196 results on '"Åke, Svensson"'
Search Results
2. Increased Knowledge-based Care is Indicated for Patients with Atopic Dermatitis
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Maria Bradley and Åke Svensson
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Health Knowledge, Attitudes, Practice ,Surveys and Questionnaires ,Humans ,Dermatology ,General Medicine ,Dermatitis, Atopic - Abstract
is not missing (Guest Editorial)
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- 2022
3. Atopy patch testing and associations with atopic conditions and specific IgE tests: a population-based study in adolescents
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Ada, Uldahl, Therese, Sterner, Magnus, Bruze, Jakob, Dahlin, Laura, Von Kobyletzki, Åke, Svensson, Hampus, Kiotseridis, Alf, Tunsäter, and Cecilia, Svedman
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Quality of Life ,Humans ,Allergens ,Immunoglobulin E ,Patch Tests ,Dermatitis, Atopic - Abstract
The clinical usefulness of the atopy patch test (APT) is unclear for investigating aeroallergen- and food-triggered atopic dermatitis (AD).This study aimed to assess the prevalence of positive APT reactions in a population of adolescents and investigate possible associations between the APT, specific serum (s) immunoglobulin E (IgE) tests, self-reported atopic conditions and health-related quality of life.A population-based study was performed on 211 adolescents (13-14 years old). Collected data included questionnaires, an APT with food and aeroallergens and s-IgE tests.Positive APT reactions were observed in 9.0% (19/211) of the adolescents. Timothy grass was the top allergen with 11 (5.2%) positive reactions, followed by cat dander (2.8%) and house dust mites (2.4%). Rhinoconjunctivitis increased the odds of any positive APT (crude odds ratio: 3.32; 95% confidence interval [CI]: 1.17–9.40), particularly when an APT was positive for aeroallergens (odds ratio: 5.02, 95% CI: 1.54-16.42). There was no association between a positive APT and AD. Four adolescents without AD and no IgE-sensitization had a positive APT.Based on a population of adolescents, the APT is associated with rhinoconjunctivitis but not AD. This finding should be taken into consideration in further attempts to clarify the role of the APT in the clinical setting.
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- 2022
4. Validation of questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix II: the EDEN Fragrance Study
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Peter Elsner, Åke Svensson, Luigi Naldi, Magnus Bruze, Malin Engfeldt, Marielouise Schuttelaar, Robert Ofenloch, Margarida Gonçalo, Cecilia Svedman, and Public Health Research (PHR)
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Allergy ,Population ,Dermatology ,Patch testing ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Medicine ,Positive test ,Fragrance mix ,education ,Allergic contact dermatitis ,education.field_of_study ,business.industry ,Patch test ,Allergens ,Patch Tests ,medicine.disease ,Perfume ,ALLERGY ,Infectious Diseases ,DOSE-RESPONSE RELATIONSHIP ,Contact allergy ,030220 oncology & carcinogenesis ,Dermatitis, Allergic Contact ,Odorants ,QUANTITATIVE ASPECTS ,business ,Algorithm ,Algorithms - Abstract
Background In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis.Objectives The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the recent repeated open application test (ROAT) and the patch test reactivity.Methods One hundred nine subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT.Results Twenty-four positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (P < 0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (P = 0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period.Conclusions The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.
- Published
- 2021
5. Curettage and electrodessication combined with photodynamic therapy in the treatment of large squamous cell carcinomas in unfit and frail patients
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Henrik, Luu, Måns, Cornefjord, Åke, Svensson, and Henry, Svensson
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Skin Neoplasms ,Photochemotherapy ,Frail Elderly ,Carcinoma, Squamous Cell ,Humans ,Female ,Aged ,Curettage - Abstract
A Caucasian female patient in her 90s was referred to the department of plastic and reconstructive surgery for surgical removal of a large invasive squamous cell carcinoma on the anterior chest wall. A skin biopsy prior to the referral indicated that the tumour was moderately differentiated. The patient suffered from severe congestive heart failure with a mechanical valve prosthesis and atrial fibrillation, and was therefore treated with anticoagulants. Hence, a surgical procedure would be hazardous. Therefore, other treatment options were considered. The principal aim was to reduce the amount of tumour tissue to an appropriate size suitable for later excision with primary wound closure. After interdisciplinary discussions, curettage and electrodessication combined with photodynamic therapy was judged the best alternative treatment in this case. At the 1.5 years follow-up after the intervention there was no indication for further surgery. The patient was at that stage content with the treatment and its outcome.
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- 2022
6. Increased prevalence of human papillomavirus in fresh tissue from penile cancers compared to non-malignant penile samples: A case-control study
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Sinja Kristiansen, Carina Bjartling, Christian Torbrand, Diane Grelaud, Martin Lindström, Åke Svensson, and Ola Forslund
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Male ,Human papillomavirus 16 ,Cancer Research ,Papillomavirus Infections ,Alphapapillomavirus ,Oncology ,Case-Control Studies ,Prevalence ,Genetics ,Humans ,Female ,RNA, Messenger ,Penile Neoplasms ,Papillomaviridae - Abstract
Background HPV has been detected in approximately 50% of invasive penile cancers but with a large span between 24 and 89%, most likely due to different types of tumors and various methods for HPV analysis. Most studies of HPV in penile cancer have been performed using paraffin-embedded tissue, argued to be at risk for contaminated HPV analysis. Viral activity of HPV, by the use of HPV mRNA expression is well studied in cervical cancer, but seldom studied in penile cancer. The aim was to determine prevalence of HPV types in fresh tissue of penile cancers compared to non-malignant age-matched penile controls. Additional aims were to analyze the viral expression and copy numbers of HPV16-positive tumors and 10 mm adjacent to the tumor. Methods Fresh tissue from penile cancer cases was biopsied inside the tumor and 10 mm outside the tumor. Controls were males circumcised for non-malignant reasons, biopsied at surgery. PCR and Luminex assays were used for identification of HPV types. HPV16-positive samples were investigated for copy numbers and expression of HPV16-mRNA. Results Among tumors (n = 135) and age-matched controls (n = 105), HPV was detected in 38.5% (52/135) and 11.4% (12/105), respectively (p p Conclusions The prevalence of HPV was significantly higher in penile cancer (38.5%) than among age-matched non-malignant penile samples (11.4%). HPV16 predominates (27.4%) in penile tumors. HPV16 expression was more common in penile cancer than in adjacent healthy tissue, strongly suggesting an etiological role for HPV16 in the development of penile cancer.
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- 2022
7. Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis
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Wasim, Jamil, Åke, Svensson, Anna, Josefson, Magnus, Lindberg, and Laura, Von Kobyletzki
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Male ,Incidence ,Eczema ,Humans ,Female ,Occupations - Abstract
Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3-27.4), as did nurses, 16.9 (95% CI 11.2-22.7), and metal workers, 12.4 (95% CI 3.5-21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2-9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.
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- 2022
8. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes on quality of life issues in dermatologic patients during the COVID‐19 pandemic
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Åke Svensson, Christine Blome, Françoise Poot, Mir-saeed Salek, Servando E Marron, Alina Suru, Andrew Yule Finlay, Jacek C Szepietowski, Francesca Sampogna, Dennis Linder, Lucia Tomas-Aragones, Florence J Dalgard, Carmen Salavastru, Andrea W M Evers, Damiano Abeni, N. Pustišek, L. Manolache, Pavel V Chernyshov, Matthias Augustin, and Anthony Bewley
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medicine.medical_specialty ,Infectious Disease Transmission, Patient-to-Professional ,Venereology ,Advisory Committees ,Pneumonia, Viral ,Population ,MEDLINE ,Dermatology ,Skin Diseases ,SARS‐CoV‐2 ,Betacoronavirus ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,COVID‐19 ,Health care ,Pandemic ,medicine ,Humans ,Infection control ,030212 general & internal medicine ,Position Statement ,education ,Pandemics ,Societies, Medical ,Infection Control ,education.field_of_study ,treatment ,SARS-CoV-2 ,business.industry ,COVID-19 ,humanities ,Europe ,Infectious Diseases ,quality of life ,Periodicals as Topic ,Coronavirus Infections ,business ,Psychosocial - Abstract
The pandemic of COVID‐19 is a global challenge for health care and dermatologists are not standing apart from trying to meet this challenge. The European Academy of Dermatology and Venereology (EADV) has collected recommendations from its Task Forces (TFs) related to COVID‐19. The Journal of the EADV has established a COVID‐19 Special Forum giving free access to related articles. The psychosocial effects of the pandemic, an increase in contact dermatitis and several other skin diseases because of stress, disinfectants and protective equipment use, especially in health care workers, the temporary limited access to dermatologic care, the dilemma whether or not to pause immunosuppressive therapy, and, finally, the occurrence of skin lesions in patients infected by COVID‐19 all contribute to significant quality of life (QoL) impairment. Here we present detailed recommendations of the EADV TF on QoL and Patient Oriented Outcomes on how to improve QoL in dermatologic patients during the COVID‐19 pandemic for several different groups of patients and for the general population.
