Associative factors for atopic dermatitis and other atopic diseases in middle-aged adults : A population-based birth cohort study among 5373 subjects

Background and aimsThe study aimed to examine parental, longitudinal and current associative factors for atopic dermatitis (AD) and to compare those to other atopic diseases in 46-year-old adults. MethodsQuestionnaire data from the Northern Finland Birth Cohort 1966 study were used. To analyze allergic sensitization, skin prick tests (n = 5373) were performed for birch, timothy, cat, and house dust mite at age 46. ResultsMaternal (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.25-2.59) and paternal allergy (OR 2.54; CI 1.76-3.64), sensitization to any of the four tested aeroallergens (OR 1.56; CI 1.04-2.30) as well as polysensitization (OR 3.04; CI 2.10-4.37) were associated with current AD. Living on a farm in infancy was negatively associated with allergic rhinitis, allergic conjunctivitis, and atopic multimorbidity. Current AD (OR 2.65; CI 1.44-4.60) and all atopic diseases associated with indoor air related symptoms. Current AD associated with other atopic diseases, most strongly with allergic rhinitis (OR 4.92; CI 3.92-6.22). ConclusionCurrent AD in a 46-year-old general population occurred frequently with allergic rhinitis, allergic conjunctivitis, and asthma in the Northern Finland Birth Cohort study 1966. Parental allergy and sensitization to common aeroallergens were found as shared associative factors for AD, allergic rhinitis, allergic conjunctivitis, and asthma. AD and other atopic diseases associated with symptoms related to poor indoor air quality. In daily practice, it is important to take these comorbidities into consideration when treating patients with AD.Peer reviewe

Gestational Pemphigoid: Placental Morphology and Function

Peer reviewe

Cyclosporine Treatment in Severe Gestational Pemphigoid

Gestational pemphigoid, a rare autoimmune skin disease typically occurring during pregnancy, is caused by autoantibodies against collagen XVII. Clinically it is characterised by severe itching followed by erythematous and bullous lesions of the skin. Topical or oral glucocorticoids usually relieve symptoms, but in more severe cases systemic immunosuppressive treatments are needed. Data on immunosuppressive medication controlling gestational pemphigoid are sparse. We report 3 intractable cases of gestational pemphigoid treated with cyclosporine.Peer reviewe

A Childhood Farm Environment Protects from Allergic Sensitization until Middle Age but Not from New-Onset Sensitization in Adulthood : A 15 Year Longitudinal Study

Data are insufficient on the protective effect of a farm environment in childhood regarding sensitization in middle age and new-onset sensitization in adulthood. A skin prick test (SPT) and questionnaire data from the Northern Finland Birth Cohort 1966 study (NFBC66) were used to investigate sensitization at age 46 years related to childhood living environment. A subpopulation of 3409 participants was analyzed to study factors related to new-onset sensitization between ages of 31 and 46 years. Data on complete SPTs were available for 5373 cohort members at age 46. Professional farming by parents (odds ratio (OR) 0.54; 95% confidence interval (CI) 0.43-0.68) and keeping of farm animals (OR 0.53; 95% CI 0.43-0.66) in infancy were associated with a lower risk of sensitization at age 46. Sensitization (OR 0.58; 95% CI 0.47-0.72) and polysensitization (OR 0.43; 95% CI 0.32-0.57) were less common in those who lived in a rural area in infancy compared to a city area. The childhood living environment had no effect on new-onset sensitization between ages 31 and 46. We conclude that living on a farm or in a rural environment in childhood had a protective effect on sensitization even in middle age, but these factors did not protect from new-onset sensitization in adults.Peer reviewe

Patients with hidradenitis suppurativa may suffer from neuropathic pain : A Finnish multicenter study

Non peer reviewe

Healthcare resource utilization patterns in psoriasis patients using biologic and conventional treatments in Finland

Introduction and aimPsoriasis vulgaris is associated with a significant healthcare burden, which increases over time as the disease progresses. The aim of this retrospective, population-based registry study was to characterize healthcare resource utilization (HCRU) in patients with psoriasis using biologics and oral immunosuppressants (conventionals) in Finland.Materials and methodsThe study cohort included all patients with a diagnosis of psoriasis vulgaris in the secondary healthcare setting between 2012–2018, who initiated a biologic (n=1,297) or conventional (n=4,753) treatment between 2013–2017. Data on primary and secondary HCRU were collected from nationwide healthcare registries.ResultsThe results indicated a remarkable decrease in contacts with a dermatologist after the treatment initiation among patients starting biologic (mean annual number of contacts 5.4 per person before and 2.3 after the initiation), but not conventional (3.3 and 3.2) treatment. For conventional starters there was a high level of contacts with a dermatologist surrounding times of treatment switching, which was not observed for biologic starters.ConclusionOverall, primary and other secondary care contacts did not decrease after the initiation or switch of treatment. The results highlight the importance of thorough consideration of the most optimal treatment alternatives, considering the overall disease burden to patients and healthcare systems

