17 research outputs found
The Impact of Sleep Quality on Mood Status and Quality of Life in Patients with Alopecia Areata: A Comparative Study
Alopecia Areata (AA) is a chronic condition which has been associated with poor quality
of life and mood status disturbances. The aim of this study is to compare the sleep quality between
AA patients and controls, and to analyze the impact of poor sleep quality on patients with AA
regarding mood status disturbances, quality of life and sexuality. A cross-sectional study including
patients suffering from mild-to-severe AA and sex- and age-matched healthy controls was performed.
Socio-demographic and clinical variables, sleep quality, quality of life, sexual disfunction, anxiety,
depression and personality were collected using validated questionnaires. A total of 120 participants
(60 patients and 60 controls) were included. Patients with AA showed worse sleep scores than
controls (p = 0.003), as well as higher rates of anxiety and depression (p < 0.05). After a multivariate
analysis, a worse sleep quality was found to be linked to anxiety, depression, a poorer quality of life
and a type D personality score independently of the disease severity. In light of the results, patients
with AA have a worse sleep quality than healthy controls. A poor sleep quality is associated with
anxiety, depression and a worse quality of life, therefore being a general marker of a poor quality of
life. Screening for sleep disturbances in specialized units could be useful to detect patients who could
benefit from additional psychological support
Quality of Life and Mood Status Disturbances in Cohabitants of Patients with Alopecia Areata: A Cross-Sectional Study in a Spanish Population
A poor quality of life has been described in patients suffering from Alopecia Areata (AA).
However, there is little evidence on how AA can impact on those living with patients. The aim of
this study is to analyze the impact of AA on a cohabitantâs quality-of-life, mood status disturbances
and sexual satisfaction. This is a cross-sectional study of AA patients and their cohabitants. Sociodemographic
variables and disease severity, the quality of life, mood status disturbances and sexual
dysfunction were collected using validated questionnaires. Eighty-four subjects were included in
the study: 42 AA patients and 42 cohabitants. A poor quality of life and worse disease control in
the patients were associated with a poorer quality of life of the family, higher scores of anxiety and
depression, and the lower sexual satisfaction of cohabitants (p < 0.05). Anxiety and depression in
patients were associated with worse family quality of life, higher rates of anxiety and less sexual
satisfaction in cohabitants (p < 0.05). To conclude, AA seems to have an impact on the quality of life
of cohabitants, leading to increased rates of anxiety, depression, a poorer quality of life, and reduced
sexual satisfaction. In light of the results, a global approach for AA patients, including the care of the
people who live with them, should be implemented
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
Impact of Water Exposure and Temperature Changes on Skin Barrier Function
We would like to thank all the individuals who generously shared their time to
participate in this research and Charlotte Bower for the English correction of this manuscript.The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest (R) (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g center dot h(-1)center dot m(-2)), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g center dot h(-1)center dot m(-2)) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g center dot h(-1)center dot m(-2)) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 degrees C) of the TempTest. No significant differences were found after contact with the cold region (4 degrees C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands
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 patientsâ 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 âacne inversaâ) and (pain
or itch or odour or malodour or suppuration or oozing or drainage) and (âquality of lifeâ). 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 patientsâ health
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
Factors Influencing Major Life-Changing Decisions in Patients with Psoriasis: A Cross-sectional Study
