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Laskowski M, Schiöler L, Åberg M, Abuabara K, Wennberg AM, Gustafsson H, Torén K. Influence of stress resilience in adolescence on long-term risk of psoriasis and psoriatic arthritis among men: A prospective register-based cohort study in Sweden. J Eur Acad Dermatol Venereol 2024. [PMID: 38767960 DOI: 10.1111/jdv.20069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/06/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Although stress is considered to be a negative factor for psoriasis, no convincing scientific evidence of this association exists, largely because of difficulties in measuring stress. Stress resilience is the ability to cope with and adapt to stressful events. Stress resilience can be measured in a standardized way and used as a marker for chronic stress. OBJECTIVES The objective of this study is to investigate whether low stress resilience in adolescence increases the risk for onset of psoriasis and psoriatic arthritis later in life. METHODS A cohort of Swedish men (mean age 18.3 years), enrolled in compulsory military service between 1968 and 2005, was created using data from the Swedish Military Service Conscription Register (n = 1,669,422). Stress resilience at conscription was estimated using standardized semi-structured interviews, and was divided into three categories: low, medium and high. The men were followed from conscription until new-onset psoriasis or psoriatic arthritis, death or emigration or at the latest until 31 December 2019. Cox regression models adjusted for confounders at conscription were used to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for incident psoriasis and psoriatic arthritis. RESULTS Men in the lowest stress resilience category had an increased risk of psoriasis and psoriatic arthritis (HR 1.31 (95% CI 1.26-1.36) and 1.23 (95% CI 1.15-1.32), respectively), compared with those in the highest stress resilience category. When including only hospitalized patients the HRs for psoriasis and psoriatic arthritis in the lowest stress resilience group were 1.79 (1.63-1.98) and 1.53 (1.32-1.77), respectively. CONCLUSIONS This large, prospective register study suggests that low stress resilience in adolescence is associated with an increased risk of incident psoriasis among men. The results indicate that patients with psoriasis have an inherent psychological vulnerability, and highlight the importance of addressing psychological well-being in the management of psoriasis.
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Affiliation(s)
- M Laskowski
- Department of Dermatology and Venereology, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - L Schiöler
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - K Abuabara
- Department of Dermatology, University of California, San Francisco, California, USA
| | - A-M Wennberg
- Department of Dermatology and Venereology, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Gustafsson
- Department of Physiology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Torén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Fadadu RP, Chee E, Jung A, Chen JY, Abuabara K, Wei ML. Air pollution and global healthcare use for atopic dermatitis: A systematic review. J Eur Acad Dermatol Venereol 2023; 37:1958-1970. [PMID: 37184289 DOI: 10.1111/jdv.19193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Increasing air pollution is common around the world, but the impacts of outdoor air pollution exposure on atopic dermatitis (AD) are unclear. We synthesized the current global epidemiologic evidence for air pollution exposure and associated medical visits for AD among adults and children. This review followed PRISMA guidelines, and searches were conducted on PubMed, MEDLINE, Web of Science and EMBASE databases. The searches yielded 390 studies, and after screening, 18 studies around the world assessing at least 5,197,643 medical visits for AD in total were included for the final analysis. We found that exposure to particulate matter ≤2.5 μm in diameter (PM2.5 ) [(10/11) of studies], particulate matter ≤10 μm in diameter (PM10 ) (11/13), nitrogen dioxide (NO2 ) (12/14) and sulfur dioxide (SO2 ) (10/13) was positively associated with AD visits. Results were equivocal for ozone [(4/8) of studies reported positive association] and limited for carbon monoxide [(1/4) of studies reported positive association]. When stratifying results by patient age, patient sex and season, we found that the associations with particulate matter, NO2 and O3 may be affected by temperature. Exposure to selected air pollutants is associated with AD visits, and increasingly poor worldwide air quality may increase global healthcare use for AD.
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Affiliation(s)
- R P Fadadu
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
| | - E Chee
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - A Jung
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- School of Information, University of California, Berkeley, Berkeley, California, USA
| | - J Y Chen
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
| | - K Abuabara
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - M L Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
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3
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Tully J, Tomaszewski N, Kidd S, Langan S, Abuabara K. 207 The impact of childhood stressful life events on atopic dermatitis disease activity and severity: A prospective study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Williams J, Kittler N, Kudlinski M, Lester J, Abuabara K, Naik H. 169 Poor validity of hidradenitis suppurativa diagnostic criteria in pediatric patients. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.176] [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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5
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Kern C, Johanis M, Johanis M, Tahir P, Ye M, Mulick A, Allen I, McCulloch C, Langan S, Abuabara K. 155 Atopic dermatitis is associated with cardiovascular risk factors in pediatric patients: A systematic review and meta-analysis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.162] [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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6
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Ye M, Chiang B, Abuabara K. 241 The association between sodium intake and atopic dermatitis in a US population-based cohort. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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7
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Bosma AL, Ascott A, Iskandar R, Farquhar K, Matthewman J, Langendam MW, Mulick A, Abuabara K, Williams HC, Spuls PI, Langan SM, Middelkamp-Hup MA. Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics. J Eur Acad Dermatol Venereol 2022; 36:807-819. [PMID: 35170821 PMCID: PMC9307020 DOI: 10.1111/jdv.18008] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/10/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
Atopic dermatitis is a heterogeneous disease, accompanied by a wide variation in disease presentation and the potential to identify many phenotypes that may be relevant for prognosis and treatment. We aimed to systematically review previously reported phenotypes of atopic dermatitis and any characteristics associated with them. Ovid EMBASE, Ovid MEDLINE and Web of Science were searched from inception till the 12th of February 2021 for studies attempting to classify atopic dermatitis. Primary outcomes are atopic dermatitis phenotypes and characteristics associated with them in subsequent analyses. A secondary outcome is the methodological approach used to derive them. In total, 8,511 records were found. By focusing only on certain clinical phenotypes, 186 studies were eligible for inclusion. The majority of studies were hospital-based (59%, 109/186) and cross-sectional (76%, 141/186). The number of included patients ranged from seven to 526,808. Data-driven approaches to identify phenotypes were only used in a minority of studies (7%, 13/186). Ninety-one studies (49%) investigated a phenotype based on disease severity. A phenotype based on disease trajectory, morphology and eczema herpeticum was investigated in 56 (30%), 22 (12%) and 11 (6%) studies, respectively. Thirty-six studies (19%) investigated morphological characteristics in other phenotypes. Investigated associated characteristics differed between studies. In conclusion, we present an overview of phenotype definitions used in literature for severity, trajectory, morphology and eczema herpeticum, including associated characteristics. There is a lack of uniform and consistent use of atopic dermatitis phenotypes across studies.
