PD-L1 expression in keratinocyte and infiltration of CD4 + T lymphocyte can predict a severe type of erythema multiforme major induced by the anti-PD-1 antibody, pembrolizumab.

Skin toxicity is the most common adverse event of treatment with immune check point inhibitors. Among them, erythema multiforme is a rare occurrence with a frequency of 4%, with most of the cases developing grade 1/2 disease. We experienced high grade erythema multiforme major developing with pembrolizumab treatment for anal canal cancer with extensive skin metastases. Steroid ointment was ineffective, and the skin lesions with blisters expanded to > 45% of the body surface area. The patient was at risk for symptom aggravation, and a pulse therapy with methylprednisolone and increasing the dose of oral prednisolone (1 mg/kg) were started. The skin lesions improved in 1.8 months. Unless urgent and appropriate treatments such as high dose steroid administration were conducted, the skin toxicities could not be controlled. The presence of CD4+ T cells and PD-L1+ keratinocytes in the skin biopsy might be a predictive marker of erythema multiforme major resistant to standard steroid treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s13691-024-00676-4.

Examining the Relationship Between Preference for Solitude and Subjective Well-Being Among Japanese Older Adults.

BACKGROUND AND OBJECTIVES: Focusing on the fact that older adults with positive emotions tend to spend time alone, this study aimed to examine the relationship between preference for solitude and subjective well-being among older adults. In Study 1, we developed a revised version of the Preference for Solitude Scale with a 3-factor structure, unlike the single-factor structure of the original scale. In Study 2, we examined the relationship between preference for solitude and subjective well-being using the revised scale. RESEARCH DESIGN AND METHODS: We conducted an Internet survey with 210 older adults in Study 1 to develop a revised Japanese scale. In Study 2, to address the possible research method bias in Study 1, we conducted a mail survey with 276 older adults. We examined the replicability of Study 1, confirming metric invariance through multigroup analysis and hypothesis model through path analysis. RESULTS: The results of the path analysis indicated that "Productivity during solitude" (Factor 3) was positively related with positive affect and life satisfaction, and "Enjoyment of solitude" (Factor 2) was negatively related with negative affect. However, the results of the mediation analysis suggested that preference for solitude was also related to loneliness, and the indirect effect of preference for solitude on well-being was negative. DISCUSSION AND IMPLICATIONS: "Enjoyment of solitude" and "Productivity during solitude" were related to maintaining subjective well-being among older adults, although the effects were marginal. The impact of preference for solitude was mixed in enhancing and decreasing subjective well-being.

The Effects of Familial Social Support Relationships on Identity Meaning in Older Adults: A Longitudinal Investigation.

This study aimed to examine whether social support promotes identity meaning among older adults. We hypothesized that when two spouses exchange social support, their sense of marital identity is enhanced. Among older adults, parental identity may be more strongly enhanced when parents provide social support to their children rather than receive social support from them. We conducted a longitudinal survey of 355 older adults (240 men and 115 women aged >60 years), who were assessed four times over 2 years. First, we confirmed the relationship between social support and identity meaning using an autoregressive path model. Second, we examined the effect of social support on the trajectory of role identities in a growth curve model. The intercepts of receiving support and providing support were significantly associated with the intercept of marital identity. In addition, the intercept of identity meaning for parents correlated with the intercept of providing support to their children but not with that of receiving support from their children. Social support between family members promotes role identities in family relationships. In particular, providing support to children correlates with parental roles which connect to subjective well-being.

The relationship between vision impairment and well-being among centenarians: findings from the Georgia Centenarian Study.

OBJECTIVE: The current study evaluated the visual function among centenarians and assessed the relationship between vision, social support, and well-being. METHODS: This study used the data set of the Georgia Centenarian Study including 106 centenarians (18 men and 88 women). We used scores of the Snellen chart for objective vision and self-reports for subjective vision. Social support, depression, and loneliness were also assessed. RESULTS: Approximately 75% of the centenarians showed some level of objective visual impairment, and 56% of them reported that they had visual impairment. Objective vision impairment was significantly related to depression. Multiple regression analysis revealed that both variables of visual function were significantly associated with depression, but not loneliness. In the model including depression, a significant interaction was obtained for social support and objective vision. Centenarians reported lower level of depression when they had social support. However, centenarians who had low level of visual function tended to report higher depression even if they had social support. IMPLICATIONS: These results indicated that vision function was related to centenarians' well-being, especially depression. Copyright © 2017 John Wiley & Sons, Ltd.

[Examination of the relationship between preference for solitude and emotional well-being after controlling for the effect of loneliness].

This study examined whether preference for solitude promotes emotional well-being after controlling for the influence of loneliness. We administered a questionnaire that included variables regarding preference for solitude, loneliness, positive affect, and negative affect. The sample consisted of 318 young adult university students and 253 individuals aged 65 and older. The results showed a significant negative correlation between preference for solitude and positive affect; however there was no correlation between preference for solitude and negative affect. Hierarchical multiple regression analysis confirmed a negative effect of preference for solitude on negative affect after controlling for the influence of loneliness, and there was no effect on positive affect. The results of this study supported the hypothesis concerning, the relationship between preference for solitude and negative affect, and demonstrated that preference for solitude decreased negative affect and promotes emotional well-being.