Browsing by Author "Wattanasillawat P."

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    Factors Associated with Symptomatic Dermographism: Findings from the UCARE PREVALENCE-D Study
    (2026-01-01) Kulthanan K.; Bernstein J.A.; Rudenko M.; Salameh P.; Komoltri C.; Hameed Z.A.; Adışen E.; Al Abri S.; Al-Ahmad M.; Al Hinai B.; Allenova A.; Alshareef S.; Angkoolpakdeekul N.; Arnaout R.; Bartosińska J.; Cherrez-Ojeda I.; Chularojanamontri L.; Criado P.R.; Elsaeed H.; Criado R.F.J.; Farahat A.; Calle C.A.G.; Giménez-Arnau A.M.; Godse K.; Gotua M.; Gülengül M.; Hide M.; Inomata N.; Jung C.G.; Kasperska-Zając A.; Khoshkhui M.; Kolkhir P.; Krasowska D.; Laomoleethorn J.; Maiorowa A.; Manuskiatti P.; Meshkova R.; Mijakoski D.; Muñoz M.; Nasr I.; de Aquino Arnoldi D.N.S.; Kara R.Ö.; Paringkarn T.; Pérez-Manich J.; Podder I.; Robles-Velasco K.; Rosmaninho I.; Saengthong-aram P.; Shengelidze G.; Sittiwanaruk S.; Tafrishi R.; Mitrevska N.T.; Trajkova V.; Tuchinda P.; Viriyaskultorn N.; Wannawittayapa T.; Wattanasillawat P.; Wilson A.; Ye Y.M.; Zalewska-Janowska A.; Maurer M.; Zuberbier T.; Kulthanan K.; Mahidol University
    Background and Objective: Symptomatic dermographism (SD), the most common chronic inducible urticaria subtype, manifests as strip-shaped, pruritic wheals after skin friction. Conclusive data on its associated factors are limited, and direct comparisons between individuals with and without SD remain scarce. We aimed to identify factors associated with SD internationally. Methods: The PREVALENCE-D (Prevalence Estimation of Dermographism) study was an international cross-sectional survey conducted from 2021 to 2024 across 19 countries. An expert-designed questionnaire diagnosed SD and assessed potential associated factors. SD participants were defined as those who self-reported chronic recurrent urticarial dermographism with itch. Factors associated with SD were identified by comparing participants with and without SD. Results: Of 68,513 participants, 3101 had SD (female 73.3%). Their mean age was 40.2 ± 16.2 years. Key factors associated with SD included atopic dermatitis (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 3.62‒4.88) and allergic rhinitis (aOR 2.11, 95% CI 1.88‒2.37). Participants with at least one atopic condition (allergic rhinitis, atopic dermatitis, or asthma) were significantly more likely to have SD (aOR 2.70, 95% CI 2.47‒2.95). Those with all three atopic conditions had a further increased likelihood of SD (aOR 7.75, 95% CI 5.31‒11.29). Other associations included working and older age groups, female sex, dyslipidemia, and thyroid disease. Conclusions: Atopic dermatitis and allergic rhinitis emerged as the strongest correlates of SD, especially those with all three atopic conditions. Thus, allergic comorbidities should be assessed in SD patients. Further research is needed to clarify the pathophysiological relationship between these conditions and SD. [
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    Knowledge, Attitude, and Behavior of Photoprotection in Thai Vitiligo Patients
    (2025-01-01) Wongpraparut O.; Wannawittayapa T.; Wattanasillawat P.; Yothachai P.; Nuntawisuttiwong N.; Silpa-archa N.; Wongpraparut O.; Mahidol University
    Background: Vitiligo is a chronic pigmentary disorder characterized by the progressive loss of melanocytes, resulting in skin depigmentation. Although UV-based therapies, such as narrowband UVB, are commonly used for treatment, excessive sun exposure may aggravate the disease. Understanding patients’ perceptions and behaviors related to sun exposure is crucial, particularly in tropical countries like Thailand, where UV levels are high. Purpose: To assess the knowledge, attitudes, and photoprotection behaviors of Thai vitiligo patients compared to healthy controls. Patients and Methods: A cross-sectional study was conducted from January to August 2025 using a self-administered questionnaire. The questionnaire assessed participants’ demographics, vitiligo-related characteristics, knowledge and attitudes toward sun exposure, perceived skin cancer risk, and sun protection practices. Data from 105 vitiligo patients and 85 controls were analyzed using chi-square and descriptive statistics. Results: Vitiligo patients showed greater awareness of the effects of sunlight on their condition than the control group. A higher proportion thought mild sunlight may improve vitiligo (57.1% vs 31.8%, p < 0.001). Only 25.7% of patients believed they had an increased risk of skin cancer. Vitiligo patients were more likely to use sunscreen regularly (53.3% vs 37.6%, p = 0.031) and during outdoor activities (61.0 vs 40.0%, p = 0.004) compared to control. However, reapplication rates were suboptimal with 75.2% of vitiligo patients never reapplied sunscreen, and fewer patients reapplied occasionally compared to controls (18.1% vs 37.6%, p = 0.002). Conclusion: Thai vitiligo patients demonstrated moderate understanding of photoprotection and skin cancer risk, but significant behavioral gaps exist, notably in terms of sunscreen reapplication and comprehensive sun protection methods. These findings underscore the need for focused educational efforts to close the knowledge-practice gap, highlighting both the benefits and risks of UV exposure in vitiligo treatment.
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    Pathophysiological insights into delayed pressure urticaria: A comprehensive review
    (2025-09-01) Kulthanan K.; Nanchaipruek Y.; Munprom K.; Sittiwanaruk S.; Wattanasillawat P.; Sadakorn P.; Chularojanamontri L.; Kulthanan K.; Mahidol University
    Delayed pressure urticaria (DPU) is a chronic inducible subtype of urticaria, characterized by painful erythematous swelling triggered by sustained mechanical pressure. After pressure stimuli, lesions often appear within 4 to 6 hours, peak around 6 hours later, and persist for 8 hours to 3 days. More than half of patients may have associated symptoms, most often malaise and fatigue. The diagnosis of DPU is based on clinical history and confirmation through provocation testing. Dermographic tester and weighted rod testing are recommended as diagnostic tools by several current guidelines due to their reproducibility and capability to determine individual trigger thresholds. Although the exact pathogenesis remains unclear, mast cell activation, histamine release, eosinophil infiltration, and multiple mediators have been implicated. These mechanisms likely interact synergistically, contributing to the clinical manifestations of DPU. This article reviews the pathogenesis, histopathological findings, effector cells, inflammatory mediators, neuropeptides, adhesion molecules, and unmet clinical needs associated with DPU. A deeper understanding of these complex processes may facilitate the development of more effective targeted immunomodulators and biological therapies for severe and treatment-resistant cases of DPU.