RESUMO
BACKGROUND: Little is known about factors affecting the quality of life (QoL) of patients with vitiligo, and previous studies have shown conflicting results. OBJECTIVES: To explore the QoL of patients with vitiligo and to identify factors affecting QoL. METHODS: A nationwide questionnaire-based study was conducted with 1123 patients with vitiligo recruited from 21 hospitals in Korea from July 2015 to June 2016. Data were collected using a structured questionnaire for demographic information and the Skindex-29 instrument. Mild or severely impaired QoL in patients with vitiligo was assessed according to each domain (symptoms, functioning and emotions) of Skindex-29. Multivariate logistic regression analyses were performed to determine the factors associated with QoL. RESULTS: Of the enrolled participants, 609 were male and 514 female, with a mean age of 49·8 years (range 20-84). The median duration of disease was 3·0 years (range 0-60). Using multivariate logistic regression modelling, the involvement of visible body parts and a larger affected body surface area were consistently associated with QoL impairment in all three domains of Skindex-29. Additionally, the QoL of patients aged 20-59 years, who potentially had a more active social life than older patients, was associated with functional impairment. Furthermore, a higher educational background was associated with emotional impairment. CONCLUSIONS: A multitude of factors significantly influence the QoL of patients with vitiligo. A better appreciation of these factors would help the management of these patients.
Assuntos
Qualidade de Vida/psicologia , Vitiligo/psicologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Atitude Frente a Saúde , Imagem Corporal/psicologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , República da Coreia/epidemiologia , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Vitiligo/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Psychological aspect and quality of life should be considered in treating patients with psoriasis. OBJECTIVE: We sought to ascertain which clinical characteristics including presence of exposed lesions are associated with impairment of health-related quality of life (HRQoL) in patients with psoriasis. METHODS: The EPI-PSODE study was a nationwide, multicenter, cross-sectional study conducted in Korea that included 1260 adult patients with psoriasis. In addition to clinical characteristics including presence of exposed lesions, data were collected using the Psoriatic Arthritis (PsA) Screening and Evaluation (PASE), Dermatology Life Quality Index (DLQI), MOS 36-Item Short-Form Health Survey (SF-36), Work Productivity and Activity Impairment Questionnaire Psoriasis (WPAI: PSO) and Medication Satisfaction Questionnaire (MSQ). RESULTS: Patients with a DLQI score > 5 (n = 990) were younger, had an earlier onset of psoriasis, scored higher on the Psoriasis Area and Severity Index (PASI), had higher body surface area (BSA) and had higher PASE scores than patients with DLQI ≤ 5 (n = 266). The group of patients with exposed lesions (n = 871) were younger and male predominance, earlier onset of psoriasis, longer disease duration, higher PASI/BSA score and a higher proportion with drinking and smoking history each than the group of patients without exposed lesions (n = 389). Presence of exposed lesions negatively influenced DLQI, 36-Item Short-Form Health Survey (SF-36) (mental component), presenteeism, total work productivity impairment and total activity impairment in the WPAI: PSO. In multiple regression model, PASI score was the only variable which was significantly associated with all HRQoL measures. Presence of exposed lesions was a significant factor affecting DLQI and SF-36 (mental). CONCLUSION: The presence of exposed lesions has a negative impact on quality of life, mental health and work productivity. Therefore, effective treatments are particularly needed for psoriasis patients with exposed lesions.
Assuntos
Psoríase/psicologia , Qualidade de Vida , Adulto , Idade de Início , Consumo de Bebidas Alcoólicas/epidemiologia , Artrite Psoriásica/diagnóstico , Superfície Corporal , Estudos Transversais , Eficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Presenteísmo , Psoríase/epidemiologia , República da Coreia/epidemiologia , Índice de Gravidade de Doença , Fatores Sexuais , Fumar/epidemiologia , Inquéritos e QuestionáriosAssuntos
Carcinoma de Células Escamosas/cirurgia , Doenças do Pé/cirurgia , Cirurgia de Mohs , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Carcinoma de Células Escamosas/patologia , Feminino , Doenças do Pé/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
The alanine to threonine substitution at codon 54 (Ala54Thr) of the fatty acid binding protein 2 (FABP2) gene has been reported to be associated with increased fat oxidation and insulin resistance in several populations. It has been hypothesized that Ala54Thr substitution results in enhanced intestinal uptake of fatty acids and thereby an impairment of insulin action, but this hypothesis has not been proven in vivo. We studied the association between the Ala54Thr polymorphism of the FABP2 gene and intestinal (3)H-oleic acid absorption, as well as basal insulin level, basal metabolic rate, and fat oxidation rate in 96 healthy young Korean men. Among our subjects, the allele frequency of the Ala54Thr substitution was 0.34. Subjects with Thr54-encoding allele were found to have a higher mean fasting plasma insulin concentration and a higher basal fat oxidation rate compared with the subjects who were homozygous for the Ala54-encoding allele. However, there was no significant difference in basal metabolic rate or (3)H-oleic acid absorption according to the FABP2 gene polymorphism. These results suggest that the Ala54Thr substitution in the FABP2 gene is associated with increased fat oxidation and hyperinsulinemia in normal Korean men, but these effects are not mediated by an increase in the intestinal fatty acid absorption.