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- 2020
9. Intervention study to evaluate the importance of information given to patients with contact allergy: a randomized, investigator‐blinded clinical trial*
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Ingrid Siemund, Åke Svensson, W. Troensegaard, A. Dizdarevic, Ada Uldahl, Ola Bergendorff, and Andreas Sonesson
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Adult ,Male ,medicine.medical_specialty ,Allergy ,Dermatology ,medicine.disease_cause ,Affect (psychology) ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Surveys and Questionnaires ,Intervention (counseling) ,medicine ,Humans ,Aged ,Response rate (survey) ,business.industry ,Patch test ,Allergens ,Middle Aged ,Patch Tests ,medicine.disease ,Clinical trial ,Research Design ,Dermatitis, Allergic Contact ,Physical therapy ,business ,Contact dermatitis - Abstract
Background: In contact dermatitis, it is crucial to understand and remember the outcome of patch testing. Unfortunately, many patients do not remember the results of their patch tests. Objectives: Our aim was to evaluate the effects of an intervention programme in which extensive information on specific contact allergy was provided, in individuals with positive patch test reactions. Methods: The study was designed as a randomized, investigator-blinded clinical trial. Participants with positive test reactions were randomized into two groups that received either standard information according to clinical routine or standard information and a reminder letter. Knowledge of contact allergies was evaluated using questionnaires 12 months after inclusion. Results: There were 184 adults included in the trial and the response rate at 1-year follow-up was 78% (143 of 184). Sixty-five per cent (45 of 69) in the intervention group and 54% (40 of 74) in the control group reported the correct name of the allergen (P = 0·23). Participants with several – as opposed to few – positive patch test reactions had difficulty in remembering the correct names of the allergens (P = 0·001). Moreover, the type of allergy had an influence on their ability to remember the name of the allergen correctly and their ability to make changes in lifestyle. Conclusions: The intervention performed did not significantly affect the participants’ ability to remember their contact allergy. To achieve better knowledge and changes in lifestyle, efforts to inform should concentrate on individuals with several positive patch test reactions, those with particular allergens, individuals over 60 years of age, and – concerning changes in lifestyle – males. (Less)
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- 2020
10. Hidradenitis Suppurativa in Sweden: A Registry-Based Cross-Sectional Study of 13,538 Patients
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Karin Sartorius, Lennart Emtestam, Hassan Killasli, and Åke Svensson
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Population ,Subgroup analysis ,Comorbidity ,Dermatology ,Overweight ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Internal medicine ,medicine ,Humans ,Hidradenitis suppurativa ,Registries ,Child ,education ,Life Style ,Aged ,Aged, 80 and over ,Sweden ,education.field_of_study ,business.industry ,Infant, Newborn ,Infant ,Middle Aged ,medicine.disease ,Hidradenitis Suppurativa ,Pregnancy Complications ,Cross-Sectional Studies ,Socioeconomic Factors ,Child, Preschool ,030220 oncology & carcinogenesis ,Cohort ,Female ,medicine.symptom ,business ,Record linkage - Abstract
Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition with nodules and fistula formation and scarring. It is a debilitating disease with a severe negative impact on quality of life. There is a need for increased knowledge about the social and lifestyle characteristics of patients with HS in general, and pregnant women in particular. Objectives: The aims of this study were to investigate and describe social characteristics and comorbidity in all HS patients in Sweden as well as to study the prevalence of lifestyle factors associated with negative impact on health and pregnancy in Swedish pregnant women with HS. Methods: A registry-based cross-sectional study was performed by record linkage between Swedish registers covering the entire population. A cohort of 13,538 HS patients diagnosed with HS in specialised care during the years 2001–2014 and a subgroup of 1,368 HS patients who had undergone pregnancy during 2010–2015 were defined and described. Aggregated public data on the entire Swedish population and all pregnancies in 2014 were described for reference. Results: The HS population had an average age of 44 years on December 31, 2014. The prevalence of HS was 0.14%. In comparison to the Swedish reference population the HS patients were more often women, unmarried (36 vs. 44% married), and had lower education (68 vs. 82% with an upper-secondary school degree or higher) and lower income (39 vs. 16% made SEK Conclusions: The results from this comprehensive characterisation of Swedish HS patients may be used to improve preventive measures, information, and care for this vulnerable group.
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- 2020
11. Recent changes in the frequency of plant species and vegetation types in Scania, S Sweden, compared to changes during the twentieth century
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Torbjörn Tyler, Åke Svensson, Stefan Andersson, Lars Fröberg, Ola Olsson, and Kjell-Arne Olsson
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0106 biological sciences ,Flora ,geography ,geography.geographical_feature_category ,010504 meteorology & atmospheric sciences ,Ecology ,Land use ,Biodiversity ,Wetland ,Vegetation ,010603 evolutionary biology ,01 natural sciences ,Grassland ,Ruderal species ,Arable land ,Ecology, Evolution, Behavior and Systematics ,0105 earth and related environmental sciences ,Nature and Landscape Conservation - Abstract
Based on data from three surveys of the vascular flora of the province of Scania, southernmost Sweden, conducted 1938–1971, 1987–2006 and 2008–2015, we analyse the change in frequency of individual species and groups of species associated with particular vegetation types. A majority of all species have experienced a change in frequency since 1938, and this turnover has continued in recent decades. The species showing the most dramatic declines since 1987 represent a mixture of arable weeds, grassland species and ruderals, but excludes forest species. In contrast, a majority of the most increasing species are escapes from cultivation that thrive under shaded conditions. The vegetation types showing the largest decreases since 1987 are all open seminatural grasslands and wetlands, while the vegetation types performing best are wooded. All vegetation types increasing since 1987 also increased during the 1900s; however, species of wooded types performed relatively better in recent decades, as opposed to the minimal increase observed for species of vegetation strongly influenced by human activities. Among decreasing vegetation types, those that have received much attention from conservationists, e.g. sand-steppe and calcareous fens tend to perform relatively better now than during the 1900s, while those that have received less attention, e.g. poor fens, oligotrophic waters and heaths, now comprise the most rapidly declining vegetation types. A majority of the species that decreased 1938–1996 also decreased 1987–2015, but, in general, species shown to have increased during the 1900s have not continued to increase.
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- 2019
12. Dermatology textbooks in Scandinavia should prepare medical students for ethnic diversity
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Åke Svensson, A. Elyas, and Florence J Dalgard
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Medical education ,Students, Medical ,Infectious Diseases ,business.industry ,Cultural diversity ,Ethnicity ,Humans ,Medicine ,Cultural Diversity ,Dermatology ,Scandinavian and Nordic Countries ,business - Published
- 2021
13. Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa
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Francesca Sampogna, Damiano Abeni, H.H. van der Zee, Thrasyvoulos Tzellos, Anthony Bewley, Andrew Yule Finlay, Dennis Linder, Åke Svensson, Lucia Tomas-Aragones, N. Pustišek, Christos C. Zouboulis, Servando E Marron, Jacek C Szepietowski, Saskia Spillekom-van Koulil, Pavel V Chernyshov, L. Manolache, Gregor Be Jemec, Matthias Augustin, and Dermatology
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medicine.medical_specialty ,Venereology ,Advisory Committees ,MEDLINE ,Dermatology ,Severity of Illness Index ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,All institutes and research themes of the Radboud University Medical Center ,Quality of life ,Severity of illness ,Acne Vulgaris ,Medicine ,Humans ,Hidradenitis suppurativa ,Patient Reported Outcome Measures ,business.industry ,Dermatology Life Quality Index ,medicine.disease ,humanities ,Hidradenitis Suppurativa ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Clinical trial ,Europe ,Infectious Diseases ,Rosacea ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Quality of Life ,business - Abstract
This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient-Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS-specific health-related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high-quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double-blind randomized placebo-controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well-designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long-term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS-specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology-specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS-specific, dermatology-specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient-Oriented Outcomes.
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- 2019
14. Atopic dermatitis, educational attainment and psychological functioning: a national cohort study
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Åke Svensson, Scott Montgomery, Jevgenija Smirnova, Sinead Langan, L.B. von Kobyletzki, and Magnus Lindberg
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Male ,Adolescent ,media_common.quotation_subject ,Dermatology ,Dermatitis, Atopic ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Risk Factors ,Prevalence ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Socioeconomic status ,media_common ,Sweden ,Academic Success ,business.industry ,Atopic dermatitis ,Resilience, Psychological ,medicine.disease ,Educational attainment ,Confidence interval ,Military Personnel ,Socioeconomic Factors ,Relative risk ,Psychological resilience ,business ,Stress, Psychological ,Record linkage ,Demography - Abstract
Background: Atopic dermatitis (AD) might adversely affect academic performance, possibly through influences on psychological functioning such as stress resilience. Objectives: To investigate the association of atopic dermatitis with stress resilience, cognitive function and educational attainment. Methods: We used data from a national cohort of men who underwent a military conscription examination at ages 17–20 years in Sweden between 1969 and 1976. All potential conscripts met a physician who assessed current or previous history of AD. Stress resilience was measured by a psychologist using a semistructured interview. The conscription assessment included a written cognitive function test. The highest level of education achieved was identified through record linkage. Results: The study population included 234 715 men, 1673 (0·7%) of whom had a diagnosis of AD. AD was associated with a greater risk of low stress resilience [adjusted relative risk ratio (RRR) 1·60, 95% confidence interval (CI) 1·38–1·86]. AD was associated with higher cognitive function (β-coefficient 0·15, 95% CI 0·05–0·24) and higher educational level (RRR 1·29, 95% CI 1·13–1·47). However, adjustment for socioeconomic characteristics of the family of origin attenuated the magnitude of the associations and eliminated the statistical significance (β-coefficient 0·06, 95% CI −0·03 to 0·15; RRR 1·16, 95% CI 1·00–1·35). Conclusions: Swedish men with AD had lower stress resilience in late adolescence but did not have lower cognitive function or poorer educational attainment. The lower stress resilience associated with AD is consistent with an increased risk of possible long-term adverse health outcomes. (Less)
- Published
- 2018
15. Quality of life measurement in alopecia areata. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes
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Matthias Augustin, Anthony Bewley, Francesca Sampogna, Åke Svensson, Alina Suru, Dennis Linder, L. Manolache, Andrew Yule Finlay, Andrea W M Evers, Jacek C Szepietowski, Sam Salek, Christine Blome, Carmen Salavastru, Damiano Abeni, Servando E Marron, Gregor B.E. Jemec, Lucia Tomas-Aragones, N. Pustišek, Saskia Spillekom-van Koulil, Pavel V Chernyshov, and Françoise Poot
- Subjects
Position statement ,medicine.medical_specialty ,Venereology ,Alopecia Areata ,MEDLINE ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Patient oriented ,medicine ,Humans ,030212 general & internal medicine ,skin and connective tissue diseases ,integumentary system ,Task force ,business.industry ,Dermatology Life Quality Index ,Alopecia areata ,medicine.disease ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Infectious Diseases ,Quality of Life ,business ,Hair - Abstract
New treatment options may lead to an increased interest in using reliable and sensitive instruments to assess health-related quality of life in people with alopecia areata (AA). The purpose of this paper is to present current knowledge about quality of life assessment in AA. The dermatology-specific Dermatology Life Quality Index (DLQI) was the most widely reported health-related quality of life instrument used in AA. Three AA-specific (Alopecia Areata Symptom Impact Scale, Alopecia Areata Quality of Life Index and Alopecia Areata Patients'' Quality of Life) and three hair disease-specific instruments (Hairdex, Scalpdex and ‘hair-specific Skindex-29’) were identified with a range of content and validation characteristics: there is little evidence yet of the actual use of these measures in AA. Scalpdex is the best-validated hair disease-specific instrument. Further extensive validation is needed for all of the AA-specific instruments. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes recommends the use of the dermatology-specific DLQI questionnaire, hair disease-specific Scalpdex and the alopecia areata-specific instruments the Alopecia Areata Symptom Impact Scale or Alopecia Areata Quality of Life Index, despite the limited experience of their use. We hope that new treatment methods will be able to improve both clinical signs and health-related quality of life in patients with AA. In order to assess the outcomes of trials on these new treatment methods, it would be helpful when further development and validation of AA-specific instruments is being encouraged and also conducted. © 2021 European Academy of Dermatology and Venereology.
