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Introduction Chronic spontaneous (previously known as idiopathic) urticaria (CSU) is a chronic skin disease with the potential for natural remission. The objectives of this targeted literature review were to identify evidence on the clinical course of CSU, including remission rates, and to estimate cumulative remission rates for different time points. Methods Electronic databases (MEDLINE, MEDLINE-In Process, Embase, Web of Science, BIOSIS Previews and the Cochrane Library) and relevant conference proceedings were searched to identify studies involving patients with CSU aged ≥ 12 years that provide data on remission rates and disease duration. Observational studies with patient follow-ups of ≥ 1 year or review articles were included. Data extracted from five selected studies were used to run Kaplan–Meier (KM) analyses and best-fit distributions to calculate remission rates per 4-week period and weighted averages. Results Ten publications were included in this review. The proportion of patients achieving remission within year 1 ranged from 21 to 47%, while reported remission rate estimates at year 5 were 34% and 45%. Based on calculated 4-weekly remission rates, cumulative remission estimates ranged from 9 to 38% at year 1, from 29 to 71% at year 5 and from 52 to 93% at year 20. Cumulative weighted average estimates for the proportion of patients remitting at years 1, 5 and 20 were 17%, 45% and 73%, respectively. Conclusions Published evidence suggests that CSU is a self-limiting condition with variable disease severity and duration, apparently dependent on multiple factors. However, data sources differed in terms of definitions of disease severity and remission, as well as in conclusions on influencing factors. Further studies and uniform definitions are required. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00641-6.

Pinyadapat Vacharanukrauh,1 Jitlada Meephansan,1 Pattarin Tangtanatakul,2 Wipasiri Soonthornchai,3 Jongkonnee Wongpiyabovorn,4 Onsiri Serirat,5 Mayumi Komine6 1Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, 12120, Thailand; 2Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand; 3Demonstration School, University of Phayao, Phayao, 56000, Thailand; 4Division of Immunology, Department of Microbiology, Faculty of Medicine, Center of Excellence in Immunology and Immune Mediated Diseases, Chulalongkorn University, Bangkok, 10330, Thailand; 5Division of Dermatology, Department of Medicine, Rajavithi Hospital, Ministry of Public Health, Bangkok, 10400, Thailand; 6Department of Dermatology, Jichi Medical University, Tochigi, JapanCorrespondence: Jitlada MeephansanDivision of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Rangsit Campus, Klong Luang, Pathum Thani, 12120, ThailandTel +662564-4444, ext.1535Fax +662564-4440, ext.7594Email kae_mdcu@yahoo.comObjective: To identify the narrowband ultraviolet B (NB-UVB)-induced molecular mechanisms that may account for their anti-inflammatory efficacy, gene expression and transcriptome profiling, which were performed using advanced molecular techniques.Methods: This research was conducted on patients with moderate-to-severe plaque-type psoriasis who received NB-UVB treatment. RNA sequencing (RNA-Seq) was conducted to assay the transcriptomes and identify the differentially expressed transcripts that had been enriched during the major pathway analysis.Results: Clinical improvement of psoriasis by NB-UVB therapy is linked to the suppression of the “immunological signaling pathways” and “cell cycle regulatory, growth and proliferation pathways” which are critical to the pathogenesis of the disease. In addition, these results were further substantiated by demonstrating that NB-UVB therapy has a significant effect on keratinocyte differentiation and affects the regulation of genes and inflammatory mediators that are related to cell proliferation and apoptosis. Moreover, NB-UVB phototherapy is also involved with the downregulation of toll-like receptors signaling in lesional psoriasis.Conclusion: NB-UVB is an effective treatment for psoriasis. Our study supports the conclusion that the clinical effectiveness of NB-UVB therapy is based on the suppression of a broad range of inflammatory signaling pathways, gene expression of inflammatory cytokines and increased expressions of anti-inflammatory signaling pathways in psoriatic skin. This is the first study that applied advanced molecular techniques to investigate phototherapy as a new key to unlock genetic knowledge and create novel information. Ultimately, the goal is to increase medical knowledge and improve the patient care of psoriasis.Keywords: psoriasis, pathogenesis, inflammation, NB-UVB, high-throughput RNA-sequencing, Inflammation, gene, translational study, chronic skin disease, UVB irradiation

Research on psoriasis pathogenesis has largely increased knowledge on skin biology in general. In the past 15 years, breakthroughs in the understanding of the pathogenesis of psoriasis have been translated into targeted and highly effective therapies providing fundamental insights into the pathogenesis of chronic inflammatory diseases with a dominant IL-23/Th17 axis. This review discusses the mechanisms involved in the initiation and development of the disease, as well as the therapeutic options that have arisen from the dissection of the inflammatory psoriatic pathways. Our discussion begins by addressing the inflammatory pathways and key cell types initiating and perpetuating psoriatic inflammation. Next, we describe the role of genetics, associated epigenetic mechanisms, and the interaction of the skin flora in the pathophysiology of psoriasis. Finally, we include a comprehensive review of well-established.

