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Sárdy M. [Dermoscopy of nonneoplastic dermatoses : A revolution in noninvasive dermatological diagnostics]. Dermatologie (Heidelb) 2023; 74:229-231. [PMID: 36977838 DOI: 10.1007/s00105-023-05127-4] [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] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/30/2023]
Affiliation(s)
- M Sárdy
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Semmelweis Universität, Mária u. 41., 1085, Budapest, Ungarn.
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München (LMU), München, Deutschland.
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Malkovics T, Joura MI, Koszorú K, Sárdy M. [Dermatitis herpetiformis and other forms of wheat sensitivity]. Dermatologie (Heidelb) 2022; 74:955-960. [PMID: 37882829 PMCID: PMC10661880 DOI: 10.1007/s00105-023-05243-1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Wheat sensitivity is a collective term for several, especially gastrointestinal, diseases that occur as part of a hypersensitivity reaction after wheat consumption. The symptoms, which are mostly similar to those of irritable bowel syndrome, are often accompanied by skin lesions. In addition to celiac disease and dermatitis herpetiformis, the cutaneous manifestation of celiac disease, wheat sensitivity also includes nonceliac gluten sensitivity (NCGS), allergic nickel contact mucositis, wheat allergy, amylase-trypsin inhibitor intolerance, and fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) intolerance. OBJECTIVES This review article aims to provide an overview of the clinical, especially dermatological and gastrointestinal features of the different forms of wheat sensitivity. Diagnosis and therapeutic management are also discussed. MATERIALS AND METHODS A selective literature search was carried out with evaluation of our own clinical data. RESULTS The skin lesions in dermatitis herpetiformis are very disease-specific. In contrast, wheat allergy often shares signs and symptoms with many other diseases. Other forms of wheat sensitivity cause primarily gastrointestinal abnormalities, but extra-intestinal manifestations can also occur. Their diagnosis is often complex and requires cross-disciplinary collaboration with experts in gastroenterology. The therapy consists of a wheat- or gluten-free diet. CONCLUSIONS Knowledge of the different and frequently occurring dermatological signs of wheat sensitivity is of great importance, because dermatological manifestations associated with gastrointestinal pathology, intolerance reactions, and allergies appear more and more frequently.
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Affiliation(s)
- T Malkovics
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Mária u. 41, 1085, Budapest, Ungarn.
| | - M I Joura
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Mária u. 41, 1085, Budapest, Ungarn
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - K Koszorú
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Mária u. 41, 1085, Budapest, Ungarn
| | - M Sárdy
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Mária u. 41, 1085, Budapest, Ungarn
- Klinik für Dermatologie und Allergologie, Klinikum der Universität München (LMU), München, Deutschland
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3
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Borradori L, Van Beek N, Feliciani C, Tedbirt B, Antiga E, Bergman R, Böckle BC, Caproni M, Caux F, Chandran NS, Cianchini G, Daneshpazhooh M, De D, Didona D, Di Zenzo GM, Dmochowski M, Drenovska K, Ehrchen J, Goebeler M, Groves R, Günther C, Horvath B, Hertl M, Hofmann S, Ioannides D, Itzlinger-Monshi B, Jedličková J, Kowalewski C, Kridin K, Lim YL, Marinovic B, Marzano AV, Mascaro JM, Meijer JM, Murrell D, Patsatsi K, Pincelli C, Prost C, Rappersberger K, Sárdy M, Setterfield J, Shahid M, Sprecher E, Tasanen K, Uzun S, Vassileva S, Vestergaard K, Vorobyev A, Vujic I, Wang G, Wozniak K, Yayli S, Zambruno G, Zillikens D, Schmidt E, Joly P. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2022; 36:1689-1704. [PMID: 35766904 DOI: 10.1111/jdv.18220] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life. OBJECTIVES AND METHODOLOGY The Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included. RESULTS Treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations. CONCLUSIONS The guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice.
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Affiliation(s)
- L Borradori
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - N Van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C Feliciani
- Dermatology Unit, Department of Medicine and Surgery, University Hospital, University of Parma, Italy
| | - B Tedbirt
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - R Bergman
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - B C Böckle
- Department of Dermatology, Venereology & Allergology, Innsbruck Medical University, Innsbruck, Austria
| | - M Caproni
- Department of Health Sciences, Section of Dermatology, AUSL Toscana Centro, Rare Diseases Unit, European Reference Network-Skin Member, University of Florence, Italy
| | - F Caux
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - N S Chandran
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - G Cianchini
- Department of Dermatology, Ospedale Classificato Cristo Re, Rome, Italy
| | - M Daneshpazhooh
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - G M Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Ehrchen
- Department of Dermatology, University of Münster, Münster, Germany
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - R Groves
- St. John's Institute of Dermatology, Viapath Analytics LLP, St. Thomas' Hospital, London, UK.,Division of Genetics and Molecular Medicine, King's College London, Guy's Hospital, London, UK
| | - C Günther
- Department of Dermatology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - B Horvath
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - S Hofmann
- Department of Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten, Herdecke, Germany
| | - D Ioannides
- 1st Department of Dermatology-Venereology, Hospital of Skin and Venereal Diseases, Aristotle University Medical School, Thessaloniki, Greece
| | - B Itzlinger-Monshi
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - J Jedličková
- Department of Dermatovenereology, Masaryk University, University Hospital St. Anna, Brno.,Department of Dermatovenereology, University Hospital Brno, Brno, Czech Republic
| | - C Kowalewski
- Department Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - K Kridin
- National Skin Centre, Singapore, Singapore
| | - Y L Lim
- Department of Dermatology and Venereology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
| | - B Marinovic
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - J-M Mascaro
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J M Meijer
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - D Murrell
- Department of Dermatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - K Patsatsi
- 2nd Department of Dermatology, Autoimmune Bullous Diseases Unit, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
| | - C Pincelli
- DermoLab, Institute of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Prost
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - K Rappersberger
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria.,Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Austria
| | - M Sárdy
- Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany.,Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - J Setterfield
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Shahid
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Tasanen
- Department of Dermatology, the PEDEGO Research Unit, University of Oulu and Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - S Uzun
- Department of Dermatology and Venereology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - S Vassileva
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - K Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A Vorobyev
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - I Vujic
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - G Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - K Wozniak
- National Skin Centre, Singapore, Singapore
| | - S Yayli
- Department of Dermatology, School of Medicine, Koç University, Istanbul, Turkey
| | - G Zambruno
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
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Koszorú K, Hajdu K, Borza J, Bodai K, Szabó Á, Bató A, Szegedi A, Brodszky V, Rencz F, Sárdy M. 080 The impact of atopic dermatitis on health-related quality of life. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.082] [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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Jobbágy A, Meznerics F, Farkas K, Bozsányi S, Fesus L, Kiss N, Lorincz K, Wikonkal N, Sárdy M, Bánvölgyi A. 065 Application of teledermatology during the first wave of the COVID-19 pandemic in Hungary. J Invest Dermatol 2021. [PMCID: PMC8497029 DOI: 10.1016/j.jid.2021.08.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schmitt T, Egu DT, Walter E, Sigmund AM, Eichkorn R, Yazdi A, Schmidt E, Sárdy M, Eming R, Goebeler M, Waschke J. Ca 2+ signalling is critical for autoantibody-induced blistering of human epidermis in pemphigus. Br J Dermatol 2021; 185:595-604. [PMID: 33792909 DOI: 10.1111/bjd.20091] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pemphigus is a severe bullous autoimmune skin disease. Pemphigus foliaceus (PF) is characterized by antidesmoglein (Dsg) 1 IgG causing epidermal blistering; mucosal pemphigus vulgaris (mPV) by anti-Dsg3 IgG inducing erosions in the mucosa; and mucocutaneous pemphigus vulgaris (PV) by affecting both, with autoantibodies targeting Dsg1 and Dsg3. OBJECTIVES To characterize the Ca2+ flux pathway and delineate its importance in pemphigus pathogenesis and clinical phenotypes caused by different antibody profiles. METHODS Immunoprecipitation, Ca2+ flux analysis, Western blotting, immunofluorescence staining, dissociation assays and a human skin ex vivo model were used. RESULTS PV IgG and PF IgG, but neither Dsg3-specific monoclonal antibody (AK23) nor mPV IgG, caused Ca2+ influx in primary human keratinocytes. Phosphatidylinositol 4-kinase α interacts with Dsg1 but not with Dsg3. Its downstream target - phospholipase-C-γ1 (PLC) - was activated by PV IgG and PF IgG but not AK23 or mPV IgG. PLC releases inositol 1,4,5-trisphosphate (IP3) causing IP3 receptor (IP3R) activation and Ca2+ flux from the endoplasmic reticulum into the cytosol, which stimulates Ca2+ release-activated channels (CRAC)-mediated Ca2+ influx. Inhibitors against PLC, IP3R and CRAC effectively blocked PV IgG and PF IgG-induced Ca2+ influx; ameliorated alterations of Dsg1 and Dsg3 localization, and reorganization of keratin and actin filaments; and inhibited loss of cell adhesion in vitro. Finally, inhibiting PLC or IP3R was protective against PV IgG-induced blister formation and redistribution of Dsg1 and Dsg3 in human skin ex vivo. CONCLUSIONS Ca2+ -mediated signalling is important for epidermal blistering and dependent on the autoantibody profile, which indicates different roles for signalling complexes organized by Dsg1 and Dsg3. Interfering with PLC and Ca2+ signalling may be a promising approach to treat epidermal manifestations of pemphigus.