- Published
- 2021
16. Selection process of measures for core outcome set should utilize the highest methodology level and should be maximally free of bias. Comment on ‘IDQoL, CDLQI and the 45‐item CADIS received a sufficient content validity rating during the HOME VII meeting in Japan: a group discussion study’
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Åke Svensson, M. J. Boffa, Françoise Poot, Anthony Bewley, N. Pustišek, J. S. Szepietowski, Pavel V Chernyshov, Carmen Salavastru, Damiano Abeni, Vincenzo Bettoli, Servando E Marron, Francesca Sampogna, Andrea W M Evers, and L. Tomas Aragones
- Subjects
business.industry ,Dermatology ,Outcome (probability) ,Dermatitis, Atopic ,Core (game theory) ,Infectious Diseases ,Group discussion ,Japan ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Statistics ,Quality of Life ,Content validity ,Humans ,Medicine ,business ,Set (psychology) ,Selection (genetic algorithm) - Published
- 2020
17. European Task Force on Atopic Dermatitis (ETFAD): treatment targets and treatable traits in atopic dermatitis
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Carsten Flohr, S. Cristen-Zaech, Carle Paul, Magdalena Trzeciak, Thomas Bieber, Ulf Darsow, Åke Svensson, Stephan Weidinger, A. Wollenberg, L.B. von Kobyletzki, J. Ring, Sébastien Barbarot, Alain Taieb, Thomas Werfel, M. Deleuran, Michael J. Cork, Julien Seneschal, Antonio Torrelo, R. Fölster-Holst, Carlo Gelmetti, J. F. Stalder, Jacob P. Thyssen, Annice Heratizadeh, DirkJan Hijnen, Dagmar Simon, Christian Vestergaard, Pavel V Chernyshov, Z. Szalai, L. De Raeve, de Bruin-Weller, Uwe Gieler, Surgical clinical sciences, Dermatology, Skin function and permeability, Herlev and Gentofte Hospital, Copenhagen Research Group for Inflammatory Skin (CORGIS), Aarhus University Hospital, Univ Med Ctr Utrecht, Dept Pediat Gastroenterol, Wilhelmina Childrens Hosp, University Hospital Bonn, Université de Bordeaux (UB), University of Sheffield [Sheffield], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, King‘s College London, Schleswig-Holstein University Hospitals, Hannover Medical School [Hannover] (MHH), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Bern University Hospital [Berne] (Inselspital), Hospital Infantil Universitario Niño Jesús [Madrid, Spain] (HIUNJ), National Medical University, Centre hospitalier universitaire de Nantes (CHU Nantes), Università degli Studi di Milano [Milano] (UNIMI), Heim Pál Children's Hospital, Skane University Hospital [Malmo], Lund University [Lund], University Clinic Schleswig–Holstein, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Centre médical Érasme, Justus-Liebig-Universität Gießen (JLU), Ludwig-Maximilians-Universität München (LMU), Klinikum der Universität [München], and Technical University of Munich (TUM)
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medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Advisory Committees ,Eczema ,MEDLINE ,Dermatology ,Dermatitis, Atopic ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Treatment targets ,TARGETS ,EFTAD ,medicine ,Humans ,atopic dermatitis ,Task force ,business.industry ,Atopic dermatitis ,Patch Tests ,medicine.disease ,3. Good health ,Infectious Diseases ,030228 respiratory system ,business - Abstract
International audience; Background: Surgery is a radical treatment for hidradenitis suppurativa (HS) and may be considered as the only one potentially curative. Objectives: To characterize HS recurrence in patients after surgery and assess the risk factors of recurrence. Methods: We conducted a monocentric retrospective cohort study. All consecutive patients who had surgery (January 1, 2012 to March 31, 2017) were included. We estimated the rate of recurrence of HS lesions after surgery (
- Published
- 2020
18. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children
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Michael J. Cork, Mette Deleuran, Jean-François Stalder, Stephan Weidinger, Magdalena Trzeciak, Ulf Darsow, Z. Szalai, Annice Heratizadeh, L.B. von Kobyletzki, Johannes Ring, Jacob P. Thyssen, DirkJan Hijnen, Dagmar Simon, Thomas Werfel, Julien Seneschal, Sébastien Barbarot, R. Fölster-Holst, Christian Vestergaard, Åke Svensson, M S de Bruin-Weller, Andreas Wollenberg, S. Christen-Zäch, Alain Taieb, U. Gieler, B. Kunz, L. De Raeve, Carle Paul, Ludwig-Maximilians-Universität München (LMU), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Internal Medicine, and Dermatology
- Subjects
Adult ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Provocation test ,Calcineurin Inhibitors ,Anti-Inflammatory Agents ,Eczema ,Dermatology ,Tacrolimus ,Dermatitis, Atopic ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Pimecrolimus ,0302 clinical medicine ,Food allergy ,medicine ,Adjuvant therapy ,Humans ,030212 general & internal medicine ,SCORAD ,Child ,medicine.diagnostic_test ,business.industry ,Pruritus ,Atopic dermatitis ,medicine.disease ,Dupilumab ,3. Good health ,Infectious Diseases ,business ,medicine.drug - Abstract
International audience; Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient's age and also target flare prevention. Basic therapy includes hydrating and barrier-stabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti-inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid-potency corticosteroids are proven agents for proactive therapy, which is defined as the long-term intermittent anti-inflammatory therapy of frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is a rapidly changing field requiring monitoring. Oral corticosteroids have a largely unfavourable benefit-risk ratio. The IL-4R-blocker dupilu-mab is a safe, effective and licensed, but expensive, treatment option with potential ocular side-effects. Other biologicals targeting key pathways in the atopic immune response, as well as different Janus kinase inhibitors, are among emerging treatment options. Dysbalanced microbial colonization and infection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) only have limited effects on AD-related itch and eczema lesions. Adjuvant therapy includes UV irradiation, preferably narrowband UVB or UVA1. Coal tar may be useful for atopic hand and foot eczema. Dietary recommendations should be patient-specific, and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. Efficacy-proven 'Eczema school' educational programmes and therapeutic patient education are recommended for both children and adults.
- Published
- 2020
19. Associations of self-reported atopic dermatitis with comorbid conditions in adults: a population-based cross-sectional study
- Author
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Åke Svensson, Laura B von Kobyletzki, Scott Montgomery, Jevgenija Smirnova, and Magnus Lindberg
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,obesity ,hypertension ,Adolescent ,Cross-sectional study ,Dermatology ,Comorbidity ,Risk Assessment ,Severity of Illness Index ,Dermatitis, Atopic ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Epidemiology ,lcsh:Dermatology ,Odds Ratio ,Prevalence ,Medicine ,Humans ,Depression (differential diagnoses) ,Asthma ,Aged ,Atopic dermatitis ,Sweden ,business.industry ,Odds ratio ,lcsh:RL1-803 ,Middle Aged ,medicine.disease ,030104 developmental biology ,Cross-Sectional Studies ,Relative risk ,Chronic Disease ,diabetes mellitus ,Population study ,oral health ,Female ,epidemiology ,Self Report ,business ,Research Article - Abstract
Background The objective of this study was to investigate the relationships between atopic dermatitis (AD) and other common chronic health conditions in adults. Methods A cross-sectional survey was sent to a randomly selected population sample of 78,004 adults in Sweden. The questionnaires included measures of self-reported physical and mental health. Binary and multinomial logistic regression were used to examine the associations of AD with common chronic health conditions and psychological wellbeing. Results AD was self-reported by 4,175 respondents, representing almost 14% of the study population of 34,313 adults. Our results showed positive associations between AD and chronic health disorders, including conditions of the oral cavity: chronic obstructive pulmonary disease (adjusted odds ratio [aOR] = 1.58, 95% confidence interval [CI]: 1.30 to 1.92), asthma (aOR = 2.13, 95% CI: 1.91 to 2.38), mild recurrent gastrointestinal symptoms (adjusted relative risk ratio [aRRR] = 1.78, 95% CI: 1.64 to 1.92), high blood pressure (aOR = 1.16, 95% CI: 1.06 to 1.26), obesity (aOR = 1.34, 95% CI: 1.23 to 1.47), mild joint pain (aRRR = 1.47, 95% CI: 1.35 to 1.61), mild headache or migraine (aRRR = 1.50, 95% CI: 1.38 to 1.64), caries (aOR = 1.25, 95% CI: 1.04 to 1.49), bleeding gums (aOR = 1.69, 95% CI: 1.38 to 2.08), periodontitis (aOR = 1.42, 95% CI: 1.13 to 1.77), sensitive teeth (aOR = 1.57, 95% CI: 1.35 to 1.82), and dry mouth (aOR = 1.52, 95% CI: 1.33 to 1.74). Adjustment for asthma and depression attenuated the magnitude of the associations between AD and the study outcomes. AD was also associated with poorer general psychological wellbeing. Conclusions Adults reporting AD may be at increased risk of chronic disorders and decreased psychological wellbeing. Physicians should recognize that individuals with severe AD and those with comorbid asthma or depression may be especially vulnerable.
