The Burden of Psoriasis in Canada: Insights from the pSoriasis Knowledge IN Canada (SKIN) Survey

2009 ◽  
Vol 13 (5) ◽  
pp. 235-252 ◽  
Author(s):  
Charles W. Lynde ◽  
Yves Poulin ◽  
Lyn Guenther ◽  
Christine Jackson
Keyword(s):  
Telephone Survey ◽  
Burden Of Illness ◽  
Skin Lesions ◽  
Severe Psoriasis ◽  
Similar Data ◽  
Daily Lives ◽  
Substantial Problem ◽  
History Of Disease ◽  
History Of ◽  
The Mean

Background: Although some data addressing the burden of illness associated with psoriasis and psoriatic arthritis (PsA) have been reported for American and European patient populations, similar data have been lacking for Canadians with these diseases. Objective: We sought to characterize the natural history of disease in a sample of Canadians with a history of moderate to severe psoriasis, with or without diagnosed PsA or other recognized comorbid conditions, and to identify factors that influenced their perception of psoriasis as a problem in their daily lives. Methods: A nationwide telephone survey, pSoriasis Knowledge IN Canada (SKIN), was conducted between April 30 and June 2, 2007, on 500 people who indicated that they had been diagnosed with psoriasis and that their skin lesions had at some time affected an area at least as large as three palms of their hand (3% of body surface area [BSA]). Results: The mean age at diagnosis for psoriasis among SKIN survey respondents was 28 years, with 31% (155 of 500) indicating that they developed the disease prior to age 18 years. At the time of the survey, 54% (269 of 500) of respondents were experiencing lesions affecting a BSA equivalent to at least three palms (3%). In response to questions on the burden of illness, 35% (176 of 500) of respondents indicated that they considered psoriasis to be a substantial problem in their daily life. Both affected BSA at the time of the survey and self-reported extent of skin involvement at the height of the condition (BSAmax) correlated with the perception of psoriasis as a substantial problem. Other subpopulations in which psoriasis was commonly identified as a substantial problem included women and individuals with diagnosed PsA. Whereas 18% (88 of 500) of respondents were diagnosed with PsA, the number who reported joint pain or stiffness was substantially higher (51%; 256 of 500), suggesting that some respondents may have had incipient or undiagnosed PsA. Conclusions: This survey reveals that psoriasis, PsA, and their associated comorbidities impose a severe burden on the daily lives of Canadians with a history of moderate to severe psoriasis.

scholarly journals A clinical study on linear dermatoses at a teriary care teaching hospital in Davangere

2021 ◽  
Vol 7 (2) ◽  
pp. 201
Author(s):  
Sowmya Manangi ◽  
Anirudh M. ◽  
Aishwarya Sivuni ◽  
Hosalli Smrutha ◽  
Suga Reddy
Keyword(s):  
Lichen Planus ◽  
Skin Lesions ◽  
Epidermal Nevus ◽  
Linear Lesions ◽  
Cosmetic Reason ◽  
Histopathological Correlation ◽  
Lichen Striatus ◽  
History Of Disease ◽  
History Of ◽  
Blaschko’S Lines

<p class="abstract"><strong>Background:</strong> Skin lesions present with innumerable patterns like discoid, petaloid, arcuate, annular, polycyclic, livedo, reticulate, target, stellate, digitate, linear, serpiginous and whorled. Most of the linear lesions follow the Blaschko’s lines. Aim was to study the incidence of linear dermatoses, the age and sex incidence, various types of clinical presentation, various sites of distribution and their clinical correlation.  </p><p class="abstract"><strong>Methods:</strong> Detailed history including family history, History of disease documented with clinical examination. After counselling and after recording their consent for the test, skin biopsy along with routine investigations was done wherever needed and the results were evaluated. <strong></strong></p><p class="abstract"><strong>Results:</strong> Lichen striatus was seen in 29.91% followed by linear herpes zoster in 24.7%, linear lichen planus in 18.22%, linear verrucous epidermal nevus in 14.01%, segmental vitiligo in 3.73%, nevus depigmentation in 2.33% and others. Maximal cases were asymptomatic and reported for cosmetic reason. Intense itching was the main reason to bring the lichen planus patients and few cases of the lichen striatus patients for treatment.  </p><p class="abstract"><strong>Conclusions:</strong> Lichen striatus was found to be more common, female preponderance. Majority of patients showed unilateral distribution more on the extremities. Histopathological correlation shows the importance of histopathology which ultimately changes the management in any given condition.</p><p> </p>

