182 results on '"Yun-Ting Chang"'
Search Results
2. Risk of Serious Infections in Patients with Bullous Pemphigoid: A Population-based Cohort Study
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Tsung-Hsien Chang, Chun-Ying Wu, Yun-Ting Chang, Ying-Syuan Lyu, and Chen-Yi Wu
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Bullous pemphigoid ,Cohort Studies ,Infections ,Pneumonia ,Sepsis ,Vesiculobullous skin disease ,Dermatology ,RL1-803 - Abstract
Patients with bullous pemphigoid are susceptible to serious infections, which are the leading cause of death in these patients. The aims of this population-based cohort study were to investigate the incidence and spectrum of serious infections in patients with bullous pemphigoid and to identify associated risk factors. The outcome measure was any infection requiring hospitalization. Hazard ratios with 95% confidence intervals were estimated using subdistribution hazard models. In total, 12,300 patients with bullous pemphigoid and 49,200 matched controls were identified through the National Health Insurance Research Database in Taiwan. Within 2 years of bullous pemphigoid diagnosis, 5,006 (40.7%) patients developed serious infections, with an incidence of 385.5/1,000 person-years. Patients with bullous pemphigoid were twice as likely to develop serious infections as controls (adjusted hazard ratio, 2.01; 95% confidence interval 1.92–2.10). Systemic corticosteroid use was the strongest risk factor, resulting in a 2-fold increase in the risk for serious infections. Other independent risk factors were advanced age, female sex, low income, and certain comorbidities. In conclusion, this study demonstrated an increased risk of serious infections following a diagnosis of bullous pemphigoid. Prophylaxis of serious infections through active intervention with the risk factors may be essential in reducing the morbidity and mortality associated with bullous pemphigoid. more...
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- 2023
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3. Taiwanese dermatological association consensus for the definition, classification, diagnosis, and management of urticaria: A 2021 update
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Yung-Tsu Cho, Tom C. Chan, Chih-Hung Lee, Wan-Yi Chou, Pa-Fan Hsiao, Yi-Ju Chen, Po-Yuan Wu, Che-Wen Yang, Tsu-Man Chiu, Yun-Ting Chang, Wei-Ming Wang, Chien-Hui Hong, Wei-Ting Tu, Yu-Huei Huang, Tsen-Fang Tsai, Cheng-Che Lan, and Chia-Yu Chu more...
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Definition ,Diagnosis ,Consensus ,Treatment ,Urticaria ,Medicine (General) ,R5-920 - Abstract
Urticaria is a prevalent disease with substantial physical, psychological, and economic impacts. With the advent of understandings of the disease and the emerging evidence of treatments, the international guidelines for treating urticaria have been updated in recent years. In order to update the 2014 edition of the Taiwanese Dermatological Association (TDA) consensus of urticaria, a total of 17 dermatologists with extensive experience in urticaria management were invited to and attended the TDA consensus meetings. All the specific aspects of the content were approved by at least 75% of the experts in attendance. Comparing to the former edition, several substantial modifications were made. For diagnosis, D-dimer was added as the recommended routine test in patients with chronic spontaneous urticaria. For pharmacological management, treatment suggestions were simplified. The approved-dosed, the up-dosed second-generation antihistamines, omalizumab, and cyclosporine were listed as the first-line to the fourth-line treatment, respectively. In addition, the management for patients of special considerations, such as the elderly, children, and pregnant women, were all discussed and mentioned in the consensus. We hope the updated TDA consensus can serve as a reference for all physicians and can help the physicians providing up-to-dated managements for these patients. more...
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- 2022
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4. Polypoid basal cell carcinoma: A scoping review
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Po-Chien Wu, Ying-Xiu Dai, Yu-Ju Chou, Yun-Ting Chang, Chih-Chiang Chen, and Sheng-Hsiang Ma
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basal cell carcinoma ,basal cell nevus syndrome ,polypoid ,scoping review ,Dermatology ,RL1-803 - Abstract
Polypoid basal cell carcinoma (BCC) is characterized by a stalk connecting the tumor and skin surfaces, with neoplastic cells restricted in the polypoid zone microscopically. A thorough review of polypoid BCC is still lacking. Thus, we performed this scoping review to investigate the clinical manifestations, dermoscopic features, histopathology, treatment, and prognosis of polypoid BCC. A literature search was conducted in the PubMed, Embase, Web of Science, and Cochrane databases until December 23, 2021. Studies reporting at least one patient with polypoid BCC following the pathology and clinical criteria were included. A total of 47 studies with 54 patients with solitary polypoid BCC and 13 patients with multiple polypoid BCCs were included. Solitary polypoid BCC occurred at a relatively younger age, with an equal sex ratio. These tumors most commonly presented as red or flesh-colored pedunculated papules and were commonly distributed over nonsun-exposed areas. Most tumors were managed with excision, and recurrence or metastasis was seldom reported. Most patients with multiple polypoid BCCs had basal cell nevus syndrome and presented with generalized distributed, flesh-colored, or brown papules mimicking skin tags. Typical dermoscopic features of BCC could still be observed in these lesions, including arborizing vessels, blue-gray globules, and ovoid nests, which could aid in early diagnosis. In conclusion, polypoid BCC is a distinct variant of BCC with pedunculated morphology. Physicians should be aware of polypoid BCC and may use dermoscopy to aid in early diagnosis and treatment. more...
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- 2022
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5. Reduced risk of skin cancer and internal malignancies in vitiligo patients: a retrospective population-based cohort study in Taiwan
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Yu-Ching Weng, Hsiu J. Ho, Yi-Ling Chang, Yun-Ting Chang, Chun-Ying Wu, and Yi-Ju Chen
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Medicine ,Science - Abstract
Abstract The relationship between cancer and vitiligo has been explored but with inconsistent results. To examine the long-term cancer risk in vitiligo patients, we conducted a retrospective nationwide cohort study. From the National Health Insurance Research Database of Taiwan, a total of 13,824 vitiligo patients were identified and matched with 55,296 reference subjects without vitiligo by age, gender, and propensity score estimated by major comorbidities from 1997 to 2013. Demographic characteristics and comorbidities were compared between these two groups. Incidence rate ratios and hazard ratios (HRs) were calculated to examine cancer risks. The 16-year incidence rates of overall cancers were 621.06 (566.56–675.55) and 726.99 (697.24–756.74) per 100,000 person-years in the vitiligo and reference groups. Patients with vitiligo showed a significantly decreased risk of overall cancers [adjusted HR, 0.85; 95% confidence interval (CI), 0.77 to 0.93, p more...
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- 2021
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6. Taiwanese Dermatological Association consensus for the management of atopic dermatitis: A 2020 update
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Tom C. Chan, Nan-Lin Wu, Lai-San Wong, Yung-Tsu Cho, Chin-Yi Yang, Yu Yu, Po-Ju Lai, Yun-Ting Chang, I-Hsin Shih, Chih-Hung Lee, and Chia-Yu Chu
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Atopic dermatitis ,Consensus ,Treatment ,Medicine (General) ,R5-920 - Abstract
Background/Purpose: Atopic dermatitis (AD) is a chronic inflammatory disease commonly seen in children and increasingly recognized in adults. With recent advances in the therapeutic development for AD, the Taiwanese Dermatological Association (TDA) established a committee to update the consensus for AD management in Taiwan. This report describes the 2020 updated consensus for the management of AD. Methods: A panel of 11 core members was convened to review and discuss aspects of AD management and draft recommendation during the first two meetings. The 2015 TDA consensus and the 2017 European guideline, along with recent peer-reviewed articles, serve as the foundation for the update. In the third meeting, AD expert dermatologists selected on a national scale were invited to vote on the final statements. A total of 27 dermatologists attended the final meeting. The consensus was achieved when ratings of 7–9 (out of a total score of 9) accounted for ≥ 75% of the total votes. Results: Consensus was achieved on the therapeutic options for AD by lines of treatment. A treatment algorithm was presented to illustrate the place of each modality in terms of basic care, acute disease control, and maintenance therapy. Special considerations for the pediatric population, as well as for women during pregnancy and lactation, are discussed. Conclusion: Topical corticosteroids with long-term emollient-based therapies remain the cornerstone of AD treatment. Systemic treatments are indicated when topical therapies and phototherapy fail to control the disease. The recent approval of dupilumab and emerging targeted therapies are expected to bring significant clinical benefit for patients whose disease is inadequately managed by existing options. more...