Introduction: Skin conditions adversely affect one’s physical and emotional well-being, thereby causing negative impact on one’s own quality of life. In Ayurveda Kushta is the term used to denote different varieties of skin diseases, which includes all major skin manifestations such as Psoriasis. Kitibha kushta is one among Kshudra kushta with predominance of vitiated Vata-Kapha dosha. The clinical features are: Shyava, Kina-Kara sparsha and Parushata, which can be co-related to Psoriasis. Psoriasis is a commonly encountered chronic skin disease, regularly encountered in day-to- day clinical practice with prevalence of 2% worldwide. Methodology: The present case report is of 26 years old female, came with complaints of Scaly Patchy discoloration all over the body predominantly over Extensor surface of both limbs and face with dry crusty flakes over scalp margins associated with Itching and Blood discharge on scratching and was effectively treated with Shodhana. Result: Patient showed encouraging result after repeated Shodhana followed by Shamana aushadis. Discussion: Patient was Initially treated with Virechana, were the flare up of the condition was observed, later treated with repeated course of Vamana followed by Virechana in regular intervals, where she was observed with 75% of relief with no further episodes of recurrence. Hence, the present case study highlights the importance of repeated Shodhana (Vamana, Virechana) as mentioned in classics for the management of Kitibha Kushta.

Background: Acne vulgaris is a chronic skin disease caused due to blockage and/or inflammation of pilosebaceous units in which lesions present as non-inflammatory, inflammatory or mixture of both. The inflammatory type, often results in distressing scars for which dermaroller therapy and fractional CO2 laser have shown to be effective treatment modalities. Material and Methods: This is a prospective, descriptive and hospital based study. Total of 140 cases were enrolled in study carried out for 1 year in the Department of Dermatology at tertiary health centre and medical college with subsequent follow up of up to six months. Patients with acne scars under the groupings of a score > 3 points on Global Acne Scarring Classification Scale were enrolled.Results: Out of 140 patients, (70 - dermaroller group, 70 - CO2 laser group) completed treatment and follow-up. Dermaroller therap results indicated that the baseline was 23.43±6.32 and reduced to 13.23±3.65 after the treatment. This difference was found to be statistically highly significant with p value as

Acne vulgaris is a chronic skin disease of the pilosebaceous unit. Several pathophysiological associations have been identified in which Propionibacterium acnes plays a major role. Although there a...

Psoriasis is a chronic skin disease in which the process of hyper-proliferation (excessive division) of skin cells starts. Externally, psoriasis appears as red papules, on the surface of which there are scales of white–gray color. There is substantial evidence that T-helper cells take vital accountability for creating the hyper-proliferation of keratinocytes (skin cells), which causes itching of skin patches. In this paper, we propose a mathematical model describing the concentrations of T-helper and keratinocyte cell populations to predict cellular behaviors for psoriasis regulation under normal or anomalous immune circumstances. Local and global asymptotic stabilities of the model equilibria are investigated. Additionally, by introducing two scalar bounded controls into the model, the effect of combined immunotherapy using IL-10 and IL-22 inhibitors is analyzed. The optimal control problem of minimizing the cost of immune therapy and simultaneous optimizing the effect of this therapy on T-helper cells and keratinocytes proliferation is formulated and solved by applying the Pontryagin maximum principle. Within the restrictions of the proposed model, the obtained analytical and numerical outcomes suggest that the optimal strategy of injecting IL-10 and IL-22 inhibitors can be effective for psoriasis treatment.

