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Contact Dermatitis Sep 2022Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking,... (Meta-Analysis)
Meta-Analysis Review
Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking, alcohol consumption, stress, physical activity, body mass index, diet, and sleep) and the prevalence, incidence, subtype, severity, and prognosis of hand eczema, a systematic review and meta-analysis were conducted in accordance with the Meta-analysis Of Observational Studies in Epidemiology consensus statement. MEDLINE, Embase, and Web of Science were searched up to October 2021. The (modified) Newcastle-Ottawa Scale was used to judge risk of bias. Quality of the evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation approach. Eligibility and quality were blindly assessed by two independent investigators; disagreements were resolved by a third investigator. Data were pooled using a random-effects model, and when insufficient for a meta-analysis, evidence was narratively summarized. Fifty-five studies were included. The meta-analysis (17 studies) found very low quality evidence that smoking is associated with a higher prevalence of hand eczema (odds ratio 1.18, 95% confidence interval 1.09-1.26). No convincing evidence of associations for the other lifestyle factors with hand eczema were found, mostly due to heterogeneity, conflicting results, and/or the limited number of studies per outcome.
Topics: Dermatitis, Allergic Contact; Eczema; Humans; Life Style; Odds Ratio; Smoking
PubMed: 35277987
DOI: 10.1111/cod.14102 -
The Ocular Surface Apr 2023Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the... (Review)
Review
Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the setting of Mycoplasma infection. Though a clinically distinct disease, MIRM exists on a diagnostic continuum with entities including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and the recently described reactive infectious mucocutaneous eruption (RIME). In this systematic review, we discuss published findings on the epidemiology, clinical manifestations, diagnosis, and management of MIRM, with an emphasis on ocular disease. Lastly, we discuss some of the most recent developments and challenges in characterizing MIRM with respect to the related diagnosis of RIME.
Topics: Humans; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome; Eye; Exanthema
PubMed: 36396020
DOI: 10.1016/j.jtos.2022.11.007 -
Rheumatology International Dec 2022We aimed to summarise effects and use of non-pharmacological and pharmacological treatments for sarcoidosis with musculoskeletal manifestations. We systematically... (Review)
Review
We aimed to summarise effects and use of non-pharmacological and pharmacological treatments for sarcoidosis with musculoskeletal manifestations. We systematically searched the Cochrane Library, Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, clinical.trials.gov, PROSPERO and PEDro for systematic reviews from 2014 to 2022 and for primary studies from date of inception to March 29, 2022, and studies with patients diagnosed with sarcoidosis with musculoskeletal manifestations. Inclusion criteria required that studies reported effects of non-pharmacological and/or pharmacological treatments or number of patients receiving these treatments. Results were reported narratively and in forest plots. Eleven studies were included. No systematic reviews fulfilled our inclusion criteria. None of the included studies had a control group. We found that between 23 and 100% received corticosteroids, 0-100% received NSAIDs, 5-100% received hydroxychloroquine, 12-100% received methotrexate, 0-100% received TNF inhibitors, and 3-4% received azathioprine. Only ten patients in one study had used non-pharmacological treatments, including occupational therapy, chiropractic and acupuncture. There are no controlled studies on treatment effects for patients with sarcoidosis with musculoskeletal manifestations. We found 11 studies reporting use of pharmacological treatments and only one study reporting use of non-pharmacological treatments. Our study identified major research gaps for pharmacological and non-pharmacological treatment in musculoskeletal sarcoidosis and warrant randomised clinical trials for both.
