International Bullous Diseases Group: consensus on diagnostic criteria for epidermolysis bullosa acquisita.

Background: Epidermolysis bullosa acquisita (EBA) is a complex autoimmune bullous disease disease with variable clinical presentations and multiple possible diagnostic tests, making an international consensus on the diagnosis of EBA essential.

Objectives: To obtain an international consensus on the clinical and diagnostic criteria for EBA.

Methods: The International Bullous Diseases Group (IBDG) met three times to discuss the clinical and diagnostic criteria for EBA.

Development of classification criteria for discoid lupus erythematosus: Results of a Delphi exercise.

Background: No classification criteria currently exist for discoid lupus erythematosus (DLE), which has led to problematic heterogeneity in both observational and interventional research efforts.

Objectives: We sought to develop DLE classification criteria based on consensus of international expert opinion of relevant stakeholders in the field.

Methods: Using a Delphi consensus process and nominal group techniques, potential items for classification criteria were generated.

Developing classification criteria for discoid lupus erythematosus: an update from the World Congress of Dermatology 2015 meeting.

Currently, no standardized classification criteria exist for cutaneous lupus erythematosus. With increased interest in studying cutaneous lupus erythematosus, specifically discoid lupus erythematosus, it is our aim to apply previously adopted methods from rheumatology to dermatologic diseases to develop feasible, validated, and standardized classification criteria useful in both academic and community practice. Here we report the progress to date to define discoid lupus erythematosus using clinical, histopathologic, and serologic features by means of a Delphi method-using a series of iterative questionnaires sent to expert stakeholders.

Using the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria to determine the diagnosis of systemic lupus erythematosus (SLE) in patients with subacute cutaneous lupus erythematosus (SCLE).

Background: Approximately 50% of patients with subacute cutaneous lupus erythematosus (SCLE) meet criteria for systemic lupus erythematosus (SLE). The Systemic Lupus International Collaborating Clinics (SLICC) developed new SLE criteria to improve the American College of Rheumatology (ACR) criteria but the SLICC criteria have not been evaluated in patients with SCLE.

Objective: We sought to determine how patients with SCLE/SLE meet the ACR and SLICC criteria to compare the 2 sets of criteria.

Redefining cutaneous lupus erythematosus: a proposed international consensus approach and results of a preliminary questionnaire.

There is currently no uniform definition of cutaneous lupus erythematosus (CLE) upon which to base a study population for observational and interventional trials. A preliminary questionnaire was derived from and sent to a panel of CLE experts which demonstrated consensus agreement that (1) there is a need for new definitions for CLE (2) CLE is distinct from systemic lupus erythematosus and that a CLE grouping scheme should remain apart from current systemic lupus erythematosus schema (3) current CLE grouping schemes are inadequate around communication, prognostic information and to meet the needs of researchers, clinicians, patients and payers.

Disparities in housing status among veterans with general medical, cognitive, and behavioral health conditions.

Objective: The study explored disparities in housing status among veterans with general medical, cognitive, and behavioral health conditions.

Methods: Multinomial mixed-effects models estimated the relationship between medical, cognitive, and behavioral health comorbidities and housing instability among veterans enrolled in the Veterans Health Administration (VHA) (N=1,582,125) who responded to the Homelessness Screening Clinical Reminder for homelessness and risk during a three-month period.

Results: Veterans were two or more times as likely to screen positive for homelessness or risk if they had a diagnosis of a cognitive or behavioral health conditions in the study.

Definitions and outcome measures for mucous membrane pemphigoid: recommendations of an international panel of experts.

Mucous membrane pemphigoid encompasses a group of autoimmune bullous diseases with a similar phenotype characterized by subepithelial blisters, erosions, and scarring of mucous membranes, skin, or both. Although knowledge about autoimmune bullous disease is increasing, there is often a lack of clear definitions of disease, outcome measures, and therapeutic end points. With clearer definitions and outcome measures, it is possible to directly compare the results and data from various studies using meta-analyses.

Five-year malignancy incidence in patients with chronic pruritus: a population-based cohort study aimed at limiting unnecessary screening practices.

Background: The incidence of malignancy in patients with chronic pruritus and nondiseased skin is unknown.

Objective: We sought to assess the hazard ratio (HR) of incident overall malignancy and incident malignancy by subtype in patients with chronic pruritus during the 5 years after diagnosis.

Methods: A population-based cohort study was performed in the Health Improvement Network.

Laser light visual cueing for freezing of gait in Parkinson disease: A pilot study with male participants.

Freezing of gait (FOG) is a debilitating feature of Parkinson disease (PD). In this pilot study, we sought to assess the efficacy of a rolling walker with a laser beam visual cue to treat FOG in PD patients. We recruited 22 subjects with idiopathic PD who experienced on- and off-medication FOG.

Characterization of clinical photosensitivity in cutaneous lupus erythematosus.

Background: Photosensitivity (PS) in lupus erythematosus (LE) is frequently determined by patient report.

Objective: We sought to characterize self-reported PS in cutaneous LE (CLE).

Methods: The PS survey was used to classify subject responses into 5 phenotypes: direct sun-induced CLE flare (directCLE); general exacerbation of CLE (genCLE); polymorphic light eruption-like reactions (genSkin); general pruritus/paresthesias (genRxn); and sun-induced systemic symptoms (genSys).

Prevalence of self-report photosensitivity in cutaneous lupus erythematosus.

Background: Little is known about the prevalence of self-reported photosensitivity (PS) and its effects on quality of life in a US cutaneous lupus population.

Objective: We sought to determine the prevalence of self-reported PS among a cutaneous lupus population and to examine its impact on quality of life.

Methods: A total of 169 patients with lupus were interviewed about PS symptoms and completed the modified Skindex-29+3, a quality-of-life survey.

Quality of life in dermatomyositis.

Background: Quality of life (QoL) for patients with inflammatory skin disease can be significant, but has been evaluated in just one study in dermatomyositis (DM).

Objective: We sought to examine the relationship between the Cutaneous Dermatomyositis Area (CDASI) and Severity Index, a DM-specific cutaneous severity instrument, and various QoL study instruments and to determine the impact of DM on QoL.

Methods: Skin-specific QoL instruments, the Skindex and the Dermatology Life Quality Index, and global medical QoL instruments, the Short Form 36 and the Health Assessment Questionnaire-Disability Index, were used.

Quality of life in cutaneous lupus erythematosus.

Background: Little is known about quality of life in patients with cutaneous lupus erythematosus.

Objective: We sought to determine how cutaneous lupus affects quality of life and which independent variables are associated with poor quality of life.

Methods: A total of 157 patients with cutaneous lupus completed surveys related to quality of life, including the Skindex-29 and the Short Form-36.

Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women?

Objective: To determine whether asymptomatic bacteriuria in elderly ambulatory women is a marker of increased mortality and, if so, whether it is because of an association with other determinants of mortality or because asymptomatic bacteriuria is itself an independent cause, the removal of which might improve longevity.

Design: A cohort study and a controlled clinical trial of the effect of antimicrobial treatment.

Setting: A geriatric center and 21 continuing care retirement communities.