A Qualitative Tool to Guide in the Interpretation of the Numerical Rating Scale for Pruritus Intensity in Patients with Atopic Dermatitis.

Atopic dermatitis is a cutaneous inflammatory disease characterized by intense pruritus, which is often underestimated despite its direct impact on patients' health-related quality of life and the high burden it poses. The authors' goal was to design a qualitative tool to guide patients and healthcare professionals in their assessment and interpretation of pruritus intensity using a numerical rating scale. The draft of this tool, henceforth "guideline", was developed based on a systematic literature review and focus groups comprising patients and a scientific committee. This draft was validated with an independent group of patients and the final version was designed following their feedback. According to the results of the systematic review, pruritus impacts 6 health-related quality of life domains: sleep quality; emotional status; overall health-related quality of life; physical function; social/sexual activity; productivity, particularly affecting sleep quality and the emotional domain. Patients considered that physical function was the most strongly affected domain, followed by sleep quality and emotional well-being, establishing that a minimum pruritus intensity of 4 and 7 points impacts moderately and severely, respectively, on the different domains of patients' health- related quality of life. The guideline may help patients and healthcare professionals to interpret and assess pruritus intensity using a numerical rating scale and to understand the impact of pruritus on patients' health-related quality of life.

Impact of psoriatic disease on women aged 18 to 45: Results from a multinational survey across 11 European countries.

BACKGROUND: Plaque psoriasis (PSO) is a long-term inflammatory condition that can cause concomitant joint symptoms (psoriatic arthritis [PsA]) in up to 30% of patients. The impact of psoriatic disease on disease outcomes and quality of life is greater in women than men. OBJECTIVE: We evaluated the impact of psoriatic disease on women aged 18 to 45 years across Europe. METHODS: Women aged 18 to 45 years with moderate to severe PSO, PsA, or PSO + PsA (PSO with progression to PsA) and prior biologic experience were recruited from market research panels and patient association groups of the International Federation of Psoriasis Associations, European Federation of Psoriasis Patient Associations, and Arthritis Ireland and asked to complete a survey. Questions covered social and psychological wellbeing, employment, and family planning. Question types included 5- or 7-point agreement scales, where the highest/lowest two ratings were considered agreement/disagreement, respectively. The results are reported as proportions of those who selected the answer, divided by overall respondents for each question. Women were not required to answer all questions. RESULTS: Survey respondents (N = 573) had a diagnosis of PSO (n = 236), PsA (n = 173), or PSO + PsA (n = 164). Women self-reported similar mean scores for physical (57.0 of 100) and mental (59.0 of 100) health. A fifth (21%) had not achieved their desired career due to PSO/PsA; career dissatisfaction and increased sick leave were linked to poor mental health. Some women reported having a limited social life (33%), smaller families (34%), and being more likely to adopt children (27%) due to PSO/PsA. A quarter of women (27%) reported not understanding enough about PSO/PsA (nonmembers vs. members of patient association groups: 37% vs. 8%). CONCLUSION: Our findings highlight the considerable burden of psoriatic disease on women of childbearing age. Increased provision of information tailored to women, training for health care professionals, and shared decision-making between patients and health care professionals may help better support women with psoriatic disease.

A rapidly growing eccrine poroma in a pregnant woman.

A variety of tumors develop or exacerbate during pregnancy and it is well known that a noticeable increase of eccrine activity occurs in this period. Eccrine poroma is a benign neoplasm that originates from the eccrine sweat gland. The development of this tumor during pregnancy is extremely infrequent. We report a rare case of rapidly growing eccrine poroma in an unusual location (the nose) in a pregnant woman.

Mastocitosis sistémica con hiperpigmentación cutánea difusa / Systemic mastocytosis: An unusual etiology for cutaneous hyperpigmentation

Presentamos un caso de mastocitosis sistémica que mostraba una importante y progresiva hiperpigmentación melánica cutánea a lo largo de los últimos 8 años. La llamativa hiperpigmentación cutánea de nuestro paciente podía estar en relación con factores estimuladores del desarrollo de mastocitos y melanocitos (AU)

Citrobacter koseri in scalp folliculitis.

Gram-negative folliculitis, an uncommon condition, is most often seen in older patients who have acne and who either have received prolonged courses of antibiotic therapy or have used antibacterial cleansers that selectively inhibit gram-positive organisms. Citrobacter infections are uncommon, and dermatologists seldom encounter them. In the past, these infections occurred in hospitals, particularly in neonatal intensive care units. Bacteremias also occur in elderly or immunocompromised patients. In this article, we present a case of Citrobacter koseri scalp folliculitis in an otherwise healthy patient.

Cloruro de aluminio hexahidratado en el tratamiento de las pustulosis palmoplantares. Estudio preliminar / Aluminium chloride hexahydratate in the treatment of palmoplantar pustulosis. A preliminary study

La pustulosis palmoplantar (PPP) es una enfermedad cutánea crónica que se caracteriza por la presencia de pústulas estériles en palmas y plantas. Actualmente se desconocen las causas por la cuales esta afección se presenta exclusivamente en esta localización, donde existe una importante riqueza de glándulas sudoríparas ecrinas en relación a otras zonas de la piel. La PPP es a menudo refractaria a los tratamientos, incluyendo corticosteroides tópicos de alta potencia y sistémicos. Objetivo: evaluar la eficacia del cloruro de aluminio hexahidratado al 20 por ciento en solución acuosa en el tratamiento de la PPP. Material y métodos: estudio abierto realizado sobre 12 pacientes con PPP (seis tratados con cloruro de aluminio hexahidratado y seis tratados con placebo) durante 5 meses. Resultados: se observó una buena respuesta en el 100 por ciento de los casos tratados con el cloruro de aluminio a los 5 meses (16% de eficacia en el grupo tratado con placebo). No se apreciaron efectos secundarios. Conclusiones: el tratamiento con cloruro de aluminio hexahidratado al 20% en solución acuosa es una terapia efectiva en pacientes con PPP (AU)