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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 42681

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Dr. Simone Garcovich

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Department of Dermatology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
Interests: dermatology; skin; keratinocytes; surgical and procedural dermatology; skin cancer; pruritus; personalized medicine; regenerative medicine; hair follicle; acne
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Dr. Elena Pezzolo

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1. Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
2. Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
Interests: dermatology; psoriasis; atopic dermatitis; skin; keratinocytes; clinical dermatology; skin cancer; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Skin diseases cause a substantial burden in terms of worldwide morbidity, yet epidemiological data are limited for several cutaneous conditions both at the population and clinical levels. Noncommunicable chronic skin diseases are increasing in prevalence worldwide and are associated with long-term morbidity, impairment, and mortality, thus requiring increased epidemiological surveillance and preventive measures. Skin cancer and aging-related skin disorders are on the rise, requiring increased epidemiological surveillance and interventions. The wide disease spectrum and the heterogeneous terminology and coding of most skin conditions require novel investigative approaches to epidemiological studies. Epidemiological factors influence current and future clinical practices of dermatology, and at the same time, novel preventive diagnostic and therapeutic concepts may alter the epidemiology and burden of skin diseases. This Special Issue, “Clinical Epidemiology of Skin Disease” is now open for submissions and is focused on the different epidemiological aspects of mucocutaneous conditions, including descriptive epidemiology, clinical burden, outcome measures, quality of life, cost and utility analysis, care models, preventive, and diagnostic and therapeutic measures across the dermatological disease spectrum.

Dr. Simone Garcovich
Dr. Elena Pezzolo
Guest Editors

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Keywords

global health and statistics and numerical data
dermatology and trends
skin diseases and diagnosis
skin diseases and epidemiology
skin neoplasms and diagnosis
skin neoplasms and epidemiology
prevalence
mortality trends
prevention and control
statistics and numerical data
noncommunicable diseases and therapy

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Related Special Issue

Clinical Epidemiology of Skin Diseases—Part II in Journal of Clinical Medicine (4 articles)

Published Papers (11 papers)

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8 pages, 260 KiB

Open AccessArticle

by Luca Fania, Giulia Giovanardi, Tonia Samela, Dante Caposiena, Andrea Chiricozzi, Flaminia Antonelli, Pierluigi Saraceni, Fulvia Elia, Simone Garcovich, Davide Ciccone, Maria Vittoria Cannizzaro, Emanuele Miraglia, Chiara Iacovino, Sandra Giustini, Nevena Skroza, Alessandra Mambrin, Concetta Potenza, Luca Bianchi, Ketty Peris and Damiano Abeni

J. Clin. Med. 2022, 11(14), 4037; https://doi.org/10.3390/jcm11144037 - 12 Jul 2022

Viewed by 1865

Abstract

Adalimumab is the only biologic agent approved for the treatment of moderate-to-severe hidradenitis suppurativa (HS) patients (i.e., with Hurley II or III), which is recommended in two different maintenance doses (i.e., 40 mg weekly or 80 mg every two weeks). We conducted a prospective multicentric study to measure outcomes related to the severity of disease and quality of life (QoL) of patients affected by moderate-to-severe HS, treated with adalimumab at a maintenance dosing of 40 mg or 80 mg. Assessments were performed at baseline (T0) and after 32 weeks of treatment (T32). We enrolled 85 moderate-to-severe HS Italian patients, 43 men (50.6%) and 42 women, aged between 16 and 62 years (median 31 years, interquartile range 24.4–43.8). Statistically significant improvements were observed for clinical status (with a mean reduction of 7.1 points for the International Hidradenitis Suppurativa Severity Score System (IHS4)), pain levels (3.1 mean decrease in VAS), and QoL (3.4 mean improvement in DLQI score). Patients with no comorbidities, and those with higher levels of perceived pain showed significantly greater improvement in QoL than their counterpart from T0 to T32. As for the proportion of patients who at follow-up reached the minimal clinical important difference (MCID) in QoL, significantly higher proportions of success were observed for age (patients in the 29–39 category), pain (patients with higher reported pain), and Hurley stage III. While both treatment regimen groups (i.e., 40 vs. 80 mg) improved significantly, no statistical differences were observed when comparing the two treatment dosages. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

