Anhedonia in Acne Vulgaris: A Cross-Sectional Study of 104 Consecutive Acne Patients.

Background: Anhedonia is defined as a reduced ability to experience or even a total loss of pleasure. Purpose: This study was undertaken to evaluate anhedonia in 104 consecutive acne patients. Material and Methods: Acne severity was assessed with Investigator Global Assessment (IGA), anhedonia was studied with the Snaith-Hamilton Pleasure Scale (SHAPS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) and Temporal Experience of Pleasure Scale (TEPS). Moreover, the quality of life (QoL) and stigmatization, as well as depression and anxiety (Hospital Anxiety and Depression Scale - HADS), were additionally evaluated. Results: Anhedonia was found in 20.19% of acne patients and was more common (p=0.007) in males (34.29%) than in females (13.04%). Based on SHAPS, males with acne showed significantly (p=0.049) higher levels of anhedonia (2.39 ± 3.18 points) than acne females (1.26 ± 2.36 points). Anhedonia significantly correlated with the clinical acne severity (SHAPS: r=0.205, p=0.038 and ACIPS: r=-0.222, p=0.026). Although the intensity of anhedonia did not show any relationship with QoL and stigmatization assessments, there was a significant correlation between anhedonia and depressive symptoms (SHAPS: r=0.310, p<0.001; ACIPS: r=-0.364, p<0.001). Such dependency was not documented for anxiety. Conclusion: Anhedonia seems to be a common phenomenon in acne and should be considered in the holistic approach to acne patients.

Basal cell carcinoma and rosacea: coincidence or relationship?

Introduction: The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma. Aim: To examine the possible connection of BCC and rosacea. Material and methods: 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA). Results: Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance. Conclusions: The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected.

Prevalence, Intensity and Psychosocial Burden of Acne Itch: Two Different Cohorts Study.

BACKGROUND: Chronic itch is a common symptom of inflammatory skin diseases. This study was undertaken to evaluate the presence and intensity of itching in two different cohorts of acne subjects. Additionally, the influence of itching on the psychosocial status of acne individuals was assessed. METHODS: Consecutive acne patients seeking dermatological advice and university students diagnosed with acne during dermatological screening were considered. The clinical and psychological aspects of acne were assessed using a variety of instruments. RESULTS: About 40% of acne subjects in both cohorts reported itching. The mean WI-NRS during the last 3 days in acne patients was 3.83 ± 2.31 points (mild itch) and was significantly more severe (p < 0.001) than in university students diagnosed with acne (2.09 ± 1.29 points). Itch intensity did not depend on the clinical severity of acne. In consecutive acne patients, itch intensity correlated with quality-of-life impairments (assessed using DLQI and CADI) and HADS scores. There was no correlation between itch intensity and stigmatization levels. CONCLUSIONS: Itching seems to be a common phenomenon in acne sufferers. Acne itch significantly influences patients' well-being and should be considered in a holistic approach to acne patients.

Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients.

Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.

The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis.

BACKGROUND: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. OBJECTIVES: The aim of this study was to investigate differences in QoL impairment and sleeping problems in patients suffering from various clinical subtypes of psoriasis and to evaluate the effects of pruritus on QoL. METHODS: This cross-sectional, multicenter study included 295 eligible subjects with diagnosed psoriasis. Each patient was examined with the use of the same questionnaire. Measures included predominant subtype of psoriasis, disease severity, pruritus scores, patients' health-related QoL and the incidence of sleep disturbance. RESULTS: The QoL of most patients was decreased irrespectively of clinical psoriasis subtype, however, the most impaired QoL was in patients with erythrodermic psoriasis. The majority of patients reported sleep disturbances caused by pruritus, albeit there was no relevant differences between analyzed subgroups in this aspect of patients' well-being. Pruritus was an important factor determining QoL and sleeping problems in the studied population. CONCLUSIONS: Identifying the most disturbing area of life and recognizing the most bothersome subjective symptoms of psoriasis are pivotal to focusing on the most relevant treatment goal and achieving therapeutic success.

Pruritus in Pregnancy.

Pruritus in pregnancy is a common and burdensome symptom that may be a first sign of a pregnancy-specific pruritic disease (atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, and intrahepatic cholestasis in pregnancy) or a dermatosis coinciding with pregnancy by chance. Despite its high prevalence, pruritus is often underrated by physicians, and data regarding the safety profiles of drugs for pruritus are very limited. In this review, we illustrate the epidemiology, possible pathophysiology, clinical characteristics, and diagnostic workup of various pregnancy-related diseases and discuss antipruritic treatments. The prevalence of pruritus in pregnancy demonstrates the importance of symptom recognition and the need for an holistic approach, taking into account both the potential benefits for the patient and the potential risks to the fetus.

Basal cell carcinoma within rhinophyma: coincidence or relationship?

