G.R. Vinding

The prevalence of inverse recurrent suppuration: a population‐based study of possible hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving inverse recurrent suppuration (IRS). The epidemiology of the disease is not well described, with previous studies reporting prevalence estimates from 0·00033% to 4%.

A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values.

Background Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden. Objective The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D) index scores reported in the published literature, and to compare this to patients with other chronic diseases. Methods Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The first search (December 2013) used search terms psoria* AND (EQ5D OR EQ OR EUROQoL). Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014) used the terms (systematic review) AND (EQ5D OR EQ 5D OR EuroQoL). Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search. Results Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities) ranged from 0.52 (standard deviation: 0.39) to 0.9 (standard deviation: 0.1). Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus) to 0.66 (liver diseases). The highest EQ-5D estimates for other diseases ranged from 0.79 (liver diseases) to 0.93 (cancer patients). Both lower and upper EQ-5D estimates in psoriasis patients were within the range of those reported for other chronic diseases. Conclusion Comparative studies of morbidity are relevant in health care studies and patient advocacy. This systematic review demonstrates that the ranges of disutility among psoriasis patients are within the ranges of other chronic diseases (cardiovascular diseases, diabetes, end-stage renal diseases, liver diseases, cancer, and visual disorders).

Assessing the influence of actinic keratosis on patients' quality of life: the AKQoL questionnaire.

Background  Limited knowledge is available regarding quality of life in patients with actinic keratosis (AK).

Cancer incidence among patients with a hospital diagnosis of pruritus: a nationwide Danish cohort study.

Pruritus is a frequent complaint in patients with cancer. However, no large study has examined pruritus as a marker of undiagnosed cancer.

Self-Reported Skin Morbidities and Health-Related Quality of Life: A Population-Based Nested Case-Control Study

Background: Impaired dermatological health-related quality of life (HRQoL) has been observed in hospital-based studies, but little is known on a population-based level. Objective: To investigate self-reported dermatological HRQoL in the general population. Methods: Hidradenitis suppurativa, psoriasis, pimples, hand rash or atopic eczema were identified using questionnaires in a 15,177 person population sample. A nested case-control study of 180 cases and 259 controls was made using the Dermatology Life Quality Index (DLQI), Skindex-29 and EQ-5D. Results: Cases had higher scores in DLQI and Skindex-29 and a lower score in EQ-5D, suggesting lower HRQoL. Adjusting for age and sex, the differences in Skindex-29 and DLQI were significant (p < 0.001). Conclusions: Persons with self-reported skin morbidity had lower HRQoL than the general population. The impairment is not as significant as in studies of hospital-based cases, but considering the high prevalence of skin diseases it may still represent a significant burden of disease on society in aggregate.

Disutility in Patients with Hidradenitis Suppurativa: A Cross-sectional Study Using EuroQoL-5D.

Disutility reflects the disability caused by a disease. The EuroQoL-5D (EQ-5D) questionnaire is a measure of health-related overall utility. The questionnaire has only been applied previously to a small number of patients with hidradenitis. In this study a survey of 421 patients with hidradenitis suppurativa was conducted using the EQ-5D questionnaire. Questions regarding pain, malodour and pruritus were included to determine quantitatively whether these factors are associated with low EQ-5D index and visual analogue scale (VAS) scores. The index and VAS scores obtained were compared with reference values for the general population in Denmark. A significantly decreased utility in patients with hidradenitis suppurativa was found for all age group levels, except for 65-74-year-olds. The total index score in the cohort was 0.705 (population mean 0.887) and the VAS was 62.25 (population mean 82.6). Multivariate analysis found significant associations between loss of utility and pain, malodour and pruritus (p < 0.0001). Patients with hidradenitis suppurativa had a significantly decreased EQ-5D compared with the background population. Malodour and pruritus were found to be associated with low index values, and pain and malodour with low VAS. Patient-reported pain and discomfort had the most negative overall effect on mean index scores.

The association of metabolic syndrome and psoriasis: a population‐ and hospital‐based cross‐sectional study

Psoriasis (PS) has been suggested to be associated with the metabolic syndrome (MetS) in numerous studies with conflicting results. The vast majority of previous data were based on PS subjects from hospitals, and when based on data from the general population the PS subjects were often identified in insurance health databases. Furthermore, many studies used a single method approach, e.g. self‐reported diagnosis.

Quality of life in non-melanoma skin cancer--the skin cancer quality of life (SCQoL) questionnaire.

BACKGROUND Disease‐specific quality of life (QoL) questionnaires are increasingly used to provide patient‐reported out‐come measures in both malignant and non‐malignant disease. OBJECTIVE To create, validate and test the psychometrics of the Skin Cancer Quality of Life (SCQoL), which was designed to measure health‐related QoL in patients with non‐melanoma skin cancer affecting any area and undergoing any therapy. METHODS AND MATERIALS The SCQoL was developed in a stepwise approach. Three pilot studies (testing content and face validity) and psychometric testing (scale structure, reliability, domains and known‐groups validity, concurrent and convergent validity) were conducted. Rasch analyses were performed on the final questionnaire. RESULTS The initial 10‐item questionnaire was reduced to 9 items following interviews and inter‐item correlations. The nine item scale was confirmed by Item Response Theory (IRT) and internal consistency. Differential Item Functioning (DIF) was found for a single item, but the effect was small. CONCLUSION The final 9‐item SCQoL is unidimensional and consists of 3 domains covering function, emotions and control. Furthermore there is one single global item. The total score range from 0 to 27. Higher score denote a greater impairment of the QoL.

Spanish Version of Actinic Keratosis Quality of Life Questionnaire (AKQoL)

Patient‐reported outcome measures are very important outcomes. For specific diseases, health‐related quality of life‐instruments (HRQoL) are increasingly used to provide data on patients’ overall perceptions of the course of a given disease. Actinic keratoses (AKs) are common keratotic lesions that occur on chronically sunlight‐exposed skin. Only few studies regarding HRQoL in AKs have been made.

Quality of life in atopic dermatitis: Changes over 6 years in patients who report persistent eczema.

considered as the prodrome of BP. We had suspected this case was possibly localized BP. However, the prodomal pruritus was generalized, and anti-BP180 antibodies titers by ELISA were high. These findings conflicted with previous reports which stated that the prodromal eruption of localized BP had appeared at the same limited sites, and that the titers of anti-BP180 antibodies were low as evaluated by western immunoblot analysis. Therefore, we diagnosed this case as atypical BP. It has been reported that the serum IgE anti-BP180 antibodies level is associated with the activity and severity of BP. This case showed high IgE levels, especially when the erythroderma appeared. However, the spread of bullous lesions was limited, and it is unclear in this case whether IgE anti-BP180 antibody level was correlated. High levels of serum IgE and eosinophilia are often recognized in BP, and have been reported to correlate with disease severity. Furthermore, the disease activity also correlated with the titer of the antibodies. In this case, after treatment with CyA for the pruritus, which alone is not usually administrated for BP, the titer of anti-BP180 antibodies dropped significantly, and the high IgE levels decreased from approximately 50 000 to approximately 20 000. Moreover, after the administration of oral corticosteroids for the erythroderma, the titer of anti-BP180 antibodies, the IgE levels and the amount of eosinophils decreased significantly. These findings correlated with the severity of the pruritus and the activity of the erythroderma, which were considered to be related to the BP despite the blisters which appeared for a limited duration.