10 pages, 2110 KiB

Open AccessArticle

Patient Visits and Prescribing Patterns Associated with Rosacea in Korea: A Real-World Retrospective Study Based on Electronic Medical Records

by Yu Ri Woo, Hyun Jeong Ju, Jung Min Bae, Minah Cho, Sang Hyun Cho and Hei Sung Kim

J. Clin. Med. 2022, 11(6), 1671; https://doi.org/10.3390/jcm11061671 - 17 Mar 2022

Cited by 2 | Viewed by 2277

Abstract

Rosacea is a common and chronic inflammatory skin disorder. The visiting trends and prescribing patterns involving Korean patients with rosacea have not been thoroughly examined. To examine the visiting trends of patients with rosacea, and to analyze the prescription patterns of Korean dermatologists managing such patients, a retrospective cross-sectional study on dermatology outpatients who visited the seven affiliated hospitals of The Catholic University of Korea between 2007 and 2018 was performed. A total of 56,651 visits were made by rosacea patients. The mean annual number of hospital visits made by rosacea patients over a 6-year period increased from 2456 in 2007–2012 to 6985 in 2013–2018. Hospital visits were most prevalent in female patients aged 40 to 59 years. There was no statistically significant difference in patient visitation between the seasons. As for prescriptions, systemic antibiotics were most commonly prescribed, followed by antihistamines, non-steroidal anti-inflammatory drugs, and retinoids. Among the topical agents, metronidazole was the most prescribed agent during 2007–2012, whereas calcineurin inhibitors were favored most during 2013–2018. Dermatology outpatient visits by individuals with rosacea have increased in Korea over time. The real-world prescription trend presented here may help dermatologists facilitate better treatment strategies and provide appropriate guidance to patients with rosacea. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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16 pages, 2095 KiB

Open AccessArticle

Chronic Plaque Psoriasis in Poland: Disease Severity, Prevalence of Comorbidities, and Quality of Life

by Dorota Purzycka-Bohdan, Anna Kisielnicka, Monika Zabłotna, Bogusław Nedoszytko, Roman J. Nowicki, Adam Reich, Dominik Samotij, Justyna Szczęch, Dorota Krasowska, Joanna Bartosińska, Joanna Narbutt, Aleksandra Lesiak, Paulina Barasińska, Agnieszka Owczarczyk-Saczonek, Joanna Czerwińska, Jacek C. Szepietowski, Aleksandra Batycka-Baran, Rafał Czajkowski, Magdalena Górecka-Sokołowska, Lidia Rudnicka, Joanna Czuwara, Marta Sobalska-Kwapis, Dominik Strapagiel and Aneta Szczerkowska-Dobosz Show full author list Hide full author list

J. Clin. Med. 2022, 11(5), 1254; https://doi.org/10.3390/jcm11051254 - 25 Feb 2022

Cited by 12 | Viewed by 3189

Abstract

The epidemiology of psoriasis has not been widely assessed in Polish population so far. This study aimed to investigate psoriasis epidemiological situation by evaluating disease course and severity, management, comorbidities, environmental factors, and knowledge about this disorder among psoriatic patients in Poland. A cross-sectional cohort population-based study enrolled 1080 psoriatic patients and 1200 controls. The mean age of psoriasis onset was 27.6 years; 78.24% had type I psoriasis. Positive family history of psoriasis was reported in 44.81% of patients, whereas itch was reported in vast majority of patients (83.33%). Based on PASI score moderate psoriasis was the most common in studied group (mean 12.63 ± 9.33, range 0–67.2). The DLQI score (12.01 ± 7.41, range 0–30.0) indicated a very large effect of psoriasis on the quality of life. Hypertension was the most prevalent comorbidity (33.80%), followed by obesity (16.85%) and dyslipidemia (11.85%). Stress was the foremost cause of disease exacerbation (66.20%); however, infections (44.07%) and seasonal changes (45.09%) had also an impact on the course of psoriasis. Psoriatic patients were more often smokers (37.59%) vs. general population (27.50%; p < 0.0001). In conclusion, epidemiological studies help clinicians in better disease and patient understanding, which may translate into better management and patient compliance. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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10 pages, 941 KiB

