Abstract:
Importance:Systemic and inhaled corticosteroids negatively affect bone remodeling and cause osteoporosis and bone fracture when given continuously or in high doses. However, risk of osteoporosis and major osteoporotic fracture (MOF) after application of topical corticosteroids (TCSs) is largely unexplored. Objective:To examine the association between cumulative exposure to potent and very potent TCSs and risk of osteoporosis and MOF. Design, Setting, and Participants:This nationwide retrospective cohort study included 723 251 Danish adults treated with potent or very potent TCSs from January 1, 2003, to December 31, 2017. Data were obtained from Danish nationwide registries. Filled prescription data were converted in equipotent doses to mometasone furoate (1 mg/g). Data were analyzed from June 1 to August 31, 2019. Exposures:Patients were considered exposed when they had filled prescriptions of cumulative amounts corresponding to the equivalent of at least 500 g of mometasone, using filled prescriptions of 200 to 499 g as the reference group. Main Outcomes and Measures:The co-primary outcomes were a diagnosis of osteoporosis or MOF. Hazard ratios (HRs) adjusted for age, sex, socioeconomic status, medication use, and comorbidity were calculated with 95% CIs using Cox proportional hazards regression models. Results:A total of 723 251 adults treated with the equivalent of at least 200 g of mometasone were included in the analysis (52.8% women; mean [SD] age, 52.8 [19.2] years). Dose-response associations were found between increased use of potent or very potent TCSs and the risk of osteoporosis and MOF. For example, HRs of MOF were 1.01 (95% CI, 0.99-1.03) for exposure to 500 to 999 g, 1.05 (95% CI, 1.02-1.08) for exposure to 1000 to 1999 g, 1.10 (95% CI, 1.07-1.13) for exposure to 2000 to 9999 g, and 1.27 (95% CI, 1.19-1.35) for exposure to at least 10 000 g. A 3% relative risk increase of osteoporosis and MOF was observed per doubling of the cumulative TCS dose (HR, 1.03 [95% CI, 1.02-1.04] for both). The overall population-attributable risk was 4.3% (95% CI, 2.7%-5.8%) for osteoporosis and 2.7% (95% CI, 1.7%-3.8%) for MOF. The lowest exposure needed for 1 additional patient to be harmed (454 person-years) was observed for MOF with exposure of at least 10 000 g. Conclusions and Relevance:These findings demonstrate that use of high cumulative amounts of potent or very potent TCSs was associated with an increased risk of osteoporosis and MOF.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Egeberg A,Schwarz P,Harsløf T,Andersen YMF,Pottegård A,Hallas J,Thyssen JPdoi
10.1001/jamadermatol.2020.4968subject
Has Abstractpub_date
2021-01-20 00:00:00eissn
2168-6068issn
2168-6084pii
2775153pub_type
杂志文章相关文献
JAMA Dermatology文献大全abstract:IMPORTANCE:Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis. OBJECTIVE:To ev...
journal_title:JAMA dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamadermatol.2013.4646
更新日期:2013-09-01 00:00:00
abstract:IMPORTANCE:The differential diagnosis for oral lentigines includes several syndromes with important associated systemic findings. McCune-Albright syndrome (MAS), a mosaic condition associated with café au lait pigmentation, is not typically considered a mucosal lentiginosis syndrome. The clinical phenotype of MAS is va...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.184
更新日期:2014-07-01 00:00:00
abstract:Importance:Patients with vascular malformations (VAMs) and vascular overgrowth syndromes have lower health-related quality of life (HRQoL) attributable to social stigmatization, poor mental health, severity, and pain. However, the factors that contribute to this decreased HRQoL are not clear. Objective:To perform a sy...
journal_title:JAMA dermatology
pub_type: 杂志文章,meta分析
doi:10.1001/jamadermatol.2018.0002
更新日期:2018-06-01 00:00:00
abstract:Importance:Sun-protective behavior affects skin cancer prevention. Shade works by physically shielding skin from direct harmful UV rays; however, skin may still remain exposed to reflected and indirect UV rays. There is no current standard metric to evaluate shade for its effectiveness in sun protection, and there is i...