Psoriasis is a chronic skin disease which affects hundreds of millions of people around the world. This disease cannot be fully cured and requires lifelong caring. If the deterioration of Psoriasis is not detected and properly treated in time, it could cause serious complications or even lead to a life threat. Therefore, a quantitative measurement that can track the Psoriasis severity is necessary. Currently, PASI (Psoriasis Area and Severity Index) is the most frequently used measurement in clinical practices. However, PASI has the following disadvantages: (1) Time consuming: calculating PASI usually takes more than 30 minutes which poses a heavy burden on dermatologists; and (2) Inconsistency: due to the complexity of PASI calculation, different or even the same dermatologist could give different scores for the same case. To overcome these drawbacks, we propose PSENet which applies deep neural networks to estimate Psoriasis severity based on skin lesion images. Different from typical deep learning frameworks for image processing, PSENet has the following characteristics: (1) PSENet introduces a score refine module which is able to capture the visual features of skin at both coarse and fine-grained granularities; (2) PSENet uses siamese structure in training and accepts pairwise inputs, which reduces the dependency on large amount of training data; and (3) PSENet can not only estimate the severity, but also locate the skin lesion regions from the input image. To train and evaluate PSENet, we work with professional dermatologists from a top hospital and spend years in building a golden dataset. The experimental results show that PSENet can achieve the mean absolute error of 2.21 and the accuracy of 77.87% in pair comparison, outperforming baseline methods. Overall, PSENet not only relieves dermatologists from the dull PASI calculation but also enables patients to track Psoriasis severity in a much more convenient manner.

Background Atopic dermatitis (AD) is the most common chronic skin disease in childhood. There is no definitive test for diagnosing AD. The Hanifin-Rajka criteria (HRC) and The United Kingdom Working Party criteria (UKC) are the most used in the literature. It is aimed to evaluate the clinical efficacy of HRC and UKC in pediatric age. Methods Children diagnosed AD in the pediatric allergy clinic were enrolled. Patients with skin problems other than AD were involved as controls. All participants were evaluated for HRC and UKC at the time of diagnosis. Clinical diagnosis by the pediatric allergist was determined as the gold standard. Results 200 children with AD and 90 controls were enrolled in the study. Median (interquartile range, IQR) age of AD patients was 13.5 (7–36) months. There was no significant difference in age and sex between groups (p = 0.11 and p = 0.34, respectively). The HRC were superior to the UKC for sensitivity, negative predictive value, kappa and accuracy rate (94% vs. 72%, 84% vs. 60%, 0.68 vs. 0.56 and 87 vs. 78, respectively). On the other hand, specificity and positive predictive value of UKC were better than those of HRC (92% vs. 71% and 95% vs. 88%, respectively). Conclusion HRC seem to be better in diagnosing AD than UKC for young children. Further studies are needed to evaluate comparableness of HRC and UKC for AD in childhood in order to generate an international consensus for clinical trials.

Importance: Managing chronic skin disease is often frustrating for both providers and patients, sometimes resulting in delayed diagnosis, inadequate therapy, and inconsistent care.Objective: This study performs stakeholder analyses to identify unmet clinical needs in chronic skin disease management. Methods: Survey of 33 providers and 25 patients at a Stanford Health Care Dermatology department.Results: When evaluating a chronic skin condition such as psoriasis, 79% of dermatologists rely solely on subjective documentation (gestalt, body surface area, descriptive exam). Objective documentation (photographs or scoring assessment tools) is used by 21% of providers upon initial assessment and by 7% of providers to assess change in disease between office visits. While 83% of providers were comfortable assessing change in disease severity based on prior document by oneself, only 31% were comfortable assessing change based on prior documentation by another provider (p