- Published
- 2020
20. 特应性湿疹的治疗 (TREAT) 登记工作组:比较 Dupilumab 与其他全身药物治疗中度至重度湿疹安全性的方法
- Author
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Christian Vestergaard, Eulalia Baselga, A.L. Bosma, Ph.I. Spuls, David Prieto-Merino, Andrea Manca, Sébastien Barbarot, Dmitri Wall, L.A.A. Gerbens, Lawrence F. Eichenfield, Christian Apfelbacher, Åke Svensson, Ignacio García-Doval, Julien Seneschal, F.M. Vermeulen, A.D. Irvine, B.W.M. Arents, Pedro Mendes-Bastos, Carsten Flohr, Luigi Naldi, Jacob P. Thyssen, Falko Tesch, Amanda Roberts, J. Schmit, Tiago Torres, M. Deleuran, S. Weidinger, M.A. Middelkamp‐Hup, and L.B. von Kobyletzki
- Subjects
Dermatology - Published
- 2020
21. TREatment of ATopic eczema (TREAT) Registry Taskforce: method for comparing the safety of dupilumab with other systemic therapies for moderate‐to‐severe eczema
- Author
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Luigi Naldi, Tiago Torres, Ignacio García-Doval, Christian Apfelbacher, Amanda Roberts, A.D. Irvine, Julien Seneschal, Dmitri Wall, Andrea Manca, L.A.A. Gerbens, Lawrence F. Eichenfield, Jacob P. Thyssen, Carsten Flohr, S. Weidinger, M. Deleuran, M.A. Middelkamp‐Hup, A.L. Bosma, L.B. von Kobyletzki, Pedro Mendes-Bastos, Falko Tesch, Christian Vestergaard, Ph.I. Spuls, Eulalia Baselga, Jochen Schmitt, David Prieto-Merino, B.W.M. Arents, Sébastien Barbarot, Åke Svensson, and F.M. Vermeulen
- Subjects
Moderate to severe ,medicine.medical_specialty ,business.industry ,medicine ,Dermatology ,business ,Dupilumab - Published
- 2020
22. Prevalence and Incidence of Atopic Dermatitis: A Systematic Review
- Author
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Åke Svensson, Simon Bylund, Laura B von Kobyletzki, and Marika Svalstedt
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Dermatology ,Dermatitis, Atopic ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Age Distribution ,systematic review ,Epidemiology ,medicine ,Prevalence ,Humans ,Child ,Aged ,Data abstraction ,Aged, 80 and over ,Study quality ,atopic dermatitis ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Infant ,General Medicine ,Atopic dermatitis ,Middle Aged ,medicine.disease ,Confidence interval ,030104 developmental biology ,RL1-803 ,Child, Preschool ,Female ,business ,Demography ,Systematic search - Abstract
The primary objective of this study was to systematically review and analyse epidemiological studies of the prevalence and incidence of atopic dermatitis (AD) during childhood and adulthood, focusing on data from the 21st century. A systematic search of PubMed, EMBASE and Google (manual search) was performed in June 2019, followed by data abstraction and study quality assessment (Newcastle–Ottawa Scale). Cross-sectional and longitudinal epidemiological studies of individuals with AD (doctor-diagnosed or standardized definition) were included. Of 7,207 references reviewed, 378 moderate/good-quality studies were included: 352 on prevalence of AD and 26 on incidence of AD. In the 21st century, the 1-year prevalence of doctor-diagnosed AD ranged from 1.2% in Asia to 17.1% in Europe in adults, and 0.96% to 22.6% in children in Asia. The 1-year incidence ranged from 10.2 (95% confidence interval (95% CI) 9.9–10.6) in Italy to 95.6 (95% CI 93.4–97.9) per 1,000 person-years in children in Scotland. There were few recent studies on incidence of AD in the 21st century and no studies on adults only; most studies were conducted in Europe and the USA. Epidemiological studies on childhood and adulthood AD in different continents are still needed, especially on the incidence of AD during adulthood.
- Published
- 2020
23. Quality of life measurement in occupational skin diseases. Position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Occupational Skin Disease
- Author
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L. Manolache, Åke Svensson, Anthony Bewley, S.M. John, Margarida Gonçalo, Mir-saeed Salek, Carmen Salavastru, Andrea W M Evers, N. Pustišek, Lucia Tomas-Aragones, Jacek C Szepietowski, Pavel V Chernyshov, Servando E Marron, G.S. Tiplica, Andrew Yule Finlay, and Alina Suru
- Subjects
medicine.medical_specialty ,Venereology ,Advisory Committees ,Psychological intervention ,MEDLINE ,Dermatology ,Task (project management) ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,Patient oriented ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,medicine.disease ,humanities ,Infectious Diseases ,Hand eczema ,Quality of Life ,Position paper ,business - Abstract
The European Academy of Dermatology and Venereology (EADV) has started the 'Healthy Skin @ Work' campaign aimed to raise awareness among the public and EU authorities on the frequency and impact of occupational skin diseases (OSDs). The EADV Task Forces (TFs) on Quality of Life and Patient Oriented Outcomes (QoL/PO) and on OSD present their mutual position statement on QoL assessment in OSDs. The EADV TFs recommend the use of the DLQI as a dermatology-specific instrument and SF-36 as a generic instrument in health-related (HR) QoL studies on OSDs. The OSD-specific questionnaire, LIOD, is not recommended for general use in its present form because of its three months recall period. The EADV TFs discourage the use of non-validated and of non-validated modifications of previously validated HRQoL instruments. The EADV TFs wish to encourage research into: the HRQoL impact of OSDs other than occupational contact dermatitis and hand eczema; comparisons between the effects of different treatments and other interventions on HRQoL in OSDs; and into the HRQoL impairment of patients with OSDs from different countries, and with different provoking factors, to predict if the results of successful therapeutic and educational interventions may be generalized across countries and between occupations.
- Published
- 2020
24. Subjective and Objective Characteristics of Patients Seen at a Psychodermatology Unit: One-year Experience in Malmö, Sweden
- Author
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Johan Fhager, Åke Svensson, Ewa Wallin, Karin Sjöström, Florence J Dalgard, and Inese Dubnika Hauksson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Dermatology ,Anxiety ,Hospital Anxiety and Depression Scale ,Personality Disorders ,Skin Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Surveys and Questionnaires ,Epidemiology ,medicine ,lcsh:Dermatology ,Humans ,signs ,Depression (differential diagnoses) ,Aged ,Retrospective Studies ,Psychiatric Status Rating Scales ,Sweden ,Schizophrenia, Paranoid ,Delusional disorder ,business.industry ,Depression ,Mood Disorders ,Mental Disorders ,Pruritus ,healthcare services ,General Medicine ,Psychodermatology ,Dermatology Life Quality Index ,lcsh:RL1-803 ,Middle Aged ,medicine.disease ,psychodermatology ,Mood disorders ,030220 oncology & carcinogenesis ,Quality of Life ,symptoms ,Female ,medicine.symptom ,business - Abstract
Clinical epidemiological knowledge concerning psychodermatology patients is scarce. The objective of this study was to assess morbidity in a new psychodermatology service. Information was gathered from patient records at the psychodermatology unit in Skane University Hospital, Malmo, Sweden, from 1 February 2017 to 31 January 2018. All patients were screened with the Hospital Anxiety and Depression Scale (HADS) and the Dermatology Life Quality Index (DLQI) at baseline and after 12 months. Additional information was collated from the patient records. A total of 50 patients were treated during the 12 months, 86% were women, mean age 44 years (standard deviation (SD) 16 years). Itch was present in 72% of patients. Forty-two percent of patients were diagnosed with mood disorders, 30% with personality disorders, and 16% with delusional disorders. At baseline 40% of patients had a DLQI score >11, clinical depression was present in 14%, and clinical anxiety in 28%. These data emphasize the need for access to a multidisciplinary unit for dermatology patients.
- Published
- 2020
25. Focus Sessions (FS)
- Author
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Åke Svensson, Thomas L. Diepgen, Marie L A Schuttelaar, Peter Elsner, Luigi Naldi, Robert Ofenloch, Magnus Bruze, and Margarida Gonçalo
- Subjects
education.field_of_study ,medicine.medical_specialty ,business.industry ,Population ,Patch test ,Dermatology ,Atopic dermatitis ,medicine.disease_cause ,medicine.disease ,Dupilumab ,Topical medication ,Allergen ,Hand eczema ,Internal medicine ,medicine ,Immunology and Allergy ,business ,education ,Prospective cohort study - Abstract
OBJECTIVES: To determine the prevalence of atopic dermatitis (AD) in the general European population and to assess differences in contact allergy and avoidance of products between subjects with AD in lifetime and those who had not. MATERIALS AND METHODS: In five European countries (The Netherlands, Germany, Italy, Portugal and Sweden) a random sample of 12 377 participants, aged 18 to 74 years were interviewed using a standardized questionnaire. Questions were asked about previous atopic dermatitis and avoidance of products because of a skin reaction. A random sample of 3119 participants was patch tested. TRUE Test panel 1, 2 and 3 and investigator-loaded chamber systems were used, testing for a total of 47 allergens, including the individual fragrance allergens of fragrance mix (FM) I and FM II. Reading was performed at day 3. RESULTS: The physician-diagnosed lifetime prevalence of AD was 7.1% (95% CI 6.7-7.6). The age-standardized physician diagnosed life time prevalences of AD stratified per country were: Germany: 9.4% (95% CI 8.5-10.3); The Netherlands: 8.5% (95% CI 7.2-10.1); Sweden: 7.2% (95% CI 6.1-8.4); Italy 4.2% (95% CI 3.3-5.3); Portugal: 3.3% (95% CI 2.6-4.2). The prevalence of contact allergy to at least one allergen was not significantly different between those with AD in lifetime (31.1%) and those without AD (27.8%). Males with AD were significantly more sensitized to allergens of TRUE Test panel 2 (14.9%) than those without AD (6.9%) (P = .026). The prevalence of contact allergy to individual allergens was not significantly different for those with AD and those without, except for p-phenylenediamine in males: AD (4.0%), no AD (0.7%) (P = .023). The prevalence of a positive patch test reaction to the group of preservatives was slightly albeit not significant (P
- Published
- 2018
26. Oral provocation of patients allergic to sesquiterpene lactones with German chamomile tea to demonstrate possible systemic allergic dermatitis
- Author
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Birgitta Gruvberger, Monica Hindsén, Lena Persson, Åke Svensson, Magnus Bruze, Kerstin Lundh, and Erik Zimerson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Matricaria ,Provocation test ,German Chamomile ,Dermatology ,Hand Dermatoses ,Placebo ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Eating ,Lactones ,Random Allocation ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Immunology and Allergy ,Medicine ,Ingestion ,Humans ,030212 general & internal medicine ,Aged ,business.industry ,Patch test ,Middle Aged ,Patch Tests ,medicine.disease ,Delayed hypersensitivity ,Hand eczema ,Case-Control Studies ,Dermatitis, Allergic Contact ,Female ,Plant Preparations ,business ,Sesquiterpenes - Abstract
Background: Most patients with contact allergy to Asteraceae plants are patch test positive to sesquiterpene lactone mix (SLM). There are several reports among these patients of a flare-up of hand eczema after ingestion of food and beverages originating from Asteraceae plants. Aim: To investigate whether German chamomile tea can elicit systemic allergic dermatitis. Patients and Methods: Individuals with or without contact allergy to SLM were patch tested with an extract of German chamomile tea. Six weeks later, they were provoked with capsules containing either freeze-dried German chamomile tea or placebo capsules containing lactose, in a double-blind, randomized study. A numerical rating scale (NRS) was used to ascertain the volunteers' opinion of their hand eczema status. The study individuals were examined to detect a possible flare-up of healed patch test reactions to chamomile. Results: None of the subjects had a flare-up of healed patch test reactions. According to the NRS, SLM-positive individuals experienced a significant worsening of hand eczema, independently of whether they received chamomile or lactose capsules. Conclusion: No evidence suggestive of systemic allergic dermatitis was found. (Less)
- Published
- 2019
27. Prenatal phthalate exposure was associated with croup in Swedish infants
- Author
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Carl-Gustaf Bornehag, Eewa Nånberg, Åke Svensson, Huan Shu, Sverre Wikström, Christian H. Lindh, and Bo A.G. Jönsson
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Offspring ,Phthalic Acids ,Urine ,010501 environmental sciences ,01 natural sciences ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,Respiratory Sounds ,0105 earth and related environmental sciences ,Sweden ,Croup ,Creatinine ,business.industry ,Confounding ,Phthalate ,Infant ,General Medicine ,medicine.disease ,Otitis Media ,Otitis ,chemistry ,Prenatal Exposure Delayed Effects ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business - Abstract
Aim: This study examined whether prenatal phthalate exposure was associated with lower or upper airway inflammation in infants. Methods: From 2007 to 2010, we used liquid chromatography-tandem mass spectrometry, adjusted for creatinine, to analyse 14 phthalate metabolites and one phthalate replacement in the urine of 1062 Swedish mothers at a median of 10 weeks of pregnancy. This was used to determine any associations between prenatal phthalate exposure and croup, wheezing or otitis in their offspring until 12 months of age, using logistic regression, adjusted for potential confounders. Results: There were significant associations between phthalate metabolites of butyl-benzyl phthalate (BBzP) and di-ethyl-hexyl phthalate (DEHP) concentrations in maternal prenatal urine and croup in 1062 infants during the first year of life, when adjusted for potential confounders. A dose-response relationship was found between prenatal phthalates exposure and maternal reported croup in the children, with a significant association in boys. There was no clear indication with regard to associations between prenatal phthalate exposure and wheezing or otitis media in the children during the first year of life. Conclusion: Our analysis suggests that exposure to BBzP and DEHP phthalates was associated with maternal reports of croup in infants up to 12 months of age. (Less)
- Published
- 2018
28. Effects of intense pulsed light in microstomia in patients with systemic sclerosis: A pilot study
- Author
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Agneta Troilius Rubin, Roger Hesselstrand, Åke Svensson, Leena Lehti, and Lisbeth Rosholm Comstedt
- Subjects
Adult ,medicine.medical_specialty ,Movement ,medicine.medical_treatment ,Pilot Projects ,Dermatology ,Intense pulsed light ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Microstomia ,medicine ,Humans ,In patient ,Aged ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,business.industry ,Intense Pulsed Light Therapy ,Significant difference ,Middle Aged ,medicine.disease ,Lip ,Confidence interval ,Surgery ,Mouth opening ,Female ,business - Abstract
Introduction: The effects of intense pulsed light (IPL) on collagen structures are well known in the treatment of photodamaged skin. Objective: The objective of this study was to investigate the effect of IPL on sclerotic skin by treating patients with microstomia due to systemic sclerosis. Methods and materials: 13 patients all with microstomia and systemic sclerosis were treated with IPL, PR (530-750 nm filter) and/or VL (555-950 nm filter) applicator. They were treated in the perioral area 8 times with 3–4 weeks of interval and follow-up for 6 months. The outcomes were the inter-incisal distance and the inter-ridge distance. Results: A significant increase in mouth opening of 4.1 mm (95% confidence interval, 1726–6638, p < 0.005) was found in the inter-ridge distance when comparing the distance before treatment with the distance at six-month follow-up. No significant difference was found in the inter-incisal distance. The patients experienced improved mobility and better control of lip movements after the treatments. Conclusion: IPL can improve the inter-ridge distance between the lips in patients with microstomia due to systemic sclerosis but does not affect the inter-incisal distance, which is also dependent on the mobility of the mandibular joints. This treatment can be considered an adjunctive therapy in patients with microstomia due to systemic sclerosis.