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Affiliation(s)
- T Schmitt
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - D T Egu
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - E Walter
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - A M Sigmund
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - R Eichkorn
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls-University, Tübingen, Germany
| | - A Yazdi
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls-University, Tübingen, Germany.,Department of Dermatology, RWTH Aachen, Aachen, Germany
| | - E Schmidt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, 23562, Germany.,Department of Dermatology, University of Lübeck, Lübeck, 23562, Germany
| | - M Sárdy
- Clinic for Dermatology, Semmelweis University, Budapest, Hungary
| | - R Eming
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, 97080, Germany
| | - J Waschke
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
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7
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Görög A, Antiga E, Caproni M, Cianchini G, De D, Dmochowski M, Dolinsek J, Drenovska K, Feliciani C, Hervonen K, Lakos Jukic I, Kinyó Á, Koltai T, Korponay-Szabó I, Marzano AV, Patsatsi A, Rose C, Salmi T, Schmidt E, Setterfield J, Shahid M, Sitaru C, Uzun S, Valitutti F, Vassileva S, Yayli S, Sárdy M. S2k guidelines (consensus statement) for diagnosis and therapy of dermatitis herpetiformis initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2021; 35:1251-1277. [PMID: 34004067 DOI: 10.1111/jdv.17183] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/14/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dermatitis herpetiformis (DH) is a chronic, pruritic, gluten-induced skin disorder characterized by subepidermal granular IgA deposition and a variable degree of enteropathy identical to that seen in coeliac disease. So far, there has been no European consensus about the management of DH. METHODS The guidelines were created by small subgroups of a guideline committee consisting of 26 specialists from various medical fields and one patients' representative. The members of the committee then discussed the guidelines and voted for the final version at two consensus meetings. The guidelines were developed under the support of the European Academy of Dermatology and Venereology (EADV) and in collaboration with the European Dermatology Forum (EDF). RESULTS The guidelines summarize evidence-based and expert-based recommendations (S2 level) for the management of DH (see Appendix). CONCLUSION These guidelines will improve the quality of management of DH and support dermatologists in their diagnostic and therapeutic decisions.
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Affiliation(s)
- A Görög
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - M Caproni
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centro, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - G Cianchini
- Department of Dermatology, Cristo Re Hospital, Rome, Italy
| | - D De
- Department of Dermatology, Postgraduate Institute of Medical Education Research, Chandigarh, India
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - J Dolinsek
- Gastroenterology Unit, Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - K Drenovska
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Feliciani
- Dermatology Unit Azienda Ospedaliero - Universitaria, Università di Parma, Parma, Italy
| | - K Hervonen
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - I Lakos Jukic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - T Koltai
- Association of European Coeliac Societies, Brussels, Belgium.,Hungarian Coeliac Society, Budapest, Hungary
| | - I Korponay-Szabó
- Coeliac Disease Centre, Heim Pál National Paediatric Institute, Budapest, Hungary.,Faculty of Medicine, Institute of Paediatrics, University of Debrecen, Debrecen, Hungary
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A Patsatsi
- Autoimmune Bullous Diseases Unit, 2nd Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
| | - C Rose
- Dermatopathology Laboratory, Lübeck, Germany.,German Coeliac Disease Society e. V., Stuttgart, Germany
| | - T Salmi
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - J Setterfield
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Host Microbiome Interactions, Faculty of Dentistry Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Shahid
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Sitaru
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.,BIOSS Centre for Biological Signalling, University of Freiburg, Freiburg, Germany
| | - S Uzun
- Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - F Valitutti
- Pediatric Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - S Vassileva
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - S Yayli
- Department of Dermatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.,Department of Dermatology and Allergy, University Hospital of LMU, Munich, Germany
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Zouboulis CC, Geilen CC, Grunewald S, Kauczok C, Raap U, Sander C, Sárdy M, Schultz E, Stadler R, Welzel J. Struktur der Hautkliniken und dermatologische Lehre in den neuen Universitäten in Deutschland. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1262-2086] [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] [Indexed: 10/22/2022]
Abstract
ZusammenfassungIm Zuge der Neugründung medizinischer Fakultäten in Deutschland muss auch die dermatologische Forschung und Lehre aufgebaut werden. Diese großen Zusatzaufgaben neben der Krankenversorgung stellen eine Herausforderung für die Klinikleitungen dar. In diesem Übersichtsbeitrag beschreiben exemplarisch Chefärztinnen und Chefärzte neuer Universitätshautkliniken und dermatologischer Fachabteilungen die Auswirkungen, die die Umwandlung in eine Universitätsklinik auf die Forschung und Lehre sowie den klinischen Alltag mit sich gebracht hat.
