Teledermatology by WhatsApp in Valencia: Characteristics of Remote Consultation and Its Emotional Impact on the Dermatologist. / Teledermatología por WhatsApp en la Comunidad Valenciana. Características de esta teleconsulta y su repercusión en la vida del dermatólogo.

BACKGROUND: WhatsApp is a preferred method of remote consultation for patients. However, the lack a legal framework for this type of patient-physician contact or the inappropriate use of the application can have negative emotional effects on the dermatologist. OBJECTIVES: To determine the basic characteristics of WhatsApp consultations, quantify the time spent on them, and assess the emotional impact on the dermatologist. Material and methods Retrospective, descriptive, observational, cross-sectional study of responses to a 43-item online survey sent to 275 dermatologists who were members of the Spanish Academy of Dermatology and Venereology (AEDV) working in the Spanish autonomous community of Valencia. RESULTS: A total of 128 dermatologists (46.6%) responded. All reported that they used WhatsApp or Telegram; 93% received consultations by this means and 88.3% responded to the messages. Acute inflammatory conditions, usually requiring medication, accounted for 74.1% of the messages. Nearly a third of the consultations required a visit with the dermatologist.The respondents thought that patients used this means of consultation because they felt at ease with the dermatologist, the app was a convenient tool, and they received quick responses. Thirty-one percent of the dermatologists reported that WhatsApp consultations had a negative emotional impact on them, and 82.3% would prefer not to receive these messages. CONCLUSIONS: WhatsApp consultation should be regulated. Few studies have looked at this type of consultation and many questions remain to be answered.

Efficacy and Safety of Ixekizumab in a Real-Life Practice: A Retrospective Bicentric Study. / Eficacia y seguridad de ixekizumab en la práctica clínica habitual: estudio retrospectivo bicéntrico.

BACKGROUND: Ixekizumab has proven efficacy and safety for the treatment of psoriasis in clinical trials. The aim of this study was to evaluate its effectiveness and safety in routine clinical practice. METHODS: Retrospective study of all patients treated with ixekizumab in 2 dermatology departments in the city of Valencia, Spain. RESULTS: Seventy-five patients (53.3% men and 46.7% women) with a mean age of 48.61 years were studied; 77.3% (n = 58) had plaque psoriasis and 22.7% (n = 17) had psoriasis predominantly affecting a specific area. The most common comorbidity was obesity (present in 48% of patients) and 40% of the overall group had not been previously treated with a biologic drug. Mean psoriasis area and severity index (PASI) fell from 9.99 at baseline to 1.5 at week 16. PASI-75 and PASI-90 (improvements of at least 75% and 90% in PASI) were independent of sex, age, baseline PASI, and the comorbidities analyzed. Responses at week 16 and 52 were significantly better in biologic-naïve patients for the overall group and the subgroup of patients with localized psoriasis. Adverse effects were reported for 25.7% of patients and the most common effect was injection-site reaction. There were no serious adverse effects. CONCLUSIONS: Our findings show that ixekizumab is both effective and safe in the treatment of psoriasis in routine clinical practice.

Efectividad, seguridad, calidad de vida y satisfacción de pacientes con psoriasis palmo-plantar tratados con espuma de calcipotriol y betametasona / Effectiveness, safety, quality of life and satisfaction of patients with palmo-plantar psoriasis treated with calcipotriol and betametasone foam

Objetivo: Evaluar la efectividad, la seguridad, la calidad de vida y la satisfacción de pacientes con psoriasis palmo-plantar (PP) no pustulosa tratados con espuma de calcipotriol y betametasona dipropionato (Cal/BD).Material y métodos: Estudio observacional, prospectivo. Se incluyeron pacientes adultos con diagnóstico de psoriasis no controlada con afectación PP para los que estuviera indicado iniciar tratamiento tópico con Cal/BD. Las variables recogidas fueron: demográficas (sexo y edad), antropométricas (índice de masa corporal (IMC)), relacionadas con la patología (Body Surface Area (BSA) categorizado como <10% o bien ≥10%) y relacionadas con el tratamiento (tratamientos farmacológicos previos).Para evaluar la efectividad y la seguridad del tratamiento se empleó el Palmoplantar Psoriasis Area Severity Index (PPASI) y el Physician’s Global Assessment (PGA), y se recogió la incidencia y gravedad de los efectos adversos. Para valorar la calidad de vida se utilizó el Dermatology Life Quality Index (DLQI), así como el Treatment Satisfaction Questionnaire for Medication (TSQM-14) para valorar la satisfacción del paciente con el tratamiento a las 4 semanas. Las variables de efectividad y de calidad de vida se evaluaron al inicio y a las 4 semanas de tratamiento, calculándose la diferencia en términos absolutos entre ambas.Resultados: Se incluyeron 19 pacientes (11 mujeres) con una edad de 59 (RIQ 11,4) años y un IMC de 25,9 (RIQ 6,0) kg/m2, todos ellos con un BSA <10%, previamente pretratados con tratamientos tópicos (74%; 14/19), acitretino (48%; 9/19) e inmunosupresores (26%; 5/19), entre otros. (AU)