journal_title:JAMA dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamadermatol.2016.4922
更新日期:2017-03-01 00:00:00
abstract:IMPORTANCE:Hidradenitis suppurativa (HS) is a chronic cutaneous disease with acutely painful flares that require appropriate and timely treatment. OBJECTIVE:To assess how individuals with HS utilize medical care, especially emergency department (ED) care, a high-cost setting, and to describe the health care costs for ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.691
更新日期:2014-09-01 00:00:00
abstract:Importance:Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. Objective:To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. Des...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2018.2357
更新日期:2018-10-01 00:00:00
abstract:IMPORTANCE:Basal cell carcinomas (BCCs) are diagnosed by clinical evaluation, which can include dermoscopic evaluation, biopsy, and histopathologic examination. Recent translation of multiphoton microscopy (MPM) to clinical practice raises the possibility of noninvasive, label-free in vivo imaging of BCCs that could re...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.0453
更新日期:2015-10-01 00:00:00
abstract:Importance:Although regression is commonly observed in cutaneous melanoma, it is uncertain whether it is associated with patient prognosis. Objective:To determine whether histologically confirmed regression was associated with better or worse survival in patients with primary cutaneous melanoma. Design, Setting, and ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.5032
更新日期:2020-12-23 00:00:00
abstract:Importance:Granuloma faciale (GF) is a rare, benign inflammatory dermatosis of unknown cause. Some reports have suggested that it could be part of the spectrum of IgG4-related sclerosing diseases. Granuloma faciale is characterized by single or multiple red-brown nodules, most frequently occurring on the face, and it c...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2018.2681
更新日期:2018-11-01 00:00:00
abstract:Importance:The US Food and Drug Administration approves Class III medical devices via the premarket approval pathway, often requiring clinical data on safety and efficacy. Manufacturers can submit incremental device changes via supplemental applications, which are not subjected to such vetting measures and can cause un...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.5757
更新日期:2018-03-01 00:00:00
abstract:Importance:Advanced practice professionals (APPs) such as nurse practitioners and physician assistants independently perform a large number and variety of dermatologic procedures, but little is known about how the number and scope of these procedures have changed over time. Objective:To examine the trends in scope and...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2018.1768
更新日期:2018-09-01 00:00:00
abstract:IMPORTANCE:Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), occurs in elderly patients and has been considered as a lymphoma with a poor prognosis, with estimated 5-year specific survival rates of approximately 50%. The hypothesis of an improvement in prognosis over time has not been studied. OB...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2013.7452
更新日期:2014-05-01 00:00:00
abstract:Importance:Inflammatory dermatoses of the lower extremity are often misdiagnosed as cellulitis (aka "pseudocellulitis") and treated with antibiotics and/or hospitalization. There is limited data on the cost and complications from misdiagnosed cellulitis. Objective:To characterize the national health care burden of mis...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.3816
更新日期:2017-02-01 00:00:00
abstract:IMPORTANCE:Treatment outcomes depend on adherence to the prescribed regimen. Primary nonadherence refers to not obtaining and starting to take a prescribed medication. The frequency of primary nonadherence to acne treatment has not been well characterized. The complexity of multidrug acne regimens may add to this probl...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.5254
更新日期:2015-06-01 00:00:00
abstract:IMPORTANCE:Pseudoaneurysm is a well-known complication of trauma and iatrogenic injury to the vasculature. We report 3 cases of postsurgical pseudoaneurysm after Mohs surgery. OBSERVATIONS:Three patients who underwent Mohs surgery for nonmelanoma skin cancers presented between 2 and 4 weeks after surgery with several ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.9073
更新日期:2014-05-01 00:00:00
abstract:Importance:Erythropoietic protoporphyria (EPP) is a rare hereditary disease of heme biosynthesis that manifests as severe photosensitivity and hepatotoxicity. There have been no effective treatments to date. Cimetidine has been shown to inhibit heme biosynthesis and results in symptomatic improvement in patients with a...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.2303
更新日期:2016-11-01 00:00:00
abstract:Importance:Pubic hair grooming is a common practice that can lead to injury and morbidity. Objective:To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. De...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.2815
更新日期:2017-11-01 00:00:00
