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Analysis of hair minerals in children with atopic dermatitis
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Abstracts / Journal of Dermatological Science 84 (2016) e89–e180
P04-31[O3-40] Analysis of hair minerals in children with atopic dermatitis Jeoung Eun Kim ∗ , Jae Min Shin, Won Seon Koh, Joo Yeon Ko, Young Suck Ro Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea Background: Trace minerals play diverse biological roles in the human body. Recently we found that the hair zinc level was lower in atopic dermatitis (AD) patients and recovered after zinc supplementation. However, there is controversy about the relationship between AD and other minerals. Objective: The aim of this study was to compare hair mineral levels of patients with AD and normal controls and to determine correlations with measures of clinical severity. Methods: We collected hair samples from 42 patients with AD and 25 normal controls and measured hair mineral levels. We also investigated the correlation between hair mineral levels and clinical severity, measured by the eczema assessment severity index (EASI) score, trans-epidermal water loss (TEWL), and the visual analogue scales (VAS) for pruritus and sleep disturbance. Results: Of the nutritional elements, calcium, magnesium, copper, zinc, and phosphate were significantly lower in AD patients, while cadmium, lead, and arsenic were higher. However, all these minerals were within the reference ranges for trace element incorporation. Moreover, the mineral levels were not significantly related to clinical severity. Conclusions: The levels of a number of hair minerals differ between AD patients and controls group. However, the changes are not related to the severity of the AD Supplementation with the hair minerals that are lower in AD patients may be needed to confirm their clinical relevance. http://dx.doi.org/10.1016/j.jdermsci.2016.08.377 P04-32[O3-41] Efficacy and safety of the interleukin-12/interleukin-23 antagonist ustekinumab in Korean patients with moderate to severe psoriasis Kyu Uang Whang 1,∗ , Young Lip Park 2 , Kyung O. Kim 2 , Je Min An 1 , Sun Bum Kwon 1 , Jong Suk Lee 3 , Ga Hee Jung 3 1
Department of Dermatology, Soonchunhyaung University Hospital, Seoul, Republic of Korea 2 Department of Dermatology, Soonchunhyaung University Hospital, Bucheon, Republic of Korea 3 Department of Dermatology, Soonchunhyaung University Hospital, Cheonan, Republic of Korea
Background: Psoriasis is a chronic, relapsing inflammatory disease that affects approximately 2–3% of the population worldwide and often requires lifelong care. Traditional treatments for psoriasis have relied upon systemic therapy with methotrexate, cyclosporine, oral retinoid and phototherapy. However, recent advances in understanding the immunogenesis of psoriasis has led to the development of biological agents that target specific immunological pathways. Ustekinumab is a human monoclonal antibody that binds to the p40 subunit common to interleukin IL-12 and IL-23, key cytokines in the pathogenesis of psoriasis. Method: 32 patients with moderate to severe psoriasis were assigned to receive ustekinumab 45 mg at weeks 0, 4, and 16. Treat-
ment effectiveness was estimated based on reported Psoriasis Area and Severity Index (PASI) 50, 75, and 90 response rates, defined as a 50%, 75%, and 90% reductions from baseline PASI scores, respectively. The main outcome measures were improvement in PASI score with respect to baseline at weeks 4 and 16. A stereotyped questionnaire was completed by the physician and the information about adverse events was collected. Result: The average baseline PASI score was 25.4. At week 4, the average PASI score was 15.3 and 37.5% of patients had achieved PASI 50. At week 16, the average PASI score was to 7.8 and the proportions of patients achieving PASI 50, 75, and 90 were 84.4% (n = 27), 43.8% (n = 14), and 12.5% (n = 4), respectively. Two serious adverse events, consisting of infection and five minor adverse events were observed. Conclusion: Ustekinumab provides an effective, safe and well tolerated alternative for the symptomatic treatment of