The COVID-19 Pandemic Affects Male Patients With Chronic Spontaneous Urticaria More Than Female Patients

Introduction: The COVID-19 pandemic dramatically disrupts health care for patients with chronic diseases including chronic spontaneous urticaria (CSU). As of now, it is unknown if the effects of the pandemic in CSU are different than in other chronic diseases. We also do not know, if different groups of CSU patients, for example female and male patients, are affected differently. Aim: To understand how CSU patients and subgroups are affected by the COVID-19 pandemic in their disease activity and control and treatment, using psoriasis as control. Patients and Methods: We analyzed 399 patients (450 visits) with CSU or psoriasis assessed during August 2019, i.e. before the pandemic, or August 2020, i.e. during the pandemic, for changes in disease activity, disease control, and the treatment they used, and how these changes are linked to age, gender, and disease duration. Results: Male but not female patients with CSU had markedly increased disease activity during the pandemic. CSU patients' age or disease duration were not linked to changes. Male and female patients with psoriasis showed similar increases in disease activity and decreases in disease control. The rate of omalizumab treatment, during the pandemic, was unchanged in male patients and increased in female patients with CSU. The efficacy of omalizumab treatment, during the pandemic, was reduced in male patients but not female patients with CSU. Conclusion: Male but not female CSU patients, during the COVID-19 pandemic, show loss of disease control linked to loss of omalizumab efficacy. The reasons for this need to be investigated

Results of Skin Prick Tests in Dermatology Outpatient Allergy Unit

WOS: 000518456300009Amaç: Deri prick testi (DPT) başlıca atopik dermatit (AD), kronik ürtiker (KÜ), alerjik astma (AA), ve alerjik rinit (AR) gibi hastalıkların tanı ve takibinde kullanılmaktadır. Bu çalışmanın amacı, Dermatoloji Kliniği Alerji Ünitesi (DKAÜ)'nde yapılan DPT sonuçlarının geriye dönük olarak incelenerek, endikasyonları ve pozitiflik oranlarının araştırılmasıdır. Gereç ve Yöntem: DKAÜ arşivi kullanılarak 2014-2016 yıllarında yapılan DPT sonuçları incelenmiştir. DPT sonuçları, her hasta için ayrıca arşivlenen DPT formları okunarak yapılmıştır. Bulgular: DKAÜ'nde 2014-2016 yılları arasında 1916 hastaya DPT yapılmıştır. Bu hastaların 941'inde AA, 133'ünde AR, 842'sinde dermatolojik hastalık olduğu görülmüştür. En az bir ve birden fazla alerjen madde ile DPT pozitiflik oranı, sırasıyla AA, AR ve dermatolojik hastalıklarda; %92.1, %71.4 ve %50 olarak saptanmıştır. Dermatolojik hastalıklar incelendiğinde, 69 kronik ürtiker (KÜ), 55 atopik dermatit (AD) hastası haricinde, geriye kalan 718 hastada, başlıca dermatit, idiopatik generalize pruritus (İGP) olmak üzere farklı dermatolojik hastalıkların olduğu görülmüştür. DPT pozitifliği KÜ’de %55.1, AD’te %52.7 ve diğer dermatolojik hastalıklarda %48.6 olarak saptanmıştır. Sonuç: Bu çalışmanın sonuçlarına göre DPT pozitiflik oranı, AR ve AA hastalarında hem KÜ ve AD hem de diğer dermatolojik hastalıklara göre daha yüksektir. Bunun nedeni, KÜ ve AD etyopatogenezinde tip 1 aşırı duyarlılık reaksiyonlarının rolünün daha az olması ve/veya farklı dermatolojik tanılarla yönlendirilen hastalarda doğru olmayan DPT endikasyonları olabilirObjective: Skin prick test (SPT) is mainly used for diagnosis and follow-up of diseases like atopic dermatitis (AD), chronic urticaria (CU), allergic asthma (AA) and allegic rhinitis (AR). The aim of current study is to explore the results of SPT retrospectively which were performed in Dermatology Outpatient Allergy Unit (DOAU) for identifying indications and positivity. Methods: Results of SPT which were performed on 2014-2016 were investigated based on archives of DOAU. Results of SPT were analyzed from the SPT Forms which were prepared for each patient. Results: SPT were performed on 1916 individuals who admitted to DOAU during 2015-2016. AA was determined in 941, AR in 133 and dermatological diseases were 842 patients. SPT positive results, for at least one or more allergen agents, of patients with AA, AR and dermatological diseases were 92.1%, 71.4% and 50% respectively. Dermatological diseases included; except CU in 69 patients and AD in 55 patients. In the remaining 718 patients were diagnosed with dermatitis, idiopathic generalised pruritus (IGP) and other dermatological disorders. SPT positivity rates in CU was 55.1%, 52.7% in AD and 48.6% in several dermatological diseases. Conclusions: As a result, the rate of SPT positivity in patients with AA and AR were higher than both CU, AD and several dermatological diseases. The reason of this may be related with lesser role of type 1 hypersensivity reaction in etiopathogenesis of CU and AD, and/or improper SPT indications who were directed with diagnosis of several dermatological diseases