Impact of COVID-19 Pandemic on the Incidence of Sexually Transmitted Infections in Northern Finland in 2019 to 2022

ActaDVADmVThe coronavirus SARS-CoV-2 (COVID-19) pandemic led to major restrictions in daily life and social con-tacts in Finland in March 2020. The effect of these restrictions on sexually transmitted infections (STIs) is unclear. The aim of this study was to analyse the incidence and positive rates of sexually transmitted infections in Northern Finland between 2020 and 2021 and compare these with the years prior to the pandemic. Numbers of positive Chlamydia tracho-matis, HIV and hepatitis C samples were lower in 2020 to 2021 than in previous years, whereas more gonorrhoea and syphilis was found during pandemic than in previous years. The number of new cases of C. trachomatis reported each month decreased in the first months of the pandemic, but exceeded the prior pandemic-level in autumn 2020. When the mean positive sample rates were compared with the years 2015 to 2019, there was a significant decrease in positive C. trachomatis (p < 0.001) and hepatitis C (p < 0.001) sample rates in both 2020 and 2021. The positive rates for Treponema pallidum in 2020 did not differ significantly (p = 0.38) from previous years. In conclusion, these results show that sexually transmitted infections occurred despite recommendations for social distancing during the COVID-19 pandemic. Thus, easy access to STI testing should always be available, even during exceptional circum stances.publishedVersionPeer reviewe

C-terminal truncation impairs glycosylation of transmembrane collagen XVII and leads to intracellular accumulation

Collagen XVII, a type II transmembrane protein in hemidesmosomes, is involved in the anchorage of stratified epithelia to the underlying mesenchyme. Its functions are regulated by ectodomain shedding, and its genetic defects lead to epidermal detachment in junctional epidermolysis bullosa (JEB), a heritable skin fragility syndrome, but the molecular disease mechanisms remain elusive. Here we used a spontaneously occurring homozygous COL17A1 deletion mutant in JEB to discern glycosylation of collagen XVII. The mutation truncated the distal ectodomain and positioned the only N-glycosylation site 34 amino acids from the newly formed C terminus, which impaired efficient N-glycosylation. Immunofluorescence staining of authentic JEB keratinocytes and of COS-7 cells transfected with the mutant indicated intracellular accumulation of collagen XVII precursor molecules. Cell surface biotinylation and quantification of ectodomain shedding demonstrated that only about 15% of the truncated collagen XVII reached the cell surface. The cell surface-associated molecules were N-glycosylated in a normal manner, in contrast to the molecules retained within the cells, indicating that N-glycosylation of the ectodomain is required for targeting of collagen XVII to the plasma membrane and that reduced accessibility of the N-glycosylation site negatively regulates this process. Functional consequences of the strong reduction of collagen XVII on the cell surface included scattered deposition of cell adhesion molecule laminin 5 into the extracellular environment and, as a consequence of faulty collagen XVII-laminin ligand interactions, aberrant motility of the mutant cells

Patients with Hidradenitis Suppurativa Suffer from Low Health-Related Quality of Life as Measured by the Generic 15D Instrument

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with various comorbidities and diminished quality of life (QoL). Among dermatological conditions, HS is reported to most severely diminish QoL. This study aimed to analyse the health-related QoL (HRQoL) of patients with HS in more detail by using generic to disease-specific HRQoL questionnaires. Correlations between the HRQoL measures and HS disease severity measures were assessed. Methods: We analysed the HRQoL and clinical severity of patients with HS (N = 92) treated in 5 Finnish hospitals using HRQoL measurement tools most often used in dermatological clinics, as well as the generic 15D instrument (standardized and self-administered 15-dimensional measure of HRQoL). The disease severity was assessed using the Hurley stage, International Hidradenitis Suppurativa Severity Score System, and disease severity evaluation by the investigator. Results: The mean 15D score of HS patients was low and comparable with that of patients with cancers. No correlation was found between HS severity measures and 15D score, indicating that even mild HS has a high impact on HRQoL. Conclusions: Our findings strengthen the understanding about HS as a debilitating disease and even compared with non-dermatological conditions and highlight the need of comprehensive care of patients with HS.</p