No abstract

Contact allergy to at least one allergen of the European baseline series was diagnosed in more than one-quarter of the general European population. Therefore measures to improve the primary prevention of contact allergy have to be enforced.

This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Acta Derm Venereol 2020; 100: adv00160 Centenary theme section: ATOPIC DERMATITIS SIGNIFICANCEAtopic dermatitis is common, and is often burdensome for the individual. An overview of how often AD occurs is therefore necessary. A systematic review was performed, which included more than 7,000 articles with data from all continents, on children and adults. Each year, up to 17.1% of adults and 22.6% of children were diagnosed with AD; with as many as 9.6% new cases of AD in children. Surprisingly, in adults, studies on new cases were from the 20 th century. The results will be useful for patient organizations, physicians, scientists and healthcare planning, especially as new therapies are emerging.The primary objective of this study was to systematically review and analyse epidemiological studies of the prevalence and incidence of atopic dermatitis (AD) during childhood and adulthood, focusing on data from the 21 st century. A systematic search of PubMed, EMBASE and Google (manual search) was performed in June 2019, followed by data abstraction and study quality assessment (Newcastle-Ottawa Scale). Cross-sectional and longitudinal epidemiological studies of individuals with AD (doctor-diagnosed or standardized definition) were included. Of 7,207 references reviewed, 378 moderate/good-quality studies were included: 352 on prevalence of AD and 26 on incidence of AD. In the 21 st century, the 1-year prevalence of doctor-diagnosed AD ranged from 1.2% in Asia to 17.1% in Europe in adults, and 0.96% to 22.6% in children in Asia. The 1-year incidence ranged from 10.2 (95% confidence interval (95% CI) 9.9-10.6) in Italy to 95.6 (95% CI 93.4-97.9) per 1,000 person-years in children in Scotland. There were few recent studies on incidence of AD in the 21 st century and no studies on adults only; most studies were conducted in Europe and the USA. Epidemiological studies on childhood and adulthood AD in different continents are still needed, especially on the incidence of AD during adulthood.

Background: The calcipotriol/betamethasone dipropionate two-compound product is safe and effective in the short-term treatment of psoriasis. Objective: The primary objective was to investigate the safety of two treatment regimens involving use of the two-compound product over 52 weeks. The efficacy results are presented here. Methods: Six hundred and thirty-four patients were randomised double-blind to treatment (once daily, when required) with either: 52 weeks of two-compound product (two-compound group), 52 weeks of alternating 4-week periods of two-compound product and calcipotriol (alternating group), or 4 weeks of two-compound product followed by 48 weeks of calcipotriol (calcipotriol group). Results: There was a trend towards a difference between treatments from the overall treatment effect for the percentage of satisfactory responses for each patient during the study (p = 0.071). This appeared to be due to the comparison of the two-compound and calcipotriol groups (p = 0.025). Conclusion: There was a trend towards the efficacy of the two-compound product used for up to 52 weeks being better than that of 4 weeks of the two-compound product followed by 48 weeks of calcipotriol.

This study shows that skin complaints referring to the most common chronic skin diseases varied with age, gender and marital status, and worsened with middle-income household. It provides evidence that household income is associated with skin morbidity, bringing dermatological aspects to studies on health inequalities.

Treatment with methotrexate or ciclosporin for chronic plaque psoriasis brings satisfactory disease control, improved quality of life and tolerable side-effects. A statistically significant difference in effectiveness between treatment groups was recorded, showing ciclosporin to be more effective than methotrexate in a short-term perspective.

This study aims to describe the range of treatment comparisons, study designs and quality of reporting of randomized clinical trials (RCTs) in psoriasis published in a variety of medical and dermatological journals, and to analyze time trends with quality items. Hand-searching of clinical trials of psoriasis published from 1977 to 2000 in 13 medical or dermatological journals, selected as relevant to a European readership, was performed. A total of 249 trials published in 226 papers were classified as RCTs. Of these, 139 (55.8%) employed a parallel control group design, 107 (43.0%) studies adopted a self-control design and 3 (1.2%) a cross-over design. The median number of patients recruited per study was 40 (range 6-699). Overall, 55 different treatment modalities, including topical, ultraviolet-based, systemic, and other miscellaneous therapies were assessed. Only 31 (12.5%) RCTs were comparative studies of treatment modalities in different therapeutic classes. Most of the studies were short-term with a median study duration of 7 weeks (range 1-104), with only 18 studies (7.2%) lasting for more than four months. A variety of outcome measures including 44 different score systems were employed. According to the conclusions of the authors, 196 (78.7%) studies were judged to provide striking or definite observations in favor of one of the treatments examined. No important variations over time were documented for quality items. Based on our survey we have identified an enormous range of treatments that have been evaluated for psoriasis over the examined period. Most studies were short-term, and only a handful compared treatment options in different therapeutic classes. Since we did not examine all the relevant journals, the number of treatment options may be even greater than we have documented. There is an urgent need to reset the research agenda focusing on long-term comparative RCTs. Editors of major medical and dermatological journals are urged to take a role in improving the quality of RCT reporting.

Summary This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12–14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long‐term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole‐group and small‐group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small‐group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole‐group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long‐term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long‐term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.