Search

Hyperhidrosis significantly reduces patients' quality of life, with many reporting feeling highly anxious. However, the relationship between hyperhidrosis and anxiety induced by sweating has not been examined in detail. The current study examined the relationship between: (1) the presence of hyperhidrosis symptoms, (2) hyperhidrosis severity, and (3) the sites of the most sweating and anxiety induced by sweating. A cross‐sectional web‐based survey was conducted among university students, and 1080 consenting participants (600 males and 480 females; mean age, 18.8 years) were included in the analysis. The survey items were: (1) diagnostic criteria for hyperhidrosis, (2) Hyperhidrosis Disease Severity Scale, (3) presence of anxiety induced by sweating, and (4) site of the most sweating. The results of multiple logistic regression analysis adjusted for sex and age showed that the odds ratio (OR) for anxiety induced by sweating was significantly higher in participants who screened positive for hyperhidrosis than in those who screened negative (OR, 9.72 [95% CI, 5.80–16.27]). The OR of anxiety induced by sweating was 7.11 (95% CI, 3.99–12.65) for mild/moderate hyperhidrosis and 23.46 (95% CI, 7.15–76.93) for severe hyperhidrosis, compared with those who screened negative for hyperhidrosis. Compared with those who screened negative for hyperhidrosis, the OR for anxiety induced by sweating in those with the palmar, plantar, axillary, and head/face as the site of the most sweating was 7.74 (95% CI, 3.91–15.33), 14.86 (95% CI, 1.83–120.58), 16.92 (95% CI, 5.95–48.14), and 5.38 (95% CI, 1.39–20.74), respectively. Our findings suggest that participants who screened positive for hyperhidrosis, mild/moderate or severe, are at a higher risk of anxiety induced by sweating than participants who screened negative for hyperhidrosis. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) is a non‐scarring hair loss disorder affecting approximately 2% of the global population. AA is reported to have a significant negative impact on the emotional and psychological well‐being of the patients. This study aimed to evaluate the health‐related quality of life (HRQoL) of Japanese patients with AA in comparison to the Japanese population norms (national standard values for Japanese) using Short Form Health Survey 36 Item Version 2.0 (SF‐36v2). The study also aimed to access the negative effect of AA on patients' daily lives and the proportion of patients having anxiety and/or depression. This cross‐sectional, non‐interventional web‐based survey study included 400 participants aged 17–84 years currently suffering from medically diagnosed AA. The assessment tools integrated in the online questionnaire included SF‐36v2, the Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). All outcome measures from the tools were evaluated across the study population. SF‐36v2 subscale scores for patients with AA revealed lower scores specifically for mental health (45.7 ± 10.1 points), social functioning (45.8 ± 10.9 points), vitality (46.2 ± 9.8 points), and role emotional (46.9 ± 11.6 points) as compared to the Japanese population norms of 50 ± 10 points each. The DLQI questionnaire‐based analysis indicated that 32.1% of respondents showed a moderate to extremely large effect on their lives; and HADS‐A (anxiety) and HADS‐D (depression) scores categorized 46.0% and 41.8% respondents as doubtful‐to‐definite cases, respectively. Multivariate linear regression revealed that hair loss range, age, comorbidities, and depression significantly worsened DLQI scores. In conclusion, the results of this survey demonstrated that a significant decrease in the HRQoL scores was observed in Japanese patients with AA in comparison with the national norms. Hence, emphasis on mental health is crucial for AA management. [ABSTRACT FROM AUTHOR]

The criteria used by physicians to assess alopecia areata severity and its associated burden from the patients' point of view are not well understood. We aimed to understand physician‐assessed determinants of disease severity, factors associated with severity, patient–physician concordance, and patient‐reported burden by severity. Data were drawn from the Adelphi Alopecia Areata Disease Specific Programme™, a point‐in‐time survey of dermatologists and their alopecia areata patients in real‐world practice in Japan conducted between January and March 2021. Patients were categorized into three groups by current disease severity according to physician subjective assessment: mild, moderate, or severe. Demographics, clinical characteristics, and outcomes were described within and compared between the three patient groups. Our study of 97 dermatologists and 587 patients found overall scalp hair loss was the most important factor considered by physicians in determining disease severity. More severe disease was associated with loss of eyebrow hair, eyelashes, and hair loss from other body areas. Agreement on disease severity between physicians and patients was moderate. From the patient perspective, greater severity of alopecia areata was associated with greater anxiety and depression, with lower work productivity and worse quality of life. Our study provides insights into which factors physicians use to determine alopecia areata severity, how physician and patient severity assessments compare, and the burden of alopecia areata on patients. [ABSTRACT FROM AUTHOR]

