Severity strata for EASI, mEASI, oSCORAD, SCORAD, ADSI and BSA in adolescents and adults with atopic dermatitis

Abstract

Background

Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to properly interpret these assessments. We sought to confirm previously reported strata for Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and objective component of SCORAD (oSCORAD) and develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface (BSA) for use in adults with AD.

Methods

Skin-examination was performed in 673 adolescents and adults (age ≥13 years) with diagnosed AD in a dermatology practice setting. Strata were selected using an anchoring approach based on a 4-point Investigator's Global Assessment of severity (clear of active skin lesions, mild, moderate or severe disease).

Results

We determined potential severity strata for EASI (0=clear, 0.1-5.9=mild, 6.0-22.9=moderate, 23.0-72=severe; kappa=0.694), mEASI (0-0.9=clear, 1-8.9=mild, 9.0-29.9=moderate, 30.0-90=severe; kappa=0.71), oSCORAD (0-7.9=clear, 8.0-23.9=mild, 24.0-37.9=moderate, 38.0-83=severe; kappa=0.70), SCORAD (0-9.9=clear, 10.0-28.9=mild, 29.0-48.9=moderate, 49.0-103=severe; kappa=0.68), ADSI (0-1.9=clear, 2-5.9=mild, 6.0-8.9=moderate and 9.0-15=severe; kappa=0.55), and BSA (0=clear, 0.1-15.9=mild, 16.0-39.9=moderate, 40.0-100=severe; kappa=0.656). oSCORAD >0 were found in clear skin due to the presence of xerosis, which is scored in oSCORAD. Similarly, SCORAD >0 were found in clear skin due to the scoring of xerosis, pruritus and sleeplessness. Similarly, mEASI and ADSI scores >0 occurred in patients with clear skin due to scoring of pruritus.

Conclusions

We recommend using these strata for interpretation of their respective measures in clinical trials of AD. There are important differences between the 5 assessments, which profoundly impact the interpretation of their scores.

This article is protected by copyright. All rights reserved.

http://ift.tt/2q195LN

Sirolimus therapy for children with problematic Kaposiform haemangioendothelioma and tufted angioma

Abstract

Kaposiform haemangioendothelioma (KHE) and tufted angioma (TA) are rare vascular tumours that typically present during infancy or childhood. Originally regarded as distinct lesions, they are now considered as part of a spectrum. Presentation is usually as an enlarging, tender, blue or red mass. Both KHE and TA may be associated with Kasabach-Merritt Phenomenon (KMP), a severe haemorrhagic state arising from intralesional platelet trapping, microangiopathic haemolytic anaemia, and consumptive coagulopathy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2pZ7yHX

Treatment satisfaction and need for shared decision-making in patients with psoriasis from Peru

Abstract

psoriasis is reported by the World Health Organization as a chronic skin disease with an elevated physical, emotional and socioeconomic burden. However, this burden is underestimated in developing countries, such as Peru, due the lack of epidemiological research in dermatology. This uncertainty hinders the development of appropriate patient-centered health care that prevent patients from unnecessary suffering.

This article is protected by copyright. All rights reserved.

http://ift.tt/2q1EkGw

Severity strata for EASI, mEASI, oSCORAD, SCORAD, ADSI and BSA in adolescents and adults with atopic dermatitis

Abstract

Background

Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to properly interpret these assessments. We sought to confirm previously reported strata for Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and objective component of SCORAD (oSCORAD) and develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface (BSA) for use in adults with AD.

Methods

Skin-examination was performed in 673 adolescents and adults (age ≥13 years) with diagnosed AD in a dermatology practice setting. Strata were selected using an anchoring approach based on a 4-point Investigator's Global Assessment of severity (clear of active skin lesions, mild, moderate or severe disease).