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Affiliation(s)
- A L Bosma
- Department of Dermatology, UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | - A Ascott
- Department of Dermatology, University Hospitals Sussex NHS Foundation Trust, Worthing, United Kingdom
| | - R Iskandar
- Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - J Matthewman
- Department of Non-communicable disease epidemiology, School of Hygiene and Tropical Medicine, London, United Kingdom
| | - M W Langendam
- Department of Epidemiology and Data Science, UMC, location Amsterdam Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - A Mulick
- Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, United Kingdom
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, United States
| | - H C Williams
- Centre of Evidence-Based Dermatology, University of Nottingham, United Kingdom
| | - P I Spuls
- Department of Dermatology, UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
| | - S M Langan
- Department of Dermatology, UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands.,Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, United Kingdom
| | - M A Middelkamp-Hup
- Department of Dermatology, UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
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Capozza K, Schwartz A, Lang JE, Chalmers J, Camilo J, Abuabara K, Kelley K, Harrison J, Vastrup A, Stancavich L, Tai A, Kimball AB, Finlay AY. The Impact of Childhood Atopic Dermatitis on Life Decisions for Caregivers and Families. J Eur Acad Dermatol Venereol 2022; 36:e451-e454. [DOI: 10.1111/jdv.17943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Capozza
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Schwartz
- Departments of Medical Education and Pediatrics University of Illinois Chicago USA
| | - JE Lang
- Global Parents for Eczema Research Santa Barbara USA
| | - J Chalmers
- Centre of Evidence Based Dermatology University of Nottingham Nottingham UK
| | - J Camilo
- ADERMAP ‐ Associação Dermatite Atópica Portugal Lisboa Portugal
| | - K Abuabara
- Department of Dermatology University of California San Francisco USA
| | - K. Kelley
- Global Parents for Eczema Research Santa Barbara USA
| | - J. Harrison
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Vastrup
- Atopisk Eksem Forening Copenhagen Denmark
| | - L. Stancavich
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Tai
- Global Parents for Eczema Research Santa Barbara USA
| | | | - AY Finlay
- Division of Infection and Immunity School of Medicine Cardiff University Cardiff UK
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9
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Wan J, Shin DB, Syed MN, Abuabara K, Lemeshow AR, Gelfand JM. Risk of herpesvirus, serious, and opportunistic infections in atopic dermatitis: a population-based cohort study. Br J Dermatol 2021; 186:664-672. [PMID: 34748650 DOI: 10.1111/bjd.20887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Staphylococcal and herpes simplex virus (HSV) infections are commonly recognized in atopic dermatitis (AD) but less is known about other types of infections. OBJECTIVES To determine the risk of herpesvirus infections, serious infections, and opportunistic infections in patients with AD. METHODS We conducted a population-based cohort study using UK-based electronic medical records data. Patients with AD were each matched to up to 5 unaffected patients on age, practice, and index date. AD severity was defined using treatments. The outcomes were incident herpesvirus infections (cytomegalovirus [CMV], Epstein-Barr virus [EBV], HSV, or varicella zoster virus [VZV]), serious infections, and opportunistic infections. RESULTS 409,431 children and 625,083 adults with AD were matched to 1,809,029 children and 2,678,888 adults without AD, respectively. In adjusted Cox regression models, children and adults with AD had 50-52% greater risk of HSV and 18-33% greater risk of VZV, with risk increasing in parallel with AD severity. CMV risk was elevated among children with AD (HR 2.50 [1.38-4.54]) and adults with severe AD (4.45 [1.76-11.25]). Patients with AD had 26-40% increase in risk of serious infections, with severe AD carrying greatest risk. Although rare, opportunistic infections were not associated with AD in children but were associated with all severities of AD in adults (overall HR 1.31 [1.20-1.42]). All estimates remained consistent after excluding patients receiving immunosuppressive treatments for AD. CONCLUSIONS AD is significantly associated with herpesvirus infections, serious infections, and opportunistic infections in a dose-responsive manner with severity. AD may increase susceptibility to infections exclusive of immunosuppressive medications.
