Paediatric Dermatology
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Recent papers in Paediatric Dermatology
the antivirus drugs and used in dermetology and venerology
Background: Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically‑mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to... more
Background: Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically‑mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN‑ and EM‑drug‑related hospitalisations in a nationwide administrative data‑ base, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. Methods: We analysed all drug‑related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in‑hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in‑hospital mortality were investigated in both conditions by logistic regression. Results: There were 132 SJS/TEN‑related and 122 EM‑related hospitalisations. Incidence and in‑hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co‑infection was more common among SJS/ TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppres‑ sive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). Conclusions: SJS/TEN in‑hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug‑ related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.
Acne is a chronic inflammatory disease of the pilosebaceous follicle, very common among adolescents and adults. His treatment uses different molecules isotretinoin used since 1982 for the treatment of severe acne with an efficiency of 65... more
Acne is a chronic inflammatory disease of the pilosebaceous follicle,
very common among adolescents and adults. His treatment uses different
molecules isotretinoin used since 1982 for the treatment of severe acne with
an efficiency of 65 to 85%. The synthesis of current scientific studies is not in
favor of an excess risk of suicide and depressive syndrome population treated
with isotretinoin per os. No study was undertaken to Kinshasa to measure the
safety and efficacy of isotretinoin in the treatment of severe acne, this state
of affairs justifies this study.
very common among adolescents and adults. His treatment uses different
molecules isotretinoin used since 1982 for the treatment of severe acne with
an efficiency of 65 to 85%. The synthesis of current scientific studies is not in
favor of an excess risk of suicide and depressive syndrome population treated
with isotretinoin per os. No study was undertaken to Kinshasa to measure the
safety and efficacy of isotretinoin in the treatment of severe acne, this state
of affairs justifies this study.
Vitiligo is a skin condition characterized by acquired complete epidermal depigmentation areas, it is the most common acquired hypomélanoses. This is a pathology, cosmopolitan, which affects about 1.5 to 2% of the world population,... more
Vitiligo is a skin condition characterized by acquired complete epidermal
depigmentation areas, it is the most common acquired hypomélanoses. This
is a pathology, cosmopolitan, which affects about 1.5 to 2% of the world
population, regardless of gender or ethnic origin.
depigmentation areas, it is the most common acquired hypomélanoses. This
is a pathology, cosmopolitan, which affects about 1.5 to 2% of the world
population, regardless of gender or ethnic origin.
Atopic dermatitis (AD) together with asthma and allergic rhinitis, is the most typical manifestation of an atopic constitution. Atopic dermatitis has been known since ancient times: Job probably suffered from it. Aetius de Amida in 534BC... more
Atopic dermatitis (AD) together with asthma and allergic rhinitis, is the most typical manifestation of an atopic constitution. Atopic dermatitis has been known since ancient times: Job probably suffered from it. Aetius de Amida in 534BC was the first to report a skin condition closely resembling AD. But the first ‘scientific’ description of childhood AD, together with advice on its treatment, is found in the first textbook of Pediatrics of the Western world “Libellus de Aegritudinibus Infantium” (Handbook of Diseases of children) by the Italian doctor Paolo Bagellardo, published in 1472. In a chapter on the skin, the author advises physicians to lubricate the skin and prevent scratching in children affected by this skin disorder.
Atopic dermatitis is associated with patchy, characteristically distributed areas of cutaneous eczema, with intense itching and subsequent lichenification of the skin. Cutaneous automic dysfunction (increased vasoconstriction) and xerosis (dryness of the skin) commonly occur in the affected patients. In addition, profound immunological dysregulation with various immune alterations has been described in affected patients. Most patients produce IgE antibodies to a number of food and inhalants allergens.
Atopic dermatitis is associated with patchy, characteristically distributed areas of cutaneous eczema, with intense itching and subsequent lichenification of the skin. Cutaneous automic dysfunction (increased vasoconstriction) and xerosis (dryness of the skin) commonly occur in the affected patients. In addition, profound immunological dysregulation with various immune alterations has been described in affected patients. Most patients produce IgE antibodies to a number of food and inhalants allergens.
