Publications by authors named "Joel Gelfand"

Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.

Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.

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  • The FORWARD Psoriasis Registry aims to gather real-world evidence on psoriasis by collecting patient-reported data independent of clinicians.
  • The study compares characteristics and treatment outcomes of two groups: those enrolling through a clinician and those self-enrolling online.
  • Results showed significant differences between the two groups in disease burden and treatment satisfaction, indicating the importance of diverse data collection methods for understanding psoriasis.
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  • The skin and cardiovascular systems are interconnected, with various cardiovascular diseases linked to specific skin manifestations.
  • Inflammatory skin conditions, like psoriasis, can lead to serious cardiovascular and metabolic health issues, while some cardiovascular medications may cause adverse skin reactions.
  • This review emphasizes the importance of integrating dermatology and cardiology insights for effective diagnosis and management of patients experiencing both skin and cardiovascular problems.
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  • The study addresses health-related stigma faced by individuals with chronic health conditions, highlighting its negative effects on mental and physical well-being.
  • Researchers created the Internalized Health-Related Stigma (I-HEARTS) Scale to measure this stigma across diverse health conditions, using feedback from affected individuals and health professionals.
  • The I-HEARTS Scale was validated through factor analysis, resulting in a reliable 25-item scale that identifies three key aspects of internalized stigma and helps indicate levels of stigma within the population studied.
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  • The study compares the effectiveness of home-based vs. office-based phototherapy for psoriasis, highlighting that while office therapy is cost-effective, it’s often hard to access compared to the more patient-preferred home therapy, which lacks sufficient clinical data, especially for those with darker skin.
  • Conducted across 42 dermatology practices in the US, the trial involved 783 participants aged 12 and older with psoriasis, who were randomly assigned to either home or office phototherapy for 12 weeks, followed by another 12 weeks of observation.
  • Results showed that home phototherapy led to better skin clearance and quality of life improvements, with 32.8% of participants achieving clear skin compared to
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  • Chronic graft-versus-host disease (cGVHD) is a serious complication after stem cell transplants, causing significant health issues and high mortality rates.
  • A study assessed skin biopsy samples from 49 cGVHD patients, identifying common histopathologic features in different types of the disease, including epidermal cGVHD (E-cGVHD) and sclerotic cGVHD (S-cGVHD).
  • Findings revealed that while most biopsies exhibited minimal active GVHD characteristics, they also shared similarities with inflammatory skin diseases, emphasizing the need for thorough histologic reports to guide treatment approaches.
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National guidelines define psoriasis as a risk enhancer for cardiovascular disease and recommend increased monitoring and more intense management of cardiovascular risk factors in these patients, who face an increased burden of cardiovascular disease morbidity and mortality. Screening for modifiable cardiovascular risk factors, including blood pressure, weight, cholesterol, glucose, and smoking, can be efficiently incorporated into routine dermatology clinical practice. Partnerships with primary care providers and preventive cardiologists are essential to improving management of cardiovascular risk in patients with psoriasis.

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Patients with autoimmune bullous diseases are at an increased risk of infection, both from the underlying skin disease and from immunosuppressive treatments. Limited information is available on vaccine beliefs and behaviors in dermatology patients and adults with autoimmune bullous diseases in particular. To understand vaccine decision making, identify perceived risks and benefits of vaccinations, and discuss individual experiences in patients with autoimmune bullous diseases in the United States.

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Systemic inflammation or insulin resistance drive atherosclerosis. However, they are difficult to capture for assessing cardiovascular risk in clinical settings. The monocyte-to-high-density lipoprotein ratio (MHR) is an accessible biomarker that integrates inflammatory and metabolic information and has been associated with poorer cardiovascular outcomes.

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Importance: Chronic graft-vs-host disease (GVHD) is associated with impaired quality of life and symptom burden. The independent association of skin involvement with patient-reported outcomes (PROs) and their utility as a clinical prognostic marker remain unknown. Identification of patients with cutaneous chronic GVHD and impaired PROs could assist in initial risk stratification and treatment selection.

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  • Psoriatic patients receiving vaccines need clear guidelines on whether to pause or maintain their systemic medications, especially for live and nonlive vaccines.
  • The National Psoriasis Foundation Medical Board and experts developed 22 consensus statements recommending that most patients can continue oral and biologic therapies for nonlive vaccines, but should consider stopping methotrexate.
  • For live vaccines, most therapies should be interrupted before and after vaccination, except for abatacept, and timing adjustments for vaccine administration are crucial.
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Muscle cramps in patients with chronic graft-versus-host disease (cGVHD) are common and associated with impaired quality of life and symptom burden. Muscle cramps are not currently captured in the 2014 National Institutes of Health (NIH) response criteria, and thus characterization and response to immunomodulatory therapies are lacking. The objective of this study was to characterize muscle cramp frequency, duration, and pain level in patients with steroid-refractory cGVHD undergoing extracorporeal photopheresis (ECP).

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Psoriasis is a chronic and inflammatory disease that affects the skin and joints and is associated with multiple comorbidities and cardiovascular risk factors. Consequently, patients with psoriasis have an increased risk of cardiovascular diseases such as atherosclerosis, a chronic pathology that shares common inflammatory and immune-response mechanisms with psoriasis, including vascular inflammation and complement activation. To better understand the relationship between atherosclerosis and psoriasis, a proteomics study followed by a bioinformatics analysis was carried out, with a subsequent validation step using ELISA and western blotting.

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Background: Atopic dermatitis (AD) is thought to induce asthma via the "atopic march," but the effects of AD on incident asthma and asthma severity have not been fully characterized.

Objective: To determine risk of asthma, asthma exacerbations, and asthma-related hospitalizations among patients fwith AD.

Methods: A cohort study was conducted using electronic health records data from UK general practices from 1994 to 2015.

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  • JAK inhibitors are effective for treating certain skin conditions but carry a FDA warning due to potential risks, including cardiovascular events and infections, based on data primarily from rheumatoid arthritis patients.
  • The study aimed to assess the risks associated with JAK inhibitors specifically in patients with dermatologic conditions, focusing on mortality and major adverse events.
  • Data from phase 3 clinical trials were analyzed using systematic review methodologies to evaluate the safety of these treatments in dermatology, with results derived from 35 randomized trials.
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Introduction: Life expectancy of patients with psoriasis is reduced by 4-5 years due to cardiovascular disease with an increased risk of myocardial infarction at an earlier age compared with the general population. This increased risk is independent of traditional cardiovascular risk factors and higher in moderate-to-severe forms of psoriasis. Inflammation may play a key role in the development of atherosclerosis in these patients.

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