Topics: Humans; Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Azathioprine; Hydroxychloroquine; Methotrexate; Sarcoidosis; Tumor Necrosis Factor Inhibitors
PubMed: 35943526
DOI: 10.1007/s00296-022-05171-8 -
Contact Dermatitis Apr 2024Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse... (Meta-Analysis)
Meta-Analysis Review
Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse the prevalence and incidence of HE in HCWs, as well as mapping the prevalence of atopic dermatitis (AD) and HE severity in HCWs. A systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Published literature from 2000 to 2022 was eligible based on predefined inclusion and exclusion criteria. A total of 18 studies were included. Pooled life-time, 1-year and point prevalence of self-reported HE in HCWs was 33.4% (95% confidence interval [CI]: 28.3-38.6), 27.4% (95% CI: 19.3-36.5) and 13.5% (95% CI: 9.3-18.4), respectively. AD prevalence was 15.4% (95% CI: 11.3-19.9). Overall, the majority of HCWs reported mild HE. One included study assessed HE incidence reporting 34 cases/1000 person years. Most studies scored low-moderate using the New Ottawa Scale and the pooled point prevalence data showed broad CIs. In conclusion, the high prevalence of HE in HCWs underlines the increased risk and need for preventive measures for this professional group. There is, however, a need of further standardized high-quality studies.
Topics: Humans; Prevalence; Dermatitis, Allergic Contact; Incidence; Eczema; Dermatitis, Atopic; Health Personnel
PubMed: 38186085
DOI: 10.1111/cod.14489 -
Archives of Dermatological Research Oct 2022Recurrence of DRESS syndrome is poorly characterized, and dermatologists must be prepared to predict, identify, and manage patients after treatment of the initial... (Review)
Review
Recurrence of DRESS syndrome is poorly characterized, and dermatologists must be prepared to predict, identify, and manage patients after treatment of the initial presentation. In this study, a primary literature search was conducted using PubMed, capturing all articles recording cases of DRESS syndrome recurrence. Forty-two articles were included for review comprising a total of 60 patients. The average age of patients was 46.3 years and time to recurrence was 123 days. Recurrent episodes presented more frequently with a higher fever and eosinophil absolute peak. Relapse was most often attributed to the introduction of a new medication (n = 18). Of the 17 cases in which outcome data were available, the survival rate of those experiencing recurrence was 71%. Viral reactivation with HHV-6 and organ involvement of the liver were frequently recorded complications. In essence, viral reactivation, severe internal organ involvement, and hematological abnormalities all portended a poorer prognosis in those experiencing DRESS syndrome recurrence. An adequate course of treatment should be maintained until clinical and laboratory parameters normalize, with a slow taper to minimize the likelihood of relapse in those most at risk.
Topics: Drug Hypersensitivity Syndrome; Humans; Leukocyte Count; Middle Aged; Recurrence
PubMed: 34505944
DOI: 10.1007/s00403-021-02274-3 -
Current Allergy and Asthma Reports Oct 2015Food allergy is relatively common in both children and adults, and its prevalence is increasing. Early exposure of food allergens onto skin with an impaired epidermal... (Review)
Review
Food allergy is relatively common in both children and adults, and its prevalence is increasing. Early exposure of food allergens onto skin with an impaired epidermal barrier predisposes to sensitization and prevents the development of oral tolerance. While immediate-type food allergies are well described, less is known about delayed-type food allergies manifesting as dermatitis. This is due, in part, to limitations with current diagnostic testing for delayed-type food allergy, including atopy patch testing. We conducted a systematic review of food avoidance diets in delayed-type food allergies manifesting as dermatitis. While beneficial in some clinical circumstances, avoidance diets should be used with caution in infants and children, as growth impairment and developmental delay may result. Ultimately, dermatitis is highly multifactorial and avoidance diets may not improve symptoms of delayed-type food allergy until combined with other targeted therapies, including restoring balance in the skin microbiome and re-establishing proper skin barrier function.
