Case-Control Cohort Study of Patients' Perceptions of Disability in Mastocytosis

BACKGROUND: Indolent forms of mastocytosis account for more than 90% of all cases, but the types and type and severity of symptoms and their impact on the quality of life have not been well studied. We therefore performed a case-control cohort study to examine self-reported disability and impact of symptoms on the quality of life in patients with mastocytosis. METHODOLOGY/PRINCIPAL FINDINGS: In 2004, 363 mastocytosis patients and 90 controls in France were asked to rate to their overall disability (OPA score) and the severity of 38 individual symptoms. The latter was used to calculate a composite score (AFIRMM score). Of the 363 respondents, 262 were part of an ongoing pathophysiological study so that the following data were available: World Health Organization classification, standard measures of physical and psychological disability, existence of the D816V KIT mutation, and serum tryptase level. The mean OPA and AFIRMM scores and the standard measures of disability indicated that most mastocytosis patients suffer from disabilities due to the disease. Surprisingly, the patient's measurable and perceived disabilities did not differ according to disease classification or presence or absence of the D816V KIT mutation or an elevated (> or = 20 ng/mL) serum tryptase level. Also, 32 of the 38 AFIRMM symptoms were more common in patients than controls, but there were not substantial differences according to disease classification, presence of the D816V mutation, or the serum tryptase level. CONCLUSIONS: On the basis of these results and for the purposes of treatment, we propose that mastocytosis be first classified as aggressive or indolent and that indolent mastocytosis then be categorized according to the severity of patients' perceived symptoms and their impact on the quality of life. In addition, it appears that mastocytosis patients suffer from more symptoms and greater disability than previously thought, that mastocytosis may therefore be under-diagnosed, and that the symptoms of the indolent forms of mastocytosis might be due more to systemic release of mediators than mast cell burden

Differential Effects of Makeup on Perceived Age

Makeup accentuates three youth‐related visual features – skin homogeneity, facial contrast, and facial feature size. By manipulating these visual features, makeup should make faces appear younger. We tested this hypothesis in an experiment in which participants estimated the age of carefully controlled photographs of faces with and without makeup. We found that 40‐ and especially 50‐year‐old women did appear significantly younger when wearing makeup. Contrary to our hypothesis, 30‐year‐old women looked no different in age with or without makeup, while 20‐year‐old women looked older with makeup. Two further studies replicated these results, finding that makeup made middle‐aged women look younger, but made young women look older. Seeking to better understand why makeup makes young women look older, we ran a final study and found evidence that people associate makeup use with adulthood. By activating associations with adulthood, makeup may provide an upward bias on age estimations of women who are not clearly adult. We propose that makeup affects social perceptions through bottom‐up routes, by modifying visual cues such as facial contrast, facial feature size, and skin homogeneity, and also through top‐down routes, by activating social representations and norms associated with makeup use

Facial Contrast Is a Cross-Cultural Cue for Perceiving Age

International audienceAge is a fundamental social dimension and a youthful appearance is of importance for many individuals, perhaps because it is a relevant predictor of aspects of health, facial attractiveness and general well-being. We recently showed that facial contrast—the color and luminance difference between facial features and the surrounding skin—is age-related and a cue to age perception of Caucasian women. Specifically, aspects of facial contrast decrease with age in Caucasian women, and Caucasian female faces with higher contrast look younger (Porcheron et al., 2013). Here we investigated faces of other ethnic groups and raters of other cultures to see whether facial contrast is a cross-cultural youth-related attribute. Using large sets of full face color photographs of Chinese, Latin American and black South African women aged 20–80, we measured the luminance and color contrast between the facial features (the eyes, the lips, and the brows) and the surrounding skin. Most aspects of facial contrast that were previously found to decrease with age in Caucasian women were also found to decrease with age in the other ethnic groups. Though the overall pattern of changes with age was common to all women, there were also some differences between the groups. In a separate study, individual faces of the 4 ethnic groups were perceived younger by French and Chinese participants when the aspects of facial contrast that vary with age in the majority of faces were artificially increased, but older when they were artificially decreased. Altogether these findings indicate that facial contrast is a cross-cultural cue to youthfulness. Because cosmetics were shown to enhance facial contrast, this work provides some support for the notion that a universal function of cosmetics is to make female faces look younger

Primer positions are indicated from the c-Kit sequence published through the NCBI accession number X06182.

<p>Primer positions are indicated from the c-Kit sequence published through the NCBI accession number X06182.</p

Description of 5 adult patients with mastocytosis not related to 816 c-kit mutation.

<p>Description of 5 adult patients with mastocytosis not related to 816 c-kit mutation.</p

Relationship between phenotype and genotype in patients with mastocytosis according to their age of onset.

<p>Data are expressed in number (percentage).</p