Novel Folliculin Gene Mutations in Polish Patients With Birt-hogg-dubé Syndrome

2021 ◽  
Author(s):  
Elzbieta Radzikowska ◽  
Urszula Lechowicz ◽  
Jolanta Winek ◽  
Lucyna Opoka
Keyword(s):  
Gene Mutations ◽  
Skin Lesions ◽  
Renal Angiomyolipoma ◽  
Inherited Disease ◽  
First Case ◽  
Renal Tumours ◽  
Pulmonary Cysts ◽  
Frequent Mutations ◽  
History Of ◽  
The Mean

Abstract Birt-Hogg-Dubé syndrome (BHDS) is a rare, autosomal dominant, inherited disease caused by mutations in the folliculin gene (FLCN). The disease is characterised by skin lesions (fibrofolliculomas, trichodiscomas, acrochordons), pulmonary cysts with pneumothoraces and renal tumours. We present the features of Polish patients with BHDS.Materials and MethodsThe first case of BHDS in Poland was diagnosed in 2016. Since then, 15 cases from 10 families have been identified. Thirteen patients were confirmed via direct FLCN sequencing, and two according to their characteristic clinical and radiological presentations.ResultsBHDS was diagnosed in 15 cases (13 women and 2 men) from 10 families. The mean ages at the time of first pneumothorax and diagnosis were 38.4 ± 13.9 and 47.7 ± 13 years, respectively. Five patients (33%) were ex-smokers (2.1 ± 1.37 packyears), and 10 (67%) had never smoked cigarettes. Twelve patients (83%) had a history of recurrent symptomatic pneumothorax. Three patients had small, asymptomatic pneumothoraces, which were only detected upon computed tomography examination. All patients had multiple bilateral pulmonary cysts, distributed predominantly in the lower and middle, peripheral, and subpleural regions of the lungs. Generally, patients exhibited preserved lung function. Skin lesions were seen in four patients (27%), one patient had renal angiomyolipoma, and one had bilateral renal cancer. Different mutations of the FLCN gene were identified (mainly in exon 6), with two novel heterozygous variants: c.490delA p.(Arg164GlyTer13) and c.40delC p.(His14ThrsfTer41). ConclusionsAll analysed patients with BHDS presented with lung lesions and with less frequent skin and renal lesions than previously reported in other populations. In addition, more frequent mutations located in exon 6 were detected, and two novel FLCN gene mutations were identified.

scholarly journals Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Yu Hu ◽  
Lin Lin ◽  
Pangen Cui ◽  
Xu Yao ◽  
Chao Luan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Liver Disorder ◽  
Severe Psoriasis ◽  
Hepatic Toxicity ◽  
Pasi Score ◽  
History Of ◽  
The Mean ◽  
Mean Time

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated safety and efficacy of combination therapy of infliximab and TGP in treating 13 severe psoriasis patients with liver disorder history.Thirteen patients with severe psoriasis, including 8 men and 5 women, with a mean age of 37.3 ± 12.3 were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean PASI score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5mg/kg and TGP at a dose of 1.8g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 week and 9.6 week, respectively. Conclusion: Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for the patients with liver disorder history.

