42 research outputs found
Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners
Hidradenitis suppurativa (HS) is a chronic skin disease that profoundly affects patients’
quality of life (QoL) and sexuality. Few data are available on the impact of HS on patients’ partners.
We aimed to explore the QoL and sexual function of patients’ partners and the factors associated
with their impairment and to compare the QoL and sexual function of single patients and those in
a stable relationship. We conducted a cross-sectional study at Hospital Universitario Virgen de las
Nieves (Granada, Spain) and at theWroclaw Medical University (Wroclaw, Poland). Patients over the
age of 16 years attending their scheduled follow-up and their partners, if any, were included. The
Dermatology Life Quality Index (DLQI) and the Family Dermatology Life Quality Index (FDLQI) were
used to estimate the QoL of patients and partners, respectively. The FSFI-6 was used to determine
sexual dysfunction in women and the IIEF-5 for erectile dysfunction in men. Thirty-four single
patients and twenty-eight patients in a stable relationship and their partners were included. Patients
had a very large impact (DLQI 12.5 7.5) and their partners a moderate impact (FDLQI 10.3 7.1)
in their QoL due to HS. Women with HS had a high prevalence of sexual dysfunction (13/32, 40.6%)
and men of erectile dysfunction (19/30, 63.3%). Male partners also had a high prevalence of erectile
dysfunction (10/17, 58.8%), while only one female partner had sexual dysfunction (1/11, 9.1%).
Factors related to disease severity, intensity of symptoms and body mass index were associated
with poorer QoL in partners and time of disease evolution with greater erectile dysfunction in male
partners. In conclusion, HS not only profoundly affects the QoL and sexuality of patients but also of
their partners. Several risk factors have been identified, which should be taken into account in the
holistic approach of the disease
Dermatology Care in Spanish Public Hospitals: A Mapping Study of Health Care Resources and Medical and Surgical Activity in Dermatology Departments in 2019
Antecedentes y objetivo: No existen datos actualizados sobre los recursos asistenciales ni la
actividad médico-quirúrgica de los servicios de dermatología espa˜noles. El objetivo de esta
investigación es conocer la situación y actividad de dichos servicios durante el a˜no 2019.
Material y métodos: Estudio transversal mediante cuestionario online distribuido a los jefes de
servicio de dermatología de hospitales públicos espa˜noles.
Resultados: De los 162 jefes de servicio encuestados, se obtuvo una participación del 36,4%
(59/162). Se observó un déficit de personal generalizado, especialmente de dermatólogos en
hospitales de complejidad media-baja. La principal causa del déficit de dermatólogos fue la
ausencia de profesionales interesados. Las infraestructuras y equipamiento disponibles fueron
superiores en los grandes complejos hospitalarios. La atención mixta presencial-telemática
estuvo presente en más de la mitad de los centros. En el ámbito de las consultas monográficas,
la de psoriasis fue la más implementada. Aproximadamente el 75% de los centros contaron con
quirófanos con anestesista. Procedimientos quirúrgicos de mayor complejidad como la biopsia
selectiva de ganglio centinela o la cirugía de Mohs se realizaban con mayor frecuencia en los
grandes complejos hospitalarios. La hospitalización de pacientes y la presencia de dermatólogos
residentes de guardia fueron igualmente más habituales en estos hospitales. La actividad
docente e investigadora también se relacionó con la complejidad del hospital. Conclusiones: Nuestros resultados describen la situación de los servicios de dermatologíaespa˜noles justo antes de la pandemia por COVID-19, y pueden ser útiles para la gestión clínicay para definir líneas de trabajo y áreas de mejora.Background and objective: No recent data on health care resources and medical and surgical activity in Spanish dermatology departments are available in the literature. The aim of this study was to compile this information for 2019.
Material and methods: Cross-sectional study based on an online survey sent to the heads of dermatology departments at public hospitals in Spain.
Results: Of the 162 department heads contacted, 59 answered the survey (participation rate, 36.4%). General findings included a shortage of staff, especially dermatologists, in hospitals of low and medium complexity. The main reason given for the shortage of dermatologists was a lack of interested applicants. Large hospital complexes had more infrastructure and equipment. Over 50% of the departments surveyed used a combination of in-person and virtual visits. Psoriasis units were the most common specialized care units. Approximately 75% of the hospitals had operating rooms with an anesthetist. More complex procedures such as sentinel lymph node biopsy and Mohs micrographic surgery were performed more often in large hospital complexes. Hospitalization and the presence of dermatology residents working call shifts were also more common in these hospitals. Teaching and research activity differed according to hospital complexity.
