Given that the COVID-19 era has changed the behavior of all individuals, and since previous reports about its possible impact on atopic dermatitis (AD) patients remained speculative, in this survey we aimed to explore the real impact of COVID-19 among AD patients. All participants provided verbal consent prior to completing the survey. A 37-question web-based survey with no personal identifiers was sent to 212 previously identified AD patients. Itching, sleep disturbances, SARS-CoV-2, illness cost, economic dependence, monthly income, and monthly investment in AD before and during the pandemic, were all included in the analysis. A response rate of 73.1% was obtained. The mean age of participants was 30 years-old, and 57% were women. Around 75% reported AD worsening, and 59.4% of the patients reported sleep problems. Uncertainty, anxiety, and pessimism were frequent during the pandemic. Only 1.3% tested positive for SARS-CoV-2, and it was only significantly associated with comorbidities (p=0.03; Chi 2 Test). A significant difference was found in economic dependence and monthly income when compared between before and during the pandemic. This study provides probably the best possible assessment of the clinical, social, and economic effects of the pandemic on patients with an already proven diagnosis of AD.
Omalizumab is a successful treatment option in cases of difficult to control chronic urticaria with associated vasculitis in which the options proposed by international guidelines have been exhausted.
Background: Atopic dermatitis (AD) is considered as one of the most frequent chronic skin conditions. Previous AD epidemiologic studies have been mainly retrospective and/or have been performed through surveys instead of in-person visits. Epidemiological studies concerning AD in Latin American countries are scarce.Objective: To describe sociodemographic and clinical features and the economic burden of AD on children and adult patients in Colombia through in-person visits.Methods: This was a cross-sectional study of 212 patients that included sociodemographic and clinimetric data. The diagnostic criteria of Hanifin and Rajka was used and data relating to disease distribution, disease severity (through the BSA: Body surface area; EASI: Eczema Area and Severity Index; SCORAD: Scoring Atopic Dermatitis), Fitzpatrick's skin phototypes, personal and familiar history of allergic diseases, previous treatments, and personal history of comorbidities, was collected.Results: Patient age range was 12-76, and 52.8% were female. Disease distribution was mainly flexural (19.6%). Early age start, Denni-Morgan fold, and infections tendency were more frequent in adolescents compared to adults. Mean age of diagnosis was 12 years old, AD diagnosis was made mostly by a dermatologist, 48.1% (102 patients) reported alcohol consumption, and 59% of consumers were heavy drinkers. Comorbidities found were: chronic rhinitis (68.9%) food allergy (32.5%), allergic conjunctivitis (29.7%), and asthma (28.8%). Around 81% earned less than $896 US dollars and 59% invested 6-30% of their monthly budget yearly, and 40% had work or school absenteeism. Mean scores of BSA, EASI, and SCORAD involvement were 32.6, 13.7, and 42.4, respectively.
La urticaria por frío es una de las cinco causas más frecuentes de urticarias crónicas; está incluida en el grupo de urticarias físicas y puede ocurrir luego de la exposición al frío, ya sea a través de un objeto, el aire o un líquido. Los pacientes pueden presentar síntomas de urticaria, angioedema, dificultad respiratoria e, incluso, anafilaxia al sacar objetos de la nevera, nadar en agua fría o al entrar a cuartos con aire acondicionado. A continuación se presentan cinco pacientes con diagnóstico de esta enfermedad y una breve revisión del tema.Palabras clave: urticaria, angioedema, anafilaxia, antagonistas de histamina, crioglobulinemia, frío. Cold urticaria: case series and literature reviewCold urticaria is one of the five most common causes of chronic urticaria and is grouped as a physical urticaria. It can occur after exposure to cold, either through solid objects, air or liquids. Patients may have symptoms of urticaria, angioedema, respiratory distress and even anaphilaxis when the skin is exposed to a cold environment, such as handling refrigerated objects, swimming in cold water or entering an air-conditioned room. Five cases of cold urticaria are presented, followed by a brief literature review.Key words: Urticaria, angioedema, anaphylaxis, histamine antagonists, cryoglobulinemia, cold temperatura. Caso 1Se trata de un paciente de sexo masculino de 41 años de edad, que consultó por un cuadro clínico de dos meses de evolución consistente en urticaria, angioedema en manos y pies, y dificultad respiratoria cuando estaba en una piscina, que cedió espontáneamente; también había presentado urticaria en un antebrazo al contacto con una botella fría. Tenía antecedentes personales de rinitis, asma y conjuntivitis alérgica. Se le practicó la prueba del cubo de hielo, que fue positiva a los cuatro minutos. Fue tratado con fexofenadina, con mejoría total de los síntomas. Caso 2Se trata de una paciente de sexo femenino de 3 años y 8 meses de edad, que fue llevada a consulta por presentar urticaria y angioedema al contacto con el agua fría. En una ocasión, mientras estaba en una piscina, presentó un episodio de hipotonía generalizada, palidez y pérdida de conciencia, que requirió hospitalización. Con el consumo de bebidas frías presentaba eritema y edema en cuello. Se le practicó la prueba del cubo de hielo, que fue positiva a los seis minutos. Se inició tratamiento con ciproheptadina, consiguiéndose mejoría de la sintomatología. Un mes después del inicio del tratamiento, se hizo una nueva prueba con cubo de hielo, la cual fue negativa a los 10 minutos. La paciente recibió ciproheptadina por seis meses llegando hasta la dosis tope para su peso, pero por persistencia de síntomas asociados al contacto con el frío, se decidió cambiar el tratamiento por cetirizina más montelukast. La paciente ha sido seguida durante cuatro años y en la actualidad todavía presenta urticaria asociada al baño y en piscinas, pero sin afectación respiratoria y de resolución espontánea. Caso 3Se trata de un paciente de sexo masculino de 41 ...
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