Marcus Schmitt-Egenolf

Umeå University | UMU · Department of Public Health and Clinical Medicine

Background Real-world data on health-related quality of life (HRQoL) in palmoplantar pustulosis (PPP) are scarce and few studies have analysed the generic HRQoL. Objectives To assess HRQoL using the generic EQ-5D instrument and the Dermatology Life Quality Index (DLQI) instrument in PPP compared to plaque psoriasis. Methods Cross-sectional data f...

Background Real-world data on health-related quality of life (HRQoL) in generalized pustular psoriasis (GPP) are scarce and studies have been restricted in terms of instruments used for assessments. Objective To assess generic and dermatology-specific HRQoL of patients with GPP compared with patients with plaque psoriasis using real-world data fro...

Background: Since the introduction of biologics for psoriasis, uptake has been uneven and limited. Few studies have investigated the influence of socioeconomic factors on access to biologics. Objective: To investigate how socioeconomic factors influenced access to biologics. Methods: Biologic-naïve patients in the Swedish National Register for Syst...

The aim of this study was to analyse sick leave in generalized pustular psoriasis, the most severe form of pustular psoriasis. Prolonged sick leave of >14 days was analysed for 502 patients with generalized pustular psoriasis compared with controls with psoriasis vulgaris and matched controls from the general population. Using data from the Swedish...

Background Patient reported experiences in individuals being investigated for cancer have been recorded in a nationwide survey in Sweden, providing an opportunity to assess the impact of the Covid-19-pandemic. Material and Methods Questionnaires from 45920 patients were analyzed to assess the experience of being investigated for cancer. Data from...

Evidence-based medicine was in the past primarily based on the (meta-)analysis of randomized clinical trials (RCTs) [...]

This study investigated the comorbidity burden of Swedish patients with palmoplantar pustulosis (PPP) vs. the general population and patients with psoriasis vulgaris (PV). We found a significantly higher comorbidity burden in patients with PPP compared with the general population, represented by higher odds for disease across different categories (...

Generalized pustular psoriasis (GPP) (prevalence 1.8-124/million people1,2) is a severe form of pustular psoriasis characterized by acute flares with systemic inflammation3. GPP is associated with several comorbidities1,4, and ~50% of patients with GPP have concomitant psoriasis vulgaris (PV)1,4. We have assessed mortality and cause of death in GPP...

Background The EQ VAS component of the EQ-5D questionnaire has been used to assess patients' valuation of their own health besides its use for self-reporting of overall health status. The objective of the present study was to identify patients' valuation of EQ-5D-3L health states using the EQ VAS in different patient groups over time and in compari...

Background Psoriasis severity has traditionally been categorized as mild, moderate, and severe. Commonly, cut-offs for severe disease require a body surface area (BSA) involvement of ≥10% or a Psoriasis Area Severity Index (PASI) > 10. However, clinical experience challenges these traditional measures and requirements, as patients with less extensi...

The aim of this study was to estimate the economic burden of palmoplantar pustulosis, a chronic relapsing skin condition commonly occurring in combination with psoriasis vulgaris. Using data from the Swedish National Patient Register and Swedish Prescribed Drug Register for 2015, the study estimated all-cause and palmoplantar pustulosis-specific he...

Background: Interleukin (IL) inhibitors have made completely cleared skin achievable for many patients with moderate to severe psoriasis in clinical trial settings. Few observational studies assess treatment response in accordance with treatment goals in guidelines. Objectives: The aim of the study was to analyze the treatment response of IL-17/...

Background: Generalized pustular psoriasis (GPP), which can occur with or without psoriasis vulgaris (PV), is a severe form of pustular psoriasis with potentially life-threatening symptoms. GPP is also associated with several comorbidities, which further adds to the burden of disease. This study investigates the economic burden of disease in patie...

Background Comprehensible, relevant information empowers patients, allowing them to take an active part in their care. We aim to investigate how Swedish melanoma patients perceive information provided in routine clinical practice and explore the correlation between satisfaction with information, symptoms and functioning scales, and quality of life....