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Affiliation(s)
- J Wan
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D B Shin
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M N Syed
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | | | - J M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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10
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Mulick AR, Mansfield KE, Silverwood RJ, Budu-Aggrey A, Roberts A, Custovic A, Pearce N, Irvine AD, Smeeth L, Abuabara K, Langan SM. Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease and internally validated in a large UK birth cohort. Br J Dermatol 2021; 185:526-536. [PMID: 33655501 PMCID: PMC8410876 DOI: 10.1111/bjd.19885] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) disease activity and severity is highly variable during childhood. Early attempts to identify subtypes based on disease trajectory have assessed AD presence over time without incorporating severity. OBJECTIVES To identify childhood AD subtypes from symptom severity and trajectories, and determine associations with genetic risk factors, comorbidities and demographic and environmental variables. METHODS We split data from children in the Avon Longitudinal Study of Parents and Children birth cohort into development and validation sets. To identify subtypes, we ran latent class analyses in the development set on AD symptom reports up to age 14 years. We regressed identified subtypes on nongenetic variables in mutually adjusted, multiply imputed (genetic: unadjusted, complete case) multinomial regression analyses. We repeated analyses in the validation set and report confirmed results. RESULTS There were 11 866 children who contributed to analyses. We identified one Unaffected/Rare class (66% of children) and four AD subtypes: Severe-Frequent (4%), Moderate-Frequent (7%), Moderate-Declining (11%) and Mild-Intermittent (12%). Symptom patterns within the first two subtypes appeared more homogeneous than the last two. Filaggrin (FLG) null mutations, an AD polygenic risk score (PRS), being female, parental AD and comorbid asthma were associated with higher risk for some or all subtypes; FLG, AD-PRS and asthma associations were stronger along a subtype gradient arranged by increasing severity and frequency; FLG and AD-PRS further differentiated some phenotypes from each other. CONCLUSIONS Considering severity and AD trajectories leads to four well-defined and recognizable subtypes. The differential associations of risk factors among and between subtypes is novel and requires further research.
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Affiliation(s)
- A R Mulick
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - K E Mansfield
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R J Silverwood
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - A Budu-Aggrey
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - A Roberts
- Nottingham Support Group for Carers of Children with Eczema, Nottingham, UK
| | - A Custovic
- National Heart & Lung Institute, Imperial College London, London, UK
| | - N Pearce
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - A D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - L Smeeth
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - S M Langan
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Health Data Research UK, London, UK
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Wan J, Abuabara K. Growing evidence for an association between inflammatory skin disease and chronic kidney disease. Br J Dermatol 2021; 185:693-694. [PMID: 34378211 DOI: 10.1111/bjd.20632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/12/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- J Wan
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.,Division of Epidemiology and Biostatistics, University of California Berkeley School of Public Health, Berkeley, CA, USA
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Abuabara K, Nicholls SG, Langan SM, Guttman-Yassky E, Reynolds NJ, Paller AS, Brown SJ. Priority research questions in atopic dermatitis: an International Eczema Council eDelphi consensus. Br J Dermatol 2021; 185:203-205. [PMID: 33570761 PMCID: PMC8359998 DOI: 10.1111/bjd.19874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
- K Abuabara
- Department of Dermatology, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - S G Nicholls
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - S M Langan
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - N J Reynolds
- Newcastle University, Newcastle upon Tyne, UK
- Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - A S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S J Brown
- University of Dundee, Dundee, UK
- Ninewells Hospital and Medical School, Dundee, UK
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13
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Tomaszewski N, Batra K, Smith Begolka W, Capozza K, Eftekhari S, Tullos K, Abuabara K. 363 The impact of atopic dermatitis on caregivers of patients of all ages. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.385] [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: 10/21/2022]
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14
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Wan J, Shin D, Syed M, Abuabara K, Gelfand J. 266 Risk of opportunistic, viral, and hospitalized infections in atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.288] [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: 11/26/2022]
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15
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Ye M, Hollenstein L, Mansfield K, Abuabara K, Langan S. 365 Adult atopic dermatitis is associated with lymphopenia in two large cohorts. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.387] [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: 10/21/2022]
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Mulick A, Mansfield K, Silverwood R, Budu-Aggrey A, Roberts A, Custovic A, Pearce N, Irvine A, Smeeth L, Abuabara K, Langan S. 247 Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.269] [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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Ascott A, Mansfield KE, Schonmann Y, Mulick A, Abuabara K, Roberts A, Smeeth L, Langan SM. Atopic eczema and obesity: a population-based study. Br J Dermatol 2020; 184:871-879. [PMID: 33090454 DOI: 10.1111/bjd.19597] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Atopic eczema is a common chronic inflammatory skin disease. Research suggests an association between atopic eczema and obesity, with inconsistent evidence from European populations. OBJECTIVES To explore the association between diagnosed atopic eczema and being overweight or obese, and whether increased atopic eczema severity was associated with higher body mass index. METHODS We undertook a cross-sectional analysis within a cohort of adults (matched by age, sex and general practice) with and without a diagnosis of atopic eczema. We used primary care (Clinical Practice Research Datalink Gold) and linked hospital admissions data (1998-2016). We used conditional logistic regression to compare the odds of being overweight or obese (adjusting for confounders and potential mediators) in those with atopic eczema (mild, moderate and severe, and all eczema) vs. those without. RESULTS We identified 441 746 people with atopic eczema, matched to 1 849 722 without. People with atopic eczema had slightly higher odds of being overweight or obese vs. those without [odds ratio (OR) 1·08, 95% confidence interval (CI) 1·07-1·09] after adjusting for age, asthma and socioeconomic deprivation. Adjusting for potential mediators (high-dose glucocorticoids, harmful alcohol use, anxiety, depression, smoking) had a minimal impact on effect estimates (OR 1·07, 95% CI 1·06-1·08). We saw no evidence that odds of being overweight or obese increased with increasing atopic eczema severity, and there was no association in people with severe eczema. CONCLUSIONS We found evidence of a small overall association between atopic eczema and being overweight or obese. However, there was no association with obesity among those with the most severe eczema. Our findings are largely reassuring for this prevalent patient group who may already have an increased risk of cardiovascular disease.
