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Graier T, Weger W, Jonak C, Sator P, Zikeli C, Prillinger K, Sassmann C, Gruber B, Saxinger W, Ratzinger G, Painsi C, Mlynek A, Häring N, Sadoghi B, Trattner H, Müllegger R, Quehenberger F, Salmhofer W, Wolf P. Author Correction: Real-world effectiveness of anti-interleukin-23 antibodies in chronic plaque-type psoriasis of patients from the Austrian Psoriasis Registry (PsoRA). Sci Rep 2024; 14:7144. [PMID: 38532006 DOI: 10.1038/s41598-024-57807-3] [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: 03/28/2024] Open
Affiliation(s)
- T Graier
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - W Weger
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - C Jonak
- Medical University of Vienna, Vienna, Austria
| | - P Sator
- Clinic Hietzing, Vienna, Austria
| | - C Zikeli
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - K Prillinger
- University Hospital of St. Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - C Sassmann
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - B Gruber
- Hospital of Wels-Grieskirchen, Wels, Austria
| | - W Saxinger
- Hospital of Wels-Grieskirchen, Wels, Austria
| | - G Ratzinger
- Medical University of Innsbruck, Innsbruck, Austria
| | - C Painsi
- State Hospital Klagenfurt, Klagenfurt, Austria
| | - A Mlynek
- Hospital of Elisabethinen, Linz, Austria
| | - N Häring
- Federal Academic Teaching Hospital, Feldkirch, Austria
| | - B Sadoghi
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - H Trattner
- Medical University of Vienna, Vienna, Austria
| | - R Müllegger
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - F Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - W Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria.
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Benezeder T, Bordag N, Woltsche J, Teufelberger A, Perchthaler I, Weger W, Salmhofer W, Gruber-Wackernagel A, Painsi C, Zhan Q, El-Heliebi A, Babina M, Clark R, Wolf P. Mast cells express IL17A, IL17F and RORC, are activated and persist with IL-17 production in resolved skin of patients with chronic plaque-type psoriasis. Res Sq 2024:rs.3.rs-3958361. [PMID: 38410434 PMCID: PMC10896398 DOI: 10.21203/rs.3.rs-3958361/v1] [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] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Little is known about IL-17 expression in psoriasis and the actual cellular source of IL-17 remains incompletely defined. We show that high numbers of IL-17 + mast cells persisted in resolved lesions after treatment (anti-IL-17A, anti-IL-23, UVB or topical dithranol) and correlated inversely with the time span in remission. IL-17 + mast cells were found in T cell-rich areas and often close to resident memory T cells (Trm) in active psoriasis and resolved lesional skin. Digital cytometry by deconvolution of RNA-seq data showed that activated mast cells were increased in psoriatic skin, while resting mast cells were almost absent and both returned to normal levels after treatment. When primary human skin mast cells were stimulated with T cell cytokines (TNFα, IL-22 and IFNγ), they responded by releasing more IL-17A, as measured by ELISA. In situ mRNA detection using padlock probes specific for transcript variants of IL17A, IL17F, and RORC (encoding the Th17 transcription factor RORγt) revealed positive mRNA signals for IL17A, IL17F, and RORCin tryptase + cells, demonstrating that mast cells have the transcriptional machinery to actively produce IL-17. Mast cells thus belong to the center of the IL-23/IL-17 axis and high numbers of IL-17 + mast cells predict an earlier disease recurrence.
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Affiliation(s)
- Theresa Benezeder
- Department of Dermatology and Venereology, Medical University of Graz
| | - Natalie Bordag
- Department of Dermatology and Venereology, Medical University of Graz
| | - Johannes Woltsche
- Department of Dermatology and Venereology, Medical University of Graz
| | | | | | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz
| | | | | | | | - Qian Zhan
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School
| | - Amin El-Heliebi
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz
| | - Magda Babina
- Institute of Allergology, Charite-Universitatsmedizin Berlin
| | | | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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Graier T, Salmhofer W, Jonak C, Weger W, Zikeli C, Gruber B, Sator P, Prillinger K, Mlynek A, Schütz-Bergmayr M, Richter L, Ratzinger G, Sassmann C, Painsi C, Häring N, Wippel-Slupetzky K, Skvara H, Trattner H, Inzinger M, Bangert C, Ellersdorfer C, Falkensteiner K, Sadoghi B, Gruber-Wackernagel A, Hofer A, Legat F, Lange-Asschenfeldt B, Schmuth M, Vujic I, Hötzenecker W, Saxinger W, Müllegger R, Quehenberger F, Wolf P. Entwicklung der Patientencharakteristika und der Wirksamkeit der Biologika-Therapie bei Patienten des Österreichischen Psoriasis-Registers von 2004 bis 2022. J Dtsch Dermatol Ges 2023; 21:1513-1523. [PMID: 38082521 DOI: 10.1111/ddg.15213_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/21/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrund und ZieleIn dieser Studie wurde untersucht, inwieweit die Einführung wirksamerer Medikamente in jüngster Zeit zu einer Verbesserung der Behandlungsergebnisse von Psoriasis‐Patienten im klinischen Alltag geführt hat.Patienten und MethodikEs wurden Patientencharakteristika und die Wirksamkeit der Therapie im ersten Behandlungsjahr bei Biologika‐naiven Patienten von 2004 bis heute analysiert, unabhängig von Therapiewechseln.ErgebnisseDie Daten von 2729 Patienten eigneten sich für die Analyse. Der Anteil der weiblichen Patienten stieg über die Jahre signifikant von 29,9% auf 36,2% (p < 0,028), während der Anteil der Patienten mit einer Psoriasis‐Arthritis von 36,6% auf 30,0% sank (p < 0,001). Außerdem nahm die Dauer der Psoriasis‐Erkrankung und der PASI‐Wert zu Beginn der Behandlung in Verlauf der Zeit signifikant ab. Die „letzte Beobachtung übernommen“ (LOCF)‐Analyse zeigte, dass das PASI‐90‐Ansprechen drei Monate nach Therapiebeginn von 18,9% auf 44,6% und 12 Monate nach Therapiebeginn von 32,9% auf 66,8% anstieg. Ebenso stiegen die PASI<3 Befunde von 33,2% auf 66,0% 3 Monate und von 41,9% auf 78,9% 12 Monate nach Behandlungsbeginn.SchlussfolgerungenDie kontinuierliche Einführung wirksamerer Biologika hat zu einer deutlichen Verbesserung des klinischen Ansprechens und der Patientenversorgung geführt. Dennoch erreicht auch heute noch, je nach gewähltem Endpunkt, jeder dritte bis fünfte Patient kein vollständig zufriedenstellendes Behandlungsergebnis (d.h. PASI 90 oder PASI ≤ 3).
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Affiliation(s)
- Thomas Graier
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Wolfgang Salmhofer
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Constanze Jonak
- Abteilung für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Wolfgang Weger
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Claudia Zikeli
- Abteilung für Dermatologie und Venerologie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich
| | - Barbara Gruber
- Abteilung für Dermatologie und Venerologie, Krankenhaus Wels-Grieskirchen, Wels-Grieskirchen, Österreich
| | - Paul Sator
- Abteilung für Dermatologie, Klinik Hietzing, Wien, Österreich
| | - Knut Prillinger
- Abteilung für Dermatologie und Venerologie, Karl-Landsteiner-Universität, St. Pölten, Österreich
| | - Alexander Mlynek
- Abteilung für Dermatologie, Krankenhaus der Elisabethinen Linz, Linz, Österreich
| | - Martina Schütz-Bergmayr
- Abteilung für Dermatologie und Venerologie, Johannes-Kepler-Universität Linz, Linz, Österreich
| | - Leo Richter
- Abteilung für Dermatologie und Venerologie, Krankenhaus der Stadt Wien Rudolfstiftung, Wien, Österreich
| | - Gudrun Ratzinger
- Abteilung für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Christoph Sassmann
- Abteilung für Dermatologie und Venerologie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich
| | - Clemens Painsi
- Abteilung für Dermatologie und Venerologie, Landeskrankenhaus Klagenfurt, Klagenfurt, Österreich
| | - Nina Häring
- Abteilung für Dermatologie und Venerologie, Akademisches Lehrkrankgenhaus Feldkirch, Feldkirch, Österreich
| | | | - Hans Skvara
- Abteilung für Dermatologie und Venerologie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich
| | - Hannes Trattner
- Abteilung für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Martin Inzinger
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Christina Bangert
- Abteilung für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Christina Ellersdorfer
- Abteilung für Dermatologie und Venerologie, Krankenhaus der Stadt Wien Rudolfstiftung, Wien, Österreich
| | | | - Birgit Sadoghi
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | | | - Angelika Hofer
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Franz Legat
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | | | - Matthias Schmuth
- Abteilung für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Igor Vujic
- Abteilung für Dermatologie und Venerologie, Krankenhaus der Stadt Wien Rudolfstiftung, Wien, Österreich
- Fakultät für Medizin und Zahnmedizin, Donau-Privatuniversität, Krems, Österreich
| | - Wolfram Hötzenecker
- Abteilung für Dermatologie und Venerologie, Johannes-Kepler-Universität Linz, Linz, Österreich
| | - Werner Saxinger
- Abteilung für Dermatologie und Venerologie, Krankenhaus Wels-Grieskirchen, Wels-Grieskirchen, Österreich
| | - Robert Müllegger
- Abteilung für Dermatologie und Venerologie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich
| | - Franz Quehenberger
- Institut für Medizinische Informatik, Statistik und Dokumentation, Medizinische Universität Graz, Graz, Österreich
| | - Peter Wolf
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
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Graier T, Salmhofer W, Jonak C, Weger W, Zikeli C, Gruber B, Sator P, Prillinger K, Mlynek A, Schütz-Bergmayr M, Richter L, Ratzinger G, Sassmann C, Painsi C, Häring N, Wippel-Slupetzky K, Skvara H, Trattner H, Inzinger M, Bangert C, Ellersdorfer C, Falkensteiner K, Sadoghi B, Gruber-Wackernagel A, Hofer A, Legat F, Lange-Asschenfeldt B, Schmuth M, Vujic I, Hötzenecker W, Saxinger W, Müllegger R, Quehenberger F, Wolf P. Evolution of characteristics and biologic treatment effectiveness in patients of the Austrian psoriasis registry from 2004-2022. J Dtsch Dermatol Ges 2023; 21:1513-1523. [PMID: 37907427 DOI: 10.1111/ddg.15213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/21/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND AND OBJECTIVES This study analyzed the extent to which the recent introduction of more effective treatments has led to an improvement in real-world psoriasis patients. PATIENTS AND METHODS Patient characteristics and the first-year treatment effectiveness in biologic-naive patients have been analyzed since 2004 until now, irrespective of treatment switches. RESULTS Data from 2,729 patients were eligible for this analysis. The proportion of female patients increased significantly over the years from 29.9% to 36.2% (p < 0.028), while the number of patients with psoriatic arthritis declined from 36.6% to 30.0% (p < 0.001). Moreover, the duration of psoriatic disease and PASI at the start of the treatment significantly decreased. Last observation carrief forward (LOCF) analysis indicated that PASI 90 response increased from 18.9 to 44.6% at 3 months and from 32.9 to 66.8% at 12 months after treatment started. Similary, the PASI ≤ 3 rates increased from 33.2% to 66.0% at 3 months and from 41.9% to 78.9% at 12 months after the treatment started. CONCLUSIONS The continuous introduction of more efficient biologics has led to significant improvements in patient care and clinical outcomes. Though one out of three to five patients, depending on the endpoint selected, nowadays still does not achieve an entirely satisfactory treatment response (i.e., PASI 90 or PASI ≤ 3).
