Effect of PTPN22, FAS/FASL, IL2RA and CTLA4 genetic polymorphisms on the risk of developing alopecia areata: A systematic review of the literature and meta-analysis.

OBJECTIVES: Genetic association studies on alopecia areata (AA) performed in various populations have shown heterogeneous results. The aim of the current review was to synthesize the results of said studies to estimate the impact of FAS, FASL, PTPN22, CTLA4 and IL2RA gene polymorphisms on AA susceptibility. DESIGN: A systematic literature search was conducted in the Medline, Web of Science, Scopus, EMBASE and LILACS databases. Studies published up to June 2020 were included. The results available in the grey literature including the Open Grey and Google Scholar databases were also used. The texts of potentially related studies were screened by individual reviewers. Evidence of publication bias was assessed using the Newcastle-Ottawa scale and the quality of evidence was assessed using the GRADE system. The quantitative synthesis was performed using the fixed effect model. RESULTS: Out of 1784 articles, we identified 18 relevant articles for the qualitative synthesis and 16 for the quantitative synthesis. In a study of rs2476601 polymorphism of PTPN22 gene, including 1292 cases and 1832 controls, a correlation was found with the risk of developing AA in the allelic model (OR1.49 [95% C:1.13-1.95]), the heterozygous codominant (OR1.44 [95% CI:1:19-1.76]) and dominant model (OR1.43 [95% CI:1.18-1.73]). No association was found between the presence of FASL, PTPN22, CTLA and IL2RA gene polymorphisms with AA susceptibility. CONCLUSIONS: The results suggest that the T allele of the single nucleoid polymorphism (SNP) rs2476601 in PTPN22 gene is a risk factor for developing alopecia areata. However, more robust studies defining the ethnic background of the population of origin are required, so that the risk identified in the present study can be validated. Additionally, a greater number of studies is necessary to evaluate the role of the FAS, FASL, PTPN22, CTLA4 and IL2RA genetic variants, given the heterogenous results found in the literature.

Dosis eritematosa mínima: correlación con el fototipo y método de medición en una muestra de población colombiana / Minimal Erythema Dose: Correlation with Fitzpatrick Skin Type and Concordance Between Methods of Erythema Assessment in a Patient Sample in Colombia

ANTECEDENTES Y OBJETIVO: La determinación de la dosis eritematosa mínima (DEM) es necesaria para el estudio de la fotosensibilidad cutánea, debe determinarse en cada población, dadas las diferencias genéticas y las metodologías utilizadas. El objetivo de este estudio fue determinar la DEM en población colombiana, su correlación con los fototipos y la concordancia de dos alternativas de medición. PACIENTES Y MÉTODOS: Estudio de corte trasversal que incluyó 113 personas en Bogotá (Colombia). Se determinó la DEM para UVA + UVB y UVA utilizando un simulador solar y para UVB de banda estrecha (UVBBE) con una cabina de fototerapia. La evaluación se realizó visualmente y por Mexameter MX(R)-18. RESULTADOS: La mediana de la DEM para UVA+UVB fue de 22 mJ/cm2 para fototipos I y II y de 33 y 43 mJ/cm2 para fototipos III y IV, respectivamente; para UVA fue de 22, 42, 86 y 100 J/cm2 y para UVBBE de 390, 550, 770 y 885 mJ/cm2 (fototiposI-IV, respectivamente). La correlación entre los fototipos y la DEM osciló entre 0,5 y 0,69. El nivel de correlación-concordancia de LIN entre el método visual y el Mexameter fue superior a 0,8 en todos los casos. CONCLUSIONES: Este estudio permitió conocer los valores de DEM para UVA + UVB, UVA y UVBBE para los diferentes fototipos en la población colombiana, y evidenció una correlación muy buena entre los métodos de medición evaluados y una correlación moderada a buena entre la DEM y los fototipos

BACKGROUND AND OBJECTIVE: The minimal erythema dose (MED), an essential measurement in studies of skin photosensitivity, requires establishing MED values for specific populations, given genetic variation. Different ways to assess erythema are also relevant. We aimed to determine MED values in a sample of Colombian patients and correlations between MED and Fitzpatrick skin type. We also studied concordance correlation between MEDs and two alternative ways to assess erythema. PATIENTS AND METHODS: Cross-sectional study of 113 individuals in Bogotá, Colombia. We used a solar simulator to measure UV-A radiation and combined UV-A and UV-B (UVA+UVB) radiation, o se podría suprimir este término porque UVA y UVB son términos conocidos for MED calculation. Narrowband UV-B (NBUVB) radiation was measured in a phototherapy cabin. Erythema was assessed visually and with a Mexameter MX 18 device. RESULTS: The median MEDs of UVA + UVB radiation were 22 mJ/cm2 for Fitzpatrick skin typesI andII, and 33 and 43 mJ/cm2, respectively, for typesIII andIV. The MEDs of UV-A radiation were 22, 42, 86, and 10 0J/cm2 for types I, II, III, and IV, respectively. The MEDs of NBUVB light were 390, 550, 770, and 885 mJ/cm2 for the 4 skin types. The correlation between MEDs and skin types ranged from 0.5 to 0.69. Lin's concordance correlation coefficients between visual and Mexameter assessments of erythema were greater than 0.8 in all cases. CONCLUSION: This study allowed us to understand MED values for UV-A, UVA + UVB, and NBUVB according to different skin types in the Colombian population. Concordance correlation coefficients between the different methods of erythema assessment were very good. Correlations between MEDs and skin types were moderate to good