scholarly journals Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

2019 ◽  
Vol 3 (2) ◽  
pp. 62
Author(s):  
Yu Hu ◽  
Lin Lin ◽  
Pangen Cui ◽  
Xu Yao ◽  
Chao Luan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Severity Index ◽  
Liver Disorder ◽  
Severe Psoriasis ◽  
Total Glucosides Of Paeony ◽  
Pasi Score ◽  
History Of ◽  
The Mean

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated the safety and efficacy of combination therapy of infliximab and total glucosides of paeony (TGP) in treating 13 severe psoriasis patients with liver disorder history. Patients with severe psoriasis, comprising eight men and five women with a mean age of 37.3 ± 12.3, were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean psoriasis area and severity index (PASI) score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5 mg/kg and TGP at a dose of 1.8 g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 weeks and 9.6 weeks, respectively. Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for patients with liver disorder history.

Iatrogenic Hyperadrenocorticism in 12 Cats

2006 ◽  
Vol 42 (6) ◽  
pp. 414-423 ◽  
Author(s):  
Yu-Hsin Lien ◽  
Hui-Pi Huang ◽  
Pen-Heng Chang
Keyword(s):  
Rare Condition ◽  
Skin Lesions ◽  
Term Treatment ◽  
Corticosteroid Withdrawal ◽  
Long Term Treatment ◽  
History Of ◽  
The Mean ◽  
Mean Time ◽  
Secondary Complication

Iatrogenic hyperadrenocorticism is an extremely rare condition in cats. Twelve cats with a medical history of progressive skin lesions and long-term treatment with corticosteroids were retrospectively studied. Noncutaneous signs in the cats were variable and included anorexia, lethargy, polydipsia, polyuria, and atrophy of the thigh muscles. Laboratory abnormalities included leukocytosis, elevated alanine aminotransferase levels, and hyperglycemia. Transient diabetes mellitus was a secondary complication in four cats, and transient hypothyroidism was suspected in four cats. The mean time for regression of signs was 4.9 months after corticosteroid withdrawal.

scholarly journals Change in a child’s naevus prompts referral to a dermatology service

2014 ◽  
Vol 6 (2) ◽  
pp. 123 ◽  
Author(s):  
Harriet Cheng ◽  
Amanda Oakley ◽  
Marius Rademaker
Keyword(s):  
Skin Lesions ◽  
Non Melanoma Skin Cancer ◽  
Specialist Referral ◽  
Spindle Cell Tumours ◽  
History Of ◽  
Melanocytic Naevi ◽  
The Mean ◽  
Sole Criterion ◽  
Referral Letters ◽  
Melanoma Skin

INTRODUCTION: Although melanoma is rare in children, parental concern about skin lesions often results in specialist referral and/or excision of benign lesions. AIM: To review dermatology referrals of children with skin lesions to determine reason for referral, macroscopic and dermatoscopic features of referred lesions, diagnosis, management and histology for excised lesions. METHODS: Referral letters, clinical and dermatoscopic images and outcomes were reviewed for skin lesions in children aged 0–18 years attending a teledermoscopy clinic over a 28-month period. RESULTS: Eighty-nine children with 128 lesions accounted for 9% of all referrals to the teledermoscopy clinic. The mean age of the children was 12 years (range 2–18 years). A ‘changing mole’ was the most common reason for referral (35 children; 39%), followed by ‘possible melanoma’ (19; 21%), and congenital naevus (9; 10%). The majority of lesions were benign melanocytic naevi (112 lesions; 88%). No lesions were diagnosed as melanoma or non-melanoma skin cancer. A history of change was given for 61/112 lesions (54%). Five lesions were excised; histopathological diagnoses were two spindle cell tumours of Reed, two compound naevi and one Spitz naevus. DISCUSSION: Change in a lesion, though a common trigger for referral, is less likely to indicate malignancy in children compared with adults and, as a sole criterion, does not necessitate specialist referral. Teledermoscopy clinics offer high quality macroscopic and dermatoscopic images and can assist in providing reassurance, where appropriate. KEYWORDS: Dermatology; dermoscopy; melanocytic naevi; melanoma

