56 research outputs found
Defining lesional, perilesional and unaffected skin in hidradenitis suppurativa: proposed recommendations for clinical trials and translational research studies
Hidradenitis suppurativa (HS) is a chronic, recurring inflammatory skin condition for which the pathogenesis is not completely elucidated1. With the increase in HSârelated research comes the need to enhance reproducibility, quality and accuracy of scientific methods. Unlike other inflammatory dermatoses such as psoriasis or atopic dermatitis, HS lesions are morphologically diverse and include nodules, abscesses, tunnels and fibrosis in various permutations and combinations admixed in the same anatomical region1. This makes general definitions as âlesionalâ and ânonâlesionalâ insufficient for HSârelated investigations. A definition for nonâlesional skin is lacking
Repeated grading of weed abundance and multivariate methods to improve the efficacy of on-farm weed control trials
Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization â systematic review and recommendations from the HS ALLIANCE working group
Hidradenitis suppurativa (HS)/acne inversa is a debilitating chronic disease that remains poorly understood and difficult to manage. Clinical practice is variable, and there is a need for international, evidence-based and easily applicable consensus on HS management. We report here the findings of a systematic literature review, which were subsequently used as a basis for the development of international consensus recommendations for the management of patients with HS. A systematic literature review was performed for each of nine clinical questions in HS (defined by an expert steering committee), covering comorbidity assessment, therapy (medical, surgical and combinations) and response to treatment. Included articles underwent data extraction and were graded according to the Oxford Centre for Evidence-based Medicine criteria. Evidence-based recommendations were then drafted, refined and voted upon, using a modified Delphi process. Overall, 5310 articles were screened, 171 articles were analysed, and 65 were used to derive recommendations. These articles included six randomized controlled trials plus cohort studies and case series. The highest level of evidence concerned dosing recommendations for topical clindamycin in mild disease (with systemic tetracyclines for more frequent/widespread lesions) and biologic therapy (especially adalimumab) as second-line agents (following conventional therapy failure). Good-quality evidence was available for the hidradenitis suppurativa clinical response (HiSCR) as a dichotomous outcome measure in inflammatory areas under treatment. Lower-level evidence supported recommendations for topical triclosan and oral zinc in mild-to-moderate HS, systemic clindamycin and rifampicin in moderate HS and intravenous ertapenem in selected patients with more severe disease. Intralesional or systemic steroids may also be considered. Local surgical excision is suggested for mild-to-moderate HS, with wide excision for more extensive disease. Despite a paucity of good-quality data on management decisions in HS, this systematic review has enabled the development of robust and easily applicable clinical recommendations for international physicians based on graded evidence
Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II
Background
A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreedâupon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two eâDelphi surveys. In this manuscript, we describe two inâperson consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items.
Objectives
To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains.
Methods
The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey.
Results
Fortyâone individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HSâspecific quality of life, satisfaction, symptoms, pain and global assessments.
Conclusions
The HISTORIC consensus meetings I and II will be followed by further eâDelphi rounds to finalize the core domain set, building on the work of the inâperson consensus meetings
What causes hidradenitis suppurativa ?â15 years after
The 14 authors of the first review article on hidradenitis suppurativa (HS) pathogenesis published 2008 in EXPERIMENTAL DERMATOLOGY cumulating from the 1st International Hidradenitis Suppurativa Research Symposium held March 30âApril 2, 2006 in Dessau, Germany with 33 participants were prophetic when they wrote âHopefully, this heralds a welcome new tradition: to get to the molecular heart of HS pathogenesis, which can only be achieved by a renaissance of solid basic HS research, as the key to developing more effective HS therapy.â (Kurzen et al. What causes hidradenitis suppurativa? Exp Dermatol 2008;17:455). Fifteen years later, th
Sporadic amyotrophic lateral sclerosis: new hypothesis regarding its etiology and pathogenesis suggests that astrocytes might be the primary target hosting a still unknown external agent
Assay and Characterization of the Factor in Porcine and Bovine Plasma which Aggregates Human Platelets
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