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- 2021
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7. Association between inflammatory bowel disease and bullous pemphigoid: a population-based case–control study
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Yi-Ju Chen, Chao-Kuei Juan, Yun-Ting Chang, Chun-Ying Wu, Hsiu J. Ho, and Hsiao-Ching Tseng
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Medicine ,Science - Abstract
Abstract The coexistence of inflammatory bowel disease (IBD) and bullous pemphigoid (BP) has been reported. No large-scale study to date has explored the relationship between these diseases. This population-based case-control study examined the association between IBD and BP by using a nationwide database. A total of 5,263 BP patients and 21,052 age- and gender-, hospital visit number-matched controls were identified in the National Health Insurance Research Database of Taiwan (1997–2013). Demographic characteristics and comorbidities including IBD were compared. Logistic regression was conducted to examine the predicting factors for BP. The mean age at diagnosis was 74.88 years and 54.3% of subjects were male. BP patients tended to have more cardiovascular risk factors, autoimmune and neurologic comorbidities, and hematologic cancers than matched controls. There were 20 cases of IBD (0.38%), mostly ulcerative colitis (N = 17, 0.32%) among BP patients, compared to 33 IBD cases (0.16%) among controls (p more...
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- 2020
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8. The association between statins and subsequent risk of bullous pemphigoid: A population-based cohort study
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Tsung-Hsien Chang, MD, Chun-Ying Wu, MD, PhD, Yun-Ting Chang, MD, PhD, Yi-Hsian Lin, MA, and Chen-Yi Wu, MD, PhD
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Dermatology ,RL1-803 - Published
- 2021
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9. Is rosacea a risk factor for cancer: A population-based cohort study in Taiwan
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Tsung-Hsien Chang, Hsiu J Ho, Yun-Ting Chang, Chung-Pin Li, Chun-Ying Wu, and Chen-Yi Wu
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cohort studies ,comorbidity ,epidemiology ,neoplasms ,rosacea ,skin diseases ,Dermatology ,RL1-803 - Abstract
Background: Rosacea is a chronic inflammatory skin disease with mounting evidence associating it with systemic disorders. Cancer, induced or facilitated by chronic inflammatory microenvironment, shares common pathogenic mechanisms with rosacea. Objectives: We performed a population-based cohort study to investigate the risk of developing cancer among people with rosacea in Taiwan. Methods: A total of 65,526 patients with rosacea and 262,104 age-, sex-, and comorbidity-matched controls were identified from the Taiwan's National Health Insurance Research Database between 1997 and 2013. All participants were followed up for 2–12 years. Incidence rates (IRs) of overall and specific types of cancer were calculated. Cumulative incidences of cancer were compared between the two cohorts by Kaplan–Meier method and modified log-rank test. Hazard ratios (HRs) adjusted for age, sex, and comorbidities for overall and specific malignancies were estimated using subdistribution proportional hazard models. Results: The IR (per 1000 person-years) of cancer was 2.83 in patients with rosacea and 3.00 in controls. There was no difference in cumulative incidence of cancer between patients with or without rosacea (P = 0.109). The risk of developing cancer did not increase among patients with rosacea (HR = 1.04; 95% confidence interval = 0.98–1.11). In addition, patients with rosacea did not have a significantly increased risk of developing any specific type of cancer. Conclusion: We found no association between rosacea and malignancy. These results did not agree with those reported in previous studies. Further research should be conducted to clarify the association between rosacea and cancer, especially focusing on the pathophysiology. more...
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- 2020
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10. Mechanical stretch induces hair regeneration through the alternative activation of macrophages
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Szu-Ying Chu, Chih-Hung Chou, Hsien-Da Huang, Meng-Hua Yen, Hsiao-Chin Hong, Po-Han Chao, Yu-Hsuan Wang, Po-Yu Chen, Shi-Xin Nian, Yu-Ru Chen, Li-Ying Liou, Yu-Chen Liu, Hui-Mei Chen, Feng-Mao Lin, Yun-Ting Chang, Chih-Chiang Chen, and Oscar K. Lee more...
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Science - Abstract
Mechanical stimulation is known to affect cell proliferation, differentiation, and regeneration. Here, the authors demonstrate that stretching mouse skin recruits macrophages and polarizes them into M2 cells that facilitate hair regeneration through the release of growth factors, including HGF and IGF-1 more...
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- 2019
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11. Zinc-responsive seronegative necrolytic acral erythema: A case report and literature review
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Yu-Hsun Wei, Sheng-Hsiang Ma, Yun-Ting Chang, and Cheng-Yuan Li
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Dermatology ,RL1-803 - Published
- 2022
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12. Skin care services and disease prevalence in Taiwan: A nationwide study
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Ying-Xiu Dai, Tzeng-Ji Chen, and Yun-Ting Chang
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Dermatology ,RL1-803 - Abstract
Background/Objective: Numerous studies have suggested that dermatologists are superior to nondermatologists in managing skin diseases. However, it is still not known whether the public are convinced that dermatologists should be the primary caretakers for the skin. This study sought to characterize the delivery of skin care services, with a particular focus on the epidemiology of skin diseases and the distributions of patients and their visits to dermatologists and nondermatologists. Methods: The cohort datasets were drawn from Taiwan's National Health Insurance Research Database (NHIRD) and contained all the original claims data for one million beneficiaries enrolled in 2010. We analyzed the epidemiologic profiles of this population-based cohort for 2013. Descriptive statistics were applied to examine the epidemiology of skin diseases and the distributions of visits and patients according to physician specialty. Results: We identified 989,039 persons who remained in the cohort in 2013. Of those, 351,330 (or 35.5%) had skin diseases, and made 989,514 ambulatory care visits in 2013. Visits to dermatologists accounted for 62.2% of these visits. Among the patients with skin diseases, 52.6% of patients made visits to dermatologists, compared with 32.6% who visited nondermatologists and 14.8% who visited both in 2013. In this cohort, dermatitis and eczema had the highest prevalence (16.2%), followed by fungal infections (6.3%) and pruritus (5.5%). Conclusion: Dermatologists play major roles in providing skin care services in Taiwan. This finding might be partially explained by the weak role of primary care physicians and the perceptions of patients toward dermatologists and nondermatologists in Taiwan. Keywords: Healthcare utilization, Skin diseases, Epidemiology, Taiwan more...
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- 2018
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13. Cancer risk in patients with alopecia areata: a nationwide population‐based matched cohort study
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Chih‐Chiang Chen, Yun‐Ting Chang, Han‐Nan Liu, and Yi‐Ju Chen
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Alopecia areata ,autoimmune disorder ,breast cancer ,cancer risk ,kidney cancer ,lymphoma ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Alopecia areata (AA) is an organ‐specific autoimmune disorder. Defective immune system related disorders are prone to increase the risk of cancer formation. However, the association among AA and variety of cancer types had never been studied. A nationwide population‐based matched cohort study was conducted to evaluate the cancer risk in patients with AA. Records from Taiwan National Health Insurance Research Database were analyzed. Cases of AA from 1997 to 2013 and cancers registered in the catastrophic illness profile from the same time period were collected. The standard incidence ratio (SIR) of each cancer was calculated. In total, 2099 cancers among 162,499 patients with AA and without prior cancers were identified. The overall cancer risks in AA patients were slightly decreased, especially among male subjects (SIR: 0.89). Refer to individual cancer, the cancer risk of nonmelanoma skin cancer (NMSC) (SIR: 0.59), upper GI cancer (SIR: 0.70), liver cancer (SIR: 0.82), uterine, and cervix cancer (SIR: 0.84) were significantly lower in patients with AA. In contrast, AA patients were inclined to have lymphoma, breast cancer, kidney, and urinary bladder cancer with the SIR of 1.55, 2.93, and 2.95, respectively. Age stratified analyses revealed female AA patients younger than 50 years old have even higher risk of breast cancer (SIR: 3.37). Further sensitivity analysis showed similar results after excluding major autoimmune disorders. Cancer risk in AA patients is organ specific, and it is not associated with the underlying autoimmune disorders in patients with AA. more...
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- 2018
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14. Statins did not reduce the mortality risk in patients with bullous pemphigoid: A population-based cohort study
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Chen-Yi Wu, Chun-Ying Wu, Yi-Hsian Lin, and Yun-Ting Chang
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Dermatology ,RL1-803 - Published
- 2021
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15. Taiwanese Dermatological Association consensus statement on management of psoriasis
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Tsen-Fang Tsai, Chih-Hung Lee, Yu-Huei Huang, Ching-Chi Chi, Yun-Ting Chang, Tak-Wah Wong, Chih-Hsun Yang, and Li-Fang Wang
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consensus development ,medication therapy management ,psoriasis ,Taiwanese Dermatological Association ,Dermatology ,RL1-803 - Abstract
Background: Effective management of psoriasis is a cause for much concern. In Taiwan, there is a lack of consensus on management strategies for psoriasis, especially the principles of drug prescribing in psoriatic patients. Objectives: The Taiwanese Dermatological Association convened Expert Panel meetings three times between 2012 and 2015 to discuss the management strategies for treatment of psoriasis in order to fill the knowledge gap and provide a reference tool for Taiwanese dermatologists. Results: This paper reports the final output from the three meetings, with the aim of aiding clinical decision making in terms of principles of prescribing, including dosing strategies, efficacy profiles, and safety concerns in connection with eight categories of antipsoriatic treatment: topical agents, phototherapy, nonbiologic conventional systemic agents, licensed biologic systemic agents, newly emerging therapies, combination therapy, transitional therapy, and traditional Chinese medicine. Conclusion: The Expert Panel, comprising distinguished Taiwanese dermatologists, succeeded in developing a consensus about the management of psoriasis in Taiwanese patients. Unavailability of data in certain areas may suggest a possibility of new directions in research. more...
