JAMA Dermatology

<jats:sec id="ab-drv250004-4"><jats:title>Importance</jats:title><jats:p>Patient and caregiver values and preferences should inform clinical management. An update to the American Academy of Allergy, Asthma &amp;amp;amp; Immunology/American College of Allergy, Asthma and Immunology’s Joint Task Force on Practice Parameters guidelines on chronic urticaria (CU) plans to incorporate them; however, a systematic review of evidence on the values and preferences of patients with CU and their caregivers has not been previously available.</jats:p></jats:sec><jats:sec id="ab-drv250004-5"><jats:title>Objective</jats:title><jats:p>To synthesize patient and caregiver values and preferences regarding CU treatment options.</jats:p></jats:sec><jats:sec id="ab-drv250004-6"><jats:title>Evidence Review</jats:title><jats:p>A systematic search was conducted of  MEDLINE, Embase, PsycINFO, and CINAHL databases, from inception to May 15, 2025, for studies addressing patient and/or caregiver values and preferences for CU management. Paired reviewers independently screened studies, extracted data, and assessed risk of bias. Thematic and inductive content analysis was used to qualitatively synthesize findings and certainty of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation−Confidence in the Evidence from Reviews of Qualitative Research approach.</jats:p></jats:sec><jats:sec id="ab-drv250004-7"><jats:title>Findings</jats:title><jats:p>The search resulted in 18 studies addressing the values and preferences among 28 497 participants. Moderate certainty evidence showed that patients were likely to place a high value on rapid improvement (eg, 2 days to 2 weeks) of disease signs and symptoms, long-term effectiveness, and treatments that were easy to prepare, use, and self-manage—oral or topical treatments were favored over injections, with the least favored being infusions. Low certainty evidence suggested that patients accepted minor feasibility burdens for rapid and sustained symptom relief but prioritized safety and tolerability as the risk or severity of adverse effects (eg, kidney injury, vomiting) increased.</jats:p></jats:sec><jats:sec id="ab-drv250004-8"><jats:title>Conclusions and Relevance</jats:title><jats:p>This systematic review suggests that patients with CU place high value on immediate and sustained hive, itch, and swelling relief, particularly long-term symptom-free periods, but may shift to prioritizing avoiding harms and burdens as the risk and severity of adverse effects increases. These findings may serve as a resource to improve the trustworthiness of recommendations and inform future CU management and research.</jats:p></jats:sec>

Chronic urticaria and angioedema: masqueraders and misdiagnoses.

J Allergy Clin Immunol Pract

The diagnosis and management of acute and chronic urticaria: 2014 update.

J Allergy Clin Immunol

Chronic Urticaria.

N Engl J Med

Chronic spontaneous urticaria guidelines: what is new?

Urticaria and angioedema across the ages.

Translating evidence to optimize patient care using GRADE.

Trustworthy patient-centered guidelines: insights from atopic dermatitis and a proposal for the future.

Values and preferences of patients and caregivers regarding treatment of atopic dermatitis (eczema): a systematic review.

JAMA Dermatol

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

Health Qual Life Outcomes

The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria.

Allergy

Topical corticosteroids for hives and itch (urticaria): systematic review and Bayesian meta-analysis of randomized trials.

Ann Allergy Asthma Immunol

Leukotriene receptor antagonists as add-on therapy to antihistamines for urticaria: systematic review and meta-analysis of randomized clinical trials.

Efficacy and safety of systemic corticosteroids for urticaria: a systematic review and meta-analysis of randomized clinical trials.

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.

Extracting data from figures with software was faster, with higher interrater reliability than manual extraction.

J Clin Epidemiol

Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review.

BMJ Open

How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review.

Int J Nurs Stud

Health-related values and preferences regarding meat consumption: a mixed-methods systematic review.

Ann Intern Med

A classification of response scale characteristics that affect data quality: a literature review.

Qual Quant

Patient values and preferences on valve replacement for aortic stenosis: a systematic review.

Heart

A framework for practical issues was developed to inform shared decision-making tools and clinical guidelines.

Needs and preferences of patients regarding atopic dermatitis care in the era of new therapeutic options: a qualitative study.

