New articles from Acta Dermato-Venereologica Acta Dermato-Venereologica is an international peer-review journal for clinical and experimental research in the field of dermatology and venereology. 94:6 2014 - Index of Volume 94, 2014
2014-10-15 Index
94:6 2014 - Periungual Swelling and Nail Dystrophy in a Healthy Male: A Quiz
Abstract is missing (Quiz)]]>
2014-01-23 Quiz
94:6 2014 - Arc-shaped Plaque on the Forehead: A Quiz
Abstract is missing (Quiz)]]>
2014-03-25 Quiz
94:6 2014 - Onychotillomania in the Course of Depression: A Case Report
Abstract is missing (Short)]]>
2014-01-29 Shortcom
94:6 2014 - Acral Acquired Cutis Laxa Associated with IgA Multiple Myeloma, Joint Hyperlaxity and Urticarial Neutrophilic Dermatosis
Abstract is missing (Short Communication)]]>
2014-04-08 Shortcom
94:6 2014 - Neutrophil-rich Anaplastic Large Cell Lymphoma Expressing Interleukin-8
Abstract is missing (Short Communication)]]>
2014-04-09 Shortcom
94:6 2014 - In transit Recurrence of Merkel Cell Carcinoma Associated with Polyarthritis Effectively Treated with Immunocryosurgery
Abstract is missing (Short Communication)]]>
2014-04-09 Shortcom
94:6 2014 - IgA/IgG Pemphigus with Infiltration of Neutrophils and Eosinophils in an Ulcerative Colitis Patient
Abstract is missing (Short Communication)]]>
2014-03-19 Shortcom
94:6 2014 - Characterization of Two Cases of Bullous Pemphigoid Reactive Only with BP230 on Japanese Enzyme-linked Immunosorbent Assays
Abstract is missing (Short Communication)]]>
2014-04-08 Shortcom
94:6 2014 - Rejection-mediated Regression of Melanocytic Naevi in an Immunosuppressed Organ Transplant Recipient
Abstract is missing (Short)]]>
2014-03-06 Shortcom
94:6 2014 - Asparagus-induced Fixed Food Eruptions Mimicking Cutaneous Lupus
Abstract is missing (Short)]]>
2014-01-09 Shortcom
94:6 2014 - Exacerbation of Pemphigus Foliaceus After Electron-beam Radiation
Abstract is missing (Short)]]>
2014-02-28 Shortcom
94:6 2014 - Disseminated Cutaneous Infection Caused by Mycobacterium colombiense
Abstract is missing (Short Communication)]]>
2014-03-17 Shortcom
94:6 2014 - Interstitial Granulomatous Dermatitis Associated with Myelodysplastic Syndrome – Complete Clearance Under Therapy with 5-azacytidine
Abstract is missing (Short Communication)]]>
2014-03-19 Shortcom
94:6 2014 - Idiopathic Pure Sudomotor Failure Responding to Oral Antihistamine with Sweating Activities
Abstract is missing (Short Communication)]]>
2014-02-26 Shortcom
94:6 2014 - Unresectable Perineal Cuniculatum Carcinoma: Partial Remission Using Systemic Isotretinoin and Interferon-α2a Therapy
Abstract is missing (Short Communication)]]>
2014-04-08 Shortcom
94:6 2014 - Can Median Nail Dystrophy be an Adverse Effect of Alitretinoin Treatment?
