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Andrew Y Finlay

Publications and source records attributed to Andrew Y Finlay.

16 recordsLinked to original sources
PubMed2006

Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne.

BACKGROUND: Patient-reported quality of life is strongly affected by some dermatologic conditions. We developed a Japanese version of the Dermatology Life Quality Index (DLQI-J) and used psychometric methods to examine its validity and reliability. METHODS: The Japanese version of the DLQI was created from the original (English) version, using a standard method. The DLQI-J was then completed by 197 people, to examine its validity and reliability. Some participants completed the DLQI-J a second time, 3 days later, to examine the reproducibility of their responses. In addition to the DLQI-J, the participants completed parts of the SF-36 and gave data on their demographic and clinical characteristics. Their physicians provided information on the location and clinical severity of the skin disease. RESULTS: The participants reported no difficulties in answering the DLQI-J items. Their mean age was 24.8 years, 77.2% were female, and 78.7% had acne vulgaris. The mean score of DLQI was 3.99(SD: 3.99). The responses were found to be reproducible and stable. Results of principal-component and factor analysis suggested that this scale measured one construct. The correlations of DLQI-J scores with sex or age were very poor, but those with SF-36 scores and with clinical severity were high. CONCLUSION: The DLQI-J provides valid and reliable data despite having only a small number of items.

Acne Vulgaris↗
PubMed2006

Imiquimod 5% cream monotherapy for cutaneous squamous cell carcinoma in situ (Bowen's disease): a randomized, double-blind, placebo-controlled trial.

BACKGROUND: We conducted a double-blind, placebo-controlled, randomized trial to evaluate the preliminary efficacy and safety of imiquimod 5% cream treatment for cutaneous squamous cell carcinoma (SCC) in situ. METHODS: In all, 31 patients with biopsy-proven cutaneous SCC in situ were randomly assigned to placebo (vehicle) (n = 16) or imiquimod 5% cream (n = 15) daily for 16 weeks. Patients were assessed at week 28 for the primary end point, resolution of cutaneous SCC in situ. RESULTS: Of the 31 patients enrolled, 3 dropped out. Intention-to-treat analysis revealed 11 of the 15 patients (73%) in the imiquimod group achieved resolution of cutaneous SCC in situ, with no relapse during the 9-month follow-up period; none in the placebo group achieved resolution (P < .001). Imiquimod 5% cream was generally well tolerated and there were no serious adverse events. LIMITATIONS: Topical imiquimod 5% cream has proven to be an effective treatment for cutaneous SCC in situ. However, studies to define the ideal dosing regimen and cost-effectiveness are required before it can be accepted as a recognized therapy. CONCLUSIONS: In this controlled trial, patients with cutaneous SCC in situ receiving topical imiquimod 5% cream as monotherapy experienced a high degree of clinical benefit compared with placebo.

Aged↗
PubMed2006

Numerous keratinocyte subtypes involved in wound re-epithelialization.

The expression of different keratin intermediate filaments has been used to define keratinocyte maturation and different phenotypic subtypes involved in acute wound (AW) healing. Immunohistochemistry with specific anti-keratin monoclonal and polyclonal antibodies was used to examine AW in normal healthy volunteers (n = 16). In all wounds examined, basal keratinocytes and cells at the leading edge of the wound expressed keratins K5 and K14. However, suprabasal cells had a more complex pattern of keratin expression, which was dependent on their position relative to the wound and location within the suprabasal compartment of the epidermis. In general, K10 was expressed in suprabasal keratinocytes at the wound edge, but not in keratinocytes covering the wound center, which expressed K6, K16, and K17 in a complex fashion. Ki67 expression, a marker of cell proliferation, was restricted to basal and immediate suprabasal layers at the wound edge. Keratinocytes populated the wound bed below the scab by migration, which was supported by keratinocyte proliferation in the surrounding epidermis both at and adjacent to the wound edge.

Cell Differentiation↗
PubMed2006

A randomized, investigator-masked clinical evaluation of the efficacy and safety of clobetasol propionate 0.05% shampoo and tar blend 1% shampoo in the treatment of moderate to severe scalp psoriasis.

