Abstract:
BACKGROUND:Non-adherence rates are high among patients with psoriasis, partly because of discordance between recommended treatments and individual preferences. OBJECTIVES:Our aim was to assess the impact of comorbidities on patients' preferences for psoriasis treatments. METHODS:A computer-based conjoint analysis experiment was conducted to analyze preferences of patients with psoriasis (N = 163) for treatment outcome attributes (probability, magnitude and duration of benefit; probability, severity and reversibility of side effects) and process attributes (treatment location, frequency, duration, delivery method, individual cost). The impact of comorbidities (psoriatic arthritis, cardiovascular disease, diabetes, and depression) on relative importance scores of each attribute was assessed by analyses of variance, post hoc test, and multivariate regression analysis. RESULTS:Among the participants included (58.9% males, mean age 49.3 yrs), 27% suffered from psoriatic arthritis, 13.5% from cardiovascular disease, 8% from diabetes, and 12.9% from depression. Preferences for treatment attributes varied significantly depending on comorbidities. Participants with psoriatic arthritis cared most about the probability of benefit (β 0.166; P = .037), whereas those participants with cardiovascular disease were highly concerned about the probability of side effects (β 0.179; P = .046). For participants with depression, treatment duration (β 0.163; P = .047), and individual cost (P = .023) were highly important. LIMITATIONS:Only patients with moderate and severe psoriasis treated at a university medical center were included. CONCLUSIONS:Integrating patients' preferences into shared decision-making may facilitate treatment adherence and optimize outcomes. Addressing patients' comorbidities, particularly depression, may be a currently neglected opportunity to improve care.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Schmieder A,Schaarschmidt ML,Umar N,Terris DD,Goebeler M,Goerdt S,Peitsch WKdoi
10.1016/j.jaad.2011.08.023subject
Has Abstractpub_date
2012-09-01 00:00:00pages
363-72issue
3eissn
0190-9622issn
1097-6787pii
S0190-9622(11)00954-6journal_volume
67pub_type
杂志文章abstract::Eosinophilic spongiosis has a distinctive but not diagnostic histologic pattern of the epidermis. This pattern may be seen in a wide variety of clinical disorders. We have observed it most commonly in bullous pemphigoid, particularly the urticarial stage. In most biopsy specimens that show eosinophilic spongiosis, add...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(83)70036-8
更新日期:1983-03-01 00:00:00
abstract::A new technic is described for more accurately checking the surgical margins of skin tumors removed by standard surgical excision. Vertical sections of surgical specimens represent check points of the margin only 7 microns thick. This means most of the surgical margin is not checked microscopically, allowing small tum...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(82)70131-8
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:Despite a lack of evidence that dysplastic nevi are precursors to melanoma, a large proportion of dermatologists continue to treat them as such. Emerging data suggest that histologic grading approach may result in many unnecessary excisions. OBJECTIVE:Using a nongrading approach to diagnosis of Clark/dyspla...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2015.09.030
更新日期:2016-01-01 00:00:00
abstract::With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatol...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2017.01.031
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Recombinant human platelet derived growth factor-BB gel (PDGF gel) has been shown to be effective in the treatment of diabetic neuropathic ulcers. It is also being used off-label to speed wound healing of flaps, grafts, and wounds from Mohs micrographic surgery. OBJECTIVE:The purpose of the study was to com...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mjd.2001.117721
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Hydroxychloroquine is widely used for the treatment of cutaneous lupus erythematosus (CLE). Although new recommendations exist for hydroxychloroquine dosing, there is still uncertainty about the dosage that will elicit a satisfactory response in CLE while limiting adverse effects, specifically retinopathy. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2019.07.027
更新日期:2020-03-01 00:00:00
abstract::This prospective study (1977-1980) of cosmetic adverse reactions by eleven dermatologists identified 487 cases of cosmetic-induced dermatitis. Approximately half of the cases were covert in nature. Eight percent were due to allergic contact dermatitis; the face, eye, and upper arm were the most involved sites. Skin ca...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(82)70080-5
