Joaquin Brieva

Comorbidities and inpatient mortality for pemphigus in the U.S.A.

The morbidity and mortality associated with pemphigus and its treatments have not been fully described. Previous studies have found conflicting results about certain comorbidities and were limited by small sample sizes.

Images in clinical medicine. Unilateral dermatoheliosis.

n engl j med 366;16 nejm.org april 19, 2012 e25 A 69-year-old man presented with a 25-year history of gradual, asymptomatic thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis. Histopathological analysis showed an accumulation of elastolytic material in the dermis and the formation of milia within the vellus hair follicles. Findings were consistent with the Favre–Racouchot syndrome of photodamaged skin, known as dermatoheliosis. The patient reported that he had driven a delivery truck for 28 years. Ultraviolet A (UVA) rays transmit through window glass, penetrating the epidermis and upper layers of dermis. Chronic UVA exposure can result in thickening of the epidermis and stratum corneum, as well as destruction of elastic fibers. This photoaging effect of UVA is contrasted with photocarcinogenesis. Although exposure to ultraviolet B (UVB) rays is linked to a higher rate of photocarcinogenesis, UVA has also been shown to induce substantial DNA mutations and direct toxicity, leading to the formation of skin cancer. The use of sun protection and topical retinoids and periodic monitoring for skin cancer were recommended for the patient.

Hospitalization, inpatient burden and comorbidities associated with bullous pemphigoid in the U.S.A.

Bullous pemphigoid (BP) is associated with significant disability and comorbid health disorders that may lead to or result from hospitalization. However, little is known about the inpatient burden and comorbidities of BP.

Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States

Background: Little is known about the epidemiology of Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children. Objective: We sought to determine the morbidity, mortality, and comorbid health conditions of SJS and TEN in US children. Methods: This was a cross‐sectional study of the 2009 to 2012 Nationwide Inpatient Sample, which contains a representative 20% sample of all US hospitalizations. Sociodemographics, inflation‐adjusted cost, length of stay, comorbidities, and mortality were analyzed using descriptive statistics and multivariate regression analyses. Results: The incidences of SJS, SJS‐TEN, and TEN were a mean 5.3, 0.8, and 0.4 cases per million children per year in the US, respectively. Prolonged length of stay and higher costs of care (SJS: 9.4 ± 0.6 days,

Costs of Care for Hospitalization for Pemphigus in the United States

24,947 ±

Validation of database search strategies for the epidemiological study of pemphigus and pemphigoid.

3171; SJS‐TEN: 15.7 ± 1.5 days,

Destructive deformation of the digits with auto-amputation: a review of pseudo-ainhum.

63,787 ±

Dermatologic Infections in Cancer Patients

8014; TEN: 20.4 ± 6.3 days,

Update and treatment of acne vulgaris

102,243 ±

Prevalence of chronic hepatitis B and C in psoriasis patients: A cross-sectional study in a large US population

37,588) were observed compared with all other admissions (4.6 ± 0.1 days,