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Affiliation(s)
- A Ascott
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, UK
| | - K E Mansfield
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Y Schonmann
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - A Mulick
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - A Roberts
- Nottingham Support Group for Carers of Children with Eczema, Nottingham, UK
| | - L Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - S M Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,St John's Institute of Dermatology, Guy's & St Thomas' Hospital NHS Foundation Trust and King's College London, London, UK.,Health Data Research UK, London, UK
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Abuabara K, Ye M, Cummings S, Mauro T, Ferrucci L. 200 Variation in skin barrier function among older adults in a large cohort of healthy aging. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Kern C, Wan J, Lewinn K, Langan S, Abuabara K. 482 Longitudinal cohort study of the association between atopic dermatitis and depression throughout childhood. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.490] [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: 11/17/2022]
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Al-Alusi N, Ramirez F, Langan S, Abuabara K. 435 The association between tobacco smoke exposure during childhood and adolescence and atopic dermatitis activity and severity. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.443] [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: 10/24/2022]
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Lee Y, Tomaszewski N, Langan S, Abuabara K. 466 The relationship between atopic dermatitis and childhood symptoms of attention deficit/hyperactivity disorder: A longitudinal cohort study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.474] [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: 10/24/2022]
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22
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Wan J, Shin D, Syed M, Abuabara K, Gelfand J. 390 Atopic dermatitis and risk of major neuropsychiatric disorders: A population-based cohort study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.398] [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: 10/24/2022]
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Cenzer I, Nkansah-Mahaney N, Wehner M, Chren MM, Berger T, Covinsky K, Berger K, Abuabara K, Linos E. A multiyear cross-sectional study of U.S. national prescribing patterns of first-generation sedating antihistamines in older adults with skin disease. Br J Dermatol 2019; 182:763-769. [PMID: 31021412 DOI: 10.1111/bjd.18042] [Citation(s) in RCA: 4] [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] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND First-generation antihistamines (FGAs) are classified as 'potentially inappropriate' for use in older patients (patients aged ≥ 65 years). However, the prevalence of and factors associated with FGA prescription have not been studied. OBJECTIVES To examine FGA prescription rates for older patients who visited dermatology offices, and compare them to those for younger patients (patients aged 18-65 years) who visited dermatology offices and those for older patients who visited primary-care physicians (PCPs). METHODS This was a multiyear cross-sectional observational study using data from the U.S. National Ambulatory Medical Care Survey (2006-2015). Visits by patients aged 18 years or older were included in the study; the data comprised 15 243 dermatology office visits and 66 036 PCP office visits. The main outcome was FGA prescription. Other variables included physician specialty (dermatologist or PCP), patient's age, diagnosis of dermatological conditions and reason for visit. RESULTS For dermatology visits, the overall FGA prescription rate for older patients was similar to that for younger patients (1·5% vs. 1·2%; P = 0·19), even when the diagnosis was dermatitis or pruritus (3·7% vs. 4·8%; P = 0·21) or when itch was a complaint (7·6% vs. 6·7%; P = 0·64). However, the rate of FGA prescription for dermatology visits was lower than that for PCP visits, in analyses matched for patient and visit characteristics (3·9% vs. 7·4%; P = 0·02). CONCLUSIONS Our findings suggest that FGAs are overprescribed to older patients but that dermatologists are less likely to prescribe FGAs than PCPs. What's already known about this topic? First-generation antihistamines (FGAs) have been shown to pose substantial risks to older adults, including cognitive impairment, falls, confusion, dry mouth and constipation. Therefore, FGAs have been classified as 'potentially inappropriate' for use in older patients by the American Geriatrics Society. It has also been shown that dermatologists do not always take patient characteristics (e.g. age or life expectancy) into account when deciding on a treatment, instead following a 'one-size-fits-all' approach. What does this study add? FGAs are often prescribed during dermatology visits, and prescription rates do not differ between older and younger patients. There were no significant differences in prescription rates when comparing younger and older adults with the same diagnosis or symptom (e.g. dermatitis, pruritus or itch). FGAs are prescribed at higher rates in primary-care offices than in dermatology offices.
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Affiliation(s)
- I Cenzer
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A.,Department of Medicine III, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - N Nkansah-Mahaney
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, U.S.A
| | - M Wehner
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - M M Chren
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A
| | - T Berger
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, CA, U.S.A
| | - K Covinsky
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A.,Veterans Affairs Medical Center, San Francisco, CA, U.S.A
| | - K Berger
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A
| | - K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, CA, U.S.A
| | - E Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, U.S.A
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Ye M, Langan S, Abuabara K. 214 Patterns of atopic eczema disease activity from birth through mid-adulthood in two British birth cohorts. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.290] [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: 10/27/2022]
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Affiliation(s)
- K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California San Francisco, San Francisco, CA, U.S.A
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' Hospital NHS Foundation Trust and King's College London, London, U.K
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Affiliation(s)
- K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California San Francisco (UCSF), San Francisco, CA, U.S.A
| | - E J van Zuuren
- Leiden University Medical Centre, Department of Dermatology, Leiden, the Netherlands
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, U.K
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Dizon M, Yu A, Singh R, Wan J, Chren M, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol 2018; 178:1280-1287. [PMID: 29336013 PMCID: PMC6033033 DOI: 10.1111/bjd.16340] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Routinely collected electronic health data obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in routinely collected electronic health data differ, and it is unknown how this might affect study results. OBJECTIVES To evaluate how patients with AD have been identified in studies using routinely collected electronic health data, to determine whether these methods were validated and to estimate how the method for identifying patients with AD affected variability in prevalence estimates. METHODS We systematically searched PubMed, Embase and Web of Science for studies using routinely collected electronic health data that reported on AD as a primary outcome. Studies of localized AD and other types of dermatitis were excluded. The protocol for this review was registered in PROSPERO (CRD42016037968). RESULTS In total, 59 studies met eligibility criteria. Medical diagnosis codes for inclusion and exclusion, number of occasions of a code, type of provider associated with a code and prescription data were used to identify patients with AD. Only two studies described validation of their methods and no study reported on disease severity. Prevalence estimates ranged from 0·18% to 38·33% (median 4·91%) and up to threefold variation in prevalence was introduced by differences in the method for identifying patients with AD. CONCLUSIONS This systematic review highlights the need for clear reporting of methods for identifying patients with AD in routinely collected electronic health data to allow for meaningful interpretation and comparison of results.