Abstract is not available (Short Communication)]]>
2014-04-10 Shortcom
94:6 2014 - External Beam Radiation Therapy for Recalcitrant Dermatitis
Abstract is missing (Short Communication)]]>
2014-04-09 Shortcom
94:6 2014 - The Potential Effect of the Tumour Necrosis Factor-α Inhibitors on Vitamin D Status in Psoriatic Patients
Abstract is missing (Short)]]>
2014-04-23 Shortcom
94:6 2014 - Qualitative Interviews on Chronic Pruritus in Haemodialysis Patients
Abstract is missing (Short Communication)]]>
2014-03-11 Shortcom
94:6 2014 - Circulating Anti-BP180 NC16a and Anti-BP230 Autoantibodies in Patients with Genital Lichen Sclerosus Do Not Correlate with Disease Activity and Pruritus
Abstract is missing (Short Communication)]]>
2014-04-08 Shortcom
94:6 2014 - Palmoplantar Keratoderma of the Gamborg-Nielsen Type is Caused by Mutations in the SLURP1 Gene and Represents a Variant of Mal de Meleda
Palmoplantar keratoderma of the Gamborg-Nielsen type (PPK-GN) is a rare autosomal recessive skin disorder described in patients from Sweden. Mal de Meleda (MDM) is also a rare autosomal recessive inherited PPK first reported in 5 families from the island of Meleda. The 2 conditions phenotypically overlap and are characterised by palmoplantar erythematous hyperkeratotic plaques. The genetic background giving rise to PPK-GN has hitherto been unknown, whereas MDM is known to be caused by mutations in the gene encoding secreted Ly-6/uPAR-related protein 1, SLURP-1. In the present study we scrutinised individuals affected by PPK-GN for mutations in the SLURP1 gene and identified 2 different mutations. Fourteen Swedish patients were homozygous for a previously described mutation, c.43T>C, while one individual was a compound heterozygote with one copy of a novel mutation, c.280T>A, in addition to one copy of the c.43T>C mutation. Hereby we confirm that PPK-GN is an allelic variant of MDM.]]>
2014-04-02 Clinical
94:6 2014 - Onychophagia is Associated with Impairment of Quality of Life
Onychophagia is defined as a chronic nail biting behaviour affecting about 20–30% of the general population. However, nail biting seems to be an ignored problem in a daily clinical practice. We have analysed the influence of onychophagia on quality of life (QoL) and stigmatisation level among 339 medical students with and without nail biting. Those with onychophagia demonstrated significantly higher QoL impairment compared to the controls (p < 0.001). Subjects who had been unable to stop nail biting behaviour in the past (p < 0.01) had visible nail abnormalities (p = 0.03), spent more time on nail biting (p = 0.02) and with a higher number of involved fingernails (p = 0.03), demonstrated further impaired QoL. Furthermore, tension before or when trying to resist nail biting (β = 12.5; p < 0.001), suffering due to nail biting (β  =12.6; p = 0.001) and nail eating behaviour (β = –7.5; p < 0.01) were independent variables influencing QoL. Participants with onychophagia also demonstrated higher level of stigmatisation (0.6 ± 1.2 vs. 0.2 ± 0.6 points, p < 0.01), although in both groups the stigmatisation level was low. ]]>
2014-03-24 Clinical
94:6 2014 - Bacteriology of Hidradenitis Suppurativa – Which Antibiotics are the Treatment of Choice?
The bacterial superinfection in hidradenitis suppurativa (HS), although it does not initiate the disease itself, seems to be one of the major contributors to an inflammatory vicious circle. Antibiotic therapy is therefore commonly prescribed in HS. This study was undertaken to evaluate the prescription of systemic antibiotics in the light of bacteriological cultures and antibiograms. The study was conducted on a group of 69 patients with HS. The huge majority (n=62) of the patients were treated with antibiotics. The antibiotics were prescribed 132 times and taken for a mean period of 9.9 ± 8.9 weeks. The most commonly used antibiotic was doxycycline (16.7%). The majority of the patients had a polymicrobial flora with up to 5 species, predominantly staphylococci and bacteria of intestinal flora. The highest effectiveness against isolates was observed for carbapanems, penicillins with β-lactamase inhibitors and fluoroquinolones – 8.5%, 11.9%, and 11.9% of resistant strains, respectively. In daily practice penicillins with β-lactamase inhibitors or fluoroquinolones could serve as first-line therapy of HS.]]>
2014-04-10 Clinical
94:6 2014 - Atopic Dermatitis in Israeli Adolescents – A Large Retrospective Cohort Study
Prevalence of atopic dermatitis (AD) has been studied mainly in infants and young children. Surveys on AD in adolescents and adults are based largely on self-reported questionnaires and cohorts of different ages, precluding meaningful comparisons and conclusions. We aimed to provide data on the prevalence of AD and its relation to demographic factors in adolescents. A large database of youths eligible for military service was searched for subjects one year before service at the age of 18. Parameters included country of origin, age of immigration to Israel, education, and presence and severity of AD. AD rose 3-fold for both genders over the study period 1998–2008 (0.4–1%). The increase was higher in females (0.5–1.2%) than males (0.3–0.9%). Mild and moderate disease was higher in females than males. Severe AD was rarely noted. Russian (OR = 1.47), Asian (OR = 1.15) and Euro-American (OR = 1.26) origins had highest association with AD. Immigrants after age 7 had higher association with AD than Israeli-born subjects and immigrants before age 7 (1.88 vs. 1.33). More years of education was significantly associated with high prevalence of AD. The increased prevalence of AD during the 11-year period underscores the need for awareness of the condition in this population, in which AD affects health and quality of life.]]>
