The Quality of Life impairment in Hidradenitis Suppurativa

Background. Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory disease of terminal hair follicles with a profound impact on the patient’s daily life, probably one of the worst that has been analysed and evaluated in dermatology. Aim. The aim of this study was to evaluate the QoL impairment in HS and identify the factors that influence it. Methods. The study was conducted with a group of forty-two patients affected by HS, aged 10–62 years, referred to the HS consultation service of Dermatology Clinic of Tor Vergata. All patients filled out the Dermatology Life Quality Index (DLQI questionnaire). The DLQI’ questions are categorized into six heading items: symptoms and feelings, daily activities, leisure, personal relationships, work and school, and treatment. The severity of the HS disease was evaluated with the Hurley staging classification, the modified Sartorius score and the Acne Inversa Severity Index (AISI score). A visual analog scale was used for pain (PAIN VAS). Patients were divided into three groups according to AISI index score: mild (4 male, 8 female), moderate (2 male, 9 female) and severe patients (6 male, 13 female). Results. Our findings are in agreement with existing literature who claims that patients with HS have a significant impairment in QoL, expressed by high DLQI score (12,6 ± 8). The most compromised elements were clinical symptoms (1,60), feelings (1,64) and daily activities (1,71). The clinical stage of disease is the most important factor related to the DLQI. The significant positive correlation between the AISI scores and DLQI scores (Pearson's r = 0,53) confirms disease severity as a predictor of worsening QoL. Pain, discomfort and embarrassment are also involved. Presence of higher PAIN VAS score was associated with an increase in DLQI (Pearson's r = 0,6). QoL was affected by age: between 26 and 49 years, an increase of the DLQI values is observed; moreover, in this group of patients, HS is a limitation in study and work activities much more than in the other categories. In patients with severe forms, the choice of clothes to wear is an important cause of discomfort. This study does not reveal a correlation between disease severity and impact on sex life. Conclusion. HS is a profoundly debilitating disease which affects patient’ lives physically, emotionally and psychologically. The average recorded of the DLQI score is higher than those found in other chronic dermatologic conditions traditionally regarded as causing significant disability. For this reason, the need to measure the quality of life of HS patients becomes particularly significant, and therefore it could be helpful design a new evaluation method or score able to specifically monitor the HS impact on QoL and evidence clearly and enclosing yet overlooked aspects

Apheresis in the treatment of recalcitrant atopic dermatitis: Case series and review of the literature

Background: Atopic dermatitis is a chronic disabling inflammatory skin disorder, typically characterized by intensely itching, oozing, crusted, eroded vesicles or papules developing on erythematous plaques. Conventional treatments, both topical and systemic, may produce unsuccessful and unsatisfactory results. Objectives: we aimed to assess the efficacy of apheretic treatments in patients with severe, recalcitrant AD, in particular, the pruritic component. Patients and methods: four patients affected by recalcitrant and debilitating atopic dermatitis, who had previously received conventional topical and systemic therapies with poor clinical improvement, were treated with extracorporeal photopheresis or therapeutic plasma exchange. Results: a satisfactory response to apheresis was observed with a reduction of pruritus and skin lesions. Conclusion: In our experience, apheretic therapies might be used as monotherapy but, more effectively, in combination with topical and/or systemic treatments. Indeed, they proved to be a safe “enhancer” for increasing the efficacy of conventional therapeutics

AISI: A New Disease Severity Assessment Tool for Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic, disabling, skin disorder. Because of renewed scientific interest in HS, different aspects of the condition, such as disease severity assessment, are being investigated and better defined. The aim of this study is to provide a novel tool for the assessment of disease severity

Olive Varieties under UV-B Stress Show Distinct Responses in Terms of Antioxidant Machinery and Isoform/Activity of RubisCO

In recent decades, atmospheric pollution led to a progressive reduction of the ozone layer with a consequent increase in UV-B radiation. Despite the high adaptation of olive trees to the Mediterranean environment, the progressive increase of UV-B radiation is a risk factor for olive tree cultivation. It is therefore necessary to understand how high levels of UV-B radiation affect olive plants and to identify olive varieties which are better adapted. In this study we analyzed two Italian olive varieties subjected to chronic UV-B stress. We focused on the effects of UV-B radiation on RubisCO, in terms of quantity, enzymatic activity and isoform composition. In addition, we also analyzed changes in the activity of antioxidant enzymes (SOD, CAT, GPox) to get a comprehensive picture of the antioxidant system. We also evaluated the effects of UV-B on the enzyme sucrose synthase. The overall damage at biochemical level was also assessed by analyzing changes in Hsp70, a protein triggered under stress conditions. The results of this work indicate that the varieties (Giar-raffa and Olivastra Seggianese) differ significantly in the use of specific antioxidant defense systems, as well as in the activity and isoform composition of RubisCO. Combined with a different use of sucrose synthase, the overall picture shows that Giarraffa optimized the use of GPox and opted for a targeted choice of RubisCO isoforms, in addition to managing the content of sucrose synthase, thereby saving energy during critical stress points. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Long-term treatment with adalimumab in psoriatic arthritis: serum adalimumab concentration, immunogenicity and the link with clinical response

Objectives: An observational study to evaluate the relationship between serum concentrations of adalimumab and disease activity in patients receiving long-term adalimumab treatment for psoriatic arthritis. Methods: Serum adalimumab and adalimumab antidrug antibodies were quantified by enzyme linked immunosorbent assay. Disease activity was assessed using Disease Activity Score (44 joint measures). Serum C-reactive protein was quantified using standard methods. Results: A total of 30 patients were recruited. There were significant inverse correlations between serum adalimumab concentration and serum C-reactive protein (CRP) concentration [r = −0.43], the number of tender joints (r = −0.4), and Disease Activity Score (DAS44)-CRP (r = −0.36). Mean serum adalimumab levels were significantly higher in patients with DAS44-CRP <1.6 than in patients with DAS44-CRP ≥1.6. Conclusions: Serum adalimumab could be an important tool that may improve the management of psoriatic arthritis in patients responding to long-term treatment