Conclusions: We have mapped health care resource availability and medical and surgical activity in Spanish dermatology departments prior to the COVID-19 pandemic. Our findings could be useful for improving clinical management and defining future actions and areas for improvement
Pyogenic Granuloma in an Atypical Location Following Isotretinoin Treatment
Interesting Medical Imag
Impact of the COVID-19 Pandemic on the Diagnosis and Prognosis of Melanoma
Background: Early detection of melanoma is one of the main diagnostic goals of dermatologists
worldwide, due to the increasing incidence of the disease in our environment. However, the
irruption of the SARS-CoV-2 pandemic has posed a challenge to global healthcare, forcing systems
to focus their resources on the fight against COVID-19. Methods: Retrospective cohort study. The
exposed cohort were patients diagnosed with melanoma in the year after the general confinement
in Spain (15 March 2020) and the unexposed cohort were patients with melanoma diagnosed in
the previous year. Results: 130 patients were included. No differences were observed between
demographic characteristics in both cohorts. The mean Breslow of melanoma before the onset of the
pandemic was 1.08, increasing to 2.65 in the year after the onset of the pandemic (p < 0.001). On the
other hand, the percentage of melanomas in situ decreased from 38.96% to 16.98% in the year after
the declaration of the state of alarm in Spain. Conclusions: The SARS-CoV-2 outbreak has led to a
reduction in the early diagnosis of melanoma, with an increase in invasive melanomas with poor
prognosis histological factors. This could lead to an increase in melanoma-related mortality in the
coming years in our environment
The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis
Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin
disease of the hair follicle that usually presents as painful, deep-seated inflamed lesions in the apocrine
gland-bearing areas of the body. HS patients suffer from uncomfortable signs and symptoms, such as
pain, pruritus, malodour and suppuration, which may impair patients’ quality of life (QoL). Although
HS patients frequently experience these signs and symptoms, they are only occasionally assessed
by clinicians and, unexpectedly, the scientific evidence available is limited and heterogeneous. The
aim of this study is to summarize the evidence regarding the impact of HS signs and symptoms
on QoL to serve as a basis for future research and help clinicians to consider them in the daily
care of HS patients. A systematic review and meta-analysis were conducted following PRISMA
Guidelines. The following search algorithm was used: (hidradenitis or “acne inversa”) and (pain
or itch or odour or malodour or suppuration or oozing or drainage) and (“quality of life”). The
literature search identified 836 references, 17 of them met the eligible criteria and were included
for analysis, representing 4929 HS patients. Mean age of the participants was 36.28 years and there
was a predominance of female sex among study participants. The BMI of the population was in
the range of over-weight and about two out five patients were active smokers. Studies included
patients with mild to moderate HS, with a mean disease duration of 13.69 years. The HS signs and
symptoms assessed were pain, pruritus, malodour and suppuration. Overall, the higher intensity
of a sign or symptom correlated with poorer general QoL or specific QoL dimensions including
sexual distress, anxiety, depression and sleep. The most frequently employed tool to assess QoL was
the Dermatology Life Quality Index (DLQI). DLQI was used in 52.9% of the studies (9/17) with a
mean value of 10.70 (2.16 SD). The scores employed to assess signs and symptoms severity were
subjective and varied between studies, being the numerical rating scale (NRS) for each of the most
used symptoms. The mean NRS value for pain was 3.99 and the mean NRS for pruritus was 4.99. In
conclusion, we have summarized, categorized and analyzed the scientific evidence regarding signs
and symptoms in HS patients and their impairment in QoL. Their assessment should be thorough
and included during routine evaluation of HS patients to motivate therapeutic modifications and
increase patients’ health
Inflammatory Reactions to Red Tattoo Inks: Three cases highlighting an emerging problem
In recent years, tattoos have become more commonplace. However, this can result in various inflammatory processes, the management of which can be challenging in daily clinical practice. Tattoo-related inflammatory reactions can comprise different patterns, including acute and immediate reactions, foreign body granulomas, sarcoid granulomas, isomorphic lesions, allergic contact dermatitis and photosensitivity. We report three cases who were referred to the Dermatology Outpatient Clinic of the Hospital Universitario San Cecilio, Granada, Spain, in 2017 with various skin reactions in the red-ink areas of their tattoos. Screening was performed for infectious diseases like atypical mycobacterial infections and systemic processes such as sarcoidosis. A good therapeutic response was achieved in all cases. An adequate differential diagnosis is essential for the therapeutic management of this emerging health problem.
