A new paradigm in the management of scalp pruritus: findings from the SCALP-PR trial.

PURPOSE: The "Impact of scalp pruritus in dermatological consultations in Spain: The SCALP-PR trial" was initiated to address the common yet often insufficiently examined issue of scalp pruritus in dermatology. This condition leads to an uncontrollable urge to scratch, affecting the patients' quality of life and potentially causing scalp damage. This study aimed to explore the prevalence, patient profile, underlying conditios, and therapeutic approaches for scalp pruritus in Spain, and to assess the safety and efficacy profile, as well as the tolerability of a non-pharmacologic treatment. METHODS: From 2021 through 2022, 75 dermatologists enrolled a total of 359 patients in a study on scalp pruritus, approved by the Bellvitge University Hospital Research Ethics Committee, Barcelona, Spain. This evidence-based research combined a meta-analysis with observational study techniques focused on real-world evidence to examine the therapeutic impact on quality of life (QoL). Utilizing the Dermatology Life Quality Index (DLQI) for QoL assessments, the study evaluated the effectiveness of the topical product over 15 days. Data collection was conducted via an eCRF and analyzed with statistical methods to provide reliable insights into the management of scalp pruritus. RESULTS: The prevalence of scalp pruritus in Spain was found to be 6.9%, predominantly among women with a mean age of 52.5 years. The leading causes identified were seborrheic dermatitis and pruritus of undetermined etiology or sensitive scalp. Stress was noted as a key factor, with corticosteroids and hygienic measures being common therapies. The topical product demonstrated significant reductions in pruritus and scratching in more than 90% of patients after 15 days. Improvements were also seen in dermatological quality of life, with 87.1% of patients showing enhancements in DLQI scores. The product was well-received thanksto its cosmetic properties, with high ratings in texture, ease of application, and fragrance. CONCLUSION: The topical product studied is a safe, effective, and cosmetically appealing treatment, improving scalp pruritus in various etiologies for most patients. The results highlight the need for patient-center treatments in dermatology, providing important insights for clinical practice and future research.

Electrostrictive and piezoelectrical properties of chitosan-poly(3-hydroxybutyrate) blend films.

Herein, we report the high apparent piezoelectric coefficient for chitosan-poly(3-hydroxybutyrate) (CS-PHB) blend films. The structure of chitosan-poly(3-hydroxybutyrate) (CS-PHB) blend films, exploiting characteristics such as dielectric, polarization, apparent piezoelectric properties, and their dependencies on the composition, were investigated. Based on the results of XRD, SEM, FTIR, PFM, and dielectric spectroscopy measurements, the structure of CS-PHB blend films has been proposed, which consists of spheric-like inclusion formed by precipitating isotactic-PHB interface layer, which consists of syndiotactic-PHB hydrogen bonding with CS, and CS matrix. The synergistic effects of piezoelectricity and electrostriction help explain the high value of the apparent piezoelectric coefficient (d33) obtained in the blend film with 13 wt% of PHB (d33 ≈ 200 pC/N). The investigated CS-PHB blend films are a good candidate for tissue engineering applications.

Association of positive psychological variables with disease activity, functional disability and erythrocyte sedimentation rate in patients with rheumatoid arthritis: a preliminary study.

Rheumatoid arthritis (RA) is a chronic autoimmune disease which has shown positive correlations between negative psychological variables and disease activity in transversal studies and in the follow-up. However, the association of positive psychological variables with disease parameters including disease activity (DAS-28), functional disability (HAQ) and erythrocyte sedimentation rate (ESR) has not been investigated. Patients with RA attending the external consultation of a third level hospital were invited to participate and fill in a questionnaire with personal, disease and psychological variables; body mass index was also obtained as well as ESR. A total of 49 patients were included. The three dependent variables correlated among them, with the highest correlation for DAS-28 and HAQ (r=0.645, p<0.01), followed by somatization and HAQ (r=0.614, p<0.01) or DAS-28 (r=0.537, P<0.01). In addition, HAQ showed negative correlations with environmental mastery (r=- 0.366, p<0.01), personal growth (r=-0.292, p<0.05) and monthly extra money (r=-0.328, p<0.05), and borderline negative correlations with emotion perception (r=-0.279, p=0.053) and self-acceptance (r=-0.250, p=0.08). ESR showed a significant negative correlation with emotion perception (r=-0.475, p<0.01). In conclusion, we observed important correlations of positive psychological variables with disease activity, functional disability and ESR that could be addressed in order to prevent or treat these disease features.

