The Association of Bullous Pemphigoid With Atopic Dermatitis and Allergic Rhinitis-A Population-Based Study.

BACKGROUND: Although bullous pemphigoid (BP), atopic dermatitis (AD), and allergic rhinitis (AR) are associated with shared pathogenic mechanisms the epidemiological relationship between these conditions remains to be investigated. OBJECTIVE: To evaluate the bidirectional association of BP with AD and AR. METHODS: A population-based retrospective cohort study was performed comparing BP patients (n = 3924) with age-, sex-, and ethnicity-matched control subjects (n = 19,280), with respect to incident cases of AD and AR. A case-control design was additionally adopted to assess the odds of BP in individuals with a preexisting diagnosis of AD and AR. RESULTS: The odds of BP was increased after a preexisting diagnosis of AD (fully adjusted odds ratio, 1.76; 95% confidence interval [CI], 1.44-2.15; P < 0.001) and AR (fully adjusted odds ratio, 1.13; 95% CI, 1.01-1.28; P = 0.047). Patients with BP were at an increased risk of subsequent AD (fully adjusted hazard ratio, 2.00; 95% CI, 1.60-2.51; P < 0.001) but not AR (fully adjusted hazard ratio, 1.00; 95% CI, 0.83-1.20; P = 0.997). Compared with other patients with BP, those with BP and comorbid AD and AR were more frequently managed by adjuvant drugs and long-term systemic and topical corticosteroids and had decreased all-cause mortality. CONCLUSIONS: A history of AD and AR confers susceptibility to the development of BP. Awareness of this association may be of help for physicians managing patients with these diseases.

Does Ostmann's fat pad size correlate with development of chronic otitis media in children?

OBJECTIVE: To compare Ostmann's fat pad (OFP) size between healthy ears and ears with chronic otitis media with cholesteatoma (COMwC) in children, to assess its role in the disease. METHODS: MRI scans of 29 children with unilateral COMwC with conductive hearing loss were used to measure OFP, represented by the maximal diameter of the high intensity area medial to the tensor veli palatini muscle (TVP): M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle: M2. Values of M1, M2 and the ratio of M1:M2 were compared between the healthy and pathological ear in each patient. RESULTS: No difference in OFP size was observed between healthy (H) ears (mean M1H:M2H ratio 0.72 ± 2.28) compared to ears with COMwC pathology (P) (mean M1P:M2P ratio .68 ± 1.57; P = .943) in children, suggesting that OFP size abnormalities do not have a role in pediatric COMwC. CONCLUSION: OFP size was not correlated to the development of unilateral COMwC in children.

Transimplant antral lavage as minimally invasive treatment of chronic rhinosinusitis: Preliminary report of 11 consecutive cases.

OBJECTIVE: The present article reports how a dental implant with an internal port dental implant valve approach (DIVA) can be utilized as oroantral port to treat chronic rhinosinusitis (CRS) in a minimally invasive manner. METHOD AND MATERIALS: Eleven patients (age mean 68.1 years) with CRS were subjected to the transimplant lavage technique. For three patients the CRS treatment was performed via previously installed dental implants, and for another eight patients the implantation procedure was combined with the CRS treatment. The moment the implant was fully installed, the sinus membrane was punctured via the implant channel. Upon completion of the pus drainage the sinus was irrigated with normal saline, followed by the injection of a steroid solution (100 mg hydrocortisone). RESULTS: Patients began to report symptomatic improvement from the first day after the first-session procedure. Nine patients had complete relief of most of their symptoms (nasal obstruction/discharge, anosmia/hyposmia) at day 30. The follow- up nasal endoscopy demonstrated no evidence of active sinus disease. All the implants used were found to be well-osseointegrated and still in use for prosthetic purposes. Clinical and radiologic results showed stability and no recurrence in the follow-up period. CONCLUSION: The dental implant with an internal central port and integral dedicated sealing screw may be used for irrigation, observation, and further treatment of the maxillary sinus in cases of CRS.