Background Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.
of the species is R. mucilaginosa; it is a ubiquitous pathogen isolated from many sources such as shower curtains, bathtubs, tooth brushes and medical equipments. Before 1985, Rhodotorula was not considered yet as a pathogen, but today it is known to cause significant infections in immunocompromised patients, usually with a malignancy or immunosuppression. Fungemia associated with central venous catheter is the most common consequence of R. mucilaginosa, followed by eye infection (keratitis and endophthalmitis), meningitis, opportunistic onycomycosis and peritonitis. 7,8 Skin infections are extremely rare. Means et al. reported a case of cutaneous R. mucilaginosa treated with photodynamic therapy. 9 Jaeger et al. described a case of R. mucilaginosa folliculitis in Li-Fraumeni-like syndrome. 10 Amphotericin B is considered the gold standard therapy for this infection.Due to the patient's HCC history and chemotherapy with sorafenib, the patient had a higher risk to develop opportunistic infections. We describe the first case of R. mucilaginosa skin infection in a patient with HCC treated with sorafenib.
Psoriasis is a chronic inflammatory skin disease showing a high burden due to its aesthetic, social, psychological, and quality of life (QoL) implications which also affect patient‐physician relationship and, consequently, the adherence to treatments. Limited data on the natural history of psoriasis and factors predicting its prognosis are available. The aim of this study was to investigate patients' global characteristics, including treatments, associated with QoL impairment in psoriasis. Questionnaires evaluating sociodemographic features and Dermatology Life Quality Index (DLQI) were administered to patients. Multiple regression analysis was performed to evaluate factors associated with a large effect on patient's life (DLQI > 10), moderate effect on patient's life (DLQI ≥ 6 ≤ 10), small effect on patient's life (DLQI ≥ 2 < 6), and no effect on patient's life (DLQI < 2). Overall, 1052 consecutive patients affected by mild‐to‐severe psoriasis were recruited. Our logistic regression analysis showed that the influencing factors for a large effect on QoL were living in Southern Italy, depression, psoriatic arthritis, and psoriasis localization on facial, intertriginous, palmoplantar, trunk and scalp regions. For a moderate effect on patient's life, phototherapy and non‐biological systemic therapies resulted to be the predictive factors. Mild psoriasis, living in social housing and the isolated involvement of scalp psoriasis had a small effect on QoL. Lastly, mild psoriasis and current biological therapies including anti‐IL‐12/23, anti‐IL‐17, and anti‐TNF‐α were positively associated with no life quality impairment. Perceived quality of life impairment in psoriasis not only depends on the skin disease but rather on patients' global characteristics. Therefore, the individual background of these patients should be respected in the selection of treatment options.
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