Background: There are gaps in our understanding of the epidemiology of atopic dermatitis (AD) in adults. Objective: To evaluate the prevalence and severity of AD in adults from countries/regions within Asia, Eurasia, Latin America, Middle East, and Russia. Methods: This international, web-based survey was performed in Argentina, Brazil, China, Colombia, Egypt, Hong Kong, Israel, Malaysia, Mexico, Russia, Kingdom of Saudi Arabia (KSA), Singapore, Taiwan, Thailand, Turkey, and United Arab Emirates. Questionnaires were sent to adult members of online respondent panels for determination of AD and assessment of severity. A diagnosis of AD required respondents to meet the modified United Kingdom (UK) Working Party criteria and to self-report they had a physician diagnosis of AD. Severity of AD was determined using Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), and Patient Global Assessment (PGA). Results: Among respondents by country/region the prevalence of AD ranged from 3.4% in Israel to 33.7% in Thailand. The prevalence was generally higher in females versus males. Severity varied by scale, although regardless of scale the proportion of respondents with mild and moderate disease was higher than severe disease. PGA consistently resulted in the lowest proportion of severe AD (range 2.4% China - 10.8% Turkey) relative to PO-SCORAD (range 13.4% China - 41.6% KSA) and POEM (range 5.1% China - 16.6% Israel). Conclusions: This survey highlights the importance of AD in adults, with high prevalence and high morbidity among respondents and emphasizes that AD is not just a disease of childhood-there is disease persistence and chronicity in adults.
BACKGROUND: The presence of Antinuclear antibodies/Dense Fine Speckled 70 (ANA/DFS70) has been proposed as a negative biomarker in the process of exclusion of systemic autoimmune/autoinflammatory rheumatic diseases (SARD). The purpose was to evaluate and characterize ANA/DFS70 patients in a large Colombian population with SARD; rheumatoid arthritis (RA), Psoriasis (PsO), Undifferentiated connective tissue disease (UCTD), first-degree relatives of (FDR), and healthy controls (HC). METHODS: ANA determination was performed using indirect immunofluorescence. Samples with positive dense fine granular staining in the nucleoplasm of the interphase cell (AC2) fluorescence were confirmed with CytoBead/ANA and ANA/modified (Knocked out for the PSPI1 gen). RESULTS: 530 mestizo Colombian participants were included. ANA/DFS70 antibody positivity in the whole group was 2.3%, and 0.8% in SARD; no RA patients were positive. ANA/DFS70 positives in UCTD were three women; the average time of evolution of the disease was 9.4 years. The most frequent clinical findings were arthralgias, non-erosive arthritis, and Raynaud's phenomenon. The PsO positive was a woman with C-reactive protein (CRP) positivity and a negative erythrocyte sedimentation rate (ESR) without any other positive autoantibody or extracutaneous manifestation. FDR and HC positives were 7/8 women. All were negative for other autoantibodies. CONCLUSIONS: ANA/DFS70 autoantibodies were present in Colombian patients with SARD at a shallow frequency, they were more prevalent in healthy individuals.
Background: Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. Objectives: To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. Methods: This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Results: Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. Conclusions: This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.
Arthritis, Psoriatic , Hypertension , Psoriasis , Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Child , Cross-Sectional Studies , Female , Humans , Hypertension/complications , Hypertension/epidemiology , Male , Middle Aged , Obesity/epidemiology , Psoriasis/epidemiology , Young Adult
Antecedentes La carga de enfermedad y el tratamiento de la psoriasis han sido bien caracterizados en los países desarrollados, pero los estudios epidemiológicos realizados en America Latina son escasos. Objetivos Describir las características sociodemográficas, clínicas y económicas de la psoriasis en pacientes pediátricos y adultos de Colombia. Métodos Este fue un estudio observacional transversal que incluyó pacientes recolectados en consultorios privados de dermatología, instituciones prestadoras de salud y hospitales de siete ciudades de Colombia. Se incluyeron datos relacionados con la distribución de la enfermedad, peso, altura, índice de masa corporal, medición de la cintura/cadera, severidad de la enfermedad, tratamiento, antecedentes de comorbilidades y costos directos para el paciente o la familia. Se realizó un análisis de regresión logística múltiple para evaluar las asociaciones entre la severidad de la psoriasis y las variables sociodemográficas y clínicas. Resultados Se incluyeron 203 pacientes (43.8% mujeres y 56.2% hombres) con un rango de edad entre 7 a 89 años. El subtipo principal fue la psoriasis vulgar y la edad media de diagnóstico fue de 37,1 años. Las comorbilidades más frecuentes fueron la obesidad, la hipertensión arterial, la artritis psoriásica, la dislipidemia y la diabetes. Las mujeres tuvieron un mayor riesgo de presentar artritis psoriásica. El índice de masa corporal y la hipertensión se asociaron significativamente con la severidad de la psoriasis, mientras que ser mujer y no obeso se relacionó con un menor riesgo, respectivamente. Un tercio de los pacientes tenía antecedentes familiares de psoriasis y trastornos del sueño. Cuarenta y uno por ciento de los participantes no tenían ingresos o tenían ingresos inferiores a 224 dólares estadounidenses por mes y >20% de sus ingresos los gastaron en la enfermedad. Conclusiones Este estudio muestra un gran impacto de la psoriasis en los pacientes afectados y contribuye a comprender la carga de la psoriasis en América Latina aportando datos científicos sólidos a la comunidad dermatológica y a las autoridades sanitarias colombianas con respecto a los estándares de atención médica. También crea conciencia sobre la carga económica de la enfermedad y también enfatiza la necesidad de un seguimiento estrecho de los pacientes con psoriasis para prevenir, identificar y manejar sus comorbilidades.