2014-03-04 Clinical
94:6 2014 - Effect of Weight Loss on the Cardiovascular Risk Profile of Obese Patients with Psoriasis
Psoriasis is associated with obesity and other cardiovascular risk factors including endothelial dysfunction. We aimed to investigate the effects of weight loss on the cardiovascular risk profile of obese patients with psoriasis. A randomised controlled study was conducted in which we measured the microvascular endothelial function with peripheral arterial tonometry (PAT), selected plasma markers of endothelial function, and traditional cardiovascular risk factors in 60 obese patients with psoriasis. The participants were randomised to either low-energy diet (n = 30) providing 800–1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n = 30) for 16 weeks. The intervention group lost significantly more weight than controls, which resulted in significant reductions of diastolic blood pressure, resting heart rate, total cholesterol, VLDL cholesterol, triglyceride, plasma glucose, glycated haemoglobin, and tissue plasminogen activator inhibitor. Microvascular endothelial function assessed by PAT remained unchanged. We conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be significantly improved by weight reduction.]]>
2014-03-10 Clinical
94:6 2014 - Chronic Hand Eczema: Perception and Knowledge in Non-affected Individuals from General and Dermatological Practice
Misunderstanding and stigmatisation are common problems encountered by patients with hand eczema. Various misconceptions about the disease circulate in the general population. Although hand eczema has gained more attention in dermatology during the past years, information on public perception of the disease is still lacking. The aim of our study was to investigate perception of and level of knowledge on the subject hand eczema. There were 624 patients included from 2 general medicine practices and 2 dermatological practices. A self-administered questionnaire was filled out by the participants, covering issues on history of hand eczema, level of knowledge and attitude towards a clinical photograph of hand eczema. We found that a larger proportion of individuals from dermatological practice were more familiar with hand eczema as a disease than those from general medical practice. Women knew significantly more about and had a more positive perception of the disease than men. Our results imply that the level of knowledge on hand eczema in the general public is rather low and influenced by prejudice.]]>
2014-03-31 Clinical
94:6 2014 - Diagnosis of Pigmented Skin Tumours in a Dermatological Setting: Different Aspects of the Number Needed to Excise as a Measure of Efficiency
The increasing incidence of melanoma prompts a need for efficient management of this patient group. In this study, we use the number needed to excise (NNE), as a measurement of the efficiency of diagnosing melanoma. From January 2009 to December 2012, postoperative records from all patients were prospectively registered. All excised tumours with the histopathological diagnosis of naevus, melanoma or seborrhoeic keratosis were included. NNE values, both excluding and including seborrhoeic keratosis, changes over time, as well as patient- and tumour-related factors influencing NNE were determined. In total, 1,717 cases were included. The overall NNE value was 6.5, and the value fell significantly (r = 0.959, p = 0.041) during the 4-year study period from 8.2 to 4.8. NNE values decreased with increasing patient age to 1.8 in patients ≥ 80 years of age. The overall NNE value including seborrhoeic keratosis was 6.8.]]>
2014-04-03 Clinical
94:6 2014 - High Magnification Digital Dermoscopy of Basal Cell Carcinoma: A Single-centre Study on 400 cases
The aim of this study was to assess the frequency of classic dermoscopic basal cell carcinoma (BCC) features and the sensitivity of new descriptors, such as light brown nests (homogeneous and structured) only visible employing a high magnification digital videomicroscope. A retrospective analysis of 2,024 highly magnified digital images referring to 400 BCCs was performed by 3 independent observers, who assessed 11 classic BCC descriptors and the new ones. Light brown nests were detected in 40.5% of BCCs. Homogeneous ones were observable in 17.8%, and structured nests in 32.8%. Light brown nests were visible in 14.3% of non-pigmented lesions, whereas in the pigmented groups these were observed in 42–54% of the cases. We suggest that brown nests described in this study may improve early recognition of superficial BCCs and of non-pigmented or slightly pigmented ones that may lack classic dermoscopic patterns. ]]>
2014-03-19 Clinical
94:6 2014 - Debio 0932, A New Oral Hsp90 Inhibitor, Alleviates Psoriasis in a Xenograft Transplantation Model