Background The first dermatology-specific proxy health related quality of life (HRQoL) instrument for children 0-4 years old with skin diseases, the Infants and Toddlers Dermatology Quality of Life (InToDermQoL), was recently developed.... more
Background The first dermatology-specific proxy health related quality of life (HRQoL)
instrument for children 0-4 years old with skin diseases, the Infants and Toddlers
Dermatology Quality of Life (InToDermQoL), was recently developed. In order to avoid the
problem of cross-cultural inequivalence focus groups work and pilot tests were organized
simultaneously in all national centres of the project. The InToDermQoL showed good
comprehensibility, clarity and acceptance.
Objective To validate the InToDermQoL questionnaire during international field tests.
Methods Internal consistency, test-retest reliability, convergent and discriminant validity of
the InToDermQoL questionnaire were checked during international field tests.
Results Parents of 473 children with skin diseases filled in national language versions of the
InToDermQoL questionnaire. All three age-specific versions of the InToDermQoL
questionnaire with 10, 12 and 15 items, respectively, showed high internal consistency
(Cronbach’s alpha 0.90-0.93), good test-retest reliability (correlation coefficients>0.9),
significant correlations with the most widely used atopic dermatitis-specific proxy
instrument, the Infants Dermatitis Quality of Life Index (correlation coefficients 0.68-0.79).
The InToDermQoL versions for children less than 3 years old well correlated with the atopic
dermatis severity measure SCORAD (correlation coefficients 0.66 and 0.86 for 10 and 12
items versions, respectively). The InToDermQoL questionnaire discriminated well among
different diagnoses and disease severity levels.
Conclusion Our field tests confirmed internal consistency, test-retest reliability, convergent
and discriminant validity of the InToDermQoL questionnaire. Development and validation of
the InToDermQoL questionnaire makes it possible to assess dermatology-specific aspects of
HRQoL in youngest children with skin diseases. There are many reasons to assess HRQoL in
dermatologic clinical practice and we hope that our new instrument will be used
internationally in pediatric dermatology for research and practical needs.
instrument for children 0-4 years old with skin diseases, the Infants and Toddlers
Dermatology Quality of Life (InToDermQoL), was recently developed. In order to avoid the
problem of cross-cultural inequivalence focus groups work and pilot tests were organized
simultaneously in all national centres of the project. The InToDermQoL showed good
comprehensibility, clarity and acceptance.
Objective To validate the InToDermQoL questionnaire during international field tests.
Methods Internal consistency, test-retest reliability, convergent and discriminant validity of
the InToDermQoL questionnaire were checked during international field tests.
Results Parents of 473 children with skin diseases filled in national language versions of the
InToDermQoL questionnaire. All three age-specific versions of the InToDermQoL
questionnaire with 10, 12 and 15 items, respectively, showed high internal consistency
(Cronbach’s alpha 0.90-0.93), good test-retest reliability (correlation coefficients>0.9),
significant correlations with the most widely used atopic dermatitis-specific proxy
instrument, the Infants Dermatitis Quality of Life Index (correlation coefficients 0.68-0.79).
The InToDermQoL versions for children less than 3 years old well correlated with the atopic
dermatis severity measure SCORAD (correlation coefficients 0.66 and 0.86 for 10 and 12
items versions, respectively). The InToDermQoL questionnaire discriminated well among
different diagnoses and disease severity levels.
Conclusion Our field tests confirmed internal consistency, test-retest reliability, convergent
and discriminant validity of the InToDermQoL questionnaire. Development and validation of
the InToDermQoL questionnaire makes it possible to assess dermatology-specific aspects of
HRQoL in youngest children with skin diseases. There are many reasons to assess HRQoL in
dermatologic clinical practice and we hope that our new instrument will be used
internationally in pediatric dermatology for research and practical needs.
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