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Affiliation(s)
- C. C. Zouboulis
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau
| | - C. C. Geilen
- Health and Medical University (HMU) Potsdam, Medical School Hamburg (MSH)
| | | | - C. Kauczok
- Zentrum für Dermatohistologie und Oralpathologie Tübingen/Würzburg
| | - U. Raap
- Universitätsklinik für Dermatologie und Allergologie, Klinikum Oldenburg
| | - C. Sander
- Eduard-Arning-Klinik für Dermatologie und Allergologie, Asklepios Klinik St. Georg, Hamburg
| | - M. Sárdy
- Klinik für Dermatologie, Dermatoonkologie und Venerologie, Semmelweis Universität Budapest, Ungarn
| | - E. Schultz
- Klinik für Dermatologie, Klinikum Nürnberg Nord, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - R. Stadler
- Universitätsklinik für Dermatologie, Johannes Wesling Klinikum Minden, Universitätsklinikum der Ruhr-Universität Bochum
| | - J. Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg
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9
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Joly P, Horvath B, Patsatsi Α, Uzun S, Bech R, Beissert S, Bergman R, Bernard P, Borradori L, Caproni M, Caux F, Cianchini G, Daneshpazhooh M, De D, Dmochowski M, Drenovska K, Ehrchen J, Feliciani C, Goebeler M, Groves R, Guenther C, Hofmann S, Ioannides D, Kowalewski C, Ludwig R, Lim Y, Marinovic B, Marzano A, Mascaró J, Mimouni D, Murrell D, Pincelli C, Squarcioni C, Sárdy M, Setterfield J, Sprecher E, Vassileva S, Wozniak K, Yayli S, Zambruno G, Zillikens D, Hertl M, Schmidt E. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV). J Eur Acad Dermatol Venereol 2020; 34:1900-1913. [DOI: 10.1111/jdv.16752] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/29/2020] [Indexed: 01/21/2023]
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10
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Gergely LH, Gáspár K, Brodszky V, Kinyó Á, Szegedi A, Remenyik É, Kiss NF, Bató A, Péntek M, Gulácsi L, Sárdy M, Bánvölgyi A, Wikonkál N, Rencz F. Validity of EQ-5D-5L, Skindex-16, DLQI and DLQI-R in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:2584-2592. [PMID: 32618022 DOI: 10.1111/jdv.16642] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Numerous generic, skin- and disease-specific health-related quality of life (HRQoL) measures are available for patients with hidradenitis suppurativa (HS). Yet, robust psychometric evidence is lacking in many aspects of these outcome measures. OBJECTIVES We sought to determine convergent and known-groups validity of multiple generic and skin-specific HRQoL measures and to identify predictors of impaired HRQoL in patients with HS. METHODS Between 2017 and 2019, a multicentre cross-sectional study was carried out involving 200 consecutive HS patients. HRQoL outcomes included the EQ-5D-5L, EQ visual analogue scale (EQ VAS), Skindex-16, Dermatology Life Quality Index (DLQI) and DLQI-Relevant (DLQI-R). Disease severity was graded by HS-Physician's Global Assessment (HS-PGA) scale and the Modified Sartorius scale (MSS). RESULTS Overall, 77%, 56%, 51%, 46% and 28% reported problems in the pain/discomfort, usual activities, anxiety/depression, mobility and self-care dimensions of EQ-5D-5L. Mean ± SD EQ VAS, DLQI and DLQI-R scores were 64.29 ± 22.68, 11.75 ± 8.11 and 12.19 ± 8.33, respectively. Skindex-16 responses indicated that the emotional burden of HS (64.55 ± 29.28) far exceeded those of functioning (49.40 ± 34.70) and physical symptoms (46.74 ± 29.36). EQ-5D-5L, EQ VAS, DLQI, DLQI-R and Skindex-16 total scores had moderate or strong correlations with each other (range: |0.487| to |0.993|), weak or moderate correlations with HS-PGA (|0.350| to |0.433|) and weak correlations with MSS (|0.324| to |0.389|). DLQI-R slightly outperformed DLQI both in terms of convergent and known-groups validity. Being female, lower education level, more severe disease and genital involvement were associated with worse HRQoL (P < 0.05). CONCLUSION This study provides high-quality evidence that among skin-specific outcomes, the DLQI, DLQI-R and Skindex-16, and among generic instruments, the EQ-5D-5L are suitable to be used in HS patients. In future research, we recommend the use of existing well-validated HRQoL tools instead of developing new measures for each study. The development of composite measures that combine physician- and patient-reported outcomes is not supported by evidence in HS. [Correction added on 25 July 2020, after first online publication: in the Abstract section, the ± signs were missing and have been added to this version.].
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Affiliation(s)
- L H Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - K Gáspár
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N F Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bató
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Budapest, Hungary
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11
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Rencz F, Gergely L, Wikonkál N, Gáspár K, Péntek M, Gulácsi L, Tamási B, Poór A, Kinyó Á, Bali G, Hidvégi B, Sárdy M, Hajdu K, Szegedi A, Remenyik É, Bata‐Csörgő Z, Holló P, Baji P, Brodszky V. Dermatology Life Quality Index (DLQI) score bands are applicable to DLQI‐Relevant (DLQI‐R) scoring. J Eur Acad Dermatol Venereol 2020; 34:e484-e486. [DOI: 10.1111/jdv.16398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Budapest Hungary
| | - L.H. Gergely
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - N. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Gáspár
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Medical School Pécs Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Hajdu
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Szeged Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - P. Baji
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
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12
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Brodszky V, Tamási B, Hajdu K, Péntek M, Szegedi A, Sárdy M, Bata-Csörgő Z, Kinyó Á, Gulácsi L, Rencz F. Disease burden of patients with pemphigus from a societal perspective. Expert Rev Pharmacoecon Outcomes Res 2020; 21:77-86. [PMID: 31978314 DOI: 10.1080/14737167.2020.1722104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: Cost-of-illness studies are widely used for healthcare decision-making; however, no such study is available in pemphigus from the societal perspective. The purpose of this analysis was to estimate annual cost-of-illness per patient with pemphigus from a societal perspective. Areas covered: Between 2014 and 2017, a multicenter, cross-sectional study was carried out. Consecutive pemphigus patients aged ≥18 years were recruited at all four university dermatology departments in Hungary. Direct and indirect costs were calculated, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. Generalized linear model was used to analyze predictors of costs. Atotal of 109 patients with pemphigus enrolled with amean age of 57.1 (SD 14.8) years. Total cost per pemphigus patient was €3,995 (SD €7,526) peryear, with productivity loss (58%) and informal care (19%) accounting for the majority. Annual means of 189 and 41 working hours were lost due to absence from work and reduced productivity, respectively. Younger age and pemphigus vulgaris were associated with higher costs (p < 0.05). Expert opinion: This is the first cost-of-illness study applying the societal perspective in pemphigus. Our results indicate a substantial economic burden on society, mainly driven by productivity loss and informal care.