Učestalost kožnih bolesti u stalnom je porastu, dok su njihovi utjecaji na psihičku dobrobit oboljelih nejasni. Cilj ovog istraživanja bio je ispitati razlikuju li se oboljeli od kroničnih kožnih bolesti od osoba koje ne boluju ni od kakvih kroničnih bolesti prema psihološkim obilježjima te utvrditi mogu li se anksioznost i depresivnost kod osoba oboljelih od kroničnih kožnih bolesti objasniti doživljajem težine bolesti i njezinim trajanjem, stresom, aleksitimijom i socijalnom podrškom. Uzorak se sastojao od 253 sudionika, od kojih je 128 bolovalo od kožne bolesti koja neprekidno traje ili se povremeno pojavljuje unazad najmanje godinu dana i 125 koji nisu bolovali ni od kakve kronične bolesti. Korišteni su Upitnik doživljaja težine bolesti, DASS-21 za depresivnost, anksioznost i stres, SPS-24 za percipiranu socijalnu podršku i TAS-20 za aleksitimiju. Rezultati su pokazali kako se oboljeli od kroničnih kožnih bolesti razlikuju od osoba koje nemaju nikakvu kroničnu bolest u intenzitetu doživljenog stresa, dok nisu pronađene razlike u anksioznosti, depresivnosti, aleksitimiji i percipiranoj socijalnoj podršci. Proveli smo dvije linearne regresijske analize na uzorku osoba oboljelih od kroničnih kožnih bolesti, jednu s anksioznošću kao kriterijskom varijablom i drugu s depresivnošću kao kriterijskom varijablom. Objasnili smo ukupno 62% varijance anksioznosti, te se kao statistički značajan prediktor pokazao stres, dok se aleksitimija, percipirana socijalna podrška, doživljaj težine bolesti i njezino trajanje nisu pokazali statistički značajnima. Za depresivnost se stres pokazao kao statistički značajan pozitivan prediktor, te percipirana socijalna podrška kao negativan prediktor. Oni zajedno objašnjavaju ukupno 71% varijance depresivnosti, dok se aleksitimija, percipirana socijalna podrška, doživljaj težine bolesti i njezino trajanje nisu pokazali statistički značajnim prediktorima. The incidence of skin diseases is constantly growing, while understanding of their effects on the psychological wellbeing of individuals remains vague. The aim of this study was to examine if individuals suffering from chronic skin diseases differ from individuals not suffering from any chronic diseases in psychological characteristics and to determine if the perceived severity of the disease, its duration, stress, alexithymia, and social support can explain anxiety and depression in individuals suffering from chronic skin diseases. The sample consisted of 253 participants, of which 128 were suffering from persisting or recurring skin disease during the last year, and 125 were not suffering from any chronic disease. Questionnaires used in this study were: Perceived severity of the disease questionnaire, DASS-21 for depression, anxiety, and stress, SPS-24 for perceived social support, and TAS-20 for alexithymia. The results showed that individuals suffering from chronic skin diseases differ from individuals not suffering from any chronic diseases in an experienced intensity of stress, while there were no differences in anxiety, depression, alexithymia, and perceived social support. We performed two linear regression analyses on the sample of individuals suffering from chronic skin diseases, one with anxiety as a criterion variable and one with depression as a criterion variable. We explained 62% of anxiety variance, with stress as a statistically significant positive predictor, while alexithymia, perceived social support, perceived severity of the disease and its duration did not prove significant. For depression, stress was a statistically significant positive predictor, and perceived social support appeared as a negative predictor. Together these two predictors explained 71% of depression variance, while alexithymia, perceived severity of the disease and its duration did not prove significant.

Psoriasis is a chronic skin disease that affects 125 million people worldwide and, particularly, 2% of the Spanish population, characterized by the appearance of skin lesions due to a growth of the epidermis that is seven times larger than usual. Its diagnosis and monitoring are based on the use of methodologies for measuring the severity and extent of these spots, and this includes a large subjective component. For this reason, this paper presents an automatic method for characterizing psoriasis images that is divided into four parts: image preparation or pre-processing, feature extraction, classification of the lesions, and the obtaining of parameters. The methodology proposed in this work covers different digital-image processing techniques, namely, marker-based image delimitation, hair removal, nipple detection, lesion contour detection, areal-measurement-based lesion classification, as well as lesion characterization by means of red and white intensity. The results obtained were also endorsed by a professional dermatologist. This methodology provides professionals with a common software tool for monitoring the different existing typologies, which proved satisfactory in the cases analyzed for a set of 20 images corresponding to different types of lesions. Ministerio de Economía, Industria y Competitividad | Ref. TIN2016-76770-R

Atopic dermatitis is a chronic skin disease that commonly affects patients. In addition to its effects on the skin, it has also been associated with other physical, psychosocial, and economic burdens in addition to numerous debilitating comorbidities. More recently, research has focused on the psychosocial and mental health aspect of atopic dermatitis, which has remained controversial. We reviewed the current literature and discussed the association of atopic dermatitis with suicide, attention-deficit/hyperactivity disorder, and schizophrenia.