- Published
- 2017
29. Tocilizumab‐induced sarcoidosis‐like reaction in a patient with giant cell arteritis. Clinical implications of a paradoxical phenomenon
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Åke Svensson, Henrik Luu, and Grigorios Theodosiou
- Subjects
medicine.medical_specialty ,Sarcoidosis ,business.industry ,Giant Cell Arteritis ,Dermatology ,Antibodies, Monoclonal, Humanized ,medicine.disease ,Giant cell arteritis ,chemistry.chemical_compound ,Tocilizumab ,chemistry ,medicine ,Humans ,business ,Glucocorticoids - Published
- 2020
30. Atopic dermatitis and educational attainment
- Author
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Åke Svensson, Jevgenija Smirnova, Magnus Lindberg, Sinead Langan, Scott Montgomery, and L.B. von Kobyletzki
- Subjects
Gerontology ,business.industry ,Medicine ,Dermatology ,Atopic dermatitis ,business ,medicine.disease ,Educational attainment - Published
- 2019
31. The significance of batch and patch test method in establishing contact allergy to fragrance mix I-EDEN Fragrance Study Group
- Author
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Magnus Bruze, Pieter Jan Coenraads, Thomas L. Diepgen, Åke Svensson, Robert Ofenloch, Margarida Gonçalo, Luigi Naldi, Peter Elsner, and Martin Mowitz
- Subjects
Male ,RECOMMENDATION ,Population ,Evernia prunastri ,Dermatology ,delayed hypersensitivity ,general population ,chloratranol/atranol ,Toxicology ,TRUE-TEST ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,McNemar's test ,True test ,medicine ,Prevalence ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Fragrance mix ,education ,Allergic contact dermatitis ,Mathematics ,ATRANOL ,education.field_of_study ,Patch test ,Allergens ,Patch Tests ,SERIES ,medicine.disease ,oak moss ,Europe ,DERMATITIS ,THOUGHTS ,Contact allergy ,Delayed hypersensitivity ,Dermatitis, Allergic Contact ,Odorants ,Female ,OAK MOSS ABSOLUTES ,allergic contact dermatitis ,CHLOROATRANOL - Abstract
Background: A fragrance mix consisting of eight separate fragrance ingredients (fragrance mix I [FM I]) is present in most baseline patch test series. Patch testing with the TRUE Test technique is considered to detect less contact allergy to FM I than testing with the Finn Chamber technique.Objective: To investigate the possible significance of batch and patch test method in establishing contact allergy to FM I.Methods: Three thousand one hundred and nineteen individuals representing a sample of the general population were patch tested with two batches of FM I with two patch test techniques at six dermatology clinics in five European countries. The TRUE Test technique and the Finn Chamber technique with pet. preparations were used. McNemar's test was used for statistical calculations.Results: The contact allergy prevalences varied between 0.7% and 2.6%. The patch tests with the mixes containing Evernia prunastri (oak moss) with a high content of chloratranol/atranol resulted in substantially more positive reactions than the corresponding tests with the mixes containing oak moss with a low content of chloratranol/atranol. The Finn Chamber technique detected significantly more contact allergic reactions than the TRUE Test technique (P Conclusion: The Finn Chamber technique detects more contact allergy to FM I than the TRUE Test technique.
- Published
- 2018
32. Itch and Mental Health in Dermatological Patients across Europe: A Cross-Sectional Study in 13 Countries
- Author
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Christina Schut, Flora Balieva, Csanád Szabó, Jacek C Szepietowski, Åke Svensson, Uwe Gieler, Laurent Misery, Lucia Tomas-Aragones, Françoise Poot, Dennis Linder, Francesca Sampogna, Jörg Kupfer, Servando E Marron, Florence J Dalgard, Sam Salek, Lars Lien, Andrew Yule Finlay, Andrey Lvov, İlknur Kıvanç Altunay, Gregor B.E. Jemec, Saskia Spillekom-van Koulil, and Jon Anders Halvorsen
- Subjects
0301 basic medicine ,Male ,hudsykdommer ,Mental health ,Cross-sectional study ,psykisk helse ,Health Status ,Itch ,Patient Health Questionnaire ,Hospital Anxiety and Depression Scale ,Biochemistry ,0302 clinical medicine ,Quality of life ,Cost of Illness ,psychological disease ,Prevalence ,Suicidal ideation ,Depression (differential diagnoses) ,Dermatologie ,Depression ,Middle Aged ,Europe ,Mental Health ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,dermatologi ,Adult ,medicine.medical_specialty ,Visual analogue scale ,Biochimie ,Dermatology ,Medisinske Fag: 700::Klinisk medisinske fag: 750::Psykiatri, barnepsykiatri: 757 [VDP] ,Suicidal Ideation ,03 medical and health sciences ,Anxiety and Depression Scale ,kløe ,Medisinske Fag: 700::Klinisk medisinske fag: 750::Dermatologi og venerologi: 753 [VDP] ,Internal medicine ,medicine ,Humans ,multidimensional symptom ,Molecular Biology ,business.industry ,Pruritus ,clinical depression ,Biologie moléculaire ,Cell Biology ,Odds ratio ,mental helse ,Confidence interval ,030104 developmental biology ,Cross-Sectional Studies ,Quality of Life ,Biologie cellulaire ,business - Abstract
Itch is a highly prevalent and multidimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multicenter study is observational and cross-sectional and was conducted in dermatological clinics across 13 European countries. A total of 3,530 patients and 1,094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity, and intensity), the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographics, suicidal ideation, and stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression (odds ratio, 1.53; 95% confidence interval, 1.15–2.02), suicidal ideation (odds ratio, 1.27; 95% confidence interval, 1.01–1.60), and economic difficulties (odds ratio, 1.24; 95% confidence interval, 1.10–1.50). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9 (standard deviation = 20.1) in patients with itch, compared with 74.7 (standard deviation = 18.0) in patients without itch (P < 0.001) and 74.9 (standard deviation = 15.7) in controls with itch compared with 82.9 (standard deviation = 15.6) in controls without itch (P < 0.001). Itch contributes substantially to the psychological disease burden in dermatological patients, and the management of patients should include access to multidisciplinary care., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2018
33. Risk Factors for Penile Intraepithelial Neoplasia: A Population-based Register Study in Sweden, 2000-2012
- Author
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Åke Svensson, Carina Bjartling, Sinja Kristiansen, Linda Drevin, Ola Forslund, and Christian Torbrand
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Dermatology ,Risk Assessment ,Organ transplantation ,Genital warts ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,medicine ,Penile cancer ,Humans ,Registries ,Risk factor ,Penile Neoplasms ,Aged ,CIS ,Aged, 80 and over ,Sweden ,lichen planus ,business.industry ,penile intraepithelial neoplasia ,Balanitis ,General Medicine ,Odds ratio ,Middle Aged ,penile cancer ,medicine.disease ,PeIN ,RL1-803 ,030220 oncology & carcinogenesis ,Case-Control Studies ,Cohort ,Penile Intraepithelial Neoplasia ,business ,Carcinoma in Situ ,penile cancer in situ - Abstract
Studies on risk factors for penile intraepithelial neoplasia have been small in size, have not distinguished penile intraepithelial neoplasia from invasive cancer, and have relied on self-reported information. This study investigated risk factors for penile intraepithelial neoplasia in a cohort of 580 penile intraepithelial neoplasia cases and 3,436 controls using information from 7 Swedish registers. Cases with penile intraepithelial neoplasia had increased odds ratios (ORs) for inflammatory skin diseases (14.7, 95% CI 6.5–33.4) including lichen planus (12.0, 95% CI 3.0–48.0), indicating lichen planus to be an important risk factor. Increased ORs were also observed for diseases of the prepuce (4.0, 95% CI 2.2–7.4), immunosuppressive drugs (5.0, 95% CI 2.5–9.8), penile surgical procedures (4.8, 95% CI 2.2–10.8), balanitis (9.2, 95% CI 5.0–16.8), genital warts (9.9, 95% CI 4.3−22.7) and organ transplantation (7.0, 95% CI 2.4–20.8). This study demonstrates important risk factors for penile intraepithelial neoplasia, providing knowledge that can help prevent the development of penile cancer.