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Affiliation(s)
- V Brodszky
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - K Hajdu
- Departments of Dermatology, University of Debrecen , Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen , Debrecen, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - A Szegedi
- Departments of Dermatology, University of Debrecen , Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen , Debrecen, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged , Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs , Pécs, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest , Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program , Budapest, Hungary
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13
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Rencz F, Gulácsi L, Péntek M, Szegedi A, Remenyik É, Bata‐Csörgő Z, Bali G, Hidvégi B, Tamási B, Poór A, Hajdu K, Holló P, Kinyó Á, Sárdy M, Brodszky V. DLQI‐R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea. Br J Dermatol 2019; 182:1167-1175. [DOI: 10.1111/bjd.18435] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Nádor u 7 H‐1051 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A. Szegedi
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Korányi fasor 6 H‐6720 Szeged Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - K. Hajdu
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Akác u 1 H‐7632 Pécs Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
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14
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Bağcı I, Aoki R, Krammer S, Ruzicka T, Sárdy M, French L, Hartmann D. Ex vivo
confocal laser scanning microscopy for bullous pemphigoid diagnostics: new era in direct immunofluorescence? J Eur Acad Dermatol Venereol 2019; 33:2123-2130. [DOI: 10.1111/jdv.15767] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022]
Affiliation(s)
- I.S. Bağcı
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - R. Aoki
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - S. Krammer
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - T. Ruzicka
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - M. Sárdy
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - L.E. French
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
| | - D. Hartmann
- Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany
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15
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Hajdu K, Brodszky V, Stalmeier PFM, Ruzsa G, Tamási B, Gulácsi L, Péntek M, Sárdy M, Bata-Csörgő Z, Kinyó Á, Szegedi A, Rencz F. Patient-assigned health utility values for controlled and uncontrolled pemphigus vulgaris and foliaceus. J Eur Acad Dermatol Venereol 2019; 33:2106-2113. [PMID: 31265151 DOI: 10.1111/jdv.15765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 06/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The assessment of health-related quality of life (HRQoL) in patients with pemphigus is now of increasing interest due to the availability of highly effective new therapies. Preference-based HRQoL values or health utilities required for medical and financial decision-making are not yet available directly from pemphigus patients. OBJECTIVE To obtain health utility values for current health and hypothetical health states from the perspective of pemphigus patients. METHODS A cross-sectional questionnaire survey was carried out with pemphigus patients. Disease severity was rated by Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Patients were asked to evaluate their current health as well as three common hypothetical pemphigus health states [uncontrolled pemphigus vulgaris (PV), uncontrolled pemphigus foliaceus (PF) and controlled PV/PF] by using composite time trade-off (cTTO). Multiple regression was applied to explore determinants of utility values. RESULTS Responses of 108 patients (64.8% women, mean age 57.4 years) were analysed. Mean ABSIS score was 11.6. The mean utility values for the hypothetical uncontrolled PV, uncontrolled PF and controlled PV/PF health states were 0.41, 0.52 and 0.66 with cTTO. The mean cTTO scores for current health were higher compared with the hypothetical health states (0.76; P < 0.001). Patients with higher ABSIS, worse pain intensity scores and those having a caregiver reported lower utility values for current health (P < 0.05). CONCLUSIONS In pemphigus, HRQoL impairment expressed in utility values seems to be considerable, especially in comparison with other chronic dermatological conditions (e.g. psoriasis, atopic eczema, chronic hand eczema). These health utilities inform physicians, policymakers and funders about the overall extent of health loss in pemphigus and provide evidence to guide medical decisions and cost-effectiveness analyses of treatment strategies. Future research is needed to evaluate the caregiver burden in pemphigus.
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Affiliation(s)
- K Hajdu
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - P F M Stalmeier
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - G Ruzsa
- Doctoral School of Psychology, Institute of Psychology, Eötvös Loránd University of Sciences, Budapest, Hungary.,Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Budapest, Hungary
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16
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ‐5D in pemphigus. Br J Dermatol 2019. [DOI: 10.1111/bjd.17652] [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: 11/27/2022]
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17
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata‐Csörgő Z, Kinyó Á, Rencz F. EQ‐5D 在天疱疮中的效度. Br J Dermatol 2019. [DOI: 10.1111/bjd.17668] [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: 11/28/2022]
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18
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Rencz F, Brodszky V, Gulácsi L, Péntek M, Poór A, Holló P, Szegedi A, Remenyik É, Sárdy M, Langenbruch A, Radtke M, Gutknecht M, Augustin M. Time to revise the Dermatology Life Quality Index scoring in psoriasis treatment guidelines. J Eur Acad Dermatol Venereol 2019; 33:e267-e269. [DOI: 10.1111/jdv.15537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Premium Postdoctoral Research Programme Hungarian Academy of Sciences Nádor u. 7 H‐1051 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Szegedi
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
- Department of Dermatological Allergology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
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19
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Abstract
Linear IgA bullous dermatosis is a rare autoimmune blistering disease that occurs in both children and adults. Strings of pearls, crowns of jewels, rosettes and urticarial plaques can occur on the whole integument with emphasis on the face (particularly perioral area) and genitalia. Pruritus is common and may be severe. The presence of IgA deposits along the basement membrane can usually be identified using direct immunofluorescence (DIF) microscopy. The histological and clinical features of this disorder may mimic those of dermatitis herpetiformis.
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Affiliation(s)
- H A Juratli
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland.
| | - M Sárdy
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Budapest, Ungarn
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Abstract
Dermatitis herpetiformis (DH) is a genetically determined, gluten sensitive autoimmune bullous dermatosis related to celiac disease in which granular, insoluble aggregates in the papillary dermis of epidermal transglutaminase (TG3), immunoglobulin A (IgA), and fibrinogen are present. Detection of the dermal IgA-TG3 immune complex is the gold standard of diagnosis. DH develops in a subpopulation of patients with gluten sensitive enteropathy, characterized by itching, erythematous, excoriated papules showing characteristic distribution over the knees, elbows and buttocks; vesicles are rarely seen. The primary therapy of DH is a strict, lifelong gluten-free diet, and it may be necessary to temporarily give dapsone in case of severe symptoms.
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Affiliation(s)
- H A Juratli
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland.
| | - A Görög
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Budapest, Ungarn
| | - M Sárdy
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Fakultät für Medizin, Semmelweis Universität, Budapest, Ungarn
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21
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Rencz F, Gulácsi L, Péntek M, Poór A, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the DLQI in psoriasis. Br J Dermatol 2018. [DOI: 10.1111/bjd.17214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. 银屑病中 DLQI 新评分公式的提议. Br J Dermatol 2018. [DOI: 10.1111/bjd.17228] [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: 11/29/2022]
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23
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the Dermatology Life Quality Index in psoriasis. Br J Dermatol 2018; 179:1102-1108. [PMID: 29968311 DOI: 10.1111/bjd.16927] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Not relevant' responses (NRRs) on the Dermatology Life Quality Index (DLQI) may occur in up to 40% of patients with psoriasis. As these responses are scored as the item of the questionnaire having no impact on the patients' lives at all, it is more difficult for these patients to fulfil the DLQI > 10 criterion required by clinical guidelines to become candidates for systemic treatment including biologics. OBJECTIVES We propose a new scoring system for the DLQI that corrects for the bias in the NRR option and test its construct validity in a sample of patients with psoriasis. METHODS Data from 242 patients (104 of whom marked at least one NRR) from two earlier cross-sectional surveys were reanalysed. For each patient, the DLQI score was calculated in two ways: (i) according to the original scoring and (ii) by applying a new scoring formula (DLQI-R) that adjusts the total score for the number of NRRs. The construct validity of the DLQI-R was tested against the Psoriasis Area and Severity Index (PASI) and EQ-5D-3L. RESULTS The mean DLQI and DLQI-R scores were 9·99 ± 7·52 and 11·0 ± 8·02, respectively. The DLQI-R allowed eight more patients (3·3%) to achieve the 'PASI > 10 and DLQI > 10' threshold. The results were robust when limiting the maximum number of NRRs allowed to two or three. Compared with the DLQI, DLQI-R correlated slightly better with PASI (rs = 0·59 vs. 0·57) and EQ-5D-3L index scores (rs = -0·58 vs. -0·54). CONCLUSIONS The DLQI-R seems to be a valid scoring system for avoiding the bias in the NRR option and can help to improve patients' access to biologics.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor u. 7, H-1051, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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Tamási B, Brodszky V, Péntek M, Gulácsi L, Hajdu K, Sárdy M, Szegedi A, Bata-Csörgő Z, Kinyó Á, Rencz F. Validity of the EQ-5D in patients with pemphigus vulgaris and pemphigus foliaceus. Br J Dermatol 2018; 180:802-809. [PMID: 29897626 DOI: 10.1111/bjd.16883] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND No studies to date have employed the EuroQoL EQ-5D questionnaire to assess health-related quality of life (HRQoL) in patients with pemphigus. OBJECTIVES To evaluate the HRQoL of patients with pemphigus by the EQ-5D and to analyse the convergent and known-groups validity of the EQ-5D in this patient population. METHODS Between 2014 and 2017, a multicentre cross-sectional study was carried out. Outcome measures included the five-level EQ-5D (EQ-5D-5L), Dermatology Life Quality Index (DLQI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and an average pain intensity visual analogue scale (VAS) for the past 3 months. RESULTS In total, 109 consecutive patients with pemphigus participated in the study (mean age 57 years; 64% women). Among the EQ-5D dimensions, the most problems were reported regarding pain/discomfort (50%), mobility (43%) and anxiety/depression (43%). No significant difference was found in mean EQ-5D index scores between patients with pemphigus vulgaris and those with pemphigus foliaceus (0·81 vs. 0·86, P = 0·14). The mean EQ-5D index scores of patients with limited, moderate, significant and extreme pemphigus were 0·88, 0·82, 0·72 and 0·67, respectively (P = 0·001). The number of comorbidities was associated with greater impairment in EQ-5D index scores (P < 0·001). DLQI (rs = -0·62, P < 0·001) and the average pain intensity VAS (rs = -0·59, P < 0·001) more strongly correlated with the EQ-5D index scores than did ABSIS (rs = -0·40, P < 0·001). CONCLUSIONS This is the first study employing the EQ-5D questionnaire in pemphigus. The EQ-5D is a valid measure of HRQoL in patients with pemphigus that can be useful both in clinical practice and in economic evaluations to assess the health gains associated with new effective treatments.
