RESUMO
Bullous pemphigoid (BP) is a chronic autoimmune disease affecting the elderly population and characterized by the formation of subepidermal tense bullae. Treatment options include topical steroids, systemic steroids, immunosuppressants, and antimicrobials, and there is emerging evidence of the efficacy of omalizumab. In this study, we aimed to demonstrate omalizumab's efficacy for treating BP, and we also reported treatment-related adverse events. The retrospective cohort study included patients with BP who were followed up in our clinic's bullous diseases department between 2016 and 2023. Patients who received omalizumab were included in the study. Treatment responses of all patients were assessed by BP Disease Area Index activity and damage scores, treatment scale scoring, steroid dose reduction, and the presence/absence of pruritus. Also, total IgE levels of patients before the treatment onset and at the last visit were compared. There were 15 (male/female = 8/7) BP patients receiving omalizumab treatment. Omalizumab therapy allowed steroid dose reduction at a median of 1 month. Omalizumab (25.5 mg, 95% confidence interval 17.2-33.9, Pâ <â .001) provided a significant steroid dose reduction at the last visit compared to the beginning of treatment. Omalizumab resulted in a decrease in BP Disease Area Index activity score of 80.8 (95% confidence interval 71.8-89.8, Pâ <â .001). Also, omalizumab caused significant decline in IgE levels compared to baseline (1102.5â ±â 834.5 vs 834.6â ±â 613.6, Pâ =â .002). In this study, omalizumab treatment was an effective and safe option in BP patients with high baseline IgE levels who are refractory to or cannot tolerate other immunosuppressive therapies.
Assuntos
Omalizumab , Penfigoide Bolhoso , Humanos , Omalizumab/uso terapêutico , Omalizumab/administração & dosagem , Penfigoide Bolhoso/tratamento farmacológico , Masculino , Feminino , Estudos Retrospectivos , Idoso , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Resultado do Tratamento , Imunoglobulina E/sangue , Antialérgicos/uso terapêutico , Antialérgicos/administração & dosagemRESUMO
Alopecia areata (AA) is an autoimmune disease that develops due to inflammation and causes sudden hair loss. Ithas been observed that family circumstances may contribute to the development of AA. This study aims to assessthe relationship between the development of alopecia areata in children, family functions, and depression andanxiety levels in their parents.Thirty-nine participants diagnosed with AA and 41 healthy controls (HC), agedbetween 8 and 18 years, and their parents participated in the study. The assessment of the children included thecompletion of a socio-demographic data form, the Parenting Style Scale (PSS), and the Revised Children's Anxietyand Depression Scale (RCADS). The parents provided information on a sociodemographic form, the BeckDepression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The children in the control group scoredsignificantly higher on the PSS acceptance/ involvement subscale than those with AA. In the AA group, the numberof authoritative and indulgent (PSS) families was statistically significantly lower than that of the families in the HC,and the number of neglectful families was statistically significantly higher than those of the control group. Totalanxiety and depression t scores (RCADS) were statistically significantly higher in the AA children than in theHC. Our study demonstrates the importance of considering familial factors and parental mental health tounderstand and address alopecia areata in children. Our findings support the psychosomatic component of AA.Implementing comprehensive treatment strategies that target psychological well-being and family dynamics couldprove crucial.
Assuntos
Alopecia em Áreas , Ansiedade , Depressão , Poder Familiar , Humanos , Alopecia em Áreas/psicologia , Alopecia em Áreas/imunologia , Alopecia em Áreas/epidemiologia , Alopecia em Áreas/diagnóstico , Criança , Feminino , Masculino , Adolescente , Poder Familiar/psicologia , Depressão/psicologia , Depressão/epidemiologia , Depressão/diagnóstico , Depressão/etiologia , Ansiedade/psicologia , Ansiedade/epidemiologia , Ansiedade/diagnóstico , Ansiedade/etiologia , Pais/psicologia , Estudos de Casos e ControlesRESUMO
BACKGROUND: There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health-related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents. MATERIALS AND METHODS: This single-center cross-sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity. RESULTS: The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001). CONCLUSION: Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families.
RESUMO
OBJECTIVE: The aim of this study is to evaluate the demographic characteristics of patients diagnosed with Spitz nevus and to investigate potential distinctions in clinicopathological findings of Spitz nevi in relation to age and location of the lesion. MATERIALS AND METHODS: Clinical and histopathological findings of 32 patients who were diagnosed with Spitz nevus from our archives between 2010 and 2020 were obtained and evaluated retrospectively. RESULTS: A total of 32 patients were included, of whom 19 (59.4%) were female and 15 (40.6%) were under the age of 18 years. Most of the lesions (14, 43.7%) were located on the upper extremity, followed by the lower extremity and the head and neck. The most common histological subtype was the compound variant. In the pediatric age group, the majority of the lesions were located on the upper extremity, and the most common histological subtypes were pigmented and compound variant. In adults, the lesions were chiefly located on the lower extremitiy and the most common histological subtype was the desmoplastic variant. CONCLUSION: In this study, it was found that the location of the lesions and histopathological subtypes of Spitz nevi may differ in children and adults. Further studies incorporating genetic data and involving larger cohorts of patients are needed in order to determine these differences between age groups more clearly. The small sample size is the main limitation of this study Cite this article as: Uzunçakmak TK, Yücesoy SN, Önenerk AM, Özdil A, Engin B. Comparison of clinicopathological findings of spitz nevus in pediatric and adult patients. Turk Arch Pediatr. 2024;59(1):49-53.
