Prevalence of actinic keratosis among dermatology outpatients in Spain.

BACKGROUND: Actinic keratoses (AKs) are common skin lesions associated with an increased risk of developing squamous cell carcinoma. Few studies in Europe have focused on AK prevalence. AIM: To determine the point prevalence of AKs in a dermatology outpatient population in Spain, to describe the clinical characteristics of these lesions and to characterise the profile of AK patients. METHODS: Observational, cross-sectional, multicentre study conducted in 19 hospitals (dermatology outpatient services) around Spain. A total of 204 consecutive patients per hospital who were ≥45 years old were screened for the presence of AKs. RESULTS: 3877 patients were assessed and the overall AKs prevalence was 28.6%. Prevalence was significantly higher in men than women (38.4% vs. 20.8%, p<0.0001) and increased with age for both sexes (45.2% in 71-80 years). Scalp and ear lesion locations were significantly more frequent in men (51.9% vs. 2.7% and 16.9% vs. 2.4%, respectively, p<0.0001 both cases) and the cheek, nose and neckline in women (46.3% vs. 34.0% [p<0.0001], 43.0% vs. 24.8% [p<0.0001] and 5.3% vs. 1.8% [p=0.002]). Men showed a significantly higher frequency of ≥2 affected areas than women (42.7% vs. 20.3%, p<0.0001). Among patients with AK lesions, only 65% confirmed that they were the reason for the visit to the clinic. CONCLUSIONS: Approximately a quarter of the dermatology outpatient population in Spain aged ≥45 years old have AKs, with the prevalence rate being highest in men and in older age groups. AK is underdiagnosed and a proactive strategy is needed for the diagnosis and early treatment of these lesions.

Oral Alitretinoin in the Treatment of Severe Refractory Chronic Hand Eczema in the Spanish National Health System: Description and Analysis of Current Clinical Practice.

BACKGROUND AND OBJECTIVE: Hand eczema affects nearly 10% of the population. The condition becomes severe and chronic in 5% to 7% of cases and is refractory to topical corticosteroids in 2% to 4%. This study aimed to describe the current use of oral alitretinoin in treating Spanish national health system patients with hand eczema that is refractory to potent topical corticosteroids. MATERIALS AND METHODS: Observational, descriptive, exploratory, cross-sectional study based on the retrospective analysis of records for patients with hand eczema treated with alitretinoin in the Spanish national health system. RESULTS: We reviewed the records for 62 patients in 13 hospitals in 5 different administrative areas (autonomous communities) of Spain. Alitretinoin was usually used at a dosage of 30mg/d. In most cases the physician judged the clinical response to be satisfactory after a single cycle. The recorded adverse effects were foreseeable and of the type reported for systemic retinoids. The dermatologists agreed that the clinical benefits achieved with alitretinoin favored adherence to treatment and an early return to work. CONCLUSIONS: The results show that oral alitretinoin is being used according to established recommendations and that response is good, with few adverse effects. The dermatologists agreed that the benefits favored adherence and improved the patients' health related quality of life.

Pharmacological compliance and acceptability of lansoprazole orally disintegrating tablets in primary care.

OBJECTIVE: To evaluate the pharmacological compliance of patients treated with lansoprazole orally disintegrating tablets (LODT) in Primary Care (PC) and their acceptability of this formulation. RESEARCH DESIGN AND METHODS: A multicenter, observational, cross-sectional study involving 433 PC physicians that included 433 patients aged at least 18 years, either diagnosed with gastroesophageal reflux disease (GERD) or taking LODT to prevent NSAID-induced gastric ulcers. Compliance with LODT treatment was assessed with the Haynes-Sackett self-reported test. Acceptability was based on global patient assessment, rating the drug's organoleptic characteristics and properties recorded with a self-administered 15-item ad hoc questionnaire with 2 and 5-point Likert-type scales. RESULTS: 423 patients (mean age 50.6 years, SD = 13.4) were evaluable for the main endpoint. Of these, 57.16% were men and 53.5% were treated with 30 mg doses of LODT for an average of 37.8 days (SD = 35.5). Compliance was achieved by 92.4% of the patients, mean percentage of compliance was 93.3. Demographical and clinical variables had no effect on compliance. Treatment with LODT was assessed as 'acceptable' or 'highly acceptable' by 91.7% of the sample. One adverse reaction, not serious, was reported by one patient (0.2%). CONCLUSIONS: In this observational study, compliance with lansoprazole orally disintegrating tablets was very high. Patients reported that this formulation improved their compliance. LODT was clearly preferred to previous medication and the drug was well tolerated.