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Affiliation(s)
- Thomas Graier
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Constanze Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Claudia Zikeli
- Department of Dermatology and Venereology, State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Barbara Gruber
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - Paul Sator
- Department of Dermatology, Clinic Hietzing, Vienna, Austria
| | - Knut Prillinger
- Department of Dermatology and Venereology, Karl-Landsteiner University, St. Pölten, Austria
| | - Alexander Mlynek
- Department of Dermatology, Hospital of Elisabethinen Linz, Linz, Austria
| | | | - Leo Richter
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - Gudrun Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Sassmann
- Department of Dermatology and Venereology, State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Clemens Painsi
- Department of Dermatology and Venereology, State Hospital Klagenfurt, Klagenfurt, Austria
| | - Nina Häring
- Department of Dermatology and Venereology, Federal Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | | | - Hans Skvara
- Department of Dermatology and Venereology, State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Hannes Trattner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Martin Inzinger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Christina Bangert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Christina Ellersdorfer
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | | | - Birgit Sadoghi
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | - Angelika Hofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Franz Legat
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | - Matthias Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Igor Vujic
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
- Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Wolfram Hötzenecker
- Department of Dermatology and Venereology, Johannes Kepler University Linz, Linz, Austria
| | - Werner Saxinger
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - Robert Müllegger
- Department of Dermatology and Venereology, State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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Griss J, Ratzinger G, Maul J, Weger W, Thaçi D, Carrascosa JM, Jonak C. No impact of disease duration on response to tildrakizumab treatment among patients with moderate-to-severe plaque psoriasis: Post hoc analyses from two phase 3 (reSURFACE 1 and reSURFACE 2) and one phase 4 (TRIBUTE) studies. Skin Health Dis 2023; 3:e263. [PMID: 37799374 PMCID: PMC10549803 DOI: 10.1002/ski2.263] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In the literature there is no consensus on the correlation between early systemic intervention and better treatment response in psoriasis. Here we present data on the impact of disease duration (<5 years, 5-<10 years, and ≥10 years) on response to tildrakizumab treatment among patients with moderate-to-severe plaque psoriasis from the reSURFACE 1 and reSURFACE 2 phase 3 trials and the TRIBUTE phase 4 study. Overall, there was no significant effect of disease duration on the Psoriasis Area and Severity Index ≤1, ≤3, and ≤5, or the Dermatology Life Quality Index 0-1 response rates. Tildrakizumab was highly effective regardless of the psoriasis disease duration.
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Affiliation(s)
- Johannes Griss
- Department of DermatologyMedical University of ViennaViennaAustria
| | - Gudrun Ratzinger
- Department of DermatologyMedical University of InnsbruckInnsbruckAustria
| | - Julia‐Tatjana Maul
- Department of DermatologyUniversity Hospital ZurichZurichSwitzerland
- Faculty of MedicineUniversity of ZurichZurichSwitzerland
| | - Wolfgang Weger
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Diamant Thaçi
- Institute and Comprehensive Centre for Inflammation MedicineUniversity of LübeckLübeckGermany
| | - José Manuel Carrascosa
- Department of DermatologyHospital Universitari Germans Trias i Pujol, IGTP, UABBadalonaSpain
| | - Constanze Jonak
- Department of DermatologyMedical University of ViennaViennaAustria
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Jonak C, Göttfried I, Perl-Convalexius S, Gruber B, Schütz-Bergmayr M, Vujic I, Weger W, Schicher N, Semlin L, Hemetsberger M, Cordey M, Sator P. Characteristics and outcomes of patients with psoriasis treated with apremilast in the real-world in Austria - results the APPRECIATE study. Ther Adv Chronic Dis 2023; 14:20406223231152785. [PMID: 36777399 PMCID: PMC9909071 DOI: 10.1177/20406223231152785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
Background Apremilast, an oral phosphodiesterase 4 inhibitor, is approved in the European Union for the treatment of moderate-to-severe chronic plaque psoriasis in adult patients refractory or contraindicated to or intolerant of other systemic therapies. Objectives The APPRECIATE study assessed apremilast use in real-world practice and its clinical value to physicians and patients. APPRECIATE was a multinational, observational, retrospective, cross-sectional study. Methods Apremilast effectiveness at 6 (±1) months was assessed on the basis of psoriasis severity and health-related quality-of-life scores and treatment satisfaction using physician/patient-reported outcomes, respectively. We report the Austrian cohort of 72 patients. Results At 6 (±1) months, three-quarters of patients remained on apremilast, while physicians and patients reported treatment benefits across all psoriasis symptoms and manifestations. Of patients, the majority were satisfied with their treatment and achieved treatment goals considered most relevant. Patients' and physicians' perceptions of treatment effectiveness were aligned, and health-related quality-of-life scores indicated an improvement in the majority of patients. Apremilast tolerability was consistent with the known safety profile. Conclusions Among psoriasis patients receiving apremilast in Austria, improvement in clinical outcomes were observed and satisfaction with apremilast treatment among patients and physicians was high. Registration ClinicalTrials.gov NCT02740218.
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Affiliation(s)
- Constanze Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | | | - Barbara Gruber
- Department of Dermatology and Venerology, Klinikum Wels-Grieskirchen, Wels, Austria
| | | | - Igor Vujic
- Faculty of Medicine and Dentistry, Danube Private University, Krems an der Donau, Austria,Department of Dermatology, Klinik Landstraße, Vienna, Austria
| | - Wolfgang Weger
- Department of Dermatology, Medical University Graz, Graz, Austria
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7
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Graier T, Weger W, Jonak C, Sator P, Zikeli C, Prillinger K, Sassmann C, Gruber B, Saxinger W, Ratzinger G, Painsi C, Mlynek A, Häring N, Sadoghi B, Trattner H, Müllegger R, Quehenberger F, Salmhofer W, Wolf P. Real-world effectiveness of anti-interleukin-23 antibodies in chronic plaque-type psoriasis of patients from the Austrian Psoriasis Registry (PsoRA). Sci Rep 2022; 12:15078. [PMID: 36064563 PMCID: PMC9442573 DOI: 10.1038/s41598-022-18790-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/19/2022] [Indexed: 11/09/2022] Open
Abstract
With the introduction of the latest class of biologic drugs targeting interleukin (IL)-23p19, three new, highly effective drugs can be used for the treatment of chronic plaque psoriasis. However, poorer skin improvement as well as higher rates of serious adverse events have been reported for patients under real-world conditions (outside clinical trials). This accounts especially for patients who have already been treated with biologic drugs. We therefore aimed to determine effectiveness and safety of IL-23p19 inhibitors in real-world patients by analysing data from the Psoriasis Registry Austria (PsoRA) in this observational, retrospective, multicentre cohort study. Data for 197 patients (52.3% biologic-non-naïve), who were treated with anti-IL-23p19 antibodies (127 guselkumab, 55 risankizumab and 15 tildrakizumab) for at least 3 months, were eligible for analysis. In general, biologic-non-naïve patients displayed a less favourable response to anti-IL-23 treatment as compared to biologic-naïve patients. However, after correction for previous biologic exposure, few differences in PASI improvement were detected among biologic-naïve and -non-naïve patients treated with different IL-23p19 inhibitors. This indicates that treatment effectiveness is not related to the class of the previously administered therapy in biologic-non-naïve patients. Therefore, IL-23p19 inhibitors represent a promising treatment alternative for patients who have not responded to previous biologics. However, as with other biologic agents (including IL-17 inhibitors), we did not observe an entirely satisfactory treatment response (i.e. PASI < 3 and/or PASI 75) to anti-IL-23 treatment in one out of four to five patients. Adverse events (mainly non-severe infections) were observed in 23 (11.7%) patients with no major differences regarding the administered IL-23 inhibitor or previous biologic exposure.
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Affiliation(s)
- T Graier
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - W Weger
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - C Jonak
- Medical University of Vienna, Vienna, Austria
| | - P Sator
- Clinic Hietzing, Vienna, Austria
| | - C Zikeli
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - K Prillinger
- University Hospital of St. Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - C Sassmann
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - B Gruber
- Hospital of Wels-Grieskirchen, Wels, Austria
| | - W Saxinger
- Hospital of Wels-Grieskirchen, Wels, Austria
| | - G Ratzinger
- Medical University of Innsbruck, Innsbruck, Austria
| | - C Painsi
- State Hospital Klagenfurt, Klagenfurt, Austria
| | - A Mlynek
- Hospital of Elisabethinen, Linz, Austria
| | - N Häring
- Federal Academic Teaching Hospital, Feldkirch, Austria
| | - B Sadoghi
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - H Trattner
- Medical University of Vienna, Vienna, Austria
| | - R Müllegger
- State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - F Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - W Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, 8036, Graz, Austria.