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- 2017
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16. Impact of the COVID-19 pandemic on dermatology clinic visits: Experience from a tertiary medical center in Taiwan
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Sheng-Hsiang Ma, Ying-Hsuan Tai, Ying-Xiu Dai, Chih-Chiang Chen, Tzeng-Ji Chen, and Yun-Ting Chang
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Dermatology ,RL1-803 - Published
- 2020
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17. Comorbidity profiles of psoriasis in Taiwan: A latent class analysis.
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Chen-Yi Wu, Hsiao-Yun Hu, Chung-Pin Li, Yiing-Jeng Chou, and Yun-Ting Chang
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Medicine ,Science - Abstract
Psoriasis is associated with many comorbidities. An understanding of these comorbidity patterns can help foster better care of patients with psoriasis.To identify the heterogeneity of psoriasis comorbidities using latent class analysis (LCA).LCA was used to empirically identify psoriasis comorbidity patterns in a nationwide sample of 110,729 incident cases of psoriasis (2002-2012) from the National Health Insurance database in Taiwan.The mean age of incident psoriasis was 46.1 years. Hypertension (28.8%), dyslipidemia (18.9%), and chronic liver disease/cirrhosis/hepatitis (18.1%) were the top three comorbidities in patients with psoriasis. LCA identified four distinct comorbidity classes among these patients, including 9.9% of patients in the "multi-comorbidity" class, 17.9% in the "metabolic syndrome" class, 11.3% in the "hypertension and chronic obstructive pulmonary disease (COPD)" class, and 60.9% in the "relatively healthy" class. Psoriatic arthritis was evenly distributed among each class. Relative to membership in the "relative healthy" class, an increase of one year of age had a higher probability of membership in the "multi-comorbidity" (odds ratio [OR], 1.25), "metabolic syndrome" (OR, 1.11), or "hypertension and COPD" (OR, 1.34) classes. Relative to membership in the "relative healthy" class, compared to women, men had a higher probability of membership in the "multi-comorbidity" (OR, 1.39), "metabolic syndrome" (OR, 1.77), or "hypertension and COPD" (OR, 1.22) classes.We observed four distinct classes of psoriasis comorbidities, including the "multi-comorbidity", "metabolic syndrome", "hypertension and COPD", and "relatively healthy" classes, as well as the clustering of liver diseases with metabolic syndrome and clustering of COPD with hypertension. more...
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- 2018
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18. Malignant peripheral nerve sheath tumor arising from solitary neurofibroma
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Pei-I Chung, Chang-Lin Chen, Yun-Ting Chang, and Han-Nan Liu
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dermis ,malignant peripheral nerve sheath tumor ,neurofibromatosis type I ,solitary neurofibroma ,Dermatology ,RL1-803 - Abstract
Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas that are strongly associated with neurofibromatosis type I (NF-1). We describe a 71-year-old woman with no stigmata of neurofibromatosis, who presented with recurrent subcutaneous tumor on her left upper back. She received two excisional biopsies on the back of her trunk at our hospital and both pathology reports revealed neurofibromas. Three years after the last skin biopsy, a rapidly growing subcutaneous tumor emerged at the same site. This tumor was totally resected and the histopathology showed an ill-defined tumor in the dermis and subcutaneous tissue. The tumor was composed of spindle cells in a myxoid stroma with a transition from the area of typical neurofibroma to the hypercellular area. The hypercellular area consisted of atypical, hyperchromatic spindled cells with frequent mitotic figures. She was therefore diagnosed with MPNST. more...
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- 2014
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19. Performance of the SCORTEN in Taiwanese patients with Stevens-Johnson syndrome and toxic epidermal necrolysis
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Yu-Ling Ho, Yun-Ting Chang, Yu-Tseng Chu, and Shiao-Chi Wu
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SCORTEN ,Stevens-Johnson syndrome ,Toxic epidermal necrolysis ,Dermatology ,RL1-803 - Abstract
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare drug-related skin conditions that are potentially life-threatening with a 20–30% mortality rate. A severity-of-illness score specified for SJS and TEN, SCORTEN, was developed in 2000. Until now, no study of SCORTEN has been conducted in Asian with SJS or TEN. The goal of the present study is to evaluate the performance of SCORTEN in predicting in-hospital mortality in Taiwanese patient with SJS or TEN. Methods: A sample of 51 patients with the diagnosis of SJS or TEN was reviewed from the chart. Performance of the SCORTEN was assessed using logistic regression. Results: The hospital mortality rate predicted by the SCORTEN was similar to the observed mortality rate. The performance of SCORTEN was well on each of the first 5 days of hospitalization, and best on the first day. There were two cases with active tuberculosis and five with diabetes mellitus among our eight deceased patients. Conclusion: The performance of SCORTEN is well in Taiwanese patients with SJS or TEN, especially on the first day of admission. The SCORTEN predicts a relatively accurate in-hospital mortality rate. We suggest that the SCORTEN should always be obtained during the first 24 hours, and can be repeated if the patient's condition deteriorates quickly in the first 5 days. Pre-existing conditions, such as tuberculosis and pre-existing diabetes, may need more consideration in future studies. more...
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- 2010
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20. Corrigendum to 'Taiwanese dermatological association consensus statement on management of psoriasis' [Dermatol Sin 35 (2017) 66–77]
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Tsen-Fang Tsai, Chih-Hung Lee, Yu-Huei Huang, Ching-Chi Chi, Yun-Ting Chang, Tak-Wah Wong, Chih-Hsun Yang, and Li-Fang Wang
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Dermatology ,RL1-803 - Published
- 2017
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21. Correlation of Disease Severity, Proinflammatory Cytokines, and Reduced Brain Gray Matter Volumes in Patients with Atopic Dermatitis.
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Cheng-Yuan Li, Wan-Chen Chang, Mu-Hong Chen, Pei-Chi Tu, Tai-Li Chen, Chih-Chiang Chen, Yun-Ting Chang, You-Yin Chen, and Ya-Mei Bai
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Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. However, few studies have investigated brain changes associated with chronic inflammation. We hypothesized that chronic inflammation might be related to brain structural alterations in patients with AD. Objectives: To investigate the association between disease severity (Eczema Area and Severity Index [EASI]), proinflammatory cytokines, and differences in brain gray matter (GM) volume in patients with AD. Methods: Nineteen patients with AD and 19 age- and sex-matched healthy subjects were enrolled. All participants underwent clinical assessment and brain magnetic resonance imaging. Voxel-based morphometry was performed to analyze GM volume differences. Results: Patients with AD exhibited significantly decreased GM volume in many brain regions, such as bilateral precentral gyrus, right frontal pole, and right middle temporal gyrus (P < 0.001), compared with healthy subjects. Notably, in patients with AD, the GM volume in right middle temporal gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R [soluble interleukin 2 receptor] and TNF-a receptor-1), whereas the GM volume in left precentral gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R and CRP). Conclusion: Patients with AD demonstrated significant brain GM volume reduction in many brain regions, which is related to disease severity and proinflammatory cytokines. [ABSTRACT FROM AUTHOR] more...