Topics: Allergens; Animals; Dermatitis; Diet; Food Hypersensitivity; Humans; Hypersensitivity, Immediate; Patch Tests
PubMed: 26300528
DOI: 10.1007/s11882-015-0563-8 -
Radiology Apr 2023Background There is no consensus regarding the relative prognostic value of cardiac MRI and fluorodeoxyglucose (FDG) PET in cardiac sarcoidosis. Purpose To perform a... (Meta-Analysis)
Meta-Analysis
Background There is no consensus regarding the relative prognostic value of cardiac MRI and fluorodeoxyglucose (FDG) PET in cardiac sarcoidosis. Purpose To perform a systematic review and meta-analysis of the prognostic value of cardiac MRI and FDG PET for major adverse cardiac events (MACE) in cardiac sarcoidosis. Materials and Methods In this systematic review, MEDLINE, Ovid Epub, CENTRAL, Embase, Emcare, and Scopus were searched from inception until January 2022. Studies that evaluated the prognostic value of cardiac MRI or FDG PET in adults with cardiac sarcoidosis were included. The primary outcome of MACE was assessed as a composite including death, ventricular arrhythmia, and heart failure hospitalization. Summary metrics were obtained using random-effects meta-analysis. Meta-regression was used to assess covariates. Risk of bias was assessed using the Quality in Prognostic Studies, or QUIPS, tool. Results Thirty-seven studies were included (3489 patients with mean follow-up of 3.1 years ± 1.5 [SD]); 29 studies evaluated MRI (2931 patients) and 17 evaluated FDG PET (1243 patients). Five studies directly compared MRI and PET in the same patients (276 patients). Left ventricular late gadolinium enhancement (LGE) at MRI and FDG uptake at PET were both predictive of MACE (odds ratio [OR], 8.0 [95% CI: 4.3, 15.0] [ < .001] and 2.1 [95% CI: 1.4, 3.2] [ < .001], respectively). At meta-regression, results varied by modality ( = .006). LGE (OR, 10.4 [95% CI: 3.5, 30.5]; < .001) was also predictive of MACE when restricted to studies with direct comparison, whereas FDG uptake (OR, 1.9 [95% CI: 0.82, 4.4]; = .13) was not. Right ventricular LGE and FDG uptake were also associated with MACE (OR, 13.1 [95% CI: 5.2, 33] [ < .001] and 4.1 [95% CI: 1.9, 8.9] [ < .001], respectively). Thirty-two studies were at risk for bias. Conclusion Left and right ventricular late gadolinium enhancement at cardiac MRI and fluorodeoxyglucose uptake at PET were predictive of major adverse cardiac events in cardiac sarcoidosis. Limitations include few studies with direct comparison and risk of bias. Systematic review registration no. CRD42021214776 (PROSPERO) © RSNA, 2023 .
Topics: Adult; Humans; Fluorodeoxyglucose F18; Prognosis; Cardiomyopathies; Contrast Media; Gadolinium; Myocarditis; Magnetic Resonance Imaging; Sarcoidosis
PubMed: 36809215
DOI: 10.1148/radiol.222483 -
International Journal of Rheumatic... Sep 2017Despite many studies suggesting an association between human leukocyte antigen (HLA)-B*5801 and allopurinol-induced toxic epidermal necrolysis (TEN) and Stevens-Johnsons... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite many studies suggesting an association between human leukocyte antigen (HLA)-B*5801 and allopurinol-induced toxic epidermal necrolysis (TEN) and Stevens-Johnsons syndrome (SJS), the evidence of association in different populations and the degree of association remain uncertain.
METHODS
The primary analysis was based on population-control studies. Data were pooled by means of a random-effects model, and sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR-), diagnostic odds ratios (DOR), and areas under summary receiver operating characteristic (SROC) curves (AUC) were calculated.
RESULTS
In nine population-control studies, HLA-B*5801 was measured in 162 patients with allopurinol-induced TEN/SJS and 7372 patients without allopurinol-induced TEN/SJS. The pooled sensitivity, specificity, LR+, LR-, DOR and AUC were 0.78 (95% CI = 0.71-0.85), 0.96 (95% CI = 0.96-0.97), 14.23 (95% CI = 7.89-25.63), 0.29 (95% CI = 0.16-0.54), 83.5 (95% CI = 50.7-137.4), and 0.97 (95% CI = 0.95-0.99), respectively. Subgroup analyses of the DORs for Chinese, Japanese, and Caucasian populations yielded similar findings for Chinese (196.1; 95% CI = 57.3-672.0), Japanese (78.8; 95% CI = 30.4-203.9), and Caucasian (58.4; 95% CI = 16.9-201.5) populations. Overall, HLA-B*5801 was associated with allopurinol-induced TEN/SJS in European and Japanese populations, but only had a 50-60% sensitivity (pooled sensitivity 56%), compared to the 80-100% sensitivity (pooled sensitivity 97%) observed in Korean, Thai, Sardinia Italian and Han Chinese populations.