Keywords: Non-Therapeutic Body Modification; Tattooing, adverse effects; Inks; Foreign Body Reaction; Inflammation; Case Report; Spain
Epidermal Barrier Function and Skin Homeostasis in Atopic Dermatitis: The Impact of Age
We would like to thank all the individuals who generously shared their time
to participate in this research. The results of this study are part of the PhD work of Trinidad
Montero-Vilchez.Skin is damaged in atopic dermatitis (AD) patients. Age is also believed to have a negative effect on epidermal barrier function. The aim of this study was to investigate skin barrier function changes with age in AD patients. A cross-sectional study was conducted including 162 participants, 81 AD patients and 81 healthy volunteers. Skin barrier function parameters, such as transepidermal water loss (TEWL), erythema, temperature, stratum corneum hydration (SCH), pH, and elasticity, were evaluated. Healthy volunteers were evaluated on the volar forearm. AD patients were measured on two regions: on an eczematous lesion on the volar forearm and on a non-involved area 5 cm from the affected area. TEWL was lower on healthy skin than uninvolved AD skin (9.98 vs. 25.51 g center dot m(-2)center dot h(-1), p < 0.001) and AD eczematous lesions (9.98 vs. 28.38 g center dot m(-2)center dot h(-1), p < 0.001). SCH was lower on AD eczematous lesions than uninvolved AD skin (24.23 vs. 39.36 AU, p < 0.001) and healthy skin (24.23 vs. 44.36 AU, p < 0.001). Elasticity was lower on AD eczematous lesions than uninvolved AD skin (0.69 vs. 0.74, p = 0.038) and healthy skin (0.69 vs. 0.77, p = 0.014). A negative correlation was found between age and elasticity in all the population (r = -0.383, p < 0.001). This correlation was stronger in AD patients (r = -0.494, p < 0.001) than in controls (r = -0.266, p = 0.092). After conducting a linear regression model in AD patients adjusted by age, sex, and SCORing Atopic Dermatitis (SCORAD), it was found that elasticity was impaired by an increasing age (beta = -0.004, p < 0.001) and a higher SCORAD (beta = -0.003, p < 0.001). The skin barrier function is impaired by age and AD, reflected mainly in poor elasticity values in older AD patients
Sexuality in hidradenitis suppurativa: dysfunction, distress & beliefs
Sexuality is an unmet need in patients with HS. The presence of profound impairment to sexual
function and high levels of distress in relation to various clinical-epidemiological features is
frequent. The disease limits personal relationships, both in patients with a partner and in single
patients. Patients often feel the need to share their sexual problems with healthcare
professionals. Dermatologists are the key staff to address this problem, as they are the main
specialists in the care of these patients.Tesis Univ. Granada
Sexuality in Patients with Hidradenitis Suppurativa: Beliefs, Behaviors and Needs.
Little is known about the impact of hidradenitis suppurativa (HS) on patients' sexuality. The aim of this research is to investigate the impact of HS on several previously unexplored aspects of sexuality. In March 2018, we conducted a crowd-sourced cross-sectional online survey hosted by the Spanish association of patients with HS (ASENDHI) and available in Spanish. A panel of experts and patients from ASENDHI designed various questions in order to explore the extent to which HS influenced participants' sex lives. The final sample consisted of 386 participants, 79.27% (306/386) of which were women and 20.73% (80/306) of which were men. Seventy-seven point one percent (236/306) of women and 67.5% (54/80) of men were in stable relationships; the rest of the participants were single. Forty-seven point nine percent (185/386) admitted to feeling fear of rejection. Pain was the symptom that most interfered with sexual relations in women and suppuration in men. Forty-four point three percent (171/386) of the participants considered themselves to be less attractive than average. Considering the participants in a stable relationship, women described receiving more emotional support from their partners, while men received more help with lesion dressing in intimate areas. Seventy-one point four percent (207/290) of participants stated that HS negatively affected their relationship. Among single patients, women experienced greater fear of rejection and were less willing to meet new people because of HS. Ninety-four point three percent (66/70) of women and 80.8% (21/26) of men stated that HS had a negative influence on their chances of having a relationship or sexual relations. In conclusion, HS has a significant, unrecognized and misunderstood impact on sexuality which must be addressed