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8
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Gruber V, Weger W, Cerroni L, Binder B. [Uncommon presentation of psoriasis vulgaris in an 11-year-old patient]. Hautarzt 2022; 73:641-646. [PMID: 34985573 PMCID: PMC9358968 DOI: 10.1007/s00105-021-04933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 11/21/2022]
Abstract
Die Psoriasis vulgaris tritt mit einer Prävalenz von bis zu 2 % im Kindes- und Jugendalter auf. Größtenteils wird die Diagnose klinisch gestellt. Wir berichten über einen pädiatrischen Patienten, welcher uns aufgrund der für eine Psoriasis vulgaris eher untypischen Lokalisation vor eine diagnostische Herausforderung stellte. Diskutiert werden die wichtigsten Differenzialdiagnosen der verschiedenen Psoriasisformen sowie die aktuellen Therapieempfehlungen im Kindes- und Jugendalter.
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Affiliation(s)
- Viktoria Gruber
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
| | - Wolfgang Weger
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
| | - Lorenzo Cerroni
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
| | - Barbara Binder
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich.
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9
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Sadoghi B, Kränke B, Cerroni L, Weger W. Unusual Cutaneous Reaction at Site of Methotrexate Injection in Two Patients with Psoriasis and Psoriatic Arthritis. Acta Derm Venereol 2021; 101:adv00593. [PMID: 34642767 PMCID: PMC9455312 DOI: 10.2340/actadv.v101.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz, Auenbruggerplatz 8, AT-8036 Graz, Austria.
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10
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Painsi C, Schmid-Zalaudek K, Weger W, Hofmann-Wellenhof R, Wolf P, Lackner HK, Fink-Puches R, Inzinger M, Gruber B, Krenmayr K, Mlynek A, Ahlgrimm-Siess V, Salmhofer W. Die Teledermatologische Beurteilung einer Psoriasis-Zielläsion und der vom Patienten selbst berechnete PASI sind suiffizient für das Psoriasis-Monitoring. J Dtsch Dermatol Ges 2021; 19:1064-1066. [PMID: 34288474 DOI: 10.1111/ddg.14468_g] [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: 11/29/2022]
Affiliation(s)
- Clemens Painsi
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich.,Abteilung für Dermatologie, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Österreich
| | - Karin Schmid-Zalaudek
- Otto-Loewi-Forschungszentrum für Gefäßbiologie, Immunologie und Entzündung Abteilung für Physiologie, Medizinische Universität Graz, Graz, Österreich
| | - Wolfgang Weger
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | | | - Peter Wolf
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Helmut Karl Lackner
- Otto-Loewi-Forschungszentrum für Gefäßbiologie, Immunologie und Entzündung Abteilung für Physiologie, Medizinische Universität Graz, Graz, Österreich
| | - Regina Fink-Puches
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Martin Inzinger
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Barbara Gruber
- Abteilung für Dermatologie, Klinikum Wels-Grieskirchen, Wels-Grieskirchen, Österreich
| | - Karin Krenmayr
- Abteilung für Dermatologie, Krankenhaus der Elisabethinen, Linz, Österreich
| | - Alexander Mlynek
- Abteilung für Dermatologie, Krankenhaus der Elisabethinen, Linz, Österreich
| | - Verena Ahlgrimm-Siess
- Abteilung für Dermatologie, Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Österreich
| | - Wolfgang Salmhofer
- Abteilung für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
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11
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Painsi C, Schmid-Zalaudek K, Weger W, Hofmann-Wellenhof R, Wolf P, Lackner HK, Fink-Puches R, Inzinger M, Gruber B, Krenmayr K, Mlynek A, Ahlgrimm-Siess V, Salmhofer W. Teledermatological assessment of one psoriasis target lesion and patient-reported-PASI are sufficient for psoriasis monitoring. J Dtsch Dermatol Ges 2021; 19:1064-1066. [PMID: 33894045 DOI: 10.1111/ddg.14468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Clemens Painsi
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.,Department of Dermatology, State Hospital Klagenfurt, Klagenfurt, Austria
| | - Karin Schmid-Zalaudek
- Otto-Loewi Research Center for Vascular Biology, Immunology and Inflammation Division of Physiology, Medical University of Graz, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Helmut Karl Lackner
- Otto-Loewi Research Center for Vascular Biology, Immunology and Inflammation Division of Physiology, Medical University of Graz, Graz, Austria
| | - Regina Fink-Puches
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Martin Inzinger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Barbara Gruber
- Department of Dermatology, Hospital of Wels--Grieskirchen, Wels-Grieskirchen, Austria
| | - Karin Krenmayr
- Department of Dermatology, Krankenhaus der Elisabethinen, Linz, Austria
| | - Alexander Mlynek
- Department of Dermatology, Krankenhaus der Elisabethinen, Linz, Austria
| | - Verena Ahlgrimm-Siess
- Department of Dermatology, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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12
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Trakaki A, Wolf P, Weger W, Eichmann TO, Scharnagl H, Stadler JT, Salmhofer W, Knuplez E, Holzer M, Marsche G. Biological anti-psoriatic therapy profoundly affects high-density lipoprotein function. Biochim Biophys Acta Mol Cell Biol Lipids 2021; 1866:158943. [PMID: 33862237 DOI: 10.1016/j.bbalip.2021.158943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 12/13/2022]
Abstract
Psoriasis is a common chronic inflammatory skin disease linked to increased cardiovascular risk. Functional impairment of high-density lipoprotein (HDL) may contribute to excessive cardiovascular mortality in psoriasis patients. Anti-cytokine therapies with biologics have been efficiently used for the management of psoriasis, however little data is available on the effects of biologic anti-psoriatic therapies on the composition and functionality of HDL. Blood samples were taken from 17 healthy volunteers and from 27 real-world psoriasis patients at baseline (no therapy with biologics) and after short-term (3 to 6 months) and intermediate-term (1 to 2 years) therapy. The biologics used included anti-interleukin (IL)-12/23p40 (ustekinumab), anti-IL17A (secukinumab) or anti-tumor necrosis factor-α (etanercept or adalimumab) antibodies. We observed that in psoriasis patients at baseline, metrics of HDL function including cholesterol efflux capacity of apolipoprotein B-depleted serum (p = 0.021), paraoxonase (p < 0.001) and lecithin-cholesterol acyltransferase (p < 0.001) activities were impaired, when compared to controls. Unexpectedly, we observed that short- and especially intermediate-term therapy with biologics markedly reduced HDL cholesterol efflux capacity (p < 0.001) and rendered HDL pro-inflammatory (p < 0.001), but increased paraoxonase (p = 0.009) and lecithin-cholesterol acyltransferase (p = 0.019) activities. All biologics caused similar changes in HDL composition, subclass distribution and cholesterol efflux capacity. Our results provide evidence that anti-psoriatic therapy with biologic agents is associated with changes in HDL functionality, particle composition and subclass distribution.
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Affiliation(s)
- Athina Trakaki
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria.
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria
| | - Thomas O Eichmann
- Institute of Molecular Biosciences, University of Graz, Graz, Austria; Center for Explorative Lipidomics, BioTechMed-Graz, Graz, Austria
| | - Hubert Scharnagl
- Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Julia T Stadler
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria
| | - Eva Knuplez
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Michael Holzer
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; BioTechMed Graz, Mozartgasse 12/II, 8010 Graz, Austria.
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13
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Graier T, Golob-Schwarzl N, Weger W, Benezeder T, Painsi C, Salmhofer W, Wolf P. Furin Expression in Patients With Psoriasis-A Patient Cohort Endangered to SARS-COV2? Front Med (Lausanne) 2021; 8:624462. [PMID: 33644099 PMCID: PMC7902756 DOI: 10.3389/fmed.2021.624462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/31/2020] [Accepted: 01/14/2021] [Indexed: 12/13/2022] Open
Abstract
Background: SARS-Cov2 has raised concerns among dermatologists regarding psoriasis and its respective treatments. Comorbidities, which induce the expression of the proprotease furin have been associated with severe course of COVID-19. Furin and angiotensin converting enzyme 2 (ACE2) play a major role in viral host cell entry of SARS-Cov2. Objective: To evaluate mRNA expression of Furin and ACE2 from blood cells in psoriasis patients, and whether systemic or topical treatment reduces expression levels. Methods: This observational translational study analyzed blood samples from patients from a clinical trial and samples retrieved from the biobank of the Psoriasis Registry Austria (PsoRA). Furin and ACE2 expression levels were analyzed prior to as well as 3 and 12–24 months after start of biologic treatment with either ustekinumab or secukinumab. Additionally, the study analyzed expression levels prior to, 6 days after start of dithranol treatment and 4–6 weeks after end of dithranol treatment. Results: Furin mRNA expression was significantly increased at baseline in the biologic (4.9 ± 2.6 fold, p < 0.0001) and in the dithranol group (2.7 ± 1.4 fold, p < 0.001) compared to controls. There was a trend for arthritis patients to express more furin than patients with psoriatic skin involvement only (5.26 ± 2.30 vs. 3.48 ± 2.27, p = 0.078). Analyzing furin mRNA expression after treatment initiation with secukinumab or ustekinumab revealed a normalization of levels after 3 and 12 to 24 months. Similar findings were obtained for patients treated with dithranol, with significantly decreased expression levels 6 days after start of dithranol treatment and also at follow-up, (4–6 weeks after dithranol treatment had been terminated). ACE2 expression levels did not differ from controls at any timepoint, regardless of biologic or topical treatment. Conclusion: Significantly overexpressed levels of furin were observed in untreated patients, and, thus, these patients may be at risk for infection and a severe course of COVID-19. However, the data indicate that successful therapeutic intervention in psoriasis, by systemic biologic or topical treatment, can efficiently reduce furin levels in blood cells, possibly limiting the risk of psoriasis patients for a severe COVID-19 course. Clinical Trial Registration:ClinicalTrials.gov, identifier NCT02752672.