Objective: To evaluate effectiveness, safety, quality of life and satisfaction of patients with non-pustular palmo-plantar (PP) psoriasis treated with calcipotriol and betamethasone (Cal/BD) foam.Material and methods: Observational, prospective study. We included adult patients with a diagnosis of uncontrolled PP psoriasis in which topical treatment was indicated. Demographic (sex and age), anthropometric (body mass index (BMI)), related to the pathology (Body Surface Area (BSA) categorized as <10% or ≥10%) and related to the treatment (previous pharmacological treatments) variables were studied. To evaluate effectiveness and safety of the treatment, Palmoplantar Psoriasis Area Severity Index (PPASI) and Physician’s Global Assessment (PGA) were used, and the incidence and severity of the adverse effects were collected. To assess quality of life, Dermatology Life Quality Index (DLQI) was used, as well as Treatment Satisfaction Questionnaire for Medication (TSQM-14) to assess patient satisfaction with treatment at the 4th week. The variables of effectiveness and quality of life were evaluated at the beginning and at 4th week of treatment, calculating the difference in absolute terms between them.Results: We included 19 patients (11 women) with a median of 59 (IQR 11.4) years old and a BMI of 25.9 (IQR 6.0) kg/m2. All the patients showed a BSA <10% and were previously treated with topical treatments (74%; 14/19), acitretin (48%; 9/19) and immunosuppressants (26%; 5/19), among others. (AU)

[Lupus-pemphigus]. / Penfigo-lupus.

A case of a woman of 23 years old with lesions in the exposed areas of the skin (face and lower neck) is presented. The histological study was compatible with pemphigus (subcorneal acantholysis and acantholytic cells). The direct immunofluorescence revealed the presence of IgG in intercellular spaces on all the surfaces of the epidermis. In the indirect immunofluorescence ANA (1/800), anti-DNA (1/200) and anti-ICS (1/200) was found. The rest of the analysis clearly showed thrombocytopenia and C4 consumption. The interesting aspect of this case rests in the coexistence of clinical and analytical findings of each of these of autoimmune diseases.

Teledermatología por WhatsApp en la Comunidad Valenciana. Características de esta teleconsulta y su repercusión en la vida del dermatólogo / Teledermatology by WhatsApp in Valencia: Characteristics of Remote Consultation and Its Emotional Impact on the Dermatologist

INTRODUCCIÓN: La aplicación WhatsApp es la herramienta preferida de los pacientes para realizar teleconsultas. Sin embargo, la falta de un claro marco de legalidad o un mal uso puede tener repercusiones emocionales negativas en el dermatólogo. OBJETIVOS: Determinar las características básicas de la consulta realizada por WhatsApp, cuantificar objetivamente la repercusión en tiempo consumido y evaluar las consecuencias emocionales en el dermatólogo. MATERIAL Y MÉTODO: Es un estudio descriptivo, observacional, transversal y retrospectivo elaborado a partir de la información recogida en una encuesta de opinión online, compuesta por 43 preguntas, que fue remitida a los 275 dermatólogos de la Sección Valenciana de la Academia Española de Dermatología y Venereología. RESULTADOS: La encuesta fue contestada por 128 dermatólogos, el 46,6% de los encuestados. Todos los participantes manifestaron utilizar WhatsApp o Telegram. El 93% recibía consultas por esta vía, y de estos, un 88,3% admitió responder a este tipo de mensajes. El 74,1% de las consultas fueron sobre enfermedad inflamatoria aguda en las que se suele aconsejar un tratamiento farmacológico. Casi un tercio de las mismas necesitó de una visita presencial. La confianza con el dermatólogo, la comodidad y la rapidez de respuesta fueron las motivaciones para este tipo de consulta. El 31% de los dermatólogos participantes reconoció que este tipo de consultas repercute negativamente en su estado de ánimo y el 82,3% preferiría dejar de recibirlas. CONCLUSIONES: Es necesario regular este tipo de consulta. Hay muy pocos estudios sobre este ámbito y quedan abiertas muchas cuestiones todavía por esclarecer

