http://www.medicaljournals.se/acta/ Acta Dermato-Venereologica is an international peer-review journal for clinical and experimental research in the field of dermatology and venereology. http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2003
Abstract is missing (Book review)]]> 2014-11-13 Bookreview http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2004
Abstract is missing (Book review)]]> 2014-11-13 Bookreview http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1913
Abstract is missing (Short Communication)]]> 2014-07-17 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1893
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Abstract is missing (Short Communication)]]> 2014-07-17 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1902
Abstract is missing (Short Communication)]]> 2014-07-23 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1892
Abstract is missing (Short Communication)]]> 2014-07-23 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1908
Abstract is missing (Short Communication)]]> 2014-07-17 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1900
Abstract is missing (Short Communication)]]> 2014-06-11 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1904
Abstract is missing (Short Communication)]]> 2014-07-17 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1887
Abstract is missing (Short Communication)]]> 2014-07-31 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1874
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Abstract is missing (Short Communication)]]> 2014-07-22 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1863
Abstract is missing (Short Communication)]]> 2014-07-23 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1909
Abstract is missing (Short Communication)]]> 2014-07-23 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1835
Abstract is missing (Short Comunication)]]> 2014-07-22 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1829
Abstract is missing (Short Communication)]]> 2014-11-27 Shortcom http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1855
Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to induce or exacerbate psoriasis. We
aimed to evaluate the association between several widely used analgesics, including aspirin, non-aspirin NSAIDs, and acetaminophen (paracetamol), and risk of psoriasis and psoriatic arthritis (PsA) in a large cohort of US women, the Nurses’ Health Study II (1991–2005). Information on regular use of aspirin, NSAIDs, and acetaminophen was collected for 95,540 participants during the follow-up. During 1,321,280 person-years of follow-up, we documented 646 incident psoriasis cases and 165 concomitant PsA cases. Compared to women who reported no use, regular acetaminophen and NSAIDs users with more than 10 years of use had multivariate hazard ratios of 3.60 [95% confidence interval (CI): 2.02–6.41] and 2.10 (95% CI: 1.11–3.96) for PsA, respectively. There was no clear association between aspirin and risk of psoriasis or PsA. In conclusion, long-term acetaminophen and NSAIDs use may be associated with an increased risk of PsA. Special attention on psoriasis and PsA screening may be needed for those who are prescribed for acetaminophen and NSAIDs for long-term periods.]]> 2014-08-27 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1885
Genital psoriasis is a neglected manifestation of psoriasis, although it affects numerous patients and has major effects on sexual quality of life (SQoL). We aimed to assess the value of specialised care for patients with genital psoriasis. Patients were treated for at least one year at a specialised research outpatient clinic with extensive attention for genital lesions and SQoL. The genital lesions were treated according to a stepwise algorithm. First follow-up was planned after 6 weeks; subsequent follow-up visits were scheduled every 3 months. At every visit, psoriasis severity and SQoL were measured with validated tools. Differences in scores between visits were analysed by a mixed model for repeated measures. Forty-two patients were included (M:F = 25:17). All objective and subjective genital psoriasis severity and QoL parameters improved significantly within the first follow-up period of approximately 6 weeks. In female patients, SQoL also significantly improved. In conclusion, genital psoriasis can relatively easy be treated within limited time exposure, resulting in significant improvement of QoL. Prompt and simple adjustments in the provided care are enough to accomplish this.]]> 2014-07-21 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1911
Children are patch tested in the same manner as adults, but little has been done to establish whether positive or negative findings influence the course of skin symptoms. To uncover the course of skin symptoms and the impact of persistent eczema on life quality in paediatric patients referred for patch testing, a retrospective questionnaire was sent to children and adolescents referred for patch testing during a 9-year period. Persistent eczema at follow-up was strongly associated to atopic dermatitis, but was not explained by gender, age, contact allergy or time span from patch testing to follow-up. Among patients without atopic dermatitis, 23.5% reported to suffer from chronic eczema. Persistent eczema increased the risk of severe impairment of life quality. Our findings indicate a significant risk of childhood eczema becoming chronic and affecting life quality considerably. Patch testing did not affect the course of eczema, highlighting the difficulties of avoidance behaviour.]]> 2014-07-22 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1899