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- 2024
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22. Management of Atopic Dermatitis During the COVID-19 Pandemic: Key Questions and Review of the Current Evidence
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Po-Chien Wu, Chia-Lun Li, Yun-Ting Chang, Chih-Chiang Chen, Chen-Yi Wu, and Sheng-Hsiang Ma
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Immunology and Allergy ,Dermatology - Published
- 2023
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23. Dupilumab in the treatment of genodermatosis: A systematic review
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Po‐Chien Wu, Ying‐Xiu Dai, Chia‐Lun Li, Chih‐Chiang Chen, Yun‐Ting Chang, and Sheng‐Hsiang Ma
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Dermatology - Published
- 2023
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24. Association between sodium–glucose co-transporter 2 inhibitors and risk of psoriasis in patients with diabetes mellitus: a nationwide population-based cohort study
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Sheng-Hsiang Ma, Chun-Ying Wu, Ying-Syuan Lyu, Yiing-Jenq Chou, Yun-Ting Chang, and Chen-Yi Wu
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Cohort Studies ,Diabetes Mellitus, Type 2 ,Insulins ,Humans ,Psoriasis ,Kidney Diseases ,Dermatology ,Sodium-Glucose Transporter 2 Inhibitors - Abstract
Background Sodium–glucose co-transporter 2 inhibitor (SGLT2i) treatment may exert anti-inflammatory effects by modulating the NOD-like receptor family pyrin domain-containing 3 inflammasome and interleukin-17/23 inflammatory axis, which are both involved in the pathogenesis of psoriasis. However, the relationship between SGLT2i treatment and psoriasis remains unclear. Aim To investigate the association between SGLT2i treatment and incident psoriasis. Methods Using the Taiwan National Health Insurance Database for the period 2007–2018, we matched 103 745 patients with Type 2 diabetes mellitus (T2DM) receiving SGLT2i with a control group of patients with T2DM who did not use SGLT2i, matching them in a 1 : 2 ratio by age, sex, diabetes duration, insulin use and comorbidities, and evaluating the psoriasis risk in both groups. Results The incident psoriasis risk did not significantly differ between the SGLT2i and control groups [hazard ratio (HR) = 1.24, 95% CI 0.95–1.64] after adjustment for potential confounders. Insulin use (HR = 1.65, 95% CI 1.24–2.19) and chronic liver disease and cirrhosis (HR = 1.34, 95% CI 1.01–1.77) were significantly associated with increased psoriasis risk. A slightly increased psoriasis risk was also detected in certain SGLT2i user subgroups, especially those with renal disease (HR = 2.73, 95% CI 1.45–5.13). Conclusion SGLT2i-mediated protective effects in psoriasis could not be established. SGLT2i treatment increased psoriasis risk by 2.7-fold in patients with T2DM exhibiting renal diseases. more...
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- 2022
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25. Implementation of NUDT15 Genotyping to Prevent Azathioprine‐Induced Leukopenia for Patients With Autoimmune Disorders in Chinese Population
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Chuang-Wei, Wang, Min-Hui, Chi, Tsen-Fang, Tsai, Kuang-Hui, Yu, Hsiao-Wen, Kao, Hsiang-Cheng, Chen, Chun-Bing, Chen, Chun-Wei, Lu, Wei-Ti, Chen, Ya-Ching, Chang, Chih-Jung, Chang, Yun-Ting, Chang, Yeong-Jian, Jan Wu, Chee-Jen, Chang, Yu Huei, Huang, Chau-Yee, Ng, Po-Wei, Huang, Yu-Jr, Lin, Rosaline Chung-Yee, Hui, and Wen-Hung, Chung more...
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Pharmacology ,Genotype ,Azathioprine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Leukopenia ,Methyltransferases ,Pyrophosphatases ,Thrombocytopenia ,Immunosuppressive Agents ,Autoimmune Diseases - Abstract
Azathioprine (AZA) is commonly used for many autoimmune disorders; however, the limitation of its clinical use is due to potential toxicities, including severe leukopenia. Recent studies have identified genetic NUDT15 variants strongly associated with AZA-induced leukopenia in Asian patients. This study aimed to investigate the strength of above genetic association and evaluate the usefulness of prospective screening of the NUDT15 variants to prevent AZA-induced leukopenia in Chinese patients. AZA-induced leukopenia in patients with autoimmune disorders were enrolled from multiple medical centers in Taiwan/China between 2012 and 2017 to determine the strength of genetic association of NUDT15 or TPMT variants by whole exome sequencing (WES). Furthermore, a prospective study was conducted between 2018 and 2021 to investigate the incidence of AZA-induced leukopenia with and without genetic screening. The WES result showed the genetic variants of NUDT15 R139C (rs116855232) (P = 3.7 × 10 more...
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- 2022
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26. Association between bullous pemphigoid and atopic dermatitis: a population-based case–control study in Taiwan
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Po-Chien Wu, Chun-Ying Wu, Ying-Syuan Lyu, Yun-Ting Chang, and Chen-Yi Wu
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Dermatology ,General Medicine - Abstract
Although bullous pemphigoid (BP) and atopic dermatitis (AD) share pathogenic mechanisms, their relationship remains controversial. Therefore, we conducted a population-based case-control study to investigate the association between BP and AD in Taiwan. Based on the Taiwan National Health Insurance Research Database, 9344 patients with BP and 18,688 age- and sex-matched controls were enrolled between 2000 and 2013. Furthermore, the study included 7,196 BP patients and 14,392 controls, matched for age, sex, and propensity score of comorbidities, with a case to controls ratio of 1:2. Logistic regression analysis was performed to examine the association between AD and BP. In the age- and sex-matched cohorts, AD (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.50-1.95) was independently associated with BP. In the age, sex, and comorbidities-matched cohorts, AD (OR 1.76, 95% CI 1.55-2.00) remained a significant risk factor for BP. Other significant risk factors included psoriasis, hypertension, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, neuropsychiatric diseases, and autoimmune connective tissue disease. Limitations of this study include the lack of information on disease severity and phenotypes of BP and misclassification of diseases as potential sources of bias. In conclusion, AD increased the risk of developing BP by 76%, and this association was independent of many BP comorbidities. Further studies are warranted to investigate the clinical and pathophysiological relevance of factors contributing to BP and AD. more...
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- 2022
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27. Association between bullous pemphigoid and risk of venous thromboembolism: A nationwide population‐based cohort study
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Ching‐Li Chen, Chun‐Ying Wu, Ying‐Syuan Lyu, Yiing‐Jenq Chou, Yun‐Ting Chang, and Chen‐Yi Wu
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Cohort Studies ,Risk Factors ,Incidence ,Pemphigoid, Bullous ,Humans ,Female ,Venous Thromboembolism ,Dermatology ,General Medicine - Abstract
Bullous pemphigoid (BP) has been reported to be associated with an increased risk of venous thromboembolism (VTE). However, the exact time course is unclear, and no previous studies have been reported in the Asian population. This nationwide population-based cohort study examined the risk of VTE among BP patients in Taiwan between 2007 and 2018. A total of 12 692 BP patients were 1:2 matched with non-BP patients by age, sex, and propensity score of comorbidities. Cumulative incidence and Cox proportional hazards models were used to investigate the risk of VTE. The BP cohort had a significantly higher VTE rate than the non-BP cohort (0.17% vs. 0.08%, p = 0.015) in 1 year; the finding was more prominent within the first 6 months after diagnosis. BP was a significant risk factor for VTE (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.01-4.06); the association mildly diminished but remained significant after extending the follow-up period to 2 years (HR, 1.73; 95% CI, 1.06-2.81). Other significant risk factors for VTE included cancer, chronic liver disease and cirrhosis, and female sex. In conclusion, this study revealed a 2.02-fold increased risk of VTE in patients with BP in Taiwan. more...
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- 2022
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28. Association Between Air Pollution and Incidence of Psoriasis: A Nationwide Population-based Case-control Study
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Chia-Lun Li, Sheng-Hsiang Ma, Chun-Ying Wu, Ying-Syuan Lyu, Yun-Ting Chang, Chon-Kit Ao, and Chen-Yi Wu
- Abstract
Background Air pollutants may aggravate psoriasis. However, the association between air pollution and psoriasis incidence remains unclear. We aimed to identify the association between air pollution and psoriasis incidence.Methods This case-control study included patients with psoriasis and age-, sex-, urbanization level-, index date-, and comorbidities-matched controls from the National Health Insurance Research Database in Taiwan from January 1, 2012, to December 31, 2018. Exposure to air pollutants (sulfur dioxide, carbon monoxide, ozone, coarse particulate matter [PM10], fine particulate matter [PM2.5], and nitrogen dioxide [NO2]) was analyzed in the 5 years preceding psoriasis diagnosis and in controls.Results Overall, 45,093 patients with psoriasis and 180,372 controls were included. After adjusting for age, sex, urbanization level, index date, and comorbidities, our conditional logistic models showed that exposure to PM10 and PM2.5 was associated with a slightly increased psoriasis incidence. Estimating the effects of different air pollutants simultaneously, the adjustment model showed that PM10, PM2.5, and NO2 were associated with a slight increase in psoriasis incidence.Conclusion Although exposure to certain PM10, PM2.5, and NO2 levels was significantly associated with incident psoriasis, the increased risks were trivial, with no dose-response relationship. more...
