Impact of COVID-19 Pandemic on Patients with Atopic Dermatitis / Impacto de la pandemia de COVID-19 en los pacientes con dermatitis atópica

Atopic dermatitis (AD) is a chronic skin disease that may be triggered by psychological conditions and several allergens. Patients with AD may be experienced disease exacerbation due to the COVID-19 pandemic lifestyle including home-quarantine and increased stress. We obtained the electronic data of 100 AD patients admitted to our hospital from 2016 to 2019 and called them with specific phone line.Out of 100 patients, 43 were male, and 57 were female (mean age±SD: 45.85±16.90). Sixty patients (37 females and 23males; mean age: 42.22±14.71) confronted disease flare-up during the COVID-19 era. Exacerbation of AD was correlated with treatment dose alteration, a lengthy history of atopic dermatitis, eczema duration, self-isolation, frequent handwashing, hand disinfection, and POEM scoring (P<0.05). Regarding the POEM scoring, 61 patients with moderate to severe AD experienced higher anxiety than 39 patients with silent to mild AD (P=0.013).In this study, most patients experienced disease exacerbation and perceived mild anxiety in this pandemic (AU)

La dermatitis atópica (DA) es una enfermedad cutánea crónica que puede desencadenarse debido a situaciones psicológicas y ciertos alérgenos. Los pacientes con DA pueden haber experimentado una exacerbación de la enfermedad debido al estilo de vida durante la pandemia de la COVID-19, incluyendo el confinamiento domiciliario y el incremento del estrés. Obtuvimos los datos electrónicos de 100 pacientes con DA ingresados en nuestro hospital de 2016 a 2019, y les llamamos con una línea telefónica específica.De los 100 pacientes, 43 eran varones y 57 mujeres (edad media ± DE: 45,85 ± 16,90), de los cuales 60 (37 mujeres y 23 varones, con edad media de 42,22 ± 14,71) experimentaron el brote de la enfermedad durante la etapa de la COVID-19. La exacerbación de la DA guardó relación con la alteración de la dosis de tratamiento, un largo historial de dermatitis atópica, la duración del eccema, el autoaislamiento, la frecuencia del lavado de manos, la desinfección de las manos, y la puntuación POEM (p < 0,05). En lo referente a dicha puntuación, los 61 pacientes con DA de moderada a grave experimentaron mayor ansiedad que los 39 pacientes con DA de silente a leve (p = 0,013).En este estudio muchos pacientes experimentaron exacerbación de la enfermedad y percibieron ansiedad leve durante la pandemia (AU)

[Artículo traducido] Impacto de la pandemia de COVID-19 en los pacientes con dermatitis atópica / Impact of COVID-19 Pandemic on Patients with Atopic Dermatitis

La dermatitis atópica (DA) es una enfermedad cutánea crónica que puede desencadenarse debido a situaciones psicológicas y ciertos alérgenos. Los pacientes con DA pueden haber experimentado una exacerbación de la enfermedad debido al estilo de vida durante la pandemia de la COVID-19, incluyendo el confinamiento domiciliario y el incremento del estrés. Obtuvimos los datos electrónicos de 100 pacientes de DA ingresados en nuestro hospital de 2016 a 2019, y les llamamos con una línea telefónica específica.De los 100 pacientes, 43 eran varones y 57 mujeres (edad media±DE: 45,85±16,90), de los cuales 60 (37 mujeres y 23 varones, con edad media de 42,22±14,71) experimentaron el brote de la enfermedad durante la etapa de la COVID-19. La exacerbación de la DA guardó relación con la alteración de la dosis de tratamiento, un largo historial de dermatitis atópica, la duración del eccema, el autoaislamiento, la frecuencia del lavado de manos, la desinfección de las manos, y la puntuación POEM (P<0,05). En lo referente a dicha puntuación, los 61 pacientes con DA de moderada a grave experimentaron mayor ansiedad que los 39 pacientes con DA de silente a leve (p=0,013).En este estudio muchos pacientes experimentaron exacerbación de la enfermedad y percibieron ansiedad leve durante la pandemia (AU)

Atopic dermatitis (AD) is a chronic skin disease that may be triggered by psychological conditions and several allergens. Patients with AD may be experienced disease exacerbation due to the COVID-19 pandemic lifestyle including home-quarantine and increased stress. We obtained the electronic data of 100 AD patients admitted to our hospital from 2016 to 2019 and called them with specific phone line.Out of 100 patients, 43 were male, and 57 were female (mean age±SD: 45.85±16.90). Sixty patients (37 females and 23males; mean age: 42.22±14.71) confronted disease flare-up during the COVID-19 era. Exacerbation of AD was correlated with treatment dose alteration, a lengthy history of atopic dermatitis, eczema duration, self-isolation, frequent handwashing, hand disinfection, and POEM scoring (P<0.05). Regarding the POEM scoring, 61 patients with moderate to severe AD experienced higher anxiety than 39 patients with silent to mild AD (p=0.013).In this study, most patients experienced disease exacerbation and perceived mild anxiety in this pandemic (AU)

Impact of COVID-19 Pandemic on Patients with Atopic Dermatitis.