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Affiliation(s)
- Thomas Graier
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Nicole Golob-Schwarzl
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Theresa Benezeder
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Clemens Painsi
- Department of Dermatology and Venereology, State Hospital, Klagenfurt, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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14
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Storck M, Sandmann S, Bruland P, Pereira MP, Steinke S, Riepe C, Soto-Rey I, Garcovich S, Augustin M, Blome C, Bobko S, Legat FJ, Potekaev N, Lvov A, Misery L, Weger W, Reich A, Şavk E, Streit M, Serra-Baldrich E, Szepietowski JC, Dugas M, Ständer S, Zeidler C. Pruritus Intensity Scales across Europe: a prospective validation study. J Eur Acad Dermatol Venereol 2021; 35:1176-1185. [PMID: 33411947 DOI: 10.1111/jdv.17111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic pruritus (CP) is a subjective symptom, and it is necessary to assess its intensity with validated patient-reported outcome tools in order to allow determination of the treatment course. OBJECTIVES So far, the itch intensity scales were validated in small cohorts and in single languages. Here, we report the validation of the numerical rating scale, the verbal rating scale and the visual analogue scale for the worst and average pruritus intensity in the last 24h in several languages across Europe and across different pruritic dermatoses. METHODS After professional translation, the intensity scales were digitized for use as a tablet computer application. Validation was performed in clinics for Dermatology in Austria, France, Germany, Italy, Poland, Russia, Spain, Switzerland and Turkey. RESULTS A total of 547 patients with contact dermatitis, chronic nodular prurigo, psoriasis vulgaris, lichen planus or cutaneous T-cell lymphoma were included. The intensity scales showed a high level of reproducibility and inter-correlations with each other. The correlation with the Dermatology Life Quality Index was weak to strong in nearly all countries and dermatoses with the exception of France and patients with chronic nodular prurigo, for which no statistically significant correlations were found. CONCLUSIONS The numerical rating scale, the verbal rating scale und the visual analogue scales are valid instruments with good reproducibility and internal consistency in German (Germany, Austria, Switzerland), French, Italian, Polish, Russian, Spanish and Turkish for different pruritic dermatoses. VAS worst was the best reproducible and consistent measuring instrument in all countries.
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Affiliation(s)
- M Storck
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - S Sandmann
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - P Bruland
- Institute of Medical Informatics, University of Münster, Münster, Germany.,inIT - Institute Industrial IT, Ostwestfalen-Lippe University of Applied Sciences, Lemgo, Germany
| | - M P Pereira
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - S Steinke
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Riepe
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - I Soto-Rey
- Institute of Medical Informatics, University of Münster, Münster, Germany.,IT-Infrastructure for Translational Medical Research, Faculty of Applied Computer Science, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - S Garcovich
- Dermatology, F. Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Bobko
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria.,Das Kurhaus, Bad Gleichenberg, Austria
| | - N Potekaev
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - A Lvov
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - W Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - E Şavk
- Department of Dermatology, Aydin Adnan Menderes University, Aydin, Turkey
| | - M Streit
- Department of Dermatology, Kantonsspital Aarau, Aarau, Switzerland
| | - E Serra-Baldrich
- Cutaneous Allergy Unit, Department of Dermatology, Hospital Sant Pau, Universitat Autònoma, Barcelona, Barcelona, Spain
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - M Dugas
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Zeidler
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
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15
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Graier T, Salmhofer W, Jonak C, Weger W, Kölli C, Gruber B, Sator PG, Prillinger K, Mlynek A, Schütz-Bergmayr M, Richter L, Ratzinger G, Painsi C, Selhofer S, Häring N, Wippel-Slupetzky K, Skvara H, Trattner H, Tanew A, Inzinger M, Tatarski R, Bangert C, Ellersdorfer C, Lichem R, Gruber-Wackernagel A, Hofer A, Legat F, Schmiedberger E, Strohal R, Lange-Asschenfeldt B, Schmuth M, Vujic I, Hoetzenecker W, Trautinger F, Saxinger W, Müllegger R, Quehenberger F, Wolf P. Biologic drug survival rates in the era of anti-interleukin-17 antibodies: a time-period-adjusted registry analysis. Br J Dermatol 2020; 184:1094-1105. [PMID: 33289075 PMCID: PMC8248155 DOI: 10.1111/bjd.19701] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 12/22/2022]
Abstract
Background Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time‐dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options. Objectives To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment. Methods This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019. Results A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long‐term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non‐naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21). Conclusions The time‐dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.
What is already known about this topic?
Female gender and previous biologic exposure have been discussed as predictors for decreased drug survival in patients with psoriasis, but it remains unknown whether a time‐dependent increased availability of treatment options alters biologic drug survival.
What does this study add?
The increased availability of alternative biologic treatments over time leads to an elevated risk for treatment discontinuation overall; therefore, drug survival analysis has to be time adjusted. Moreover, the study reveals that the impact of previous biologic treatment on drug survival is tremendous and confirms worse drug survival in female patients.
Linked Comment: Gniadecki. Br J Dermatol 2021; 184:996–997.
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Affiliation(s)
- T Graier
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - W Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - W Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - C Kölli
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - B Gruber
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - P G Sator
- Department of Dermatology, Hietzing Hospital, Vienna, Austria
| | - K Prillinger
- Department of Dermatology and Venereology, University Hospital St Pölten, St Pölten, Austria
| | - A Mlynek
- Department of Dermatology, Hospital of Elisabethinen, Linz, Austria
| | - M Schütz-Bergmayr
- Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria
| | - L Richter
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - G Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - C Painsi
- Department of Dermatology and Venereology, State Hospital, Klagenfurt, Austria
| | - S Selhofer
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - N Häring
- Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria
| | | | - H Skvara
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - H Trattner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - M Inzinger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - R Tatarski
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - C Bangert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Ellersdorfer
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - R Lichem
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Gruber-Wackernagel
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Hofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - F Legat
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - E Schmiedberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - R Strohal
- Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria
| | | | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - I Vujic
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - W Hoetzenecker
- Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria
| | - F Trautinger
- Department of Dermatology and Venereology, University Hospital St Pölten, St Pölten, Austria
| | - W Saxinger
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - R Müllegger
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - F Quehenberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - P Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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16
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Repelnig M, Weger W, Cerpes U, Wolf P, Legat FJ. Methyl aminolevulinate photodynamic therapy for Bowen's disease on the fingers—Is monotherapy sufficiently effective? Photodermatol Photoimmunol Photomed 2020; 36:487-489. [PMID: 32623780 PMCID: PMC7689839 DOI: 10.1111/phpp.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Maria‐Lisa Repelnig
- Department of Dermatology and Venerology Medical University of Graz Graz Austria
| | - Wolfgang Weger
- Department of Dermatology and Venerology Medical University of Graz Graz Austria
| | - Urban Cerpes
- Department of Dermatology and Venerology Medical University of Graz Graz Austria
| | - Peter Wolf
- Department of Dermatology and Venerology Medical University of Graz Graz Austria
| | - Franz Josef Legat
- Department of Dermatology and Venerology Medical University of Graz Graz Austria
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17
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Deinlein T, Kränke B, Cerroni L, Weger W. Intracorneal pustular drug eruption associated with nivolumab in a patient with metastatic renal cancer. Int J Dermatol 2020; 59:e435-e437. [PMID: 32864767 DOI: 10.1111/ijd.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Teresa Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Birger Kränke
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
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18
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Homayoon D, Hiebler-Ragger M, Zenker M, Weger W, Unterrainer H, Aberer E. Relationship Between Skin Shame, Psychological Distress and Quality of Life in Patients with Psoriasis: a Pilot Study. Acta Derm Venereol 2020; 100:adv00205. [PMID: 32556357 PMCID: PMC9199924 DOI: 10.2340/00015555-3563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Shame has been registered as a part of psychosocial distress in patients with psoriasis. This study investigated 44 patients with psoriasis and 88 age- and sex-matched individuals without skin disease. Skin shame, multifarious expressions of shame, psychological symptoms, overall health, dermatological quality of life, disease burden and disease severity were measured. Higher levels of skin shame correlated with a greater disease burden (r=0.63; p < 0.01), higher Dermatology Life Quality Index (r=0.33; p < 0.05), and lower mental quality of life (r=-0.30; p <´ 0.05). Patients had a higher level of skin shame (F=74.03; eta2= 0.36; p < 0.01) and less physical quality of life on the SF-36 (F=5.14; eta2= 0.04; p < 0.05) than non-dermatological controls. General shame was not related to disease burden or quality of life. While self-rated skin shame appears to be related to quality of life in patients with psoriasis, no association was registered between expert-rated Psoriasis Area and Severity Index and quality of life.
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Affiliation(s)
- Donja Homayoon
- Department of Dermatology und Venereology, Medical University of Graz, AT-8036 Graz, Austria
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19
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Aberer E, Hiebler-Ragger M, Zenker M, Weger W, Hofer A, Unterrainer HF. Facets of shame are differently expressed in dermatological disease: a prospective observational study. Br J Dermatol 2020; 183:169-171. [PMID: 31997342 PMCID: PMC7383988 DOI: 10.1111/bjd.18899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Hiebler-Ragger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - M Zenker
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - W Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Hofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - H F Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.,CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria.,Department of Religious Studies, University of Vienna, Vienna, Austria
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20
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Trieb M, Wolf P, Knuplez E, Weger W, Schuster C, Peinhaupt M, Holzer M, Trakaki A, Eichmann T, Lass A, Wadsack C, Schuligoi R, Heinemann A, Marsche G. Abnormal composition and function of high-density lipoproteins in atopic dermatitis patients. Allergy 2019; 74:398-402. [PMID: 30267572 PMCID: PMC6491993 DOI: 10.1111/all.13620] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Markus Trieb
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
- BioTechMed-Graz; Graz Austria
| | - Peter Wolf
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - Eva Knuplez
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
| | - Wolfgang Weger
- Department of Dermatology; Medical University of Graz; Graz Austria
| | | | - Miriam Peinhaupt
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
| | - Michael Holzer
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
| | - Athina Trakaki
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
| | - Thomas Eichmann
- BioTechMed-Graz; Graz Austria
- Center of Explorative Lipidomics; Graz Austria
| | - Achim Lass
- BioTechMed-Graz; Graz Austria
- Institute of Molecular Biosciences; University of Graz; Graz Austria
| | - Christian Wadsack
- BioTechMed-Graz; Graz Austria
- Department of Obstetrics and Gynaecology; Medical University of Graz; Graz Austria
| | - Rufina Schuligoi
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
| | - Akos Heinemann
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
- BioTechMed-Graz; Graz Austria
| | - Gunther Marsche
- Division of Pharmacology; Otto Loewi Research Center; Medical University of Graz; Graz Austria
- BioTechMed-Graz; Graz Austria
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21
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Puchner A, Gröchenig HP, Sautner J, Helmy-Bader Y, Juch H, Reinisch S, Högenauer C, Koch R, Hermann J, Studnicka-Benke A, Weger W, Puchner R, Dejaco C. Immunosuppressives and biologics during pregnancy and lactation : A consensus report issued by the Austrian Societies of Gastroenterology and Hepatology and Rheumatology and Rehabilitation. Wien Klin Wochenschr 2019; 131:29-44. [PMID: 30643992 PMCID: PMC6342891 DOI: 10.1007/s00508-019-1448-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/06/2018] [Indexed: 12/14/2022]
Abstract
An increasing and early-onset use of immunosuppressives and biologics has become more frequently seen among patients with inflammatory bowel diseases (IBD) and rheumatic disorders. Many women in their childbearing years currently receive such medications, and some of them in an interdisciplinary setting. Many questions arise in women already pregnant or wishing to conceive with respect to continuing or discontinuing treatment, the risks borne by the newborns and their mothers and long-term safety. Together with the Austrian Society of Rheumatology and Rehabilitation, the IBD working group of the Austrian Society of Gastroenterology and Hepatology has elaborated consensus statements on the use of immunosuppressives and biologics in pregnancy and lactation. This is the first Austrian interdisciplinary consensus on this topic. It is intended to serve as a basis and support for providing advice to our patients and their treating physicians.