Results

We determined potential severity strata for EASI (0=clear, 0.1-5.9=mild, 6.0-22.9=moderate, 23.0-72=severe; kappa=0.694), mEASI (0-0.9=clear, 1-8.9=mild, 9.0-29.9=moderate, 30.0-90=severe; kappa=0.71), oSCORAD (0-7.9=clear, 8.0-23.9=mild, 24.0-37.9=moderate, 38.0-83=severe; kappa=0.70), SCORAD (0-9.9=clear, 10.0-28.9=mild, 29.0-48.9=moderate, 49.0-103=severe; kappa=0.68), ADSI (0-1.9=clear, 2-5.9=mild, 6.0-8.9=moderate and 9.0-15=severe; kappa=0.55), and BSA (0=clear, 0.1-15.9=mild, 16.0-39.9=moderate, 40.0-100=severe; kappa=0.656). oSCORAD >0 were found in clear skin due to the presence of xerosis, which is scored in oSCORAD. Similarly, SCORAD >0 were found in clear skin due to the scoring of xerosis, pruritus and sleeplessness. Similarly, mEASI and ADSI scores >0 occurred in patients with clear skin due to scoring of pruritus.

Conclusions

We recommend using these strata for interpretation of their respective measures in clinical trials of AD. There are important differences between the 5 assessments, which profoundly impact the interpretation of their scores.

This article is protected by copyright. All rights reserved.

http://ift.tt/2q195LN

Sirolimus therapy for children with problematic Kaposiform haemangioendothelioma and tufted angioma

Abstract

Kaposiform haemangioendothelioma (KHE) and tufted angioma (TA) are rare vascular tumours that typically present during infancy or childhood. Originally regarded as distinct lesions, they are now considered as part of a spectrum. Presentation is usually as an enlarging, tender, blue or red mass. Both KHE and TA may be associated with Kasabach-Merritt Phenomenon (KMP), a severe haemorrhagic state arising from intralesional platelet trapping, microangiopathic haemolytic anaemia, and consumptive coagulopathy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2pZ7yHX

Treatment satisfaction and need for shared decision-making in patients with psoriasis from Peru

Abstract

psoriasis is reported by the World Health Organization as a chronic skin disease with an elevated physical, emotional and socioeconomic burden. However, this burden is underestimated in developing countries, such as Peru, due the lack of epidemiological research in dermatology. This uncertainty hinders the development of appropriate patient-centered health care that prevent patients from unnecessary suffering.

This article is protected by copyright. All rights reserved.

http://ift.tt/2q1EkGw

The adaptor protein ARA55 and the nuclear kinase HIPK1 assist c-Myb in recruiting p300 to chromatin

Publication date: Available online 8 May 2017
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Mads Bengtsen, Linda Sørensen, Linn Aabel, Marit Ledsaak, Vilborg Matre, Odd Stokke Gabrielsen
LIM-domain proteins, containing multiple cysteine-rich zinc finger-like motifs, have been shown to play diverse roles in several cellular processes. A common theme is that they mediate important protein-protein interactions that are key to their function. Androgen receptor-associated protein 55 (ARA55) belongs to this family of bridging proteins containing four C-terminal LIM domains. It has a dual role with functions both at focal adhesions and in the nucleus, apparently shuttling between the two compartments. In the present work, we have expanded our understanding of its nuclear functions by showing that it interacts with three nuclear regulators not previously linked to ARA55. We first identified ARA55 as a novel interaction partner of the nuclear kinase HIPK1 and found that ARA55, like HIPK1, also interacts with the transcription factor c-Myb. In search of a function for these associations, we observed that the coactivator p300 not only binds to c-Myb, but to ARA55 as well. When combined, c-Myb, p300, HIPK1 and ARA55 caused strong synergistic activation of a chromatinized reporter gene. In parallel, all partners, including p300, were efficiently recruited to chromatin at the c-Myb-bound promoter. Consistent with this cooperation, we found that c-Myb and ARA55 share a common set of target genes in an osteosarcoma cellular context. We propose that ARA55 and HIPK1 assist c-Myb in recruiting the coactivator and acetyltransferase p300 to chromatin.



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