Background Dermatophytosis is a world‐wide distributed common infection. Antifungal drug resistance in dermatophytosis used to be rare, but unfortunately the current Indian epidemic of atypical widespread recalcitrant and terbinafine‐resistant dermatophytosis is spreading and has sporadically been reported in Europe. Objectives To explore the occurrence of clinical and mycological proven antifungal drug resistance in dermatophytes in Europe. Methods A standardized questionnaire was distributed through the EADV Task Force of Mycology network to dermatologists in Europe. Results Representatives from 20 countries completed the questionnaires of which 17 (85 %) had observed clinical and/or mycological confirmed antifungal resistance, two countries published cases of antifungal resistance and one country had no known cases. Conclusions This pilot study confirms that both clinical and mycological antifungal resistance exist in Europe.
Actinic cheilitis is thought to be a premalignant lesion or a superficial squamous cell carcinoma. The prevalence of actinic cheilitis in Europe is unknown. The aim of this study was to determine the prevalence of actinic cheilitis in the Galicia region (north-west Spain). Secondary objectives were the description of risk factors of actinic cheilitis. A cross-sectional multicentre study in patients ≥ 45 years of age was performed in 8 dermatology departments in Galicia region during a 1-year period. The prevalence of actinic cheilitis was 31.3%. Significant and independent risk factors of actinic cheilitis after multivariate analysis were age ≥ 60 years, Fitzpatrick skin phototype II, outdoor working for more than 25 years, and previous history of non-melanoma skin cancer. This is the first cross-sectional multicentre study of the prevalence of actinic cheilitis in Europe. Actinic cheilitis was present in almost one-third of the screened patients. Lip examination should be performed in all patients with chronic actinic damage.
Use of lip photoprotection in patients suffering from actinic cheilitisBackground: Actinic cheilitis (AC) is a chronic condition that affects mainly the lower lip. Objectives: To investigate the use of lip photoprotection in patients with AC. Materials and Methods: A cross-sectional multicentre study of patients, ≥45 years of age, was performed in eight dermatology departments in the Galicia region over a period of one year. From 1,239 patients included in the study, 410 were diagnosed with AC and complete data were available for 408. An analysis of lip photoprotection habits and possible associations in patients with AC is reported. Results: Mean age of patients with AC was 71.9 years and 53.8% were women. More than 90% of AC patients (370/408) had never used lip photoprotection. In the group of patients who used it, 62.16% of them had only used a single stick within the previous year. The only variable significantly associated with the use of lip sun protection was low Fitzpatrick's skin types I and II (p=0.039). Study limitations include the inclusion of patients 45 years or older and the use of a semiquantitative scale for measuring the frequency of application of lip photoprotection. Conclusion: To our knowledge, this is the first European study focused on lip photoprotection in patients suffering from AC. Only a minority of AC patients protect their lips from UV radiation. Specific lip sun protection recommendations should be promoted, especially in high-risk populations.
Actinic cheilitis (AC) is a common condition that mainly involves the lower lip, which is associated with chronic exposure to ultraviolet (UV) radiation. AC is considered a precursor of malignancy (1), but the rate of progression from AC to invasive squamous cell carcinoma (SCC) has not yet been established. An epidemiological study previously described the prevalence of AC and its associated variables in the Galicia region (north-western Spain); the prevalence of AC in a population aged 45 years and over was 31.3%, and multivariate analysis showed that significant and independent risk factors for AC were age ≥ 60 years, Fitzpatrick skin phototypes I and II, working outdoors for more than 25 years, and a history of non-melanoma skin cancer (NMSC) (2). We report here a subanalysis of the clinical manifestations of AC and the associations of AC with other markers of actinic damage. METHODSA cross-sectional multicentre study was conducted in Galicia (the total population in 2016 was 2,718,525, data from Galician Statistics Institute; http://www.ige.eu), a region located in northwestern Spain. Eight dermatology departments participated in the study, and patient data were collected prospectively from 12 January 2016 to 31 January 2017. Consecutive patients aged ≥45 years that attended a general dermatology outpatient clinic were recruited once a week. A physical examination of each patient was performed visually with or without a magnifying glass (2). Clinical characteristics of AC were precisely specified in a previous meeting attended by all the investigators to minimize inter-observer bias; characteristics were classified as follows: persistent desquamation, persistent erythema, a mottled appearance (erythema and white patches), and a plaque (solid, raised, flat lesion >1 cm) and/ or an erosion/ulceration that could not be attributed to other dermatological disorders (modified from Ribeiro et al.) (3). Patients with uncertain eroded/ulcerated lesions underwent a biopsy to exclude SCC. A binary regression logistic analysis was performed to determine the significant associations with each clinical form of AC. Univariate and multivariate analyses of the different variables related to other markers of actinic damage (lentigines and actinic keratosis (AK)) in patients with AC were also analysed.The study protocol was approved by the Research Ethics Committee of Pontevedra-Vigo-Ourense, Spain (protocol number 2015/582).All statistical analyses were performed using SPSS 22.0 statistical software for Windows. RESULTSA total of 1,250 patients were selected for the study. Eleven patients declined to participate in the study or were not willing to sign the consent form; therefore, a total of 1,239 patients completed the screening form. Of these, 410 were diagnosed with AC, and complete data were available for 408 patients. The prevalence of AC in the study population was 31.3% (95% confidence interval (95% CI) 28.7-33.8).Regarding AC clinical manifestations, 47.3% (193) of patients had only one clinical manifestation of AC,...
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