Background Generalised pustular psoriasis (GPP) is a severe form of pustular psoriasis with generalised eruption of sterile pustules, often along with systemic symptoms. There is a scarcity of population-based estimates of GPP prevalence and incidence. Objectives To estimate i) the prevalence and incidence of GPP in the Swedish general population...

Purpose Evidence is insufficient to infer whether topical calcineurin inhibitors (TCIs; tacrolimus and pimecrolimus) cause malignancy. The study objective was to estimate the long-term risk of skin cancer and lymphoma associated with topical TCI use in adults and children, separately. Patients and Methods A cohort study in Denmark, Sweden, UK, and...

IntroductionBiologic treatments for psoriasis are commonly switched. Treatment persistence represents an important parameter related to long-term therapeutic performance. The objective of the study was to analyse the real-world persistence with biologics over time in the treatment of psoriasis.MethodsA retrospective observational study of adults wi...

Background EQ-5D is one of the most commonly used questionnaires to measure health-related quality of life. It is included in many of the Swedish National Quality Registers (NQRs). EQ-5D health states are usually summarized using “values” obtained from members of the general public, a majority of whom are healthy. However, an alternative, which rem...

Studies of the effects of bariatric surgery on psoriasis are few, with conflicting results. By linking the Swedish National Register for Systemic Treatment of Psoriasis (PsoReg) with the Scandinavian Obesity Surgery Registry (SOReg), individuals with psoriasis who had undergone bariatric surgery in Sweden during 2008 to 2018 were identified, and ma...

Background Palmoplantaris pustulosis (PPP) is a chronic relapsing skin condition characterized by sterile pustules on the palm and soles. Population‐based estimates of PPP incidence and prevalence are limited. Objectives To estimate the prevalence and incidence of PPP in the Swedish general population and to estimate the prevalence of psoriasis vu...

This evidence- and consensus-based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The second part of the guideline provides guidance for specific clinical and comorbid situations such as treating psoriasis vulgaris patient with concomitant psoriatic arth...

This evidence‐ and consensus‐based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The first part of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline. Sug...

Linked Article: Warren et al. Br J Dermatol 2021; 184:50–59.

Background Most anti‐tumour necrosis factor (anti‐TNF) agents are transferred across the placenta and may increase paediatric susceptibility to infections. Aims To assess the risk of paediatric infections after maternal anti‐TNF treatment. Methods Population‐based cohort study in Denmark, Finland and Sweden 2006‐2013 in which 1027 children born t...

Importance Psoriasis is a complex systemic disease with skin involvement, somatic comorbidity, and psychiatric illness (PI). Although this view of psoriasis is widely accepted, potential synergies within this triad of symptoms have not been adequately investigated. Objectives To investigate the independent association of skin psoriasis and somatic...

Purpose: To study the risk of preterm birth, caesarean section, and small for gestational age after anti-tumor necrosis factor agent treatment (anti-TNF) in pregnancy. Methods: Population-based study including women with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis, and their infant...

Only few studies that have investigated the Health‐Related Quality of Life (HR‐QoL) in melanoma patients 1‐4, reviewed in Chernyshov et al.5. This is to the best of our knowledge the first population‐based study investigating HR‐QoL in proximity to the time the patient has received melanoma diagnosis. A cross‐sectional survey, approved by the ethic...

Background: PASI90 is suggested to be the new standard endpoint RCTs of biologics for psoriasis, whereas treatment guidelines often still refer to PASI75. Objectives: To analyse in a real-world setting: Firstly, what factors are associated with higher levels of treatment response to biologics. Secondly, the Health-Related Quality of Life gains a...

National Psoriasis guidelines for Sweden by The National Board of Health and Welfare (Socialstyrelsen)

Linked Article: Nast et al. Br J Dermatol 2018; 178:400–405.

Patients with mild disease are usually treated with topical treatments, meaning applied to the skin, while patients with moderate to severe disease require systemic treatments (taken inside the body), which includes drugs called biologics. PsoReg is the Swedish national register established in 2006 to monitor the long term effectiveness and safety...

We are experiencing a revolution in the distribution of knowledge in the twenty-first century. Knowledge is no more centrifugally dispensed, means centrally produced and distributed in the periphery—today knowledge is produced everywhere and can be accessed instantaneously everywhere. Technological and methodological progress allows us now to evalu...

