Background: Morbihan's disease (MD), also known as solid persistent facial edema, solid facial ly... more Background: Morbihan's disease (MD), also known as solid persistent facial edema, solid facial lymphedema or rosacea lymphedema, is a rare condition. Objective: Despite existing case reports and literature reviews, clinical guidance for diagnosis and management is lacking. This review aims to provide comprehensive information on the etiology, differential diagnoses, diagnostics, and management of MD. Methods: PubMed was searched up to April 2023 for relevant studies on MD with no language restriction. Furthermore, references were checked of found reports. Results: A comprehensive overview of the literature and clinical guidance for MD. We found 95 studies involving 166 patients (118 male, 46 female and 2 gender unreported) evaluating management options, categorized into: isotretinoin (16 studies), isotretinoin plus antihistamines (8), isotretinoin plus corticosteroids (8), antibiotics (13), antibiotics plus corticosteroids (7), surgical debulking (10) and miscellaneous/combination treatments (43). Some studies contributed to two categories. Treatment with isotretinoin as monotherapy or combined with antihistamines, doxycycline or minocycline as well as surgical procedures demonstrated mostly satisfactory results, although recurrences were common. Longer treatment duration, of at least 6 to 12 months, is recommended for pharmacological treatments. Adding systemic or intralesional corticosteroids to previous treatments may be beneficial. Manual lymph drainage seems to contribute to satisfying result. Limitations: This is not a systematic review and randomized controlled trials are lacking. Conclusion: Diagnosis of MD is based on specific clinical features and excluding diseases with similar appearance. Prolonged treatment is often necessary to obtain satisfactory results, which might be limited to a partial and/or temporary response.
Journal of the European Academy of Dermatology and Venereology
Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermato... more Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer‐reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T‐related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the I...
The HOME initiative has successfully completed a core outcome set for atopic dermatitis (AD) tria... more The HOME initiative has successfully completed a core outcome set for atopic dermatitis (AD) trials, and most trials now include the core set instruments. However, to enable evidence synthesis of all relevant trials, reporting must also be standardized. In this study, we evaluated the reporting of the core outcome set instruments in AD systemic treatment trials included in a living systematic review and network meta-analysis. We found that although the core instruments were measured in most trials, they were often not reported sufficiently to enable inclusion in network meta-analysis.
This editorial for the British Journal of Dermatology provides an update from a patient editor po... more This editorial for the British Journal of Dermatology provides an update from a patient editor point of view.
ImportanceMeasuring outcomes in clinical practice can aid patient care, quality improvement, and ... more ImportanceMeasuring outcomes in clinical practice can aid patient care, quality improvement, and real-world evidence generation. The Harmonising Outcome Measures for Eczema (HOME) Clinical Practice initiative is developing a list of validated, feasible instruments to measure atopic eczema in clinical care. Prior work identified symptoms and long-term control as the most important domains to measure in clinical practice. The Patient-Oriented Eczema Measure (POEM) and the Patient-Oriented Scoring Atopic Dermatitis Index (PO-SCORAD) were recommended by consensus to measure symptoms in clinical practice, but a need for instruments to measure itch intensity specifically was recognized. The HOME group also previously decided that long-term control should be captured by repeated measurements of eczema control. Recommended instruments to measure eczema control in clinical practice have not been defined.ObjectiveTo recommend instruments to measure eczema control and itch intensity in patient...
Background A rapid expansion of systemic immunological treatment options for atopic dermatitis (A... more Background A rapid expansion of systemic immunological treatment options for atopic dermatitis (AD) has created a need for clinically relevant and understandable comparative efficacy and safety information for patients and clinicians. Given the scarcity of head-to-head trials, network meta-analysis (NMA) is an alternative way to enable robust comparisons among treatment options; however, NMA results are often complex and difficult to directly implement in shared decision-making. Objective The aim of this study is to develop a website that effectively presents the results of a living systematic review and NMA on AD treatments to patient and clinician users. Methods We conducted a multimethod study using iterative feedback from adults with AD, adult caregivers of children with AD, dermatologists, and allergists within a user-centered design framework. We used questionnaires followed by workshops among patients and clinicians to develop and improve the website interface. Usability test...
The ACCORD (ACcurate COnsensus Reporting Document) reporting guideline will provide a set of mini... more The ACCORD (ACcurate COnsensus Reporting Document) reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes.
Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% o... more Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% of children and between 2 and 15% of the adults in Western Europe. Since 2000, therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus (S.) aureus. Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point, there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD. Methods This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with moderat...
Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protoc... more Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents.
Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% o... more Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% of children and between 2 and 15% of the adults in Western Europe. Since 2000, therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus ( S .) aureus . Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point, there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD. Methods This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with mode...
Education and coaching that focuses on both somatic and psychosocial aspects, is an essential par... more Education and coaching that focuses on both somatic and psychosocial aspects, is an essential part of the treatment of patients with atopic dermatitis. These interventions are important to reinforce self-management of the patient. Education and coaching by nurses, via outpatient visits or eHealth, seems to be effective and cost-saving.
References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World ... more References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World J Pediatr 2017;13:405–15. 2. GoswamiM, BhushanU, Jangra B.Goldenhar syndrome: a case report with review. Int J Clin Pediatr Dent 2016;9:278–80. 3. Vong A, Funamura J. Multidisciplinary management of oculoauriculo-vertebral spectrum. Curr Opin Otolaryngol Head Neck Surg 2018;26:234–41. 4. Chae JB, Park JT, Kim BR, Shin JW. Agminated eruptive pyogenic granuloma on chin following redundant needle injections. J Dermatol 2016;43:577–8. 5. Said J,Hoda ST,Muhlrad S. Pyogenic granuloma: a tumor thatmimics infection. JAAPA 2018;31:27–9.
