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American Journal of Clinical Dermatology Nov 2022There is a clear link between skin disease and psychological factors and this relationship works both ways: skin diseases can cause psychological distress and...
BACKGROUND
There is a clear link between skin disease and psychological factors and this relationship works both ways: skin diseases can cause psychological distress and psychological issues can worsen skin disease. There are a number of therapies that approach this problem from the psychological side and may be useful, especially as adjunctive therapies in select patients.
OBJECTIVE
The aim of this review was to determine the efficacy of various psychological therapies and mind-body techniques in the management of common dermatologic diseases in individuals of all ages.
METHODS
A systematic review of PubMed, Elsevier, and Wiley was performed for studies investigating psychological and mind-body interventions in the management of various skin diseases. Both physical and non-physical treatment outcomes were considered. Studies were evaluated for both risk of bias and overall quality of evidence.
RESULTS
A total of 40 articles studying unique sets of dermatological patients receiving psychological therapies or mind-body interventions were identified. Of the 40 included articles encompassing 3112 patients, 18 investigated these interventions in psoriasis management while 15 focused on atopic dermatitis. The remaining studies investigated vitiligo (2), pruritus (2), acne vulgaris (2), and acne excoriée (1).
CONCLUSIONS
Based on the analysis of included studies and an assessment of their quality of evidence, the most promising interventions are cognitive behavioral therapy, mindfulness-based interventions, and habit reversal therapy.
Topics: Acne Vulgaris; Cognitive Behavioral Therapy; Dermatitis, Atopic; Humans; Psoriasis; Treatment Outcome
PubMed: 35945404
DOI: 10.1007/s40257-022-00714-y -
Dermatologic Surgery : Official... Aug 2022Although vitiligo is often treated medically, there is increasing evidence for surgical therapies. Overlap with in-office surgical therapies that are already employed... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although vitiligo is often treated medically, there is increasing evidence for surgical therapies. Overlap with in-office surgical therapies that are already employed for other dermatologic conditions suggest that there is a significant opportunity to expand dermatologists' therapeutic repertoire for vitiligo.
OBJECTIVE
To systematically review the efficacy of nonphototherapy surgical treatments for vitiligo in comparative or placebo-controlled trials.
METHODS
A systematic review for surgical treatments for vitiligo was conducted. Primary outcomes were treatment success (>75% repigmentation) and failure (<25% repigmentation) for which meta-analyses were performed. Adverse effects were noted. The Cochrane risk of bias tool was used to assess study quality.
RESULTS
Surgical treatments reviewed included platelet-rich plasma, microneedling, ablative therapies, and surgical modalities. Seventy-three studies with 2,911 patients were included. The repigmentation benefits and adverse events are summarized. Meta-analyses suggest benefits for ablative laser therapies or microneedling in combination with narrowband ultraviolet B (NB-UVB) and for suction blister epidermal grafting over punch grafting.
CONCLUSION
The addition of microneedling or ablative laser therapy to NB-UVB phototherapy may improve repigmentation with minimal adverse effects. Surgical therapies, such as suction blister grafting and punch grafting, may offer the highest likelihood of repigmentation but have a risk of adverse effects including scarring and hyperpigmentation.
Topics: Blister; Combined Modality Therapy; Humans; Phototherapy; Treatment Outcome; Ultraviolet Therapy; Vitiligo
PubMed: 35917262
DOI: 10.1097/DSS.0000000000003503 -
Pigment Cell & Melanoma Research Sep 2022Several digital image analysis systems have been developed for surface calculation of vitiligo lesions. Critical assessment of their measurement properties is crucial to... (Review)
Review
Several digital image analysis systems have been developed for surface calculation of vitiligo lesions. Critical assessment of their measurement properties is crucial to support evidence-based recommendations on the most suitable instruments and will reveal the need for future research. A systematic review was performed to systematically summarize, compare, and critically assess the measurement properties of digital and analogue analysis systems for surface calculation of vitiligo lesions following the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations. Nineteen clinical trials were selected including 25 different instruments. Manual tracing on transparent sheets (contact planimetry) combined with digital measurement or point counting can be considered as the best validated method for the evaluation of target lesions taking into account the skin curvatures. Two-dimensional digital imaging analysis on photographs seems also robust although confirmatory data of different research groups using the same digital instrument in a wide range of skin types are missing. Analysis based on 3D photography is still in its early stage but is promising for whole-body analysis. However, the reported data on the quality of the instruments for surface area calculation of vitiligo lesions were in general rather limited. Therefore, future high-quality validation studies are required also including full body evaluations.