The involvement of genital lesions in patients with atopic dermatitis (AD) is poorly understood. Moreover, clinical characteristics, potentially related factors, and impact on the quality of life (QOL) of genital eczema in patients with AD are also largely unknown. This study aims to evaluate the prevalence and burden of genital eczema in patients with AD. A prospective cross‐sectional study recruited a total of 220 patients diagnosed with AD. The participants were asked to complete the self‐administrated questionnaire asking sociodemographic characteristics, details about their AD, and individual experiences of their genital eczema. Among 220 responders, 99 patients (45.00%) reported that they had experienced genital eczema at some time during the course of AD. Longer disease duration (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.13–4.62; p = 0.02), marital status (OR, 0.43; 95% CI, 0.21–0.89; p = 0.003), involvement of the trunk (OR, 3.44; 95% CI, 1.81–6.52; p = 0.001), and involvement of the nipple (OR, 6.20; 95% CI, 1.39–27.63; p = 0.017) were the significant associated factors for the presence of genital eczema among patients with AD. Of note, the severe impairment of genital eczema‐specific QOL was observed in 28.29% of AD patients with genital eczema. Especially, female sex (OR, 2.22; 95% CI, 0.84–5.82; p = 0.04) was more associated with severe impairment of genital eczema‐specific QOL. Many patients with AD suffer from the genital presentation of the disease. Moreover, genital involvement of the disease has a significant impact on the QOL of patients with AD. We suggest that more attention should be paid to the genital presentation of the disease to increase QOL and provide further delicate treatment of patients with AD. [ABSTRACT FROM AUTHOR]

This phase 3, multicenter, open‐label single‐arm study evaluated adalimumab (ADA) in Japanese patients with moderate to severe hidradenitis suppurativa (HS). Fifteen patients received ADA 160 mg s.c. at week 0, 80 mg at week 2 and 40 mg at week 4 and every week thereafter. At any time after week 52, patients were given the option to receive 80 mg ADA every other week or remain on 40 mg every week. The primary end‐point (achievement of HS Clinical Response [HiSCR] at week 24) and results up to week 24 were published previously. Secondary end‐points included total abscess and inflammatory nodule (AN) count, 30% or more and 1 unit or more reduction in Patient's Global Assessment of Skin Pain Numeric Rating Scale (NRS30), modified Sartorius score and quality of life (QoL). After 12 weeks of ADA treatment, the achievement rate in HiSCR was 86.7%; HiSCR achievement rate was sustained through week 52 at 66.7%. Improvements at week 12 were also seen in the proportion of patients achieving an AN count of 0–2; NRS30 response rate among the nine patients with a baseline NRS of 3 or more; mean decrease in modified Sartorius score (61.4); and QoL as assessed by Dermatology Life Quality Index and Treatment Satisfaction Questionnaire; these improvements were maintained through 52 weeks. Similar efficacy was observed when patients switched dosing from ADA 40 mg every week to ADA 80 mg every other week. There were no new safety findings with ADA 40 mg weekly dosing during the study, and no differences in safety were found between patients who switched to 80 mg ADA every other week and patients who remained on 40 mg every week. The results of this study indicate that long‐term ADA treatment is effective and well tolerated in Japanese patients with moderate to severe HS. [ABSTRACT FROM AUTHOR]

Primary hyperhidrosis affects approximately 3% of the population and reduces quality of life in affected persons. Few studies have investigated the symptoms of anxiety, depression and hazardous alcohol consumption among those with hyperhidrosis and the effect of treatment with botulinum toxin. The first aim of this study was to investigate the effect of primary hyperhidrosis on mental and physical health, and alcohol consumption. Our second aim was to study whether and how treatment with botulinum toxin changed these effects. One hundred and fourteen patients answered questionnaires regarding hyperhidrosis and symptoms, including hyperhidrosis disease severity scale ( HDSS), visual analog scale ( VAS) 10-point scale for hyperhidrosis symptoms, hospital anxiety and depression scale ( HADS), alcohol use disorder identification test ( AUDIT) and short-form health survey ( SF-36) before treatment with botulinum toxin and 2 weeks after. The age of onset of hyperhidrosis was on average 13.4 years and 48% described heredity for hyperhidrosis. Significant improvements were noted in patients with axillary and palmar hyperhidrosis regarding mean HDSS, VAS 10-point scale, HADS, SF-36 and sweat-related health problems 2 weeks after treatment with botulinum toxin. Changes in mean AUDIT for all participants were not significant. Primary hyperhidrosis mainly impairs mental rather than physical aspects of life and also interferes with specific daily activities of the affected individuals. Despite this, our patients did not show signs of anxiety, depression or hazardous alcohol consumption. Treatment with botulinum toxin reduced sweat-related problems and led to significant improvements in HDSS, VAS, HADS and SF-36 in our patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin disease whose clinical characteristics vary from patient to patient. We aimed to analyze how comorbidities and quality of life (QoL, as per the Dermatology Life Quality Index [ DLQI]) may be affected by a family history of psoriasis and by age. The ARIZONA study was a multicenter, cross-sectional study in 1022 adult patients diagnosed with moderate to severe psoriasis at least 6 months prior to inclusion. The severity of psoriasis and the proportion of patients with comorbidities were not affected by the presence of a family history. The regression analysis revealed that the presence of a family history of psoriasis was associated with the effect on the patient's QoL ( P = 0.002), regardless of disease severity. The mean DLQI total score varied significantly across age groups (5.1 ± 5.3 for the 18-30-year group, 5.7 ± 6.5 for the 31-60-year group and 3.8 ± 5.1 for the >60-year group; P = 0.001). In conclusion, the presence of a family history of psoriasis appears to disrupt QoL in patients with moderate to severe psoriasis, but it hardly affected the prevalence of comorbid conditions. The effect of age on QoL was particularly noticeable in younger patients, highlighting its negative impact. As expected, older patients appeared to be burdened with a higher number of comorbidities than their younger counterparts. [ABSTRACT FROM AUTHOR]