Korean patients with moderate to severe psoriasis. http://dx.doi.org/10.1016/j.jdermsci.2016.08.378 P04-33[O3-42] Fingernail onychomycosis caused by molds: Epidemiology, clinical and laboratory characteristics Charussri Leeyaphan ∗ , Sumanas Bunyaratavej, Sutasinee Phaitoonwattanakij, Chanai Muanprasat, Lalita Matthapan Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand Background: Fingernail onychomycosis caused by molds was unusual due to causative organisms which were commonly transmitted from grounds. Methods: The study was a retrospective chart review of outpatients with molds onychomycosis between January 2012 and December 2014. The diagnostic criteria of nondermatophyte molds (NDMs) onychomycosis required at least 3 positive of the following laboratory: microscopic examination, culture, at least two consistent isolations, dermatophyte exclusion and histology. Mixed infection meant infection by dermatophytes (DMPs) along with NDMs which had at least two consistent isolations. Results: A total of 1496 patients presented with onychomycosis were included. Two hundred and twenty-one were fingernail involvement, which prevalence was 14.8%. Patients with fingernail onychomycosis, 61.5% were male and mean age (SD) was 53.1 (21.4) years old. Thumbs were the most common sites of infection (31.6%). Regarding causative organism for fingernails onychomycosis, DMPs was leading agents (76.9%) including Trichophyton rubrum; 53.4%, Trichophyton mentagrophytes; 22.6% and Trichophyton tonsurans; 0.9%. Of patients who had NDMs fingernail onychomycosis (21.3%), 14.5% were Fusarium spp., 3.6% were Aspergillus spp. and 2.7% were Neoscytalidium dimidiatum. There were 4 (1.8%) patients who had mixed DMPs and NDMs infection. Considering between fingernail and toenailgroups, patients with fingernail onychomycosis were significantly younger (mean age 53.1 vs 61.5; p value <0.001) and were significantly caused by DMPs (76.9% vs 68.4%; p value <0.001). Conclusion: Prevalence of fingernails onychomycosis was 14.8%. Patients with fingernails involvement trended to have younger age and were predominantly caused by DMPs. http://dx.doi.org/10.1016/j.jdermsci.2016.08.379
Abstracts / Journal of Dermatological Science 84 (2016) e89–e180
P04-31[O3-40] Analysis of hair minerals in children with atopic dermatitis Jeoung Eun Kim ∗ , Jae Min Shin, Won Seon Koh, Joo Yeon Ko, Young Suck Ro Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea Background: Trace minerals play diverse biological roles in the human body. Recently we found that the hair zinc level was lower in atopic dermatitis (AD) patients and recovered after zinc supplementation. However, there is controversy about the relationship between AD and other minerals. Objective: The aim of this study was to compare hair mineral levels of patients with AD and normal controls and to determine correlations with measures of clinical severity. Methods: We collected hair samples from 42 patients with AD and 25 normal controls and measured hair mineral levels. We also investigated the correlation between hair mineral levels and clinical severity, measured by the eczema assessment severity index (EASI) score, trans-epidermal water loss (TEWL), and the visual analogue scales (VAS) for pruritus and sleep disturbance. Results: Of the nutritional elements, calcium, magnesium, copper, zinc, and phosphate were significantly lower in AD patients, while cadmium, lead, and arsenic were higher. However, all these minerals were within the reference ranges for trace element incorporation. Moreover, the mineral levels were not significantly related to clinical severity. Conclusions: The levels of a number of hair minerals differ between AD patients and controls group. However, the changes are not related to the severity of the AD Supplementation with the hair minerals that are lower in AD patients may be needed to confirm their clinical relevance. http://dx.doi.org/10.1016/j.jdermsci.2016.08.377 P04-32[O3-41] Efficacy and safety of the interleukin-12/interleukin-23 antagonist ustekinumab in Korean patients with moderate to severe psoriasis Kyu Uang Whang 1,∗ , Young Lip Park 2 , Kyung O. Kim 2 , Je Min An 1 , Sun Bum Kwon 1 , Jong Suk Lee 3 , Ga Hee Jung 3 1