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Affiliation(s)
- B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - K Hajdu
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical Centre, University of Szeged, Korányi fasor 6, H-6720, Szeged, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Akác u. 1, H-7632, Pécs, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Program, Nádor u. 7, H-1051, Budapest, Hungary
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25
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Bali G, Kárpáti S, Sárdy M, Brodszky V, Hidvégi B, Rencz F. Association between quality of life and clinical characteristics in patients with morphea. Qual Life Res 2018; 27:2525-2532. [DOI: 10.1007/s11136-018-1897-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/19/2022]
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Bac I, Horváth O, Flaig M, Vancsik T, Vural S, Ruzicka T, Sárdy M. 033 Increased expression of IL-31, IL-31RA and OSMRβ in bullous pemphigoid. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.037] [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: 10/17/2022]
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27
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Affiliation(s)
- B. Diczig
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - I. Németh
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - G. Pónyai
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
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28
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Jankásková J, Horváth ON, Varga R, Arenberger P, Schmidt E, Ruzicka T, Sárdy M. Increased sensitivity and high specificity of indirect immunofluorescence in detecting IgG subclasses for diagnosis of bullous pemphigoid. Clin Exp Dermatol 2018; 43:248-253. [DOI: 10.1111/ced.13371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2017] [Indexed: 11/27/2022]
Affiliation(s)
- J. Jankásková
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
- Department of Dermato-Venerology; Teaching Hospital Královské Vinohrady; Third Faculty of Medicine; Charles University in Prague; Prague Czech Republic
| | - O. N. Horváth
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
| | - R. Varga
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
| | - P. Arenberger
- Department of Dermato-Venerology; Teaching Hospital Královské Vinohrady; Third Faculty of Medicine; Charles University in Prague; Prague Czech Republic
| | - E. Schmidt
- Department of Dermatology, Allergology and Venerology; University of Lübeck; Lübeck Germany
- Lübeck Institute of Experimental Dermatology (LIED); University of Lübeck; Lübeck Germany
| | - T. Ruzicka
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
| | - M. Sárdy
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
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29
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Schmidt T, Hoch M, Lotfi Jad SS, Solimani F, Di Zenzo G, Marzano AV, Goebeler M, Cozzani E, Kern JS, Sitaru C, Lakoš Jukić I, Sárdy M, Uzun S, Jedlickova H, Gläser R, Kaneda M, Eming R, Göpel G, Ishii N, Greene B, Hashimoto T, Hertl M. Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis. Br J Dermatol 2017; 177:1683-1692. [PMID: 28703393 DOI: 10.1111/bjd.15800] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Epidermolysis bullosa acquisita (EBA) is a rare, potentially devastating autoimmune disease of the skin. IgG autoantibodies directed against type VII collagen (Col7), the major component of anchoring fibrils, induce skin fragility leading to cutaneous and mucocutaneous blister formation, which is mostly of a scarring phenotype. Thus, powerful and reproducible diagnostic assays are critical to establish the diagnosis of EBA early to avoid irreversible sequelae. OBJECTIVES The present international, retrospective multicentre study included a large cohort of patients with EBA and evaluated the diagnostic power of four different diagnostic assays for the detection of anti-Col7 IgG autoantibodies. METHODS Overall, 95 EBA sera and 200 control sera consisting of 100 bullous pemphigoid sera, 50 pemphigus vulgaris sera and 50 sera of healthy controls were tested for anti-Col7 IgG autoantibodies using indirect immunofluorescence (IIF), two commercial enzyme-linked immunosorbent assay (ELISA) systems and Western blot (WB) analysis. EBA sera were taken from patients with positive direct immunofluorescence and IgG reactivity in at least one of the immunoserological assays (IIF, ELISA, WB). RESULTS A Col7-NC1/NC2 ELISA (MBL, Nagoya, Japan) showed the highest sensitivity (97·9%), followed by a Col7-NC1 ELISA (Euroimmun, Lübeck, Germany) (89·5%), WB with Col7-NC1 (85·3%), and IIF on saline-split human skin (74·7%). The specificities of both ELISA systems were comparable (NC1 98·7%, NC1/NC2 99·3%). Furthermore, WB was more sensitive than IIF, which was more specific. CONCLUSIONS The two commercially available ELISA systems allow for a highly sensitive and specific diagnosis of EBA. The sensitivity of the Col7-NC1/NC2 ELISA is significantly higher compared with the ELISA based on the Col7-NC1 domain only.
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Affiliation(s)
- T Schmidt
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - M Hoch
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - S S Lotfi Jad
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - F Solimani
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - G Di Zenzo
- Istituto Dermopatico dell'Immacolata, Rome, Italy
| | - A V Marzano
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano - Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - E Cozzani
- Dermatology, IRCCS AOU San Martino Di.S.Sal., Genoa, Italy
| | - J S Kern
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | - C Sitaru
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | - I Lakoš Jukić
- Department of Dermatovenerology, University of Zagreb, Zagreb, Croatia
| | - M Sárdy
- München, Department of Dermatology and Allergology, Ludwig Maximilians University Munich, Munich, Germany
| | - S Uzun
- Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - H Jedlickova
- Department of Dermatovenereology, St. Anna University Hospital, Masaryk University, Brno, Czech Republic
| | - R Gläser
- Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - M Kaneda
- Medical and Biological Laboratories, Co. Ltd, Nagoya, Japan
| | - R Eming
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - G Göpel
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
| | - N Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - B Greene
- Institute of Biometry and Statistics, Philipps-University Marburg, D-35043, Marburg, Germany
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - M Hertl
- Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany
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30
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Horváth ON, Kapser C, Sárdy M. [Inflammatory diseases of oral mucous membranes]. Hautarzt 2016; 67:786-792. [PMID: 27576550 DOI: 10.1007/s00105-016-3862-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Mucous membranes are involved in many different inflammatory disorders. METHODS We describe the clinical features, diagnostic workup, and therapy of inflammatory diseases of mucous membranes. RESULTS The diagnostic workup is based on medical history, clinical manifestations, histopathology, and serology. Inadequate dental hygiene is one of the main pathogenetic factors. Treatment options depend on the diagnosis, underlying cause, and disease severity. Both local and systemic immunosuppressive or immunomodulatory strategies may be effective. CONCLUSIONS The diagnostic and therapeutic management of inflammatory mucous membrane disorders is usually more difficult than that of skin diseases and requires interdisciplinary cooperation.