The clinical benefit of currently available tar blend shampoos for the treatment of scalp psoriasis is restricted due to their limited efficacy, low cosmetic appeal and potential for carcinogenicity. This 4-week multicentre, randomized, parallel-group, investigator-masked study included 162 subjects and aimed to compare the efficacy, safety and cosmetic acceptability of clobetasol propionate 0.05% shampoo versus a currently marketed tar blend 1% shampoo in subjects with moderate to severe scalp psoriasis. Clobetasol propionate shampoo was superior to tar blend shampoo with respect to all efficacy variables tested (p<0.001): Total and Global Severity Score; erythema; plaque thickening; desquamation; pruritus; total scalp area involved; and the subject's global assessment of clinical improvement. Both treatments were safe and well-tolerated. Furthermore, more subjects indicated that clobetasol propionate shampoo was more cosmetically acceptable than tar blend shampoo. Clobetasol propionate 0.05% shampoo is a good alternative to tar blend shampoo in the treatment of moderate to severe scalp psoriasis.

Administration, Cutaneous↗
PubMed2006

Need and greed in dermatology: disease and outcome measures in dermatological healthcare planning.

Assessing dermatological needs in the population and our ability to meet them is a challenge. The choice of outcome measures is central in dermatological healthcare planning. The concept of ill health and its relationship to dermatological outcome measures is described. Outcome measures used should provide information on these issues in order to gain insight into genuine needs and illness behavior in the population and to ensure quality of healthcare. Nevertheless, the dilemma of assigning priorities in healthcare planning remains; outcome measures in dermatology should be perceived as appropriate by patients as well as by caregivers and policy makers. It is important to stimulate research to develop and refine person-focused outcome measures. Their use is essential to assess dermatological health needs and to understand illness behavior. The information they can provide can enable provision and evaluation of healthcare quality and contribute to the challenge of making appropriate priority decisions in healthcare.

Attitude to Health↗
PubMed2005

A critical review of Quality-of-Life Scales for Psoriasis.

Psoriasis can have a major impact on the lives of patients who have psoriasis and many different methods are described to measure this effect. This article describes four general health measures, six dermatology-specific measures, four psoriasis-specific measures, and four utility measure concepts that are used in psoriasis. For each of these, the extent of validation, including reliability of each measure and correlation with other measures, is described. The experience of use of each measure is summarized and key references listed. Advice is given concerning strategy for choosing which measures to use.

Dermatology↗
PubMed2005

Translating the science of quality of life into practice: What do dermatology life quality index scores mean?

This study's aim was to determine the relationship between Dermatology Life Quality Index (DLQI) scores and a Global Question (GQ) concerning patients' views of the overall impairment of their skin-related quality of life (QoL), and to express this relationship by identifying bands of DLQI scores equivalent to each GQ descriptor. A DLQI questionnaire and the GQ were mailed to 3834 adult general dermatology outpatients. There were 1993 (52%) responses: male 841; female 1152. Mean DLQI score = 4.86 (range 0-30, standard deviation (SD) = 5.83). Mean GQ score = 1.22 (range 0-4, SD = 1.20). The mean, mode, and median of the GQ scores for each DLQI score were used to devise several sets of bands of DLQI scores, and kappa coefficients of agreement calculated. The set proposed for adoption is: DLQI scores 0-1 = no effect on patient's life (GQ = 0, n = 754); DLQI scores 2-5 = small effect on patient's life (GQ = 1, n = 611); DLQI scores 6-10 = moderate effect on patient's life (GQ = 2, n = 327); DLQI scores 11-20 = very large effect on patient's life (GQ = 3, n = 242); DLQI scores 21-30 = extremely large effect on patient's life (GQ = 4, n = 59); kappa coefficient 0.489. Banding of the DLQI will aid the clinical interpretation of an individual's DLQI score and allow DLQI scores to inform clinical decisions.

Adolescent↗
PubMed2005

Two decades experience of the Psoriasis Disability Index.

The Psoriasis Disability Index (PDI) was formed 20 years ago. Since its introduction it has been used widely as a tool for assessment of quality of life in psoriasis. This paper reviews its use in 23 peer-reviewed articles and over 35 published abstracts, and describes its use in conjunction with other general and psoriasis-specific quality of life assessments, and with a range of physical and psychological measures. The PDI is effective in demonstrating the effects of interventions, both of treatments and in health service research. The PDI has been translated into at least 16 languages and has been used in published research in 20 countries.

Activities of Daily Living↗
PubMed2004

DLQI scores in vitiligo: reliability and validity of the Persian version.