Arch Dermatol Res

Methods for the thematic synthesis of qualitative research in systematic reviews.

BMC Med Res Methodol

Parents and GPs’ understandings and beliefs about food allergy testing in children with eczema: qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial.

GRADE Guidelines: 19. Assessing the certainty of evidence in the importance of outcomes or values and preferences-Risk of bias and indirectness.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 7: understanding the potential impacts of dissemination bias.

Implement Sci

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a summary of qualitative findings table.

Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data.

Do traditional beliefs about urticaria affect patient satisfaction in South India? – A knowledge, attitude and practices survey.

J Pak Assoc Dermatol

Educational level and job status are the most important factors affecting compliance with oral antihistamine therapy for patients with chronic urticaria.

J Dermatolog Treat

Quantifying patient preferences for treatments for refractory chronic spontaneous urticaria.

An open-label, multicentre study of levocetirizine for the treatment of allergic rhinitis and urticaria in Taiwanese patients.

Chin J Physiol

Rapid transition to home omalizumab treatment for chronic spontaneous urticaria during the COVID-19 pandemic: A patient perspective.

World Allergy Organ J

ATTENTUS, a German online survey of patients with chronic urticaria highlighting the burden of disease, unmet needs and real-life clinical practice.

Br J Dermatol

Chronic urticaria: a patient survey on quality-of-life, treatment usage and doctor-patient relation.

Treatment satisfaction in chronic urticaria during guideline-based therapy.

J Dtsch Dermatol Ges

Characteristics and determinants of patient burden and needs in the treatment of chronic spontaneous urticaria.

Eur J Dermatol

Use of, satisfaction with, and willingness to switch prescription and over-the-counter treatments for chronic urticaria: an online survey.

Patient

Patients with Chronic Urticaria Remain Largely Undertreated: results from the DERMLINE Online Survey.

Dermatol Ther (Heidelb)

Psychological well-being, quality of life and patient satisfaction among adults with chronic spontaneous urticaria in a multi-ethnic Asian population.

Psychol Health Med

Autoadministração de omalizumab na urticária crónica espontânea – Estudo observacional num centro UCARE.

Rev Port Imunoalergol

Assessing preferences of patients with chronic spontaneous urticaria for injectable treatment profiles.

Patient experiences of using Chinese herbal medicine for psoriasis vulgaris and chronic urticaria: a qualitative study.

Multicentre experience of home omalizumab treatment for chronic spontaneous urticaria.

Eur J Hosp Pharm

Perspectives on living with chronic spontaneous urticaria: from onset through diagnosis and disease management in the US.

Acta Derm Venereol

Understanding the impact of chronic spontaneous urticaria (CSU) and what is most important to patients 2014; results from qualitative patient interviews.

Value Health

Core GRADE 1: overview of the Core GRADE approach.

Urticaria voices: real-world experience of patients living with chronic spontaneous urticaria.

Online education with the patient voice highlights continuous gaps in care and needs for therapeutic options for chronic spontaneous urticaria (CSU) management.

A Patient charter for chronic urticaria.

Adv Ther

Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.

Long-term efficacy of fixed-dose omalizumab for patients with severe chronic spontaneous urticaria.

Long-term omalizumab in elderly patients with chronic urticaria: is it a safe therapy?

Int Arch Allergy Immunol

Comparative efficacy and safety of biologics and systemic immunomodulatory treatments for chronic urticaria: Systematic review and network meta-analysis.

Multinational drug survival study of omalizumab in patients with chronic urticaria and potential predictors for discontinuation.

Practical applications of methods to incorporate patient preferences into medical decision models: a scoping review.

