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Psoriasis and dementia are both common conditions. Because of how both diseases develop within the body, they might have certain shared traits, and it has been suggested that patients with psoriasis may be at greater risk of developing impaired mental function and/or dementia. This study from Taiwan examines the published research to see whether there may be evidence of such a link. The authors carried out a systematic literature search using PubMed and Embase looking for relevant studies published up to July 2019. Initially, a total of 814 publications was screened. Using established research methods to eliminate duplication and minimise bias, eventually only 11 studies met the authors' inclusion criteria. Of these, 10 studies compared 165 74 patients with psoriasis against over 450 78 controls (people without the disease), and one study compared 7118 dementia sufferers with 213 54 controls. Most of the studies (nine out of 11) found a positive association (a 'link') between psoriasis and the risk of developing cognitive impairment and dementia. In one study there was no association, and the remaining paper showed an inverse link (meaning that there was a reduced risk of dementia in patients with psoriasis). The authors suggest that the risk of dementia may be greatest in those with moderate to severe, rather than mild psoriasis. They also indicate that so far there is no published evidence to support the use of any specific anti‐psoriatic treatment based on effectiveness at protecting against dementia. Finally, they support the use of simple screening tools for detecting early cognitive impairment in psoriasis patients. Linked Article: Yen et al. Br J Dermatol 2021; 184:34–42. Linked Article: Yen et al. Br J Dermatol 2021; 184:34–42. [ABSTRACT FROM AUTHOR]

Summary: Background: Acral melanoma (AM) is the most common histopathological subtype of malignant melanoma in Asians. However, differences in the mutational profiles underlying AM and nonacral cutaneous melanoma (NAM) in Asians are not well understood. Objectives: To augment the understanding of the prevalence, patterns and associations of various mutations between different subtypes of melanoma. Methods: We performed comprehensive genomic profiling of 409 cancer‐associated genes, using next‐generation sequencing, in 66 primary melanomas comprised of 45 AMs and 21 NAMs. Results: Most of the AMs (n = 27/45; 60%), but only five of 21 (24%) NAMs, were triple wild‐type (triple‐WT) tumours. Compared with AMs, NAMs exhibited a significantly higher frequency of BRAF mutations. The frequencies of NRAS/KRAS mutations, cell‐cycle aberrations, copy number gains in BIRC2,BIRC3 and BIRC5, and gains of receptor tyrosine kinase genes were significantly higher in AMs. Ulceration was found at significantly higher rates in the AMs and NAMs with cell‐cycle aberrations and gains of receptor tyrosine kinase genes. Notably, cell‐cycle aberrations and copy number gains in BIRC2,BIRC3 and BIRC5 were significantly associated with poor melanoma‐specific survival in the 66 patients with melanoma and especially in the 45 patients with AM. Multivariate analysis showed that lymph node metastasis and cell‐cycle aberrations were independent prognostic factors of melanoma‐specific survival. Conclusions: This study strengthens our understanding of the patterns and clinical associations of oncogenic mutations in AMs and NAMs in Asians. What's already known about this topic? Mutation frequencies of driver genes vary between melanoma subtypes.Acral melanoma is the most common subtype of melanoma in Asians.KIT mutations and copy number variations occur more frequently in the acral subtype of melanoma than in the nonacral subtype What does this study add? NRAS/KRAS mutations, cell‐cycle aberrations, copy number gains in BIRC2, BIRC3 and BIRC5, and amplifications of receptor tyrosine kinase genes were significantly enriched in acral melanoma and could be potential targets for treatment.Melanomas with cell‐cycle aberrations and gains in receptor tyrosine kinase genes were significantly more likely to contain ulceration. What is the translational message? Cell‐cycle aberrations and copy number gains in BIRC2, BIRC3 and BIRC5 were significantly associated with poor melanoma‐specific survival.These observations should be explored further for future drug development. Linked Comment: Johansson. Br J Dermatol 2020; 182:1085. Plain language summary available online [ABSTRACT FROM AUTHOR]

Summary: Background: The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown. Objectives: To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan. Methods: Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011. Results: Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001). Conclusions: Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%.Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population.The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls.The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls.Mental health evaluations and management are important elements in CU management. Plain language summary available online [ABSTRACT FROM AUTHOR]