BACKGROUND: The objective of this study was to translate and to test the reliability and validity of the 10-item Dermatology Life Quality Index (DLQI) questionnaire in Iranian patients with vitiligo. METHODS: Using a standard "forward-backward" translation procedure, the English language version of the questionnaire was translated into Persian (the Iranian official language) by two bilinguals. Seventy patients with vitiligo attending the Department of Dermatology, Saadi Hospital, Shiraz, Iran, were enrolled in this study. The reliability and internal consistency of the questionnaire were assessed by Cronbach's alpha coefficient and Spearman's correlation, respectively. Validity was performed using convergent validity. RESULTS: In all, seventy people entered into the study. The mean age of respondents was 28.3 (SD = 11.09) years. Scores on the DLQI ranged from 0 to 24 (mean +/- SD, 7.05 +/- 5.13). Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.77). There were no statistically significant differences between daily activity (DA) and personal relationship (PR) scale mean scores in generalized versus focal-segmental involvement in sufferers (P = 0.056, P = 0.053, respectively). There were also strong differences between the mean scores of the PR (personal relationship) scale with the involvement of covered only and covered/uncovered areas (P= 0.016) that was statistically significant in the second group. CONCLUSIONS: The study findings showed that the Persian version of the DLQI questionnaire has a good structural characteristic and is a reliable and valid instrument that can be used for measuring the effects of vitiligo on quality of life.

Adolescent↗
PubMed2004

The Cardiff Acne Disability Index: cultural and linguistic validation in French.

BACKGROUND: The Cardiff Acne Disability Index (CADI) evaluates the impact of acne on the patient's life. OBJECTIVE: The objective of the present study was to translate the CADI into French and to validate the French version. METHOD: The CADI was translated into French following international methodological recommendations (translation, quality control, back-translation and pilot test). RESULTS: Compatibility difficulties between the cultural background of UK and France were identified and resolved by the translation process, which should guarantee that specific words and phrases reflect the cultures in the respective countries. A pilot test in volunteers demonstrated the clarity and understandability of the questions across social classes and ages. A preliminary test-retest comparison of the final scale showed sufficient reliability, with a correlation coefficient of 0.90 for the total CADI score of the French version. Moreover, the good internal consistency of the scale was demonstrated with a Cronbach alpha of 0.87. CONCLUSION: The CADI, a valuable tool for assessing the impact of acne on a patient's life, can now be used in French.

Acne Vulgaris↗
PubMed2003

Hospitalization for severe skin disease improves quality of life in the United Kingdom and the United States: a comparative study.

BACKGROUND: Financial and managerial constraints have resulted in the rationalization of dermatology inpatient services in the United Kingdom and the United States. Therapeutic regimes may vary locally, regionally, and internationally but the clinical outcome of treatment remains the same. OBJECTIVE: We studied 2 inpatient units: the University of Wales College of Medicine, Cardiff, United Kingdom, and the University of Miami School of Medicine, Miami, Florida, to compare the use and effectiveness of the service provided. METHODS: Data were collected prospectively from inpatients during a 12-month period. The Dermatology Life Quality Index was administered on admission and after discharge. Data were recorded about the diagnosis, duration of admission, and referring dermatologist. RESULTS: In all, 295 patients (Cardiff, UK) and 366 patients (Miami, Fla) participated. The average duration of admission in Miami was 6.7 days compared with 14.2 (P <.0001) in Cardiff. In Miami, the most common reasons necessitating admission were extensive disease (54%), the patient being unwell (18%), photophoresis (14%), outpatient treatment failure (8%), and acute deterioration of disease (4%). In Cardiff, the common reasons were acute deterioration (35%), extensive disease (28%), outpatient treatment failure (22%), and liver biopsy (4%). The most common diagnoses in Cardiff were psoriasis (31%) and eczema (26%). In contrast, the most common diagnoses in Miami, were psoriasis (19%), leg ulcers (17%), and mycosis fungoides (14%). The mean Dermatology Life Quality Index value for all patients decreased after admission in Cardiff (14.9-8.2, P <.0001) and Miami (12.0-8.5, P <.0001). CONCLUSION: Despite the differences in the 2 health care systems, inpatient therapy remains an important and effective therapeutic option in the United States and the United Kingdom.

Delivery of Health Care↗
PubMed2003

Staphylococcal scalded skin syndrome: diagnosis and management.

