Background and objective
Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real‐world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of ‘asthma’, ‘COPD’ or ‘asthma + COPD’.
Methods
The authors selected 30 frequently occurring TTs from the NOVELTY study cohort (NOVEL observational longiTudinal studY; NCT02760329), a large (n = 11,226), global study that systematically collects data in a real‐world setting, both in primary care clinics and specialized centres, for patients with ‘asthma’ (n = 5932, 52.8%), ‘COPD’ (n = 3898, 34.7%) or both (‘asthma + COPD’; n = 1396, 12.4%).
Results
The results indicate that (1) the prevalence of the 30 TTs evaluated varied widely, with a mean ± SD of 4.6 ± 2.6, 5.4 ± 2.6 and 6.4 ± 2.8 TTs/patient in those with ‘asthma’, ‘COPD’ and ‘asthma + COPD’, respectively (p < 0.0001); (2) there were no large global geographical variations, but the prevalence of TTs was different in primary versus specialized clinics; (3) several TTs were specific to the diagnosis and severity of disease, but many were not; and (4) both the presence and absence of TTs formed a pattern that is recognized by clinicians to establish a diagnosis and grade its severity.
Conclusion
These results provide the largest and most granular characterization of TTs in patients with airway diseases in a real‐world setting to date.
Dermatophagoides pteronyssinus subcutaneous allergen immunotherapy in depot presentation exhibited good safety and tolerability. Group A seemed to show the best profile for further clinical development.
Dermatitis Research Group guidelines. Scrapings of rosewood 5% pet.were also applied using the same chambers. Patch tests were positive at D2 and D4 (+++) for rosewood and (++) potassium dichromate.Rosewood patch test controls were performed in 10 patients with negative results. After replacing the rosewood of the musical instrument by a plastic material, eczema resolved and the patient has since remained asymptomatic.
DISCUSSIONThe woods of the genus Dalbergia can cause both typical contact dermatitis 2-4 and erythema multiforme-like reactions. 5 Contact dermatitis has been commonly described in workers who handle this wood. In our patient, sensitization has occurred due to direct contact with the instrument she plays as a musician. Other cases in musicians have been attributed to the sensitizer (R)-4-methoxydalbergione. 6 The relatively short time elapsing between the start of exposure and the onset of symptoms could be favored by the humidity caused by salivation when playing the instrument. The sensitization to chromium detected in our patient does not seem to be clinically relevant, as she has been able to continue playing the instrument without problems after the removal of the rosewood piece. In short, we present a case of allergic contact dermatitis caused by rosewood in a musician which resolved after the avoidance of contact with the wooden piece.
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