Minimal Erythema Dose: Correlation with Fitzpatrick Skin Type and Concordance Between Methods of Erythema Assessment in a Patient Sample in Colombia. / Dosis eritematosa mínima: correlación con el fototipo y método de medición en una muestra de población colombiana.

BACKGROUND AND OBJECTIVE: The minimal erythema dose (MED), an essential measurement in studies of skin photosensitivity, requires establishing MED values for specific populations, given genetic variation. Different ways to assess erythema are also relevant. We aimed to determine MED values in a sample of Colombian patients and correlations between MED and Fitzpatrick skin type. We also studied concordance correlation between MEDs and two alternative ways to assess erythema. PATIENTS AND METHODS: Cross-sectional study of 113 individuals in Bogotá, Colombia. We used a solar simulator to measure UV-A radiation and combined UV-A and UV-B (UVA+UVB) radiation, o se podría suprimir este término porque UVA y UVB son términos conocidos for MED calculation. Narrowband UV-B (NBUVB) radiation was measured in a phototherapy cabin. Erythema was assessed visually and with a Mexameter MX 18 device. RESULTS: The median MEDs of UVA+UVB radiation were 22mJ/cm2 for Fitzpatrick skin typesI andII, and 33 and 43mJ/cm2, respectively, for typesIII andIV. The MEDs of UV-A radiation were 22, 42, 86, and 100J/cm2 for typesI, II, III, andIV, respectively. The MEDs of NBUVB light were 390, 550, 770, and 885mJ/cm2 for the 4 skin types. The correlation between MEDs and skin types ranged from 0.5 to 0.69. Lin's concordance correlation coefficients between visual and Mexameter assessments of erythema were greater than 0.8 in all cases. CONCLUSION: This study allowed us to understand MED values for UV-A, UVA+UVB, and NBUVB according to different skin types in the Colombian population. Concordance correlation coefficients between the different methods of erythema assessment were very good. Correlations between MEDs and skin types were moderate to good.

Epidemiología y Antropología: Una propuesta frente a problemas complejos en Salud Pública

Los problemas de salud pública son objetos complejos, multifacéticos, concatenados y contradictorios. La epidemiología requiere de un complemento que le permita lidiar con esos objetos. El riesgo visto desde la perspectiva epidemiológica de los modelos multivariados, ofrece un alto potencial, pero es insuficiente para la comprensión integral de los fenómenos de estudio. La propuesta plantea una integración entre la epidemiología y la antropología, a partir del diálogo entre modelos de riesgo y narrativas provenientes de una etnografía abductiva, iterativa y recursiva.

Tasa de recaída y factores pronóstico de recaída después del tratamiento con isotretinoína oral en pacientes con acné quístico / Acne Relapse Rate and Predictors of Relapse Following Treatment with Oral Isotretinoin

Introducción: Las recaídas después del tratamiento con isotretinoína oral varían entre el 10 y el 60% según los esquemas utilizados, el tiempo de seguimiento y las características de la población estudiada. El objetivo de este estudio fue establecer la tasa de recaída durante los 2 primeros años de seguimiento postratamiento e identificar los factores pronóstico asociados con la recaída. Material y método: Se realizó un estudio de seguimiento a una cohorte de pacientes con acné quístico que completaron una dosis terapéutica total de mínimo 120mg/kg de isotretinoína oral. Se analizaron los datos utilizando herramientas de estadística descriptiva y analítica. Se calculó la tasa de recaída empleando el número de eventos sobre el denominador persona tiempo. Los factores pronóstico se establecieron a través del método de análisis multivariado de regresión de Cox. Resultados: Se siguieron 142 pacientes durante 24 meses o hasta la ocurrencia del evento. La tasa de incidencia de recaída fue de 15 eventos por 100 personas/año de seguimiento. El riesgo de recaer fue el doble en los pacientes de sexo masculino. El tratamiento de mantenimiento con retinoides tópicos brindó una protección del 32% por cada mes de uso. Las mujeres que no tomaron tratamiento antiandrógeno tuvieron un riesgo de sufrir recaída 3,5 veces mayor. Conclusiones: La tasa de recaída en nuestra población es alta y similar a la comunicada en otros estudios. El tratamiento de mantenimiento con retinoides tópicos en hombres y mujeres, y el tratamiento antiandrógeno en mujeres, ayudan a evitar recaídas (AU)