BMC Med Inform Decis Mak

Patient and caregiver values and preferences should inform clinical management. An update to the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology's Joint Task Force on Practice Parameters guidelines on chronic urticaria (CU) plans to incorporate them; however, a systematic review of evidence on the values and preferences of patients with CU and their caregivers has not been previously available.
To synthesize patient and caregiver values and preferences regarding CU treatment options.
A systematic search was conducted of MEDLINE, Embase, PsycINFO, and CINAHL databases, from inception to May 15, 2025, for studies addressing patient and/or caregiver values and preferences for CU management. Paired reviewers independently screened studies, extracted data, and assessed risk of bias. Thematic and inductive content analysis was used to qualitatively synthesize findings and certainty of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach.
The search resulted in 18 studies addressing the values and preferences among 28 497 participants. Moderate certainty evidence showed that patients were likely to place a high value on rapid improvement (eg, 2 days to 2 weeks) of disease signs and symptoms, long-term effectiveness, and treatments that were easy to prepare, use, and self-manage-oral or topical treatments were favored over injections, with the least favored being infusions. Low certainty evidence suggested that patients accepted minor feasibility burdens for rapid and sustained symptom relief but prioritized safety and tolerability as the risk or severity of adverse effects (eg, kidney injury, vomiting) increased.
This systematic review suggests that patients with CU place high value on immediate and sustained hive, itch, and swelling relief, particularly long-term symptom-free periods, but may shift to prioritizing avoiding harms and burdens as the risk and severity of adverse effects increases. These findings may serve as a resource to improve the trustworthiness of recommendations and inform future CU management and research.

Patient Values and Preferences in Chronic Urticaria Treatment: A Systematic Review.

Patient Values and Preferences in Chronic Urticaria Treatment

International Journal of Dermatology

<jats:title>ABSTRACT</jats:title><jats:p>Although dermatologic conditions primarily manifest on the skin, an increasing amount of evidence demonstrates that these inflammatory conditions can have a deeper impact on our systemic health. The use of epigenetics to measure biological age, instead of chronological age, can give us insight into the systemic burden of these diseases on aging. We aimed to understand the degree to which each dermatological condition affects biological aging. A systematic review was performed of PubMed, Embase, and Web of Science to identify all publications that measured biological age in dermatological patients using epigenetic clocks. Six articles involved the following conditions: atopic dermatitis (AD) (1), hidradenitis suppurativa (HS) (1), and psoriasis (PsO) (4). Notably, patients with psoriatic arthritis, but not psoriasis alone, demonstrated significantly increased epigenetic aging compared to controls. Pediatric AD patients had an increase in the rate of biological aging as measured by the Horvath, Skin and Blood, PhenoAge, and GrimAge clocks. HS patients were found to have an increased biological age when assessing tissue from affected skin. Further research is needed to investigate correlations between disease severity and epigenetic aging, and for expansion into other dermatological diseases. Additionally, epigenetic clocks need to be developed that utilize different subsets of inflammation more broadly and skin biomarkers to provide a more accurate estimation for chronic inflammatory dermatological conditions.</jats:p>

publication_history

received

accepted

published

Risk of Myocardial Infarction in Patients With Psoriasis

JAMA

Psoriasis: A Possible Risk Factor for Development of Coronary Artery Calcification

British Journal of Dermatology

Management of Psoriasis as a Systemic Disease: What Is the Evidence?

DNA Methylation Analysis

Methods in Molecular Biology

Association Between Lifestyle Factors and CpG Island Methylation in a Cancer‐Free Population

Cancer Epidemiology, Biomarkers & Prevention

UV Radiation and Its Relation to DNA Methylation in Epidermal Cells: A Review

Epigenomes

Exercise Training and DNA Methylation in Humans

Acta Physiologica (Oxford)

Sleep Deprivation and the Epigenome

Frontiers in Neural Circuits

Filaggrin Mutations Associated With Skin and Allergic Diseases

New England Journal of Medicine

Genomic, Epigenomic, Transcriptomic, Proteomic and Metabolomic Approaches in Atopic Dermatitis

Current Issues in Molecular Biology

How Epigenetics Impacts on Human Diseases

European Journal of Internal Medicine

Epigenetic Clock: A Promising Biomarker and Practical Tool in Aging

Ageing Research Reviews

Epigenetic Biomarkers of Ageing Are Predictive of Mortality Risk in a Longitudinal Clinical Cohort of Individuals Diagnosed With Oropharyngeal Cancer