Cuero cabelludo sensible: diagnóstico y manejo práctico / Sensitive Scalp: Diagnosis and Practical Management

El cuero cabelludo sensible es una piel sensible de localización especial. Puede ser primario, cuando se presenta sin enfermedad del cuero cabelludo, y secundario cuando es atribuible a procesos como psoriasis, dermatitis seborreica, dermatitis atópica y otros. Las manifestaciones clínicas de la forma primaria son subjetivas. El escozor, picor, tricodinia y sensaciones disestésicas son el motivo de consulta, muy a menudo coincidiendo con alopecia. Clínicamente la piel del cuero cabelludo puede ser normal o eritematosa. No hay datos de laboratorio o histológicos específicos para un diagnóstico objetivo. Los factores desencadenantes son endógenos como el estrés y alteraciones emocionales y psicopatológicas, o ambientales como los tópicos inadecuados y los cosméticos. El tratamiento debe ser personalizado, incluyendo pimecrólimus, la hidratación con ácido hialurónico, y la mesoterapia con plasma rico en factores de crecimiento (AU)

Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors (AU)

[Translated article] Sensitive Scalp: Diagnosis and Practical Management / Cuero cabelludo sensible: diagnóstico y manejo práctico

Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors (AU)

El cuero cabelludo sensible es una piel sensible de localización especial. Puede ser primario, cuando se presenta sin enfermedad del cuero cabelludo, y secundario cuando es atribuible a procesos como psoriasis, dermatitis seborreica, dermatitis atópica y otros. Las manifestaciones clínicas de la forma primaria son subjetivas. El escozor, picor, tricodinia y sensaciones disestésicas son el motivo de consulta, muy a menudo coincidiendo con alopecia. Clínicamente la piel del cuero cabelludo puede ser normal o eritematosa. No hay datos de laboratorio o histológicos específicos para un diagnóstico objetivo. Los factores desencadenantes son endógenos como el estrés y alteraciones emocionales y psicopatológicas, o ambientales como los tópicos inadecuados y los cosméticos. El tratamiento debe ser personalizado, incluyendo pimecrólimus, la hidratación con ácido hialurónico, y la mesoterapia con plasma rico en factores de crecimiento (AU)

Sensitive Scalp: Diagnosis and Practical Management. / Cuero cabelludo sensible: diagnóstico y manejo práctico.

Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors.

Evaluation of a psychoeducational intervention including emotional intelligence to increase treatment adherence in rheumatoid arthritis (A pilot study).

Our objective was to perform two studies: a cross-sectional study in order to identify the main psychological variables associated to treatment adherence in rheumatoid arthritis and an intervention based on psychoeducation to assess its impact on the variables identified in the first study. We measured treatment adherence, self-efficacy, beliefs about medication, emotional intelligence and disability along with personal and disease variables in the cross-sectional study and the same variables were measured in the intervention before and after the program and 3 months later in 2 groups (an experimental group and an active control group). In the cross-sectional study (N=33) we found that the variables most associated with treatment adherence were emotional clarity (r=0.352, p<0.05) and emotional repair (r=0.363, p<0.05). In the intervention, we divided the patients into 2 groups: the control group (N=7) and the intervention group (N=10). At the end of the study and at follow-up, we found a significant increase in adherence and self-efficacy in the intervention group, when compared with the control group. Emotional clarity was increased only in the post-test, and at follow up a decrease in beliefs of concern about medication was found. Psychoeducational programs based on information about the disease and its treatment together with emotional management are effective in increasing treatment adherence in the long term.

Germination, viability and dormancy of 47 species from threatened tropical montane grassland in southeast Brazil: Implications for ex situ conservation.