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- 2023
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29. Increased risk of suicide attempt in patients with alopecia areata: a nationwide population-based cohort study
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Li Hsin Wang, Sheng-Hsiang Ma, Ying-Hsuan Tai, Ying-Xiu Dai, Yun-Ting Chang, Tzeng-Ji Chen, and Mu-Hong Chen
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Dermatology - Abstract
Background: There is growing evidence that patients with alopecia areata (AA) have an increased risk of developing psychiatric comorbidities. However, the relationship between AA and suicidal behaviors remains unclear. Objective: To investigate the association between AA and suicidal behaviors Methods: Participants were recruited from the National Health Insurance Research Database in Taiwan, including 10,515 patients with AA and 10,5150 matched controls, to assess the risk of suicide attempts. A Cox regression model was used for all analyses. Results: Compared with the controls, an increased risk of suicide attempts was observed in patients with AA, with an adjusted hazard ratio of 6.28 (95% confidence interval, 4.47-8.81). Suicide risk remained significantly elevated in AA patients when stratified by underlying psychiatric disorders. The mean age of initial suicidal behaviors was also lower in patients with AA. Conclusions: Patients with AA had a significantly higher incidence of suicidal attempts than controls, regardless of concurrent psychiatric illness. Further studies are needed to elucidate the pathophysiology of the association between AA and suicidality. In addition, dermatologists should be aware of the increased suicidality of patients with alopecia areata. more...
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- 2023
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30. Lack of association between vitiligo and major adverse cardiovascular events: A population‐based cohort study
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Po‐Chien Wu, Sheng‐Hsiang Ma, Chun‐Ying Wu, Tzu‐Yun Pan, Yun‐Ting Chang, and Chen‐Yi Wu
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Infectious Diseases ,Dermatology - Published
- 2023
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31. Pemphigus aggravation following Pfizer‐BioNTech vaccination: A case report and review of literature
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Hsuan‐Chi Chen, Sheng‐Hsiang Ma, Li‐Hsin Wang, Yun‐Ting Chang, and Chen‐Yi Wu
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Rheumatology - Published
- 2023
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32. Psoriasis and Dry Eye Disease: A Systematic Review and Meta-Analysis
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Po-Chien Wu, Sheng-Hsiang Ma, Ya-Yun Huang, Jin-Yu Chang, Yun-Ting Chang, and Ying-Xiu Dai
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Dermatology - Abstract
Background: Psoriasis is a chronic inflammatory skin disease with potential systemic involvement. Some evidence suggests an increased risk of dry eye in patients with psoriasis. However, the relationship between these two conditions remains unclear. The aim of our study is to investigate the association between psoriasis and dry eye disease. Methods: This meta-analysis was registered in PROSPERO (CRD42020199445) and adhered to MOOSE checklist and PRISMA guidance for all processes. PubMed, Embase, Web of Science, and Cochrane databases were searched for studies examining the association between psoriasis and dry eye disease from inception to December 13, 2020. The primary outcome was the prevalence of dry eye disease in patients with psoriasis relative to controls. The secondary outcomes were the Schirmer I test score, tear film breakup time (TBUT), and ocular surface disease index (OSDI). The risk of bias of the selected studies was assessed using the Newcastle-Ottawa Scale. Results: The meta-analysis showed a significant association between dry eye disease and psoriasis (OR, 8.49; 95% CI, 3.34–21.58). Moreover, patients with psoriasis had a significantly lower Schirmer I test score (MD, −2.80; 95% CI, −4.07 to −1.52), shorter TBUT (MD, −4.12; 95% CI, −5.22 to −3.02), and higher OSDI (MD, 20.15; 95% CI, 6.24–34.05; p < 0.01), compared to controls. Conclusions: The current evidence supports an association between dry eye disease and psoriasis. These results suggest ophthalmologic assessment for the early recognition and management of dry eye in patients with psoriasis. more...
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- 2022
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33. Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis
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Sheng-Hsiang Ma, Po-Chien Wu, Jin-Yu Chang, Yun-Ting Chang, and Ying-Xiu Dai
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sense organs ,Dermatology ,eye diseases - Abstract
Background: Vitiligo is a skin depigmentation disorder that results from the autoimmune destruction of cutaneous melanocytes. Several ocular abnormalities, including uveitis, dry eye, glaucoma, and retinal diseases, have been reported in patients with vitiligo. The aim of our study was to investigate the association of ocular abnormalities with vitiligo. Methods: This meta-analysis was registered in PROSPERO (CRD42021224167) and adhered to MOOSE checklist and PRISMA guidance for all processes. PubMed, Embase, Web of Science, and Cochrane databases were searched for studies examining the association between ocular abnormalities and vitiligo from inception to December 10, 2020. Studies recruiting patients with Sjogren’s syndrome or Vogt-Koyanagi-Harada syndrome were excluded. The primary outcomes were the Schirmer test, tear film break-up time (TBUT), and ocular surface disease index (OSDI) of vitiligo patients compared to the controls. The risk of bias of the selected studies was assessed using the Newcastle-Ottawa Scale (NOS) of case-control studies. Results: This meta-analysis of 16 case-control studies showed that patients with vitiligo had significantly lower Schirmer test values (mean difference [MD], −1.65; 95% CI, −2.81 to −0.49), shorter TBUTs (MD, −4.66; 95% CI, −7.05 to −2.26), higher ocular surface disease indices (MD, 18.02; 95% CI, 5.7–30.35), and thinner subfoveal choroidal thicknesses (MD, −53.10; 95% CI, −69.84 to −36.36). No significant differences were found in the prevalence of glaucoma and the level of intraocular pressure. Conclusions: Our study supports an association between dry eye and thinner subfoveal choroidal thickness in patients with vitiligo. Dermatologists should be aware of these possible comorbidities and refer vitiligo patients with ocular symptoms to ophthalmologists for further management. more...
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- 2022
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34. Association between vitiligo and hearing loss
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Sheng-Hsiang Ma, Min-De Ang, Yun-Ting Chang, and Ying-Xiu Dai
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medicine.medical_specialty ,Hearing loss ,Hearing Loss, Sensorineural ,Vitiligo ,MEDLINE ,Dermatology ,Deafness ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Hearing Loss ,skin and connective tissue diseases ,Association (psychology) ,integumentary system ,business.industry ,Publication bias ,Odds ratio ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Sensorineural hearing loss ,medicine.symptom ,business - Abstract
Background Vitiligo is a common depigmenting disorder caused by the autoimmune destruction of melanocytes. Some evidence suggests the involvement of melanocytes in the auditory system in the disease process. However, the relationship between vitiligo and sensorineural hearing loss (SNHL) remains uncertain. Objective We investigated the association between vitiligo and SNHL. Methods In this systematic review and meta-analysis, EMBASE, MEDLINE, PubMed, and the Cochrane database were searched for studies examining the association between SNHL and vitiligo from inception to June 28, 2020. Results A total of 14 case-control studies with 938 patients with vitiligo were included. The meta-analysis showed a significant association of SNHL with vitiligo (odds ratio [OR] 6.02 [95% confidence interval {CI} 3.41-10.62]). The association remained significant after adjustment of study quality and publication bias, with ORs of 5.30 (95% CI 1.53-18.35), and 3.45 (95% CI 1.75-6.81), respectively. Limitations Heterogenous definition and measurement of hearing loss and racial differences are potential sources of bias. Conclusion The evidence to date supports an association of SNHL with vitiligo. These results suggest audiologic assessment for early recognition and management of hearing loss in patients with vitiligo. more...
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- 2021
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35. Populationsbasierte Fall‐Kontroll‐Studie zeigt keinen Zusammenhang zwischen bullösem Pemphigoid und Autoimmunerkrankungen der Schilddrüse
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Po-Chien, Wu, Chun-Ying, Wu, Ying-Syuan, Lyu, Yun-Ting, Chang, and Chen-Yi, Wu
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Pemphigoid, Bullous ,Humans ,Dermatology - Published
- 2022
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36. Lack of association between bullous pemphigoid and autoimmune thyroid disease: A population‐based case‐control study
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Po‐Chien Wu, Chun‐Ying Wu, Ying‐Syuan Lyu, Yun‐Ting Chang, and Chen‐Yi Wu
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Case-Control Studies ,Pemphigoid, Bullous ,Humans ,Dermatology ,Thyroid Diseases ,Autoimmune Diseases - Published
- 2022
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37. Proton-pump inhibitors are associated with an increased risk of asthma: A nationwide nested case-control study.