scholarly journals Novel folliculin gene mutations in Polish patients with Birt–Hogg–Dubé syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Elżbieta Radzikowska ◽  
Urszula Lechowicz ◽  
Jolanta Winek ◽  
Lucyna Opoka
Keyword(s):  
Gene Mutations ◽  
Skin Lesions ◽  
Renal Angiomyolipoma ◽  
Inherited Disease ◽  
First Case ◽  
Renal Tumours ◽  
Pulmonary Cysts ◽  
Frequent Mutations ◽  
History Of ◽  
The Mean

Abstract Background Birt–Hogg–Dubé syndrome (BHDS) is a rare, autosomal dominant, inherited disease caused by mutations in the folliculin gene (FLCN). The disease is characterised by skin lesions (fibrofolliculomas, trichodiscomas, acrochordons), pulmonary cysts with pneumothoraces and renal tumours. We present the features of Polish patients with BHDS. Materials and methods The first case of BHDS in Poland was diagnosed in 2016. Since then, 15 cases from 10 families have been identified. Thirteen patients were confirmed via direct FLCN sequencing, and two according to their characteristic clinical and radiological presentations. Results BHDS was diagnosed in 15 cases (13 women and 2 men) from 10 families. The mean ages at the time of first pneumothorax and diagnosis were 38.4 ± 13.9 and 47.7 ± 13 years, respectively. Five patients (33%) were ex-smokers (2.1 ± 1.37 packyears), and 10 (67%) had never smoked cigarettes. Twelve patients (83%) had a history of recurrent symptomatic pneumothorax. Three patients had small, asymptomatic pneumothoraces, which were only detected upon computed tomography examination. All patients had multiple bilateral pulmonary cysts, distributed predominantly in the lower and middle, peripheral, and subpleural regions of the lungs. Generally, patients exhibited preserved lung function. Skin lesions were seen in four patients (27%), one patient had renal angiomyolipoma, and one had bilateral renal cancer. Different mutations of the FLCN gene were identified (mainly in exon 6), with two novel heterozygous variants: c.490delA p.(Arg164GlyTer13) and c.40delC p.(His14ThrsfTer41). Conclusions All analysed patients with BHDS presented with lung lesions and with less frequent skin and renal lesions than previously reported in other populations. In addition, more frequent mutations located in exon 6 were detected, and two novel FLCN gene mutations were identified.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

Voices and Visions: Mind, Body and Affect in Medieval Writing

2018 ◽  
Author(s):  
Corinne Saunders
Keyword(s):  
Medical Humanities ◽  
Family Care ◽  
Literary Texts ◽  
Cultural Perspective ◽  
Historical Sources ◽  
Disease Treatment ◽  
History Of Disease ◽  
Health And Illness ◽  
History Of ◽  
Cultural Texts

A properly critical medical humanities is also a historically grounded medical humanities. Such historical grounding requires taking a long cultural perspective, going beyond traditional medical history – typically the history of disease, treatment and practice – to trace the origins and development of the ideas that underpin medicine in its broadest sense – ideas concerning the most fundamental aspects of human existence: health and illness, body and mind, gender and family, care and community. Historical sources can only go so far in illuminating such topics; we must also look to other cultural texts, and in particular literary texts, which, through their imaginative worlds, provide crucial insights into cultural and intellectual attitudes, experience and creativity. Reading from a critical medical humanities perspective requires not only cultural archaeology across a range of discourses, but also putting past and present into conversation, to discover continuities and contrasts with later perspectives. Medical humanities research is illuminated by cultural and literary studies, and also brings to them new ways of seeing; the relation is dynamic. This chapter explores the ways mind, body and affect are constructed and intersect in medieval thought and literature, with a particular focus on how voice-hearing and visionary experience are portrayed and understood.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

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