Prevalence of Acne Inversa (Hidradenitis Suppurativa) in China: A Nationwide Cross-Sectional Epidemiological Study

Objective::This study was performed to estimate the prevalence of hidradenitis suppurativa (HS) in China and describe the demographic and clinical features of H...     

Itch and Pain in Adolescents are Associated with Suicidal Ideation: A Population-based Cross-sectional Study

The association between itch and suicidal ideation has not been explored previously in the general population. The aim of the present study is to analyse the association between itch and suicidal ideation in adolescents, and to compare the findings with an expected association between pain and suicidal ideation in the same sample. A total of 4,744 adolescents were invited to join the questionnaire-based study. The participation rate was 80%. The prevalence of suicidal ideation among those who reported no itch was 8.4% vs 21.1% among those who reported severe itch. Significant association between itch and suicidal ideation was found in a multivariate model (odds ratio 3.0, 95% confidence interval (CI) 2.1-4.2) and between pain and suicidal ideation (odds ratio 3.8, 95% CI 2.6-5.7). The findings were similar and statistically significant in girls and boys separately. Itch and pain are approximately equally strongly associated with suicidal ideation in a large general population of adolescents.     

Prevalence of Skin Changes in Diabetes Mellitus and its Correlation with Internal Diseases: A Single Center Observational Study

Background and Aim:

This single-center observational cross-sectional study has been done in an attempt to find out the prevalence of various skin manifestations in diabetes patients (DM) and their correlation with diabetes control and complications.

Materials and Methods:

Skin manifestations present over 12 months among those attend diabetes clinic were included in the study. Apart from demographic data and type, patients were also screened for micro vascular complications and control of diabetes over last 3 months.

Results and Discussion:

Sixty (n = 60) diabetes patisents (Type 1 DM, 9 patients and Type 2 DM 51 patients) have been found to have various skin lesions. Thirty-one (51.67%) patients presented with infectious conditions, vascular complications were present in 21 (35%) and dermatomes belonging to the miscellaneous group were present in 50 (83.33%) patients. Pyoderma, diabetic dermopathy, and pruritus without skin lesions were found to be most common manifestations in infective, vascular and miscellaneous group, respectively. Higher level of HB1_AC was found in patient with diabetic bulla (10.5 ± 0), scleredema (9.75 ± 0.77), lichen planus (9.3 ± 1.6), and acanthosis nigricans (9.15 ± 0.89). Patients with psoriasis and vitiligo had statistically significant lower level of glycosylated hemoglobin (P =< 0.001 and 0.03, respectively). However, no association of any kind of skin manifestation with DM with other microangiopathic complications was found in this study.     

上海市两家养老机构老年瘙痒性皮肤病发病情况分析

目的了解入住养老机构老人瘙痒性皮肤病的发病情况,探讨其发病原因与预防措施。方法现场收集60岁以上老人的身体健康状况和皮肤基本状况,查看皮肤发病情况并做病种分类和统计。结果 2家机构426位老人中患各种皮肤病122例,占28.6%,其中瘙痒性皮肤病97例,分别占皮肤病人数及总人数的79.5%和22.8%。结论瘙痒性皮肤病在养老机构中发病率较高,原因较复杂,给老人的身心健康和生活质量带来较大危害,应当加强防护。     

Atopic Dermatitis and Celiac Disease: A Cross-Sectional Study of 116,816 Patients

Background

Both atopic dermatitis and celiac disease are often accompanied by other immune-mediated disorders.

Objective

The objective of this study was to evaluate the potential association between atopic dermatitis and celiac disease in a broad community-based population.

Methods

A cross-sectional observational design was used. Demographic and clinical data were collected for patients enrolled in a large health management organization who were diagnosed with atopic dermatitis by a dermatologist in 2002–17. The presence of celiac disease/celiac disease-related morbidities was recorded for the whole group, for adults (age > 18 years), and for adults with moderate-to-severe atopic dermatitis. Findings were compared with a matched control group without atopic dermatitis.

Results

The study group included 116,816 patients of whom 45,157 were adults; 1909 adult patients had moderate-to-severe atopic dermatitis. Compared to the respective control subjects, the prevalence rate of celiac disease in the whole group was 0.6% vs. 0.4%; in the adults, 0.6% vs. 0.3%; and in the adults with moderate-to-severe atopic dermatitis, 0.8% vs. 0.3% (p < 0.001 for all). On multivariate analysis, atopic dermatitis was associated with a significantly higher prevalence of celiac disease (odds ratio = 1.609, 95% confidence interval 1.42–1.82, p < 0.001) in the entire study population and each subgroup.

Conclusions

We observed a significant association between atopic dermatitis and celiac disease. This association emphasizes the need for timely screening of gastrointestinal morbidities in individuals with atopic dermatitis to prevent long-term complications.

     

Neuropathic Itch of the Back: A Case of Notalgia Paresthetica

Notalgia paresthetica refers to an isolated mononeuropathy involving chronic localized itch or paresthesia most often at the skin of the scapula or surrounding regions. There are no specific skin manifestations except those arising from chronic scratching and rubbing. The specific etiology remains unknown; however, it has been theorized that the neuropathic itch is caused by sensory nerve entrapment involving the posterior rami of the T2 to T6 nerve root. The entrapment is due to degenerative changes in the vertebrae. We report here a particular case of notalgia paresthetica in a 55-year-old woman. The patient visited our hospital for tingling pain around the left inferior angle of the scapula. Pruritus was first reported seven years ago with tingling pain developing only four months ago. There were no specific skin lesions observed except for excoriation and vague hyperpigmentation. A skin biopsy revealed only epidermal thinning with pigmentary incontinence. The patient was treated with 600 mg of gabapentin daily as well as capsaicin cream. The response was deemed unsatisfactory.     