INTRODUCTION: Rhinophyma is a relatively rare form of rosacea, while basal cell carcinoma (BCC) is the most frequent skin cancer in humans - both diseases prevail in the elderly. AIM: To analyse patients with rhinophyma treated surgically in the Dermatosurgery Unit and look for possible cases with BCC within the rhinophyma. MATERIAL AND METHODS: We performed a retrospective review of all treated rhinophymas in the Dermatosurgery Unit in 2004-2019. RESULTS: Among 140 rhinophyma patients 2 (1.4%) subjects with concomitant clinically diagnosed and histologically confirmed BCC were found, with BCC located in the hypertrophic tissue of the nose. There were no patients with BCC located in other anatomical regions of the skin. Both of these patients were in more advanced age. CONCLUSIONS: Taking into consideration these two conditions: advanced age and anatomical location, typical for BCC, one may speculate that the development of BCC within rhinophyma is rather a simple coincidence. However, more numerous series of patients with rhinophyma are needed to clear the controversy of BCC within rhinophyma hypertrophic tissue.

Itch in Adult Population with Type 2 Diabetes Mellitus: Clinical Profile, Pathogenesis and Disease-Related Burden in a Cross-Sectional Study.

BACKGROUND: Despite growing interest in itch, data regarding itch in type 2 diabetes mellitus (DM2) are still limited, and mostly based on outdated studies. This study aimed to evaluate the clinical characteristics of itch in the adult population with DM2 and explore potential underlying causes. METHODS: The study group consisted of 109 adult patients with DM2. Standardized questionnaires were completed in order to assess the itch intensity [Numerical Rating Scale (three days, 24hours) (NRS)] and the Four-item Itch Questionnaire (4IIQ) and to assess the psychological impact of itch [ItchyQoL, Six-Item Stigmatization Scale (6-ISS), Hospital Anxiety and Depression Scale (HADS)]. Skin dryness was evaluated clinically and by non-invasive assessment of epidermis moisturizing. Neuropathy was assessed using the clinical Katzenwadel neuropathy scale. RESULTS: Itch occurred in 35.8% of adult patients with DM2, with NRSmax three days 6.31 ± 2.16 and 8.1 ± 3.5 points in 4IIQ. Itchy patients have had significantly higher FPG levels compared with the non-itchy population (p = 0.01). Patients with itch had a significantly higher possibility of neuropathy compared with non-itchy subjects (p < 0.01). Skin xerosis was significantly more advanced in patients with itch compared to those without (p < 0.01). The mean ItchyQol score was assessed as 41.2 ± 13.4 points, indicating mild life quality impairment and correlated positively with itch intensity. Itchy subjects had significantly higher scores in both anxiety and depression dimensions of HADS (in each p < 0.01). CONCLUSIONS: We suggest that the primary cause of itch is prolonged poor diabetes control with altered glucose and insulin levels, subsequently causing skin dryness and neuropathy in long-lasting DM2.

Is Face and Mask Touching a Real Struggle During the COVID-19 Pandemic? A Prospective Study Among Medical Students.

There are limited data in the literature on the frequency of face- and mask-touching behavior as a potential vector for the self-inoculation and transmission of the novel coronavirus. In this prospective study, we assessed the facial touching behavior of 204 medical students. One hundred thirty-four subjects (65.68%) during the 15-min observation at least once touched the area of the mask (38.23%), eyes (38.23%), or other parts of the facial zone (49.02%). The mean number of touches was 11.98 ± 16.33 per hour. The results of our study reveal that there is no significant association between mask wearing and gender; however, there might be a tendency for people with eyeglasses to touch the area near the eyes more often.

Burden of Itch in Patients with Basal Cell Carcinoma.

The incidence of basal cell carcinoma has increased in recent years. The aim of this study was to analyse the influence of itch on quality of life and psychosocial status of patients with basal cell carcinoma. A total of 180 patients with basal cell carcinoma were included in the study. Itch intensity was assessed with Numerical Rating Scale and 4-Item Itch Questionnaire (4IIQ). Quality of life in basal cell carcinoma was assessed with the 36-item Short-Form Health Survey (SF-36), Dermatology Life Quality Index (DLQI), 6 Item Stigmatization Scale (6-ISS) and Beck Depression Inventory (BDI). Mean DLQI in the study group was 2.0 ± 2.0, while mean SF-36 was 71.38 ± 15.77 points. The intensity of itch assessed with 4IIQ correlated negatively with SF-36 (R = -0.48, p = 0.003). The mean ± SD BDI score was 6.16 ± 5.72 points and mean 6-ISS score was 0.66 ± 1.24. In conclusion, presence and intensity of itch may debilitate quality of life among patients with basal cell carcinoma.

Itch in diabetes: a common underestimated problem.

Introduction: Diabetes mellitus is associated with several skin manifestations, however the association with itch remains unclear. Aim: To present a detailed literature review in order to analyse the frequency, pathogenesis, and course of itch in diabetes mellitus. Material and methods: Data were collected from the PubMed and Cochrane databases. Articles were excluded if the populations presented with comorbidities or received treatment with drugs affecting the skin. Also, animal studies, studies with poor methodology and pilot studies were excluded. Results: Among the 5 original articles included, the epidemiology of itch in diabetes varies from 18.4% to 27.5%. Two main factors are associated with the pathogenesis of itch in diabetes, namely skin xerosis and diabetic polyneuropathy. It is still poorly defined how glycaemic control is associated with generalized itch. No treatment of choice is available; however, topical therapy (emollients) provides significant relief in varying percentages of patients. Conclusions: The results indicate a benefit of diabetes screening in individuals presenting with chronic itch without primary skin lesions.