Background Assessing the impact of disease severity on generic quality of life (QOL) is a critical step in outcomes research and in the development of decision-analytic models structured around health states defined by clinical measures. While data from routine clinical practice found in healthcare registers are increasingly used for research, more...

Background: Few studies have analysed the long-term effects of biological treatment in psoriasis. PsoReg, the Swedish national register for systemic psoriasis treatment, started in 2006 and includes now ten years of real-world data on effectiveness of biological treatment. Objective: To analyse long-term real-world outcome data on biological-naï...

Background Psoriasis is a common skin disease and moderate to severe psoriasis is associated with a dose-dependent risk for metabolic and cardiovascular morbidity. It has previously been speculated that women have less severe psoriasis, as men are overrepresented in psoriasis registers and consume more care. Objective The objective of this study wa...

Background Although biologics introduced a new era in psoriasis care when available a decade ago, it is unclear to what extent the available systemic treatments treat patients adequately. Objective To analyse the clinical severity and quality of life of the psoriasis population in Sweden treated with systemics. Methods Data included 2,646 patients...

Background Observational studies suggest an inequitable prescription of biologics in psoriasis care, which may be attributed to geographical differences in treatment access. Sweden regularly ranks high in international comparisons of equitable healthcare, and is, in connection with established national registries, an ideal country to investigate po...

Periodontal Ehlers-Danlos syndrome (pEDS) is an autosomal-dominant disorder characterized by early-onset periodontitis leading to premature loss of teeth, joint hypermobility, and mild skin findings. A locus was mapped to an approximately 5.8 Mb region at 12p13.1 but no candidate gene was identified. In an international consortium we recruited 19 i...

Background Previous research indicates an uneven uptake of biologics in patients with moderate-to-severe psoriasis in Sweden. Therefore, it is essential to scrutinise variations in treatment patterns. Objective The aim of this study was to evaluate the extent to which the uptake of biologics for psoriasis differs between types of healthcare provide...

Background The Swedish National Register for Systemic Treatment of Psoriasis (PsoReg) was established in 2006. This article analyzes the implementation phase of biologics in the treatment of moderate to severe psoriasis in Sweden in the period 2006–2012. Clinical studies have shown efficacy of biologic agents in psoriasis, but their relative effect...

Background: Inequality in healthcare has been identified in many contexts. To the best of our knowledge, this is the first study investigating age inequality in the form of prescription patterns of biologics in psoriasis care. Objectives: To determine whether patients with psoriasis have equal opportunities to receive biological medications as t...

Background: Mutations in the EDAR-gene cause hypohidrotic ectodermal dysplasia with defects in ectodermal appendage development including teeth, skin, exocrine glands and hair. Hair defects are sparsely described in genetically defined samples. The aim of this study was to investigate hair structures in three families with a heterozygous c.1072C >...

Background: Clinical studies of continuous versus intermittent biologic therapy for moderate to severe psoriasis demonstrate improved efficacy with continuous treatment. Objective: To analyse Swedish real-world data of continuously and intermittently treated biologic-naïve patients after switching to a biologic agent. Methods: This is an obser...

Background Following the establishment of the National Quality Registry for systemic psoriasis treatment (PsoReg), the two psoriasis outcome measurements, Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), are now integrated in clinical practice in Sweden. According to current guidelines, the initiation of a biologi...

Background Mutations in the EDAR-gene cause hypohidrotic ectodermal dysplasia, however, the oral phenotype has been described in a limited number of cases. The aim of the present study was to clinically describe individuals with the c.1072C > T mutation (p. Arg358X) in the EDAR gene with respect to dental signs and saliva secretion, symptoms from o...

The introduction of biologics has changed treatment patterns as well as costs in patients with psoriasis. To estimate direct and indirect costs of the psoriasis population in Sweden, and to analyse changes in costs between 2006 and 2009. The study population was identified in national registers. Direct costs included health care visits with primary...

We aimed to describe and compare patients diagnosed with malignant melanoma (MM), depending on their initial contact with care and with regard to age, sex, and MM type and thickness, and to explore pathways and time intervals (lead times) between clinics from the initial contact to diagnosis and treatment. The sample from northern Sweden was identi...

Den farligaste typen av hudcancer – malignt melanom – kan vara dödlig om den inte upptäcks och opereras bort i tid. Här får du råd om hur du skyddar dig och dina nära. Malignt melanom ökar Varje år upptäcks mer än 3 000 nya maligna melanom i Sverige och dess -utom 1 500 fall av förstadier till malignt melanom, så kallade in-situ-melanom. Det är dub...

Moderate to severe psoriasis, once regarded as merely a skin disease, is today seen as an inflammatory systemic disease. The sex ratio of the prevalence of psoriasis is balanced. In recent years several reports have documented that men receive more systemic or UV treatment than women, and different hypotheses were made. In PsoReg, the national regi...

Early care seeking is important for prognosis of malignant melanoma. Coping styles in decision-making to seek care can relate to prognosis since avoidant strategies could delay care seeking. The aim of this study was to compare self-reported coping styles in decision-making between men and women diagnosed with malignant melanoma. We used the Swedis...

Background: Although clinical studies have shown efficacy of biological agents in moderate to severe psoriasis, observational studies of real-world effectiveness are rare. Objective: To analyse the psoriasis area and severity index (PASI) and quality of life by the EQ-5D questionnaire and dermatology quality of life index (DLQI) in psoriasis pat...

Large disease registries are the preferred method to assess long-term treatment safety. If psoriasis registries collaborate in a network, their power to assess safety is increased. To identify heterogeneity in psoriasis registries and methodological challenges for synthesising the data they provide. We surveyed the registries in PSONET and identifi...

As moderate to severe psoriasis is a systemic disease with large effects on health-related quality of life, generic measures that include overall health, not only skin involvement, are necessary. Knowledge about the relationship between the generic preference-based EuroQol 5D (EQ-5D) and dermatology-specific measures in psoriasis is limited. To ana...

Gender patterns in self-detection of melanoma are not sufficiently highlighted in the literature. The aim of the study was to identify specific patterns in the decision-making process to seek care for suspect melanoma, as narrated by women and men. Females have a more favourable prognosis than males and also a higher level of perceived susceptibili...

hajdarevic s, hörnsten a, sundbom e, brulin c, schmitt-egenolf m (2010) Journal of Nursing and Healthcare of Chronic Illness 2, 164–173 Patients’ decision making in seeking care for suspected malignant melanoma Aim. To explore patients’ decision making about seeking care for malignant melanoma (MM). Background. Unlike other cancers, MM is generally...

Sorry, there is no abstract.

With the introduction of new systemic drugs for the management of psoriasis, we felt an obligation in Sweden to establish a trusted tool to monitor their use. We formed PsoReg to create a solid, long-term database in order to analyze safety and effectiveness of different systemic psoriasis treatment regimens. PsoReg will provide information to help...

The introduction of new therapeutic options for the management of psoriasis is a challenge for the dermatology community, and new tools are needed to face this challenge. This article argues for the establishment of profession-based registries to collect solid, long-term data on the safety and effectiveness of different psoriasis treatment regimens...

Hypohidrotic ectodermal dysplasia (HED) is a genetic disorder characterized by defective development of teeth, hair, nails and eccrine sweat glands. Both autosomal dominant and autosomal recessive forms of HED have previously been linked to mutations in the ectodysplasin 1 anhidrotic receptor (EDAR) protein that plays an important role during embry...

The introduction of a new generation of drugs for the systemic treatment of psoriasis might be a challenge to the dermatologic community. How do we face this challenge?

The anti-inflammatory cytokine interleukin (IL)-10 is considered to play a major role in the pathophysiology of psoriasis, which is characterized by an IL-10 deficiency. Systemic administration of IL-10 has been shown to be an effective therapy for psoriasis. The IL-10 promoter region contains a highly polymorphic microsatellite (IL10.G) and in a r...

To follow up the novel psoriasis susceptibility region on chromosome 19 (PSORS6), we performed an association scan for psoriasis vulgaris using 45 evenly spaced DNA microsatellite markers. For this study, a new independent sample of 210 nuclear psoriasis families (trio design) from Northern Germany was recruited. We used the family based associatio...