Psoriasis is an immune-related chronic skin disease, and interleukin-22 (IL-22) is involved in psoriasis pathogenesis through promoting proliferation and migration abilities of keratinocytes. Here, we analysed the role of circular RNA (circRNA) RAB3B, member RAS oncogene family (circRAB3B) in regulating the phenotypes of IL-22-induced HaCaT cells.RT-qPCR was implemented to assess RNA abundance. Western blot assay was adopted to assess protein abundance. Cell proliferation capacity was examined by cell counting kit-8 (CCK8) assay and 5-ethynyl-2'-deoxyuridine (Edu) assay. Cell motility was assessed by transwell assays and wound healing assay. Flow cytometric analysis was utilized to evaluate cell cycle progression and apoptosis. The intermolecular binding relations were tested via dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. CircRAB3B expression was reduced in psoriatic cutaneous specimens and IL-22-treated HaCaT cells.CircRAB3B overexpression hampered the proliferation, motility, and cell cycle progression and elevated the apoptotic rate of IL-22-treated HaCaT cells, and circRAB3B silencing exhibited opposite effects in IL-22-induced HaCaT cells. CircRAB3B acted as microRNA-1228-3p (miR-1228-3p) sponge in HaCaT cells, and miR-1228-3p overexpression largely overturned circRAB3B overexpression-induced effects in HaCaT cells. MiR-1228-3p interacted with phosphatase and tensin homolog (PTEN), and circRAB3B sponged miR-1228-3p to induce PTEN level. MiR-1228-3p accumulation-mediated effects were partly alleviated by PTEN overexpression in HaCaT cells upon IL-22 treatment.CircRAB3B suppressed psoriasis progression partly through down-regulating miR-1228-3p and up-regulating PTEN.

Psoriasis is a chronic skin disease, and it is especially characterized by the occurrence of red, itchy, and scaly eruptions on the skin. The quality of life of patients with psoriasis is decreased because this disease remains incurable, despite the rapid progress of therapeutic methods and the introduction of many innovative antipsoriatic drugs. Moreover, many patients with psoriasis are dissatisfied with their current treatment methods and the form with which the drug is applied. The patients complain about skin irritation, clothing stains, unpleasant smell, or excessive viscosity of the preparation. The causes of these issues should be linked with little effectiveness of the therapy caused by low permeation of the drug into the skin, as well as patients’ disobeying doctors’ recommendations, e.g., concerning regular application of the preparation. Both of these factors are closely related to the physicochemical form of the preparation and its rheological and mechanical properties. To improve the quality of patients’ lives, it is important to gain knowledge about the specific form of the drug and its effect on the safety and efficacy of a therapy as well as the patients’ comfort during application. Therefore, we present a literature review and a detailed analysis of the composition, rheological properties, and mechanical properties of polymeric gels as an alternative to viscous and greasy ointments. We discuss the following polymeric gels: hydrogels, oleogels, emulgels, and bigels. In our opinion, they have many characteristics (i.e., safety, effectiveness, desired durability, acceptance by patients), which can contribute to the development of an effective and, at the same time comfortable, method of local treatment of psoriasis for patients.

Acne or commonly referred as Acne Vulgaris is a chronic skin disease due to abnormalities of sebum production in sebaceous glands caused by Staphylococcus epidermis bacteria. Acne treatment is usually done by using antibiotics, both topical and oral like Clindamycin 1%. However, the long-term use of antibiotics might lead to resistant of Propionibacterium acne strains or immune to Clindamycin 1%. People in Bima, particulary in Wawo district have local wisdom, that is facial using Bongi Me’e which is a traditional scrubs made of rice, tamarind, and temu giring extract that officacious as antibacterial. The purpose of this study was to determine the effectiveness of Bongi Me’e liquid soap as the antibacterial against Staphylococcus epidermis. In this research, four soap formulas were formulated and tested using well diffusion method. Formula 1 (4 ml rice extract, 3 ml temu giring extract and 2 ml tamarind extract). Formula 2 ( 2 ml rice extract, 3 ml temu giring extract and 4 ml tamarind extract). Formula 3 (2 ml rice extract, 4 ml temu giring extract, and 3 ml tamarind extract). Formula 4 (4 ml rice extract, 2 ml temu giring extract, and 3 ml tamarind extract). The inhibitory zone test indicated that the highest diameter of inhibition zone obtained in the formula 1 of 29,3 mm, followed by the formula 2 of 28 mm, formula 4 of 26,6 mm, and formula 3 that has smallest inhibitory zone by 25 mm. So, the antibacterial Bongi Me’e liquid soap was effective to inhibit acne-cause bacteria Staphylococcus epidermis