RESUMO
Abstract Background: Alopecia areata (AA) is a hair disease that causes hair loss without scarring. The etiopathogenesis of AA has not been fully understood yet. Objective: To determine serum interleukin levels (IL-2, IL-4, IL-15, and IL-17) in patients diagnosed with alopecia areata and to investigate the relationship of IL levels with the duration and severity of alopecia areata and the response to tofacitinib therapy. Methods: Patients (≥16 years old) diagnosed with alopecia areata and healthy individuals as a control group was enrolled. Baseline serum interleukin levels of the patients and controls were measured. In the patient group receiving tofacitinib therapy, serum interleukin levels were measured again after 6 months. Disease severity for alopecia areata was assessed using the Severity of Alopecia Tool. Results: Sixty-one AA patients and 30 healthy individuals were included; they were comparable regarding age and sex. The mean disease duration for AA was 7 ± 6 years and the baseline mean Severity of Alopecia Tool score was 71 ± 30 (range, 20-100). Baseline IL-2, IL-4 and IL-15 levels were significantly higher in the patient group than those in the control group (p < 0.001 for each). No significant correlation was found between the baseline interleukin levels and either disease duration or disease severity (baseline Severity of Alopecia Tool score). Among the patients receiving tofacitinib (n = 22), all interleukin levels significantly decreased after treatment. However, no significant relationship between the change in interleukin levels and the change in the Severity of Alopecia Tool scores was observed after tofacitinib treatment. Study limitations: This is a monocentric study conducted in a single university hospital. Conclusion: High interleukin levels in alopecia areata patients and the significant decrease with treatment support the idea that interleukins have a role in pathogenesis. Nevertheless, no relationship could be demonstrated between IL levels and disease duration or severity.
Assuntos
Humanos , Adolescente , Interleucina-2 , Alopecia em Áreas/tratamento farmacológico , Índice de Gravidade de Doença , Interleucinas , Interleucina-4 , Interleucina-15 , Interleucina-17RESUMO
BACKGROUND: Alopecia areata (AA) is a hair disease that causes hair loss without scarring. The etiopathogenesis of AA has not been fully understood yet. OBJECTIVE: To determine serum interleukin levels (IL-2, IL-4, IL-15, and IL-17) in patients diagnosed with alopecia areata and to investigate the relationship of IL levels with the duration and severity of alopecia areata and the response to tofacitinib therapy. METHODS: Patients (≥16 years old) diagnosed with alopecia areata and healthy individuals as a control group was enrolled. Baseline serum interleukin levels of the patients and controls were measured. In the patient group receiving tofacitinib therapy, serum interleukin levels were measured again after 6 months. Disease severity for alopecia areata was assessed using the Severity of Alopecia Tool. RESULTS: Sixty-one AA patients and 30 healthy individuals were included; they were comparable regarding age and sex. The mean disease duration for AA was 7 ± 6 years and the baseline mean Severity of Alopecia Tool score was 71 ± 30 (range, 20-100). Baseline IL-2, IL-4 and IL-15 levels were significantly higher in the patient group than those in the control group (p < 0.001 for each). No significant correlation was found between the baseline interleukin levels and either disease duration or disease severity (baseline Severity of Alopecia Tool score). Among the patients receiving tofacitinib (n = 22), all interleukin levels significantly decreased after treatment. However, no significant relationship between the change in interleukin levels and the change in the Severity of Alopecia Tool scores was observed after tofacitinib treatment. STUDY LIMITATIONS: This is a monocentric study conducted in a single university hospital. CONCLUSION: High interleukin levels in alopecia areata patients and the significant decrease with treatment support the idea that interleukins have a role in pathogenesis. Nevertheless, no relationship could be demonstrated between IL levels and disease duration or severity.
Assuntos
Alopecia em Áreas , Interleucina-2 , Adolescente , Alopecia em Áreas/tratamento farmacológico , Humanos , Interleucina-15 , Interleucina-17 , Interleucina-4 , Interleucinas , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: This study aims to demonstrate real-life effectiveness of dupilumab treatment in moderate-to-severe atopic dermatitis patients. METHODS: The 14 patients diagnosed with moderate-to-severe atopic dermatitis were included in this study. All of the patients started dupilumab treatment in our faculty between October 2019 and October 2020. The patients were evaluated at the beginning of the treatment and after 12 weeks of treatments. The baseline scoring atopic dermatitis (SCORAD) scores, the total immunoglobulin E (IgE) levels, and the visual analog scale (VAS) of 0-10 points for itch intensity compared with the post-treatment scores. RESULTS: The SCORAD scores, the serum total IgE levels, and the VAS itch scores of the patients receiving dupilumab treatment dropped significantly following 12 weeks of dupilumab treatment. No significant correlation was demonstrated between the initial SCORAD scores and the serum total IgE values. Besides, no correlation was shown to exist in the reduction of the SCORAD and the serum total IgE values after dupilumab treatment. CONCLUSION: Dupilumab treatment showed significant improvement in disease severity with remarkable reduction in serum total IgE levels.