Open AccessArticle

Alexithymia in Adolescents with Acne: Association with Quality of Life Impairment and Stigmatization

by Marta Szepietowska, Alicja Dąbrowska, Bernadetta Nowak, Katarzyna Skinderowicz, Bartosz Wilczyński, Piotr K. Krajewski and Alina Jankowska-Konsur

J. Clin. Med. 2022, 11(3), 732; https://doi.org/10.3390/jcm11030732 - 29 Jan 2022

Cited by 6 | Viewed by 2650

Abstract

Alexithymia seems to be more common among patients with skin diseases. However, studies on acne patients are very limited. We conducted this study to evaluate alexithymia in adolescents with acne. In our cross-sectional study, 730 high school students (mean age: 17.05 ± 1.18 years) were recruited. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Dermatology Life Quality Index (DLQI) was employed to study quality of life (QoL), and the 6-item Stigmatization Scale (6ISS) was used to evaluate the level of stigmatization in acne subjects. Alexithymia was found in 31% of adolescents, with similar prevalence among those with and without acne (31.3% and 30.1%, respectively). The mean scoring on the TAS-20 in patients with acne (53.1 ± 12.8 points) was not significantly different from that of the non-acne group (53.5 ± 11.9 points). However, significant correlations between TAS-20 scores and QoL assessments (r = 0.332, p < 0.001) as well as stigmatization level (r = 0.284, p < 0.001) were found. These correlations were also significant for the domains of alexithymia described as difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF), but not for externally oriented thinking (EOT). The findings clearly showed that acne does not predispose to alexithymia; however, alexithymia in acne subjects is related to impaired QoL and stigmatization. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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12 pages, 804 KiB

Open AccessArticle

Epidemiology, Comorbidities, and Prescription Patterns of Korean Prurigo Nodularis Patients: A Multi-Institution Study

by Yu-Ri Woo, Sehee Wang, Kyung-Ah Sohn and Hei-Sung Kim

J. Clin. Med. 2022, 11(1), 95; https://doi.org/10.3390/jcm11010095 - 24 Dec 2021

Cited by 17 | Viewed by 3822

Abstract

Prurigo nodularis (PN) is a chronic dermatosis typified by extraordinarily itchy nodules. However, little is known of the nature and extent of PN in Asian people. This study aimed to describe the epidemiology, comorbidities, and prescription pattern of PN in Koreans based on a large dermatology outpatient cohort. Patients with PN were identified from the Catholic Medical Center (CMC) clinical data warehouse. Anonymized data on age, sex, diagnostic codes, prescriptions, visitation dates, and other relevant parameters were collected. Pearson correlation analysis was used to calculate the correlation between PN prevalence and patient age. Conditional logistic regression modeling was adopted to measure the comorbidity risk of PN. A total of 3591 patients with PN were identified at the Catholic Medical Center Health System dermatology outpatient clinic in the period 2007–2020. A comparison of the study patients with age- and sex-matched controls (dermatology outpatients without PN) indicated that PN was associated with various comorbidities including chronic kidney disease (adjusted odds ratio (aOR), 1.48; 95% confidence interval (CI), 1.29–1.70), dyslipidemia (aOR, 1.88; 95% CI, 1.56–2.27), type 2 diabetes mellitus (aOR, 1.37; 95% CI, 1.22–1.54), arterial hypertension (aOR, 1.50; 95% CI, 1.30–1.73), autoimmune thyroiditis (aOR, 2.43; 95% CI, 1.42–4.16), non-Hodgkin’s lymphoma (aOR, 1.95; 95% CI, 1.23–3.07), and atopic dermatitis (aOR, 2.16, 95% CI, 1.91–2.45). Regarding prescription patterns, topical steroids were most favored, followed by topical calcineurin inhibitors; oral antihistamines were the most preferred systemic agent for PN. PN is a relatively rare but significant disease among Korean dermatology outpatients with a high comorbidity burden compared to dermatology outpatients without PN. There is great need for breakthroughs in PN treatment. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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13 pages, 1291 KiB