espanolLa papulosis linfomatoide (PL) es un trastorno linfoproliferativo de linfocitos T CD30+ cutaneo primario (TLTCP). Descrita por Macaulay en 1968 como “erupcion continua con autorreparacion, clinicamente benigna e histologicamente maligna”. Es una rara enfermedad cutanea cronica recurrente y de etiologia desconocida. La PL se incluye en el grupo de las (TLTCP), junto al linfoma cutaneo anaplasico de celulas grandes y las lesiones borderline. Hay varios tipos segun rasgos histoquimicos (A, B, C…). Su mecanismo etiopatogenico se ha vinculado con factores geneticos e inmunitarios. La PL es mas propia de adultos y ancianos, con predominio en el sexo masculino. El curso clinico suele ser prolongado (varios anos) y generalmente benigno, aunque el 10-20 % progresan hacia linfomas. La PL se caracteriza por la presencia de lesiones exclusivamente cutaneas papulo-nodulares multiples, con regresion espontanea en semanas y tendencia a recidivar. La anatomia patologica de estas lesiones muestra una infiltracion dermica por linfocitos T atipicos junto a un numero variable de celulas inflamatorias. El diagnostico diferencial puede a veces resultar muy dificil. El metotrexato es uno de los farmacos utilizados en su abordaje. EnglishLymphomatoid papulosis (PL) is a primary cutaneous CD30 + T lymphoproliferative disorder (TLTCP). Described by Macaulay in 1968 as “continuous eruption with self-repair, clinically benign and histologically malignant”. It is a rare recurrent chronic skin disease, and of unknown etiology. PL is included in the TLTCP group, along with anaplastic large cell cutaneous lymphoma and borderline lesions. There are several types according to histochemical features (A, B, C ...). Its etiopathogenic mechanism has been linked with genetic and immune factors.PL is more typical of adults and the elderly, with predominance in males. The clinical course is usually prolonged (several years) and usually benign; although 10-20% progress to lymphomas. PL is characterized by the presence of exclusively multiple skin lesions of the papulonodular region, with spontaneous regression in weeks and a tendency to recur. The pathological anatomy of these lesions shows a dermal infiltration by atypical T lymphocytes together with a variable number of inflammatory cells. The differential diagnosis can sometimes be very difficult. Methotrexate is one of the drugs used in its approach

Background and objective: Seborrheic dermatitis is chronic skin disease with exacerbation and remission, many topical and systemic therapies were used, including oral antifungal itraconazole, oral isotretinoin efficacy in the treatment of seborrheic dermatitis less studied. This study aimed to compare the efficacy and safety of low dose oral isotretinoin and oral itraconazole in the treatment of patients with seborrheic dermatitis. Methods: A total of 68 patients with seborrheic dermatitis were participating in a randomized, parallel-group study. One group (n = 31) took 200-mg/day oral itraconazole for one week of the first month, followed by 200 mg for the first two days of the next two months. The second group (n = 37) took oral isotretinoin 20 mg twice weekly for three months. Seborrheic dermatitis area severity index and intensity of itching and burning sensation were calculated before, during three months and one month after treatment. Results: Both drugs significantly reduced the severity of seborrheic dermatitis (P

Both physical and emotional effects are linked with the natural history of chronic skin diseases (CSD). Skin lesions can be confined to covered areas or involve emotionally charged regions (genitalia/exposed areas).To investigate the contribution of the physical effects of CSD and their emotional burden in adversely affecting the quality of life (QOL) and sexual function.Two groups were included: A group of women suffering from CSD and a control group. All participants answered the 19-item Female Sexual Function Index (FSFI) questionnaire. Women suffering from CSD answered the 10-item Dermatology Life Quality Index (DLQI) questionnaire; this group was divided into various subgroups according to the type of disease and regional involvement.Neither the DLQI score (P = .06) nor the FSFI scores were significantly affected by the type of disease. The DLQI score was significantly higher in the subgroups with involvement of genitalia or exposed areas (P:0.001and 0.01, respectively). Moreover, genital involvement was associated with pervasive and significantly lower FSFI scores, and the arousal, satisfaction, and total scores were significantly lower among women with the involvement of exposed areas. The DLQI score was significantly negatively correlated with the FSFI scores.The emotional burden of CSD should not be overlooked as it dominates the physical effects of disease by adversely affecting QOL and sexual function among women. It is necessary to provide this information to dermatologists and patients, especially in light of effective cognitive-behavior therapy that can be undertaken to ameliorate the emotional stresses.