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Affiliation(s)
- O N Horváth
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - C Kapser
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - M Sárdy
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland.
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31
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Moinzadeh P, Blank N, Siegert E, Henes J, Susok L, Distler J, Juche A, Worm M, Gil H, Schmeiser T, Zeidler G, Gäbelein-Wissing N, Krieg T, Sunderkoetter C, Kreuter A, Sárdy M, Riemekasten G, Mueller-Ladner U, Frerix M, Kuhr K, Hunzelmann N. AB0164 Disease Progression in 282 Patients with Undifferentiated SSc – Data from The German Network for Systemic Scleroderma. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3847] [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: 11/04/2022]
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Hunzelmann N, Riemekasten G, Becker M, Moinzadeh P, Kreuter A, Melchers I, Mueller‐Ladner U, Meier F, Worm M, Lee H, Herrgott I, Pfeiffer C, Fierlbeck G, Henes J, Juche A, Zeidler G, Mensing H, Günther C, Sárdy M, Burkhardt H, Koehm M, Kuhr K, Krieg T, Sunderkötter C. The Predict Study: low risk for digital ulcer development in patients with systemic sclerosis with increasing disease duration and lack of topoisomerase‐1 antibodies. Br J Dermatol 2016; 174:1384-7. [DOI: 10.1111/bjd.14367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- N. Hunzelmann
- Department of Dermatology and Venereology University Hospital of Cologne Kerpener Straße 62 Köln 50937 Germany
| | - G. Riemekasten
- Department of Rheumatology and Clinical Immunology University of Berlin, Charité Berlin Germany
| | - M.O. Becker
- Department of Rheumatology and Clinical Immunology University of Berlin, Charité Berlin Germany
| | - P. Moinzadeh
- Department of Dermatology and Venereology University Hospital of Cologne Kerpener Straße 62 Köln 50937 Germany
| | - A. Kreuter
- Helios St Elisabeth Clinic Dermatology and Venereology Oberhausen Germany
| | - I. Melchers
- University Medical Center Freiburg Clinical Research Unit for Rheumatology Freiburg Germany
| | - U. Mueller‐Ladner
- Justus Liebig University Giessen Kerckhoff Clinic Rheumatology and Clinical Immunology Bad Nauheim Germany
| | - F. Meier
- Justus Liebig University Giessen Kerckhoff Clinic Rheumatology and Clinical Immunology Bad Nauheim Germany
| | - M. Worm
- Department of Dermatology and Venereology University of Berlin, Charité Berlin Germany
| | - H. Lee
- Department of Dermatology and Venereology University of Berlin, Charité Berlin Germany
| | - I. Herrgott
- Department of Dermatology and Department of Translational Dermatoinfectiology University of Muenster Muenster Germany
| | - C. Pfeiffer
- University Hospital Ulm Dermatology Ulm Germany
| | - G. Fierlbeck
- Department of Dermatology University of Tübingen Tübingen Germany
| | - J. Henes
- Department of Rheumatology University of Tübingen Tübingen Germany
| | - A. Juche
- Johanniter Hospital Treuenbrietzen Rheumatology Treuenbrietzen Germany
| | - G. Zeidler
- Johanniter Hospital Treuenbrietzen Rheumatology Treuenbrietzen Germany
| | - H. Mensing
- Hamburg Alstertal Clinic for Dermatology Hamburg Germany
| | - C. Günther
- University Hospital Carl Gustav Carus Dermatology Dresden Germany
| | - M. Sárdy
- Ludwig Maximilian University Dermatology and Allergology Munich Germany
| | - H. Burkhardt
- Goethe‐University Frankfurt & Clinical Research Fraunhofer IME Translational Medicine and Pharmacology (TMP), RheumatologyFrankfurt/Main Germany
| | - M. Koehm
- Goethe‐University Frankfurt & Clinical Research Fraunhofer IME Translational Medicine and Pharmacology (TMP), RheumatologyFrankfurt/Main Germany
| | - K. Kuhr
- Institute of Medical Statistics, Informatics and Epidemiology University Hospital of Cologne Kerpener Straße 62 50937 Köln Germany
| | - T. Krieg
- Department of Dermatology and Venereology University Hospital of Cologne Kerpener Straße 62 Köln 50937 Germany
| | - C. Sunderkötter
- Department of Dermatology and Department of Translational Dermatoinfectiology University of Muenster Muenster Germany
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33
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Moinzadeh P, Riemekasten G, Fierlbeck G, Henes J, Blank N, Melchers I, Mueller-Ladner U, Kreuter A, Susok L, Guenther C, Zeidler G, Pfeiffer C, Worm M, Aberer E, Genth E, Distler J, Hein R, Sárdy M, Mensing H, Koetter I, Sunderkoetter C, Hellmich M, Krieg T, Hunzelmann N. SAT0440 New Data on Renal Crisis and Predictive Markers from More Than 3000 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ibekwe PU, Ogunbiyi AO, Besch R, Ruzicka T, Sárdy M. The spectrum of Malassezia species isolated from students with pityriasis vesicolor in Nigeria. Mycoses 2015; 58:203-8. [PMID: 25703018 DOI: 10.1111/myc.12298] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/03/2015] [Accepted: 01/05/2015] [Indexed: 11/30/2022]
Abstract
Pityriasis versicolor (PV) is a common superficial fungal infection of the skin caused by Malassezia. Initially M. furfur was suggested as its main aetiological agent; however, more recent studies suggest M. globosa as the dominant species. The possibility of a variance in predominant species based on geographical basis has not been fully evaluated. The objective of this study was to identify the Malassezia species on affected and non-affected skin of students with PV who reside in a tropical environment (Abuja, Nigeria) and correlate them to clinical characteristics. In this study, the literature on prevalence of Malassezia genus in PV was also reviewed. Samples were taken from 304 PV lesions and 110 normal appearing skin. Microscopy, culture and identification of Malassezia species utilising polymerase chain reaction-restriction fragment length polymorphism analysis were performed. Three Malassezia species were detected in PV with the major species being M. furfur. On normal appearing skin, M. furfur (77.6%) and M. restricta (10.4%) were both detected. No case of M. globosa was identified in this study. There was no significant difference between species identified and clinical features of PV. M. furfur is probably still the most predominant species causing PV in the tropical environment.