Evaluation of platelet parameters and neutrophil/lymphocyte ratio during omalizumab treatment in patients with severe chronic spontaneous urticaria

Ertas, Ragip/0000-0002-9269-2619; Akkus, Muhammet Resat/0000-0002-7938-2173; Karakukcu, Cigdem/0000-0001-9858-3272WOS: 000452890300026PubMed: 30541255Background/aim: Spontaneous wheals and/or angioedema lasting longer than six weeks are described as chronic spontaneous urticaria (CSU). Omalizumab is used for the treatment of antihistamine-resistant CSU. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) are considered important indicators of inflammation and platelet activation in chronic diseases. We aimed to determine the NLR, PLR, MPV, and PDW levels in patients with CSU compared with healthy controls. We also aimed to investigate the effects of omalizumab therapy on these parameters in CSU patients. Materials and methods: This hospital-based, retrospective study included 143 patients with CSU and 132 healthy controls with a mean age of 40.0 +/- 13.17 and 42.0 +/- 16.34, respectively. Patients with equal or higher-than-baseline UAS scores at week 12 of omalizumab treatment were considered nonresponders, others were considered responders. We analyzed the neutrophils, lymphocytes, platelet counts, NLR, PLR, MPV, and PDW before, during, and after omalizumab treatment and compared the results with those of healthy controls. Results: CSU patients presented higher baseline MPV (P = 0.035) and lower baseline PDW values (P < 0.001) than healthy controls. There were statistically significant increases in the MPV (P < 0.001), MPV/platelet count (P = 0.005), and PDW (P = 0.003) and there was a statistically significant decrease in the NLR (P = 0.018) during omalizumab treatment. The percent increase of MPV was low in nonresponders (P = 0.009). Nonresponders had lower PDW values than responders (P = 0.040). Conclusion: The increase in the MPV and PDW may be due to platelet activation during omalizumab treatment. The decrease in the NLR may be regarded as an antiinflammatory effect of omalizumab. The effect of omalizumab on platelet and inflammatory markers may be used to discriminate the responders from nonresponders

Survival of biological therapeutics in psoriasis: Retrospective analysis of 3-years data in a Turkish Registry, PSORTAKSIS.

Background/aim: PSORTAKSIS is a psoriasis registry, which is used for follow-up of patients in Kayseri City Education and Research Hospital, Dermatology Clinic since 2016 in Turkey. PSORTAKSIS includes demographic data, follow-up clinical findings, laboratory output, and treatment information of patients. Here, drug survivals of biologic therapeutics (BT) according to three-year data of PSORTAKSIS will be presented. Materials and methods: Drug survival of BT in PSORTAKSIS was analyzed from 2016 to March 2019. Results: 158 patients (111 of them BT-naive) with psoriasis under BT were enrolled in the current study. Drug survival analysis of patients with ongoing BT (158 treatment periods) revealed mean survival time as 15.49 months for ustekinumab, 15.37 months for adalimumab, 14.00 months for etanercept, 5 months for infliximab, and 4.59 months for secukinumab. The differences between drug survivals of BT were statistically significant (log-rank test, χ2 = 79.915, p < 0.0001). Age of onset was found to be the only independent risk factor of drug survival according to regression analysis (p = 0.029). Conclusion: As a conclusion, drug survival of UST was significantly higher than that of TNF-alpha inhibitors and SEC in the treatment of psoriasis. This study revealed that among predictors, age at disease onset may influence drug survival