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Affiliation(s)
- M.P. Dizon
- Program for Clinical ResearchDepartment of DermatologyUniversity of CaliforniaSan Francisco School of MedicineSan FranciscoCAU.S.A.
| | - A.M. Yu
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - R.K. Singh
- University of California, Los AngelesDavid Geffen School of Medicine at UCLALos AngelesCAU.S.A.
| | - J. Wan
- Department of DermatologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
| | - M.‐M. Chren
- Department of DermatologyVanderbilt University Medical CenterNashvilleTN 37204U.S.A.
| | - C. Flohr
- Unit for Population‐Based Dermatology ResearchSt John's Institute of DermatologyGuy's & St Thomas' NHS Foundation Trust and King's College LondonChicagoILU.S.A.
| | - J.I. Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoILU.S.A.
| | - D.J. Margolis
- Department of DermatologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
- Department of Biostatistics, Epidemiology and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAU.S.A.
| | - S.M. Langan
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonU.K.
| | - K. Abuabara
- Program for Clinical ResearchDepartment of DermatologyUniversity of CaliforniaSan Francisco School of MedicineSan FranciscoCAU.S.A.
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Dizon M, Yu A, Singh R, Wan J, Chren MM, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol 2018. [DOI: 10.1111/bjd.16749] [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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29
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Dizon M, Yu A, Singh R, Wan J, Chren MM, Flohr C, Silverberg J, Margolis D, Langan S, Abuabara K. 使用定期收集的健康数据的研究中特应性皮炎疾病定义的系统综述. Br J Dermatol 2018. [DOI: 10.1111/bjd.16761] [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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30
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Chalmers JR, Thomas KS, Apfelbacher C, Williams HC, Prinsen CA, Spuls PI, Simpson E, Gerbens LAA, Boers M, Barbarot S, Stalder JF, Abuabara K, Aoki V, Ardeleanu M, Armstrong J, Bang B, Berents TL, Burton T, Butler L, Chubachi T, Cresswell-Melville A, DeLozier A, Eckert L, Eichenfield L, Flohr C, Futamura M, Gadkari A, Gjerde ES, van Halewijn KF, Hawkes C, Howells L, Howie L, Humphreys R, Ishii HA, Kataoka Y, Katayama I, Kouwenhoven W, Langan SM, Leshem YA, Merhand S, Mina-Osorio P, Murota H, Nakahara T, Nunes FP, Nygaard U, Nygårdas M, Ohya Y, Ono E, Rehbinder E, Rogers NK, Romeijn GLE, Schuttelaar MLA, Sears AV, Simpson MA, Singh JA, Srour J, Stuart B, Svensson Å, Talmo G, Talmo H, Teixeira HD, Thyssen JP, Todd G, Torchet F, Volke A, von Kobyletzki L, Weisshaar E, Wollenberg A, Zaniboni M. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). Br J Dermatol 2018; 178:e332-e341. [PMID: 29672835 DOI: 10.1111/bjd.16543] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/11/2022]
Abstract
This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
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Affiliation(s)
- J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C A Prinsen
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - P I Spuls
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - E Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, U.S.A
| | - L A A Gerbens
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - M Boers
- VU University Medical Center, Amsterdam, the Netherlands
| | - S Barbarot
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - J F Stalder
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, U.S.A
| | - V Aoki
- University of São Paulo Medical School, São Paulo, Brazil
| | - M Ardeleanu
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | | | - B Bang
- LEO Pharma, Ballerup, Denmark
| | | | | | - L Butler
- National Eczema Association, San Rafael, CA, U.S.A
| | - T Chubachi
- GlaxoSmithKline, Research Triangle Park, NC, U.S.A
| | | | - A DeLozier
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - L Eichenfield
- Rady Children's Hospital, University of California San Francisco, San Diego, CA, U.S.A
| | - C Flohr
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - A Gadkari
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | - E S Gjerde
- The Psoriasis and Eczema Association of Norway, Oslo, Norway
| | - K F van Halewijn
- Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | | | - L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | | | - H A Ishii
- Brazilian Atopic Dermatitis Association (AADA), São Paulo, Brazil
| | - Y Kataoka
- Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | | | - W Kouwenhoven
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - S M Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K
| | - Y A Leshem
- Beilinson Hospital and Tel Aviv University, Petah Tikva and Tel Aviv, Israel
| | - S Merhand
- Association Française de l'Eczéma, Redon, France
| | | | - H Murota
- Department of Dermatology, Osaka University, Suita, Japan
| | - T Nakahara
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - F P Nunes
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - U Nygaard
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - Y Ohya
- National Centre for Child Health and Development, Tokyo, Japan
| | - E Ono
- Osaka University, Osaka, Japan
| | - E Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - N K Rogers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - G L E Romeijn
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A V Sears
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - J A Singh
- Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, U.S.A
| | - J Srour
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU - München, Munich, Germany