To mitigate anthropogenic impacts on plant diversity in tropical montane grasslands, one of the most threatened ecosystems in Brazil, it will be essential to develop ex situ conservation strategies to preserve wild species. The lack of basic research on the seed storage behaviour of grassland species may, however, limit their use for reintroduction and restoration projects. We investigated seed storage behaviour at the community level by comparing the effects of cold-low RH (10 °C; 10% RH) and freezing-low RH (20 °C; 10% RH) conditions on seed viability, germination and dormancy of 47 species. Fresh seeds of 43% of the species showed primary dormancy. More than half of the species showed high seed survival responses (viability >60%) under both storage temperatures. Despite a variety of dormancy responses among the different species, the low RH storage conditions tested released dormancy for most species during 12- and 30-month storage times. Multivariate analysis of the best (freezing-low RH, 30 months) storage condition evidenced the formation of five distinct groups, three with species having high conservation potential in seed banks. Although further studies are needed to test dormancy-breaking treatments and improve seed conservation practices, this first approach to assessing seed banking techniques could contribute to demand for locally adapted seeds for ecological restoration projects in tropical montane grasslands.

Comment on "Investigation on the structure and thermoelectric properties of CuxTe binary compounds" by Shriparna Mukherjee et al., Dalton Trans., 2019, 48, 1040.

The Raman spectra of copper tellurides are nearly unknown. This is due not only to the difficulty in obtaining single-phase specimens, but also to the low inelastic light scattering efficiency of Cu2-xTe. To date, only the Raman spectrum of the vulcanite phase, CuTe, has been both measured and calculated by density functional theory. The authors of the commented work reported the Raman spectra of Cu2Te, Cu1.6Te and Cu1.25Te samples. However, the assignment of the measured modes has been defective and their Raman spectra lack some of the features usually found for copper tellurides.

Body dysmorphic disorder in patients with acne: a multicentre study.

BACKGROUND AND OBJECTIVE: Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM-IV and DSM-5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. METHODS: A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. RESULTS: In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6-13.6%). The prevalence was the same with DSM-IV or DSM-5 criteria. Possible cases of BDD were predominantly women (P = 0.021), and 56% had non-inflammatory lesions vs. 30% of negative patients (P = 0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make-up (72.1%). CONCLUSIONS: As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.

Dermatología Estética: habilidades humanas claves en comunicación. Modelo de los tres pilares / Key Communication Skills in Cosmetic Dermatology: A 3-Pillar Model

La Dermatología Estética se ocupa de la belleza y apariencia de la piel, una parte importantísima de la imagen corporal. Los tratamientos utilizados en Dermatología Estética (higiene, hidratación, protección, reparación) buscan potenciar las características propias de la piel, en su anatomía, función y vitalidad, y esto se traduce en mejoras del aspecto estético. La comunicación con el paciente es fundamental en la consulta médica y entendemos que la Dermatología Estética tiene connotaciones especiales que deben considerarse. En este artículo se presenta un modelo propio de tres pilares en la comunicación con el paciente estético y se exponen tres habilidades humanas como dichos pilares: asertividad, empatía y juicio crítico

Cosmetic dermatology deals with the beauty and appearance of the skin - a most important element of body image. Treatments used in cosmetic dermatology (hygiene, hydration, protection, repair) aim to enhance the characteristics of the skin, its anatomy, its function, and its vitality, to produce aesthetic improvements. Communication with the patient is essential in medical consultations and we believe that it has special connotations in cosmetic dermatology that must be taken into account. In this article, we present a 3 - pillar model for communication with cosmetic dermatology patients that rests on 3 skills: assertiveness, empathy, and critical judgement

Diagnóstico y tratamiento del síndrome de piel sensible: un algoritmo para la práctica clínica habitual / Diagnosis and Treatment of Sensitive Skin Syndrome: An Algorithm for Clinical Practice

Tradicionalmente, la piel sensible se ha considerado como un problema cosmético o como una alteración puramente psicosomática con un fuerte componente subjetivo. Sin embargo, diversos estudios científicos sobre sus procesos fisiopatológicos y su etiopatogenia han demostrado que se trata de una entidad compleja que ya diversos autores consideran un síndrome neurodermatológico. Sus características hacen que su diagnóstico y tratamiento puedan resultar complicados en la práctica clínica habitual, siendo necesarias herramientas sencillas que se puedan usar de rutina, tanto para identificar esta entidad, que puede presentarse acompañada de otra patología, como para su manejo independiente. En este trabajo realizamos una revisión práctica de los avances científicos más recientes el campo de la piel sensible que justifican su consideración individual y ofrecen herramientas para identificarla y tratarla. Proponemos algoritmos de diagnóstico y de tratamiento basados en las evidencias de la literatura y en la opinión de los expertos que firman este artículo