Dupilumab represents a breakthrough in the management of atopic dermatitis (AD), thanks to its powerful T-helper (Th)2-mediated immunity modulating activity. It can reduce the atopic skin molecular signature and induce a significant decrease in the clinical signs and symptoms of AD patients.Th2 activation has been confirmed or suspected in skin diseases other than AD, and several reports about the treatment with dupilumab in these conditions have been published. In order to review the new indications of dupilumab in dermatology, we performed a search on PubMed, Embase, Cochrane Skin databases, and clinicaltrials.gov.The analysis of available literature suggests that dupilumab may have a large application in dermatology, besides AD. Clinical trials are underway on some widespread disease (i.e. chronic urticaria, bullous pemphigoid, alopecia areata, or allergic contact dermatitis). The data are still partial, but they seem to indicate that dupilumab is efficacious and safe. On the other hand, the dupilumab use in some rare skin diseases remains only hypothetical or linked to few case reports. Dupilumab could have a prominent position in the therapeutic algorithm of chronic skin diseases that significantly affect the quality of life of patients, require long-term treatment, or lacking effective therapies.

Rosacea is a common chronic skin disease affecting mostly people aged 40 and above, with currently no cure. When it affects the eyelids and periocular skin, it leads to dry eye and potentially corneal damage. Research performed over the last decade shed light into the potential mechanisms leading to skin hypersensitivity and provided promising avenues for development of novel, rational therapeutics aimed at reducing the skin inflammatory state. In this review, we discuss the current knowledge on the mechanisms of rosacea in general and of periocular skin-affecting disease in particular, identify key questions that remain to be answered in future research, and offer a disease model that can explain the key characteristics of this disease, with particular emphasis on a potential positive feedback loop that could explain both the acute and chronic features of rosacea.

Background: To date there is limited literature on the prevalence of chronic skin conditions and its association with levels of physical activity (PA) in Spain. Aim: To determine the prevalence of chronic skin disease and to compare levels of PA between people with and without chronic skin disease in a large representative sample of Spanish adults aged 15–69years. Methods: Data from the Spanish National Health Survey 2017 were analysed. Chronic skin disease was assessed using a yes/no question. PA was measured using the short form of the International Physical Activity Questionnaire. Total PA metabolic equivalent of task min/week were calculated, and PA was included in the analyses as a continuous and a five-category variable. Results: This cross-sectional study included 17777 adult participants (52.0% women; mean±SD age 45.8±14.1years), of whom 940 (5.3%) had chronic skin disease. After adjusting for several potential confounders, there was a negative association between chronic skin disease and PA (OR=0.87, 95% CI 0.76–1.00, P=0.05), which was significant for men (OR=0.76, 95% CI 0.62–0.93, P=0.01) but not for women (OR=0.97, 95% CI 0.81–1.16, P=0.72). Conclusions: In this large representative sample of Spanish adults, the prevalence of chronic skin disease was low. Levels of PA were lower in men with than in men without chronic skin conditions, but this association was not seen in women. © 2020 British Association of Dermatologists

Introduction This study aims to compare the choroidal thickness (CT) of patients with rosacea with healthy individuals. Methods This study was conducted with 42 patients with Papulopustular Rosacea (PPR), 38 patients with Erythematotelangiectatic Rosacea (ETR), and gender and age-matched 37 healthy individuals in the control group. CT measurements were done using the spectral-domain optical coherence tomography. Results Choroidal thickness means were measured as 352 +/- 78 mu m, 331 +/- 67 mu m, and 346 +/- 83 mu m at the subfoveal region; 323 +/- 72.3 mu m, 303.5 +/- 68.4 mu m, and 314 +/- 80.3 mu m at 1000 mu m nasal; and 325.2 +/- 71 mu m, 304.4 +/- 52.2 mu m, and 309 +/- 67 mu m at 1000 mu m temporal in the PPR, ETR, and control groups, respectively (p > 0.05). Conclusion Although rosacea is a common chronic skin disease that could have systemic findings, CT is not affected by this disease. WOS:000693179400001 2-s2.0-85114096175 PubMed: 34473882

Psoriasis is a chronic skin disease which occurs to 2%–3% of the world’s entire population. If treated properly, patients can still maintain a relatively high quality of life. Otherwise, Psoriasis could cause severe complications or even threat to life. Therefore, continuous tracking of severity degree is critical in Psoriasis treatment. However, due to the shortage of dermatologists, it’s hard for patients to receive regular severity evaluation. Furthermore, evaluating the severity degree of Psoriasis is both time-consuming and error-prone which poses a heavy burden for dermatologists. To address this problem, we propose an automatic rating model which measures the severity degree quantitatively based on skin lesion pictures. The proposed rating model applies coarse to fine grained neural networks to evaluate skin lesions from multiple perspectives. According to experimental results, the proposed model outperforms experienced dermatologists.