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Lentigo maligna (LM) is a relatively common tumor with increasing prevalence and substantial morbidity. A variety of treatment modalities are available, though margin-control surgery offers the highest cure rate. We were interested in comparing long-term outcomes of Mohs micrographic surgery (MMS) versus sta...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2007.02.011
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe cutaneous adverse reactions to medications and infections. OBJECTIVE:We sought to determine whether a seasonal variation to SJS and TEN exists and to define the characteristics in our tertiary referral hospital. METHODS...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2008.11.884
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Azathioprine is efficacious in the treatment of severe childhood atopic dermatitis; however, robust data on adverse effects in this population are lacking. OBJECTIVE:We sought to assess adverse effects of azathioprine treatment in a pediatric atopic dermatitis cohort, and make recommendations for monitoring...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2014.08.048
更新日期:2015-01-01 00:00:00
abstract::Subungual Bowen's disease and squamous cell carcinoma are not as rare as has been implied by earlier literature. The course of the lesions is protracted. Clinically the diseases may mimic onychomycosis, chronic paronychia, eczema, verruca vulgaris, pyogenic granuloma, subungual exostosis, or malignant melanoma. Histol...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(84)70165-4
更新日期:1984-08-01 00:00:00
abstract::Epithelioid hemangioendothelioma (EHE) is a unique tumor, mainly of adults, which is characterized by epithelioid or histiocytoid endothelial cells. It is a low-grade malignant vascular tumor first described as a distinctive entity in 1982 by Weiss and Enzinger. An 8-year-old girl presented with an approximately 3-yea...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(00)90267-6
更新日期:2000-05-01 00:00:00
abstract::Five patients with the yellow nail syndrome triad are described; all five had yellow nails, primary lymphedema, and respiratory tract involvement. Four of the patients noted the onset of the syndrome after an episode of pneumonia. Four patients had a chronic productive cough, two had bronchiectasis, two had chronic si...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(84)70021-1
更新日期:1984-02-01 00:00:00
abstract::The use of the various forms of phototherapy remains an essential treatment option for psoriasis vulgaris. Expertise concerning the mechanisms involved with the actions of therapeutic ultraviolet light and the proper delivery of office-based treatments resides within the specialty of dermatology. New therapies for the...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(03)01139-3
更新日期:2003-08-01 00:00:00
abstract::Sunscreen preparations can reduce the erythemogenic ( sunburning ) effects of solar ultraviolet radiation (UVR). Less is known about the ability of sunscreens to protect against other forms of UVR-induced damage. This study was designed to yield data on epidermal cell damage at UVR doses sufficient to provoke vascular...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(84)70088-0
更新日期:1984-05-01 00:00:00
abstract::Tuberous sclerosis is characterized by epilepsy, mental retardation, and adenoma sebaceum. Computerized axial tomography (CAT) is a noninvasive laboratory test that can assist in the diagnosis of this syndrome radiologically. A positive CAT scan is often present before the calcifications are noted on skull x-rays and ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(81)70009-4
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Single-institution studies show that frozen section Mohs micrographic surgery (MMS) is an effective treatment modality for cutaneous melanoma, but no multi-institutional studies have been published. OBJECTIVE:To characterize the use of MMS in the treatment of melanoma at 3 academic and 8 private practices t...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jaad.2019.05.057
更新日期:2019-09-01 00:00:00
abstract::We report an unusual case of congenital melanocytic nevus presenting in a 19-year-old African woman as widespread papules and variably sized nodules and tumors affecting the entire body, including the palms, soles, and oral mucous membrane. Histopathologic examination of 3 representative skin lesions showed mainly der...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/s0190-9622(03)00365-7
更新日期:2003-10-01 00:00:00
abstract::More than 1100 patients were tested with methylchloroisothiazolinone-methylisothiazolinone, 100 ppm, in aqueous and petrolatum-based patch test materials from 1985 to 1987 by members of the North American Contact Dermatitis Group. Thirteen reactions to the aqueous materials and 10 to the petrolatum-based materials wer...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(90)70099-4