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Affiliation(s)
- Antonia Puchner
- Division of Rheumatology, Third Medical Department, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| | - Hans Peter Gröchenig
- Medical Department, Hospital of the Brothers of Mercy, St. Veit an der Glan, Austria
| | - Judith Sautner
- Second Medical Department, Korneuburg-Stockerau Hospital/Lower Austrian Center for Rheumatology, Stockerau, Austria
| | - Yvonne Helmy-Bader
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Herbert Juch
- Department of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - Sieglinde Reinisch
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christoph Högenauer
- Division of Gastroenterology and Hepatology, Medical Department, Medical University of Graz, Graz, Austria
| | - Robert Koch
- Division of Gastroenterology, First Medical Department, Medical University of Innsbruck, Innsbruck, Austria
| | - Josef Hermann
- Division of Rheumatology and Immunology, Medical Department, Medical University of Graz, Graz, Austria
| | | | - Wolfgang Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Rudolf Puchner
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Clemens Dejaco
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
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22
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Steinke S, Zeidler C, Riepe C, Bruland P, Soto-Rey I, Storck M, Augustin M, Bobko S, Garcovich S, Legat FJ, Lvov A, Misery L, Osada N, Reich A, Şavk E, Serra-Baldrich E, Streit M, Szepietowski JC, Weger W, Dugas M, Ständer S. Humanistic burden of chronic pruritus in patients with inflammatory dermatoses: Results of the European Academy of Dermatology and Venereology Network on Assessment of Severity and Burden of Pruritus (PruNet) cross-sectional trial. J Am Acad Dermatol 2019; 79:457-463.e5. [PMID: 30119869 DOI: 10.1016/j.jaad.2018.04.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/17/2018] [Accepted: 04/20/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Chronic pruritus is a multifactorial, challenging symptom of global relevance. OBJECTIVE The European Academy of Dermatology and Venereology Network on Assessment of Severity and Burden of Pruritus (PruNet) investigation aimed to analyze the severity and humanistic burden of chronic pruritus in patients suffering from inflammatory dermatoses across Europe. METHODS Prospectively collected routine data on 552 patients (with atopic dermatitis, contact dermatitis, prurigo nodularis, psoriasis vulgaris, lichen planus, or mycosis fungoides [pruritus numeric rating scale score ≥3]) from 9 European centers (in Austria, France, Germany, Italy, Poland, Russia, Spain, Switzerland, and Turkey) were analyzed by univariate and multivariate variance analyses of various itch characteristics and quality of life (as measured by the Dermatology Life Quality Index and the ItchyQoL). RESULTS Duration, frequency, and intensity of pruritus (according to a numeric rating scale and visual analog scale) and related impairment of quality of life differed between European centers and dermatologic diagnoses (P < .05). The country in which the center was located had a greater impact on how patients evaluated pruritus intensity and quality of life than diagnosis did (P < .001). LIMITATIONS One center per country was included. CONCLUSION The humanistic burden of chronic pruritus in patients with inflammatory dermatoses is high. European cross-cultural factors may have a stronger influence than a specific dermatologic diagnosis on how patients rate intensity of pruritus and quality of life.
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Affiliation(s)
- Sabine Steinke
- Center for Chronic Pruritus, Department of Dermatology, University Hospital of Münster, Münster, Germany; Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Claudia Zeidler
- Center for Chronic Pruritus, Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - Claudia Riepe
- Center for Chronic Pruritus, Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - Philipp Bruland
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Iñaki Soto-Rey
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Michael Storck
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Svetlana Bobko
- Department of Dermatology, University Hospital Moscow, Moscow, Russia
| | - Simone Garcovich
- Department of Dermatology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Franz J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria; Das Kurhaus-Bad Gleichenberg, Bad Gleichenberg, Austria
| | - Andrey Lvov
- Department of Dermatology, University Hospital Moscow, Moscow, Russia
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Nani Osada
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Adam Reich
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland; Department of Dermatology, University of Rzeszow, Rzeszow, Poland
| | - Ekin Şavk
- Department of Dermatology, Adnan Menderes University, Aydın, Turkey
| | - Esther Serra-Baldrich
- Cutaneous Allergy Unit, Department of Dermatology, Hospital Sant Pau, Universitat Autònoma Barcelona, Barcelona, Spain
| | - Markus Streit
- Department of Dermatology, Kantonsspital Aarau, Aarau, Switzerland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Wolfgang Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Martin Dugas
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Sonja Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital of Münster, Münster, Germany
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23
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Zeidler C, Steinke S, Riepe C, Bruland P, Soto-Rey I, Storck M, Garcovich S, Blome C, Bobko S, Legat FJ, Potekaev N, Lvov A, Misery L, Weger W, Reich A, Şavk E, Streit M, Serra-Baldrich E, Szepietowski JC, Yosipovitch G, Chen SC, Dugas M, Ständer S. Cross-European validation of the ItchyQoL in pruritic dermatoses. J Eur Acad Dermatol Venereol 2018; 33:391-397. [PMID: 30193410 DOI: 10.1111/jdv.15225] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/26/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic pruritus (CP) is a frequently occurring symptom in inflammatory dermatoses, causing a high burden and limitations to health-related quality of life (HRQoL). OBJECTIVE The ItchyQoL was developed to assess the impairment to HRQoL in patients with CP. However, it has only been validated in English and German. Here, we report the validation in several languages across Europe. METHODS After professional translation, the versions of ItchyQoL were digitized for use as a tablet application. Validation was performed in clinics for dermatology in Austria, France, Germany, Italy, Poland, Russia, Spain, Switzerland and Turkey. RESULTS Five hundred and thirty-five patients with either contact dermatitis, chronic prurigo - nodular type, psoriasis vulgaris, lichen planus or mycosis fungoides/Sézary syndrome and with CP ≥ 3 on the numerical rating scale were included. ItchyQoL showed a high level of consistency (Cronbach's-α, all: 0.95) and test-retest reliability (intraclass correlation: 0.91). It strongly correlated with the Dermatology Life Quality Index (r = 0.72, P < 0.001) and moderately correlated with itch intensity scales in the study population (visual analogue scale r = 0.46; numerical rating scale r = 0.51; verbal rating scale r = 0.51, for all: P < 0.001). CONCLUSION ItchyQoL is now also validated in French, Italian, Polish, Russian, Spanish and Turkish and can be used in clinical trials in countries speaking these languages.
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Affiliation(s)
- C Zeidler
- Department of Dermatology and Center for Chronic Pruritus, University Hospital of Münster, Münster, Germany
| | - S Steinke
- Department of Dermatology and Center for Chronic Pruritus, University Hospital of Münster, Münster, Germany
| | - C Riepe
- Department of Dermatology and Center for Chronic Pruritus, University Hospital of Münster, Münster, Germany
| | - P Bruland
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - I Soto-Rey
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - M Storck
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - S Garcovich
- Institute of Dermatology, Policlinico A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg, Hamburg, Germany
| | - S Bobko
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria.,Das Kurhaus, Bad Gleichenberg, Austria
| | - N Potekaev
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - A Lvov
- Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - W Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - A Reich
- Department of Dermatology, University of Rzeszów, Rzeszów, Poland
| | - E Şavk
- Department of Dermatology, Adnan Menderes University, Aydın, Turkey
| | - M Streit
- Department of Dermatology, Kantonsspital Aarau, Aarau, Switzerland
| | - E Serra-Baldrich
- Cutaneous Allergy Unit, Department of Dermatology, Hospital Sant Pau, Universitat Autònoma Barcelona, Barcelona, Spain
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - G Yosipovitch
- Department of Dermatology and Cutaneous Surgery and Miami Itch Center, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - S C Chen
- Department of Dermatology, University of Rzeszów, Rzeszów, Poland
| | - M Dugas
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital of Münster, Münster, Germany
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24
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Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange-Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Quality of life and treatment goals in psoriasis from the patient perspective: results of an Austrian cross-sectional survey. J Dtsch Dermatol Ges 2018; 16:981-990. [PMID: 30117711 DOI: 10.1111/ddg.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with psoriasis experience impairment in quality of life. Thus, high-quality dermatological care is of particular importance. PATIENTS AND METHODS We performed a nationwide cross-sectional survey in Austria (BQSAustria Psoriasis 2014/2015) with a special focus on quality of life and satisfaction with treatment among psoriasis patients predominantly treated at tertiary care centers. RESULTS Overall, 70.2 % of 1,184 patients reported impaired quality of life (DLQI 2-5: 29.4 %; 6-10: 19.3 %; 11-15: 11.5 %; 16-20: 5.2 % and > 20: 4.9 %) despite treatment over the preceding four weeks (topical treatment in 88.2 % of cases and/or systemic treatment in 38.7 %). On average, none of the 25 defined subjective treatment goals was achieved to a sufficient degree. In particular, 82.2 % of patients continued to have pruritus despite treatment, which was highly significantly associated with a poor general health status over the preceding week (Spearman's rank correlation; p = 1.1e-45), the extent of body surface area (p = 3.2e-11) and scalp area (p = 3.2e-11) affected, as well as pain (p = 2.3e-22). Treatment with a biologic was significantly correlated with higher patient satisfaction (Wilcoxon-Test, p = 2.0e-16). CONCLUSIONS Despite dermatological care, the majority of Austrian psoriasis patients continues to experience impaired quality of life; there is potential for improvement in the achievement of treatment goals.