| | - B Stuart
- Primary Care and Population Sciences Division, University of Southampton, Southampton, U.K
| | - Å Svensson
- Department of Dermatology and Venereology, Lund University, Malmö, Sweden
| | - G Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | - H Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | | | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - G Todd
- University of Cape Town, Cape Town, South Africa
| | - F Torchet
- Association Française de l'Eczéma, Redon, France
| | - A Volke
- Department of Dermatology, University of Tartu, Tartu, Estonia
| | - L von Kobyletzki
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.,CF Wahlgren, Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden.,Department of Dermatology, Venereology and Allergy University Hospital Schleswig-Holstein, Kiel, Germany
| | - E Weisshaar
- Department of Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, Heidelberg, Germany
| | | | - M Zaniboni
- University of São Paulo, Campinas, Brazil
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Linos E, Wehner M, Nkansah-Mahaney N, Stijacic I, Abuabara K, Morrison L, Torres J, Berger T, Chren M, Covinsky K. 373 Dermatologists’ prescriptions of sedating antihistamines in older adults: Data from the national ambulatory health survey 2006-2015. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.379] [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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Abuabara K, Yu AM, Okhovat J, Allen IE, Langan SM. The prevalence of atopic dermatitis beyond childhood: A systematic review and meta-analysis of longitudinal studies. Allergy 2018; 73:696-704. [PMID: 28960336 PMCID: PMC5830308 DOI: 10.1111/all.13320] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are sparse and conflicting data regarding the long-term clinical course of atopic dermatitis (AD). Although often described as a childhood disease, newer population-based estimates suggest the prevalence of pediatric and adult disease may be similar. METHODS Our objective was to determine whether there is a decline in the prevalence of AD in population-based cohorts of patients followed longitudinally beyond childhood. We conducted a systematic review and meta-analysis including studies assessing AD prevalence across 3 or more points in time. The primary outcome was weighted overall risk difference (percentage decrease in AD prevalence). RESULTS Of 2080 references reviewed, 7 studies with 13 515 participants were included. Participants were assessed at 3-6 time points, ranging from age 3 months to 26 years. The percentage decrease in prevalence after age 12 was 1%, which was not significantly different from zero (95% confidence interval -2%-5%). Similar results were found with other age cut-offs. CONCLUSION The prevalence of AD in longitudinal birth cohort studies is similar in childhood and adolescence/early adulthood.
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Affiliation(s)
- K. Abuabara
- Program for Clinical ResearchDepartment of DermatologyUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - A. M. Yu
- Faculty of MedicineUniversity of OttawaOttawaONCanada
| | - J.‐P. Okhovat
- Harvard T.H. Chan School of Public Health, Beth Israel Deaconess Medical Center, and Harvard Medical SchoolBostonMAUSA
| | - I. E. Allen
- Department of Epidemiology and BiostatisticsUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - S. M. Langan
- Faculty of Epidemiology & Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
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Affiliation(s)
- H.B. Naik
- Program for Clinical Research; Department of Dermatology; UCSF; 2340 Sutter St, N421 San Francisco CA 94115 U.S.A
| | - K. Abuabara
- Program for Clinical Research; Department of Dermatology; UCSF; 2340 Sutter St, N421 San Francisco CA 94115 U.S.A
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Affiliation(s)
- C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California San Francisco (UCSF), CA, U.S.A
| | - F Bath-Hextall
- Centre for Evidence Based Healthcare, School of Health Sciences, University of Nottingham, Nottingham, U.K
| | - A Nast
- Division of Evidence based Medicine (dEBM), Department of Dermatology, Venerology und Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E van Zuuren
- Dermatology Department, Leiden University Medical Centre, Leiden, the Netherlands
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von Kobyletzki LB, Beckman L, Smirnova J, Smeeth L, Williams HC, McKee M, Abuabara K, Langan SM. Eczema and educational attainment: a systematic review. Br J Dermatol 2017; 177:e47-e49. [PMID: 27995605 DOI: 10.1111/bjd.15242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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)
- L B von Kobyletzki
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.,Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden
| | - L Beckman
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
| | - J Smirnova
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
| | - L Smeeth
- London School of Hygiene and Tropical Medicine, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - M McKee
- London School of Hygiene and Tropical Medicine, London, U.K.,European Observatory on Health Systems and Policies, London, U.K
| | - K Abuabara
- University of California, San Francisco, CA, U.S.A
| | - S M Langan
- London School of Hygiene and Tropical Medicine, London, U.K.,St John's Institute of Dermatology, London, U.K
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Abuabara K, Kohn L, Langan S. 221 Does atopic dermatitis remain a disease of the advantaged in adulthood? A national birth cohort study. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.236] [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: 10/19/2022]