Outcome measures are crucial in assessing an autoimmune blistering disease's ( AIBD) severity as well as its impact on the patient's quality of life ( QOL). The standardization of AIBD outcome measures is pivotal to accurately monitor the patient and to pool results from randomized controlled trials for meta-analysis, and thereby provide knowledge of the optimal AIBD therapies. In the past decade, several AIBD severity outcome measures have been developed and validated. For pemphigus severity, the Pemphigus Disease Area Index ( PDAI) developed by the International Pemphigus Definitions Group was shown to be the most superior, followed by the Autoimmune Bullous Skin Disorder Intensity Score ( ABSIS) by the German group. For bullous pemphigoid severity, the Bullous Pemphigoid Disease Area Index ( BPDAI) was shown to be an accurate and valid measure. To quantify the burden of AIBD and its treatments on QOL, the Autoimmune Bullous Disease Quality of Life ( ABQOL) and the Treatment of Autoimmune Bullous Disease Quality of Life ( TABQOL) were also developed, validated, and are now being validated in multiple languages and cultures. [ABSTRACT FROM AUTHOR]

Psoriasis is a common, chronic inflammatory immunologically mediated disease of the skin, showing a high prevalence of associated comorbidities, and strongly affecting patients' health-related quality of life (HR-QOL), with profound impact on the psychological aspect. We aimed to establish the correlation between HR-QOL and the associated comorbidities in patients with moderate to severe psoriasis in Spain. A cross-sectional, observational, epidemiological study was conducted at 68 dermatology-based centers across Spain. From October 2010 to June 2011, all adult patients diagnosed with moderate to severe psoriasis at least 6 months prior to the study visit and receiving or not receiving treatment for psoriasis were eligible for inclusion. A total of 1022 patients were included. The study population showed mean 36-item short-form (SF-36) physical and mental health scores and Dermatological Life Quality Index (DLQI) of 49.7, 46.2 and 5.3, respectively. The multiple linear regression models showed that patients with moderate to severe psoriasis and a diagnosis of psoriatic arthritis (PsA), hypertension, diabetes mellitus, sleep disturbances or obesity were found to have lower SF-36 health physical scores. Female patients with depression or anxiety disorders had lower SF-36 health mental scores. Patients diagnosed with moderate to severe psoriatic disease and associated anxiety disorder had greater DLQI scores. Moderate to severe psoriasis has a significant burden on the HR-QOL of patients. Regardless of sex, patients with several comorbidities such as PsA, hypertension or obesity were found to have worse scores in the physical component of the QOL questionnaire, whilst women were more affected in the mental health component than men. [ABSTRACT FROM AUTHOR]

There has been no epidemiological survey of foot diseases in Japan. In this study we determined the prevalence of foot diseases, especially tinea pedis (TP) and tinea unguium (TU) in Japan. We conducted a randomized survey of outpatients who visited a dermatologist during the third week of May in 1999, 2000 and 2006. The most frequently reported condition was “fungal infection” in 8737 (40.0%) of 21 820 patients in 1999/2000, and 3848 (49.4%) of 7783 patients in 2006. The patients who visited a dermatologist for reasons other than superficial fungal infection but were diagnosed with TP or TU comprised 18.6% of the study population in 2000 and 24.1% in 2006. Of the patients with TP or TU, 63.2% used topical medication only. This survey showed that often patients are not aware of fungal infections and that their treatment is sometimes insufficient. Dermatologists should actively examine and treat patients with TP and TU. [ABSTRACT FROM AUTHOR]