Assuntos
Proteínas de Transporte/genética , Gorduras na Dieta/metabolismo , Ácidos Graxos/metabolismo , Hiperinsulinismo/genética , Absorção Intestinal/genética , Proteínas de Neoplasias , Polimorfismo Genético/genética , Proteínas Supressoras de Tumor , Animais , Índice de Massa Corporal , Calorimetria Indireta , Códon/genética , Metabolismo Energético/genética , Proteína 7 de Ligação a Ácidos Graxos , Proteínas de Ligação a Ácido Graxo , Teste de Tolerância a Glucose , Hemodinâmica , Humanos , Hiperinsulinismo/metabolismo , Insulina/sangue , Coreia (Geográfico) , Masculino , Ácido Oleico/farmacocinética , OxirreduçãoRESUMO
OBJECTIVES: Dimethyl sulfoxide (DMSO), an agent that provides symptomatic relief in patients with interstitial cystitis (IC) works via an unknown mechanism. We investigated whether DMSO acts as a chemical stimulant of mast cell degranulation. METHODS: A radioimmunoassay (RIA) specific for histamine was used to test this hypothesis. Twelve women with strictly diagnosed IC were treated with intravesical instillations of DMSO. Treatments were repeated at varying intervals, and each patient received three to six treatments. Urine histamine levels were measured before and after each intravesical instillation of DMSO. Dilutional effects of DMSO were corrected for by conversion of urine histamine concentration to urine histamine:creatinine ratio. RESULTS: The RIA was unaffected by the addition of DMSO to urine. No consistent change in the urine histamine:creatinine ratio following DMSO instillation was found. Trend analysis revealed no trend in the histamine:creatinine ratio with time. CONCLUSIONS: The relief of symptoms reported in 50% to 77% of patients treated with intravesical DMSO is not related to detectable mast cell release of histamine. Other mechanisms of action must be investigated to explain the beneficial effect of this agent.
Assuntos
Anti-Inflamatórios/farmacologia , Cistite Intersticial/urina , Dimetil Sulfóxido/farmacologia , Liberação de Histamina/efeitos dos fármacos , Administração Tópica , Creatinina/urina , Feminino , Humanos , Análise de RegressãoRESUMO
A 56-year-old woman suffering from cutaneous sporotrichosis on the right cheek and right knee is described. The sporotrichotic nodule of the knee was thought to have been caused by distant autoinoculation.
Assuntos
Dermatomicoses/diagnóstico , Dermatoses Faciais/microbiologia , Joelho , Esporotricose/diagnóstico , Diagnóstico Diferencial , Dermatoses Faciais/diagnóstico , Feminino , Humanos , Joelho/microbiologia , Pessoa de Meia-Idade , Sporothrix/isolamento & purificação , Tuberculose Cutânea/diagnósticoRESUMO
BACKGROUND: Suction devices for epidermal grafting need a suction pump to provide a negative pressure. The authors have developed a suction device in which a syringe and a manometer are employed to provide a negative pressure. OBJECTIVE: The purpose of this study was to evaluate the efficacy of our suction device in vitiligo patients. METHODS: The suction device was used to obtain epidermal blisters from the donor site. A CO2 laser was employed to remove the depigmented epidermis. The blister roofs of the donor site were harvested and were placed onto the recipient area. Ten patients with stable vitiligo were treated by epidermal grafting. RESULTS: Epidermal blisters were produced by suction in all patients. Also, all 10 patients regained repigmentation. CONCLUSION: Our suction blister device is simple and inexpensive to make, and it may become an alternative to the other suction devices.
Assuntos
Epiderme/transplante , Manometria/instrumentação , Seringas , Vitiligo/cirurgia , Adolescente , Adulto , Vesícula , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sucção/instrumentação , Transplante AutólogoRESUMO
The diagnosis of interstitial cystitis is primarily made based on clinical and cystoscopic findings with exclusion of other bladder diseases. Despite all of the efforts at definitive identification, interstitial cystitis lacks universal objective findings. Mast cell activation with associated histamine release has been postulated as an etiological factor leading to the symptom complex associated with interstitial cystitis. To investigate this hypothesis, a 3-step controlled prospective study was conducted. In step 1 reliability of urine histamine assay was critically examined, and the assay was established to be simple, reliable and valid. In step 2 random spot urine histamine levels (basal state) were measured in 25 noninterstitial cystitis and 15 interstitial cystitis patients (22.1 +/- 0.95 ng./ml. versus 19.2 +/- 1.19 ng./ml.). There was no significant difference in the random urine histamine levels between the 2 groups (p greater than 0.05). In step 3 urine histamine levels were measured before and after hydrodistention (acute stimulation) in 7 noninterstitial cystitis controls and 6 newly diagnosed interstitial cystitis patients under general anesthesia. The urine histamine-to-creatinine ratio was used to correct for the dilutional effect of normal saline used during hydrodistention. The urine histamine-to-creatinine ratios of the control group showed no significant difference before and after hydrodistention. However, the difference in the urine histamine-to-creatinine ratios of the interstitial cystitis group compared to the controls before and after hydrodistention was highly significant (p less than 0.001). Although measurement of random spot urine histamine alone (basal state) was not found useful to make the diagnosis of interstitial cystitis, measurement of urine histamine before and immediately after hydrodistention (acute stimulation) may become an important objective parameter to assist in the diagnosis of interstitial cystitis.
Assuntos
Cistite/urina , Histamina/urina , Adulto , Idoso , Creatinina/urina , Feminino , Humanos , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
We studied the 1-type isoproterenol inhalation therapy for patients with severe asthmatic attacks who were admitted at the Department of Allergy of National Children's Hospital from 1981 to 1991. One hour after l-type isoproterenol inhalation therapy, statistically significant effects were noted with regard to the asthmatic status. Moreover, no side effect was found amoung the subjects. From these data, 1-type isoproterenol inhalation therapy is thought to be effective for severe asthmatic attacks.