Publications by authors named "Kulthanan K"
Article Synopsis
- Chronic urticaria (CU) in the Asia-Pacific region presents significant challenges for patients, highlighting the need for patient-centred care to involve them in health decisions.
- A survey and discussions with 13 expert dermatologists and allergists identified barriers to implementing these approaches, including patient awareness, healthcare access delays, financial issues, and low adherence to treatment.
- Experts recommended enhancing patient education, tailoring treatments to individual needs, promoting shared decision-making, and utilizing patient-reported outcome measures to improve CU management.
Purpose: A booster coronavirus disease 2019 (COVID-19) vaccination was proposed to preserve immunity and prevent new variants of the severe acute respiratory syndrome coronavirus 2 virus. The objectives of this study are to investigate clinical manifestations, associated factors and course of cutaneous reactions after the booster dose of COVID-19 vaccination, compared to the recommended 1st and 2nd doses.
Materials And Methods: This retrospective cohort study was conducted at Siriraj Hospital, Bangkok.
Article Synopsis
- CRUSE® is an app designed for people with chronic spontaneous urticaria (CSU) to track their symptoms using visual analogue scales (VASs), aiming to assess the app's effectiveness in measuring disease activity.
- A study analyzed three VASs related to CSU impact on daily life, including one specifically for the severity of urticaria, one for productivity, and a general health measure (EQ-5D), using data from nearly 6,000 patients over many days.
- The results showed that the CRUSE® app's VASs demonstrate strong validity and reliability, with the "VAS urticaria" being most effective in capturing symptom changes, while the minimal important difference (MID) values indicated meaningful changes
Background: Limited knowledge exists about genital psoriasis in Thai individuals.
Objectives: This study aimed to assess the clinical features of genital psoriasis and its effects on quality of life and sexual health in Thai patients.
Materials And Methods: A cross-sectional, self-administered question-based study was conducted at Siriraj Hospital.
Background: The understanding of genital vitiligo among Thai individuals is limited.
Objectives: This study evaluated the clinical presentation, quality of life, and sexual health consequences of genital vitiligo.
Methods: This cross-sectional, questionnaire-based study involving vitiligo patients aged 18 years or older with past or present genital involvement was conducted at Siriraj Hospital.
Background: Indirect immunofluorescence (IIF) plays a crucial role in the diagnosis of pemphigus and bullous pemphigoid (BP) by detecting the presence of circulating autoantibodies in the serum of patients. The standard serum transportation method requires delivery to laboratories at 2-8 °C within a day and storage at -20 to -80 °C. However, this protocol poses logistical challenges.
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- * Current treatment guidelines suggest increasing doses of second-generation antihistamines, but many patients don't see improvement due to various underlying causes.
- * New research is shifting toward personalized treatments based on individual patient factors, with promising developments like targeted therapies and medications that may effectively modify the disease.
Limited data exist on the factors associated with hospitalization and mortality in Asian inpatients with autoimmune bullous dermatoses (AIBDs). This study aimed to elucidate the risk factors affecting hospitalization and mortality rates in Asian patients with AIBDs. A retrospective analysis of patients with AIBDs treated at Siriraj Hospital during a 17-year period was performed using the International Classification of Diseases 10th revision codes.
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- A significant percentage (31.2%) of patients with chronic spontaneous urticaria (CSU) experience non-skin-related symptoms (NSRS) like recurrent fever, joint/bone/muscle pain, and malaise.
- These NSRS are linked to various trigger factors such as food and infections, as well as clinical characteristics like sleep disturbances and elevated inflammation markers.
- Patients with NSRS tend to have worse disease activity, longer duration of CSU, lower quality of life, and a higher likelihood of poor control over their symptoms, highlighting the need for improved management strategies.
Article Synopsis
- Angioedema (AE) is a condition characterized by localized swelling in the skin or mucous membranes and can be hereditary or acquired, making its classification complex due to various underlying mechanisms and taxonomies.
- The DANCE initiative, involving 91 experts from 35 countries, aimed to create a unified consensus on the definition, acronyms, and classification of AE through an extensive online discussion and voting process over 16 months.
- The resulting DANCE classification introduces five types of AE, standardizes terminology, and is designed to enhance research and patient care while complementing existing clinical guidelines without replacing them.
Background: There is a lack of real-life safety data on treatment options for chronic urticaria in the presence of comedication and comorbidities.
Methods: We present a single-center UCARE pilot study of 212 outpatients with chronic urticaria. Patients were divided into three groups according to different CU therapies according to international guidelines.
Background: Acne vulgaris (AV) is a prevalent skin condition known for its potential to cause scarring and psychological distress, often leading to diminished self-esteem. While topical and oral treatments are commonly prescribed, some patients experience treatment failure, adverse effects, or contraindications to conventional therapies. In response to these challenges, laser and energy-based device therapies have emerged as promising alternatives for individuals who fall into these categories, showing considerable potential in the treatment of AV.