Background: Relapse rates in patients with acne after treatment with oral isotretinoin vary between 10% and 60% depending on the dosage regimen used, the length of follow-up, and the characteristics of the study population. The aim of this study was to determine the acne relapse rate within 2 years of completion of isotretinoin therapy and to identify the prognostic factors associated with relapse. Material and methods: We studied a series of patients with cystic acne who had received acumulative therapeutic dose of at least 120 mg/kg of oral isotretinoin. Data were analyzed using descriptive and analytical statistical methods. The relapse rate was expressed as the number of events divided by the amount of person-time. Factors predicting relapse were identified using multivariate Cox regression analysis. Results: A total of 142 patients were followed up for 24 months or until relapse occurred. The relapse rate was 15 events per 100 person-years of follow-up. The risk of relapse was twice as high among men. The protective effect of maintenance treatment with topical retinoids was32% for each month of use. The risk of relapse was 3.5 times higher among women not receiving antiandrogen therapy. Conclusions: The relapse rate in our study was high and similar to that reported in the literature, Maintenance treatment with topical retinoids in men and women and androgen treatment in women helped to prevent relapse (AU)

Acne relapse rate and predictors of relapse following treatment with oral isotretinoin.

BACKGROUND: Relapse rates in patients with acne after treatment with oral isotretinoin vary between 10% and 60% depending on the dosage regimen used, the length of follow-up, and the characteristics of the study population. The aim of this study was to determine the acne relapse rate within 2 years of completion of isotretinoin therapy and to identify the prognostic factors associated with relapse. MATERIAL AND METHODS: We studied a series of patients with cystic acne who had received a cumulative therapeutic dose of at least 120 mg/kg of oral isotretinoin. Data were analyzed using descriptive and analytical statistical methods. The relapse rate was expressed as the number of events divided by the amount of person-time. Factors predicting relapse were identified using multivariate Cox regression analysis. RESULTS: A total of 142 patients were followed up for 24 months or until relapse occurred. The relapse rate was 15 events per 100 person-years of follow-up. The risk of relapse was twice as high among men. The protective effect of maintenance treatment with topical retinoids was 32% for each month of use. The risk of relapse was 3.5 times higher among women not receiving antiandrogen therapy. CONCLUSIONS: The relapse rate in our study was high and similar to that reported in the literature, Maintenance treatment with topical retinoids in men and women and androgen treatment in women helped to prevent relapse.

Indagación desde los conocimientos, actitudes y prácticas en salud reproductiva femenina: algunos aportes desde la investigación / Inquiry based on knowledge, attitudes & practices in women's reproductive health: some insights from research

La morbilidad materna es una de las primeras causas de alteración del bienestar de la mujer en el mundo en vías de desarrollo, por lo cual la salud reproductiva de la mujer sigue siendo una prioridad investigativa en la mayoría de estas sociedades. Sin embargo, es notable la hegemonía de la investigación clínica biomédica en esta área que ha dejado ver la ausencia y la necesidad de estudios que den cuenta del fenómeno desde una perspectiva integral. Los estudios de "conocimientos, actitudes y prácticas" (CAP) son una alternativa conceptual para acercase a la complejidad del fenómeno en el área de la salud reproductiva. La propuesta de los estudios tipo CAP plantea un acercamiento integral para entender los comportamientos con respecto a la salud de las personas a través de sus tres elementos; y sus resultados han sido base fundamental de los diagnósticos para la creación, ejecución y evaluación de programas sanitarios. Por lo anterior, este artículo se propone mostrar y discutir algunas evidencias relacionadas con la utilidad de este tipo de trabajos en el área de la salud reproductiva de las mujeres (AU)

Maternal morbidity is one of the first causes of women`s welfare alteration in the less-developed countries; therefore, their reproductive health has been a research priority in most of these societies. However, the dominance of the clinical/biomedical research on this topic has been notable, and shown the gap and need for studies reporting this phenomenon from an integral perspective. The Knowledge, Attitude and Practices (KAP) studies are an alternative design to approaching this complex situation. The KAP proposal offers a comprehensive approach to understanding the behaviors related to people`s health through its three main components, and its results have been cornerstone for the situation diagnoses, leading to the creation, execution and evaluation of sanitary programs. Hence, the objective of this paper is to show and to discuss some evidences related to the utility of this approach in women`s reproductive health (AU)