Topics: Consensus; Humans; Image Processing, Computer-Assisted; Research Design; Vitiligo
PubMed: 35822353
DOI: 10.1111/pcmr.13056 -
Journal of the European Academy of... Oct 2022
Meta-Analysis
Topics: Humans; Hypopigmentation; Melanoma; Skin Neoplasms; Vitiligo; Melanoma, Cutaneous Malignant
PubMed: 35686630
DOI: 10.1111/jdv.18310 -
Lasers in Medical Science Dec 2022
Topics: Humans; Vitiligo; Intense Pulsed Light Therapy; Lasers; Light; Treatment Outcome
PubMed: 35639193
DOI: 10.1007/s10103-022-03582-4 -
Dermatology (Basel, Switzerland) 2022Alexithymia is a psychological construct that describes one's difficulty in understanding and describing their own emotions as well as differentiating feelings from... (Review)
Review
BACKGROUND
Alexithymia is a psychological construct that describes one's difficulty in understanding and describing their own emotions as well as differentiating feelings from bodily signals of arousal. In the general population, alexithymia's prevalence is approximately 10%. Alexithymia may act as a triggering factor for many medical and psychiatric disorders. In patients with physical disease, alexithymia's prevalence reaches up to 63%. Additionally, alexithymia is associated with worse outcomes and heightened psychosocial comorbidities.
OBJECTIVE
This review continues where an earlier review (Willemsen, 2008) left off to (1) clarify alexithymia's prevalence in dermatology patients and (2) further investigate alexithymia's impact on disease burden, psychosocial comorbidities, and treatment.
METHODS
Systematic searches on alexithymia and dermatologic conditions were conducted using PubMed, Embase, PsycInfo, and Web of Science databases from March 8, 2021, to March 12, 2021. Data from eligible publications, which were full-text, clinical studies published after September 1, 2008, and available in English, were extracted by two medical students and summarized.
RESULTS
Despite a small number of publications (n = 37), data showed a markedly greater prevalence and severity of alexithymia in patients with alopecia, vitiligo, psoriasis, hidradenitis suppurativa, atopic dermatitis, chronic idiopathic urticaria, and primary focal hyperhidrosis compared to healthy controls. Further, data consistently demonstrate a complex interplay between alexithymia, disease burden, and psychosocial comorbidity.
CONCLUSIONS
Identifying and addressing alexithymia in dermatology patients may improve treatment outcomes, associated comorbidities, and health-related quality of life.
Topics: Humans; Affective Symptoms; Quality of Life; Psoriasis; Comorbidity; Prevalence
PubMed: 35636409
DOI: 10.1159/000524736 -
Actas Dermo-sifiliograficas Apr 2022Immune checkpoint inhibitors (ICIs) have significantly advanced the treatment of cancer. They are not, however, free of adverse effects. These effects are called... (Review)
Review
Immune checkpoint inhibitors (ICIs) have significantly advanced the treatment of cancer. They are not, however, free of adverse effects. These effects are called immune-related adverse events (irAEs) and often involve the skin. Most of the information on cutaneous irAEs comes from clinical practice. We therefore conducted a thorough review of the characteristics of cutaneous irAEs, recommendations for treatment, and their association with prognosis. The most common events are exanthema, pruritus, vitiligo, and hair loss, although ICIs can cause a wide range of cutaneous dermatoses. The reported association observed between certain reactions and a favorable response to cancer treatment should be interpreted with caution. Dermatologists should be involved in the multidisciplinary care of patients being treated with ICIs as they have an essential role in the diagnosis and treatment of cutaneous irAEs.
Topics: Drug-Related Side Effects and Adverse Reactions; Exanthema; Humans; Immune Checkpoint Inhibitors; Neoplasms; Prognosis
PubMed: 35623728
DOI: 10.1016/j.ad.2021.09.005 -
Journal Der Deutschen Dermatologischen... May 2022This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components. (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components.
MATERIAL AND METHODS
We searched PubMed, Web of Science, Cochrane Library and Embase databases from inception to March 30, 2021, for relevant studies. Cross-sectional and case-control studies that reported either the prevalence or odds ratio [OR] of MetS or its components in vitiligo patients were included. Data were pooled using either random-effects model or fixed-effects model according to the heterogeneity.