BACKGROUND: WhatsApp is a preferred method of remote consultation for patients. However, the lack a legal framework for this type of patient-physician contact or the inappropriate use of the application can have negative emotional effects on the dermatologist. OBJECTIVES: To determine the basic characteristics of WhatsApp consultations, quantify the time spent on them, and assess the emotional impact on the dermatologist. Material and methods Retrospective, descriptive, observational, cross-sectional study of responses to a 43-item online survey sent to 275 dermatologists who were members of the Spanish Academy of Dermatology and Venereology (AEDV) working in the Spanish autonomous community of Valencia. RESULTS: A total of 128 dermatologists (46.6%) responded. All reported that they used WhatsApp or Telegram; 93% received consultations by this means and 88.3% responded to the messages. Acute inflammatory conditions, usually requiring medication, accounted for 74.1% of the messages. Nearly a third of the consultations required a visit with the dermatologist.The respondents thought that patients used this means of consultation because they felt at ease with the dermatologist, the app was a convenient tool, and they received quick responses. Thirty-one percent of the dermatologists reported that WhatsApp consultations had a negative emotional impact on them, and 82.3% would prefer not to receive these messages. CONCLUSIONS: WhatsApp consultation should be regulated. Few studies have looked at this type of consultation and many questions remain to be answered

Eficacia y seguridad de ixekizumab en la práctica clínica habitual: estudio retrospectivo bicéntrico / Efficacy and Safety of Ixekizumab in a Real-Life Practice: A Retrospective Bicentric Study

Introducción: Ixekizumab es un fármaco efectivo y seguro en el tratamiento de pacientes con psoriasis dentro de ensayos clínicos. Nuestro objetivo es valorar la eficacia y seguridad de ixekizumab en la práctica clínica habitual. Material: Estudio retrospectivo incluyendo todos los pacientes que han recibido ixekizumab en 2 servicios de dermatología de la ciudad de Valencia. Resultados: Se incluyeron un total de 75 pacientes, siendo el 53,3% varones y el 46,7% mujeres con una edad media de 48,61 años. El 77,3% (58 pacientes) presentaba una psoriasis en placas, mientras que el 22,7% (17 pacientes) presentaba psoriasis de predominio en un área especial. La comorbilidad más frecuente fue obesidad en el 48% de ellos y el 40% eran naive a biológicos. El PASI inicial medio fue de 9,99, mientras que el PASI medio a la semana 16 era de 1,5. Las respuestas de PASI75 y PASI90 fueron independientes de las comorbilidades analizadas, del sexo, de la edad y del PASI basal. Los pacientes naive a biológicos respondieron mejor que los pacientes que habían recibido tratamiento biológico previo, tanto en la semana 16 como en la semana 52 de forma estadísticamente significativa. Esta observación también se mantuveroni en los pacientes con psoriasis en un área especial. El 25,7% de los pacientes refería algún efecto adverso, siendo lo más frecuente reacción en el sitio de inyección. No se observaron reacciones adversas graves. Conclusiones: El estudio plasma nuestra experiencia en la práctica clínica real de ixekizumab, siendo un fármaco efectivo y seguro para el tratamiento de la psoriasis

Background: Ixekizumab has proven efficacy and safety for the treatment of psoriasis in clinical trials. The aim of this study was to evaluate its effectiveness and safety in routine clinical practice. Methods: Retrospective study of all patients treated with ixekizumab in 2 dermatology departments in the city of Valencia, Spain. Results: Seventy-five patients (53.3% men and 46.7% women) with a mean age of 48.61 years were studied; 77.3% (n = 58) had plaque psoriasis and 22.7% (n = 17) had psoriasis predominantly affecting a specific area. The most common comorbidity was obesity (present in 48% of patients) and 40% of the overall group had not been previously treated with a biologic drug. Mean psoriasis area and severity index (PASI) fell from 9.99 at baseline to 1.5 at week 16. PASI-75 and PASI-90 (improvements of at least 75% and 90% in PASI) were independent of sex, age, baseline PASI, and the comorbidities analyzed. Responses at week 16 and 52 were significantly better in biologic-naïve patients for the overall group and the subgroup of patients with localized psoriasis. Adverse effects were reported for 25.7% of patients and the most common effect was injection-site reaction. There were no serious adverse effects. Conclusions: Our findings show that ixekizumab is both effective and safe in the treatment of psoriasis in routine clinical practice

Es la teledermatología una herramienta útil para médicos, pacientes y administración? / Teledermatology: A Useful Tool for Physicians, Patients, and Administrators?

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