Department of Dermatology, Soonchunhyaung University Hospital, Seoul, Republic of Korea 2 Department of Dermatology, Soonchunhyaung University Hospital, Bucheon, Republic of Korea 3 Department of Dermatology, Soonchunhyaung University Hospital, Cheonan, Republic of Korea
Background: Psoriasis is a chronic, relapsing inflammatory disease that affects approximately 2–3% of the population worldwide and often requires lifelong care. Traditional treatments for psoriasis have relied upon systemic therapy with methotrexate, cyclosporine, oral retinoid and phototherapy. However, recent advances in understanding the immunogenesis of psoriasis has led to the development of biological agents that target specific immunological pathways. Ustekinumab is a human monoclonal antibody that binds to the p40 subunit common to interleukin IL-12 and IL-23, key cytokines in the pathogenesis of psoriasis. Method: 32 patients with moderate to severe psoriasis were assigned to receive ustekinumab 45 mg at weeks 0, 4, and 16. Treat-
ment effectiveness was estimated based on reported Psoriasis Area and Severity Index (PASI) 50, 75, and 90 response rates, defined as a 50%, 75%, and 90% reductions from baseline PASI scores, respectively. The main outcome measures were improvement in PASI score with respect to baseline at weeks 4 and 16. A stereotyped questionnaire was completed by the physician and the information about adverse events was collected. Result: The average baseline PASI score was 25.4. At week 4, the average PASI score was 15.3 and 37.5% of patients had achieved PASI 50. At week 16, the average PASI score was to 7.8 and the proportions of patients achieving PASI 50, 75, and 90 were 84.4% (n = 27), 43.8% (n = 14), and 12.5% (n = 4), respectively. Two serious adverse events, consisting of infection and five minor adverse events were observed. Conclusion: Ustekinumab provides an effective, safe and well tolerated alternative for the symptomatic treatment of Korean patients with moderate to severe psoriasis. http://dx.doi.org/10.1016/j.jdermsci.2016.08.378 P04-33[O3-42] Fingernail onychomycosis caused by molds: Epidemiology, clinical and laboratory characteristics Charussri Leeyaphan ∗ , Sumanas Bunyaratavej, Sutasinee Phaitoonwattanakij, Chanai Muanprasat, Lalita Matthapan Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand Background: Fingernail onychomycosis caused by molds was unusual due to causative organisms which were commonly transmitted from grounds. Methods: The study was a retrospective chart review of outpatients with molds onychomycosis between January 2012 and December 2014. The diagnostic criteria of nondermatophyte molds (NDMs) onychomycosis required at least 3 positive of the following laboratory: microscopic examination, culture, at least two consistent isolations, dermatophyte exclusion and histology. Mixed infection meant infection by dermatophytes (DMPs) along with NDMs which had at least two consistent isolations. Results: A total of 1496 patients presented with onychomycosis were included. Two hundred and twenty-one were fingernail involvement, which prevalence was 14.8%. Patients with fingernail onychomycosis, 61.5% were male and mean age (SD) was 53.1 (21.4) years old. Thumbs were the most common sites of infection (31.6%). Regarding causative organism for fingernails onychomycosis, DMPs was leading agents (76.9%) including Trichophyton rubrum; 53.4%, Trichophyton mentagrophytes; 22.6% and Trichophyton tonsurans; 0.9%. Of patients who had NDMs fingernail onychomycosis (21.3%), 14.5% were Fusarium spp., 3.6% were Aspergillus spp. and 2.7% were Neoscytalidium dimidiatum. There were 4 (1.8%) patients who had mixed DMPs and NDMs infection. Considering between fingernail and toenailgroups, patients with fingernail onychomycosis were significantly younger (mean age 53.1 vs 61.5; p value <0.001) and were significantly caused by DMPs (76.9% vs 68.4%; p value <0.001). Conclusion: Prevalence of fingernails onychomycosis was 14.8%. Patients with fingernails involvement trended to have younger age and were predominantly caused by DMPs. http://dx.doi.org/10.1016/j.jdermsci.2016.08.379