Open AccessArticle

Non-Melanoma Skin Cancer Mortality in Spain: A Predictive Model up to 2044

by Mercedes Sendín-Martin, Juan Carlos Hernández-Rodríguez, Antonio-José Durán-Romero, Juan Ortiz-Álvarez, Julian Conejo-Mir and José-Juan Pereyra-Rodríguez

J. Clin. Med. 2021, 10(24), 5750; https://doi.org/10.3390/jcm10245750 - 8 Dec 2021

Cited by 7 | Viewed by 2297

Abstract

Non-melanoma skin cancers (NMSC) are the most common malignancies worldwide and are, worryingly, increasing in incidence. However, data in the literature on NMSC specific mortality are scarce, because these tumors are excluded from most mortality registries. The main objective of this study is to analyze NMSC’s mortality rates and use them to generate a predictive model for the coming years in Spain. Data on mid-year population and death certificates for the period 1979–2019 were obtained from the Spanish National Statistics Institute. The Nordpred program (Cancer Registry of Norway, Oslo, Norway) within statistical program R was used to calculate mortality adjusted rates, as well as the mortality projection with an age-period-cohort model. This is the first study to report a prediction about NMSC mortality in the next years. According to our findings, the number of NMSC deaths in older people will grow in both sexes, especially in those older than >85 years old (y.o.). The age-specific mortality rates of NMSC will tend to stabilize or gradually decrease, with the exception of women between 75–79 y.o., who will present a slight increase at the end of the period. Early prevention and screening of NMSC specifically oriented to this population might change this tendency. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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14 pages, 817 KiB

Open AccessArticle

A Network Analysis of Drug Combinations Associated with Acute Generalized Exanthematous Pustulosis (AGEP)

by Adrian Martinez-De la Torre, Eva van Weenen, Mathias Kraus, Stefan Weiler, Stefan Feuerriegel and Andrea M. Burden

J. Clin. Med. 2021, 10(19), 4486; https://doi.org/10.3390/jcm10194486 - 29 Sep 2021

Cited by 10 | Viewed by 3588

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a rare skin adverse drug reaction. The pathophysiology and causative drugs associated with AGEP are poorly understood, with the majority of studies in AGEP focusing on a single-drug-outcome association. We therefore aimed to explore and characterize frequently reported drug combinations associated with AGEP using the WHO pharmacovigilance database VigiBase. In this explorative cross-sectional study of a pharmacovigilance database using a data-driven approach, we assessed individual case safety reports (ICSR) with two or more drugs reported to VigiBase. A total of 2649 ICSRs reported two or more drugs. Cardiovascular drugs, including antithrombotics and beta-blockers, were frequently reported in combination with other drugs, particularly antibiotics. The drug pair of amoxicillin and furosemide was reported in 57 ICSRs (2.2%), with an O/E ratio of 1.3, and the combination of bisoprolol and furosemide was recorded 44 times (1.7%), with an O/E ratio of 5.5. The network analysis identified 10 different communities of varying sizes. The largest cluster primarily consisted of cardiovascular drugs. This data-driven and exploratory study provides the largest real-world assessment of drugs associated with AGEP to date. The results identify a high frequency of cardiovascular drugs, particularly used in combination with antibiotics. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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9 pages, 1091 KiB

Open AccessArticle

Height and Risk of Vitiligo: A Nationwide Cohort Study

by Young-Bok Lee and Hei-Sung Kim

J. Clin. Med. 2021, 10(17), 3958; https://doi.org/10.3390/jcm10173958 - 31 Aug 2021

Cited by 1 | Viewed by 2995

Abstract

Adult height is linked to the risk of several diseases, but its association with vitiligo has not been established. This study aimed to investigate the relationship between adult height and vitiligo incidence. Korean nationwide claims data from 15,980,754 individuals (20 years of age or older) who received a health checkup during the period 2005–2008, were examined. Subjects were categorized into age- and gender-specific height quintiles. Participants were followed until vitiligo diagnosis or until the end of 2015. The Cox proportional-hazards model for cumulative risk was computed for height categories. During the follow-up period, 29,196 cases (136,020,214 person-years) of newly diagnosed vitiligo were reported. A positive association was found between height and risk of vitiligo in which the hazard ratio between the highest and lowest quintiles of height was 1.36 (95% confidence interval: 1.31–1.42). While more diverse cohort studies are needed, our findings suggest that taller stature increases the risk of vitiligo. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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Review