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Wei-Ting Wang, Cheng-Yuan Li, Yun-Ting Chang, Ya-Mei Bai, Shih-Jen Tsai, Tzeng-Ji Chen, Shih-Hwa Chiou, and Mu-Hong Chen
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ASTHMA ,WHEEZE ,CASE-control method - Abstract
Background: Proton-pump inhibitors (PPI) are among the most widely used drugs worldwide. However, the association between PPI use and the risk of asthma remains unclear. Objective: To investigate the association between PPI use and subsequent asthma risk. Methods: We included participants from the Taiwan National Health Insurance Research Database between 1999 and 2013. Patients who used PPIs and experienced new-onset asthma (n = 20,344) were assigned to the case cohort and matched in a 1:1 ratio with controls who did not subsequently develop asthma. PPI use was defined as > 30 cumulative defined daily doses (cDDD); non-PPI use was defined as ≥ 30 cDDDs. The Charlson Comorbidity Index (CCI) score was used for clinical prognosis and comorbidity adjustment. Multivariate Cox regression models were used for the calculation of adjusted odds ratios (OR). Results: There was a significant and dose-dependent association between PPI use and the risk of developing asthma. The adjusted ORs were 1.24 (95% confidence interval [CI], 1.15-1.33), 1.39 (95% CI, 1.28-1.50), and 1.61 (95% CI, 1.43-1.81) for the male subject with 31-120 cDDDs, 120-365 cDDDs, and >365 cDDDs, respectively, compared with PPI nonusers. Men were at higher risk of developing asthma with longer PPI use compared with women. Stratified analyses based on the PPI type showed that exposure to lansoprazole, pantoprazole, omeprazole, and esomeprazole was associated with subsequent asthma risk. Conclusion: Extended use of PPIs was found to be linked to an increased risk of asthma development. This association remained consistent across different age groups, sexes, demographic factors, indications for PPI use, CCI scores, and other atopic diseases. However, further prospective studies are required to elucidate the causal mechanisms involved. [ABSTRACT FROM AUTHOR] more...
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- 2023
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38. Risk of malignancy in patients with psoriasis receiving systemic medications: A nested case‐control study
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Yu-Ju, Chou, Chun-Ying, Wu, Tzu-Yun, Pan, Chen-Yi, Wu, and Yun-Ting, Chang
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Biological Products ,Methotrexate ,Case-Control Studies ,Neoplasms ,Adalimumab ,Cyclosporine ,Humans ,Psoriasis ,Ustekinumab ,Dermatologic Agents ,Dermatology ,General Medicine ,Etanercept - Abstract
Large-scale, real-world studies on the side effects of systemic therapies (including biologics) in patients with psoriasis are limited. We aimed to calculate the risk of malignancy in patients with psoriasis who were treated with systemic medications. Nested case-control analyses were performed among psoriasis patients without a history of malignancy. We recruited 4188 patients with newly diagnosed psoriasis and successive malignancies, and 8376 matched controls from the National Health Insurance Research Database in Taiwan. The therapy duration was within 5 years before malignancy onset and further stratified into two groups according to the duration of medication usage. Multivariate conditional logistic regression adjusted for potential confounders was used to estimate malignancy risk associated with systemic treatments. Among psoriasis patients, long-term ( 12 months) treatment with cyclosporine increased the risk of malignancy compared with no exposure (odds ratio, 1.57; p = 0.01). Short-term (≤ 12 months) or long-term ( 12 months) use of other systemic treatments, including methotrexate, azathioprine, systemic retinoids, mycophenolate mofetil, sulfasalazine, etanercept, adalimumab, and ustekinumab, was not associated with an increased risk of malignancy in patients with psoriasis. Long-term treatment with cyclosporine increased the risk of malignancy in patients with psoriasis by 1.57-fold. more...
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- 2022
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39. Risk of retinal diseases in patients with psoriasis: A population‐based cohort study in Taiwan
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Mu Hong Chen, Yun Ting Chang, Tzeng Ji Chen, Ying Xiu Dai, Ying Hsuan Tai, and Din Dar Lee
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medicine.medical_specialty ,Taiwan ,Dermatology ,Disease ,Cohort Studies ,chemistry.chemical_compound ,Retinal Diseases ,Risk Factors ,Internal medicine ,Psoriasis ,medicine ,Humans ,Retrospective Studies ,Retinal Vascular Occlusion ,business.industry ,Incidence ,Hazard ratio ,Retinal detachment ,Retinal ,General Medicine ,medicine.disease ,Confidence interval ,chemistry ,business ,Retinopathy - Abstract
Psoriasis has been associated with the risk of several ocular complications; however, its relationship with retinal diseases remains unknown. This study aimed to investigate the risk of developing retinal diseases in patients with psoriasis. Study participants were recruited from the National Health Insurance Research Database in Taiwan. A total of 11 729 psoriasis patients and 117 290 matched controls were included, showing an incidence rate of 121.15 and 28.34 cases of retinal diseases per 100 000 person-years, respectively. Compared with controls, patients with psoriasis had an adjusted hazard ratio (aHR) of 3.40 (95% confidence interval [CI], 2.63-4.39) for retinal diseases after adjustment for potential confounders. Regarding the individual retinal disease, psoriasis patients had a significantly higher risk of developing retinal detachment (aHR, 5.07; 95% CI, 2.92-8.79), retinal vascular occlusion (aHR, 3.75; 95% CI 2.42-5.82), and retinopathy (aHR, 2.84; 95% CI, 1.99-4.05) than controls. In conclusion, patients with psoriasis had a significantly higher risk of retinal diseases than controls. Further studies are necessary to investigate the pathophysiology underlying the relationship between psoriasis and retinal diseases. more...
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- 2021
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40. Long-Term Risk of Autoimmune Diseases other than Systemic Lupus Erythematosus in Cutaneous Lupus Erythematosus-Alone Patients: A 10-Year Nationwide Cohort Study
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Chao Kuei Juan, Yi Ju Chen, Yun Ting Chang, Teng Li Lin, and Chun Ying Wu
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Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,Taiwan ,Dermatology ,Autoimmune Diseases ,Cohort Studies ,Internal medicine ,Lupus Erythematosus, Cutaneous ,Humans ,Medicine ,Cumulative incidence ,Longitudinal Studies ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Incidence ,fungi ,Hazard ratio ,Middle Aged ,Confidence interval ,Long term risk ,Cohort ,Cutaneous Lupus Erythematosus ,Female ,business ,Cohort study - Abstract
Background: Up to 25% of patients with cutaneous lupus erythematosus (CLE) can develop systemic lupus erythematosus (SLE). However, the risk of autoimmune diseases other than SLE in CLE patients who have only skin manifestations (CLE-alone) has rarely been explored. Objective: To investigate the long-term risk and independent factors of non-SLE autoimmune diseases among CLE-alone patients. Method: A nationwide cohort study using the Taiwanese National Health Insurance Research Database 1997–2013. CLE patients and matched subjects were included. Cumulative incidences of autoimmune diseases after 1 year of CLE-alone diagnosis were compared. Cox proportional hazard model was also performed. Results: A total of 971 CLE-alone patients and 5,175 reference subjects were identified. The 10-year cumulative incidence of autoimmune diseases other than SLE was significantly elevated in the CLE-alone cohort (9.00%, 95% confidence interval [CI] 6.72–11.29) than in the reference cohort (4.20%, 95% CI 3.53–4.87%) (p < 0.001). CLE-alone was independently associated with non-SLE autoimmune diseases (adjusted hazard ratio 1.55, 95% CI 1.10–2.18). Among CLE-alone patients, females and those taking long-term systemic corticosteroids (a proxy for extensive disease) were associated with non-SLE autoimmune diseases after adjusting for the number of repeated autoimmune laboratory tests. Conclusion: CLE-alone is independently associated with future non-SLE autoimmune diseases. more...
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- 2021
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41. Single-Port Three-Dimensional (3D) Videoscope-Assisted Endoscopic Nipple-Sparing Mastectomy in the Management of Breast Cancer: Technique, Clinical Outcomes, Medical Cost, Learning Curve, and Patient-Reported Aesthetic Results from 80 Preliminary Procedures
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Hung-Wen Lai, Shou-Tung Chen, Shih-Lung Lin, Dar-Ren Chen, Shou-Jen Kuo, Chi Wei Mok, Yun-Ting Chang, and Ying-Jen Lin
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Nipple-Sparing Mastectomy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Medical record ,CUSUM ,Margin involvement ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Port (medical) ,Breast cancer ,Oncology ,030220 oncology & carcinogenesis ,medicine ,Implant reconstruction ,030211 gastroenterology & hepatology ,business ,Mastectomy - Abstract
The preliminary results of an innovative surgical technique, which incorporated single-port three-dimensional (3D) videoscope and instruments for endoscopic nipple-sparing mastectomy (E-NSM), were reported. The medical records of patients who underwent single-port 3D E-NSM for breast cancer from August 2018 to September 2020 were analyzed, and the preliminary outcome of this procedure as well as the patient-reported aesthetic results are described in this article. The study enrolled 70 patients who received 80 procedures of single-port 3D E-NSM. The mean operation time was 158 ± 36 min, and the mean blood loss was 41 ± 26 ml. Three procedures (3.8 %) associated with delayed axillary wound-healing, eight cases of transient nipple ischemia (10 %), three cases of partial nipple ischemia/necrosis (3.7 %), and one case of total nipple-areolar complex (NAC) necrosis (1.3 %) were observed. No patient had margin involvement. Satisfaction rates of approximately 90 % were observed in terms of postoperative scar appearance, location, and length. Most of the patients (87.8 %) reported that they would choose the same operation again if given the chance to do so. The overall cost of a single-port 3D E-NSM was 7522 ± 470 U.S. dollars. According to cumulative sum (CUSUM) plot analysis, about 14 cases were needed for surgeons to familiarize themselves with single-port 3D E-NSM and immediate gel implant reconstruction and to decrease their operation time significantly in the initial learning phase. Single-port 3D E-NSM, a safe, efficient, lower-cost procedure, is associated with a good aesthetic result. It is a promising new technique for breast cancer patients indicated for mastectomy, but long-term oncologic safety follow-up evaluation still is needed. more...