Background This is the first study analyzing levels of physical activity in a sample of quarantined adults with chronic conditions. The aim of this study was to compare moderate- and vigorous-intensity physical activity levels in Spanish adults with chronic conditions before and during coronavirus disease 2019 (COVID-19) quarantine. Methods A cross-sectional online survey was administered during the COVID-19 quarantine in Spain. A total of 163 participants with chronic conditions (113 females and 47 males; age range 18–64 years) completed the survey. A total of 26 chronic conditions were included. Participants self-reported average minutes/day of moderate and vigorous physical activity before and during quarantine. Differences in moderate- and vigorous-intensity physical activity levels before and during COVID-19 quarantine (overall, by gender, by age, by number of chronic conditions and by each chronic condition) were assessed by Wilcoxon-signed rank test. Results During COVID-19 quarantine, there was a significant decrease of moderate-intensity physical activity in Spanish people with chronic conditions (in both males and females, in those aged 18–24, 25–34, 35–44 and 55–64 years, in those with multimorbidity, in those with one/two chronic condition/s, and in those diagnosed with asthma/hypercholesterolaemia/chronic skin disease/haemorrhoids). Also, there was a significant decrease of vigorous-intensity physical activity in Spanish males with chronic conditions and in those with multimorbidity. Conclusions These results should be considered to develop effective strategies of physical activity promotion targeting these specific groups when new quarantine or restriction measures are implemented, in order to avoid new significant decreases of physical activity in these vulnerable populations.

Introduction: Psoriasis (PsO) is a chronic skin disease associated with increased CV risk. Systemic and vascular endothelial inflammation in PsO is highly prevalent and associated with CVD. Statins reduce LDL-C, systemic inflammation, and CV events. There is minimal data supporting the use of statins in PsO. We, therefore, investigated the effect of statins on circulating and vascular endothelial biomarkers of CV risk in PsO. Methods: We performed blood RNA sequencing, targeted proteomics (n=88), and brachial vein endothelial harvesting in PsO participants (n=45, average age 45 ± 14 years, 49% male, body surface area [BSA] of PsO 8 ± 14%, Framingham Risk Score 6 ± 7%) and age- gender-matched controls (n=18). Next, PsO subjects were randomly assigned to 40 mg atorvastatin (n=15) or no-treatment (n=10). A repeat assessment occurred at week two with the primary end-point change in vascular endothelial inflammation (mean composite of LTB, CCL3, CX3CL1, CCL2, CXCL1, ICAM1, iNOS, IL-8, IL-1B, COX- 2 expression). Results: Blood RNA sequencing with pathway analysis revealed inflammasome signaling as highly upregulated in PsO compared to control with protein expression of IL-6 ( r =0.68, p r =0.80, p p =0.02) in PsO compared to control and correlated with both PASI ( r =0.40, p =0.01) and LDL-C ( r =0.29, p =0.05). In PsO patients randomized to two weeks of statin therapy, LDL-C was reduced by ~50% compared to the no-treatment group (60 mg/dL vs. 111 mg/dL, p p =0.02). Change in vascular endothelial inflammation correlated with change in LDL-C ( r =0.53, p r =-0.25, p =0.30) or hs-CRP ( r =0.15, p =0.58). Conclusions: Two-weeks of high-intensity atorvastatin reduced vascular endothelial but not systemic inflammation in PsO. These findings suggest that statins may reduce CV risk in PsO either through lipid-mediated or a direct effect of statins on the vascular endothelium.

Psoriasis is a chronic skin disease, that often develops below the age of 18. In an integrated approach to childhood psoriasis, the impact of psoriasis on family members merits consideration. In this study, the impact of childhood psoriasis on caregivers (61 mothers and 4 fathers) of 65 children (age range 5-17.5 years) was measured using Family Dermatology Life Quality Index (FDLQI). Childhood psoriasis exerted a substantial impact on the QoL of caregivers (mean FDLQI 13.62±6.15 points). Caregivers rated routine household expenditure, time spent caring for the skin of the child, and emotional distress as the areas most impacted by psoriasis. The areas least affected were parent-child relationships, and caregivers’ social lives. The impact of other people’s reactions to the child’s disease was rated as more severe by caregivers of girls compared with those of boys (p=0.004).