abstract:IMPORTANCE:Describing the relationship between the availability of free prescription drug samples and dermatologists' prescribing patterns on a national scale can help inform policy guidelines on the use of free samples in a physician's office. OBJECTIVES:To investigate the relationships between free drug samples and ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.9715
更新日期:2014-05-01 00:00:00
abstract:IMPORTANCE:Cryolipolysis is the noninvasive reduction of fat with localized cutaneous cooling. Since initial introduction, over 650,000 cryolipolysis treatment cycles have been performed worldwide. We present a previously unreported, rare adverse effect following cryolipolysis: paradoxical adipose hyperplasia. OBSERVA...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.8071
更新日期:2014-03-01 00:00:00
abstract:Clinical Question:Which treatments have been shown to be effective in randomized clinical trials (RCTs) for hidradenitis suppurativa (HS) in adults? Bottom Line:There is high-quality evidence of benefit from adalimumab given weekly, while every other week dosing is ineffective, with reductions in Dermatology Life Qual...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.0432
更新日期:2017-05-01 00:00:00
abstract:Importance:Necrobiotic xanthogranuloma (NXG) is a non-Langerhans cell histiocytosis classically associated with paraproteinemia attributable to plasma-cell dyscrasias or lymphoproliferative disorders. Despite the morbidity of NXG, the literature is limited to case reports and small studies, and diagnostic criteria are ...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2019.4221
更新日期:2020-03-01 00:00:00
abstract:Importance:Dermatofibrosarcoma protuberans (DFSP) is a rare skin cancer that develops in the deep dermis to subcutaneous adipose tissues. A COL1A1-PDGFB gene fusion, leading to the constitutive expression of PDGFB, is the tumorigenic mechanism in most DFSP cases. Objectives:To evaluate the specificity of PDGFB express...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.2389
更新日期:2015-12-01 00:00:00
abstract:Importance:Pyoderma gangrenosum and necrotizing Sweet syndrome are diagnostically challenging variants of neutrophilic dermatosis that can clinically mimic the cutaneous and systemic features of necrotizing fasciitis. Improved characterization of these rare variants is needed, as improper diagnosis may lead to inapprop...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2018.3890
更新日期:2019-01-01 00:00:00
abstract:IMPORTANCE:Evidence-based treatment guidelines are not available for primary cutaneous mucinous carcinoma (PCMC). OBJECTIVE:To assess outcomes associated with surgical treatment of PCMC. DATA SOURCES:MEDLINE, Cumulative Index to Nursing and Allied Health, and Embase from 1952 to 2010. Search terms were "primary cutan...
journal_title:JAMA dermatology
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamadermatol.2013.6006
更新日期:2014-04-01 00:00:00
abstract:Importance:Erythromelalgia is a clinical diagnosis based on intermittent warmth, erythema, and pain in the distal extremities. One problem facing physicians is how to objectively test for this disease. Given that other painful conditions of the distal extremities (ie, neuropathy related to human immunodeficiency virus,...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.4404
更新日期:2017-02-01 00:00:00
abstract:Importance:Cutaneous squamous cell carcinoma (cSCC) has metastatic potential, but the prognostic value of current staging systems in nonselected patients is uncertain. Objective:To assess the effect of risk factors for metastasis and to evaluate validity and usefulness of 4 staging systems for cSCC using population-ba...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.6428
更新日期:2018-04-01 00:00:00
abstract:IMPORTANCE:How complications associated with chronic venous insufficiency (CVI) develop is not clear. The central source of the complications is likely a dysfunction of the calf muscle pump, which includes veins and their valves, the gastrocnemius and other lower leg and foot muscles as well as the nerves supplying the...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.6723
更新日期:2014-04-01 00:00:00
abstract:IMPORTANCE:Purse-string suture is a closure method that purportedly reduces the scar area compared with second intention healing. Randomized clinical trials comparing these 2 methods appear to be limited or absent. OBJECTIVE:To determine if purse-string suture improves cosmetic outcome, healing time, and scar to defec...
journal_title:JAMA dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamadermatol.2014.2313
更新日期:2015-03-01 00:00:00
abstract:Importance:A phase 2 trial comparing talimogene laherparepvec plus ipilimumab vs ipilimumab monotherapy in patients with advanced unresectable melanoma found no differential benefit in progression-free survival (PFS) but noted objective response rates (ORRs) of 38.8% (38 of 98 patients) vs 18.0% (18 of 100 patients), r...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamadermatol.2018.3958
更新日期:2019-01-01 00:00:00
abstract:Importance:Hidradenitis suppurativa (HS) places a significant burden on the health-related quality of life (HRQOL) of patients, many of whom have depression. Resilience can play a role in mitigating the negative stressors, such as the symptoms of HS, on patients' mental health. Objective:To investigate the correlation...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2017.3596
更新日期:2017-12-01 00:00:00