- Published
- 2018
34. The underreporting of hepatocellular carcinoma to the cancer register and a log‐linear model to estimate a more correct incidence
- Author
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Knut Stokkeland, Anna Törner, Rolf Hultcrantz, Paul W. Dickman, Åke Svensson, Ann-Sofi Duberg, and Scott Montgomery
- Subjects
Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Risk Assessment ,Sensitivity and Specificity ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Prevalence ,Carcinoma ,Humans ,Medicine ,Registries ,Cause of death ,Sweden ,Hepatitis ,Hepatology ,business.industry ,Incidence (epidemiology) ,Liver Neoplasms ,Cancer ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,030211 gastroenterology & hepatology ,business ,Liver cancer ,Needs Assessment - Abstract
The Cancer Register (CR) in Sweden has reported that the incidence of primary liver cancer (PLC) has slowly declined over the last decades. Even though all cancers, irrespective of diagnostic method, should be reported to the CR, the PLC incidence may not reflect the true rate. Improved diagnostic tools have enabled diagnosis of hepatocellular carcinoma based on noninvasive methods without histological verification, possibly associated with missed cancer reports or misclassification in the CR. Our objective was to study the completeness and assess the underreporting of PLC to the CR and to produce a more accurate estimate based on three registers. The CR, the Cause of Death Register, and the Patient Register were investigated. Differences and overlap were examined, the incidence was estimated by merging data from the registers, and the number reported to none of the registers was estimated using a log-linear capture-recapture model. The results show that 98% of the PLCs reported to the CR were histologically verified; 80% were hepatocellular carcinoma and 20% were intrahepatic cholangiocarcinoma. Unspecified liver cancer decreased over time and constituted
- Published
- 2016
35. Usefulness of Rajka & Langeland Eczema Severity Score in Clinical Practice
- Author
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Agneta Gånemo, Cecilia Svedman, Carl-Fredrik Wahlgren, Ann-Charlotte Öhman Johansson, Åke Svensson, and Britt-Marie Grönberg
- Subjects
medicine.medical_specialty ,Time Factors ,Health Status ,Eczema ,Dermatology ,Severity of Illness Index ,Judgment ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Predictive Value of Tests ,Surveys and Questionnaires ,Severity of illness ,medicine ,Content validity ,Humans ,030212 general & internal medicine ,SCORAD ,Reliability (statistics) ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Remission Induction ,Reproducibility of Results ,Construct validity ,General Medicine ,Atopic dermatitis ,medicine.disease ,Treatment Outcome ,Scale (social sciences) ,Quality of Life ,Physical therapy ,business - Abstract
Simple, validated eczema severity scores are required for the evaluation of interventions. The RajkaLangeland (RL) scale is based on 3 domains (extent, course, and intensity); however, its validity is not yet confirmed. The aim of this study was to investigate the quality aspects of the RL scale in clinical practice. In the first part of the study, experts and consumers judged the content validity of the scale. The second part of the study was performed with 87 children during a 4-month eczema school. Construct validity, internal consistency, sensitivity to change, time consumption and health-related quality of life variables were investigated. The content of the RL scale was considered valid by 45 panellists. Inter- and intra-observer reliability was very good. Divergent construct validity was adequate, while convergent construct validity and internal consistency were inadequate. The RL scale was able to define a significant improvement in eczema during the eczema school. The time required for completing the RL assessment was significantly shorter than for objective Severity Scoring of Atopic Dermatitis (SCORAD). The RL scale is a simple, fast, valid, reliable and sensitive tool for scoring of atopic dermatitis in everyday clinical practice.
- Published
- 2016
36. The influence of assumptions on generation time distributions in epidemic models
- Author
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Åke Svensson
- Subjects
Statistics and Probability ,Time Factors ,Scale (ratio) ,Stochastic modelling ,Secondary infection ,Basic Reproduction Number ,Communicable Diseases ,Models, Biological ,Quantitative Biology::Other ,Outcome (game theory) ,Statistics, Nonparametric ,General Biochemistry, Genetics and Molecular Biology ,Statistics ,Epidemic spread ,Humans ,Quantitative Biology::Populations and Evolution ,Medicine ,Epidemics ,Models, Statistical ,Generation time ,General Immunology and Microbiology ,business.industry ,Applied Mathematics ,Mathematical Concepts ,Computer Science::Social and Information Networks ,General Medicine ,Modeling and Simulation ,General Agricultural and Biological Sciences ,business ,Basic reproduction number - Abstract
A simple class of stochastic models for epidemic spread in finite, but large, populations is studied. The purpose is to investigate how assumptions about the times between primary and secondary infections influences the outcome of the epidemic. Of particular interest is how assumptions of individual variability in infectiousness relates to variability of the epidemic curve. The main concern is the final size of the epidemic and the time scale at which it evolves. The theoretical results are illustrated by simulations.
- Published
- 2015
37. Methodological aspects of assessing hand eczema: comparison of two tools and three different categories of evaluators
- Author
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Åke Svensson, Anna Josefson, Agneta Gånemo, Magnus Lindberg, Monica Hindsén-Stenström, Anna Hallander, Birgitta Meding, and Mats Berg
- Subjects
0301 basic medicine ,MEDLINE ,Dermatology ,medicine.disease ,030207 dermatology & venereal diseases ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Multicenter study ,Hand eczema ,Severity of illness ,medicine ,Psychology ,Observer variation ,Clinical psychology - Abstract
Methodological aspects of assessing hand eczema : comparison of two tools and three different categories of evaluators
- Published
- 2017
38. The Southern Sweden Adolescent Allergy-Cohort: Prevalence of allergic diseases and cross-sectional associations with individual and social factors
- Author
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Alf Tunsäter, Åke Svensson, Ada Uldahl, Cecilia Svedman, Magnus Bruze, Jonas Björk, Therese Sterner, Hampus Kiotseridis, and Christel Nielsen
- Subjects
Pulmonary and Respiratory Medicine ,Male ,Pediatrics ,medicine.medical_specialty ,Allergy ,Adolescent ,Eczema ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Health care ,medicine ,Hypersensitivity ,Prevalence ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Life Style ,Asthma ,Conjunctivitis, Allergic ,Respiratory Sounds ,Sweden ,Health professionals ,business.industry ,medicine.disease ,Food hypersensitivity ,Rhinitis, Allergic ,Cross-Sectional Studies ,030228 respiratory system ,Socioeconomic Factors ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,business ,Food Hypersensitivity - Abstract
Objectives: Asthma and allergic diseases are the most frequent chronic diseases in childhood worldwide, and considered a burden for the affected children and their families. The diseases impose an economic burden on society if not diagnosed and treated properly and management of and these diseases are challenging for healthcare professionals. The aim of the present investigation was to assess the prevalence of allergic diseases in an unselected cohort of adolescents in southern Sweden. Additionally, associations with sociodemographic factors were investigated, as well as impact on daily life. Methods: This cross-sectional study was based on a cohort of n = 1 530 school children, aged 13 to 14, from 13 municipalities in southern Sweden. Data were collected through web-based questionnaires. Results: Of all children 32% reported at least one allergic disease. 67% reported one allergic disease and 33% reported more than one. No allergy-related disease were reported by 68%. Current asthma was reported by 9.8% and current rhino-conjunctivitis was reported by 13%. The prevalence of food hypersensitivity was 12% and the prevalence of eczema was 11%. One to three wheezing attacks were reported from 55% and 40% reported more than four attacks of wheezing in the preceding year. The self-reported allergic diseases were diagnosed by a doctor in; 36% (food hypersensitivity) to 69% (rhinoconjunctivitis) of the cases. Conclusions: A high number of affected children were identified. Some children being undiagnosed and some not receiving satisfactory treatment. These results suggest that additional studies to evaluate treatment procedures in order to improve healthcare for allergic children are warranted. (Less)
- Published
- 2018
39. Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes
- Author
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Vincenzo Bettoli, Andrea W M Evers, Åke Svensson, Lucia Tomas-Aragones, Servando E Marron, Gregor Be Jemec, Pavel V Chernyshov, L. Manolache, and Jacek C Szepietowski
- Subjects
medicine.medical_specialty ,Venereology ,Advisory Committees ,Dermatology ,Severity of Illness Index ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Adapalene ,Acne Vulgaris ,medicine ,Humans ,Hidradenitis suppurativa ,Acne ,business.industry ,medicine.disease ,humanities ,Clinical trial ,Infectious Diseases ,Rosacea ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Quality of Life ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,Dermatologic Agents ,Dermatology Life Quality Index Questionnaire ,business ,medicine.drug - Abstract
Item does not contain fulltext According to results of a recent literature search performed by the European Academy of Dermatology and Venereology (EADV) Task Forces (TF) on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS), most of the publications where health-related (HR) QoL of acne patients was studied were clinical trials. Members of the EADV TF on QoL and PO decided to detect which acne treatment has the best influence on HRQoL of acne patients. A new literature search was organized to find publications on acne treatment where the HRQoL of patients was assessed as an outcome measure. From 186 papers with HRQoL assessment, 37 papers were included for further analysis. Our results revealed that oral isotretinoin had the best influence on HRQoL of acne patients. Several other treatment methods also showed good effects on the HRQoL of acne patients. Oral isotretinoin and norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide and adapalene/benzoyl peroxide showed significantly better effect on HRQoL than placebo. There is limited number of the high-quality studies on acne treatment where HRQoL was assessed. Dermatology-specific and acne-specific instruments showed much better sensitivity to successful therapeutic intervention than generic HRQoL instruments. The most frequently used HRQoL instrument was the Dermatology Life Quality Index questionnaire.