Staphylococcal scalded skin syndrome (SSSS) is a common disorder that is usually seen in infants and children and rarely seen in adults. SSSS usually presents with a prodrome of sore throat or conjunctivitis. Extremely tender flaccid bullae, which are Nikolsky sign-positive, develop within 48 hours and commonly affect the flexures; occasionally, large areas of the skin may be involved. The bullae enlarge and rupture easily to reveal a moist erythematous base, which gives rise to the scalded appearance. SSSS in adults is a rare disorder, though there are now over 50 documented cases. Usually SSSS occurs in predisposed individuals, but not all adults have an underlying illness. Whereas mortality in childhood SSSS is approximately 4%, the mortality rate in adults is reported to be greater than 60%. SSSS is caused by an infection with a particular strain of Staphylococcus aureus, which leads to blistering of the upper layer of the skin, by the release of a circulating exotoxin. It has recently been demonstrated that the exfoliative exotoxin responsible for SSSS leads to the cleavage of desmoglein 1 complex, an important desmosomal protein. The same toxins that are responsible for causing SSSS also cause bullous impetigo. There appears to be a relationship between the disease extent, the amount of toxin produced and whether the toxin is released locally or systemically. As a result there is likely to be a spectrum of disease and there are likely to be a number of milder cases of adult SSSS that go undiagnosed. Social improvements and hygiene have led to a dramatic fall in the number of cases of SSSS. Treatment is usually straightforward, when there is no coexistent morbidity and the presentation is mild, but can be demanding if the patient is particularly ill. SSSS is still associated with mortality, particularly when it occurs in adults.

Biopsy, Needle↗
PubMedDate not supplied

Patient satisfaction with psoriasis therapies: an update and introduction to biologic therapy.

BACKGROUND: Psoriasis is a chronic, immune-mediated skin condition that often requires lifelong treatment. Many patients report dissatisfaction with traditional nonbiologic therapies because they are ineffective for their psoriasis, are associated with side effects, or impact negatively on quality of life. OBJECTIVES: The aim of this article is to review the effect on patient quality of life of traditional nonbiologic psoriasis therapies and to discuss the impact of biologic psoriasis therapies on patient satisfaction. METHODS: A review of the literature is presented. RESULTS: Traditional nonbiologic psoriasis therapies can negatively impact quality of life due to a variety of factors including inconvenience and toxicity. Biologic agents have been developed that target the immunopathogenesis of psoriasis. Based on favorable efficacy and safety results in clinical trials, some of these agents are now approved for clinical use. Evidence suggests that patients receiving biologic therapies experience significant improvements in health-related quality of life. CONCLUSION: Biologic agents offer new hope for patients with psoriasis that their chronic condition can be controlled in a manner that improves their quality of life and may lead to high levels of satisfaction with their treatment.

Alefacept↗
PubMedDate not supplied

The effect of atopic dermatitis on total burden of illness and quality of life on adults and children in a large managed care organization.

OBJECTIVE: To assess the impact of atopic dermatitis (AD) on total burden of illness and quality of life in a managed care population. METHODS: This study included retrospective evaluation of electronic claims, patient surveys of financial burden and quality of life (QOL), and medical chart review. A total of 962 AD patients had 12 months of claims data available. Of these, the Dermatology Life Quality Index (DLQI), SF-36, and Children's Dermatology Life Quality Index (CDLQI) were mailed to 400 participants (42%) who consented to take part in the prospective evaluation, 298 of whom returned evaluable questionnaires (75% response rate to survey and 31% of eligible patients). Survey responders comprised the cohort used for determination of economic and humanistic burden of illness. Additionally, socioeconomic demographics, out-of-pocket expenses, and clinical history (including disease severity) were collected via survey. Provider assessments of disease severity were collected via chart review. RESULTS: The patient mean age was 17.22+/-0.94 years, which was not unexpected considering AD is the eighth most common disease in people younger than 25 years. Mean 167 dollars per person, or only 27.4% of the total burden. A vast majority of the direct medical expenditures occurred in the outpatient setting and were composed primarily of clinic visits and medications. Approximately 50% of the total burden of illness associated with AD resulted from days lost from work. The remainder of the burden was out-of-pocket costs to the patients and their families. More than 75% of the out-of-pocket costs resulted from household items and medications. The mean DLQI score for the 107 adults was 6.6+/-5.4, and the mean CDLQI score among the 132 children aged 4 to 16 years was 5.8+/-5.9, compared with adults without skin disease (0.5+/-1.1) and children without skin disease (0.38+/-0.71) in the validation populations. Patient-assessed severity demonstrated a stronger correlation with CDLQI and DLQI than did provider-assessed severity. CONCLUSION: Atopic dermatitis, while not a life-threatening illness, imposes a financial burden on the health care system, but even more so on the individual. Indirect costs, such as the purchase of special household items and days lost from work, comprise a great proportion of this burden and should not be overlooked when evaluating this disease.

Journal Article↗