Psoriasis is a chronic inflammatory disease associated with significant impairment in quality of life. Although quality of life in patients with psoriasis has been widely studied, there is little evidence regarding the impact of psoriasis on major life-changing decisions (MLCD). The aims of this study are to describe the impact of psoriasis on MLCD and to explore the potential clinical factors associated with MLCD. This cross-sectional study included 113 patients with psoriasis, regardless of disease severity, duration, or current treatment. The impact of the disease on different MLCD, including those related to professional career, decision of having children, choice of clothing, and leisure activities, was explored using Likert scales. Mean age was 51 years old and female to male ratio was 1.08 (54/50). The mean Psoriasis Area Severity Index was 3.75, and 30% (35/113) of the patients had psoriatic arthropathy. The most affected MLCD were career choice (median (interquartile range) score 3 (2â4)), social relationships (2 (1â3)), choice of clothing (2 (1â3)), job performance, absenteeism, and choice of holiday destination (1 (0â2)). Female sex, early age of onset and psoriatic arthropathy were associated with a greater impact of the disease on MLCD (pâ<â0.05). The results showed that a range of MLCD are affected in patients with psoriasis, such as career choice, job performance, absenteeism, or choice of clothing. Female sex, psoriatic arthritis and early age of onset are factors associated with a greater impact on MLCD. In order to limit the long-term negative effects of psoriasis on patients, special attention should be paid to detection of psoriatic arthritis, and to patients with early disease onset
Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas: a Systematic Review and Meta-analysis
Since December 2019, the COVID-19 pandemic has
profoundly affected healthcare. The real effects of the
COVID-19 pandemic on skin cancer are still unclear,
more than 3 years later. This study aims to summarise
the pandemicâs impact on skin cancer diagnosis and
outcome. A systematic review and meta-analysis was
conducted, selecting studies comparing skin cancer
diagnosis
and prognosis post-pandemic with pre-pandemic
data. A total of 27 papers were reviewed including
102,263 melanomas and 271,483 keratinocyte
carcinomas. During the initial pandemic months (Januaryâ
July 2020), melanoma surgeries dropped by 29.7%
and keratinocyte carcinomas surgeries by 50.8%. Early
pandemic tumours exhibited greater thickness and
stage. In a long-term period beyond the initial months,
melanoma surgeries decreased by 9.3%, keratinocyte
carcinomas by 16.6%. No significant differences were
observed in the Breslow thickness of melanomas after
the start of the pandemic (mean difference 0.06, 95%
confidence interval â0.46, 0.58). Melanomas operated on
post-pandemic onset had an increased risk of ulceration
(odds ratio 1.35, 95% confidence interval 1.22â1.50).
Keratinocyte carcinomas showed increased thickness
and worsened stage post-pandemic. However,
studies
included were mostly retrospective and cross-sectional,
reporting diverse data. This review indicates that the
pandemic likely caused delays in skin cancer diagnosis
and treatment, potentially impacting patient outcomes
Intralesional Treatments in Hidradenitis Suppurativa: A Systematic Review.
Hidradenitis suppurativa (HS) is an inflammatory chronic disease with difficult management. In some scenarios, intralesional (IL) treatments could be useful. However, the scientific evidence available is limited and heterogeneous. We aimed to synthesize the available scientific evidence on IL treatments in HS. We conducted a systematic review in July 2021. The clinical databases reviewed included MEDLINE and Embase. All types of epidemiological studies and case series with at least 10 patients were included; reviews, guidelines, protocols, conference abstracts, case series with less than 10 patients, and case reports were excluded. Fifteen articles representing 599 patients and 1,032 lesions were included for review. Corticosteroid injections were the most reported treatment. They showed effectiveness for the treatment of acute inflammatory lesions and fistulas in terms of reduction of lesion counts, symptoms, and signs of inflammation and were safe in general terms. Light-based therapies were the other main treatment group, including photodynamic therapy and 1,064-nm diode laser. They were also effective, but more local and systemic adverse events were reported. Other treatments included botulinum toxin type B and punch-trocar-assisted cryoinsufflation (cryopunch). They were effective and safe, although were reported anecdotally. The main limitation of the systematic review was the general quality of the articles included. In conclusion, IL treatments such as corticosteroid injections and light-based therapies seem to be effective and safe for both acute inflammatory lesions and fistulas, although more prospective studies, with higher sample sizes and with standardized outcomes are needed to provide more scientific evidence on the subject
Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas: a Systematic Review and Meta-analysis
Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to summarise the pandemicâs impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (JanuaryâJuly 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval â0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22â1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes