Psoriasis in Sri-Lanka—a computer analysis of 1366 cases

A clinical and epidemiological study of psoriasis in Sri-Lanka is presented. The prevalence in the population is estimated to be over 0.4%. The clinic incidence was 8.7%; of these 53.2% were male, and 46.8% female and 8.3% reported a family history of the disease. The mean age at onset was 25.2 years. The frequency distribution for the age at onset was bimodal with peaks at the second and fifth decades. The age at onset was significantly low in females, in patients with a family history of the disease, in those affected by weather changes and in patients whose disease was precipitated by sore throats. The existence of natural subpopulations of patients is suggested. Clinical types and complications of the disease were not essentially different from those observed in the West.     

1005例白癜风患者遗传因素的调查

目的 探讨白癜风患者发病过程中遗传因素所起的作用。方法 采用问卷调查方法收集1997年9月至2009年3月于我科门诊就诊的1005例白癜风确诊患者的临床资料,应用SPSS 13.0软件对所得数据进行统计学分析。结果 本调查的1005例白癜风先证者中,有家族史者206例,占20.5%。家族史阳性者的平均发病年龄（24.45 ± 15.87岁）比家族史阴性者（28.12 ± 16.88岁）小（P < 0.05）。家族史阳性者皮损双侧分布的比例比家族史阴性者高（71.3%比60.8%）（P < 0.05）。家族史阳性者以B型血居多（19.9%）,家族史阴性者以O型血居多（16.8%）（P > 0.05）。结论 ①白癜风的发病符合多基因遗传规律,具有家族聚集性,且血缘关系愈近,其发病率愈高。②白癜风的发病与性别无关。③家族史阳性者的平均发病年龄较家族史阴性者小,父系或母系遗传对发病年龄无影响。④家族史阳性者皮损双侧分布的比例较家族史阴性者高,而对其他临床表现无影响。     

Profile of vitiligo patients attending a training and research hospital in Central Anatolia: a retrospective study

Clinical characteristics of vitiligo had been reported in different countries previously. This is the second report from Turkey and it is from a different region of Turkey, middle Anatolia, and a more detailed study. The age and sex of patients, onset age, duration, areas of involvement, course, clinical types and severity of the disease, family history of vitiligo, associated disorders, the values of vitamin B12, folic acid, ferritin, iron and hemoglobin, antithyroglobulin and antithyroid peroxidase antibodies and positivity of viral markers were obtained from the records of the patients retrospectively. The study involved 93 vitiligo patients with a mean age of 37.4±17.05 years. The median age of onset disease was 33 years and onset age of disease was significantly lower in women. Of the patients, 24.8% had family history. The most frequent form of vitiligo was vitiligo vulgaris. Facial involvement was the most common localization. Trunk involvement was significantly higher in women but anogenital involvement was significantly higher in men. Of the patients, 40.3% had another autoimmune disease, 19.7% of the patients had low ferritin levels, 12% had low iron levels, 9.9% had anemia, 4.9% had low vitamin B12 levels, 3.8% had low folic acid levels and 4.3% had positivity of viral markers. The age of onset and the incidence of family history were higher and sites of involvement according to sex were different from the published work. The knowledge of clinical characteristics, course and associated conditions of vitiligo may improve the approach of dermatologists to vitiligo patients.     

The natural history of hidradenitis suppurativa

AIM: To investigate aspects of the natural history of hidradenitis. BACKGROUND: The natural history of hidradenitis suppurativa (HS) is not well known. There is incomplete published data on the average age of disease onset, progression of the disease, average monthly incidence and duration of boils, and factors that relieve or exacerbate disease symptoms. STUDY DESIGN: Questionnaire-based survey among HS patients identified from hospital records of three hospitals in Nottinghamshire, UK. RESULTS: One hundred and ten of 156 questionnaires (70.5%) were returned, 93 from females and 17 from males. The average patient's age was 40.1 years and the average reported age of disease onset was 21.8 years. At the time of the survey patients had suffered an average disease duration of 18.8 years. Most patients (98 of 110) still had experienced active disease within the past year. There was some evidence that in women the condition has a tendency to ease or subside after the menopause. Forty-four per cent of women felt that their condition was aggravated by menstruation. Thirty-eight per cent of patients gave a positive family history of the disorder. The average duration of painful boils was 6.9 days. In addition, 62% of patients acknowledged the presence of permanently painful boils that failed to subside. Patients developed a median of two boils per month. Factors that could aggravate the condition were primarily sweating or heat, stress or fatigue and tight clothing or friction. Factors that could improve the condition consisted largely of a variety of medical treatments and a number of life-style measures, such as swimming or baths. Twenty-four per cent of patients had failed to find anything at all to help their condition, despite an average disease duration of almost 19 years. CONCLUSIONS: The study highlights several of the factors that make HS one of the most distressing dermatological diseases, such as the average monthly incidence of painful lesions, their average duration and the chronicity of the disease. It seems striking that the mean duration of an HS boil (6.9 days) roughly equals the duration of an average course of antibiotics. The postulated response of HS to oral antibiotics may thus simply have its explanation in the natural history of the condition itself.     

