Flare Frequency and Duration in Patients with Generalized Pustular Psoriasis (GPP)
Notice bibliographique
Résumé
Introduction: Generalized pustular psoriasis (GPP) is a rare, neutrophilic, chronic skin disease in which an overactivation of inflammatory pathways causes widespread erythema and eruption of sterile pustules that may coalesce into ‘lakes of pus’. GPP flares are heterogeneous, and there is no standard clinical definition. GPP flares are painful; severe cases may require emergency treatment and can lead to life-threatening complications such as sepsis. The objective of this study was to characterize the frequency, number, and duration of flares in patients with GPP. Methods: We conducted a retrospective chart review including patients of all ages with a confirmed diagnosis of GPP after 2011 receiving care at 27 sites in France, Malaysia, and Tunisia. Results: Data from 175 patients were included (France: 58.9%, Malaysia: 31.4%, Tunisia: 9.7%). Mean (SD) follow-up was 5.0 (3.1) years. Flare-related care was the second most common reason for patient visits, accounting for 200 of 1378 follow-up visits after GPP diagnosis, surpassed only by routine follow-up. The mean (SD) annual number of flare episodes was 2.3 (2.0); the total number of flare episodes since the initial flare leading to diagnosis ranged from 0 to 9. Eighty-three (47.4%) patients experienced ≥1 flare episode after diagnosis, though individual country data suggested a higher flare burden in Tunisia (70.6%) and Malaysia (54.5%) versus France (39.8%). Twenty-eight patients (16.0%) had ≥2 flare episodes (60 visits); median (min, max) time between episodes was 11.6 (0.1, 52) months. The mean (SD) duration of flares was 34.3 (41.3) days during follow-up. Of 254 hospitalizations, 128 (50.4%) were flare-related inpatient admissions. Overall, 37.5% of GPP flares required inpatient care. The mean (SD) duration of flare-related admissions was almost twice as long as non-flare admissions at 19.2 (23.1) days versus 10.5 (8.1) days. Mean (SD) time between flare-related hospitalizations among 66 patients (128 hospitalizations) was 14.1 (17.1) months, with a median of 9.5 months indicating a skew distribution. Conclusion: Flare episodes are a heavy burden for patients with GPP, with flares recurring as often as once a year and lasting up to 2 weeks or more. Flares account for >50% of hospitalizations for patients with GPP and are an important cause of follow-up care visits. The frequency of flares varied between patients, with some individuals experiencing up to 10 episodes over the study period. Heterogeneity of flares and rarity of GPP make diagnosis and clinical study challenging, while the severity of acute episodes and the burden of flare reoccurrence demonstrate the need for more effective treatment options.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».