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Affiliation(s)
- Peter Wolf
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Franz Legat
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Kurhaus Bad Gleichenberg, Bad Gleichenberg, Austria
| | - Clemens Painsi
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Department of Dermatology and Venereology, Klagenfurt Medical Center, Klagenfurt, Austria
| | - Werner Saxinger
- Department of Dermatology and Venereology, Wels-Grieskirchen Medical Center, Wels, Austria
| | - Robert Müllegger
- Department of Dermatology and Venereology, State Medical Center, Wiener Neustadt, Austria
| | - Paul Sator
- Department of Dermatology, Hietzing Hospital, Vienna, Austria
| | - Gudrun Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Austria
| | - Sylvia Selhofer
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - Leo Richter
- Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Vienna, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | | | - Franz Trautinger
- Department of Dermatology and Venereology, University Medical Center St. Pölten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Alexander Mlynek
- Department of Dermatology, Elisabethinen Medical Center, Linz, Austria
| | - Robert Strohal
- Department of Dermatology and Venereology, State Hospital and Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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25
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Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange‐Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Lebensqualität und Behandlungsziele bei Psoriasis aus Patientensicht: Ergebnisse eines österreichweiten Querschnitt‐Survey. J Dtsch Dermatol Ges 2018; 16:981-991. [DOI: 10.1111/ddg.13613_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Peter Wolf
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Wolfgang Weger
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Franz Legat
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Das Kurhaus Bad GleichenbergBad Gleichenberg Österreich
| | - Clemens Painsi
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Abteilung für Dermatologie und VenerologieKlinikum Klagenfurt am Wörthersee Klagenfurt Österreich
| | - Werner Saxinger
- Abteilung für Haut‐ und GeschlechtskrankheitenKlinikum Wels‐Grieskirchen Wels Österreich
| | - Robert Müllegger
- Abteilung für Dermatologie und VenerologieLandesklinikum Wiener Neustadt Wiener Neustadt Österreich
| | - Paul Sator
- Dermatologische AbteilungKrankenhaus Hietzing Wien Österreich
| | - Gudrun Ratzinger
- Universitätsklinik für DermatologieVenerologie und AllergologieMedizinische Universität Innsbruck Innsbruck Österreich
| | - Sylvia Selhofer
- Universitätsklinik für DermatologieParacelsus Medizinische Privatuniversität Salzburg Salzburg Österreich
| | - Leo Richter
- Abteilung für Dermatologie und VenerologieKrankenanstalt Wien‐Rudolfstiftung Wien Österreich
| | - Wolfgang Salmhofer
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | | | - Franz Trautinger
- Abteilung für Haut‐ und GeschlechtskrankheitenUniversitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften Krems Österreich
| | - Alexander Mlynek
- Abteilung für DermatologieOrdensklinikum Linz – Elisabethinen Linz Österreich
| | - Robert Strohal
- Abteilung für Dermatologie und VenerologieLandeskrankenhaus Feldkirch – Akademisches Lehrspital Feldkirch Österreich
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei PflegeberufenUniversitätsklinikum Hamburg‐Eppendorf Hamburg Deutschland
| | - Franz Quehenberger
- Institut für Medizinische InformatikStatistik und DokumentationMedizinische Universität Graz, Graz Österreich
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Wolf P, Weger W, Patra V, Gruber-Wackernagel A, Byrne SN. Desired response to phototherapy vs photoaggravation in psoriasis: what makes the difference? Exp Dermatol 2018; 25:937-944. [PMID: 27376966 DOI: 10.1111/exd.13137] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Abstract
Psoriasis commonly responds beneficially to UV radiation from natural sunlight or artificial sources. Therapeutic mechanisms include the proapoptotic and immunomodulating effects of UV, affecting many cells and involving a variety of pro- and anti-inflammatory cytokines, downregulating the Th17/IL-23 response with simultaneous induction of regulatory immune cells. However, exposure to UV radiation in a subset of psoriasis patients leads to exacerbation of the disease. We herein shed light on the predisposing factors of photosensitive psoriasis, including genetics (such as HLA-Cw*0602 or CARD14), gender and coexisting photodermatoses such as polymorphic light eruption (PLE) in the context of potential molecular mechanisms behind therapeutic photoresponsiveness or photoaggravation. UV-induced damage/pathogen-associated molecular patterns, damage to self-coding RNA (signalling through Toll-like receptors), certain antimicrobial peptides and/or inflammasome activation may induce innate immunity, leading to psoriasis at the site of UV exposure when there is concomitant, predisposing resistance against UV-induced suppression of the adaptive immune response (like in PLE) that otherwise would act to reduce psoriasis.
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Affiliation(s)
- Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Wolfgang Weger
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - VijayKumar Patra
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Scott N Byrne
- Cellular Photoimmunology Group, Infectious Diseases and Immunology, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Inzinger M, Wippel-Slupetzky K, Weger W, Richter L, Mlynek A, Fleischander B, Scheurecker C, Sandor N, Mairhofer D, Sator PG, Moser-Oberthaler S, Häring N, Viznerova P, Painsi C, Tanew A, Ponholzer P, Tatarski R, Brenner W, Stingl G, Salmhofer W, Rappersberger K, Klein G, Saxinger W, Auböck J, Kölli C, Trautinger F, Steiner A, Ratzinger G, Strohal R, Riedl E, Lange-Asschenfeldt B, Pehamberger H, Volc-Platzer B, Selhofer S, Legat FJ, Müllegger R, Reider N, Schmuth M, Hintner H, Hofer A, Gruber-Wackernagel A, Aberer W, Quehenberger F, Wolf P. Survival and Effectiveness of Tumour Necrosis Factor-alpha Inhibitors in the Treatment of Plaque Psoriasis under Daily Life Conditions: Report from the Psoriasis Registry Austria. Acta Derm Venereol 2016; 96:207-12. [PMID: 26271044 DOI: 10.2340/00015555-2214] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 11/16/2022] Open
Abstract
This retrospective multicentre analysis from the Psoriasis Registry Austria (PsoRA) was conducted to determine drug effectiveness and survival of anti-tumour necrosis factor alpha (anti-TNF-α) agents in patients with moderate-to-severe chronic plaque psoriasis over a 9-year period. Data on 1,019 treatment cycles with adalimumab (n = 460), etanercept (n = 501), and/or infliximab (n = 58) administered to 827 patients (272 women, 555 men) were available for analysis. Compared with etanercept, adalimumab and infliximab showed superior short-term effectiveness. Intention-to-treat-calculated median drug survivals for adalimumab (1,264 days) and etanercept (1,438 days) were similar to each other (p = 0.74), but significantly superior to that of infliximab (477 days) (p = 7.0e-07 vs. adalimumab and p=2.2e-07 vs. etanercept, respectively). Their drug survival rates at 36 months were 51.6%, 56.0%, and 22.6%, respectively. Survival rates correlated significantly with effectiveness for adalimumab and etanercept, but not for infliximab.
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Affiliation(s)
- Martin Inzinger
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, AT-8036 Graz, Austria
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Skrabl-Baumgartner A, Weger W, Salmhofer W, Jahnel J. Childhood generalized pustular psoriasis: longtime remission with combined infliximab and methotrexate treatment. Pediatr Dermatol 2015; 32:e13-4. [PMID: 25644044 DOI: 10.1111/pde.12457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An 8-year old boy with generalized pustular psoriasis unresponsive to several topical and systemic treatments responded dramatically with long-lasting remission to infliximab in combination with methotrexate. Combined therapy might offer a new therapeutic strategy yielding long-term remission.
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Inzinger M, Legat F, Hofer A, Weger W, Gruber‐Wackernagel A, Salmhofer W, Wolf P. Short‐ to intermediate‐term follow‐up in patients treated with the combination of 311‐nm ultraviolet B phototherapy and biological agents. Br J Dermatol 2014; 171:915-7. [PMID: 24665924 DOI: 10.1111/bjd.12992] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M. Inzinger
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - F.J. Legat
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - A. Hofer
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - W. Weger
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - A. Gruber‐Wackernagel
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - W. Salmhofer
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
| | - P. Wolf
- Research Unit for Photodermatology Department of Dermatology Medical University of Graz Graz Austria
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30
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Tsoi LC, Spain SL, Knight J, Ellinghaus E, Stuart PE, Capon F, Ding J, Li Y, Tejasvi T, Gudjonsson JE, Kang HM, Allen MH, McManus R, Novelli G, Samuelsson L, Schalkwijk J, Ståhle M, Burden AD, Smith CH, Cork MJ, Estivill X, Bowcock AM, Krueger GG, Weger W, Worthington J, Tazi-Ahnini R, Nestle FO, Hayday A, Hoffmann P, Winkelmann J, Wijmenga C, Langford C, Edkins S, Andrews R, Blackburn H, Strange A, Band G, Pearson RD, Vukcevic D, Spencer CCA, Deloukas P, Mrowietz U, Schreiber S, Weidinger S, Koks S, Kingo K, Esko T, Metspalu A, Lim HW, Voorhees JJ, Weichenthal M, Wichmann HE, Chandran V, Rosen CF, Rahman P, Gladman DD, Griffiths CEM, Reis A, Kere J, Nair RP, Franke A, Barker JNWN, Abecasis GR, Elder JT, Trembath RC. Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet 2012; 44:1341-8. [PMID: 23143594 PMCID: PMC3510312 DOI: 10.1038/ng.2467] [Citation(s) in RCA: 706] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 10/17/2012] [Indexed: 02/08/2023]
Abstract
To gain further insight into the genetic architecture of psoriasis, we conducted a meta-analysis of 3 genome-wide association studies (GWAS) and 2 independent data sets genotyped on the Immunochip, including 10,588 cases and 22,806 controls. We identified 15 new susceptibility loci, increasing to 36 the number associated with psoriasis in European individuals. We also identified, using conditional analyses, five independent signals within previously known loci. The newly identified loci shared with other autoimmune diseases include candidate genes with roles in regulating T-cell function (such as RUNX3, TAGAP and STAT3). Notably, they included candidate genes whose products are involved in innate host defense, including interferon-mediated antiviral responses (DDX58), macrophage activation (ZC3H12C) and nuclear factor (NF)-κB signaling (CARD14 and CARM1). These results portend a better understanding of shared and distinctive genetic determinants of immune-mediated inflammatory disorders and emphasize the importance of the skin in innate and acquired host defense.
