RESUMEN
In March 2023, the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual Summit in Brussels with expert panel members of EUFOREA, representatives of the EUFOREA patient advisory board, and the EUFOREA board and management teams. Its aim was to define the research, educational and advocacy initiatives to be developed by EUFOREA over the next 2 years until the 10th anniversary in 2025. EUFOREA is an international non-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic allergic and respiratory diseases via research, education, and advocacy. Based on its medical scientific core competency, EUFOREA offers an evidence-supported platform to introduce innovation and education in healthcare leading to optimal patient care, bridging the gap between latest scientific evidence and daily practice. Aligned with the mission of improving health care, the expert panels of asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS) & European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), allergen immunotherapy (AIT) and paediatrics have proposed and elaborated a variety of activities that correspond to major unmet needs in the allergy and respiratory field. The current report provides a concise overview of the achievements, ambitions, and action plan of EUFOREA for the future, allowing all stakeholders in the allergy and respiratory field to be up-dated and inspired to join forces in Europe and beyond.
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Folículo Piloso , Vitíligo/patología , Adulto , Células Cultivadas , Femenino , Humanos , Masculino , Vitíligo/terapia , Adulto JovenRESUMEN
BACKGROUND: Data on prevalence and factors influencing psychological burden in pigmentary disorders are scarce. OBJECTIVE: To determine the point prevalence of anxiety disorder, depression and somatoform disorder in patients with melasma, vitiligo and acquired dermal macular hyperpigmentation (ADMH). METHODS: A prospective cross-sectional study involving 100 patients each with melasma, ADMH and vitiligo with lesions on exposed body parts was conducted in the pigmentary clinic of a tertiary care referral hospital from June 2015 to December 2017. Dermatology life quality index, PRIME-MD Patient Health Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-15 were used for assessment of quality of life, psychiatric comorbidities, depression, general anxiety disorder and somatoform disorders, respectively, and correlated with age, gender, occupation, marital status, severity and progression of the disease. RESULTS: The prevalence of anxiety disorder in patients with melasma, vitiligo and ADMH was 11.6%, 21% and 18.7%, respectively. Depression was seen in 12.8%, 27% and 24.1% patients with melasma, vitiligo and ADMH, respectively. Somatoform disorder was more common in vitiligo (17.9%) as compared to ADMH (14.3%) and melasma (8.1%). There were positive correlations between the severity of disease and the point prevalence of anxiety and depression in all disorders. CONCLUSION: A high point prevalence of anxiety, depression and somatoform disorders was observed with pigmentary diseases, especially vitiligo and ADMH. The prevalence of anxiety and depression correlated with the disease severity and activity. Future research involving comparison with the general healthy population is required for a more affirmative conclusion.
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Trastornos de la Pigmentación/psicología , Adolescente , Adulto , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Dermal pigmentation area and severity score (DPASI) is a recently proposed scoring system for acquired dermal macular hyperpigmentation (ADMH). OBJECTIVE: To determine the reliability and validity of DPASI. METHODS: After standardized training, three researchers independently rated 55 patients with ADMH on two consecutive days within 1 week, to determine intra-rater and inter-rater reliability. Validation was performed by comparing DPASI with the physician global assessment score. RESULTS: Test-retest reliability of individual raters tested by Pearson's r showed good correlation for all three raters (r = 0.984, P < 0.0001; r = 0.983, P < 0.000 and r = 0.970, P < 0.0001). Inter-rater agreement computed by intra-class correlation coefficient also showed good correlation (ICC = 0.997, P < 0.0001). Internal consistency as measured by Cronbach's alpha was 0.997. The score faired well in face and content validity (I-CVI of 0.87). On usability assessment, the scale had a median score of 4 on a scale from 1 to 5. The meantime taken to score the patients were 307.2 ± 83, 308.9 ± 84.4, 350.15 ± 91.8 s by three observers, respectively. CONCLUSION: The DPASI is a reliable measure of ADMH severity. The use of dermoscopy decreases inter and intra-observer variation resulting in a more objective score.
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Dermatosis Facial/fisiopatología , Hiperpigmentación/fisiopatología , Índice de Severidad de la Enfermedad , Pigmentación de la Piel , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Estudios Prospectivos , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Lichen planus pigmentosus (LPP) is a rare disease characterized by persistent and asymptomatic slate-grey pigmentation, which mostly affects patients with skin types IV-VI. The face and neck are the most commonly involved sites, followed by the trunk and extremities. LPP is believed to spare the palms, soles and nails. In this report, we describe palmoplantar involvement in 10 (4.65%, 10/215) patients with LPP, and compare its clinicodemographic features with those of classic LPP. LPP lesions on the palms and soles present as asymptomatic, well-circumscribed, hyperpigmented, brown-black patches without any history of prior lichen planus lesions. They are mostly observed in young patients with rapidly spreading active disease, who often require systemic treatment to control the disease activity. Strikingly, palmoplantar involvement is frequently associated with other atypical LPP variants. It is important to identify palmoplantar involvement in LPP, as it has a different clinical course and associations compared with classic LPP.
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Pie , Mano , Liquen Plano/patología , Adolescente , Adulto , Brazo/patología , Niño , Cara/patología , Femenino , Pie/patología , Mano/patología , Humanos , Pierna/patología , Masculino , Persona de Mediana Edad , Cuello/patología , Estudios Retrospectivos , Piel/patología , Tórax/patología , Adulto JovenAsunto(s)
Dermoscopía/métodos , Esporotricosis/diagnóstico , Adulto , Humanos , Masculino , Esporotricosis/patologíaAsunto(s)
Lepra/diagnóstico , Mucosa Bucal/patología , Mycobacterium leprae/aislamiento & purificación , Piel/patología , Adulto , Diagnóstico Diferencial , Femenino , Histiocitosis/diagnóstico , Humanos , Lepra/microbiología , Lepra/patología , Mucosa Bucal/microbiología , Piel/microbiología , Adulto JovenAsunto(s)
Dermatosis del Pie/diagnóstico por imagen , Dermatosis de la Mano/diagnóstico por imagen , Hipopigmentación/diagnóstico por imagen , Adolescente , Biopsia , Dermoscopía , Diagnóstico Diferencial , Femenino , Dermatosis del Pie/patología , Dermatosis de la Mano/patología , Humanos , Hipopigmentación/patología , Masculino , Piel/patología , Adulto JovenRESUMEN
BACKGROUND: Literature on the efficacy of phototherapy in steroid-dependent antihistamine-refractory chronic urticaria (CRU) is limited. OBJECTIVES: To assess and compare the efficacy of psoralen plus ultraviolet A (PUVA) and narrowband ultraviolet B (NB-UVB) in steroid-dependent CRU. METHODS: In this randomized, prospective observer-blinded comparative study, 50 patients with steroid-dependent CRU (6 months of spontaneous urticaria with no response after 3 consecutive months of antihistamines and steroid dependence) were administered either PUVA (group A) or NB-UVB (group B) for 90 days, with a post-treatment follow-up of 90 days. The treatment efficacy was assessed using the average urticaria activity score 7 (aUAS7) and outcome scoring scale (OSS) every 2 weeks. RESULTS: The mean values of aUAS7 progressively decreased from 4·9 ± 0·8 and 5·0 ± 0·7 at baseline to 1·9 ± 0·7 and 1·4 ± 0·7 in groups A and B, respectively, by day 90. This further decreased to 1·5 ± 0·8 and 1·4 ± 1·0 at day 180 in both groups. The values of OSS progressively increased from baseline (1·6 ± 0·5 in group A and 1·3 ± 0·5 in group B) to 3·9 ± 0·3 and 4·0 ± 0·3 in groups A and B, respectively, by day 90, and 3·9 ± 0·5 and 4·0 ± 0·6 by day 180. NB-UVB fared statistically better than PUVA at different time points. Adverse events encountered were minimal and did not warrant treatment discontinuation. CONCLUSIONS: Phototherapy, especially NB-UVB, is an effective, safe and affordable therapeutic modality for steroid-dependent CRU and should be tried prior to third-line treatment options such as omalizumab, ciclosporin and other immunosuppressants.