Postinflammatory hyperpigmentation (PIH) is the most common adverse effect of laser treatment in dark-skinned individuals. Little is known whether PIH can be prevented or minimised. The objective of this study was to investigate the effect of short-term application of topical corticosteroids on the incidence of PIH after ablative fractional resurfacing in Asians. Forty subjects with skin phototype IV and atrophic acne scars were treated with a fractional CO2 laser on both sides of the face. Post-operatively, clobetasol propionate 0.05% ointment was applied to one randomly selected side of the face for the first 2 days, followed by an application of petrolatum jelly for the rest of the week (petrolatum was applied to the other side for 7 days). Assessments on the clinical outcome, the wound healing process and the occurrence of PIH were obtained once weekly for the first month and at 2 and 3 months post-treatment. The side of the face treated with petrolatum alone had significantly (p < 0.001) higher incidence of PIH (75%) after laser irradiation than the side of the face treated with topical corticosteroids and petrolatum (40%). The PIH occurring on the petrolatum-treated sides had significantly higher intensity (p < 0.001) and was spread over a significantly larger area (p < 0.001), compared with the corticosteroid- and petrolatum-treated sides. In conclusion, a short-term application of topical corticosteroids postoperatively is associated with a decreased risk of PIH after ablative fractional resurfacing.]]> 2014-06-05 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1897
Melanoma-associated leukoderma (MAL) is a relatively uncommon phenomenon in the literature that can present (1) before melanoma detection, (2) after detection and before treatment, and (3) after treatment with immunotherapeutic agents. We report a case of MAL in an 83-year-old man after treatment with high dose IL-2 for metastatic melanoma and further describe the literature of the underlying mechanisms behind it that involve the immune system. Cytotoxic CD8+ T cells are thought the mediate the process at a cellular level. Self-antigens (e.g. MART-1/2, gp100, tyrosinase) have been presented on the surface of both normal and malignant melanocytes and mediate the development of MAL after cytotoxic CD8+ T cells attack both cell types. Autoimmune manifestations have a positive effect on tumor immunity, with patients at stage III and stage IV melanoma showing a better prognosis after leukoderma development. In addition, immunotherapy induced leukoderma has been associated with a higher therapeutic response rate. Recently, newer immuno­therapeutic drugs, such as vemurafenib and ipilimumab, have been associated with leukoderma as a side effect.]]> 2014-06-09 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1864
The significance of allergen-specific IgE as marker for severity of atopic dermatitis is controversial. The aim of this study was to determine the frequency of IgE-mediated sensitisation to food and environmental allergens in 132 children and 67 adults with atopic dermatitis, and its correlation to severity of atopic dermatitis (SCORAD). Total IgE was elevated (> 100 kU/l) in 79.7% of adults and 46.8% of children. Sensitisation frequencies to allergens, particularly microbial allergens, were up to 10-fold higher in adults compared to children. Severity of atopic dermatitis correlated with elevated total IgE in adults (r = 0.549, p < 0.001) and children (r = 0.344, p = 0.005) and with Malassezia spp.-specific IgE in adults (r = 0.429, p = 0.007). Total IgE is a marker for severe atopic dermatitis in both age groups. Malassezia spp.-specific IgE is an important allergen-specific marker for severity of atopic dermatitis in adults.]]> 2014-08-19 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1906
In this open, controlled, multicentre and prospective observational study, smartphone teledermoscopy referrals were sent from 20 primary healthcare centres to 2 dermatology departments for triage of skin lesions of concern using a smartphone application and a compatible digital dermoscope. The outcome for 816 patients referred via smartphone teledermoscopy was compared with 746 patients referred via the traditional paper-based system. When surgical treatment was required, the waiting time was significantly shorter using teledermoscopy for patients with melanoma, melanoma in situ, squamous cell carcinoma, squamous cell carcinoma in situ and basal cell carcinoma. Triage decisions were also more reliable with teledermoscopy and over 40% of the teledermoscopy patients could potentially have avoided face-to-face visits. Only 4 teledermoscopy referrals (0.4%) had to be excluded due to poor image quality. Smartphone teledermoscopy referrals allow for faster and more efficient management of patients with skin cancer as compared to traditional paper referrals.]]> 2014-08-06 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1826
Diagnosis and subsequent treatment of cutaneous squamous cell carcinoma are frequently based on punch biopsies. Regarding the current TNM classification and stage grouping for cutaneous squamous cell carcinoma, it is important to identify the high-risk features (infiltration depth > 4 mm, perineural and/or lymphovascular invasion and poor differentiation). This study investigates the agreement of histological high-risk features and TNM grouping stage on 3 mm punch biopsies and subsequent surgical excision in 105 patients diagnosed with cutaneous squamous cell carcinoma. On punch biopsy, infiltration depth > 4 mm is not identified in 83.3% (30/36), perineural invasion in 90.9% (10/11) and poor differentiation in 85.7% (6/7) of cases. The TNM stage was underestimated on punch biopsy in 15.4% (16/104). This study shows that on a 3 mm punch biopsy, high-risk features in cSCC can remain undetected and that the actual TNM stage is not identified in 1 out of 6 tumours.]]> 2014-06-18 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1884
