PEDIATRIC DERMATOLOGY

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI] = 2.27-3.78) and 2.94(95% CI = 2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (>26) than controls (OR = 2.52; 95% CI = 1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis

LID - 10.1111/ced.14478 [doi]

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. AIM: In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. METHODS: In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. RESULTS: The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. CONCLUSIONS: Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity

Ultrahigh-resolution combined coronal optical coherence tomography confocal scanning ophthalmoscope (OCT/SLO): A pilot study

Objective: To evaluate clinical images from a prototype ultrahigh resolution (UHR) combined coronal optical coherence tomography/confocal scanning ophthalmoscope (OCT/SLO) and to compare them to standard-resolution OCT/SLO images on the same patients. Design: Cross-sectional pilot-study. Participants: Sixty-six eyes of 42 patients with various macular pathologies, such as age-related macular degeneration, macular edema, macular hole, central serous retinopathy, epiretinal membrane and posterior vitreous traction syndrome. Methods: Each subject was first scanned with a standard-resolution OCT/SLO that has an axial resolution of ?10 micron. Immediately following, patients were scanned with the prototype UHR OCT/SLO device. The UHR system employs a compact super luminescent diode (SLD) with a 150 nm bandwidth centered at 890 nm, which allows imaging of the retina with an axial resolution of 3 microns. Both coronal and longitudinal OCT scans were acquired with each system, and compared side-by-side. Scan quality was assessed for the observer's ability to visualize the vitreo-retinal interface and retinal layers - in particular of the outer retina/RPE/choroidal interface, increased discrimination of pathological changes, and better signal intensity. Main outcome measures: Ultrahigh and standard-resolution coronal and longitudinal OCT/SLO images of macular pathologies. Results: In the side-by-side comparison with the commercial standard-resolution OCT/SLO images, the scans in the Ultrahigh resolution OCT/SLO images were superior in 85% of cases. Relatively poor quality images were attributed to lower signal-to-noise ratio, limited focusing, or media opacities. Several images that had a better signal intensity in the standard-resolution OCT/SLO system were found to show more retinal detail in the UHR system. In general, intraretinal layers in the UHR OCT/SLO images were better delineated in both coronal and longitudinal scans. Enhanced details were also seen in the outer retina/RPE/choroidal complex. The UHR OCT/SLO system produced better definition of morphological changes in several macular pathologies. Conclusions: Broadband SLD-based UHR OCT/SLO offers a compact, efficient, and economic enhancement to the currently available clinical OCT imaging systems. UHR OCT/SLO imaging enhanced the quality of the OCT C-scans, facilitated appreciation of vitreo-retinal pathologies, and improved sensitivity to small changes in the retina, and the outer retina/RPE/choroidal interface