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- 2021
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42. Posttraumatic Stress Disorder and the Associated Risk of Autoimmune Skin Diseases: A Nationwide Population-Based Cohort Study
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Ying Hsuan Tai, Yun Ting Chang, Mu Hong Chen, Ying Xiu Dai, and Tzeng Ji Chen
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medicine.medical_specialty ,Alopecia Areata ,Taiwan ,Vitiligo ,behavioral disciplines and activities ,Cohort Studies ,Stress Disorders, Post-Traumatic ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Psoriasis ,Internal medicine ,mental disorders ,medicine ,Humans ,Risk factor ,Applied Psychology ,business.industry ,Proportional hazards model ,Incidence ,Confounding ,Hazard ratio ,Alopecia areata ,medicine.disease ,Confidence interval ,030227 psychiatry ,Psychiatry and Mental health ,business ,030217 neurology & neurosurgery - Abstract
Objective Posttraumatic stress disorder (PTSD) is known as a risk factor for various immune-related disorders; however, the association between PTSD and related autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of PTSD with the risk of related ASDs. Methods Participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9801 patients with PTSD and 39,204 matched controls to assess the risk of developing ASDs. Cox regression model was used for analyses. Results After adjusting for confounders, we found an increased risk of ASDs among the patients with PTSD (adjusted hazard ratio [aHR] = 3.00, 95% confidence interval [CI] = 2.21-4.07) compared with that among matched controls. Statistically significant associations were found between PTSD and five individual ASDs, including psoriasis (aHR = 3.81, 95% CI = 1.90-7.67), lichen planus (aHR = 31.63, 95% CI = 4.00-249.91), alopecia areata (aHR = 4.77, 95% CI = 2.47-9.20), autoimmune bullous diseases (aHR = 9.55, 95% CI = 1.98-45.99), and vitiligo (aHR = 16.06, 95% CI = 4.48-57.54). Conclusions Patients with PTSD had an increased risk of developing ASDs compared with the matched controls. Further studies are needed for better understanding of the underlying mechanisms. more...
- Published
- 2021
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43. Efficacy and safety of <scp>PavéDerm J‐Fill</scp> for nasolabial folds: A phase <scp>III</scp> randomized, blinded, prospective, and s <scp>plit‐faced head‐to‐head</scp> trial
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Sheng‐Hsiang Ma, Yu‐Hsun Wei, Ding‐Dar Lee, Yun‐Ting Chang, and Chih‐Chiang Chen
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Dermatology ,General Medicine - Published
- 2022
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44. Association between vitiligo and subsequent risk of dementia: A population‐based cohort study
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Mu Hong Chen, Yun Ting Chang, Tsung Hsien Chang, Ying Hsuan Tai, Ying Xiu Dai, and Tzeng Ji Chen
- Subjects
medicine.medical_specialty ,Taiwan ,Vitiligo ,Comorbidity ,Dermatology ,Disease ,Cohort Studies ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Population based cohort ,0302 clinical medicine ,Risk Factors ,Internal medicine ,mental disorders ,medicine ,Humans ,Dementia ,skin and connective tissue diseases ,Vascular dementia ,Retrospective Studies ,integumentary system ,Proportional hazards model ,business.industry ,Incidence ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,business - Abstract
Increasing evidence suggests a positive association between autoimmune disorders and the subsequent risk of dementia, supporting the idea that neuroinflammation is a major contributor to dementia. However, whether or not adults with vitiligo have an increased risk of dementia remains unclear. We aimed to investigate the association between vitiligo and the subsequent risk of dementia. A total of 1320 patients with vitiligo and 5280 matched controls were identified from the Taiwan National Health Insurance Research Database between 1998 and 2011. Dementia was diagnosed by board-certificated psychiatrists or neurologists in the follow-up period. Cox proportional hazards models were used to estimate the adjusted hazard ratios (aHR) after controlling for age, sex, income-related monthly premium, residence and comorbidities associated with dementia. The incidence rate of dementia (per 100 000 person-years) was 502.8 among patients with vitiligo and 101.9 among the controls. Patients with vitiligo were more likely to develop any type of dementia (aHR, 5.30; 95% confidence interval [CI], 3.30-8.51), Alzheimer's disease (aHR, 12.22; 95% CI, 3.71-40.28) and vascular dementia (aHR, 3.99; 95% CI, 1.31-12.15) compared with the controls. In conclusion, middle-aged and old patients with vitiligo are more likely to develop dementia compared with those without vitiligo. This novel finding reminds physicians to be more careful about signs of dementia when managing patients with vitiligo and provides the basis for further investigations that clarify the underlying mechanisms. more...
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- 2020
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45. Bidirectional association between alopecia areata and sleep disorders: a population-based cohort study in Taiwan
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Chih Chiang Chen, Tzeng Ji Chen, Yun Ting Chang, Mu Hong Chen, Ying Xiu Dai, and Ying Hsuan Tai
- Subjects
Sleep Wake Disorders ,medicine.medical_specialty ,Alopecia Areata ,Taiwan ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Epidemiology ,Insomnia ,Humans ,Medicine ,Retrospective Studies ,Sleep disorder ,business.industry ,Proportional hazards model ,Incidence ,Hazard ratio ,General Medicine ,Alopecia areata ,medicine.disease ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background The relationship between alopecia areata (AA) and sleep disorders remains uncertain. This study aims to investigate the bidirectional association between AA and sleep disorders. Methods To assess the risk of developing sleep disorders, we recruited 5648 patients with AA and 22,592 matched controls from the National Health Insurance Research Database (NHIRD) in Taiwan. Similarly, risk of developing AA was assessed in 93,130 patients with sleep disorders (including 7310 patients with obstructive sleep apnea [OSA] and 85,820 patients with non-apnea insomnia) and 372,520 matched controls. Cox regression model was used for the analysis. Results AA patients had a significantly increased risk of developing OSA (adjusted hazard ratio [aHR] 3.80; 95% confidence interval [CI] 2.53–5.71) and non-apnea insomnia (aHR 4.20; 95% CI 3.68–4.79). Conversely, presence of sleep disorders significantly increased the risk of AA development (aHR 4.70; 95% CI 3.99–5.54). Both OSA (aHR 3.89; 95% CI 2.46–6.16) and nonapnea insomnia (aHR 4.77; 95% CI 4.03–5.64) were associated an increased risk of developing AA. Conclusions Patients with AA have a higher risk of developing sleep disorders compared to controls, and vice versa. Further studies are needed to investigate the shared pathogenic mechanism underlying these two conditions. more...
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- 2020
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46. Cigarette Smoking, Alcohol Consumption, and Risk of Alopecia Areata: A Population-Based Cohort Study in Taiwan
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Ying Hsuan Tai, Fang Yu Yeh, Yun Ting Chang, Ying Xiu Dai, Yiing Jenq Chou, Chen Yi Wu, Chung Pin Li, Yi Jung Shen, and Tzeng Ji Chen
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Adult ,Male ,Adolescent ,Alcohol Drinking ,Alopecia Areata ,Taiwan ,Dermatology ,Risk Assessment ,Cigarette Smoking ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Population based cohort ,0302 clinical medicine ,Cigarette smoking ,Risk Factors ,Humans ,National Health Interview Survey ,Medicine ,Aged ,Proportional Hazards Models ,Smokers ,business.industry ,Incidence ,Confounding ,Hazard ratio ,Non-Smokers ,General Medicine ,Middle Aged ,Protective Factors ,Alopecia areata ,medicine.disease ,Health Surveys ,Confidence interval ,Female ,business ,Alcohol consumption ,Follow-Up Studies ,Demography - Abstract
The effects of cigarette smoking and alcohol consumption on the risk of alopecia areata (AA) are unclear. The aim was to examine the association of cigarette smoking and alcohol consumption with AA. We collected participants from four rounds (2001, 2005, 2009, and 2013) of the Taiwan National Health Interview Survey. Incident AA cases were identified from the National Health Insurance database. Of the 60,055 participants, 154 developed AA during the 647,902 person-years of follow-up. After controlling for confounders, current smokers had a higher risk of incident AA than never smokers [adjusted hazard ratio (aHR) 1.88; 95% confidence interval (CI) 1.22–2.88]. There was a trend toward an increased risk of AA with increasing numbers of years of smoking and cumulative pack-years of smoking among current smokers. The aHRs (95% CIs) of current smokers of > 5 and ≤ 15 cigarettes per day, > 10 and ≤ 20 years of smoking, ≤ 10, and > 10 and ≤ 20 pack-years of smoking were 2.03 (1.17–3.51), 2.25 (1.21–4.18), 1.86 (1.12–3.09), and 2.04 (1.04–4.01), respectively. Conversely, social and regular drinkers had significantly lower risks of AA than never drinkers [aHRs (95% CIs) 0.65 (0.43–0.98) and 0.49 (0.26–0.93), respectively]. Current smokers had an increased risk of developing AA, while alcohol consumption was associated with a decreased risk of AA. more...