Background Both psoriasis and asthma are chronic immune-mediated inflammatory diseases. Objectives To evaluate the risk of developing asthma in patients with psoriasis compared with controls. Methods This cohort study was conducted using data from the Taiwan National Health Insurance Research Database. Patients with psoriasis ( n = 10 288) and matched comparison patients without psoriasis ( n = 41 152) were evaluated. A Cox proportional hazard regression analysis was used to determine the risk of asthma in patients with and without psoriasis. Results The risk of asthma was 1·38-fold higher [95% confidence interval ( CI) 1·23-1·54] in the cohort with psoriasis than in the reference cohort, after adjusting for age, sex and comorbidities. The incidence of asthma in men and women with psoriasis exhibited nonsignificant differences. Among all patients aged > 50 years, psoriasis was associated with a higher risk of asthma compared with not having psoriasis [adjusted hazard ratio ( HR) 1·49; 95% CI 1·18-1·88 (in patients aged 50-64 years); adjusted HR 1·63; 95% CI 1·34-1·99 (in patients aged > 65 years)]. Conclusions Our results indicate that patients with psoriasis are associated with a increased risk of developing asthma. [ABSTRACT FROM AUTHOR]

Background Although chronic rhinosinusitis without nasal polyps (CRSsNP) and psoriasis both share immunological disturbances as pathological factors, no prior study has investigated the risk for psoriasis among patients with CRSsNP. Objectives To investigate the subsequent risk for psoriasis following a diagnosis of CRSsNP by utilizing a cohort study design and a population-based dataset in Taiwan. Methods In total, 13 242 subjects with CRSsNP were included in the study cohort and 39 726 subjects were randomly extracted for the comparison cohort. We individually tracked each individual in this study ( n = 52 968) for a 5-year period following their index date to identify those subjects who received a subsequent diagnosis of psoriasis. Cox proportional hazards regression analysis was conducted to calculate the 5-year risk of subsequent psoriasis following a diagnosis of CRS among the sampled subjects. Results The incidence rate of psoriasis during the 5-year follow-up period was 1·41 [95% confidence interval (CI) 1·14-1·71] per 1000 person-years and 0·69 (95% CI 0·59-0·81) per 1000 person-years for the study and comparison cohort, respectively. Stratified Cox proportional hazards regression revealed that the hazard ratio for psoriasis during the 5-year follow-up period for subjects with CRSsNP compared with the control group was 2·01 (95% CI 1·54-2·62) after adjusting for monthly income, geographical region, hypertension, diabetes, coronary heart disease and hyperlipidaemia, and censoring the cases who died during the 5-year follow-up period. Conclusion This study detected an increased risk for psoriasis among patients with CRSsNP. [ABSTRACT FROM AUTHOR]

Summary Aim Hwang et al. aimed to evaluate the risk of malignancy among individuals with eczema, allergic rhinitis (AR) and asthma, compared with the general Taiwanese population. Hypothesis People with atopic conditions, including eczema, have an altered risk of malignancy. Setting and design This was a prospective nationwide cohort study. The authors used the Taiwanese National Health Insurance Research Database (NHIRD) to compare the incidence of cancers among people with established allergic disease relative to the risk in the general population. Study exposure Exposure was the presence of one or more atopic conditions (eczema, AR or asthma). Data were extracted on 997 729 randomly selected people registered on the NHIRD at any time point between 1996 and 2008. Eczema was identified via ICD-9-CM codes with the diagnosis being made by a dermatologist, paediatrician or allergist. Follow-up was until 2008, date of first cancer or death. Outcomes The outcome was a new diagnosis of malignancy, identified via catastrophic illness insurance certificates, again using ICD-9-CM diagnostic codes. Primary outcome measure Standardized incidence ratios (SIRs) for cancers overall and different types of malignancy among patients with eczema, AR or asthma were calculated against the expected number of cancer cases in the general population, adjusted for age and sex. Results The number of patients identified with eczema, AR and asthma was 34 263, 225 315 and 107 601, respectively. Overall cancer rates in patients with these conditions were not significantly different from those in the general population [SIR eczema = 0·97 (95% confidence interval 0·87-1·09), SIR AR = 1·02 (0·98-1·05) and SIR asthma = 1·01 (0·97-1·04)]. However, when the results for eczema were stratified by age, people aged between 20 and 39 years appeared to have a 56% increase in risk in relation to 'any cancer' [SIR = 1·56 (1·13-2·09)]. Looking at individual cancer types in patients with eczema, only the risk of brain cancer was significantly raised [SIR = 2·52 (1·15-4·79)]. Patients who had had all three allergic conditions had a reduced SIR for 'cancers overall' [SIR = 0·59 (0·37-0·88)]. This inverse association was less strong for those with eczema and asthma [SIR = 0·73 (0·55-0·97)] or asthma and AR [SIR = 0·79 (0·73-0·84)] and statistically only of borderline significance for those with eczema and AR [SIR = 0·85 (0·67-1·07)]. Conclusions Hwang et al. conclude that the relationship between allergic diseases and cancer risk is complex and site specific. The risk of malignancy was highest in all atopic conditions in the 20-39-year age group. In patients with eczema, the incidence of brain cancer was higher than expected, which the authors note is at odds with previous studies. However, numbers were too small to allow stratification by histological subtypes. The authors warn against deriving conclusions for rarer cancers and that borderline SIRs must be interpreted with caution. [ABSTRACT FROM AUTHOR]