Background: Morbihan's disease (MD), also known as solid persistent facial edema, solid facial ly... more Background: Morbihan's disease (MD), also known as solid persistent facial edema, solid facial lymphedema or rosacea lymphedema, is a rare condition. Objective: Despite existing case reports and literature reviews, clinical guidance for diagnosis and management is lacking. This review aims to provide comprehensive information on the etiology, differential diagnoses, diagnostics, and management of MD. Methods: PubMed was searched up to April 2023 for relevant studies on MD with no language restriction. Furthermore, references were checked of found reports. Results: A comprehensive overview of the literature and clinical guidance for MD. We found 95 studies involving 166 patients (118 male, 46 female and 2 gender unreported) evaluating management options, categorized into: isotretinoin (16 studies), isotretinoin plus antihistamines (8), isotretinoin plus corticosteroids (8), antibiotics (13), antibiotics plus corticosteroids (7), surgical debulking (10) and miscellaneous/combination treatments (43). Some studies contributed to two categories. Treatment with isotretinoin as monotherapy or combined with antihistamines, doxycycline or minocycline as well as surgical procedures demonstrated mostly satisfactory results, although recurrences were common. Longer treatment duration, of at least 6 to 12 months, is recommended for pharmacological treatments. Adding systemic or intralesional corticosteroids to previous treatments may be beneficial. Manual lymph drainage seems to contribute to satisfying result. Limitations: This is not a systematic review and randomized controlled trials are lacking. Conclusion: Diagnosis of MD is based on specific clinical features and excluding diseases with similar appearance. Prolonged treatment is often necessary to obtain satisfactory results, which might be limited to a partial and/or temporary response.
Journal of the European Academy of Dermatology and Venereology
Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermato... more Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer‐reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T‐related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the I...
The HOME initiative has successfully completed a core outcome set for atopic dermatitis (AD) tria... more The HOME initiative has successfully completed a core outcome set for atopic dermatitis (AD) trials, and most trials now include the core set instruments. However, to enable evidence synthesis of all relevant trials, reporting must also be standardized. In this study, we evaluated the reporting of the core outcome set instruments in AD systemic treatment trials included in a living systematic review and network meta-analysis. We found that although the core instruments were measured in most trials, they were often not reported sufficiently to enable inclusion in network meta-analysis.
This editorial for the British Journal of Dermatology provides an update from a patient editor po... more This editorial for the British Journal of Dermatology provides an update from a patient editor point of view.
ImportanceMeasuring outcomes in clinical practice can aid patient care, quality improvement, and ... more ImportanceMeasuring outcomes in clinical practice can aid patient care, quality improvement, and real-world evidence generation. The Harmonising Outcome Measures for Eczema (HOME) Clinical Practice initiative is developing a list of validated, feasible instruments to measure atopic eczema in clinical care. Prior work identified symptoms and long-term control as the most important domains to measure in clinical practice. The Patient-Oriented Eczema Measure (POEM) and the Patient-Oriented Scoring Atopic Dermatitis Index (PO-SCORAD) were recommended by consensus to measure symptoms in clinical practice, but a need for instruments to measure itch intensity specifically was recognized. The HOME group also previously decided that long-term control should be captured by repeated measurements of eczema control. Recommended instruments to measure eczema control in clinical practice have not been defined.ObjectiveTo recommend instruments to measure eczema control and itch intensity in patient...
Background A rapid expansion of systemic immunological treatment options for atopic dermatitis (A... more Background A rapid expansion of systemic immunological treatment options for atopic dermatitis (AD) has created a need for clinically relevant and understandable comparative efficacy and safety information for patients and clinicians. Given the scarcity of head-to-head trials, network meta-analysis (NMA) is an alternative way to enable robust comparisons among treatment options; however, NMA results are often complex and difficult to directly implement in shared decision-making. Objective The aim of this study is to develop a website that effectively presents the results of a living systematic review and NMA on AD treatments to patient and clinician users. Methods We conducted a multimethod study using iterative feedback from adults with AD, adult caregivers of children with AD, dermatologists, and allergists within a user-centered design framework. We used questionnaires followed by workshops among patients and clinicians to develop and improve the website interface. Usability test...
The ACCORD (ACcurate COnsensus Reporting Document) reporting guideline will provide a set of mini... more The ACCORD (ACcurate COnsensus Reporting Document) reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes.
Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% o... more Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% of children and between 2 and 15% of the adults in Western Europe. Since 2000, therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus (S.) aureus. Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point, there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD. Methods This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with moderat...
Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protoc... more Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents.
Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% o... more Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% of children and between 2 and 15% of the adults in Western Europe. Since 2000, therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus ( S .) aureus . Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point, there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD. Methods This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with mode...
Education and coaching that focuses on both somatic and psychosocial aspects, is an essential par... more Education and coaching that focuses on both somatic and psychosocial aspects, is an essential part of the treatment of patients with atopic dermatitis. These interventions are important to reinforce self-management of the patient. Education and coaching by nurses, via outpatient visits or eHealth, seems to be effective and cost-saving.
References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World ... more References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World J Pediatr 2017;13:405–15. 2. GoswamiM, BhushanU, Jangra B.Goldenhar syndrome: a case report with review. Int J Clin Pediatr Dent 2016;9:278–80. 3. Vong A, Funamura J. Multidisciplinary management of oculoauriculo-vertebral spectrum. Curr Opin Otolaryngol Head Neck Surg 2018;26:234–41. 4. Chae JB, Park JT, Kim BR, Shin JW. Agminated eruptive pyogenic granuloma on chin following redundant needle injections. J Dermatol 2016;43:577–8. 5. Said J,Hoda ST,Muhlrad S. Pyogenic granuloma: a tumor thatmimics infection. JAAPA 2018;31:27–9.
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