Background: The SCORing Atopic Dermatitis (SCORAD) index is used worldwide to assess the severity of atopic eczema. Patient involvement in the treatment process is of major current interest. There are very few validated patient self-assessment tools for atopic dermatitis (AD). Objective: To develop a self-assessment score for AD patients, the patient-oriented SCORAD (PO-SCORAD) based on the SCORAD index, and to assess its acceptability in a pilot study. Methods:A multicenter working group decided on the initial form of the PO-SCORAD. A prospective, single-center pilot study was then carried out to assess its acceptability and validity. A SCORAD and a PO-SCORAD were applied at baseline and after 18 days; the acceptability of the tool was assessed by questionnaire, its validity by comparing SCORAD and PO-SCORAD on both visits. Results: The study involved 15 children and 18 adults. 80% of the respondents found the questions clear and the form easy to fill in; 96% spent less than 10 min on it. A correlation was found between the SCORAD and the PO-SCORAD. Conclusion:This study shows that self-assessment is feasible in AD, and that there is a correlation between the physician and the patient scores. This study was the first step in validating the PO-SCORAD.
Lymphomatoid papulosis (LyP) is a rare cutaneous lymphoproliferative disorder in children, which can rarely be associated with a cutaneous or systemic lymphoma. We report a 13-year-old girl who presented with typical LyP and pathological features of subtype A. Six months later, the patient presented with rapidly progressive peripheral and systemic lymphadenopathy. On examination of a lymph-node biopsy, a lymphoid infiltrate negative for anaplastic lymphoma kinase (ALK) and positive for CD30 was found, suggestive of systemic anaplastic large T-cell lymphoma (S-ALCL). The patient was treated with chemotherapy, followed by allogeneic bone-marrow transplant (BMT). Over the following 6 years, she presented with biopsy-confirmed LyP relapses with complete cutaneous, peripheral-blood and bone-marrow chimerism. This is only the third reported paediatric association of S-ALCL with LyP to our knowledge, and seems to be the first paediatric case of recurrent relapses of LyP after bone-marrow allograft for S-ALCL with total (100%) cutaneous and bone-marrow chimerism. LyP occurring after allogenic BMT does not appear to be donor-derived.
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