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Affiliation(s)
- P U Ibekwe
- Dermatology unit, Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Nigeria; Center for International Health, Ludwig Maximilian University, Munich, Germany
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Kuhn A, Sigges J, Biazar C, Ruland V, Patsinakidis N, Landmann A, Amler S, Bonsmann G, Haust M, Nyberg F, Bata Z, Mihályi L, Olteanu R, Pujol R, Sánchez‐Schmidt J, Medenica L, Skiljevic D, Reich A, Szepietowski J, Dalle Vedove C, Girolomoni G, Hawro T, Zalewska‐Janowska A, Glaeser R, Huegel R, Jedličková H, Bygum A, Laurinaviciene R, Benoit S, Broecker E, Bahmer F, Aberer E, Wutte N, Lipozencic J, Marinovic B, Sárdy M, Bekou V, Ruzicka T, Frances C, Soutou B, Lee H, Worm M, Gruschke A, Hunzelmann N, Steinbrink K, Romiti R, Sticherling M, Erfurt‐Berge C, Avgerinou G, Papafragkaki D, Antiga E, Caproni M, Mayer B, Volc‐Platzer B, Kreuter A, Tigges C, Heil P, Stingl G. Influence of smoking on disease severity and antimalarial therapy in cutaneous lupus erythematosus: analysis of 1002 patients from the
EUSCLE
database. Br J Dermatol 2014; 171:571-9. [DOI: 10.1111/bjd.13006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 12/27/2022]
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Moinzadeh P, Elisabeth A, Blank N, Distler J, Fierlbeck G, Genth E, Guenther C, Hein R, Henes J, Hellmich M, Herrgott I, Koetter I, Kreuter A, Krieg T, Melchers I, Mensing H, Mueller-Ladner U, Pfeiffer C, Riemekasten G, Sárdy M, Susok L, Worm M, Wozel G, Zeidler G, Sunderkoetter C, Hunzelmann N. FRI0488 Analysis of REAL Life Vasoactive Therapy in over 3000 Patients with Systemic Sclerosis (SSC) Reveals Considerable Undertreatment and Significant Changes of Treatment Practice since 2004. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4946] [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: 11/03/2022]
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Sárdy M, Kasperkiewicz M. Bullöse Autoimmunkrankheiten bei Kindern. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3085-x] [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: 11/24/2022]
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Affiliation(s)
- M. Sárdy
- Department of Dermatology and Allergy; Ludwig Maximilian University Munich; Frauenlobstr. 9-11 D-80337 Munich Germany
| | - T. Ruzicka
- Department of Dermatology and Allergy; Ludwig Maximilian University Munich; Frauenlobstr. 9-11 D-80337 Munich Germany
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Sárdy M, Kornseé Z, Kelemen D, Papp S, Medvecz M, Kárpáti S. Celiac disease screening among healthy blood donors in Hungary. Z Gastroenterol 2013; 51:1235-9. [PMID: 24243570 DOI: 10.1055/s-0033-1335450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Celiac disease (CD) is a common chronic systemic autoimmune disease in Europe. The prevalence of CD in Hungarian children is estimated at 1.2 - 1.4 %. To date, however, no data on adult CD prevalence has been published. AIMS Analysis of the serological evidence for CD among Hungarian adults in order to estimate its prevalence. METHODS Plasma samples from 4155 healthy blood donors were anonymously screened for circulating IgA autoantibodies by a highly sensitive tissue transglutaminase ELISA. Positive results were subsequently confirmed by endomysial antibody test. RESULTS Endomysial antibody test confirmed positivity in 25 samples suggesting a prevalence of CD of at least 0.6 % (1:166). Since no identification on the samples was provided, no further examinations could be done on endomysial antibody positive individuals. CONCLUSIONS The first serological screening study among healthy Hungarian adult blood donors showed a prevalence of CD similar to other central European countries and lower than that in Hungarian children. Among countries worldwide, the Hungarian prevalence of CD appears to be in the mid-range, although pediatric data suggest a higher prevalence.
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Affiliation(s)
- M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest
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Kostaki D, Castillo J, Ruzicka T, Sárdy M. Longitudinal leuconychia striata: is it a common sign in Hailey-Hailey and Darier disease? J Eur Acad Dermatol Venereol 2013; 28:126-7. [DOI: 10.1111/jdv.12133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/13/2013] [Indexed: 11/30/2022]
Affiliation(s)
- D. Kostaki
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
- Department of Dermatology; University of L'Aquila; L'Aquila Italy
| | - J.C. Castillo
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
- Department of Dermatology; Makati Medical Center; Makati Philippines
| | - T. Ruzicka
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
| | - M. Sárdy
- Department of Dermatology and Allergology; Ludwig Maximilian University; Munich Germany
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Hoheisel U, Sárdy M, Mense S. Experiments on the nature of the signal that induces spinal neuroplastic changes following a peripheral lesion. Eur J Pain 2012; 1:243-59. [PMID: 15102390 DOI: 10.1016/s1090-3801(97)90034-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/1997] [Accepted: 09/02/1997] [Indexed: 10/26/2022]
Abstract
This study aimed at identifying the signal(s) that elicit myositis-induced neuroplastic changes in background activity and responsiveness of spinal neurones. It is based on previous data suggesting that in dorsal horn neurones, responsiveness to peripheral input on one hand and background activity on the other are probably controlled by different mechanisms. In anaesthetized rats, myositis was induced in the gastrocnemius-soleus muscle and the activity of single dorsal horn neurones was recorded in segment L3. Impulse traffic and axoplasmatic transport in dorsal roots L4 and L5 were selectively blocked by lignocaine or vinblastine for various time periods relative to the induction of the myositis. The results show that the main triggering signal for the myositis-induced changes in both responsiveness and background activity is the altered impulse activity in primary afferent fibres. In contrast, 'no axonally transported chemical signal controlling the discharge behaviour of dorsal horn neurones was found. However, the time course of the electrical signals that cause the myositis-induced changes in background activity and responsiveness is different. For changes in responsiveness, a rather narrow time window of 2 h directly after induction of the myositis existed, during which the impulses from the inflamed muscle must reach the spinal cord. Accordingly, to prevent the increase in responsiveness, the electrical input had to be blocked during the first 2 h; a block of the same duration at another time had no effect. The change in background activity seems to be due to a continuous input from the inflamed muscle which adds up over the hours. Therefore, with regard to background activity, blocking the electrical signals is effective at any time, but only a block of long duration has a significant effect.
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Affiliation(s)
- U Hoheisel
- Institut für Anatomie and Zellbiologie III der Universität Heidelberg, Heidelberg, Germany
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Abstract
The multifactorial pathogenesis of dermatitis herpetiformis is reviewed in light of current experimental data. Genetic background, gluten consumption, and abnormal immune and autoimmune reactions are the most important pathogenetic factors, but other agents also participate in the disease development. The predisposing and inducing factors are summarized, while the pathophysiological steps leading to the development of skin symptoms are detailed.
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Affiliation(s)
- M Sárdy
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilans-Universität München, Frauenlobstr. 9-11, 80337 München.