Debio 0932 is a novel oral heat shock protein 90 (Hsp90) inhibitor developed for anti-cancer therapy. Surprising-ly, during the first clinical trial, one psoriasis patient experienced complete remission of his skin manifestation. However, a possible therapeutic utility of Hsp90 in psoriasis has not previously been reported. The objective of the present study was to explore the ability of Debio 0932 to alleviate psoriasis in a preclinical model. A psoriasis xenograft transplantation model was employed where skin from 5 psoriasis patients was transplanted onto immunodeficient mice (8 xenografts per donor). Debio
0932 was administered perorally daily for 3 weeks and resulted in significant clinical alleviation of psoriasis by day 11 and reduced epidermal thickness evaluated post-treatment. Alleviation of psoriasis in the psoriasis xenograft transplantation model, which may be due to Hsp90’s involvement in signalling pathways that are up-regulated in psoriasis, substantiates a potential role of Debio 0932 in psoriasis treatment.]]>
2014-03-25 Investigative
94:6 2014 - Genotype–Phenotype Correlations in a Prospective Cohort Study of Paediatric Plaque Psoriasis: Lack of Correlation Between HLA-C*06 and Family History of Psoriasis
This study aims to investigate associations between observed clinical parameters and known genetic risk factors of psoriasis in a well-defined prospective cohort of paediatric patients with plaque psoriasis (n = 151). Significant associations were found for paediatric-onset psoriasis with ERAP1 (p = 0.002), IL23R (p = 0.01), LCE3C_LCE3B-del (p = 0.00049) and HLA-C*06 (p = 3.15 × 10–30). Psoriasis severity was associated with the single nucleotide polymorphisms tagging IFIH1 and ERAP1 (p < 0.05). An onset before 10 years of age was associated with IL12B (p = 0.02). Nail psoriasis was more often seen in HLA-C*06-negative patients (p = 0.008). Remarkably, family history is clearly not associated with HLA-C*06 in this specific group. The large proportion of patients with a positive family history in HLA-C*06 negative patients (and the lack of correlation between the two) indicates that other genes, either alone or interaction between two or more genes, may have significant effects on heritability. ]]>
2014-04-10 Investigative
94:6 2014 - Neurofibromatosis Type 1 Gene Mutation Analysis Using Sequence Capture and High-throughput Sequencing
Neurofibromatosis type 1 syndrome (NF1) is caused by mutations in the NF1 gene. Availability of new sequencing technology prompted us to search for an alternative method for NF1 mutation analysis. Genomic DNA was isolated from saliva avoiding invasive sampling. The NF1 exons with an additional 50bp of flanking intronic sequences were captured and enriched using the SeqCap EZ Choice Library protocol. The captured DNA was sequenced with the Roche/454 GS Junior system. The mean coverages of the targeted regions were 41x and 74x in 2 separate sets of samples. An NF1 mutation was discovered in 10 out of 16 separate patient samples. Our study provides proof of principle that the sequence capture methodology combined with high-throughput sequencing is applicable to NF1 mutation analysis. Deep intronic mutations may however remain undetectable, and change at the DNA level may not predict the outcome at the mRNA or protein levels. ]]>
2014-04-07 Investigative
94:6 2014 - Assessing Health-related Quality of Life in Hand Eczema Patients: How to Overcome Psychometric Faults when Using the Dermatology Life Quality Index
Health-related quality of life (HRQOL) has become an important patient reported outcome in health service research. The dermatology life quality index (DLQI) is the most commonly used instrument in dermatology. In recent years, the psychometric properties of the DLQI have been a subject of debate as requirements of modern test theory seem not to be fulfilled. The aim of this study was to test whether those violations also occur in patients with hand eczema. We collected data of 602 hand eczema patients who participated in an inpatient dermatology rehabilitation program in Germany. In order to report meaningful scores of the DLQI, data were analysed according to the principles of modern test theory. We calibrated the DLQI using the Rasch model, resulting in a 6 item version with a range between 0–15 points. This version showed no significant misfit to the Rasch model (p>0.14). By using a Rasch analysis the results were evaluated in a second sample of hand eczema patients (n=511). Even if all demographic characteristic of this sample were different, we were able to replicate the results found in this study (p>0.21). In conclusion, we recommend to use an alternative scoring procedure as presented in this article if the DLQI is used in hand eczema patients.]]>
2014-04-08 Investigative
94:6 2014 - Implementation of Recommendations for Hand Eczema Through a Multifaceted Strategy. A Process Evaluation Among Health Care Workers
Process data give important insights into how an intervention is implemented. The aim of the present study is to conduct a process evaluation, alongside a randomised controlled trail, on the implementation of recommendations for the prevention of hand eczema. The intervention was carried out in healthcare workers’ departments and consisted of working groups and role models. The role models were selected based on their representativeness, their influence on colleagues, and their motivation. The focus of the working group was to implement recommendations for hand eczema at the department by choosing solutions to overcome barriers for implementation. Out of the 104 solutions, 87 were realised. Solutions regarding moisturisers and use of cotton under gloves, were used by 90.9% and 30.8% of the employees, respectively. Of all participants, 58.2% actively engaged with the role models. This process evaluation showed that the intervention was executed according to protocol and that the solutions were implemented well. However, the role model component in the intervention should be improved.]]>