There are no studies of the possible association of the human leukocyte antigen (HLA) system with lichen planopilaris (LPP). To determine whether the HLA system is associated with LPP, 40 consecutive Jewish Israeli patients with LPP (study group) and 252 volunteers (controls) were typed for DRB1*and DQB1* loci by molecular methods. Compared with controls, the study group had a significantly higher frequency of the DRB1*11 allele (62% vs. 21%, corrected p-value (pc) = 0.001) owing to increased frequencies of DRB1*11: 01 and DRB1*11: 04. The DQB1*03 allele was also expressed at a significantly higher frequency in the study group (70% vs. 33%, pc = 0.0005); specifically, the frequency of DQB1*03: 01 was increased. The majority (82.5%) of the patients were of non-Ashkenazi origin. We conclude that LPP appears to be over-represented in non-Ashkenazi Jewish patients and is associated with an increased frequency of HLA DRB1*11 and DQB1*03 alleles. These findings suggest that immunogenetic factors play a role in LPP.]]> 2014-07-15 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1912
Risk of human papillomavirus (HPV) transmission during laser vaporisation of genital warts or loop electrode excision procedure is controversial. An oral rinse, a nasal swabs, history of HPV related diseases and data on HPV exposure were collected from 287 employees at departments of dermato-venerology and gynaecology in Denmark. A mucosal HPV type was found among 5.8% of employees with experience of laser treatment of genital warts as compared to 1.7% of those with no experience (p = 0.12). HPV prevalence was not higher in employees participating in electrosurgical treatment or cryotherapy of genital warts, or loop electrode excision procedure compared with those who did not. HPV 6 or 11 were not detected in any samples. Hand warts after the age of 24 years was more common among dermatology than among non-dermatology personnel (18% vs. 8.0%, p = 0.03). Mucosal HPV types are infrequent in the oral and nasal cavity of health care personnel, however, employees at departments of dermato-venereology are at risk of acquiring hand warts]]> 2014-07-23 Clinical http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1896
In this cross-sectional, exploratory case-control study the vegetative arousal in vitiligo patients compared to an age and gender matched healthy control group was assessed. Forty-eight participants (24 outpatients with generalised vitiligo and 24 healthy controls) completed a test procedure consisting of an initial period of rest (R1), a defined mental stress task (the d2 test of attention), a second period of rest (R2) followed by an individually, age adapted physical stress task (bicycle ergometry) and a final period of rest (R3). Based on a continuously recorded electrocardiogram, heart rate variability, in particular high frequency (HF) and low frequency (LF) components were determined. Within the 3 periods of rest, vitiligo patients showed a higher vegetative arousal than controls, represented by the ratio of LF/HF which mirrors the sympatho-vagal balance (R1: p = 0.027; R2: p = 0.003; R3: p = 0.029). No differences between the 2 groups were found during the mental (p = 0.187) and the physical stress task (p = 0.773). The results suggest a higher vegetative arousal in vitiligo patients.]]> 2014-06-11 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1907
Recently more and more studies have reported high prevalence rates for a ‘tanning dependence’ among tanning bed users. The authors of these studies base their argumentation on a modified (m) version of the CAGE (Cut-down, Annoyed, Guilty and Eye-opener) Criteria, initially used for alcohol addiction. By means of cognitive interviews and a large population survey, we tested the validity of the mCAGE Criteria and the abovementioned prevalence that was deduced on the basis of rather small collectives. Firstly, it seems that the mCAGE Criteria wording used so far is inconsistent, misleading and intrinsically invalid. Secondly, our population-based data show a much lower percentage (15%) of current sunbed users with potential dependence symptoms than the abovementioned previously published studies. Thirdly, the usage parameters for most of the supposed ‘addicts’ do not indicate a substance addiction: 38% of the users with positive scores reported not having visited a tanning studio at all in the previous month, 39% did not use sunbeds regularly and 89% did not show signs of tolerance to UV radiation. The mCAGE Criteria do not seem suitable for assessing tanning dependenc]]> 2014-07-22 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1895
The introduction of biologics has changed treatment patterns as well as costs in patients with psoriasis. To estimate direct and indirect costs of the psoriasis population in Sweden, and to analyse changes in costs between 2006 and 2009. The study population was identified in national registers. Direct costs included health care visits with primary psoriasis diagnoses in specialist care and drugs relevant for treating psoriasis. Productivity loss, including long-term sick leave and disability pension, was estimated as the difference compared to matched controls from the general population. Total direct cost (in SEK 2009 price level) increased from SEK 348 million in 2006 to SEK 459 million in 2009, whereas the total productivity loss decreased from SEK 1,646 to 1,618 million between 2006 and 2009. Although direct costs, especially for biologic agents, have increased for patients with psoriasis over time, this study indicates that costs related to productivity loss are still more substantial.]]> 2014-07-21 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1882