银屑病早发型和晚发型的研究

目的 探讨中国人银屑病是否也存在早发型、晚发型的差别以及这种分型方法的合理性。方法 统计1632例寻常型银屑病患者发病年龄的分布,按照就诊时病情轻重、随访时病情轻重及是否有家族史,做统计学分析。并结合我国1984年全国调查资料进行探讨。结果 本组资料和1984年全国大规模调查资料均显示寻常型银屑病发病年龄只有一个高峰,没有双峰现象。本组资料虽然显示发病年龄早者有家族史的患者多,病情轻重与发病年龄也有一定关系,但都没有比较明确的年龄分界。结论 银屑病按照发病年龄分型除了说明早发者有较高的家族史外,对指导临床并无多大价值。     

Vitiligo is associated with HLA-DR4 in black patients. A preliminary report

We have determined the HLA-DR and HLA-DQ phenotypes of 24 black patients with vitiligo and compared these with phenotypes of 143 local black controls. HLA-DR4 was significantly increased in patients, 38% vs 11% for controls. HLA-DQw3 was also increased in patients, 58% vs 32% for controls and may be explained in part by linkage disequilibrium with HLA-DR4. When patients were subgrouped according to family history of autoimmune disease and compared with controls, the increase in HLA-DR4 and HLA-DQw3 segregated with a positive family history. HLA-DRw6 in patients with a negative family history of autoimmune disease (64%) was significantly greater than the 10% in patients with a positive family history. When patients were subgrouped according to age at onset of disease, HLA-DR4 was increased in those with early onset of disease (younger than 20 years) while HLA-DRw6 was greater in patients who were older at onset of disease. These findings support the hypothesis of an immunogenetic influence on the expression of vitiligo in black patients with vitiligo.     

244例斑秃临床分析及自身抗体、免疫复合物检查

本文观察了斑秃患者244例,发现20～30岁为发病高峰年龄,有斑秃既往史及家族史者均显著多于对照组。50.5%患者发病前有精神因素。33.3%重型斑秃自身抗体阳性。这些结果提示斑秃发病与遗传,情神因素及免疫机能紊乱有关。固相C_(lq)酶联免疫法检查CIC未发现异常。     

A case series of alopecia areata in children: impact of personal and family history of stress and autoimmunity

BACKGROUND: The epidemiology of alopecia areata (AA) is well documented in adults but has not been studied adequately in children. OBJECTIVE: To evaluate the clinical and epidemiological profile of AA in children and assess the significance of thyroid screening. METHODS: One hundred and fifty-seven children (83 boys, 74 girls, aged 1-16 years) who visited our clinic with a first episode of AA from 1996 to 2000 were retrospectively studied. One hundred children served as clinical controls. RESULTS: The age of peak incidence of AA was 0-5 years. The youngest child was 1 year old. In the majority of the cases (131/157, 83.4%) the disease was mild or moderate (less than 50% hair loss). In 15 patients (9.5%), AA was preceded by a stressful event. Five patients had a personal history of autoimmune disease (3.2 vs. 5% of the controls, (P = not significant [NS]) while 18 patients had a personal history of atopy (11.4 vs. 18% of the controls, P = NS). Twenty-one patients had a family history of autoimmune disease other than thyroiditis (13.4 vs. 5% of the controls, P = 0.04), while 23 patients had a family history of thyroid disorder (14.6 vs. 3% of the controls, P = 0.006). In eight patients (5%) subclinical hypothyroidism of autoimmune aetiology (Hashimoto's thyroiditis) was revealed at the time of investigation. Six out of the eight patients with Hashimoto's thyroiditis had a family history of thyroid disorder, which was statistically significant when compared to AA patients without thyroiditis (P < 0.001). The severity of AA was associated with early age of onset of the disease (P = 0.02). CONCLUSION: The age of peak incidence of AA in children is 0-5 years. Children with AA have an increased family history of autoimmunity, and, among children with a first episode and short duration of AA (< 6 months), thyroid screening might be restricted in those with a positive family history of thyroid disorder. Thyroid screening should be routinely performed in all children with long-standing AA.     