2014-03-26 Investigative
94:6 2014 - Surfactant-induced Chronic Pruritus: Role of L-Histidine Decarboxylase Expression and Histamine Production in Epidermis
Shampoo and cleansers containing anionic surfactants including sodium dodecyl sulphate (SDS) often cause pruritus in humans. Daily application of 1–10% SDS for 4 days induced hind-paw scratching (an itch-related behaviour) in a concentration-dependent manner, and 10% SDS also caused dermatitis, skin dryness, barrier disruption, and an increase in skin surface pH in mice. SDS-induced scratching was inhibited by the opioid receptor antagonist naloxone and the H histamine receptor antagonist terfenadine. Mast-cell deficiency did not inhibit SDS-induced scratching, although it almost completely depleted histamine in the dermis. Treatment with SDS increased the histamine content of the epidermis, but not that of the dermis. SDS treatment increased the gene expression and post-translation processing of L-histidine decarboxylase in the epidermis. The present results suggest that repeated application of SDS induces itch through increased production of epidermal histamine, which results from an increase in the gene expression and post-translation processing of L-histidine decarboxylase.]]>
2014-04-09 Investigative
94:6 2014 - Skin Barrier Integrity and Natural Moisturising Factor Levels After Cumulative Dermal Exposure to Alkaline Agents in Atopic Dermatitis
Dermal exposure to alkaline agents may lead to skin barrier damage and irritant contact dermatitis. The objective of this study was to investigate the effects of cumulative exposure to 0.5% sodium lauryl sulphate (SLS) and 0.15% NaOH on the barrier function and natural moisturising factor (NMF) levels in atopic dermatitis and healthy volunteers with known filaggrin genotype. The skin response was monitored by measurement of erythema and transepidermal water loss. The stratum corneum NMF levels were determined by high-performance liquid chromatography. Repeated exposure to 0.5% SLS and/or 0.15% NaOH in atopic dermatitis resulted in more severe impairment of the skin barrier function. Cumulative exposure to the irritants reduced significantly NMF in both the atopic and healthy controls group. The pronounced decrease of NMF after repeated single and sequential irritant exposure may be a pathogenetically relevant factor for development of chronic irritant contact dermatitis in both healthy and atopic individuals. ]]>
2014-03-05 Investigative
94:6 2014 - A New Ten-Item Questionnaire For Assessing Sensitive Skin: The Sensitive Scale-10
Sensitive skin is common but until now there has been no scale for measuring its severity. The Sensitive Scale is a new scale with a 14-item and a 10-item version that was tested in 11 countries in different languages on 2,966 participants. The aim of this study was to validate the pertinence of using the Sensitive Scale to measure the severity of sensitive skin. The internal consistency was high. Correlations with the dry skin type, higher age, female gender, fair phototypes and Dermatology Life Quality Index were found. Using the 10-item version appeared to be preferable because it was quicker and easier to complete, with the same internal consistency and the 4 items that were excluded were very rarely observed in patients. The mean initial scores were around 44/140 and 37/100. The use of a cream for sensitive skin showed the pertinence of the scale before and after treatment.]]>
2014-06-09 Investigative
94:6 2014 - Current Concepts in Psoriatic Arthritis: Pathogenesis and Management
Psoriatic arthritis occurs in a subset of psoriasis patients and is therefore commonly encountered in dermatology practice. Although its exact pathogenesis is unknown, psoriatic arthritis is thought to share common mechanisms with psoriatic skin symptoms. Innate and adaptive immune responses are abnormally activated in psoriasis and may acquire the ability to attack peripheral joints and other sites following an environmental trigger (e.g. mechanical stress, trauma, infection) in genetically susceptible patients. The increased cardiovascular risk inherent in psoriasis appears further enhanced in psoriatic arthritis, likely reflecting the overall burden of systemic inflammation contributing to atherogenic processes. Basic research and clinical trials have suggested that tumour necrosis factor is important in psoriatic arthritis pathophysiology, and accumulating evidence suggests that Th17 cells and interleukin-17A may also be important. Basic research and clinical trials inform our understanding of psoriatic arthritis pathophysiology and, in turn, help dermatologists to make better treatment decisions.]]>
2014-07-15 Review
94:5 2014 - Unilateral Eruption of Painful Papules: A Quiz
Abstract is missing (Quiz)]]>
2013-12-13 Quiz
94:5 2014 - Solitary Tumour on the Neck: A Quiz
Abstract is missing (Quiz)]]>
2014-01-09 Quiz