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Chronic spontaneous urticaria has a substantial impact on patients' quality of life. The first disease-specific tool to assess quality of life impairment in this condition, the Chronic Urticaria Quality of Life Questionnaire (CU-Q2OL), was developed recently. The aim of this study was to adapt the original Italian version to the Turkish langu-age and to evaluate its reliability, validity, and sensitivity to change. The Turkish version was developed by perfor-ming forward- and back-translation. It was then applied to 140 consecutive patients with chronic spontaneous urticaria, along with the Dermatology Life Quality Index and the Skindex-29. Disease activity was assessed using the Urticaria Activity Score. Sensitivity to change was measured in 101 patients, who completed the instruments twice at intervals of 4 weeks. Confirmatory factor analy-sis demonstrated that the six-scale structure of the ori-ginal Italian version ("pruritus", "swelling", "impact on life activities", "sleep problems", "limits", "looks") can be retained in the TUrkish instrument. Analysis regarding convergent validity showed good correlations of the TUrkish CU-Q2OL with the other instruments. In addition, it was found to discriminate well between patients with dif-ferent levels of urticaria activity, and to be sensitive to change. In conclusion, the Turkish version of CU-Q2OL is a reliable, valid, and sensitive instrument, which will help to characterize better the clinical impact of chronic spontaneous urticaria and treatment outcomes in Tukish patients. Its identical scale structure to that of other CU-Q2OL instruments makes it ideal for cross-cultural comparisons and for its application in future national and multinational studies. [ABSTRACT FROM AUTHOR]

The recommended dose of omalizumab for the treatment of chronic spontaneous urticaria (CSU) is 300 mg every 4 weeks, but there is no recommendation for patients who do not benefit from this dose. Our aim is to present the experiences on the use of doses of omalizumab higher than those recommended for CSU patients and to propose a protocol for updosing. This was a retrospective analysis of patients treated with omalizumab for CSU from 2 urticaria centers in Istanbul and Barcelona. The weekly urticaria activity score and/or the Urticaria Control Test (UCT) were used to monitor response. In Barcelona, a stepwise updosing regimen was preferred (450 mg first, then increasing to 600 mg), while in Istanbul, direct updosing to 600 mg was chosen. In Istanbul, 81 (88%) patients were treated with 300 mg, while 11 (12%) received 600 mg of omalizumab. In Barcelona, 7 (8.8%), 45 (56.3%), 17 (21.3%), and 11 (13.8%) patients received 150, 300, 450, and 600 mg of omalizumab, respectively. Urticaria control was achieved in 82.6% of the patients with 300 mg and in 8.7% of the patients with 600 mg in Istanbul, while it was achieved with 150 mg in 10%, with 300 mg in 48.8%, with 450 mg in 16.3%, and with 600 mg in 6.3% of the patients in Barcelona. In total, 123 (71.5%) patients responded to 150-300 mg and 26 (15.1%) to 450-600 mg. When responders to 150-300 mg (n = 123) were compared with responders to 450-600 mg (n = 26), BMI was found to be higher, and pre-omalizumab UCT was found to be lower in patients receiving updosed omalizumab (p = 0.029). Baseline data of the patients, especially BMI and pre-oma UCT, might be useful to determine if the patient will require higher doses of omalizumab. We recommend a stepwise approach starting from 450 mg and then updosing to 600 mg in CSU patients who do not respond or partially respond to 300 mg of omalizumab after 3-6 months of treatment., (© 2018 S. Karger AG, Basel.)

Prisons have been studied as communal places where risk of contagious diseases and dermatological diseases associated with stress are more frequent. We aimed to investigate the prevalence of skin diseases in female prisoners with special focus on psychological stress. We held a day-time dermatology polyclinic for 6-weeks. The patients were given Beck Depression Inventory (BDI) and a questionnaire on the psychological impact of skin disease. A total of 383 female prisoners were examined; 41 dermatological diseases were diagnosed. Acne was the most prevalent condition (34%), followed by hair loss (19%), dry skin (16%), and eczema (12%). Thirty-six percent of the prisoners felt embarrassed, 34% felt anxious, and 45% felt sad about their skin disease. Fourty seven of the responders were found to be in severe depression according to BDI responses. We could not find any association between BDI results and any kind of skin disease diagnosed in inmates. Our study demonstrates that prisoners have benign and common skin conditions similar to those in the general population.