Simon Francis Thomsen , et al . – Bispebjerg Hospital , Department of Dermato-Venereology : Current and Future Research Activities
Clinical databases
The department has initiated and maintains several clinical and pharmacotherapeutic research databases containing patients with various skin diseases , particularly chronic urticaria , hidradenitis suppurativa , atopic dermatitis , psoriasis , systemic sclerosis , and chronic wounds .
As of October 2017 , approximately 400 patients have been treated with omalizumab ( anti-IgE ) at our department . Of these , 325 have chronic spontaneous urticaria and 35 have chronic inducible urticaria , whereas another 40 patients have been treated off-label for various other itching skin disorders , notably atopic dermatitis . Results from this database have shown that omalizumab leads to complete resolution of symptoms in 70 % of patients with chronic spontaneous urticaria and in 50 % with chronic inducible urticaria , but to resolution in only 25 % with detectable autoimmunity towards IgE or to the IgE receptor on mast cells and basophils ( 13 ). Our studies originating from the database have also investigated the effectiveness and safety of omalizumab in selected patients with related diseases , e . g . atopic dermatitis and systemic mastocytosis and in pregnant woman with chronic spontaneous urticaria . Ongoing studies focus on response patterns to omalizumab based on extensive biomarker profiling .
The department is a tertiary referral centre for patients with hidradenitis suppurativa and keeps databases on treatment outcomes and clinical and paraclinical characteristics of these , approximately 125 newly referred , patients per year . Studies on these patients focus on comorbidities , sub-phenotypes and quality of life . A recent study from the database population showed that patients with hidradenitis suppurativa have a thus-far unrecognized high occurrence of undiagnosed and undertreated cardiovascular risk factors , notably dyslipidaemia , hypertension , hyperglycaemia , and elevated levels of systemic inflammatory markers , independently of age ; and moreover , the systemic inflammatory load seemed to be associated with increased risk of dyslipidaemia , independently of obesity ( 14 ). These findings signal that screening and treatment of cardiovascular risk factors are warranted in patients with hidradenitis suppurativa . Ongoing studies of the database population are focused on therapeutic response to biologic medications , deep phenotyping and disease burden .
From 2012 onwards all outpatients with atopic dermatitis referred to the department have been included in a clinical research database , allowing studies of the aetiology , natural history , management , and long-term follow-up of atopic dermatitis . With a yearly referral rate of around 150 new patients the database , at present , contains clinical and paraclinical data on ~ 700 patients with atopic dermatitis covering all ages . Studies originating from the database have so far shown that atopic dermatitis has a strong negative impact on the quality of life proportionally to the severity of the disease , and that presence of facial eczema and female sex are associated with low quality of life in patients with atopic dermatitis independently of eczema severity ( 15 ). Current studies concern genetic and serological biomarkers of atopic dermatitis .
We actively participate in the national database for biological treatments in psoriasis , which is internationally recognized and one of the largest registries of its kind in the world . We have helped to develop the concept of biological drug survival as an endpoint for the real-life assessment of the efficacy of biological therapy ( 16 ).
References
1 . Petersen B , Wulf HC , Triguero-Mas M , Philipsen PA , Thieden E , Olsen P , et al . Sun and ski holidays improve vitamin D status , but are associated with high levels of DNA damage . J Invest Dermatol 2014 ; 134 : 2806 – 2813 .
2 . Bogh MK , Schmedes AV , Philipsen PA , Thieden E , Wulf HC . A small suberythemal ultraviolet B dose every second week is sufficient to maintain summer vitamin D levels : a randomized controlled trial . Br J Dermatol 2012 ; 166 : 430 – 433 .
3 . Idorn LW , Datta P , Heydenreich J , Philipsen PA , Wulf HC . A 3-year follow-up of sun behavior in patients with cutaneous malignant melanoma . JAMA Dermatol 2014 ; 150 : 163 – 168 .
4 . Kamstrup MR , Gniadecki R , Friberg L . Integrated positron-emission tomography and computed tomography manifestations of cutaneous T-cell lymphoma . Arch Dermatol 2012 ; 148 : 1420 – 1422 .
5 . Kamstrup MR , Gniadecki R , Iversen L , Skov L , Petersen PM , Loft A , et al . Low-dose ( 10-gy ) total skin electron beam therapy for cutaneous T-cell lymphoma : an open clinical study and pooled data analysis . Int J Radiat Oncol Biol Phys 2015 ; 92 : 138 – 143 .
6 . Kamstrup MR , Gjerdrum LM , Biskup E , Lauenborg BT , Ralfkiaer E , Woetmann A , et al . Notch1 as a potential therapeutic target in cutaneous T-cell lymphoma . Blood 2010 ; 116 : 2504 – 2512 .
7 . Haedersdal M , Erlendsson AM , Paasch U , Anderson RR . Translational medicine in the field of ablative fractional laser ( AFXL ) -assisted drug delivery : a critical review from basics to current clinical status . J Am Acad Dermatol 2016 ; 74 : 981 – 1004 .
8 . Agner T , Aalto-Korte K , Andersen KE , Foti C , Gimenéz-Arnau A , Goncalo M , et al . Classification of hand eczema . J Eur Acad Dermatol Venereol 2015 ; 29 : 2417 – 2422 .
9 . Clausen ML , Edslev SM , Andersen PS , Clemmensen K , Krogfelt KA , Agner T . Staphylococcus aureus colonization in atopic eczema and its association with filaggrin gene mutations . Br J Dermatol 2017 Mar 19 . [ Epub ahead of print ].
10 . Clausen ML , Slotved HC , Krogfelt KA , Agner T . Tape stripping technique for stratum corneum protein analysis . Sci Rep 2016 ; 6 : 19918 .
11 . Serup J , Kluger N , Bäumler W ( editors ). Tattooed skin and health . Curr Probl Dermatol , 2015 . Basel , Switzerland : Karger Publishers .
12 . Serup J , Bäumler W ( editors ). Diagnosis and therapy of tattoo complications . With atlas of illustrative cases . Curr Probl Dermatol , 2017 . Basel , Switzerland : Karger Publishers .
13 . Ghazanfar MN , Sand C , Thomsen SF . Effectiveness and safety of omalizumab in chronic spontaneous or inducible urticaria : evaluation of 154 patients . Br J Dermatol 2016 ; 175 : 404 – 406 .
14 . Vinkel C , Thomsen SF . Risk factors for cardiovascular disease in patients with hidradenitis suppurativa . J Eur Acad Dermatol Venereol 2017 ; 31 : 411 – 413 .
15 . Holm JG , Agner T , Clausen ML , Thomsen SF . Quality of life and disease severity in patients with atopic dermatitis . J Eur Acad Dermatol Venereol 2016 ; 30 : 1760 – 1767 .
16 . Gniadecki R , Kragballe K , Dam TN , Skov L . Comparison of drug survival rates for adalimumab , etanercept and infliximab in patients with psoriasis vulgaris . Br J Dermatol 2011 ; 164 : 1091 – 1096 .
12 Dermato-Venereology in the Nordic Countries
Forum for Nord Derm Ven 2018 , Vol . 23 , No . 1