Background Vitiligo vulgaris is a depigmentary disorder resulting from the disappearance of functional melanocytes. Currently, the pathogenesis of this disorder remains obscure. Objectives Genetic analysis of patients with vitilgo may provide important clues for elucidating the complex pathomechanisms involved in the disease process. Because dysfunctional keratinocytes have recently been implicated in the pathogenesis of vitiligo vulgaris, we conducted a case–control association study to investigate this phenomenon. Patients and methods Fifty-one patients with vitiligo vulgaris and 118 healthy controls from Taiwan were recruited to investigate the association between relevant keratinocyte-related genes and the occurrence of vitiligo vulgaris. This study genotyped 11 single-nucleotide polymorphisms (SNPs) in five genes including stem cell factor ( SCF, also known as KITLG), basic fibroblast growth factor ( bFGF, also known as NuDT6), endothelin-1 ( EDN1), hepatocyte growth factor ( HGF) and stem cell growth factor ( SCGF, also known as CLEC11A). Results Our results revealed that the A allele for SNP rs11104947 in the SCF gene and the T allele for SNP rs13866 in the SCGF gene were, respectively, associated with a 1·95- and a 2·14-fold risk of developing vitiligo vulgaris. A higher risk was also detected among subjects who carried the SCF rs995029/rs11104947 C/A haplotype (odds ratio = 2·45). Furthermore, the at-risk alleles for SCF rs11104947 (A allele) and for SCGF SNP rs13866 (T allele) were found to display a 7·92-fold increased gene–gene combined risk. No significant relationship between polymorphic frequency for genes bFGF, EDN1 as well as HGF and occurrence of vitiligo vulgaris was observed. Conclusions These novel genetic findings provide new insights in relation to the mechanisms that might be involved in the development of vitiligo vulgaris. [ABSTRACT FROM AUTHOR]

There is a high incidence of primary cutaneous amyloidosis (PCA) in South America, South-east Asia and Taiwan. To date, the aetiology of PCA remains unknown, but it is believed to be multifactorial. Although most cases are sporadic, some patients have a family history. Familial aggregation and different susceptibility to PCA among ethnic groups suggest that genetic factors may play an important role in its pathogenesis. However, no genetic loci for familial PCA (FPCA) have been identified so far.In order to identify the susceptibility gene of FPCA, we took a candidate gene approach and performed linkage analysis on chromosome 1q21.3–24.2, including the 1q23.2 region where the gene encoding serum amyloid P component (APCS) is located.Nine FPCA families including 29 individuals affected with PCA were recruited for this linkage study. Initially, 11 highly polymorphic microsatellite markers spanning the region from 1q21.3 to 1q24.2 were genotyped and revealed a suggestive linkage region. This region was further fine-mapped with seven additional markers. We also re-sequenced the 2·5-kb genomic region of theAPCSgene in 29 affected and 42 control individuals. Two-point and multipoint linkage analyses were performed using the LINKAGE program. Nonparametric linkage (NPL) analysis and reconstruction of haplotypes were performed with the GENEHUNTER program.Both two-point and multipoint linkage analysis for all 11 markers generated negative or small positive total lod scores for all nine families. However, when we considered only three families, a maximum two-point total lod score of 2·09 was obtained for the marker D1S2844 atθ = 0·01. A plateau of multipoint total lod score between D1S2768 and D1S2878 with a maximum of 2·48 at the marker D1S2844 was observed. A maximum NPL score of 3·11 (P = 0·008) was also obtained for the marker D1S2878. However, re-sequencing of theAPCSgene identified no functional mutation.Both parametric and nonparametric linkage evidence suggested that a possible susceptibility locus for a subset of FPCA might exist on chromosome 1q23. This is the first report demonstrating suggestive evidence of linkage of FPCA to a locus in this candidate region. No functional sequence variations of theAPCSgene were found to be associated with this disease among the study families. Our data imply the existence of at least one additional locus responsible for FPCA in these families, confirming genetic heterogeneity of this skin disorder. [ABSTRACT FROM AUTHOR]

We have studied 122 patients with polychlorinated biphenyls (PCB) poisoning. All of the patients had one or more signs of poisoning, particularly mucocutaneous pigmentation, acneform eruptions, deformity of nails, dry skin or dyshidrosis. A marked increase of blood PCB levels was found in every case. [ABSTRACT FROM AUTHOR]