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Background: Disease burden in chronic urticaria (CU) is poorly understood., Objective: To estimate standardized overall and sex-, age-, and race-specific prevalence estimates for CU among adults in the United States., Methods: A cross-sectional analysis with electronic health records data for a demographically heterogeneous population-based sample of >55 million patients across all 4 census regions., Results: The overall CU prevalence was 0.23%, or 230 CU cases/100,000 adults. The adjusted prevalence in women was 310 (95% confidence interval [CI] 307-312) cases/100,000 adults, more than twice that of men (146 [95% CI 143-148] cases/100,000 adults, P < .001). CU prevalence was highest among patients aged 40-49 years (256 [95% CI 252-261] cases/100,000 adults) and 50-59 years (246 [95% CI 242-251] cases/100,000 adults) compared with all other age groups (P < .0001). Adjusted prevalences for black (292 [95% CI 285-298] cases/100,000 adults) and other (331 [95% CI 323-338] cases/100,000 adults) patients were higher than that for white patients (262 [95% CI 260-264] cases/100,000 adults; P < .001)., Limitations: Use of administrative data has the potential to underestimate burden., Conclusion: There are >500,000 people estimated to have CU in the United States, most of whom are women or adults ≥40 years of age., (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The burden of the pemphigoid group of autoimmune blistering diseases is poorly understood., Objective: To estimate standardized overall and sex-specific, age-specific, and race-specific prevalence estimates for pemphigoid among adults in the United States., Methods: Cross-sectional analysis of electronic health records data for a demographically heterogeneous population-based sample of >55 million patients across all 4 census regions., Results: Overall pemphigoid prevalence was 0.012%, or 12 pemphigoid patients/100,000 adults. Prevalence of pemphigoid among those aged ≥60 years was 0.038%, or 37.7 cases/100,000 adults. Prevalence increased ∼2-fold within each successive age group and was highest among patients aged ≥90 years (123.6 [95% CI 115.2-132.5] cases/100,000 adults). Adjusted prevalence in women was 12.7 (95% CI 12.3-13.2) cases/100,000 adults, slightly more than that in men (11.0 [95% CI 10.5-11.6] cases/100,000 adults). Adjusted prevalences were similar for blacks (15.4 [95% CI 14.0-17.0] cases/100,000 adults) and whites (13.5 [95% CI 13.0-13.9] cases/100,000 adults)., Limitations: Analysis of electronic health data might result in disease misclassification., Conclusion: Pemphigoid is rare in the United States. Patients aged ≥60 years comprise the majority of cases., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

The prevalence of hidradenitis suppurativa (HS) in the pediatric population is unknown. We sought to establish standardized overall as well as gender-, age-, and race-specific prevalence estimates of HS among children and adolescents in the United States. We performed a cross-sectional analysis in a heterogeneous sample of 55 million patients across all census regions. We identified 1,240 patients with HS in whom the ratio of girls to boys was 3.8:1. Almost all (96.8%) patients with HS were ≥10 years of age. Overall, HS prevalence was 0.028%, or 28.1 (95% confidence interval [CI] 26.5-29.7) per 100,000 children and adolescents. Standardized prevalence was higher in girls (44.6 [95% CI 41.8-47.5] per 100,000), in patients aged 15-17 years (113.7 [95% CI 106.4-121.4] per 100,000), and among African Americans (78.7 [95% CI 71.0-86.9] per 100,000). Highest prevalence of HS was observed among female adolescents aged 15-17 years who were African Americans (525.1 [95% CI 459.4-597.5] per 100,000) and biracial (253.2 [95% CI 121.4-465.6] per 100,000). Patients with HS who went undiagnosed were not captured, and as such prevalence estimates may be underestimated. HS appears to be a postpubertal disease that disproportionately afflicts girls and African Americans in the pediatric population., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The health effects of bisphenol A (BPA) and di-(2-ethylhexyl) phthalate (DEHP) have been studied extensively in children. The impact of other chemicals in these two classes has not been investigated as fully., Methods: We conducted a cross-sectional pilot study of 10-13 y old healthy children. We assessed descriptive, univariable, and multivariable associations of urinary metabolites of bisphenols and phthalates with oxidant stress, insulin resistance, body mass, and endothelial dysfunction. Possible associations with brachial artery distensibility, pulse wave velocity (markers of vascular stiffness), and serum endothelial cell-derived microparticle levels were also assessed., Results: We enrolled 41 participants, 12.1 ± 1.0 y, most of whom were Mexican Americans (42%) or other Hispanics (34%). Increased BPA levels were associated with increased levels of F2-isoprostane (ng/ml) (P = 0.02), with a similar trend for DEHP metabolites. Each log unit increase of high molecular weight (HMW) phthalate metabolites was associated with a 0.550 increase in Homeostatic Model Assessment of insulin resistance (HOMA-IR) units (P = 0.019) and altered circulating levels of activated endothelial cell-derived microparticles (% per ml) (P = 0.026). Bisphenol S (BPS), a replacement for BPA, was associated with increased albumin (mg):creatinine (g) ratio (P = 0.04). Metabolites of HMW phthalates were also associated with decreased brachial artery distensibility (P = 0.047)., Conclusion: Exposure to bisphenols and phthalates, including a BPA replacement, is associated with increased oxidant stress, insulin resistance, albuminuria, as well as disturbances in vascular function in healthy children.

Background. Restless legs syndrome (RLS) is a sleep disorder characterized by an urge to move or the presence of unpleasant sensations in the extremities. The prevalence of RLS is higher in children and adults with chronic kidney disease and in adults with glomerular disease. Objective. To determine the prevalence of RLS in children with nephrotic syndrome. Methods. We studied 50 children with nephrotic syndrome and 22 controls. The following surveys were administered: Pediatric Emory RLS questionnaire, Pediatric Daytime Sleepiness Scale, and Pediatric Sleep Questionnaire. Results. Children with nephrotic syndrome were 9.0 ± 4.4 years old, 27 were male, and 27 were in remission. The prevalence of RLS was similar in the nephrotic syndrome cases and controls, whether or not indeterminate cases were considered positive: 14.0% versus 13.6% including indeterminate cases, and 8.0% versus 9.1% excluding indeterminate cases. Conclusion. RLS is not more common in children with glomerular disease compared to healthy controls.