ABSTRACT
Background@#Atopic dermatitis (AD) patients usually wonder if their condition will worsen after vaccination or if they should continue with the treatment they are receiving. Considering that many patients treated with dupilumab had previously experienced severe AD symptoms and flares, the concerns are more understandable. @*Objective@#This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab. @*Methods@#We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agentstreated as control group) with AD from six hospitals. Patients were asked about worsening pruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severity index [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS], sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and postvaccination. Adverse reactions to the COVID-19 vaccination were observed. @*Results@#The incidence of adverse reactions to COVID-19 vaccines and worsening AD symptoms in dupilumab-treated patients were not significantly different compared with that in the control group. The itch NRS score increased significantly after vaccination (p<0.001).However, there were no statistically significant differences between the pre-and post-EASI, IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescue therapy; however, most were easily managed with low-dose steroids or topical agents. None of the patients discontinued dupilumab treatment. @*Conclusion@#No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but was mostly mild and transient.
ABSTRACT
Background@#Patients with atopic dermatitis (AD) have an impaired quality of life (QoL). To our knowledge, impairments in mental health status and health-related QoL (HRQoL) have not yet been evaluated in adult-onset and child-onset AD in a large-scale study. @*Objective@#This study compared the mental health status and HRQoL (using the EuroQoL [EQ] five-dimensional [5D] questionnaire) in child-onset AD and adult-onset AD to those in normal controls. @*Methods@#We used nationwide, population-based, cross-sectional data from the Korean National Health and Nutrition Examination Survey conducted from 2008 to 2013. We performed multiple logistic regression analyses with adjustments for age, sex, body mass index, income, education level, drinking status, current smoking, regular exercise, diabetes mellitus, hypertension, and dyslipidemia, and analyzed odds ratios (OR) for factors associated with impaired QoL. @*Results@#The OR for strong psychological stress, depressed mood, and suicidal ideation were significantly increased in adult-onset AD patients compared to in normal controls.In addition, the OR (95% confidence interval [CI]) values for the EQ-5D questionnaire responses (for physical activity, self-control, daily activities, pain/discomfort, and anxiety/ depression) were significantly high in adult-onset AD compared to in normal controls after adjustments for covariates. However, patients with child-onset AD showed a significantly increased OR (95% CI) only for problems in pain/discomfort in the EQ-5D questionnaire. @*Conclusion@#Adult-onset AD patients suffer from impaired HRQoL and significant mental problems compared to normal controls. Dermatologists should focus not only on the clinical phenotype but also patients’ psychological health status to ensure a better treatment outcome.
ABSTRACT
Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.
ABSTRACT
Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.