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Affiliation(s)
- Lam C Tsoi
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan Ann Arbor, MI 48109, USA
| | - Sarah L Spain
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
| | - Jo Knight
- Neuroscience Research, Centre for Addiction and Mental Health, Toronto, ON, Canada M5T 1R8
- National Institute for Health Research (NIHR), Biomedical Research Centre, Guy’s and St. Thomas’ NHS Foundation Trust
| | - Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, 24105 Kiel, Germany
| | - Philip E Stuart
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Francesca Capon
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
| | - Jun Ding
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan Ann Arbor, MI 48109, USA
| | - Yanming Li
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan Ann Arbor, MI 48109, USA
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Hyun M Kang
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan Ann Arbor, MI 48109, USA
| | - Michael H Allen
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
| | - Ross McManus
- Department of Clinical Medicine Trinity College Dublin, Ireland
- Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - Giuseppe Novelli
- National Agency for Evaluation of Universities and Research Institutes (ANVUR)
- Research Center San Pietro Hospital, Rome, Italy
| | - Lena Samuelsson
- Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joost Schalkwijk
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mona Ståhle
- Dermatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Catherine H Smith
- St John’s Institute of Dermatology, King’s College London, London, UK
| | - Michael J Cork
- Academic Unit of Dermatology Research, Department of Infection and Immunity, The University of Sheffield, Sheffield, UK
| | - Xavier Estivill
- Genes and Disease Programme, Centre for Genomic Regulation (CRG) and UPF, Hospital del Mar Research Institute (CRG) and Public Health and Epidemiology Network Biomedical Research Centre (CIBERESP), Barcelona, Spain
| | - Anne M Bowcock
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | | | - Wolfgang Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Jane Worthington
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Rachid Tazi-Ahnini
- Academic Unit of Dermatology Research, Department of Infection and Immunity, The University of Sheffield, Sheffield, UK
| | - Frank O Nestle
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
| | - Adrian Hayday
- Division of Immunology, Infection and Inflammatory Disease; King’s College London, London, UK
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, 54127 Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, 54127 Bonn, Germany
| | - Juliane Winkelmann
- Department of Neurology, Technische Universität München, Munich, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
- Institute of Human Genetics, Helmholtz Zentrum Munich, German Research Center for Environmental Health, Munich, Germany
| | - Cisca Wijmenga
- Genetics Department, University Medical Center and University of Groningen, Groningen, The Netherlands
| | | | - Sarah Edkins
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | | | | | - Amy Strange
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7LJ, UK
| | - Gavin Band
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7LJ, UK
| | - Richard D Pearson
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7LJ, UK
| | - Damjan Vukcevic
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7LJ, UK
| | - Chris CA Spencer
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7LJ, UK
| | | | - Ulrich Mrowietz
- Department of Dermatology, University Hospital, Schleswig-Holstein, Christian-Albrechts-University, 24105 Kiel, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, 24105 Kiel, Germany
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, 24105 Kiel, Germany
- PopGen biobank, University Hospital S.-H., Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, University Hospital, Schleswig-Holstein, Christian-Albrechts-University, 24105 Kiel, Germany
| | - Sulev Koks
- Department of Physiology, Centre of Translational Medicine and Centre for Translational Genomics, University of Tartu, 50409 Tartu, Estonia
| | - Külli Kingo
- Department of Dermatology and Venerology, University of Tartu, 50409 Tartu, Estonia
| | - Tonu Esko
- Estonian Genome Center, University of Tartu, 51010 Tartu, Estonia
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, 51010 Tartu, Estonia
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, 48202, USA
| | - John J Voorhees
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Michael Weichenthal
- Department of Dermatology, University Hospital, Schleswig-Holstein, Christian-Albrechts-University, 24105 Kiel, Germany
| | - H. Erich Wichmann
- Institute of Epidemiology I, Helmholtz Centre Munich, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, 81377 Munich, Germany
- Klinikum Grosshadern, 81377 Munich, Germany
| | - Vinod Chandran
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada
| | - Cheryl F Rosen
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto, Ontario M5T 2S8
| | - Proton Rahman
- Department of Medicine, Memorial University, St. John’s, Newfoundland A1C 5B8, Canada
| | - Dafna D Gladman
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada
| | - Christopher EM Griffiths
- Dermatological Sciences, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Andre Reis
- Institute of Human Genetics, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Juha Kere
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
- Folkhälsan Institute of Genetics, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Finland
| | | | | | | | | | - Rajan P Nair
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, 24105 Kiel, Germany
| | - Jonathan NWN Barker
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
- St John’s Institute of Dermatology, King’s College London, London, UK
| | - Goncalo R Abecasis
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan Ann Arbor, MI 48109, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, 48105, USA
| | - Richard C Trembath
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK
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Affiliation(s)
- Martin Inzinger
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, AT-8036 Graz, Austria
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Inzinger M, Weger W, Heschl B, Salmhofer W, Quehenberger F, Wolf P. Methotrexate vs. fumaric acid esters in moderate-to-severe chronic plaque psoriasis: data registry report on the efficacy under daily life conditions. J Eur Acad Dermatol Venereol 2012; 27:861-6. [DOI: 10.1111/j.1468-3083.2012.04596.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Holzer M, Wolf P, Curcic S, Birner-Gruenberger R, Weger W, Inzinger M, El-Gamal D, Wadsack C, Heinemann A, Marsche G. Psoriasis alters HDL composition and cholesterol efflux capacity. J Lipid Res 2012; 53:1618-24. [PMID: 22649206 DOI: 10.1194/jlr.m027367] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Psoriasis, a chronic inflammatory skin disease, has been linked to increased myocardial infarction and stroke. Functional impairment of HDL may contribute to the excess cardiovascular mortality of psoriatic patients. However, data available regarding the impact of psoriasis on HDL composition and function are limited. HDL from psoriasis patients and healthy controls was isolated by ultracentrifugation and shotgun proteomics, and biochemical methods were used to monitor changed HDL composition. We observed a significant reduction in apoA-I levels of HDL from psoriatic patients, whereas levels of apoA-II and proteins involved in acute-phase response, immune response, and endopeptidase/protease inhibition were increased. Psoriatic HDL contained reduced phospholipid and cholesterol. With regard to function, these compositional alterations impaired the ability of psoriatic HDL to promote cholesterol efflux from macrophages. Importantly, HDL-cholesterol efflux capability negatively correlated with psoriasis area and severity index. We observed that control HDL, as well as psoriatic HDL, inhibited dihydrorhodamine (DHR) oxidation to a similar extent, suggesting that the anti-oxidative activity of psoriatic HDL is not significantly altered. Our observations suggest that the compositional alterations observed in psoriatic HDL reflect a shift to a pro-inflammatory profile that impairs cholesterol efflux capacity of HDL and may provide a link between psoriasis and cardiovascular disease.
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Affiliation(s)
- Michael Holzer
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
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Frühauf J, Schwantzer G, Ambros-Rudolph CM, Weger W, Ahlgrimm-Siess V, Salmhofer W, Hofmann-Wellenhof R. Pilot study on the acceptance of mobile teledermatology for the home monitoring of high-need patients with psoriasis. Australas J Dermatol 2012; 53:41-6. [PMID: 22309330 DOI: 10.1111/j.1440-0960.2011.00852.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVES The willingness to be educated is one of the highest desires among patients with psoriasis. Therefore, a collaborative model of management would appear to be essential in enhancing patient satisfaction in this challenging condition. The present study aimed at examining the applicability of a mobile teledermatology service in this regard and assessing the association between patient acceptance and perceived health-related quality of life. METHODS High-need patients with psoriasis performed visits over 12 weeks transmitting clinical images together with some relevant clinical information via mobile phones to teledermatologists, who provided treatment instructions. Ten patients and two teledermatologists completed 20-item patient (weeks 6 and 12) and 10-item physician (at week 12) acceptance questionnaires. In addition, patients answered the dermatology life quality index (DLQI) at weeks 0, 6 and 12. RESULTS Both patients and teledermatologists were pleased with the service with high acceptance rates (patients: 81.0% at week 6 and 82.9% at week 12; teledermatologists: 74.0%). In addition, 80% of the patients considered the service an alternative to in-person consultation and 90% felt they were in good hands but had achieved a more flexible and empowered lifestyle. No significant correlations were found between patient acceptance and DLQI. Both teledermatologists found the service a convenient and reliable tool for patient monitoring. Neither patients nor teledermatologists thought further in-person consultations necessary. CONCLUSION Mobile teledermatology is a valuable tool for the home monitoring of patients with psoriasis that makes a meaningful difference in their lives. It is well accepted by both patients and the physicians involved.
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Affiliation(s)
- Julia Frühauf
- Department of Dermatology, Medical University of Graz, Austria.
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Wolf P, Weger W, Legat F, Posch-Fabian T, Gruber-Wackernagel A, Inzinger M, Salmhofer W, Hofer A. Treatment with 311-nm ultraviolet B enhanced response of psoriatic lesions in ustekinumab-treated patients: a randomized intraindividual trial. Br J Dermatol 2011; 166:147-53. [DOI: 10.1111/j.1365-2133.2011.10616.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [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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Koller S, Hofmann-Wellenhof R, Hayn D, Weger W, Kastner P, Schreier G, Salmhofer W. Teledermatological monitoring of psoriasis patients on biologic therapy. Acta Derm Venereol 2011; 91:680-5. [PMID: 21879250 DOI: 10.2340/00015555-1148] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [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: 11/16/2022] Open
Abstract
Patients with psoriasis who are being treated with biologics require intensive monitoring. However, the monitoring tool teledermatology is not commonly used. We investigated the applicability of a mobile phone based teledermatological system for monitoring psoriasis patients on biologic therapy. Nineteen patients were given mobile phones with built-in cameras, in order to transmit health status data and images (mobile visits) weekly for a 6-month period. Face-to-face visits were carried out at weeks 0, 4, 12 and 24. Image quality, the Psoriasis Area and Severity Index (PASI), the handling of adverse events, and patients' feedback questionnaires were evaluated. Ninety-five percent of the images were of sufficient quality to enable accurate assessment of the PASI. The distance between the interpolated face-to-face PASIs and the corresponding mobile visit PASIs was 0.46 ± 2.15 (median ± interquartile range). All 155 adverse events were handled correctly by the system. This teledermatological system represents a reliable tool for management of psoriasis patients who are on systemic treatment.
