Case Clustering in Pityriasis Rosea

Chuh, Antonio; Lee, Albert; Molinari, Nicolas

doi:10.1001/archderm.139.4.489

Cited by 30 publications

(10 citation statements)

References 40 publications

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“…Many systematic epidemiology studies 22–25,87–96 were reported for PR. A meta-analysis 97 reported that the overall incidence of PR was around 0.68 per 100 dermatological patients in specialist settings.…”

Section: Epidemiology Studiesmentioning

confidence: 99%

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Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

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Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagn...

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Section: Epidemiology Studiesmentioning

confidence: 99%

“…98 No analytical epidemiology study was reported for GCS. For PR, studies 87–94,96,99,100 reported conflicting results on seasonal variation. PR was reported not to be associated with climate data including the monthly mean temperature, mean total rainfall, and mean relative humidity.…”

Section: Epidemiology Studiesmentioning

confidence: 99%

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

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“…Chuh ve ark. 41 hastal›k seride pitriyazis rozea ile mevsimler aras›ndaki iliflkiyi araflt›rm›fl olup araflt›rma sonucunda, mevsimsel istatistiksel iliflki tespit edilmifl, k›fl mevsimi, flubat ay› en yüksek oranda bulunmufltur 31 . fiahin ve ark.…”

Section: Tart›flmaunclassified

Comparison of the Distributions of Seborrheic Dermatitis, Herpes Zoster and Pityriasis Rosea According to Seasons

Saçar¹,

Saçar²

2010

turkderm

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ÖzetAmaç: Seboreik dermatit, herpes zoster ve pitriyazis rozean›n ortak özellikleri hava ›s›s›n›n düflük oldu¤u dönemlerde görülme s›kl›klar›n›n artmas›d›r. Biz çal›flmam›zda seboreik dermatit, herpes zoster ve pitriyazis rozea'n›n y›l içinde aylar ve mevsimler ile olan iliflkilerini saptamay› amaçlad›k. Gereç ve Yöntem: Aral›k 2006 -Aral›k 2009 tarihleri aras›nda dermatoloji poliklini¤imize baflvuran 20397 hasta ve seboreik dermatit, herpes zoster ve pitriyazis rozea tan›s› alm›fl olan 1801 hasta otomasyon dosya sisteminden retrospektif olarak analiz edildi. Hastalar demografik verilere ve tan›lara göre grupland›r›ld›. Bulgular: Hastal›klar ile s›k görüldü¤ü mevsimler aras›nda istatistiksel olarak anlaml› iliflki tespit edildi (p<0,001). Seboreik dermatit %32,5 oran›nda sonbahar mevsiminde, herpes zoster %29,8 oran›nda sonbahar mevsiminde, pitriyazis rozea %31,0 oran›nda k›fl mevsiminde, tüm dermatolojik hastal›klar %29,1 oran›nda k›fl mevsiminde tespit edildi. Hastal›klar ile s›k görüldü¤ü aylar aras›nda istatistiksel olarak anlaml› iliflki tespit edildi (p<0,001). Seboreik dermatit %12,3 oran›nda kas›m ay›nda, herpes zoster %11,5 oran›nda eylül ay›nda, pitriyazis rozea %10,7 oran›nda ocak ay›nda, tüm dermatolojik hastal›klar %8,21 oran›nda flubat ay›nda tespit edildi. Sonuç: Çal›flma sonuçlar›m›z literatür bilgileri ile paralellik göstermektedir. Seboreik dermatit, herpes zoster, pitriyazis rozea ve tüm dermatolojik hastal›klar›n görülmesi aç›s›ndan sonbahar ve k›fl aylar› en yüksek oranda tespit edilmifltir. Ortam ›s›s›n›n düfl-mesi hücresel immun direncin deprese olmas›na neden olmakta, bunun da hastal›klara yatk›n bireylerde hastal›klar›n ortaya ç›k-mas›na ya da nüksüne neden oldu¤unu düflünüyoruz. (Türkderm 2010; 44: 65-8) Anahtar Kelimeler: Seboreik dermatit, herpes zoster, pitriyazis rozea, mevsim, k›fl, sonbahar SummaryBackground and Design: The common characteristic of seborrheic dermatitis, herpes zoster and pityriasis rosea is the increase in their incidence in the low weather temperature periods. The aim of this study was to determine the relationships of seborrheic dermatitis, herpes zoster and pityriasis rosea with the months and sessions during the year. Material and Method: Twenty thousends three hundreds ninety seven patients referred to our dermatology policlinic between December 2006 and December 2009 with 1801 patients being diagnosed as seborrheic dermatitis, herpes zoster or pityriasis rosea were retrospectively analysed from the automation record system. The patients were grouped according to demographic data and diagnosis. Results: A statistically significant relationship was found between the diseases and the seasons in which they were frequently seen (p<0.001). It was found that 32.5% of seborrheic dermatitis was seen in autumn season, 29.8% of herpes zoster was seen in autumn season, 31.0% of pityriasis rosea was seen in winter season, and 29.1% of all dermatological diseases was seen in winter season. A statistically significant relationship was found between the diseases and the ...

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“…GPs are prompt in detecting and reporting epidemics and mini-epidemics of viral illnesses [26,27]. The epidemiological data obtained in primary care represents the best proxy measurements of the day-by-day prevalence of ailments in the community.…”

Section: Discussionmentioning

confidence: 99%

Facing the threat of influenza pandemic - roles of and implications to general practitioners

Lee

Chuh

2010

BMC Public Health

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The 2009 pandemic of H1N1 influenza, compounded with seasonal influenza, posed a global challenge. Despite the announcement of post-pandemic period on 10 August 2010 by theWHO, H1N1 (2009) virus would continue to circulate as a seasonal virus for some years and national health authorities should remain vigilant due to unpredictable behaviour of the virus. Majority of the world population is living in countries with inadequate resources to purchase vaccines and stockpile antiviral drugs. Basic hygienic measures such as wearing face masks and the hygienic practice of hand washing could reduce the spread of the respiratory viruses. However, the imminent issue is translating these measures into day-to-day practice. The experience from Severe Acute Respiratory Syndrome (SARS) in Hong Kong has shown that general practitioners (GPs) were willing to discharge their duties despite risks of getting infected themselves. SARS event has highlighted the inadequate interface between primary and secondary care and valuable health care resources were thus inappropriately matched to community needs.There are various ways for GPs to contribute in combating the influenza pandemic. They are prompt in detecting and monitoring epidemics and mini-epidemics of viral illnesses in the community. They can empower and raise the health literacy of the community such as advocating personal hygiene and other precautious measures. GPs could also assist in the development of protocols for primary care management of patients with flu-like illnesses and conduct clinical audits on the standards of preventive and treatment measures. GPs with adequate liaison with public health agencies would facilitate early diagnosis of patients with influenza.In this article, we summarise the primary care actions for phases 4-6 of the pandemic. We shall discuss the novel roles of GPs as alternative source of health care for patients who would otherwise be cared for in the secondary care level. The health care system would thus remain sustainable during the public health crisis.

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Case Clustering in Pityriasis Rosea

Cited by 30 publications

References 40 publications

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Comparison of the Distributions of Seborrheic Dermatitis, Herpes Zoster and Pityriasis Rosea According to Seasons

Facing the threat of influenza pandemic - roles of and implications to general practitioners

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