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Sárdy M, Preisz K, Berecz M, Horváth C, Kárpáti S, Horváth A. Methotrexate treatment of recurrent impetigo herpetiformis with hypoparathyroidism. J Eur Acad Dermatol Venereol 2006; 20:742-3. [PMID: 16836512 DOI: 10.1111/j.1468-3083.2006.01473.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Preisz K, Sárdy M, Horváth A, Kárpáti S. Immunoglobulin, complement and epidermal transglutaminase deposition in the cutaneous vessels in dermatitis herpetiformis. J Eur Acad Dermatol Venereol 2005; 19:74-9. [PMID: 15649195 DOI: 10.1111/j.1468-3083.2004.01132.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Recently, epidermal transglutaminase (TG) has been identified within the papillary IgA granules in dermatitis herpetiformis (DH). Although IgA type autoantibodies to tissue and epidermal TGs are characteristic serological markers for DH, these antibodies do not bind to normal papillary skin structures. AIMS To test the possibility of IgA immune complex precipitation within the vessel walls as a first step in the pathogenesis of skin symptoms, we analysed immunoglobulin, complement, and epidermal TG deposition along the vascular system of DH skin. METHODS Punch biopsy specimen were taken from 116 DH patients' skin, and evaluated for the presence of vascular immune precipitates by direct immunofluorescence. Skin samples from 16 DH patients were also studied for tissue and epidermal TGs. RESULTS In 74 (64%) of the 116 DH skin studied, significant vascular staining accompanied the DH-specific granular IgA fluorescence (IgA and C3 in 39 patients; IgA alone in 18; IgA, C3 and IgM together in five; IgM alone in 12). In most cases (92%), the precipitates were detected in the small vessels of the papillary dermis; however, a subpapillary vascular fluorescence was also observed in a few patients (8%). Skin IgA colocalized with epidermal TG in the vessel walls and within the scattered papillary peri- and intervascular DH bodies. Tissue TG did not colocalize either with the immunoglobulins or with the complement precipitates of the dermis. Furthermore, we could not detect keratinocyte TG in the DH bodies nor in the vessel walls. CONCLUSIONS These findings support possible immune complex precipitation in the vessel walls of DH skin and further confirm the significance of epidermal but not tissue TG in the pathomechanism of skin symptoms.
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Affiliation(s)
- K Preisz
- Department of Dermato-Venereology and -Oncology, Semmelweis University, Budapest, Hungary.
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Preisz K, Horváth A, Sárdy M, Somlai B, Hársing J, Amagai M, Hashimoto T, Nagata Y, Fekete S, Kárpáti S. Exacerbation of paraneoplastic pemphigus by cyclophosphamide treatment: detection of novel autoantigens and bronchial autoantibodies. Br J Dermatol 2004; 150:1018-24. [PMID: 15149520 DOI: 10.1111/j.1365-2133.2004.05978.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 48-year-old woman with a follicular, grade III, B-cell non-Hodgkin lymphoma developed clinical, immunopathological and histological features of paraneoplastic pemphigus. The skin symptoms flared after repeated cyclophosphamide infusions, and were preceded and accompanied by a progressive dyspnoea. Although the skin and oral mucosal disease went into remission with high-dose steroid and intravenous immunoglobulin therapy, the severe alveolitis led to death. Immunoblotting of human epidermal extracts showed that the patient's serum IgG reacted with the 210-kDa envoplakin, 190-kDa periplakin, as well as the recombinant protein of BP180 NC16a domain. IgG and IgA enzyme-linked immunosorbent assays for desmoglein 3 were positive, too. Indirect immunofluorescence studies on COS-7 cells transiently transfected with desmocollin 1-3 cDNAs showed that the patient's serum contained IgG and IgA antibodies to desmocollin 3 as well as IgG antibodies to desmocollin 2. Serum IgG and IgA strongly stained rat bronchial epithelium, corresponding to autoantibodies possibly involved in the pathomechanism of the severe lung disease. In this case, which was characterized by a mixed IgA/IgG antibody panel displaying known and unique antigenicity, the serious episodes of paraneoplastic pemphigus flared after cyclophosphamide treatment.
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Affiliation(s)
- K Preisz
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
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Becker K, Csikós M, Sárdy M, Szalai ZS, Horváth A, Kárpáti S. Identification of two novel nonsense mutations in the transglutaminase 1 gene in a Hungarian patient with congenital ichthyosiform erythroderma. Exp Dermatol 2003; 12:324-9. [PMID: 12823447 DOI: 10.1034/j.1600-0625.2003.120313.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Congenital ichthyosiform erythroderma (CIE) belongs together with lamellar ichthyosis (LI) to the group of autosomal recessive congenital ichthyoses (ARCI). Mutations in the transglutaminase (TGase) 1 gene (TGM1) have been identified in several families with LI and in some families with CIE. We report a case of CIE with two new nonsense mutations: a C7780G transversion in exon 11 resulting in a premature stop codon at aminoacid residue Y503X and a C8533G transversion in exon 13 leading to a nonsense mutation at S669X. These mutations were also identified in a heterozygous pattern in the unaffected parents. These two termination-codons result in the translation of a truncated protein at the C-terminal end domain of the TGM 1 molecule. B.C1 monoclonal antibody failed to detect TGase 1 in the patient's skin sample, and TGase activity measured by monodansyl cadaverine-incorporation showed the reduced TGase activity at the distribution of TGase 1 in the epidermis.
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Affiliation(s)
- K Becker
- Department of Dermatology, Semmelweis University, Budapest, Hungary.
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Abstract
Trends in morbidity from syphilis in Hungary between 1952 and 1996 were analysed. The incidence of syphilis/100,000 inhabitants declined rapidly owing to the public health and therapeutic measures of the early 1950s (1952: total=73.6, early infections=60.2; 1962: total=13.7, early infections=8.7). After a temporary, slight increase until 1973 the number of reported syphilis cases declined continuously between 1978 and 1989 (1989: total=0.9, early infections=0.84). In 1994 a marked increase occurred when compared with 1993 (1993: total=early: 1.4. 1994: total=2.3, early infections=2.2). Incidence trends were statistically analysed using Chi-square test and linear regression. Chi-square analysis showed that the changes in the incidence of total and early syphilis are significant (P<0.00001) comparing the time intervals 1952-1962 with 1962-1966 and 1975-1979 with 1988-1992. The same trends were found using the linear regression test, except for the time interval of 1960-1973.
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Affiliation(s)
- V Várkonyi
- National Institute of Dermato-Venereology, Semmelweis University of Medicine, Budapest, Hungary
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Sárdy M, Kárpáti S, Péterfy F, Rásky K, Tomsits E, Zágoni T, Horváth A. Comparison of a tissue transglutaminase ELISA with the endomysium antibody test in the diagnosis of gluten-sensitive enteropathy. Z Gastroenterol 2000; 38:357-64. [PMID: 10875144 DOI: 10.1055/s-2000-14883] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Tissue transglutaminase (tTG) has recently been found to be the major if not the only autoantigen of gluten-sensitive enteropathy (GSE). OBJECTIVES To further determine the significance of this finding for diagnostic (screening) and follow-up purposes, we performed tTG-based ELISAs, and compared the results to the endomysium antibody test (EMA). PATIENTS We examined 120 serum samples from patients with celiac disease (CD) including 72 on a gluten-free diet (GFD) and eleven on a gluten challenge, 47 with dermatitis herpetiformis (DH) including 16 on a GFD and one on a gluten challenge, 96 with non-CD gastrointestinal diseases, and 117 with others; i.e. 380 serum samples altogether. Follow-up sera from 13 patients were included. METHODS Results of an ELISA with guinea pig liver tTG were compared with the EMA test using monkey esophagus. Inhibition of endomysial staining was performed with sera positive on the EMA test but negative with the guinea pig tTG ELISA. RESULTS The specificity and sensitivity of the tTG ELISA are high (98.6% and 92.5%). The serum IgA antibody titers against tTG decrease after introduction of a GFD. In one case, endomysial staining could not be inhibited. CONCLUSIONS Our results show that the guinea pig tTG ELISA is suitable for use as a simple diagnostic screening and follow-up method for GSE. Further studies are necessary to identify possible additional minor antigens in GSE.
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Affiliation(s)
- M Sárdy
- Department of Dermato-Venereology, Semmelweis University of Medicine, Budapest, Hungary.
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