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Yu A, Okhovat J, Allen I, Langan S, Abuabara K. 228 The prevalence of eczema beyond childhood: A systematic review and meta-analysis of longitudinal studies. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.243] [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: 10/19/2022]
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Dizon M, Linos E, Arron S, Abuabara K, Ruiz de Luzuriaga A, Jin C, Boscardin W, Chren M. Comparisons of patients’ satisfaction should take expectations into account. Br J Dermatol 2016; 176:252-254. [DOI: 10.1111/bjd.14755] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Dizon
- University of California San Francisco School of Medicine San Francisco CA U.S.A
| | - E. Linos
- Program for Clinical Research Department of Dermatology San Francisco CA U.S.A
| | - S.T. Arron
- Program for Clinical Research Department of Dermatology San Francisco CA U.S.A
- San Francisco Veterans Affairs Medical Center San Francisco CA U.S.A
| | - K. Abuabara
- Program for Clinical Research Department of Dermatology San Francisco CA U.S.A
| | | | - C. Jin
- Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA U.S.A
| | - W.J. Boscardin
- Department of Medicine Division of Geriatrics University of California San Francisco San Francisco CA U.S.A
| | - M.‐M. Chren
- Program for Clinical Research Department of Dermatology San Francisco CA U.S.A
- San Francisco Veterans Affairs Medical Center San Francisco CA U.S.A
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Chalmers J, Simpson E, Apfelbacher C, Thomas K, Kobyletzki L, Schmitt J, Singh J, Svensson Å, Williams H, Abuabara K, Aoki V, Ardeleanu M, Awici‐Rasmussen M, Barbarot S, Berents T, Block J, Bragg A, Burton T, Bjerring Clemmensen K, Creswell‐Melville A, Dinesen M, Drucker A, Eckert L, Flohr C, Garg M, Gerbens L, Graff A, Hanifin J, Heinl D, Humphreys R, Ishii H, Kataoka Y, Leshem Y, Marquort B, Massuel M, Merhand S, Mizutani H, Murota H, Murrell D, Nakahara T, Nasr I, Nograles K, Ohya Y, Osterloh I, Pander J, Prinsen C, Purkins L, Ridd M, Sach T, Schuttelaar MA, Shindo S, Smirnova J, Sulzer A, Synnøve Gjerde E, Takaoka R, Vestby Talmo H, Tauber M, Torchet F, Volke A, Wahlgren C, Weidinger S, Weisshaar E, Wollenberg A, Yamaga K, Zhao C, Spuls P. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). Br J Dermatol 2016; 175:69-79. [DOI: 10.1111/bjd.14773] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2016] [Indexed: 12/24/2022]
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Abuabara K, Hoffstad O, Troxel A, Gelfand J, Margolis D. 197 Sociodemographic characteristics predict persistent atopic dermatitis disease activity into early adulthood: A longitudinal cohort study. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.225] [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: 10/21/2022]
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Barbarot S, Abuabara K, Aubert H, Chalmers J, Flohr C, Hanifin J, Naldi L, Margolis D, Paul C, Rogers N, Ridd M, Schuttelaar ML, Simpson E, Tauber M, Volke A, Weidinger S, Wilkes S, Wollenberg A, Thomas K. Comment évaluer le contrôle à long terme de la dermatite atopique dans les essais randomisés ? Une revue systématique. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.136] [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: 11/26/2022]
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Ahluwalia J, Abuabara K, Perman MJ, Yan AC. Human herpesvirus 6 involvement in paediatric drug hypersensitivity syndrome. Br J Dermatol 2015; 172:1090-5. [PMID: 25369238 DOI: 10.1111/bjd.13512] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human herpesvirus (HHV)6 positivity in the context of drug hypersensitivity syndrome (DHS) may influence disease severity. Systemic corticosteroid treatment of those with DHS testing positive for HHV6 has been speculated to prolong the duration of disease. OBJECTIVES To evaluate whether paediatric HHV6-positive patients with DHS develop a more severe illness than those without presumed reactivation, and to evaluate the response to systemic corticosteroid treatment. METHODS A retrospective case series of 29 paediatric inpatients treated for DHS and tested for HHV6 was undertaken. HHV6-positive and -negative patients were identified and stratified into groups treated or not treated with systemic corticosteroids to examine their disease severity on the basis of hospital length of stay (LOS), total number of febrile days (Tfeb) and days until cessation of progression (CTP). RESULTS Human herpesvirus6-positive patients had similar demographic characteristics to those of HHV6-negative patients, but had significantly longer hospital LOS (11·5 days vs. 5 days, P = 0·039), Tfeb (12·5 days vs. 3 days, P = 0·032) and CTP (4 days vs. 2 days, P = 0·014). All HHV6-positive patients and most (80%) of the HHV6-negative patients received systemic corticosteroids. Among the HHV6-negative patients, those who received corticosteroids showed significantly shorter CTP than those who did not (3 days vs. 2 days, P = 0·043). Additionally, there was a trend towards shorter hospital LOS and Tfeb among HHV6-negative patients who received corticosteroids vs. those who did not, although these differences were not statistically significant. The most common inciting drugs included trimethoprim-sulfamethoxazole (34%), phenytoin (10%) and amoxicillin (10%). CONCLUSIONS Human herpesvirus6 positivity with DHS is associated with a more severe disease course. Treatment with systemic corticosteroids was associated with a trend towards reduced hospital LOS and Tfeb, and a significantly reduced number of days until cessation of progression.
