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The general population has a wide-ranging understanding of skin diseases and the central role of dermatologists in skin care. Patients are looking for technical competence and loyalty, because this lead to more trusted and satisfactory physician-patient relationship. Public campaigns may be relevant in increasing awareness on curability of common skin diseases.

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POSTERSfactors predictive of death were a higher serum AST (p < 0.04), ALP (p < 0.02), sodium (p < 0.02), and INR (p < 0.01) and the development of HE (p < 0.000). Of the 51 patients known to be alive, 27 were available for review. Of these, 21 (78%) had some degree of HE; less than 30% were on anti-encephalopathy treatment. The factors predictive of HE were older age (p < 0.01), with the risk of developing HE increasing by 6.5% for every year of age, and non-British white ethnicity (p < 0.03). Conclusion: HE is one of the most important predictors of mortality post-TIPS. Patients are often unaware of the risk of HE development and are rarely monitored beyond the immediate post-TIPS period. Better assessment of the risk of developing HE pre-TIPS as well as closer and longer term follow-up and treatment may help preventing the development of HE and hence improve survival.

Background: A differential diagnosis between angiotensin-converting enzyme inhibitor (ACEi) angioedema (AE) and histaminergic AE (hAE) might be challenging. Follow-up data may help discriminate these conditions but are scarcely reported. Objective: To report on the follow-up of patients with suspected ACEi-AE and to describe the baseline characteristics of AE attacks in patients with a diagnosis of ACEi-AE after follow-up. Methods: Sixty-four patients with suspected ACEi-AE (i.e., with exposure to ACEi before the first attack, no urticaria associated, and normal C1-inhibitor levels) and at least one follow-up visit were included. Data were retrospectively collected at baseline and during the follow-up. Results: After the follow-up, the diagnosis of ACEi-AE was probable in only 30 patients. The remaining patients were reclassified as having probable hAE (21 patients) or undetermined-mechanism AE (13 patients). Patients with ACEi-AE were mostly men (61%), with a median age of 64 years (interquartile range [IQR] ±17 years), with a highly variable delay from ACEi introduction (median: 23 months; interquartile range: 103 months). Attacks preferentially involved lips (50%), tongue (47%), and throat (30%). Interestingly, patients with probable ACEi-AE after a follow-up also frequently presented with a history of allergy and atopic conditions (20%), attacks with preferential evening onset (25%), and spontaneous resolution in < 24 hours (26%), which are usually considered as suggestive of hAE. ACEi-AE attacks responded to icatibant in 79% of the patients. Conclusion: Patients with probable ACEi-AE were mostly men with facial involvement. A third of the patients with an initial suspected diagnosis of ACEi-AE had a final diagnosis of probable hAE. Although a follow-up of all patients should be a standard of care, it is critical to the correct diagnosis in the case of suspected bradykinin-associated AE, which may actually be due to histamine.

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