Acta dermato-venereologica
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Acta Derm. Venereol. · Nov 2012
Randomized Controlled TrialLight fractionation significantly improves the response of superficial basal cell carcinoma to aminolaevulinic acid photodynamic therapy: five-year follow-up of a randomized, prospective trial.
Photodynamic therapy (PDT) using topical porphyrin-precursors is a promising treatment for superficial basal cell carcinoma (sBCC), but it needs further optimization. The aim of this study was to compare 5-year lesion (complete) response rates of sBCC treated with topical aminolaevulinic acid (ALA)-PDT using a single illumination vs. ALA-PDT using a 2-fold illumination scheme. ⋯ Five years after therapy the CR rate after 2-fold illumination was 88%, whereas the CR rate after single illumination was 75%. The CR rate in the third group of lesions, treated with 2-fold illumination was 97% and 88% at 12 months and 5 years after therapy, respectively. Long-term follow-up indicates superior efficacy in sBCC of ALA-PDT with 2-fold illumination compared with ALA-PDT with single illumination.
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Acta Derm. Venereol. · Sep 2012
Comparative StudyItch severity and quality of life in patients with pruritus: preliminary validity of a Danish adaptation of the itch severity scale.
The aim of this study was to examine the validity of a Danish adaptation of the Itch Severity Scale (ISS) by exploring the associations between pruritus severity, psychological symptoms, and quality of life in a consecutively recruited sample of 20 patients with atopic dermatitis, 20 with psoriasis, 20 with urticaria, 12 with genital pruritus, 11 with nephrogenic pruritus, and 20 controls with vascular malformations. Convergent and discriminative validity was explored by analysing the associations of the ISS total score and the individual ISS component scores with age, sex, diagnosis, disease severity, sleep quality, depressive symptoms, anxiety, non-specific somatic symptoms, and pruritus-related quality of life impairment. ⋯ The results also confirmed the multidimensional nature of pruritus, with the affective dimension of pruritus being a better predictor of depressive symptoms, anxiety, and quality of life impairment than the sensory dimension. Finally, our results confirmed previous findings that the associations between pruritus severity and depressive symptoms and somatic symptoms were partly mediated by the effect of pruritus on sleep quality.
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Acta Derm. Venereol. · Sep 2012
ReviewSystemic kappa opioid receptor agonists in the treatment of chronic pruritus: a literature review.
Chronic pruritus is frequently refractory to currently available treatments. Studies suggest that pruritus may arise from an imbalance of the mu- and kappa-opioid receptor system activity in either the skin or the central nervous system. Stimulation of kappa-opioid receptors by their agonists inhibits pruritus in both animals and humans. ⋯ To date, several case reports and 2 controlled trials have demonstrated a beneficial effect of systemic kappa-opioid receptor agonists in the treatment of uraemic pruritus, prurigo nodularis, paraneoplastic and cholestatic pruritus. Nalfurafine hydrochloride (Remitch(®)), a selective kappa-opioid receptor agonist, is approved for the treatment of chronic pruritus in Japan. The aim of this review is to provide an overview of the promising role of kappa- opioid receptors and their agonist in the pathophysiology and treatment of pruritus.
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Acta Derm. Venereol. · Sep 2012
Comparative StudyAssessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus.
The most commonly used tool for self-report of pruritus intensity is the visual analogue scale (VAS). Similar tools are the numerical rating scale (NRS) and verbal rating scale (VRS). In the present study, initiated by the International Forum for the Study of Itch assessing reliability of these tools, 471 randomly selected patients with chronic itch (200 males, 271 females, mean age 58.44 years) recorded their pruritus intensity on VAS (100-mm line), NRS (0-10) and VRS (four-point) scales. ⋯ In conclusion, high reliability and concurrent validity was found for VAS, NRS and VRS. On re-test, higher correlation and less missing values were observed. A training session before starting a clinical trial is recommended.
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Acta Derm. Venereol. · Sep 2012
Multicenter StudyVisual analogue scale: evaluation of the instrument for the assessment of pruritus.
The aim of this study was to evaluate the visual analogue scale (VAS) as a method of pruritus assessment. A total of 310 subjects with pruritic dermatoses (148 Caucasian subjects and 162 Asian subjects) were recruited. The patients assessed pruritus intensity using the horizontal and vertical VAS, numeric rating scale (NRS) and verbal rating scale (VRS). ⋯ VRS showed the highest correlation with NRS (R = 0.82, p < 0.001), followed by horizontal (R = 0.75, p < 0.001) and vertical VAS (R=0.74, p < 0.001). Based on detailed analysis following VAS categories were proposed: 0 = no pruritus, > 0-< 4 points = mild pruritus, ≥ 4-< 7 points = moderate pruritus, ≥ 7-< 9 points = severe pruritus, and ≥ 9 points = very severe pruritus. In conclusion, the VAS is a valuable method of pruritus measurement.