Sexual quality of life in patients with pemphigus: A case-control study.

BACKGROUND: Pemphigus, an autoimmune blistering disease that affects the skin and mucous membranes, significantly impairs the quality of life (QoL) of affected individuals. While there are a variety of QoL measurement tools available for assessing this disease, there is a lack of studies that specifically evaluate the sexual QoL of patients with pemphigus. OBJECTIVES: This case-control study aims to investigate the impact of the disease on sexual activity as well as its overall effect on QoL. MATERIALS AND METHODS: Fifty pemphigus patients, who were referred to the Dermatology Department at the University Hospital of Brescia in the period March 2019-September 2021, completed several QoL surveys, including the 36-item Short Form Health survey (SF-36), the 12-Item General Health Questionnaire (GHQ-12), the Autoimmune Bullous Disease Quality of Life (ABQOL) and either the International Index of Erectile Function (IIEF) or the Female Sexual Function Index (FSFI). The severity of the disease was assessed using the Pemphigus Disease Area Index (PDAI). Differences in QoL surveys between the case and control groups were analysed using either the t-test or the Wilcoxon-Mann-Whitney test. The correlation between QoL surveys in pemphigus patients and disease severity were analysed using Spearman's coefficient (r). RESULTS: The results revealed a marked impairment in overall QoL among patients with pemphigus compared to the healthy control subjects. Significant differences were observed in various domains of QoL, including physical health, mental well-being, social functioning and, notably, sexual health. Furthermore, disease severity as evaluated by the PDAI showed correlations with specific aspects of health status, and disease-specific QoL demonstrated associations with nearly all domains of health status. No significant correlations were found between sexual activity, mucosal involvement or steroid therapy and PDAI scores or disease-specific QoL measures. CONCLUSION: These findings emphasize the significant impact of pemphigus on patients' well-being, with particular attention to the impaired sexual activity.

Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy.

BACKGROUND: Vascular endothelial growth factor (VEGF) is a pivotal cytokine in the pathogenesis of psoriasis, and upregulation of VEGF by tumour necrosis factor (TNF)-α and inflammatory factors causes marked alterations in the cutaneous microcirculation. Etanercept is a fully soluble TNF receptor fusion protein that primarily binds soluble TNF-α, thus blocking its pro-angiogenic function. AIM: To assess the modifications in the superficial capillary bed in psoriatic plaques during treatment with etanercept. METHODS: The study enrolled 22 patients (13 men, 9 women; age range 31-74 years) with plaque psoriasis resistant to conventional therapy. The patients were stated on etanercept 50 mg/week, which was continued for 24 weeks. At the beginning of the study (baseline), and at weeks 6, 12, 18 and 24, in vivo videocapillaroscopy analysis of a selected plaque was performed. Levels of erythema, scaling and infiltration were assessed using a four-point plaque severity score, with an overall score obtained by the sum of these three scores. The Psoriasis Activity and Severity Index (PASI) was also determined. RESULTS: Etanercept produced a significant reduction in PASI, plaque severity score and diameter of the basket-weave area at every time point. Four patients had complete remission, although none of the patients regained a normal capillaroscopic pattern. CONCLUSIONS: Similar to other conventional therapies, etanercept is able to improve PASI, plaque severity score and basket-weave area diameter, but it is unable to induce normalization of the microcirculation in psoriatic plaques.

Population Dynamics and Temperature-Dependent Development of Chrysomphalus aonidum (L.) to Aid Sustainable Pest Management Decisions.

The increasing worldwide trades progressively led to decreased impact of natural barriers on wild species movement. The exotic scale Chrysomphalus aonidum (L.) (Hemiptera: Diaspididae), recently reported on citrus in southern Italy, may represent a new threat to Mediterranean citriculture. We studied C. aonidum population dynamics under field conditions and documented its development under various temperatures. To enable describing temperature-dependent development through the use of linear and non-linear models, low temperature thresholds and thermal constants for each developmental stage were estimated. Chrysomphalus aonidum was able to perform four generations on green parts (leaves, sprouts) of citrus trees and three on fruits. In addition, an overall higher population density was observed on samples collected in the southern part of the tree canopy. Temperature had a significant effect on the developmental rate; female needed 625 degree days (DD) to complete its development, while male needed 833 DD. The low threshold temperatures, together with data from population dynamics, demonstrated that C. aonidum is able to overwinter as second instar and as an adult. The results obtained, validated by those collected in the field, revealed few differences between predicted and observed dates of first occurrence of each C. aonidum instar in citrus orchards. Data on C. aonidum phenology and the definition of the thermal parameters (lower and upper threshold temperatures, optimum temperature, and the thermal constant) by non-linear models could allow the estimation of the occurrence in the field of each life stage and would be helpful in developing effective integrated control strategies.