Clinical Epigenetics

The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews

A Case‐Control Study: Epigenetic Age Acceleration in Psoriasis

Archives of Dermatological Research

Aging in Psoriasis Vulgaris: Female Patients Are Epigenetically Older Than Healthy Controls

Immunity & Ageing

DNA Methylation Age Is Not Affected in Psoriatic Skin Tissue

Dysregulation of Epigenetic, Biological and Mitotic Age in the Context of Biologic Drug Treatment and Phototherapy in Plaque Psoriasis Patients

Journal of the European Academy of Dermatology and Venereology

Increased Epigenetic Age Acceleration in the Hidradenitis Suppurativa Skin

Epigenetic and Biological Age Acceleration in Children With Atopic Dermatitis

Journal of Allergy and Clinical Immunology: Global

An Epigenetic Biomarker of Aging for Lifespan and Healthspan

Aging (Albany NY)

Cutaneous and Systemic Psoriasis: Classifications and Classification for the Distinction

Frontier Medicine (Lausanne)

DNA Methylation GrimAge Strongly Predicts Lifespan and Healthspan

Genetic and Epigenetic Aspects of Atopic Dermatitis

International Journal of Molecular Sciences

The Aging of the Immune System

Transplant International

Role of Oestrogens on Oxidative Stress and Inflammation in Ageing

Hormone Molecular Biology and Clinical Investigation

Hidradenitis Suppurativa: Epidemiology, Clinical Presentation, and Pathogenesis

Journal of the American Academy of Dermatology

Epigenetic Regulation of Cellular Functions in Wound Healing

Experimental Dermatology

The Gut and Skin Microbiome and Its Association With Aging Clocks

Prolonging Fixation Time of an Alternative Fixative to Formalin for Dermatological Samples Using Standard Laboratory Protocols

Journal of Clinical Pathology

Although dermatologic conditions primarily manifest on the skin, an increasing amount of evidence demonstrates that these inflammatory conditions can have a deeper impact on our systemic health. The use of epigenetics to measure biological age, instead of chronological age, can give us insight into the systemic burden of these diseases on aging. We aimed to understand the degree to which each dermatological condition affects biological aging. A systematic review was performed of PubMed, Embase, and Web of Science to identify all publications that measured biological age in dermatological patients using epigenetic clocks. Six articles involved the following conditions: atopic dermatitis (AD) (1), hidradenitis suppurativa (HS) (1), and psoriasis (PsO) (4). Notably, patients with psoriatic arthritis, but not psoriasis alone, demonstrated significantly increased epigenetic aging compared to controls. Pediatric AD patients had an increase in the rate of biological aging as measured by the Horvath, Skin and Blood, PhenoAge, and GrimAge clocks. HS patients were found to have an increased biological age when assessing tissue from affected skin. Further research is needed to investigate correlations between disease severity and epigenetic aging, and for expansion into other dermatological diseases. Additionally, epigenetic clocks need to be developed that utilize different subsets of inflammation more broadly and skin biomarkers to provide a more accurate estimation for chronic inflammatory dermatological conditions.

Systematic Review of Accelerated Epigenetic Aging in Chronic Inflammatory Dermatology Conditions.

Systematic Review of Accelerated Epigenetic Aging in Chronic Inflammatory Dermatology Conditions

Journal of Dermatological Treatment

peerreview_statement

aims_and_scope_url

High doses intravenous immunoglobulin versus oral cyclosporine in the treatment of severe atopic dermatitis

Iran J Allergy Asthma Immunol

A body-weight-independent dosing regimen of cyclosporine microemulsion is effective in severe atopic dermatitis and improves the quality of life

J Am Acad Dermatol

For individuals with atopic dermatitis (AD), interpreting scientific papers that present clinical outcomes including the Eczema Area and Severity Index (EASI) and Investigators Global Assessment may be difficult. When compared to tabulated data and graphs, images from before and after treatment are often far more meaningful to these patients that ultimately will be candidates for the treatment. This systematic review focused on determining the frequency of clinical image sharing in AD research. Conducted in accordance with PRISMA guidelines, the review concentrated on randomized controlled trials that investigated predefined and available systemic treatments for AD. The search was performed in the MEDLINE database for studies published from the inception until 21 December 2023. The review included 60 studies, encompassing 17,799 randomized patients. Across these studies, 16 images representing 6 patients were shared in the manuscripts, leading to a sharing rate of 0.3‰. The almost missing inclusion of patient images in clinical trial publications hinders patient understanding. Adding images to scientific manuscripts could significantly improve patients' comprehension of potential treatment outcomes. This review highlights the need for authors, the pharmaceutical industry, study sponsors, and publishers to enhance and promote patient information through increased use of visual data.