View Article and Find Full Text PDFBackground: Baricitinib treatment in adults with moderate-to-severe atopic dermatitis (AD) has demonstrated rapid improvements in itch as well as AD sign severity and affected body surface area as assessed by the Eczema Area and Severity Index (EASI) total score, whether administered as monotherapy or in combination with topical corticosteroids (TCS). As EASI clinical signs differ in time course and associated antecedents, the effects of baricitinib on each individual clinical sign are of interest.
Objectives: In this post hoc analysis, we aimed to investigate the effects of baricitinib on individual EASI subscores, namely excoriation, oedema/papulation, erythema and lichenification, in both monotherapy and TCS combination therapy trials.
Background: Many patients with chronic spontaneous urticaria (CSU) do not achieve complete control of their symptoms with current available treatments. In a dose-finding phase 2b study, ligelizumab improved urticaria symptoms in patients with H1-antihistamine (H1-AH) refractory CSU. Here, we report the efficacy and safety outcomes from two ligelizumab phase 3 studies.
View Article and Find Full Text PDFIn vitro investigations of mast cell (MC) degranulation are essential for studying many diseases, particularly allergy and urticaria. Many MC-degranulation inducers are currently available. However, there is no previous systematic comparative analysis of these available inducers in term of their efficacies to induce MC degranulation.
View Article and Find Full Text PDFUnveiling the role of neutrophils in chronic spontaneous urticaria: Beyond mast cells.
Asian Pac J Allergy Immunol
September 2023
Mast cells and eosinophils are considered pivotal contributors to the pathogenesis of chronic spontaneous urticaria (CSU). However, emerging evidence suggests that neutrophils also play a central role. Cutaneous mast cells and macrophages orchestrate the recruitment of neutrophils through the regulation and activation of diverse processes, including heightened local vascular permeability and chemokine release.
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- - The integrated care pathways for atopic dermatitis (AD-ICPs) serve to connect existing treatment guidelines and expert insights into a structured plan that caters to different levels of AD severity and healthcare resources across various countries.
- - Developed by the GA LEN ADCARE network and other stakeholders in 2020-2021, the AD-ICPs detail diagnostics, treatment options, and emphasize the roles of pharmacologists and other contributors in managing AD, particularly in pediatric cases.
- - The initiative aims to enhance AD management through a multidisciplinary approach that addresses urgent needs like better access to care, specialist training, educational programs, and personalized treatments, ultimately leading to improved patient outcomes.
Background: Patients with chronic spontaneous urticaria (CSU) have spontaneous wheals (W), angioedema (AE), or both, for longer than 6 weeks. Clinical differences between patients with standalone W, standalone AE, and W and AE (W+AE) remain incompletely understood.
Objective: To compare W, AE, and W+AE CSU patients regarding demographics, disease characteristics, comorbidities, disease burden, and treatment response.
Blue Wheals and Blue Angioedema Induced by Blue Dyes: A Systematic Review.
J Allergy Clin Immunol Pract
October 2023
Background: Blue wheals and blue angioedema, the adverse reactions to blue dye injections with or without anaphylaxis, are poorly defined.
Objective: The objective is to review the characteristics (ie, sex and age at onset, interval between blue dye injection and symptom onset, clinical manifestations, duration of blue wheals or angioedema), natural courses, and treatments of blue dye adverse reactions.
Methods: A review of the articles published through July 2021 was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations.
Potential Therapeutic Approaches for Chronic Urticaria: Beyond H1-Antihistamines and Biologics.
J Allergy Clin Immunol Pract
August 2023
Chronic urticaria is a disease that can significantly impact a patient's quality of life and ability to function. There are effective treatment options, such as nonsedating antihistamines or biologics, but some patients do not respond to these therapies, or the therapies are not available or affordable to all patients. This review aims to summarize potential treatment strategies for patients (1) who do not respond to antihistamines and (2) cannot readily access or do not respond to biologics.
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- - This study aims to clarify the prevalence and severity of atopic dermatitis (AD) in adults across various regions, including Asia, Eurasia, and Latin America, revealing significant gaps in current understanding.
- - An international web-based survey collected data from multiple countries, finding AD prevalence varies from 3.4% in Israel to 33.7% in Thailand, often higher in females, with mild and moderate cases being more common than severe cases.
- - Results indicate that AD is a significant health concern in adults, challenging the notion that it predominantly affects children, as many respondents experience chronicity and high morbidity related to the condition.
Background: Angioedema (AE) is a condition associated with considerable morbidity and mortality that can significantly affect quality of life. AE often occurs in patients with CSU although the true prevalence remains unknown. Therefore, we conducted this systematic review and meta-analysis to summarize the available data.
View Article and Find Full Text PDFBackground: Food-dependent exercise-induced allergic reactions can manifest with wheals, angioedema, and anaphylaxis, alone or in combination.
Objective: To systematically review the clinical manifestation, culprit foods and exercise, augmenting factors, comorbidities, and treatment options of each phenotype.
Methods: Using predefined search terms, we assessed and analyzed the relevant literature until June 2021.