Itch, Stress and Self-efficacy Among 18-year-old Boys and Girls: A Norwegian Population-based Cross-sectional Study

Itch is the most common dermatological symptom and worsens with stress. The general belief of a person in their own ability to cope in stressful situations, known as self-efficacy, is relevant in the management of chronic diseases other than skin diseases. The aim of this study was to explore the association between perceived self-efficacy, itch and stress among late-stage adolescents. The study was cross-sectional and questionnaire-based. Information on psycho-social factors and skin symptoms among late adolescents was collected in a sample of the general population in Oslo, Norway. In this sample of 2,489 boys and girls, the prevalence of current itch was 7% among adolescents with high self-efficacy and low stress, and 17% among adolescents with low self-efficacy (p?=?0.028). Adolescents with low self-efficacy under higher stress were twice as likely to report itch than those with high self-efficacy (30% vs. 15%, p?=?0.072). In the adjusted logistic regression the report of current itch was significantly associated with low self-efficacy, with an odds ratio of 2.85 (1.71; 3.82). In conclusion, current itch was significantly associated with low self-efficacy among adolescents. Further clinical research is needed to determine whether improvement in self-efficacy could contribute positively to the management of patients with itch.     

Cognitive Impairment in Patients with Psoriasis: A Cross-Sectional Study Using the Montreal Cognitive Assessment

Background

Psoriasis is a multisystem chronic inflammatory disorder that is thought to be associated with cognitive impairment.

Aims

We aimed to investigate cognitive performance using the Montreal Cognitive Assessment (MoCA) in patients with psoriasis.

Methods

In total, 77 patients with psoriasis and 83 age- and sex-matched control subjects were enrolled in this prospective cross-sectional study. Physical and/or histopathological findings were used to diagnose psoriasis vulgaris, and patients with psoriasis were evaluated according to disease characteristics, including duration, severity, onset age, medical treatment, and cosmetic involvement. All participants provided sociodemographic data and completed the Beck Depression Inventory. Cognitive functions were evaluated using the MoCA tool.

Results

The MoCA scores were significantly lower in the psoriasis group than in the control group (p = 0.004). More psoriasis patients than control subjects presented with deficits in visuospatial domain (p = 0.037) and executive functioning (p = 0.010). In the multivariate model, the presence of psoriasis (odds ratio [OR] 3.64; 95 % confidence interval [CI] 1.65–8.02; p = 0.001), education level (3.74; 95 % CI 1.65–8.48; p = 0.002), and area of residence (3.56; 95 % CI 1.61–7.87; p = 0.002) were found to be independently associated with cognitive impairment in patients with psoriasis and control subjects. On the other hand, no correlations were observed between disease characteristics and cognitive impairment in patients with psoriasis vulgaris (p > 0.05).

Conclusions

The results suggest that psoriasis patients might have early or subtle cognitive impairment, including visuospatial domain and executive functioning.

     

Dental Caries in Adults with Atopic Dermatitis: A Nationwide Cross-Sectional Study in Korea

BackgroundDental caries is the most prevalent chronic infectious oral disease of multifactorial etiology. Increased risk of dental caries development in patients with asthma and allergic rhinitis has been frequently reported. In contrast, only a few studies on dental caries in patients with atopic dermatitis (AD) have been reported.ObjectiveWe investigated the association between AD and dental caries development in an adult population in the Republic of Korea.MethodsA total of 21,606 adults who participated in the Korean National Health and Nutrition Examination Survey, a nationwide, population-based, cross-sectional survey between 2010 and 2015, were included in the study. Multiple logistic regression analyses with confounder adjustment suggested odds ratios (ORs) to identify the possible association between AD and decayed, missing, filled teeth (DMFT) experience compared to non-AD participants. Multiple Poisson regression analyses estimated the mean ratio of the DMFT index according to the presence of AD.ResultsAfter adjusting for various confounding factors, the prevalence of DMFT was significantly associated with AD (OR, 1.58; 95% confidence interval (CI), 1.08~2.29; p=0.017). In addition, the mean value of the DMFT index was significantly different between the AD and non-AD groups (mean ratio, 1.07; 95% CI, 1.00~1.14; p=0.046).ConclusionAD was significantly associated with the development of dental caries. Dermatologists should be aware of the dental manifestations of AD patients and recommend regular dental check-ups for the early detection of caries.     

Itch and psyche: psychiatric aspects of pruritus

Itch, also referred to as pruritus, is an unpleasant cutaneous sensation provoking the desire to scratch. It is often an uncomfortable, subjective sensation responsible for decreased quality of life in a variety of psychodermatological conditions. Comorbid psychiatric conditions, including depression and anxiety, are frequently associated with itch and scratch cycle. The reciprocal and intricate relationship between the psyche and itch has been widely studied. The neurobiology of itch involves the complexity of specific mediators, itch-related neuronal pathways, and central processing of itch. The connection between itch and the psyche can be grouped under three headings: pruritic diseases with psychosocial sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Itch and pain modulation go together in most circumstances and involve various substances including histamine, interleukins, protease-activated receptors, transient receptor potential receptors, opioids, and cannabinoids. The close interaction between keratinocytes and nerve endings modulating pain and itch also play a major role. Management of itch associated with its psychosomatic components is directed at an underlying cause and adopting a holistic approach to address not only dermatologic and somatosensory aspects, but also the cognitive, emotional, and psychosocial components. An integrated multidisciplinary team consisting of a dermatologist, psychiatrist, psychologist, and social worker is vital in addressing the multifaceted aspects of pruritus.