The R620W polymorphism in PTPN22 confers general susceptibility for the development of alopecia areata

BACKGROUND: The functional R620W (c.1858C>T) variant of the protein tyrosine phosphatase nonreceptor 22 gene (PTPN22) has been associated with a variety of autoimmune disorders. A recent study has suggested that R620W also contributes to the severe form of alopecia areata (AA). OBJECTIVES: We sought to replicate the finding of an association between PTPN22 and severe AA. In addition, we wanted to study the effect of PTPN22 on the general risk to develop AA and on other subtypes of AA (mild AA, early/late age at onset, positive/negative family history). METHODS: The R620W variant was genotyped in a large case-control sample of Belgian-German origin with 435 patients and 628 controls. RESULTS: Significant results were obtained for the overall collective of patients with AA (P=0.007). Subdividing the sample according to severity of AA, family history and age at onset, we detected lowest P-values for patients with the severe form of AA (Pcorr=0.036), with a positive family history (Pcorr=0.042) and with an age at onset相似文献   

斑秃655例伴发疾病分析

目的探讨斑秃发病的临床特点及伴发疾病分析。方法收集本科门诊2006年1月-2008年5月确诊的斑秃患者,以调查表的形式收集患者临床资料及伴发疾病情况,包括斑秃发病年龄、病程、严重程度、家族史和复发情况等,用SPSS13.0软件分析。结果 655例斑秃患者,男320例,女335例,平均年龄(38.4±12.4)岁,平均病程(14.8±35.7)个月,88例(13.44%)为全秃/普秃,84例(12.82%)家族史阳性,195例(29.77%)斑秃反复发作。655例患者中,190例(29.01%)除斑秃外,还伴发至少1种过敏性疾病或自身免疫性疾病,仅伴过敏性疾病者123例(18.78%)。未发现伴发疾病与性别、发病年龄、病程、斑秃类型、既往史及家族史相关联(P>0.05)。全秃/普秃更易伴发过敏性疾病,包括湿疹、荨麻疹、哮喘和药物过敏(P=0.004),与无伴发过敏性疾病的斑秃患者相比,伴发者发病更早(P=0.033)。结论斑秃与伴发的其他疾病可能有着相同的遗传学、免疫学基础,不同的伴发疾病可能对斑秃的发生、发展和预后产生不同的影响。     

The Annual Changes of Clinical Manifestation of Androgenetic Alopecia Clinic in Korean Males and Females: A Outpatient-Based Study

Background

Androgenetic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. There are no studies that analyze annual changes in age, patterns, family history, and associated disease.

Objective

We investigated the severity of hair loss, age of onset, the frequency of family history, and past medical histories in Korean patients with AGA.

Methods

A retrospective chart review was performed to identify all patients with AGA referred to the Dermatology Clinic at Chung-Ang University Hospital from January 2006 to December 2010.

Results

The age of onset was also gradually decreased from 34.1±10.1 years to 31.6±10.9 years between 2006 and 2010. In female patients, specific annual changes were not observed. Hamilton-Norwood Type IIIv AGA was most common in male patients and Ludwig Type I AGA was most common in female patients at all times between 2006 and 2010. The majority of patients with AGA had a family history of baldness and was most commonly associated with a paternal pattern of inheritance. Seborrheic dermatitis was the most common associated disease in male and female patients.

Conclusion

Our results show the possibilities that the average age of onset is decreasing. The period of the present study was only 5 years, which is not sufficient for the precise determination of onset age for AGA. Clearly, a long-term study is needed.     

136例儿童斑秃发病相关因素分析

目的:了解影响斑秃发病的相关因素。方法:对广州市妇女儿童医疗中心皮肤科收治的136例儿童斑秃临床资料作回顾性分析,包括年龄、性别、既往病史、家族史,首次出现斑秃的年龄,脱发严重程度评分以及实验室结果。结果:136例患儿平均首次发病年龄为(4.66±3.12)岁,85例(62.5%)首次出现斑秃的年龄小于6岁。136例患儿中75例为轻症斑秃,平均发病年龄(4.76±2.02)岁,61例为重症斑秃,平均发病年龄(2.81±2.42)岁。26例(19.12%)患儿患有注意缺陷多动障碍,53例(39%)患有过敏性疾病及9例(6.62%)患有自身免疫性疾病。16例(11.76%)有斑秃家族史,27例(20.59%)有自身免疫性疾病家族史。结论:儿童斑秃可能与遗传、精神心理、自身免疫和变态反应有关。     