- Published
- 2018
40. Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations
- Author
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Sam Salek, Andrew Yule Finlay, Dennis Linder, Laurent Misery, Andrea W M Evers, Servando E Marron, Lars Lien, I. K. Alturnay, Csanád Szabó, Andrey Lvov, Jacek C Szepietowski, Lucia Tomas-Aragones, Åke Svensson, Gregor B.E. Jemec, Flora Balieva, Uwe Gieler, Florence J Dalgard, Francesca Sampogna, J. Anders Halvorsen, Françoise Poot, and Jörg Kupfer
- Subjects
Adult ,medicine.medical_specialty ,Psychometrics ,Cross-sectional study ,Concordance ,Physical examination ,Dermatology ,Disease ,Anxiety ,Hospital Anxiety and Depression Scale ,Risk Assessment ,Skin Diseases ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Prevalence ,Humans ,Medicine ,030212 general & internal medicine ,Psychiatry ,skin and connective tissue diseases ,Referral and Consultation ,Depression (differential diagnoses) ,medicine.diagnostic_test ,Depression ,business.industry ,medicine.disease ,Europe ,Cross-Sectional Studies ,Mood disorders ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,medicine.symptom ,business ,Dermatologists - Abstract
Background It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrists underdiagnose depression. This has not been explored among dermatologists. Objectives To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale (HADS). Methods The study was an observational cross‐sectional multicentre study of prevalent cases of skin diseases in 13 countries in Europe. Consecutive patients were recruited in outpatient clinics and filled in questionnaires prior to clinical examination by a dermatologist who reported any diagnosis of skin disease and signs of mood disorders.ResultsAnalysis of the 3635 consultations showed that the agreement between dermatologist and HADS was poor to fair (lower than 0·4) for all diagnosis categories. The true‐positive rate (represented by the percentage of dermatologists recognizing signs of depression or anxiety in patients with depression or anxiety as defined by a HADS value ≥ 11) was 44·0% for depression and 35·6% for anxiety. The true negative rate (represented by the percentage of dermatologists not detecting signs of depression or anxiety in non‐depressed or non‐anxious patients defined by HADS‐value < 11) was 88.8% for depression and 85.7% for anxiety.ConclusionsDermatologists in Europe tend to underestimate mood disorders. The results suggest that further training for dermatologists to improve their skills in diagnosing depression and anxiety might be appropriate. When present, the psychological suffering of patients with dermatological conditions needs to be addressed.
- Published
- 2018
41. Diffuse Purpura on the Abdomen and Extremities: A Quiz
- Author
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Åke Svensson, Iva Johansson, and Grigorios Theodosiou
- Subjects
Male ,medicine.medical_specialty ,Anemia ,scurvy ,Ascorbic Acid ,Dermatology ,Abdomen ,medicine ,Humans ,business.industry ,Extremities ,hair ,Vitamins ,General Medicine ,Middle Aged ,Scurvy ,medicine.disease ,anemia ,Purpura ,medicine.anatomical_structure ,RL1-803 ,purpura ,dermoscopy ,medicine.symptom ,business - Published
- 2019
42. Prevalence of skin disease in a population-based sample of adults from five European countries
- Author
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Peter Elsner, Simone Cazzaniga, Thomas L. Diepgen, Magnus Bruze, Åke Svensson, Luigi Naldi, Margarida Gonçalo, Robert Ofenloch, Marielouise Schuttelaar, and Public Health Research (PHR)
- Subjects
ATOPIC ECZEMA ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Population ,CHILDREN ,Disease ,CONTACT ALLERGY ,Dermatology ,Skin Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Age Distribution ,WORLDWIDE ,Epidemiology ,Prevalence ,Medicine ,EPIDEMIOLOGY ,Humans ,030212 general & internal medicine ,Young adult ,Sex Distribution ,education ,Acne ,Aged ,GENERAL-POPULATION ,education.field_of_study ,integumentary system ,business.industry ,Population based sample ,GLOBAL BURDEN ,Middle Aged ,medicine.disease ,PRODUCTS ,Europe ,Cross-Sectional Studies ,MAIN FINDINGS ,Female ,Skin cancer ,business ,Facilities and Services Utilization ,Demography ,Dermatologists - Abstract
Background There is a lack of prevalence data on skin diseases in the general adult population; most studies have been carried out in small, national or consecutive clinical samples.Objectives To determine the prevalence of common skin disease in the general European population and to assess differences in the characteristics of treatment between countries.Methods A random sample consisting of 12 377 participants aged 18-74 years was drawn from the general population of five European countries (Germany, Italy, the Netherlands, Portugal and Sweden). This was a cross-sectional study and all participants were interviewed using a standardized questionnaire that assessed the occurrence of 10 common skin diseases during lifetime, past year and past month. If a skin disease was reported, we additionally assessed who performed the diagnosis and treatment, and whether drugs had been prescribed.Results The most common skin disease was warts (41.3%), followed by acne (19.2%) and contact dermatitis (15.0%). In general, women were more often affected by skin diseases compared with men; only skin cancer had a slightly higher prevalence in men. The prevalence of skin diseases in northern countries (Germany, the Netherlands and Sweden) was generally higher than in the southern countries (Italy and Portugal). In the Netherlands the treatment of skin diseases was less often performed by a dermatologist compared with the other countries.Conclusions The prevalence estimates reported in this study are derived from a representative sample of the general population. Data assessment was performed comprehensively across countries, thus country-specific prevalence estimates are comparable.
- Published
- 2017
43. Heredity of port-wine stains: Investigation of families without a RASA1 mutation
- Author
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Bo Ljunggren, Agneta Troilius Rubin, Nicole Revencu, Miikka Vikkula, Åke Svensson, Edgar Lauritzen, UCL - SSS/DDUV - Institut de Duve, UCL - (SLuc) Centre de génétique médicale UCL, and UCL - (SLuc) Centre de malformations vasculaires congénitales
- Subjects
Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Heredity ,Adolescent ,RASA1 gene ,Port wine ,heredity ,port-wine stain ,Port-Wine Stain ,Dermatology ,medicine.disease_cause ,Original Research Report ,Vascular anomaly ,Congenital ,Young Adult ,Report ,Humans ,Medicine ,Genetic Predisposition to Disease ,In patient ,Family history ,Child ,Retrospective Studies ,Mutation ,business.industry ,capillary malformation ,congenital ,nutritional and metabolic diseases ,p120 GTPase Activating Protein ,Middle Aged ,medicine.disease ,Penetrance ,Surgery ,Capillary malformation ,Child, Preschool ,Female ,business - Abstract
Background: The prevalence of capillary malformations, also known as port-wine stains (PWS), is 0.3%. Familial segregation can occur. The capillary malformation–arteriovenous malformation (CM-AVM) phenotype is caused by mutations in the RASA1 gene. In PWS familial cases, the inheritance is considered to be autosomal dominant with variable penetrance. Objective: Investigation of the heredity of PWS among patients who attended the vascular anomaly section at the Department of Dermatology in Malmoe, Southern Sweden, between 1993 and 2004 and to study the involvement of the RASA1 gene in patients with a positive family history of PWS. Subjects and methods: A total of 254 patients were examined and given a questionnaire regarding family history of PWS. The first group of 175 patients (109 females and 66 males) reported a negative family history. The other group of 65 patients (46 females and 19 males) reported a positive family history (50% parents or brothers and sisters). Results: The heredity of PWS was 27% (65/240). Twenty-one patients with a positive family history and relatives had no CM-AVM phenotype for mutations in the RASA1 gene. Conclusion: PWS may have a stronger heredity component than it was reported earlier and inheritance should be considered when counseling a patient. RASA1 mutations do not explain the PWS in our patients.
- Published
- 2015
44. Pruritus in Psoriasis: A Study of Personality Traits, Depression and Anxiety
- Author
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Charlotta Remröd, Åke Svensson, and Karin Sjöström
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,macromolecular substances ,Dermatology ,Anxiety ,Personality Assessment ,Severity of Illness Index ,Young Adult ,Psoriasis ,Activities of Daily Living ,Interview, Psychological ,Severity of illness ,medicine ,Humans ,Personality ,Big Five personality traits ,skin and connective tissue diseases ,Psychiatry ,Depression (differential diagnoses) ,Aged ,media_common ,Psychiatric Status Rating Scales ,integumentary system ,Depression ,business.industry ,Pruritus ,General Medicine ,Middle Aged ,medicine.disease ,Dermatology and Venereal Diseases ,body regions ,Logistic Models ,Etiology ,Female ,medicine.symptom ,Personality Assessment Inventory ,business - Abstract
Pruritus intensity is often not proportional to disease severity in patients with psoriasis or other pruritic dermatoses. Increasing evidence indicates that psychological factors may play an important role in the overall aetiology of pruritus. The aim of this study was to examine whether patients with psoriasis and severe pruritus differ psychologically from those with mild pruritus. In this study of 101 patients with plaque psoriasis, those with severe pruritus reported significantly higher scores for both depression and anxiety. Using the Swedish universities Scales of Personality, 4 personality traits were significantly associated with severe pruritus: Somatic trait anxiety, Embitterment, Mistrust, and Physical trait aggression. These results indicate that patients with psoriasis and severe pruritus might have a more vulnerable psychological constitution. This suggests important opportunities for clinicians to identify patients who could benefit from psychological interventions.