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Affiliation(s)
- Silvia Koller
- Department of Dermatology, Medical University of Graz, Austria.
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Inzinger M, Heschl B, Weger W, Hofer A, Legat F, Gruber-Wackernagel A, Tilz H, Salmhofer W, Quehenberger F, Wolf P. Efficacy of psoralen plus ultraviolet A therapy vs. biologics in moderate to severe chronic plaque psoriasis: retrospective data analysis of a patient registry. Br J Dermatol 2011; 165:640-5. [DOI: 10.1111/j.1365-2133.2011.10396.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [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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Wolf P, Hofer A, Weger W, Posch-Fabian T, Gruber-Wackernagel A, Legat FJ. 311 nm ultraviolet B-accelerated response of psoriatic lesions in adalimumab-treated patients. Photodermatology, Photoimmunology & Photomedicine 2011; 27:186-9. [DOI: 10.1111/j.1600-0781.2011.00594.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Binder B, Lackner HK, Poessl BD, Propst E, Weger W, Smolle J, Ginter-Hanselmayer G. Prevalence of tinea capitis in Southeastern Austria between 1985 and 2008: up-to-date picture of the current situation. Mycoses 2011; 54:243-7. [DOI: 10.1111/j.1439-0507.2009.01804.x] [Citation(s) in RCA: 18] [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] [Indexed: 11/28/2022]
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Weger W. An update on the diagnosis and management of psoriatic arthritis. GIORN ITAL DERMAT V 2011; 146:1-8. [PMID: 21317852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Psoriasis is a common inflammatory disease with complex genetic background affecting approximately 2-3% of the population in the Western hemisphere. Around 20% of psoriasis patients also suffer from psoriatic arthritis (PsA). The clinical spectrum comprises a wide variety of arthritic manifestations ranging from dactylitis, peripheral symmetric or asymmetric mono-, oligo-, and polyarticular arthritis, spinal disease and enthesitis. As psoriasis precedes PsA in 75-80% of affected patients, dermatologists might play a pivotal role in early diagnosis of the disease. Furthermore, magnetic resonance imaging (MRI) scanning and ultrasonography have improved the radiological diagnosis of peripheral PsA, psoriatic spondylarthropathy and enthesitis. Besides the traditional treatment of PsA the introduction of biologics has led to a significant improvement in the treatment of the disease. To further improve diagnosis, treatment and quality of life in our patients suffering from PsA an excellent interdisciplinary collaboration between dermatologists, radiologists and rheumatologists is a necessity of utmost importance.
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Affiliation(s)
- W Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria.
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Abstract
Psoriasis is a chronic inflammatory disease affecting 1-3% of the general population. Among psoriatic patients, 5-40% are affected by psoriatic arthritis. Due to the chronic nature of the disease, patients suffer from substantial psychological and financial burdens, thus adding to a significantly impaired quality of life. Traditional systemic therapies for psoriasis, such as methotrexate, cyclosporin A, retinoids or PUVA therapy, have a potential for long-term toxicity and may not always provide sufficient improvement of the disease. The development of novel therapies targeting key steps in the pathogenesis of psoriasis and psoriatic arthritis now provide new and efficient treatment options. Biological therapies for the treatment of psoriasis and/or psoriatic arthritis are defined by their mode of action and can be classified into three categories: the T-cell modulating agents (alefacept and efalizumab), the inhibitors of tumour necrosis factor-alpha (TNFalpha blockers, e.g. adalimumab, certolizumab, etanercept, golimumab and infliximab) and the inhibitors of interleukin (IL) 12 and IL-23 (e.g. ustekinumab and briakinumab). This article provides a brief overview of the currently approved biological agents in the European Union and of some newer agents, such as briakinumab, certolizumab and golimumab.
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Affiliation(s)
- Wolfgang Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria.
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Koller S, Wiltgen M, Ahlgrimm-Siess V, Weger W, Hofmann-Wellenhof R, Richtig E, Smolle J, Gerger A. In vivo reflectance confocal microscopy: automated diagnostic image analysis of melanocytic skin tumours. J Eur Acad Dermatol Venereol 2010; 25:554-8. [PMID: 20735518 DOI: 10.1111/j.1468-3083.2010.03834.x] [Citation(s) in RCA: 44] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND In vivo reflectance confocal microscopy (RCM) has been shown to be a valuable imaging tool in the diagnosis of melanocytic skin tumours. However, diagnostic image analysis performed by automated systems is to date quite rare. OBJECTIVES In this study, we investigated the applicability of an automated image analysis system using a machine learning algorithm on diagnostic discrimination of benign and malignant melanocytic skin tumours in RCM. METHODS Overall, 16,269 RCM tumour images were evaluated. Image analysis was based on features of the wavelet transform. A learning set of 6147 images was used to establish a classification tree algorithm and an independent test set of 10, 122 images was applied to validate the tree model (grouping method 1). Additionally, randomly generated 'new' learning and test sets, tumour images only and different skin layers were evaluated (grouping method 2, 3 and 4). RESULTS The classification tree analysis correctly classified 93.60% of the melanoma and 90.40% of the nevi images of the learning set. When the classification tree was applied to the independent test set 46.71 ± 19.97% (range 7.81-83.87%) of the tumour images in benign melanocytic skin lesions were classified as 'malignant', in contrast to 55.68 ± 14.58% (range 30.65-83.59%; t-test: P < 0.036) in malignant melanocytic skin lesions (grouping method 1). Further investigations could not improve the results significantly (grouping method 2, 3 and 4). CONCLUSIONS The automated RCM image analysis procedure holds promise for further investigations. However, to date our system cannot be applied to routine skin tumour screening.
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Affiliation(s)
- S Koller
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Frühauf J, Schwantzer G, Ambros-Rudolph CM, Weger W, Ahlgrimm-Siess V, Salmhofer W, Hofmann-Wellenhof R. Pilot Study Using Teledermatology to Manage High-Need Patients With Psoriasis. ACTA ACUST UNITED AC 2010; 146:200-1. [DOI: 10.1001/archdermatol.2009.375] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Weger W, Hofer A, Wolf P, El-Shabrawi Y, Renner W, Kerl H, Salmhofer W. Common polymorphisms in the interleukin-22 gene are not associated with chronic plaque psoriasis. Exp Dermatol 2009; 18:796-8. [PMID: 19469905 DOI: 10.1111/j.1600-0625.2009.00840.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory skin disease. Among other cytokines, interleukin 22 (IL-22) has been implicated in the pathogenesis of chronic plaque psoriasis. The purpose of this study was to investigate a hypothesized association between common IL-22 gene polymorphisms and chronic plaque psoriasis. METHODS Genotypes of 10 common polymorphisms of the IL-22 gene were determined by fluorogenic 5' exonuclease assays (TaqMan) in 475 patients with chronic plaque psoriasis and 252 controls. RESULTS Two blocks of high linkage disequilibrium, formed by eight polymorphisms upstream of exon 5 (rs2227485, rs2227491, rs2046068, rs1179251, rs1012356, rs2227501, rs2227503, rs976748) and two polymorphisms in the 3' near gene region (rs1182844, rs1179246), were observed within the IL-22 gene. Neither single polymorphisms nor haplotypes were significantly associated with the presence or clinical features of chronic plaque psoriasis (P > 0.05). CONCLUSIONS Our data suggest that the investigated IL-22 gene polymorphisms are unlikely major risk factors for chronic plaque psoriasis.
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Abstract
The neurofibromatoses comprise at least two separate genetic disorders with variable clinical features and an unpredictable course. The most common type, neurofibromatosis 1, is characterized by > or = 6 café-au-lait spots and the occurrence of neurofibromas, which may present as cutaneous, subcutaneous or plexiform lesions. Normally, excision of neurofibromas is only indicated in the presence of neurological symptoms, suspicion of malignancy or for exceptional cosmetic reasons. For a good functional and aesthetic result with the least danger of recurrence, the surgeon's goal is to excise as much tissue as necessary and as little tissue as possible. One of the main issues during the surgical procedure is to distinguish between neurofibroma and surrounding tissue. We report for the first time the use of confocal laser scanning microscopy to differentiate between neurofibroma and healthy skin.
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Affiliation(s)
- S Koller
- Department of Dermatology, Medical University of Graz, Graz, Austria.
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Koller S, Gerger A, Ahlgrimm-Siess V, Weger W, Smolle J, Hofmann-Wellenhof R. In vivoreflectance confocal microscopy of erythematosquamous skin diseases. Exp Dermatol 2009; 18:536-40. [DOI: 10.1111/j.1600-0625.2008.00822.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [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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Lorber A, Wiltgen M, Hofmann-Wellenhof R, Koller S, Weger W, Ahlgrimm-Siess V, Smolle J, Gerger A. Correlation of image analysis features and visual morphology in melanocytic skin tumours usingin vivoconfocal laser scanning microscopy. Skin Res Technol 2009; 15:237-41. [DOI: 10.1111/j.1600-0846.2009.00361.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Tinea capitis is the most common fungal infection of the scalp in childhood, but a very rare disorder in the first year of life. OBJECTIVE To evaluate the efficacy, tolerability and safety of itraconazole in 7 children aged between 3 and 46 weeks (median: 36 weeks) suffering from tinea capitis caused by Microsporum canis. METHODS Prospective case note study. In all patients KOH testing and fungal cultivation on Sabouraud dextrose agar were performed. RESULTS 7 patients (5 girls and 2 boys) were included in the period between 2001 and 2008. The causative etiologic agent was Microsporum canis in all children. The patients received itraconazole 5mg/kg bodyweight daily for 3 to 6 weeks with no clinically side effects being noted. In all patients clinical and mycological cure could be achieved. CONCLUSION Itraconazole proved to be a safe and effective treatment option for Microsporum canis induced tinea capitis in children in their first year of life.
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Affiliation(s)
- B Binder
- Department of Dermatology, Medical University of Graz, Graz, Austria.
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Wolf P, Hofer A, Legat F, Bretterklieber A, Weger W, Salmhofer W, Kerl H. Treatment with 311-nm ultraviolet B accelerates and improves the clearance of psoriatic lesions in patients treated with etanercept. Br J Dermatol 2009; 160:186-9. [DOI: 10.1111/j.1365-2133.2008.08926.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [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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