A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy.

A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy

Advances in Skin &amp; Wound Care

<jats:title>ABSTRACT</jats:title>
          <jats:sec>
            <jats:title>OBJECTIVE</jats:title>
            <jats:p>To review the literature to determine whether compression therapies and nutrition status influence venous ulcer healing.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>DATA SOURCE</jats:title>
            <jats:p>A systematized bibliographic review was carried out by searching PubMed, Scopus, and Cochrane databases for studies published between 2015 and 2020, using descriptors in Spanish and English.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>STUDY SELECTION</jats:title>
            <jats:p>After establishing the research question and applying the filters based on inclusion and exclusion criteria, 114 articles were found. After screening, 11 articles were selected for the review: 8 were identified in the literature search, and 3 were added from the bibliographic references of other studies.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>DATA EXTRACTION</jats:title>
            <jats:p>The authors developed a data extraction sheet that recorded the following variables: author, country, year of publication, level of evidence, research design, therapy type, initial ulcer size, active ulcer history, pain, healed wounds, wound reduction, therapy tolerance, nutrition assessment method, body mass index, and nutrition disorders.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>DATA SYNTHESIS</jats:title>
            <jats:p>Four studies analyzed the relationship between nutrition status and venous ulcer healing, finding that these patients tend to have a high body mass index; a deficit of nutrients such as vitamin A, D, or zinc; and an excess of lipids and carbohydrates. Seven studies compared different types of compression to determine which provided the best results, with two- and four-layer therapy being the most commonly used. Variables such as small wound size and recent onset were associated with better prognosis.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>CONCLUSIONS</jats:title>
            <jats:p>In terms of nutrition, the parameters analyzed are very limited. Although several studies show that two-layer therapy produces the greatest ulcer healing, there is not enough information to recommend one type of therapy over the other. Therefore, more clinical trials are needed to study broader nutrition parameters and compare the types of therapy under matched conditions to determine their influence on ulcer healing.</jats:p>
          </jats:sec>

Why venous leg ulcers have difficulty healing: overview on pathophysiology, clinical consequences, and treatment

J Clin Med

What’s new: management of venous leg ulcers: approach to venous leg ulcers

Prevalence and clinical characteristics of chronic venous disease in patients seen in primary care in Spain: results of the international study Vein Consult Program

Cir Esp

Overview of guidelines for the prevention and treatment of venous leg ulcers: a US perspective

J Multidiscip Healthc

Venous ulcers: diagnosis and treatment

Am Fam Physician

Effects and associations of nutrition in patients with venous leg ulcers: a systematic review

J Adv Nurs

Nutrition in wound care management: a comprehensive overview

Wounds

Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers

Rev Col Bras Cir

Vitamin D deficiency in patients with chronic venous ulcers

Factors associated with poor healing and recurrence of venous ulceration

Plast Reconstr Surg

Nutritional support in the treatment and prevention of pressure ulcers: an overview of studies with an arginine enriched oral nutritional supplement

J Tissue Viability

Nutritional status and food intake in nine patients with chronic low-limb ulcers and pressure ulcers: importance of oral supplements

Nutrition

Understanding the role of nutrition and wound healing

Nutr Clin Pract

PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation

Hierarchy of evidence: levels of evidence and grades of recommendation from current use [in Spanish]

Rev Chilena Infectol

Clinical and cost-effectiveness of compression hosiery versus compression bandages in treatment of venous leg ulcers (Venous Leg Ulcer Study IV, VenUS IV): a randomised controlled trial

Lancet

Influence of Nutrition Status and Compression Therapy on Venous Ulcer Healing: A Systematic Review

Papers