- Published
- 2015
45. Climate warming and land-use changes drive broad-scale floristic changes in Southern Sweden
- Author
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Pål Axel Olsson, Åke Svensson, Lina Herbertsson, Torbjörn Tyler, Lars Fröberg, Kjell-Arne Olsson, and Ola Olsson
- Subjects
0106 biological sciences ,010504 meteorology & atmospheric sciences ,Climate Change ,Biodiversity ,Climate change ,Biology ,010603 evolutionary biology ,01 natural sciences ,Environmental Chemistry ,Ruderal species ,Ecosystem ,0105 earth and related environmental sciences ,General Environmental Science ,Sweden ,Global and Planetary Change ,Ecology ,Phenology ,Plant Dispersal ,Global warming ,Agriculture ,Pollinator decline ,Habitat ,Embryophyta - Abstract
Land-use changes, pollution and climate warming during the 20th century havecaused changes in biodiversity across the world. However, in many cases, the environmental drivers are poorly understood. To identify and rank the drivers currentlycausing broad-scale floristic changes in N Europe, we analysed data from two vascularplant surveys of 200 randomly selected 2.5 9 2.5 km grid-squares in Scania,southernmost Sweden, conducted 1989–2006 and 2008–2015, respectively, andrelated the change in frequency (performance) of the species to a wide range ofspecies-specific plant traits. We chose traits representing all plausible drivers ofrecent floristic changes: climatic change (northern distribution limit, flowering time),land-use change (light requirement, response to grazing/mowing, response to soildisturbance), drainage (water requirement), acidification (pH optimum), nitrogendeposition and eutrophication (N requirement, N fixation ability, carnivory, parasitism,mycorrhizal associations), pollinator decline (mode of reproduction) andchanges in CO2 levels (photosynthetic pathway). Our results suggest that climatewarming and changes in land-use were the main drivers of changes in the flora duringthe last decades. Climate warming appeared as the most influential driver, withnorthern distribution limit explaining 30%–60% of the variance in the GLMM models.However, the relative importance of the drivers differed among habitat types,with grassland species being affected the most by cessation of grazing/mowing andspecies of ruderal habitats by on-going concentration of both agriculture and humanpopulation to the most productive soils. For wetland species, only pH optimum wassignificantly related to species performance, possibly an effect of the increasinghumification of acidic water bodies. An observed relative decline of mycorrhizal species may possibly be explained by decreasing nitrogen deposition resulting in lesscompetition for phosphorus. We found no effect of shortage or decline of pollinatinglepidopterans and bees. (Less)
- Published
- 2017
46. Methotrexate-associated Sexual Dysfunction: Two Case Reports
- Author
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Åke Svensson and Grigorios Theodosiou
- Subjects
musculoskeletal diseases ,Male ,medicine.medical_specialty ,Libido ,MEDLINE ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Erectile Dysfunction ,Internal medicine ,Medicine ,Humans ,skin and connective tissue diseases ,Aged ,030203 arthritis & rheumatology ,Hardware_MEMORYSTRUCTURES ,business.industry ,General Medicine ,Middle Aged ,Sexual dysfunction ,Methotrexate ,RL1-803 ,Dermatologic Agents ,medicine.symptom ,business ,medicine.drug - Abstract
is missing (Short communication)
- Published
- 2017
47. The Role of Topical Timolol in the Treatment of Infantile Hemangiomas: A Systematic Review and Meta-analysis
- Author
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David Prieto-Merino, Carsten Flohr, A.E. Boyce, Maham Khan, Åke Svensson, and Emma Wedgeworth
- Subjects
medicine.medical_specialty ,Time Factors ,genetic structures ,medicine.drug_class ,Adrenergic beta-Antagonists ,Timolol ,Antineoplastic Agents ,Dermatology ,Administration, Cutaneous ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Infantile hemangioma ,medicine ,Odds Ratio ,Humans ,030212 general & internal medicine ,Age of Onset ,Adverse effect ,Beta blocker ,Response rate (survey) ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Odds ratio ,eye diseases ,Surgery ,Tumor Burden ,Treatment Outcome ,Meta-analysis ,sense organs ,Age of onset ,business ,Hemangioma ,medicine.drug - Abstract
To date the efficacy and safety of topical timolol in the treatment of infantile hemangioma has not been reviewed and analysed systematically. We collated all published data on the efficacy and safety of topical timolol in the treatment of infantile hemangioma. A total of 31 studies with 691 patients were included. The fixed effects pooled estimate of the response rate defined as any improvement from baseline of infantile hemangioma after treatment with topical timolol was significant (RR = 8.96; 95% CI 5.07-15.47; heterogeneity test p = 0.99), and the treatment was overall well tolerated. However, the quality of evidence was low to moderate. Topical timolol is an effective treatment for small infantile hemangioma, with no significant adverse effects noted. However, there is still a need for adequately powered randomised controlled trials.
- Published
- 2017
48. Temporal trends of phthalate exposures during 2007-2010 in Swedish pregnant women
- Author
-
Christian H. Lindh, Carl-Gustaf Bornehag, Huan Shu, Åke Svensson, Eewa Nånberg, Bo A.G. Jönsson, Chris Gennings, Malin Knutz, and Tim K. Takaro
- Subjects
Adult ,010504 meteorology & atmospheric sciences ,Epidemiology ,education ,Population ,Phthalic Acids ,010501 environmental sciences ,Endocrine Disruptors ,Toxicology ,01 natural sciences ,Cohort Studies ,chemistry.chemical_compound ,Young Adult ,Pregnancy ,Tandem Mass Spectrometry ,Environmental health ,Surveys and Questionnaires ,Endocrine system ,Medicine ,Humans ,0105 earth and related environmental sciences ,Sweden ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,Phthalate ,Environmental Exposure ,Pollution ,Pregnancy Trimester, First ,chemistry ,Regression Analysis ,Female ,Pregnant Women ,business ,Biomarkers ,Environmental Monitoring - Abstract
The general population is exposed to phthalates, a group of chemicals with strong evidence for endocrine disrupting properties, commonly used in a large number of consumer products. Based on published research and evidence compiled by environmental agencies, certain phthalate applications and products have become restricted, leading to an increasing number of "new generation compounds" coming onto the market during recent years replacing older phthalates. Some examples of such newer compounds are di-iso-nonyl phthalate (DiNP), di-iso-decyl phthalate (DiDP), and most recently di-isononyl-cyclohexane-1,2-dicarboxylate (DiNCH).In order to evaluate temporal trends in phthalate exposure, first trimester urinary biomarkers of phthalates were measured in the Swedish SELMA study over a period of 2.5 years (2007-2010).We collected first morning void urine samples around week 10 of pregnancy from 1651 pregnant women. Spot samples were analyzed for 13 phthalate metabolites and one phthalate replacement and least square geometric mean (LSGM) levels of the metabolites were compared between the sampling years when adjusted for potential confounders.All 14 metabolites were detectable in more than 99% of the SELMA subjects. The levels were generally comparable to other studies, but the SELMA subjects showed slightly higher exposure to butyl-benzyl phthalate (BBzP) and di-butyl phthalate (DBP). Di-ethyl-hexyl phthalate (DEHP) metabolites levels decreased while DiNP, DiDP/di-2-propylheptyl phthalate (DPHP), and DiNCH metabolites levels increased during the sampling period.Urinary metabolite levels of the older phthalates and more recently introduced phthalate replacement compound changed during the short sampling period in this Swedish pregnancy cohort. Our results indicate that replacement of phthalates can make an impact on human exposure to these chemicals. During this particularly vulnerable stage of life, phthalate exposures are of particular concern as the impacts, though not immediately noticeable, may increase the risk for health effects later in life.
- Published
- 2017
49. Measuring the impact of dermatological conditions on family and caregivers: a review of dermatology-specific instruments
- Author
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L. Manolache, Damiano Abeni, Lucia Tomas-Aragones, Françoise Poot, Andrew Yule Finlay, Andrea W M Evers, Florence J Dalgard, Sam Salek, Saskia Spillekom-van Koulil, Pavel V Chernyshov, Åke Svensson, Dennis Linder, Servando E Marron, Francesca Sampogna, and Jacek C Szepietowski
- Subjects
Adult ,medicine.medical_specialty ,Venereology ,Dermatology ,Disease ,Skin Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Psoriasis ,medicine ,Humans ,Family ,030212 general & internal medicine ,Child ,business.industry ,Ichthyosis ,Atopic dermatitis ,Dermatology Life Quality Index ,medicine.disease ,R1 ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,body regions ,Infectious Diseases ,Caregivers ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,Quality of Life ,Epidermolysis bullosa ,business - Abstract
Item does not contain fulltext The patient is the centre of a web of relationships, and the impact of his/her disease on family members and caregivers must be taken into account. The aim of this study was to identify the specific instruments that measure the impact of a dermatological disease on the quality of life (QoL) of family members, by performing a systematic search of the literature. Fifteen papers were identified, describing the creation and validation of nine instruments. Four of them concerned atopic dermatitis (Dermatitis Family Index, DFI; Parents' Index QoL Atopic Dermatitis, PiQoL-AD; QoL in primary caregivers of children with atopic dermatitis, QPCAD; Childhood Atopic Dermatitis Impact Scale, CADIS), two measured the impact of psoriasis in family members (Psoriasis Family Index, PFI; FamilyPso), one the impact of epidermolysis bullosa (Epidermolysis Bullosa Burden of Disease, EB-BoD), one of ichthyosis (Family Burden Ichthyosis, FBI), and one was generic for dermatological conditions (Family Dermatology Life Quality Index, FDLQI). The European Academy of Dermatology and Venereology quality of life taskforce recommends that the impact of a skin disease on family and caregivers should be measured as part of any thorough evaluation of the burden of a disease. Guidelines are given to choose the most appropriate instruments.
- Published
- 2017
50. Cross-Cultural Validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ)
- Author
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Thomas L. Diepgen, Christian Apfelbacher, Jart A F Oosterhaven, Meltem Önder, Marielouise Schuttelaar, Åke Svensson, Elke Weisshaar, Keiko Minamoto, Emel Bülbül Başkan, Päivikki Susitaival, Robert Ofenloch, Public Health Research (PHR), Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı., and Başkan, Emel Bülbül
- Subjects
0301 basic medicine ,Male ,Eczema ,Quality of life in hand eczema questionnaire ,Procedures ,Global Health ,Biochemistry ,Turkey (republic) ,RESPONSIVENESS ,RASCH MODEL ,030207 dermatology & venereal diseases ,0302 clinical medicine ,Quality of life ,Japan ,Germany ,Surveys and Questionnaires ,Item response theory ,Psychology ,GERMAN VERSION ,Finland ,POPULATION ,Netherlands ,Priority journal ,PSORIASIS ,Incidence ,Middle Aged ,Multicenter study ,Reproducibility ,Clinical trial ,Hand eczema ,RELIABILITY ,Female ,Functional assessment ,Psychometry ,Treatment indication ,Clinical psychology ,Alitretinoin ,Contact Allergy ,Human ,Quality of life assessment ,SEVERITY INDEX ,Adult ,Cross-Cultural Comparison ,Emotion assessment ,Adolescent ,Psychometrics ,Separation (statistics) ,Symptom ,Dermatology ,Major clinical study ,behavioral disciplines and activities ,Article ,03 medical and health sciences ,Young Adult ,medicine ,Cross-cultural ,Humans ,In patient ,VALIDITY ,Molecular Biology ,Aged ,Sweden ,Questionnaire ,Prevention ,Cultural factor ,Reproducibility of Results ,Cell Biology ,INSTRUMENTS ,medicine.disease ,Differential item functioning ,Internal consistency ,DERMATITIS ,030104 developmental biology ,Quality of Life - Abstract
The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is the only instrument assessing disease-specific health-related quality of life in patients with hand eczema. It is available in eight language versions. In this study we assessed if the items of different language versions of the QOLHEQ yield comparable values across countries. An international multicenter study was conducted with participating centers in Finland, Germany, Japan, The Netherlands, Sweden, and Turkey. Methods of item response theory were applied to each subscale to assess differential item functioning for items among countries. Overall, 662 hand eczema patients were recruited into the study. Single items were removed or split according to the item response theory model by country to resolve differential item functioning. After this adjustment, none of the four subscales of the QOLHEQ showed significant misfit to the item response theory model (P < 0.01), and a Person Separation Index of greater than 0.7 showed good internal consistency for each subscale. By adapting the scoring of the QOLHEQ using the methods of item response theory, it was possible to obtain QOLHEQ values that are comparable across countries. Cross-cultural variations in the interpretation of single items were resolved. The QOLHEQ is now ready to be used in international studies assessing the health-related quality of life impact of hand eczema.
- Published
- 2016
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