Our aim was to assess whether the presence of highly active effector T cells in atopic dermatitis (AD) is associated with changes in the number and/or function of regulatory T cells (Tregs). Flow cytometry was utilised to determine the percentage of CD4+CD25brightCD127–/lowFOXP3+ and skin-homing CLA+CD4+CD25brightFOXP3+ Tregs in healthy controls and AD patients. The correlation between disease severity and Treg percentages was estimated. Treg suppressor activity and cell proliferation were measured after T-cell stimulation. Significantly increased percentages of Tregs were found in AD patients compared to healthy individuals, and significant correlation between the frequency of Tregs and disease severity was also detected. The otherwise normal suppressor activity of Tregs decreased in the presence of Staphylococcus enterotoxin B (SEB). In conclusion, the continuous presence of SEB can trigger an acquired functional impairment of Tregs in AD patients and the correlation between the increased frequency of Tregs and disease severity supports their important role in AD pathogenesis.]]> 2014-07-14 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1879
The kappa-opioid agonist, nalfurafine, has been approved in Japan for treatment of itch in patients with chronic kidney disease. We presently investigated if systemic administration of nalfurafine inhibited ongoing or touch-evoked scratching behavior (alloknesis) following acute intradermal injection of histamine or the non-histaminergic itch mediator, chloroquine, in mice. We also investigated if nalfurafine suppressed spontaneous or touch-evoked scratching in an experimental model of chronic dry skin itch. Nalfurafine reduced scratching evoked by histamine and chloroquine. Following acute histamine, but not chloroquine, low-threshold mechanical stimuli reliably elicited directed hindlimb scratching behavior, which was significantly attenuated by nalfurafine. In mice with experimental dry skin, nalfurafine abolished spontaneous scratching but had no effect on alloknesis. Nalfurafine thus appears to be a promising treatment for acute itch as well as ongoing itch of dry skin]]> 2014-05-16 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1905
Narrow-band UVB (NB-UVB) phototherapy is commonly used for treatment of psoriasis, though the mechanisms underlying its efficacy have not been completely elucidated. We used gene expression profiling to characterise gene expression in lesional epidermis from psoriasis patients in the middle and late stages of NB-UVB photo­therapy. Increased melanogenesis gene expression was the earliest response to phototherapy. At the end of treatment, genes responding to phototherapy and correlated to treatment outcome were involved in oxidation reduction, growth and mitochondria organisation. Particularly, SPATA18, a key regulator of mitochondrial quality, was significantly down-regulated in psoriasis (p < 0.05). Poly(dA:dT) and poly(I:C) stimulation increased SPATA18 level in primary keratinocytes, indicating the importance of mitochondria quality control under innate immune induced oxidative stress. Normalised SPATA18 expression after phototherapy indicates improved mitochondrial quality control and restored cellular redox status. Our data suggest that oxidation reduction is critical for the resolution of psoriatic plaques following NB-UVB phototherapy.]]> 2014-07-15 Investigative http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1931
In recent years, the increased understanding of the pathophysiology of psoriasis has resulted in several new treatments. The success of ustekinumab proved the importance of the IL-23/T helper cell 17 axis in psoriatic diseases. Several new biologics targeting this axis will reach the clinic in the next years. Biologics are costly, require injections, and some patients experience tacaphylaxis, thus, the development of orally available, small-molecule inhibitors is desirable. Among small-molecules under investigation are A3 adenosine receptor agonists, Janus kinase inhibitors, and phosphodiesterase inhibitors. We review published clinical trials, and conference abstracts presented during the last years, concerned with new drugs under development for the treatment of psoriasis. In conclusion, our psoriasis armamentarium will be filled with several new effective therapeutic options the coming years. We need to be aware of the limitations of drug safety data when selecting new novel treatments. Monitoring and clinical registries are still important tools.]]> 2014-08-19 Review http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2039
Abstract is missing (Debate)]]> 2015-01-15 Debate http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-2038
Abstract is missing (Editorial)]]> 2015-01-15 Editorial http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1982
Abstract is missing (Book review)]]> 2014-10-01 Bookreview http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1967
Abstract is missing (Book review)]]> 2014-09-11 Bookreview http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1966
No Abstract available (Book review)]]> 2014-09-11 Bookreview http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1880
Abstract is missing (Quiz)]]> 2014-07-17 Quiz