Atopic dermatitis (AD) is a chronic skin disease that may be triggered by psychological conditions and several allergens. Patients with AD may be experienced disease exacerbation due to the COVID-19 pandemic lifestyle including home-quarantine and increased stress. We obtained the electronic data of 100 AD patients admitted to our hospital from 2016 to 2019 and called them with specific phone line. Out of 100 patients, 43 were male, and 57 were female (mean age ± SD: 45.85 ± 16.90). Sixty patients (37 females and 23males; mean age: 42.22 ± 14.71) confronted disease flare-up during the COVID-19 era. Exacerbation of AD was correlated with treatment dose alteration, a lengthy history of atopic dermatitis, eczema duration, self-isolation, frequent handwashing, hand disinfection, and POEM scoring (P < 0.05). Regarding the POEM scoring, 61 patients with moderate to severe AD experienced higher anxiety than 39 patients with silent to mild AD (P = 0.013). In this study, most patients experienced disease exacerbation and perceived mild anxiety in this pandemic.

La dermatitis atópica (DA) es una enfermedad cutánea crónica que puede desencadenarse debido a situaciones psicológicas y ciertos alérgenos. Los pacientes con DA pueden haber experimentado una exacerbación de la enfermedad debido al estilo de vida durante la pandemia de la COVID-19, incluyendo el confinamiento domiciliario y el incremento del estrés. Obtuvimos los datos electrónicos de 100 pacientes con DA ingresados en nuestro hospital de 2016 a 2019, y les llamamos con una línea telefónica específica.De los 100 pacientes, 43 eran varones y 57 mujeres (edad media ± DE: 45,85 ± 16,90), de los cuales 60 (37 mujeres y 23 varones, con edad media de 42,22 ± 14,71) experimentaron el brote de la enfermedad durante la etapa de la COVID-19. La exacerbación de la DA guardó relación con la alteración de la dosis de tratamiento, un largo historial de dermatitis atópica, la duración del eccema, el autoaislamiento, la frecuencia del lavado de manos, la desinfección de las manos, y la puntuación POEM (p < 0,05). En lo referente a dicha puntuación, los 61 pacientes con DA de moderada a grave experimentaron mayor ansiedad que los 39 pacientes con DA de silente a leve (p = 0,013).En este estudio muchos pacientes experimentaron exacerbación de la enfermedad y percibieron ansiedad leve durante la pandemia.

[Impact of COVID-19 Pandemic on Patients with Atopic Dermatitis]. / [Artículo traducido] Impacto de la pandemia de COVID-19 en los pacientes con dermatitis atópica.

Atopic dermatitis (AD) is a chronic skin disease that may be triggered by psychological conditions and several allergens. Patients with AD may be experienced disease exacerbation due to the COVID-19 pandemic lifestyle including home-quarantine and increased stress. We obtained the electronic data of 100 AD patients admitted to our hospital from 2016 to 2019 and called them with specific phone line.Out of 100 patients, 43 were male, and 57 were female (mean age ± SD: 45.85 ± 16.90). Sixty patients (37 females and 23males; mean age: 42.22± 14.71) confronted disease flare-up during the COVID-19 era. Exacerbation of AD was correlated with treatment dose alteration, a lengthy history of atopic dermatitis, eczema duration, self-isolation, frequent handwashing, hand disinfection, and POEM scoring (P < 0.05). Regarding the POEM scoring, 61 patients with moderate to severe AD experienced higher anxiety than 39 patients with silent to mild AD (p = 0.013).In this study, most patients experienced disease exacerbation and perceived mild anxiety in this pandemic.

Pachyonychia congenita: a case report of a successful treatment with rosuvastatin in a patient with a KRT6A mutation.

Pachyonychia congenita (PC) is a rare autosomal dominant disorder characterized by nail dystrophy and palmoplantar keratoderma with severe plantar pain affecting quality of life. There is no effective treatment. Heterozygous mutations in the keratin genes KRT6A, KRT6B, KRT6C, KRT16 and KRT17 have been reported as a cause of PC. Herein we present a female patient with an amino acid substitution mutation in KRT6A (c.1381G>A, p.Glu461Lys in exon 7) and classic features of PC associated with oral leucokeratosis and follicular hyperkeratosis. We also demonstrate successful treatment of the patient with rosuvastatin. A 3.6-mm reduction in plantar callosity thickness was demonstrated by sonography. Our patient also experienced significant pain relief that allowed her to increase physical activity (Children's Dermatology Life Quality Index score dropped nine points following treatment). Collectively, these improvements suggest that rosuvastatin may offer a promising treatment for PC. What's already known about this topic? Pachyonychia congenita (PC) is an autosomal dominant disease characterized by nail dystrophy and painful plantar keratoderma. Keratolytics, emollients, retinoids and steroids have been used for treatment but with limited benefits. What does this study add? A patient with PC who had a KRT6A mutation was treated with rosuvastatin with significant improvement in plantar hyperkeratosis and pain. Statins could be a promising treatment for PC with long-term safety, but further studies are needed.