Association of insertion/deletion polymorphism of the angiotensin-converting enzyme gene with psoriasis

BACKGROUND: Genetic factors are likely to be of fundamental importance in the pathogenesis of psoriasis. There are reports concerning the induction or/and exacerbation of psoriasis by angiotensin-converting enzyme (ACE) inhibitors, which have been attributed to the ACE inhibitor-induced augmentation of kinin levels in skin. However, to the best of our knowledge there has been no molecular genetic study investigating whether ACE insertion/deletion (I/D) polymorphism may contribute to the genetic background in psoriasis. OBJECTIVES: To assess the role of ACE I/D polymorphism in psoriasis. METHODS: A group of 86 patients with psoriasis and 154 control subjects were analysed for ACE I/D polymorphism by polymerase chain reaction. RESULTS: The distribution of ACE I/D polymorphism and allele frequencies in psoriatic patients was not significantly different from controls. Further analyses of psoriasis patients showed that ACE I/D polymorphism was not associated with age at onset of disease, clinical type of psoriasis or gender. However, the frequency of the I allele was significantly higher in patients with a positive family history of psoriasis than in those with no family history (sporadic psoriasis) (48% vs. 32%; P =0.03). In addition, the I allele was found significantly more frequently in type I psoriasis patients (onset < 40 years and positive family history) than in type II psoriasis patients (onset >/= 40 years, no family history) (48% vs. 27%; P = 0.04). CONCLUSIONS: Our results suggest that the presence of the I allele may confer susceptibility to development of psoriasis in individuals from psoriatic families.     

白癜风患者215例临床分析

目的：总结白癜风患者的临床特点和发病诱因.方法：对确诊的白癜风患者进行问卷设计和调查,用SPSS 11.5软件包进行统计分析.结果：资料完整的215例白癜风患者中男98例,女117例;平均发病年龄18.76±7.43岁;最常见的受累部位为上肢（54.42%）;伴发疾病中以甲状腺疾病最常见（5.58%）;有家族史者占13.02%,有家族史患者发病年龄为14.6±4.31岁,无家族史为25.09±5.45岁（P〈0.001）,两者间有显著性差异;春夏季发病最常见;25.58%的患者可发现诱因,其中常见的诱因包括精神因素 （43.64%）和皮肤损伤（56.36%）.结论：本地区白癜风好发于青少年,有家族史患者发病年龄早于无家族史患者,上肢为最常见的好发部位,可能与精神因素和皮肤外伤、日晒伤有关.     

Alopecia areata in children: a clinical profile

Alopecia areata (AA) is prevalent among children in Kuwait. In this prospective survey we studied 215 children with AA to determine their clinical and epidemiologic features. Ninety-seven percent of the children were of Arab ancestry. Girls outnumbered boys by a 2.5:1 ratio. The peak age of onset was seen between 2 and 6 years of age with a mean age of onset at 5.7 +/- 2.8 years. A majority of the patients (80.5%) had mild disease and extensive disease (more than 50% hair loss) was seen in 13% of the children. A positive family history of AA was obtained in 51.6% of cases and nail changes were seen in 26.5% of the children. The age of onset, a positive family history of AA, and associated atopic disorders were observed to have no influence on the extent and severity of the disease. The results were compared with those reported elsewhere for this age group.     

白癜风发病中遗传因素的调查分析

目的 探讨遗传因素在白癜风发病中的作用。方法 采用问卷调查形式对815例白癜风患者进行调查,有家族史者与无家族史者两组进行比较,用SPSS10.软件包对资料进行分析。结果 ①所调查的815例白癜风先证者中,有家族史与无家族史者比例为128:687。②与父母都不发病者比较,父亲患白癜风时子女患白癜风的危险性为132倍;母亲患病时子女患病危险性为72倍。先证者各一级亲属患病相对危险性为12～28倍不等。③父系遗传与母系遗传后代发病年龄及临床表型均无统计学差异。④有家族史和无家族史两组性别和发病年龄均无统计学差异。⑤有家族史者以散发、双侧、进展期居多,与无家族史组比较差异有统计学意义。⑥环境因素中,平均每天日照时间对白癜风遗传者的发病有显著性影响。结论 白癜风患者的发病及严重程度与遗传因素有一定关系。     

