ABSTRACT
INTRODUCTION: Topical immunotherapy is frequently used in the treatment of alopecia areata (AA) although few studies report long-term follow-up. Our goals were to determine the efficacy and the prognostic factors of topical immunotherapy in a large cohort of patients with AA treated in the departments of Dermatology and Venereology of Bergamo, Como and Pavia, from 1978 to January 2016. METHODS: A total of 252 patients with AA were evaluated retrospectively. RESULTS: All our patients developed an allergic reaction to a 2% solution of dinitrochlorobenzene (DNCB) or squaric acid dibutylester (SADBE) or diphenylcyclopropenone (DPCP). No patients discontinued therapy because of side effects. In total 112 patients (44.05%, p < 0.001) had a good response. Statistical analysis revealed that the main prognostic factors influencing the clinical results were the severity of hair loss at the beginning of therapy, the duration of AA, a history of atopy (particularly eczema), and the early development of sensitization to the three sensitizers. CONCLUSION: Topical immunotherapy in patients with AA is quite effective, mostly well tolerated, and provides prolonged therapeutic benefits.
ABSTRACT
BACKGROUND: Contact dermatitis (CD) is a chronic disease with a significant impact on quality of life (QoL). There have been relatively few reports in the literature on specific QoL outcomes for patients suffering from CD. OBJECTIVES: To develop a new instrument specifically designed to measure QoL in CD and to investigate which disease features could strongly influence QoL. METHODS: Three hundred seventy-two patients affected by CD were administered a 20-item questionnaire, which comprised some questions taken and modified from the Dermatology Life Quality Index and the Skindex 16. Six more items were added. Univariate analysis and a chi-square test were performed. RESULTS: Females reported lower QoL scores than males. Three aspects (itching, discomfort, and difficulty in daily activities) were strongly associated with a poor QoL; even if patients who experienced difficulty in using their hands at work had a poor QoL, the statistical significance was very low. CONCLUSION: A CD-specific questionnaire can be used to understand a priori the impact on psychological behaviour of the patient and can lead to specific choices, such as the appropriate therapy to be used, the evaluation of treatment efficacy, the choice of preventive devices, and the comparison with QoL of other dermatoses.
Subject(s)
Dermatitis, Contact/psychology , Quality of Life , Surveys and Questionnaires , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Dermatitis, Contact/therapy , Female , Humans , Male , Middle Aged , Pruritus/psychology , Pruritus/therapy , Severity of Illness Index , Treatment Outcome , Young AdultSubject(s)
Blastocystis Infections/diagnosis , Blastocystis hominis/isolation & purification , Skin Diseases, Parasitic/diagnosis , Adult , Aged , Animals , Antiparasitic Agents , Blastocystis Infections/drug therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Paromomycin/therapeutic use , Severity of Illness Index , Treatment OutcomeSubject(s)
Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/epidemiology , Urticaria/epidemiology , Veterinarians/statistics & numerical data , Adult , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Patch Tests , Surveys and Questionnaires , Urticaria/etiologyABSTRACT
BACKGROUND: Eyelids can be affected by various types of dermatitis that are often difficult to diagnose. OBJECTIVE: The aim of the study was to establish some guidelines for a correct diagnosis. METHODS: A total of 447 patients treated at 12 research units for eczema or other inflammatory dermatitis located on the eyelids were invited to complete a questionnaire. When necessary, patch tests with haptens of the standard series from Gruppo Italiano di Ricerca sulle Dermatiti da Contatto e Ambientali della Società Italiana di Dermatologia e Venereologia (SIDEV-GIRDCA) were performed. RESULTS: Of the subjects studied, 50.2 % were diagnosed with allergic contact dermatitis (ACD); 20.9% were affected by irritant contact dermatitis (ICD), 13.5% by atopic dermatitis, 6.3% by seborrheic dermatitis, 6.5% by aspecific xerotic dermatitis, and 2.3% by psoriasis. Approximately 91% of all subjects reported an absence of familial atopy. A significant statistical association between diagnosis type and a personal history of atopy was evident (p <.000001, chi-square test). The results of gradual logistic regression models showed four-eyelid involvement as the main risk factor for ACD (odds ratio [OR] = 3.0; 95% CI, 1.1-8.1); with ICD, the main risk factor was the onset of symptoms at between 2 and 6 months (OR = 2.1; 95% CI, 1.1-4.0), whereas for atopic dermatitis, the main risk factors were the onset of symptoms later than 6 months and a personal history of atopy (OR = 4.9 and 3.6, respectively). CONCLUSION: Results suggest that many characteristics of the patients examined can be used for the differential diagnosis of palpebral eczematous dermatitis.