A comparative immunohistochemical study of epidermal and dermal/perifollicular Langerhans cell concentration in discoid lupus erythematosus and lichen planopilaris: a cross-sectional study.

BACKGROUND: There are times when differentiation between discoid lupus erythematosus (DLE) and lichen planopilaris (LPP) becomes quite challenging clinicopathologically. OBJECTIVES: The aim of this study was to evaluate and compare the concentration, distribution pattern and role of Langerhans cells (LCs), identified by CD1a staining in DLE and LPP. METHODS: Twenty-five specimens of skin biopsies from patients diagnosed with LPP and DLE were included. Immunohistochemistry (IHC) staining was performed against CD1a antigen to assess and compare the concentration and distribution pattern of LCs. RESULTS: Compared with LPP, the mean number of epidermal CD1a+ cells per three high power fields was significantly lower in DLE ( p = 0.003). On the other hand, DLE cases had a significantly higher mean number of dermal/perifollicular CD1a+ cells in three high power fields than LPP cases ( p = 0.01). LIMITATIONS: A small sample size and limited IHC markers. CONCLUSIONS: There are differences in the density and distribution pattern of LCs in LPP and DLE in the epidermis and perifollicular regions. Our findings of a statistically significant decrease in LC concentration in the epidermis of DLE cases and also in the perifollicular region of LPP may serve as helpful clues in further characterization of these entities, especially in equivocal cases. However, more extensive studies are required to better understand the underlying immunopathogenesis of these diseases in providing further clues to a specific diagnosis.

Cultured allogeneic fibroblast injection vs. fibroblasts cultured on amniotic membrane scaffold for dystrophic epidermolysis bullosa treatment.

BACKGROUND: Different methods of fibroblast application have been examined to treat recessive dystrophic epidermolysis bullosa (RDEB). OBJECTIVES: To compare the effects of intradermal injection of cultured allogeneic fibroblasts in healing RDEB wounds with those of fibroblasts seeded on amniotic membrane scaffolds (FAMS) or standard wound care (SWC) with Vaseline® gauze as controls. METHODS: Seven patients were recruited, and seven wounds were assessed in each patient: three wounds were treated with injection of intradermal fibroblasts, three were treated with FAMS and one was dressed with SWC. Changes in wound size were assessed after 2 and 12 weeks of treatment. Qualitative wound scores (QWS) were used to assess wound severity. Additionally, biopsies and antigen mapping were performed to detect type VII collagen in the dermoepidermal junction. RESULTS: In both treated areas, the QWS and wound size were significantly decreased (P < 0·001), whereas there were no changes in the control group (P = 0·29). After 2 and 12 weeks of treatment, the wound size was significantly decreased in wounds that were treated with fibroblast injection compared with those treated with FAMS (P < 0·001); but no significant changes were found in the control group. CONCLUSIONS: Fibroblast injection has been shown to promote healing of RDEB wounds and is superior to FAMS or the control treatment.

Evaluation of Subcision for the Correction of the Prominent Nasolabial Folds.

Background. A prominent nasolabial fold (NLF) is a cosmetic problem. Currently, numerous therapeutic modalities are available for pronounced NLFs with variable efficacy. Objective. To determine the efficacy and safety of subcision using a hypodermic needle for the correction of the prominent NLFs and its effect on skin elasticity. Methods. Sixteen patients with prominent NLFs underwent subcision. The investigators' assessment of improvement and the patients' satisfaction were both recorded 1 and 6 months after the procedure. Also, we evaluate the skin elasticity of NLFs before and after the treatment using a sensitive biometrologic device with the measurement of cutaneous resonance running time (CRRT). Results. Thirteen (81.25%) patients showed a moderate improvement at 1st month and 13 (81.25%) patients had at least a mild improvement at 6th month. There was no persistent side effect lasting more than a few days. Mean CRRT at 1 and 6 months after the treatment was significantly higher compared to the baseline. Conclusion. Subcision may be considered effective for the correction of pronounced NLFs. However, further controlled studies with larger sample size are necessary to assess the efficacy of this technique in particular with use of more objective assessment of skin biometric characteristics. This trial is registered with IRCT201108097270N1 (registered on January 27, 2012).

Olmsted syndrome in an Iranian boy with a new de novo mutation in TRPV3.

Olmsted syndrome (OS) is a rare congenital skin disorder characterized by palmoplantar keratoderma, periorificial hyperkeratotic lesions and alopecia. Constriction of digits, onychodystrophy and pruritus may also occur. Recently, pathogenic heterozygous mutations in TRPV3 were identified, with most cases showing de novo dominant inheritance. We present the clinical and molecular features of OS in a 10-year-old Iranian boy. He had mutilating palmoplantar keratoderma, periorificial keratotic plaques, diffuse alopecia and constriction bands (pseudoainhum), which led to autoamputation of two digits. TRPV3 was sequenced and a new de novo heterozygous missense mutation, c.2076G>C (p.Trp692Cys), was identified. This case illustrates the characteristic clinical features and complications that can present in OS, and further expands the molecular basis of this genodermatosis.