Background Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. Objectives To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. Methods This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Results Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. Conclusions This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.
Resumen El síndrome de anticuerpos antifosfolípidos es una condición de reciente descripción, cuyo diagnóstico se basa en la presencia de eventos trombóticos sin predisposición previa, con positividad de anticuerpos antifosfolípidos. Su presentación clínica incluye gran variedad de patrones, algunos de ellos no incluidos dentro de los criterios clínicos de diagnóstico, pero que deben ser conocidos. El compromiso dérmico es usual como livedo, sin embargo, la necrosis dérmica no es usual. Se presenta un caso de síndrome de anticuerpos antifosfolípidos con necrosis dérmica como manifestación primaria de la enfermedad.
Abstract Antiphospholipid antibodies syndrome is a recently described condition. The diagnosis of this condition is based on the presence of thrombotic events without previous predisposition and the positivity of anti-phospholipid antibodies. Its clinical presentation includes a variety of patterns, some of which are not included within the clinical criteria of the diagnosis, but must be known. Dermal involvement as livedo reticularis is common. However, dermal necrosis is not usual. Thus, a case of antiphospholipid syndrome with dermal necrosis is presented as a primary manifestation of the disease.
Humans , Female , Aged , Antiphospholipid Syndrome , Necrosis , Thrombosis , Antibodies, Antiphospholipid , Diagnosis
Estimating the population attributable fraction (PAF) of melanomas due to sun exposure is challenging as there are no unexposed population nor reliable exposure data. In high incidence countries, a historic cohort of the South Thames cancer registry was used as a minimally exposed population using the formula PAF = (observed incidence-incidence in minimally exposure)/observed incidence. In this study, we apply this method, constructing a minimally exposed cohort for Colombia and also using the historical South Thames data, using melanoma incidence data from the population-based cancer registry of Cali, Colombia for the period 1967-2012. The historic cohort incidence rates were very similar to those of Thames, but cohort effects were smaller for women and nonexistent for men. Age-specific incidence rates of these minimally exposed cohorts were applied to recent population numbers. For females, PAFs were 19% using the historic Thames cohort and 25% using the historic Cali cohort, corresponding numbers for males were 62% (vs. Thames) and 0% (vs. Cali). Taking into account the incidence rates of acral melanomas, which are not sun related, the PAF increased in women to 26% (vs. Thames) and 34% (vs. Cali) and for men 77% (vs. Thames). This exercise shows the modest contribution of exposure to ultraviolet radiation in the burden of melanoma in low-incidence countries, as well as the importance to take into consideration the acral lentiginous melanomas.
Melanoma/epidemiology , Skin Neoplasms/epidemiology , Sunlight/adverse effects , Ultraviolet Rays/adverse effects , Adult , Age Factors , Aged , Colombia , Female , Humans , Male , Melanoma/etiology , Melanoma/pathology , Middle Aged , Registries , Sex Characteristics , Skin Neoplasms/etiology , Skin Neoplasms/pathology , Melanoma, Cutaneous Malignant
La Escoliosis Congénita es un síndrome poco común y pobremente comprendido. Las anomalías del desarrollo vertebral durante el primer trimestre del embarazo suelen provocar deformidades estructurales de la columna vertebral, visibles ya desde el nacimiento o que se manifiestan durante la primera etapa de la infancia. En este trabajo se presenta el caso de un lactante de 45 días de nacido con Escoliosis Congénita asociada a defecto costal. Se destacan los hallazgos encontrados al examen físico y el resultado de los complementarios que hicieron posible el diagnóstico(AU)
Congenital scoliosis is an uncommon and poorly understood syndrome. The anomalies of vertebral development during the first trimester of pregnancy usually cause structural deformities of the spine, already visible from birth, or manifested during the first stage of childhood. In this work, the case of a 45 day-old nursling with congenital scoliosis associated to a costal defect is presented. Findings on physical exam and the result of the complementary ones that made the diagnosis possible are highlighted(AU)
Humans , Scoliosis/congenital , Scoliosis/diagnosis , Infant , Child
La Escoliosis Congénita es un síndrome poco común y pobremente comprendido. Las anomalías del desarrollo vertebral durante el primer trimestre del embarazo suelen provocar deformidades estructurales de la columna vertebral, visibles ya desde el nacimiento o que se manifiestan durante la primera etapa de la infancia. En este trabajo se presenta el caso de un lactante de 45 días de nacido con Escoliosis Congénita asociada a defecto costal. Se destacan los hallazgos encontrados al examen físico y el resultado de los complementarios que hicieron posible el diagnóstico.[AU]
Scoliosis/congenital