更新日期:1990-05-01 00:00:00
abstract::A combination of topical and oral antifungals is widely used to treat onychomycosis, but treatment failure is common and oral drugs may cause toxicity and potential drug interactions. For this reason, new approaches and strategies should be considered. The following case shows that photodynamic therapy (PDT) may repre...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2008.06.015
更新日期:2008-11-01 00:00:00
abstract::A case of phaeohyphomycosis caused by Phialophora richardsiae is presented. The patient was a 30-year-old man with end stage malignant lymphoma. A subcutaneous abscess that developed on the dorsum of the right foot was removed surgically but immediately recurred. The causative mold was isolated from the pus in the les...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(88)70200-5
更新日期:1988-09-01 00:00:00
abstract::In this third and last part of our review of cutaneous vascular proliferations we include malignant vascular neoplasms and a group of heterogeneous cutaneous neoplasms characterized by a significant vascular component. We also review some disorders that, in our opinion, have been erroneously considered as vascular neo...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(98)70237-3
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Onychomatricoma (OM) is a rare benign tumor of the nail matrix in which genome-wide analyses have never been performed. It is clinically characterized by an increased transversal curvature of the nail plate, a longitudinal yellowish discoloration, and splinter hemorrhages. Once the nail plate has been remove...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2009.07.051
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Necrolytic migratory erythema (NME) is an uncommon inflammatory dermatosis with a distinct clinical and histologic appearance. NME is usually associated with glucagonoma. Only a few cases of NME in the absence of glucagonoma have been previously reported. OBJECTIVE:We sought to understand further the pathog...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(95)90345-3
更新日期:1995-04-01 00:00:00
abstract::Two babies were found to have large hemangiomas. Histologically there were many islands of compactly packed mesenchymal cells in the deep dermis and subcutaneous tissue. Electron microscopically there was proliferation of immature endothelial cells and pericytes. Characteristic crystalline lamellae were in the endothe...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(83)70009-5
更新日期:1983-01-01 00:00:00
abstract::Blisters from five patients with porphyria cutanea tarda and two patients with drug-induced pseudoporphyria were examined by direct immunofluorescence and by immunofluorescence mapping with antibodies against laminin and type IV collagen to determine the level of subepidermal separation. Primary screening by direct im...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(91)70169-3
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Interferon-alfa (IFN-alpha) has been implicated in the pathogenesis of psoriasis. OBJECTIVE:To evaluate the safety profile of MEDI-545, a fully human anti-IFN-alpha monoclonal antibody and to explore its effect on the involvement of type I IFN-alpha activity in the maintenance of established plaque psoriasi...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaad.2009.05.042
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Novel picosecond lasers have been available for various pigmentary disorders. However, there are limited data directly comparing picosecond lasers and Q-switched lasers for treatment of nevus of Ota. OBJECTIVE:To compare the efficacy and safety of a picosecond alexandrite laser (PSAL) with a Q-switched alex...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2019.03.016
更新日期:2020-08-01 00:00:00
abstract::Skin cancer is the most common form of cancer in the United States and accounts for an estimated 1 million new cases per year. In the white population, the rate of new melanomas diagnosed yearly has more than doubled from 5/100,000 in 1973 to 12/100,000 in 1990. The current lifetime risks for white persons are estimat...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2002.120450
更新日期:2002-07-01 00:00:00
abstract::Direct-to-consumer teledermatology is radically changing the way some patients obtain dermatologic care. Many direct-to-consumer teledermatology services offer care to patients younger than 18 years, but policies and standards are nonuniform. For pediatric patients, direct-to-consumer teledermatology is a substantial ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2016.08.002
更新日期:2016-11-01 00:00:00