [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: 02/17/2023] [Accepted: 04/20/2023] [Indexed: 04/27/2023]
Abstract
Little is known about differences in shared decision-making and patient satisfaction with acne care among different ethnicities and races. We conducted a cross-sectional study to determine differences between patients with acne who are White and those with skin of colour (SOC), i.e. (i) engagement in shared decision-making, and (ii) patient satisfaction with care, using the 2009-2017 and 2019 Medical Panel Expenditure Survey. Patients with acne with SOC were nearly two times more likely to engage in high shared decision-making compared with White patients [adjusted odds ratio 1.80, 95% confidence interval (CI) 1.30-2.51, P < 0.001]. Patients with SOC with acne reported lower satisfaction with care compared with White patients (β = -0.38, 95% CI -0.69 to -0.06, P = 0.02). Patients with SOC who had acne reported higher levels of shared decision-making than White patients. However, compared with the White patients, patients with SOC report lower satisfaction with their care. There may be other factors contributing to lower satisfaction with care in patients with SOC who have acne.
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Affiliation(s)
| | - Danielle Yee
- Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | - Edwin Korouri
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, Chicago, IL, USA
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kathryn Lee
- Saint Louis University School of Medicine, St Louis, MO, USA
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