Background Hidradenitis suppurativa (HS), a chronic, recurrent, debilitating skin disease, is characterized by painful, inflammatory, subcutaneous lesions of the axilla, inguinal and anogenital regions. Overall prevalence of HS is ˜1%, and the impact of disease on patient quality of life (QoL) and healthcare resource utilization (HRU) is high.Objectives To estimate the real-world effectiveness of adalimumab (Humiraâ) treatment in patients with moderate-tosevere HS on disease severity, pain, QoL, work productivity and HRU.Methods HARMONY (Effectiveness of Adalimumab in Moderate to Severe HidrAdenitis SuppuRativa Patientsa Multi-cOuNtry studY in Real Life Setting) is a multicentre, postmarketing observational study in adult patients with moderate-to-severe HS. Disease severity and QoL parameters were evaluated using validated measures at 12-week intervals over 52 weeks of treatment. The primary endpoint was the proportion of patients achieving a Hidradenitis Suppurativa Clinical Response (HiSCR: ≥50% reduction in abscess and inflammatory nodule count, with no increase in abscess and draining fistula counts relative to baseline) at 12 weeks. Secondary endpoints were HiSCR at 24, 36 and 52 weeks and changes in QoL parameters and work productivity assessments. Analyses were conducted using asobserved data.
ResultsThe proportion of patients reaching the primary HiSCR endpoint was 70.2% (n = 132/188 enrolled) and remained ≥70% until study completion. There were statistically significant (P < 0.0001) reductions in worst and average skin pain. All of the QoL measures evaluated improved significantly (P < 0.0001) by 12 weeks of adalimumab treatment, as did work productivity assessments (P < 0.05), and there was a ˜50% decrease in HRU between baseline and week 52. Adalimumab was well tolerated.Conclusions In this real-world setting, adalimumab treatment of moderate-to-severe HS resulted in decreased disease severity and improvements in QoL and productivity. Response to adalimumab was rapid (within 12 weeks) and sustained (52 weeks). No unexpected safety signals were reported.
Background: Many different materials are used in the perineal area, making it liable to contact sensitisation. Objective: We report the results of a retrospective study of patients with perineal dermatoses involving the vulva investigated for possible contact allergy. Methods: 240 female patients with dermatoses in the perineal area, specifically including the vulva, were patch tested to our standard series and a special patch test series devised for perineal problems. Results: 79 out of 240 patients (32.9%) demonstrated relevant positive results. These related to medicaments (49 patients), perfumes (22 patients), cosmetics (5 patients), dyes (4 patients) and rubber (4 patients). Conclusions: Perineal dermatoses involving the vulva may require patch testing to identify suspected and unanticipated contact allergy. An extended comprehensive series of patch test allergens will be necessary in these cases.
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Papular umbilicated granuloma annulare is usually localized and is relatively asymptomatic. The generalized condition is rarely reported in children and tends to respond less well to treatment than the localized form. We report the first instance of generalized papular umbilicated granuloma annulare in an 11-year-old boy, which cleared following bath psoralen plus ultraviolet A therapy.
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