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Affiliation(s)
- J Ahluwalia
- Department of Pediatrics, Division of General Pediatrics, Section of Dermatology, The Children's Hospital of Philadelphia, 3550 Market Street, 2nd Floor, Philadelphia, 19104, PA, U.S.A
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Abstract
BACKGROUND Psoriasis confers an independent risk of cardiovascular disease that is likely to be related to systemic inflammation. Anti-inflammatory treatment could theoretically reduce the risk of cardiovascular disease, and initial data suggest that treatment may reduce the incidence of cardiovascular risk factors. OBJECTIVES To determine the impact of anti-inflammatory therapy on the risk of acute myocardial infarction (MI) in patients with moderate-to-severe psoriasis. METHODS Cohort study using administrative and pharmacy claims data from a large U.S. insurer comparing patients with psoriasis aged ≥ 18 years receiving systemic immunomodulatory therapies (methotrexate, ciclosporin, alefacept, efalizumab, adalimumab, etancercept and infliximab) with a control group treated with ultraviolet B phototherapy that has limited systemic anti-inflammatory effects. The risk of acute MI was calculated using a proportional hazards model while controlling for sex, age, hypertension, hyperlipidaemia, diabetes and depression. Significant interaction terms were included in the final model. RESULTS The study group included 25,554 patients with psoriasis receiving systemic treatment or phototherapy. There was a trend towards an increased risk of MI in the systemic treatment group but not a significant difference in overall MI risk [hazard ratio (HR) 1·33, 95% confidence interval (CI) 0·90-1·96]. Additionally, there was a significant interaction with age: in patients under 50 years the HR for MI if receiving systemic therapy was 0·65 (95% CI 0·32-1·34), and in patients aged 50-70 years it was 1·37 (95% CI 0·79-2·38). CONCLUSIONS Overall, there does not appear to be a reduced risk of MI in patients with psoriasis receiving systemic therapy compared with a group undergoing phototherapy. The risk of MI may vary by age.
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Affiliation(s)
- K Abuabara
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA.
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Seminara NM, Abuabara K, Shin DB, Langan SM, Kimmel SE, Margolis D, Troxel AB, Gelfand JM. Validity of The Health Improvement Network (THIN) for the study of psoriasis. Br J Dermatol 2011; 164:602-9. [PMID: 21073449 PMCID: PMC3064479 DOI: 10.1111/j.1365-2133.2010.10134.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriasis is a common disease frequently studied in large databases. To date the validity of psoriasis information has not been established in The Health Improvement Network (THIN). OBJECTIVES To investigate the validity of THIN for identifying patients with psoriasis and to determine if the database can be used to determine the natural history of the disease. METHODS First, we conducted a cross-sectional study to determine if psoriasis prevalence in THIN is similar to expected. Second, we created a cohort of 4900 patients, aged 45-64 years, with a psoriasis diagnostic Read Code and surveyed their general practitioners (GPs) to confirm the diagnosis clinically. Third, we created models to determine if psoriasis descriptors (extent, severity, duration and dermatologist confirmation) could be accurately captured from database records. RESULTS Psoriasis prevalence was 1·9%, and showed the characteristic age distribution expected. GP questionnaires were received for 4634 of 4900 cohort patients (95% response rate), and psoriasis diagnoses were confirmed in 90% of patients. Duration of disease in the database showed substantial agreement with physician query (κ = 0·69). GPs confirmed that the psoriasis diagnosis was corroborated by a dermatologist in 91% of patients whose database records contained a dermatology referral code associated with a psoriasis code. We achieved good discrimination between patients with and without extensive disease based on the number of psoriasis codes received per year (area under curve = 0·8). CONCLUSIONS THIN is a valid data resource for studying psoriasis and can be used to identify characteristics of the disease such as duration and confirmation by a dermatologist.
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Affiliation(s)
- N M Seminara
- Department of Dermatology, University of Pennsylvania, Philadelphia, 19104, USA.
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Abuabara K, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the U.K. Br J Dermatol 2011; 163:586-92. [PMID: 20633008 DOI: 10.1111/j.1365-2133.2010.09941.x] [Citation(s) in RCA: 374] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Severe psoriasis is associated with excess mortality and increased risk of cardiovascular death. Population-based data evaluating cause-specific mortality in patients with psoriasis are limited. OBJECTIVES To describe cause-specific mortality in patients with severe psoriasis. METHODS We performed a cohort study from 1987 to 2002 of patients ≥18 years using the General Practice Research Database. We compared patients with a psoriasis code and a history of systemic therapy consistent with severe psoriasis (n=3603) with patients with no history of psoriasis (n=14,330). Age- and sex-adjusted Cox models were created for each of the leading causes of death defined by the Centers for Disease Control. RESULTS Patients with severe psoriasis were at increased risk of death from cardiovascular disease [hazard ratio (HR) 1·57, 95% confidence interval (CI) 1·26-1·96], malignancies (HR 1·41, 95% CI 1·07-1·86), chronic lower respiratory disease (HR 2·08, 95% CI 1·24-3·48), diabetes (HR 2·86, 95% CI 1·08-7·59), dementia (HR 3·64, 95% CI 1·36-9·72), infection (HR 1·65, 95% CI 1·26-2·18), kidney disease (HR 4·37, 95% CI 2·24-8·53) and unknown/missing causes (HR 1·43, 95% CI 1·09-1·89). The absolute and excess risk of death was highest for cardiovascular disease (61·9 and 3·5 deaths per 1000 patient-years, respectively). CONCLUSIONS Severe psoriasis is associated with an increased risk of death from a variety of causes, with cardiovascular death being the most common aetiology. These patients were also at increased risk of death from causes not previously reported, such as infection, kidney disease and dementia. Additional studies are necessary to determine the degree to which excess causes of death are due to psoriasis, its treatments, associated behaviours, or other factors.
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Affiliation(s)
- K Abuabara
- Department of Dermatology Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA
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Díaz-Olavarrieta C, Paz F, Abuabara K, Martínez Ayala H, Kolstad K, Palermo T. Abuse during pregnancy in Mexico City. Int J Gynaecol Obstet 2007; 97:57-64. [DOI: 10.1016/j.ijgo.2006.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Revised: 10/11/2006] [Accepted: 10/25/2006] [Indexed: 11/27/2022]
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