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Ficusina/uso terapéutico , Fármacos Fotosensibilizantes/uso terapéutico , Terapia Ultravioleta/métodos , Urticaria/tratamiento farmacológico , Adolescente , Adulto , Anciano , Análisis de Varianza , Enfermedad Crónica , Resistencia a Medicamentos , Femenino , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Método Simple Ciego , Pruebas Cutáneas , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Treatment of vitiligo is a challenge. Steroids are known to be effective but are associated with serious adverse effects. Many uncontrolled studies have shown calcipotriol to be a promising therapeutic modality in vitiligo. OBJECTIVE: To conduct a randomized trial to evaluate the effect of topical calcipotriol ointment (0.005%) and betamethasone dipropionate (0.05%) cream, given alone or in combination, in treatment of localized vitiligo. METHODS: Forty-nine patients with vitiligo affecting 5% of their skin were recruited. Patients were randomized into three groups. Group I patients were treated with betamethasone dipropionate (0.05%) cream twice daily. Group II patients were treated with calcipotriol ointment (0.005%) twice daily, and group III with betamethasone dipropionate (0.05%) in the morning and calcipotriol (0.005%) in the evening. RESULTS: Forty-five patients completed the study period of 3 months with 15 patients in each group. No patient achieved excellent (> 75%) pigmentation. Marked (50% to 75%) repigmentation was observed in 2 (13.3%), 1 (6.7%) and 4 (26.7%) patients in groups I, II and III, respectively. Moderate (25-50%) repigmentation was observed in 7 (46.7%), 5 (33.3%) and 7 (46.7%) patients in groups I, II and III, respectively. Patients with < 25% pigmentation were termed as minimal pigmentation or no response. The mean time for initial pigmentation to appear was 9.04 +/- 2.0 weeks in group I, 10.18 +/- 1.6 weeks in group II and 5.17 +/- 2.4 weeks in group III (P < 0.01). The acquired pigmentation in the lesions was more stable in group III as compared with patients in groups II and I (P < 0.01). Side-effects in the form of atrophy and lesional burning sensations were more common in group I when compared with groups II and III (P < 0.05). CONCLUSION: Combined therapy appeared to give a significantly faster onset of repigmentation along with better stability of the achieved pigmentation and with lesser number of side-effects.
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Betametasona/análogos & derivados , Calcitriol/análogos & derivados , Fármacos Dermatológicos/uso terapéutico , Vitíligo/tratamiento farmacológico , Administración Cutánea , Adulto , Betametasona/administración & dosificación , Betametasona/uso terapéutico , Calcitriol/administración & dosificación , Calcitriol/uso terapéutico , Fármacos Dermatológicos/administración & dosificación , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Masculino , Pomadas , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Vitíligo/patologíaAsunto(s)
Enfermedades del Ano/diagnóstico , Condiloma Acuminado/diagnóstico , Enfermedades de los Genitales Femeninos/diagnóstico , Administración Tópica , Enfermedades del Ano/tratamiento farmacológico , Condiloma Acuminado/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa , Queratolíticos/administración & dosificación , Queratolíticos/uso terapéutico , Podofilino/administración & dosificación , Podofilino/uso terapéutico , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/tratamiento farmacológicoAsunto(s)
Neoplasias Faciales/patología , Neurofibromatosis/patología , Adulto , Humanos , MasculinoRESUMEN
A young boy with periarticular nodules and discharging sinuses diagnosed as tumoral calcinosis is described. The case is reported to highlight its rarity and low index of suspicion for this disease. Mechanisms of these solid tumours deposits and their management are discussed.