Background/ObjectivesMeasures of pruritus severity and quality of life (QoL) are necessary for the development of therapeutics for children with chronic pruritus. In children, questionnaires need to be developed for specific age groups given the differences in cognitive levels. In this study, we aimed to develop tools to assess QoL and pruritus severity in children 6 to 7‐years‐old with chronic pruritus.MethodsBased on open interviews with children, we developed a cartoon‐annotated QoL instrument, KidsItchyQoL, and validated an existing pruritus severity instrument, ItchyQuant, that measures pruritus impact and severity for the preceding week. Both instruments were administered to 100 children aged 6‐7 years with chronic pruritus. The data were analyzed for reliability, reproducibility, construct validity, and responsiveness.ResultsWe found the 14‐item KidsItchyQoL to be reliable (Cronbach's α = 0.846) and reproducible (intraclass correlation coefficient (ICC) = 0.66) as was the ItchyQuant (ICC = 0.47). With respect to construct validity, examination of eigenvalues of the inter‐item polychoric correlation matrix suggested three dominant factors. A subsequent confirmatory factor analysis suggested that a 3‐dimensional simple structure model with correlated factors provided a reasonable data representation. The responsiveness of KidsItchyQoL and ItchyQuant (P = .005, GLM procedure) were demonstrated with scores changing as expected with the self‐reported change of itch severity.ConclusionsThese results demonstrate promise for a new set of reliable research tools to assess QoL and pruritus severity in children 6 to 7 years of age.
The pathogenesis of atopic dermatitis (AD) is complex and multifactorial. However, recent advancements in the genetics and pathophysiology of AD suggest that epidermal barrier dysfunction is paramount in the development and progression of the condition (Boguniewicz and Leung, Immunol Rev 242(1):233-246, 2011). In addition to standard therapy for AD, there are a plethora of non-prescription treatment modalities which may be employed. Over-the-counter treatments for atopic dermatitis can come in the form of topical corticosteroids, moisturizers/emollients, and oral anti-histamines. Though these treatments are beneficial, prescription treatments may be quicker acting and more efficacious in patients with moderate to severe disease or during flares. OTC agents are best used for maintenance between flares and to prevent progression of mild disease. Alternative and complementary treatments lack strong efficacy evidence. However, wet wraps, bleach baths, and other treatments appear to be promising when used in conjunction with conventional treatments. With the financial burden of atopic dermatitis ranging from 364 million to 3.8 billion dollars each year in the United States, we suspect this topic will gain further research attention.
Introduction: There is no approved topical prescription medicine to treat molluscum contagiosum (MC). SB206 is an investigational topical product that consists of 2 components; a gel containing berdazimer sodium that releases nitric oxide (NO) when co-administered with a hydrogel. NO, an endogenous small molecule, is known to be an immune modulator as well as an antimicrobial agent. Objective: A Phase 2, 12-week, randomized, vehiclecontrolled ascending dose trial was conducted in patients with MC to evaluate the efficacy and safety of SB206 compared to vehicle (VH). Materials and Methods: Patients 2 years of age were randomized 3:1 (active: vehicle) to ascending, sequential dose groups of SB206. After 30 patients randomized in a dose group completed 2 weeks of treatment, the Data Safety Monitoring Board reviewed unblinded safety and tolerability data and recommended to open the higher dose group. Consequently, 256 patients were randomized into the following dose groups: 47 (4% BID), 48 (8% BID), 47 (12% BID), 48 (12% QD) and 66 (VH). The primary endpoint was the proportion of patients demonstrating complete clearance of MC at Week 12 in the modified intent-to-treat (mITT) population. Results: The following proportion of patients achieved complete clearance at Week 12: 13.2% and 10.6% (4% BID), 41.0% and 33.3% (8% BID), 35.1% and 27.7% (12% BID), 41.9% and 37.5 % (12% QD) and 20.0% and 18.2% (VH) in the mITT and ITT population, respectively. The efficacy signals appeared as early as 2 weeks. There were no SAEs or deaths. The number (%) of patients who discontinued treatment due to AEs were 0 in vehicle group and 7 (4%) in the combined SB206 groups. The majority of AEs were application site reactions. No quantifiable systemic exposure of SB206 was observed. Conclusions: Overall, SB206 was well tolerated and efficacious in treating MC in this study and further studies are warranted.
Atopic dermatitis (AD) is a chronic inflammatory skin disease. Many patients with AD seek care from both primary care physicians and dermatologists. However, little is known regarding topical corticosteroid prescribing patterns between these two specialties. We sought to determine if differences exist in the topical corticosteroid (TCS) prescribing patterns between dermatologists, family medicine physicians, and internal medicine physicians. We conducted a population-based, cross-sectional analysis using data from the National Ambulatory Medical Care Survey (NAMCS) from 2006 to 2016. There were 5,071,158 (weighted) outpatient AD visits between 2006 and 2016 for adults who were seen by physicians from family medicine, internal medicine, and dermatology. There was not a statistically significant difference in the rate of TCS prescriptions for AD between family medicine physicians and dermatologists (39.1% vs. 52.2%; p¼0.27). However, family medicine physicians had a higher rate of prescribing TCS for AD than internal medicine physicians (39.1% vs. 5.1%; p¼0.002). Dermatologists had a significantly higher rate of prescribing TCS for AD compared to internal medicine physicians (52% versus 5%; p<0.001). Our findings demonstrate that dermatologists prescribe topical corticosteroids for atopic dermatitis more frequently compared to internal medicine physicians but not in comparison to family medicine physicians. It is important to understand the key differences in practice patterns among medical specialties for AD care and identify educational gaps.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.