家族过敏史在遗传过敏性皮炎患者中的意义

为了解家族过敏史在遗传性过敏性皮炎(AD)患者临床及实验室方面所起的作用,我们将确诊为AD的年龄>2岁的158例患者按有无家族过敏史分成二组(89和69例),分别观察个人及家族过敏史、皮损形态和范围、五项伴发症状及某些实验室指标。结果显示有或无家族过敏史的患者发病年龄<2岁者分别占92.1%和84.1%,连续发病55.1%和43.5%,间断时间平均5.7年和9.6年,呼吸道过敏的平均发生年龄分别为哮喘4.1岁和6.2岁,过敏性鼻炎8.8岁和11.1岁。皮损范围和形态、五项伴发症状差异不大,个人及家族中以哮喘患病率高.并以Ⅰ、Ⅱ级亲属较高。个人及家族有呼吸道过敏史者其血清总IgE高于无过敏史者(P<0.01)。其他各项指标P>0.05。结论:有家族过敏史的AD患者比无家族过敏史者发病年龄较早.连续发病较多,间断时间较短,呼吸道过敏的平均发生年龄较早,个人及家族中以哮喘患病率高,近亲的过敏史比远亲更有价值,个人及家族有呼吸道过敏对患者总IgE有重要影响,并且总IgE升高与皮损严重度一致。     

1 125例非节段型白癜风皮损分布的相关因素分析

目的 分析非节段型白癜风皮损分布与性别、发病年龄、病程、自身免疫病病史或家族史、白癜风家族史等因素的相关性。方法 回顾性分析2009年1月至2019年1月在北京医院皮肤科确诊的1 125例非节段型白癜风患者的临床资料,应用SPSS 20.0软件通过独立样本t检验及χ2检验对数据进行统计学分析。结果 1 125例非节段型白癜风患者中,男599例,女526例,男女比例1.14∶1,发病年龄（27.9 ± 17.1）岁,病程（5.2 ± 8.0）年。皮损累及率最高的部位是躯干（544例,48.4%）和面部（535例,47.6%）,其次是肢端（430例,38.2%）、四肢（297例,26.4%）和颈部（231例,20.5%）。599例男性口周（17.2%）、手部（47.9%）及外生殖器部位（14.5%）的受累率高于526例女性（9.7%、22.6%、6.3%,χ2值分别为13.33、77.66、20.01,均P＜0.001）,而女性颈部（27.0%）的受累率则高于男性（14.9%,χ2 = 25.29,P＜0.001）。下肢、膝部、足部、躯干、外生殖器及眼周受累的白癜风患者发病年龄显著低于相应部位未受累者（均P＜0.05）,而上肢和手部受累者发病年龄显著高于上述部位未受累者（均P＜0.05）。自身免疫性甲状腺病病史或家族史阳性的患者手部受累率（50.0%）高于阴性者（27.9%,χ2 = 6.62,P = 0.010）。有白癜风家族史者躯干受累率（59.6%）高于无白癜风家族史者（45.7%,χ2 = 13.36,P＜0.001）。结论 非节段型白癜风皮损的分布模式与性别、发病年龄、自身免疫病病史或家族史以及白癜风家族史等因素均有一定相关性。     

Differences in Comorbidity Profiles between Early-Onset and Late-Onset Alopecia Areata Patients: A Retrospective Study of 871 Korean Patients

Background

Alopecia areata (AA) is a common dermatologic condition with a broad spectrum of clinical features and age of onset, classically characterized by nonscarring patches of hair loss. In the past, early-onset (before adolescence) AA has been associated with various autoimmune diseases, especially atopic diseases and lupus erythematosus and demonstrates a worse prognosis compared with late onset AA.

Objective

To evaluate the differences in the comorbidity profile of AA with regard to age at onset.

Methods

We completed a retrospective study of 871 Korean AA patients seen at our department within the last 10 years. After these patients were subdivided according to onset before or after age 13 years, the two groups were compared on the basis of their comorbid disorders, family history of AA, and hematologic test results.

Results

Our results demonstrate that significantly more patients in the early-onset group had a personal history of atopic dermatitis or family history of AA. These findings are consistent with previous reports associating early-onset AA with autoimmune diseases and a family history of AA in different ethnic populations. Most of the serologic test values showed no significant differences between the groups and the results were considerably affected by age.

Conclusion

This study is significant because it is a large group study in Korean AA patients, and Korean AA patients with an onset age before adolescence show similar clinical manifestations to other ethnic populations.