Sensitive skin has traditionally been viewed as a cosmetic problem or as a purely psychosomatic alteration with a major subjective component. Different studies of its pathophysiologic etiology, however, have shown it to be a complex entity that several authors now consider to be a neurodermatological syndrome. Because of this complexity, skin sensitivity can be difficult to diagnose and treat, particularly considering that it may present with another disease. Simple tools applicable to clinical practice are thus necessary to identify and manage this disease as an independent entity. In this study, we perform a practical review of the most recent scientific advances in the area of sensitive skin that justify it being considered an individual entity, and provide tools for its identification and treatment. We propose diagnostic and treatment algorithms based on evidence from the literature and our experience and expertise

Fase final de la validación transcultural al español de la escala Hair Specific Skindex-29: sensibilidad al cambio y correlación con la escala SF-12 / Final Phase in the Validation of the Cross-Cultural Adaptation of the Hair-Specific Skindex-29 Questionnaire Into Spanish: Sensitivity to Change and Correlation With the 12-Item Short-Form Health Survey

Antecedentes y objetivo: Previamente se había iniciado el proceso metodológico para la validación transcultural al idioma español de la escala Hair Specific Skindex-29 (HSS-29), que mide el impacto de la alopecia androgénica femenina sobre la calidad de vida relacionada con la salud (CVRS). Para finalizar el proceso, el objetivo del estudio fue completar la validación a través de la determinación de su sensibilidad al cambio y su correlación con una escala generalista de CVRS (SF-12). Material y método: Se establecieron dos visitas, una basal y otra tras 6meses de tratamiento con suplemento alimenticio con actividad inhibidora de la enzima 5-alfa reductasa. En cada visita, investigadores y pacientes valoraron la gravedad de la alopecia mediante la escala Sinclair, el estado de la apariencia del cabello, y se administraron las escalas HSS-29 y SF-12. Resultados: Participaron 983 mujeres con alopecia androgénica. La media de puntuación en la escala HSS-29 cambió de 27,5 ± 18,7 en la visita basal a 19,3 ± 15,7 en la de seguimiento, y sus dimensiones funcional, emocional y sintomática también cambiaron significativamente. Tanto las diferencias entre basal y seguimiento en el índice HSS-29 global como en cada una de sus dimensiones se correlacionaron significativamente con las diferencias encontradas en las dimensiones de SF-12. Los coeficientes de correlación de Pearson oscilaron entre -0,1 y -0,4, y en todos los casos el grado de significación fue p < 0,001. Conclusiones: La versión en español de la escala HSS-29 posee sensibilidad, es decir, detecta cambios relacionados con la calidad de vida cuando las condiciones objetivas varían. Igualmente, se observó una correlación entre las escalas HSS-29 y SF-12

Background and objective: Work has already been done on validating the cross-cultural adaptation of the Hair-Specific Skindex-29 questionnaire (HSS-29) into Spanish. This questionnaire measures the impact of female-pattern hair loss on health-related quality of life (HRQoL). The aim of this study was to complete the validation process by testing the questionnaire's sensitivity to change and assessing its correlation with the generic 12-item Short-Form Health Survey (SF-12). Material and method: Patients who started treatment with a nutritional supplement that blocks the activity of 5-alpha-reductase were seen in two visits: a baseline visit and a follow-up visit at 6months. At each visit, hair loss severity was assessed by both investigators and patients via the Sinclair scale, evaluation of hair condition, and administration of HSS-29 and SF-12. Results: In total, 983 women with female-pattern hair loss participated in the study. The mean HSS-29 score decreased from 25.7 ± 18.7 at baseline to 19.3 ± 15.7 at follow-up and significant changes were also observed in the functioning, emotions, and symptoms domains. Changes in overall and subscale HSS-29 scores from baseline to follow-up were all significantly correlated with changes in SF-12 subscale scores. The Pearson correlation coefficients ranged from -0.1 to -0.4 and were all significant at P <.001. Conclusions: The Spanish version of HSS-29 is sensitive to change, as it detected changes in objective measurements of HRQoL. Correlations between HSS-29 and SF-12 scores were also observed