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14 pages, 1645 KiB

Open AccessReview

Tinea Gladiatorum: Epidemiology, Clinical Aspects, and Management

by Adam Zalewski, Mohamad Goldust and Jacek Cezary Szepietowski

J. Clin. Med. 2022, 11(14), 4066; https://doi.org/10.3390/jcm11144066 - 14 Jul 2022

Cited by 4 | Viewed by 5569

Abstract

Tinea gladiatorum (TG) is a fungal skin infection that occurs among wrestlers and other contact sport athletes with a varied prevalence rate. The most common causative factor responsible as well for local outbreaks of the infection is an anthropophilic dermatophyte species—Trichophyton tonsurans (T. tonsurans). The purpose of this study was to gather current data about TG, including epidemiology, possible diagnosing methods, clinical features, treatment approaches, and potential prevention techniques. We also performed a systematic review of studies describing TG incidence. The prevalence of the disease varied from 2.4% up to 100%. That wide range of variability forces medical practitioners to update knowledge about TG and points to the fact that it still may be a diagnostic and therapeutic challenge. Spreading awareness among athletes and trainers is one of the most important preventive steps. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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22 pages, 399 KiB

Open AccessReview

Drug Triggers and Clinic of Acute Generalized Exanthematous Pustulosis (AGEP): A Literature Case Series of 297 Patients

by Enriqueta Vallejo-Yagüe, Adrian Martinez-De la Torre, Omar S. Mohamad, Shweta Sabu and Andrea M. Burden

J. Clin. Med. 2022, 11(2), 397; https://doi.org/10.3390/jcm11020397 - 13 Jan 2022

Cited by 17 | Viewed by 4592

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a rare skin reaction, commonly caused by drugs. Available evidence mostly relies on small studies or case reports. We collected published AGEP case reports and, subsequently, described the patient characteristics, suspect and concomitant drugs, time to onset, disease management, and clinical prognosis. This study included 297 AGEP patients (64.3% women) obtained from 250 published case reports or case series with individual patient data. AGEP affected patients of all ages, but the majority of patients (88.2%) were ≥25 years old. The most frequently reported suspect drugs were anti-infectives for systemic use (36.5%), particularly antibacterials for systemic use (31.0%), and especially beta-lactam antibacterials (18.3%) and macrolides (4.3%). Other frequent suspect drugs were antineoplastics (12.2%), and anti-inflammatory/anti-rheumatic products (5.2%) plus hydroxychloroquine (12.8%). Mean time to onset was 9.1 days (standard deviation SD 13.94). Some patients developed fever (64.3%) and systemic involvement (18.9%), and most patients (76.4%) received pharmacological treatment for AGEP. Seven patients died, although five of them were already critically ill prior to AGEP. In conclusion, antibiotics remain the most common suspected cause of AGEP. While case mortality rate may be up to 2.5%, disentangling the role of AGEP on the fatal outcome from the role of the preexisting health conditions remains challenging. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

21 pages, 16650 KiB

Open AccessReview

Pili Torti: A Feature of Numerous Congenital and Acquired Conditions

by Aleksandra Hoffmann, Anna Waśkiel-Burnat, Jakub Żółkiewicz, Leszek Blicharz, Adriana Rakowska, Mohamad Goldust, Małgorzata Olszewska and Lidia Rudnicka

J. Clin. Med. 2021, 10(17), 3901; https://doi.org/10.3390/jcm10173901 - 30 Aug 2021

Cited by 12 | Viewed by 7533

Abstract

Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs.-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended. Full article

(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases)

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