CONCLUSIONS
The present study reveals that allopurinol is the leading cause of TEN/SJS in many countries. In contrast to carbamazepine, which is ethnic/population specific, the HLA-B*5801 for detecting allopurinol-induced TEN/SJS is universal. Screening of HLA-B*5801 may help patients to prevent the occurrence of allopurinol-induced TEN/SJS, especially in populations with a higher (≥ 5%) risk allele frequency.
Topics: Allopurinol; Area Under Curve; Chi-Square Distribution; Enzyme Inhibitors; Gene Frequency; Genetic Predisposition to Disease; Genetic Testing; Gout Suppressants; HLA-B Antigens; Humans; Odds Ratio; Phenotype; Predictive Value of Tests; ROC Curve; Racial Groups; Risk Factors; Severity of Illness Index; Stevens-Johnson Syndrome
PubMed: 28857441
DOI: 10.1111/1756-185X.13143 -
European Journal of Dermatology : EJD 2015Instrumental musicians are a risk group for skin diseases. A systematic review was performed on Pubmed database and in the musical literature. Most publications on... (Review)
Review
Instrumental musicians are a risk group for skin diseases. A systematic review was performed on Pubmed database and in the musical literature. Most publications on dermatoses in musicians are case reports. The exact prevalence of skin diseases in musicians is unknown but high rates have been reported. The most at-risk musicians are percussionists, string and wind instrumentalists. Repeated physical trauma is a frequent cause of skin conditions in musicians (callosities, fiddler's neck syndrome…). The allergens most often reported in musicians' allergic contact dermatitis are metals (nickel, dichromate), exotic woods and cane reed components, colophony and propolis. The key preventive measures are early management of the skin disease, specific tests and avoidance of the causative allergens, together with better adjustment of playing techniques to reduce trauma.
Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dermatitis, Occupational; Female; Humans; Incidence; Male; Music; Nickel; Occupational Health; Propolis; Resins, Plant; Risk Assessment; Severity of Illness Index
PubMed: 25905552
DOI: 10.1684/ejd.2015.2559 -
Chest Mar 2015An increased cancer risk in patients with sarcoidosis has been suggested, although results are conflicting in a number of case-control and cohort studies. We conducted a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An increased cancer risk in patients with sarcoidosis has been suggested, although results are conflicting in a number of case-control and cohort studies. We conducted a systematic review of all available data and performed a meta-analysis to better define and quantify the association between sarcoidosis and cancer.
METHODS
We searched Medline and Embase for all original articles on cancer and sarcoidosis published up to January 2013. Two independent authors reviewed all titles/abstracts to identify studies according to predefined selection criteria. We derived summary estimates using a random-effects model and reported them as relative risk (RR). Publication bias was evaluated using a funnel plot and was quantified by the Egger test.
RESULTS
Sixteen original studies, involving > 25,000 patients, were included in the present review. The summary RR to develop all invasive cancers was 1.19 (95% CI, 1.07-1.32). The results for selected cancer sites indicated a significantly increased risk of skin (RR, 2.00; 95% CI, 1.69-2.36), hematopoietic (RR, 1.92; 95% CI, 1.41-2.62), upper digestive tract (RR, 1.73; 95% CI, 1.07-2.79), kidney (RR, 1.55; 95% CI, 1.21-1.99), liver (RR, 1.79; 95% CI, 1.03-3.11), and colorectal cancers (RR, 1.33; 95% CI, 1.07-1.67). There was no evidence of publication bias for all cancers (P = .9), nor for any specific cancer site.
CONCLUSIONS
The present meta-analysis suggests a significant, though moderate, association between sarcoidosis and malignancy.
Topics: Female; Humans; Lung Neoplasms; Male; Observational Studies as Topic; Risk Factors; Sarcoidosis, Pulmonary
PubMed: 25340385
DOI: 10.1378/chest.14-1475