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Sjögren's Disease
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Measuring treatment outcome in SjD is a challenge. The multifaceted nature of the disease makes it difficult to devise an outcome measure able to capture all aspects of disease burden and activity. The divergence between symptoms and objective measures of dryness is well-documented. Additionally, patient-reported symptoms correlate poorly with systemic disease activity; therefore, these two independent facets of the disease need to be measured to capture a complete picture of the disease (229, 230). To address this, a composite end point named CRESS was developed, which simultaneously captures multiple facets of the disease, including systemic activity, patient-reported symptoms, objective measurement of glandular function, and serologic parameters (231). It awaits prospective validation in clinical trials, but post hoc application of this outcome measure to the abatacept trials showed positive outcomes. Table 7.4 lists major completed, randomized, placebo-controlled trials in SjD.
The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
Sjögren's syndrome is an autoimmune chronic inflammatory condition in which there is a generalized exocrinopathy. The salivary glands and lacrimal glands are the most obviously involved, thus the main symptoms are of oral and ocular dryness (xerostomia and xerophthalmia, respectively). The dry eyes and mouth may occur in isolation (primary Sjögren's syndrome) or as secondary Sjögren's syndrome associated with a connective tissue disorder, most frequently rheumatoid arthritis. Biopsy of the lower labial minor salivary glands, to identify focal lymphocytic infiltration, is used as one of a range of diagnostic tools. In major glands, particularly the parotids, there is acinar loss and extensive infiltration of lymphocytes. This may give obvious parotid swelling. In longstanding cases there is a risk of lymphoma, particularly in primary Sjögren's syndrome.
Retinoids in Keratinization Disorders
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Ichthyosis vulgaris is an autosomal dominant disease with a prevalence of about 1/250. Profilaggrin mutations can cause ichthyosis vulgaris. The dryness is usually mild, and symptoms may be few. The scales and dryness occur mostly on the extensor part of the extremities and palmoplantar creases and less frequently on the flexures. Keratosis pilaris is common on arms and legs. The skin manifestations are usually present in early childhood. Lesions can disappear in adult life, particularly during summer.
Dry eye and dry skin - is there a connection?
Published in Ophthalmic Epidemiology, 2023
Igor Petriček, Sania Vidas Pauk, Martina Tomić, Tomislav Bulum
Surprisingly, in the literature, authors found only one study investigating the association between self-reported dryness from different body regions, published by a group of gynecologists.33 They proposed a new concept stating that dryness from various areas, such as the eyes, nose, mouth, vagina, and skin, represents a common ‘dryness syndrome”. They conducted a study using a web questionnaire of subjective feeling of dryness of the eyes, nose, mouth, skin, and vagina on 310 women of different ages. The results showed that subjects who feel dryness in a specific region might also feel dryness in the other areas. They suggested that it may be caused by factors affecting the autonomic nervous system or hormonal changes in menopause. The main drawback of this study was that the authors used only subjective data reported by the patients themselves to investigate this connection without using any objective test.
The humanistic and economic burden of atopic dermatitis among adults and adolescents in Saudi Arabia
Published in Journal of Medical Economics, 2022
Baher Elezbawy, Ahmad Nader Fasseeh, Essam Fouly, Laila Carolina Abu Esba, Hana Al Abdulkarim, Mohammed Al-Haddab, Afaf Al-Sheikh, Esraa Altawil, Abdulrahman Al Turaiki, Maysa Eshmawi, Issam Hamadah, Mohamed Tannira, Hala Dalle, Sandrine Aderian, Ahmed Roshdy, Ahmed Jaheen, Tharwat Hamad, Sherif Abaza, Zoltán Kaló
Currently, there is no cure for AD, but several treatment options are available for all severity grades. Treatments usually involve topical emollients and hydrating creams to decrease skin dryness, as well as skin repairing creams. Topical corticosteroids are often used to reduce inflammation and itching, and other creams, such as topical calcineurin inhibitors, are commonly used to control immune response. Systemic immunosuppressants and anti-inflammatories may be used in more severe cases, but efficacy has been questioned21,22. New monoclonal antibodies (e.g. dupilumab) and Janus kinase (JAK) inhibitors (e.g. upadacitinib and baricitinib) have been developed as second-line treatments for nonresponsive patients. Phototherapy may be used as a treatment option in some cases22,23.
Design of a questionnaire for detecting contact lens discomfort: the Contact Lens Discomfort Index
Published in Clinical and Experimental Optometry, 2022
Cristina Arroyo-del Arroyo, Itziar Fernández, Alberto López-de la Rosa, José Pinto-Fraga, María J. González-García, Alberto López-Miguel
‘Dryness’ is reported most often and with greater severity than in non-lens wearers.6,7 This condition, previously known as CL related-dry eye or CL-induced dry eye, was named as CL discomfort (CLD) at the Tear Film & Ocular Surface (TFOS) Society international workshop on CLD.8 It was defined by TFOS as ‘a condition characterised by episodic or persistent adverse ocular sensations related to lens wear, either with or without visual disturbance, resulting from reduced compatibility between the contact lens and the ocular environment, which can lead to decreased wearing time and discontinuation of contact lens wear’.8 Additionally, it was recognised as a complex condition caused by several factors, some related to the CL itself, such as material9,10 or design,9,11 while others are related to the external CL environment, such as humidity or air quality.12