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- 2020
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47. Bidirectional association between alopecia areata and thyroid diseases: a nationwide population-based cohort study
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Ying Hsuan Tai, Tzeng Ji Chen, Ying Xiu Dai, Yun Ting Chang, and Mu Hong Chen
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endocrine system ,medicine.medical_specialty ,Goiter ,endocrine system diseases ,business.industry ,Thyroid disease ,Incidence (epidemiology) ,Thyroid ,Toxic nodular goiter ,Dermatology ,General Medicine ,Disease ,Alopecia areata ,medicine.disease ,Gastroenterology ,Thyroiditis ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,business - Abstract
Alopecia areata (AA) has long been associated with thyroid diseases; however, the temporality of their association remains unclear. This study aimed to investigate the bidirectional association between AA and thyroid diseases. In analysis 1, we included 5929 AA patients and 59,290 matched controls to assess the risk of thyroid diseases. In analysis 2, we included 35,071 patients with thyrotoxicosis, 19,227 patients with Graves' disease, 5460 patients with thyroiditis, 3352 patients with Hashimoto's thyroiditis, and their matched controls (1:10) to assess the risk of AA. Incidence of thyroid diseases and AA were the outcomes in analysis 1 and analysis 2, respectively. After adjusting the potential confounders, AA patients had an increased risk of all thyroid diseases, including toxic nodular goiter, (aHR 10.17; 95% confidence interval [CI] 5.32-19.44), nontoxic nodular goiter (aHR 5.23; 95% CI 3.76-7.28), thyrotoxicosis (aHR 7.96; 95% CI 6.01-10.54), Graves' disease (aHR 8.36; 95% CI 5.66-12.35), thyroiditis (aHR 4.04; 95% CI 2.12-7.73), and Hashimoto thyroiditis (aHR 4.35; 95% CI 1.88-10.04). On the contrary, a significantly increased risk of developing AA was observed among patients with thyrotoxicosis (aHR 9.29; 95% CI, 7.11-12.14), Graves' disease (aHR 8.66; 95% CI 6.03-12.42), and thyroiditis (aHR 6.42; 95% CI 3.15-13.11) but not in patients with Hashimoto's thyroiditis. In conclusion, our study found a bidirectional association between AA and thyroid diseases, suggesting shared biological mechanisms underlying these two diseases. more...
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- 2020
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48. Use of proton pump inhibitors and risk of rosacea: A nationwide population‐based study
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Ying Xiu Dai, Ying Hsuan Tai, Chih Chiang Chen, Tzeng Ji Chen, Mu Hong Chen, and Yun Ting Chang
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Male ,medicine.medical_specialty ,Peptic ,Taiwan ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,Odds Ratio ,medicine ,Humans ,business.industry ,Confounding ,Case-control study ,Proton Pump Inhibitors ,General Medicine ,Odds ratio ,medicine.disease ,Confidence interval ,Defined daily dose ,Rosacea ,Case-Control Studies ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Proton pump inhibitors (PPI) are commonly used drugs. However, little is known about the association between PPI use and rosacea. This study aimed to investigate the association between PPI use and rosacea risk. Patients with prior PPI therapy, including 1067 rosacea cases and 4268 matched controls, were identified from the National Health Insurance Research Database in Taiwan. The cumulative defined daily dose (cDDD) was used to quantify the PPI use. Logistic regression was used for the analyses. After adjustment for potential confounders, PPI use with cDDD of more than 365 was significantly associated with an increased risk of rosacea (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.10-2.15). Rosacea risk was significantly associated with PPI use of cDDD of more than 365 in women (OR, 1.62; 95% CI, 1.08-2.46) but not in men. Stratified by PPI indications, risk of rosacea was significantly associated with PPI use of cDDD of more than 365 for peptic ulcer (OR, 1.58; 95% CI, 1.12-2.21). In conclusion, prolonged PPI use was associated with an increased risk of rosacea, particularly in women and patients with peptic ulcers. more...
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- 2020
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49. Bidirectional association between alopecia areata and major depressive disorder among probands and unaffected siblings: A nationwide population-based study
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Ying Hsuan Tai, Mu Hong Chen, Tzeng Ji Chen, Yun Ting Chang, Chih Chiang Chen, and Ying Xiu Dai
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Adult ,Male ,Proband ,medicine.medical_specialty ,Alopecia Areata ,Taiwan ,Comorbidity ,Dermatology ,Risk Assessment ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Reference Values ,Internal medicine ,Epidemiology ,Humans ,Medicine ,Genetic Predisposition to Disease ,Sex Distribution ,Retrospective Studies ,Depressive Disorder, Major ,business.industry ,Incidence ,Siblings ,Middle Aged ,Alopecia areata ,Prognosis ,medicine.disease ,Confidence interval ,Cross-Sectional Studies ,Case-Control Studies ,030220 oncology & carcinogenesis ,Relative risk ,Major depressive disorder ,Female ,business ,Body mass index ,Cohort study - Abstract
Background Alopecia areata (AA) has long been associated with major depressive disorder (MDD). However, most evidence to date has derived from cross-sectional or case-control studies. Objective To investigate the bidirectional association between AA and MDD among probands and unaffected siblings. Methods Study participants were recruited from the National Health Insurance Research Database in Taiwan. We included 2123 probands with AA, 2298 unaffected siblings, and 9192 matched controls to assess the risk of MDD. We included 16,543 probands with MDD, 17,352 unaffected siblings, and 69,408 matched controls to assess the risk of AA. The Breslow-Cox model was used to calculate the adjusted relative risk. Results Compared with controls, AA probands and unaffected siblings had adjusted relative risks of 8.22 (95% confidence interval [CI], 6.41-10.54) and 2.55 (95% CI, 1.91-3.40), respectively, for MDD. MDD probands and unaffected siblings had adjusted relative risks for AA of 1.66 (95% CI, 1.24-2.22) and 1.64 (95% CI, 1.27-2.12), respectively. Limitation The National Health Insurance Research Database lacked information on disease severity, body mass index, smoking habit, alcohol consumption, and stressful life events. Conclusion Our study demonstrated a bidirectional association between AA and MDD among probands and unaffected siblings, thus suggesting shared familial mechanisms underlying AA and MDD. more...
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- 2020
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50. Psoriasis is not a risk factor for dementia: a 12-year nationwide population-based cohort study
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Hsiao Yun Hu, Yun Ting Chang, Yiing Jenq Chou, Chen Yi Wu, and Chung Pin Li
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Adult ,Male ,medicine.medical_specialty ,Population ,Taiwan ,Dermatology ,Risk Assessment ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Psoriasis ,mental disorders ,medicine ,Humans ,Dementia ,Risk factor ,Vascular dementia ,education ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,Case-Control Studies ,030220 oncology & carcinogenesis ,Cohort ,Female ,business ,Cohort study - Abstract
Studies investigating the risk for dementia in psoriatic patients remain inconclusive. There are a limited number of population-based studies on the association between psoriasis and dementia. This study aims to investigate the risk for dementia in psoriatic patients. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Research Database between 2000 and 2012. A total of 111,825 patients with psoriasis and 111,825 age-, sex-, and index date-matched controls were recruited. The hazard ratio (HR) for subsequent dementia in patients with psoriasis was analyzed using a Cox model and a Fine-Gray competing risk model. During 1,358,774 person-years of follow-up, 2688 patients developed dementia in the psoriatic cohort, and 2062 developed dementia in the control cohort. In the multivariate adjusted Cox model, the hazard ratio (HR) of psoriatic patients for dementia was 1.02 [95% confidence interval (CI) 0.96-1.09] relative to the controls. Psoriasis did not increase the risk for dementia (both vascular dementia and degenerative dementia). In the competing risk model, the HR of dementia was 0.96 (95% CI 0.90-1.02) for psoriatic patients. Compared to psoriatic patients who had not received phototherapy or systemic treatment, those psoriatic patients receiving phototherapy or systemic treatment had a lower risk for dementia. However, this phenomenon was not observed in psoriatic patients who were observed for longer than 6 years. Psoriasis was not found to be a risk factor for dementia. Phototherapy and systemic treatment might not have a protective effect against dementia in psoriatic patients. more...
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- 2020
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