RESULTS
Thirty studies with a total of 28,325 vitiligo patients were included. Significant associations were found between vitiligo and diabetes mellitus (pooled OR, 3.30; 95 % confidence interval [CI], 2.10-5.17) and between vitiligo and obesity (pooled OR, 2.08; 95 % CI, 1.40-3.11). The overall prevalence of hypertension in the patients with vitiligo was 19.0 % (95 % CI, 2.0 %-36.0 %).
CONCLUSIONS
Our findings suggest the association of vitiligo with diabetes mellitus, obesity, and hypertension. It is recommended for dermatologists to take these associations into account so as to identify potential comorbidities promptly in vitiligo patients. Additionally, vitiligo patients are advised to monitor the indexes including BMI, blood glucose, and blood pressure levels and the consultation with specialists is necessary upon abnormal changes of these indexes.
Topics: Cross-Sectional Studies; Diabetes Mellitus; Humans; Hypertension; Metabolic Syndrome; Obesity; Vitiligo
PubMed: 35499212
DOI: 10.1111/ddg.14717 -
Expert Review of Clinical Pharmacology Mar 2022Vitiligo is a common cutaneous depigmentation disorder. Although multiple treatment options are available, no single modality is satisfactory for all patients. Several... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitiligo is a common cutaneous depigmentation disorder. Although multiple treatment options are available, no single modality is satisfactory for all patients. Several studies have demonstrated that prostaglandin analogues can potentially treat cutaneous depigmentation, but the evidence is limited to their inconsistent study design.
RESEARCH DESIGN & METHODS
A systematic review was performed for studies published before 29 June 2021, in PubMed, Embase, Web of Science, or the Cochrane Library. The primary outcome of pooled analysis was the repigmentation efficacy of local prostaglandin analogues compared with other therapies for vitiligo.
RESULTS
Six randomized controlled trials (RCTs) and three non-RCTs were included in this systematic review, and seven studies among them were used for the meta-analysis. The pooled analysis demonstrated that local prostaglandin analogues could significantly increase repigmentation along with narrowband ultraviolet B phototherapy compared with phototherapy alone. Furthermore, the repigmentation efficacy of topical prostaglandin analogues was not significantly different from that of topical tacrolimus. In summary, local prostaglandin analogues either used alone or as add-on therapy could be safe and effective therapies for vitiligo.
Topics: Combined Modality Therapy; Humans; Phototherapy; Prostaglandins, Synthetic; Tacrolimus; Treatment Outcome; Ultraviolet Therapy; Vitiligo
PubMed: 35473496
DOI: 10.1080/17512433.2022.2071699 -
International Immunopharmacology Aug 2022This systematic review was to assess the effects of phototherapies (psoralen plus ultraviolet A [PUVA], narrowband ultraviolet B [NBUVB], or 308 nm excimer laser [EL])...
OBJECTIVES
This systematic review was to assess the effects of phototherapies (psoralen plus ultraviolet A [PUVA], narrowband ultraviolet B [NBUVB], or 308 nm excimer laser [EL]) in combination with vitamin D analogs compared with phototherapy alone on vitiligo.
METHODS
Four databases were searched up to 18 October 2021 for relevant studies. The primary outcome was the proportion of response to treatment (≥50% repigmentation) after treatment. Secondary outcomes included excellent response, treatment failure, and safety. The risk ratio (RR) was used as the estimate measure in meta-analyses.
RESULTS
Fourteen studies (n = 642) were included. The meta-analyses showed that the combination of either calcipotriol or tacalcitol and NBUVB was superior to NBUVB monotherapy for vitiligo in the proportion of response to treatment (RR 1.67, 95% CI 1.21-2.31), treatment failure (RR 0.43, 95% CI 0.22-0.85), and excellent response (RR 7.48, 95% CI 1.09-51.13). The tacalcitol was more effective than calcipotriol in increasing the rate of response to treatment when combined with NBUVB (RR 2.25 versus 1.24, interaction p = 0.002). The results did not support better efficacy with the combination of PUVA or EL with vitamin D analogs over phototherapy alone in all outcomes. Adverse events were minor and transient.
CONCLUSIONS
The current evidence suggests that the additional use of topical calcipotriol or tacalcitol to NB-UVB may increase the treatment effect of vitiligo, and the effect of tacalcitol is greater than that of calcipotriol. None of the vitamin D analogs were found to enhance the efficacy of PUVA or EL for vitiligo.
Topics: Humans; Phototherapy; Randomized Controlled Trials as Topic; Treatment Outcome; Ultraviolet Therapy; Vitamin D; Vitiligo
PubMed: 35468365
DOI: 10.1016/j.intimp.2022.108789