Abstract：
OBJECTIVE: Royal Darwin Hospital (RDH) is the sole public dermatology service in the Northern Territory (NT). Prescription of biologic therapies (BT) in the NT is uniquely challenging, with remote populations carrying a high tropical disease burden. The aim of this audit is to examine the demographics and outcomes of patients on BT for dermatologic conditions.
METHODS: Retrospective case note review of patients receiving BT through the RDH Dermatology department between August 2021 and October 2023. Data analysed were demographics, location, dermatological diagnosis and serology status.
RESULTS: In this audit, 115 patients were included. Age range of 13-91 years, mean of 51.1 years (±14.7), 52 (45.2%) patients were female and 8 (7.8%) identified as First Nations Australian. A large geographical area was serviced, with a primary address between 1 and 1496 km from RDH. Eighteen patients (15.7%) have discontinued BT completely. There was a statistically significant relationship between cessation of BT and increased distance of primary residence from RDH (p < 0.0007). Eighteen patients (15.7%) required management of infections identified in opportunistic infection screening. These infections were strongyloidiasis, tuberculosis, melioidosis and hepatitis B.
CONCLUSIONS: There is significant anxiety surrounding BT and tropical infections, including in returning travellers in southern Australian states. There has been particular interest in strongyloidiasis infection, as dupilumab acts on the Th2 immunity mechanism critical to parasitic infection response. This audit exhibits the unique experience of dermatological care in a tropical setting, demonstrating how BT can be used safely and how, when identified, these tropical infections can be successfully managed.
METHODS: Retrospective case note review of patients receiving BT through the RDH Dermatology department between August 2021 and October 2023. Data analysed were demographics, location, dermatological diagnosis and serology status.
RESULTS: In this audit, 115 patients were included. Age range of 13-91 years, mean of 51.1 years (±14.7), 52 (45.2%) patients were female and 8 (7.8%) identified as First Nations Australian. A large geographical area was serviced, with a primary address between 1 and 1496 km from RDH. Eighteen patients (15.7%) have discontinued BT completely. There was a statistically significant relationship between cessation of BT and increased distance of primary residence from RDH (p < 0.0007). Eighteen patients (15.7%) required management of infections identified in opportunistic infection screening. These infections were strongyloidiasis, tuberculosis, melioidosis and hepatitis B.
CONCLUSIONS: There is significant anxiety surrounding BT and tropical infections, including in returning travellers in southern Australian states. There has been particular interest in strongyloidiasis infection, as dupilumab acts on the Th2 immunity mechanism critical to parasitic infection response. This audit exhibits the unique experience of dermatological care in a tropical setting, demonstrating how BT can be used safely and how, when identified, these tropical infections can be successfully managed.
摘要：
目的：皇家达尔文医院（RDH）是北领地（NT）唯一的公共皮肤科服务。NT中生物疗法（BT）的处方具有独特的挑战性，偏远人群携带高热带疾病负担。此审核的目的是检查BT患者的人口统计学和皮肤病学状况。
方法：对2021年8月至2023年10月通过RDH皮肤科接受BT治疗的患者进行回顾性病例回顾。分析的数据是人口统计学，location,皮肤病学诊断和血清学状况。
结果：在此审核中，包括115名患者。年龄范围为13-91岁，平均51.1年(±14.7)，52名（45.2％）患者为女性，8名（7.8％）被确定为澳大利亚原住民。服务了很大的地理区域，主地址在距离RDH1到1496公里之间。18例患者（15.7%）完全停止BT。BT停止与与RDH的主要居住距离增加之间存在统计学上的显着关系（p<0.0007）。18例患者（15.7％）需要对机会性感染筛查中发现的感染进行管理。这些感染是线虫病，结核病,类lioidosis和乙型肝炎
结论：围绕BT和热带感染存在显著的焦虑，包括澳大利亚南部各州的返回旅客。人们对线虫病感染特别感兴趣，因为dupilumab对Th2免疫机制起作用，对寄生虫感染反应至关重要。这次审计展示了在热带环境中皮肤科护理的独特体验，演示如何安全使用BT以及如何使用BT，当被识别时，这些热带感染可以成功管理。
方法：对2021年8月至2023年10月通过RDH皮肤科接受BT治疗的患者进行回顾性病例回顾。分析的数据是人口统计学，location,皮肤病学诊断和血清学状况。
结果：在此审核中，包括115名患者。年龄范围为13-91岁，平均51.1年(±14.7)，52名（45.2％）患者为女性，8名（7.8％）被确定为澳大利亚原住民。服务了很大的地理区域，主地址在距离RDH1到1496公里之间。18例患者（15.7%）完全停止BT。BT停止与与RDH的主要居住距离增加之间存在统计学上的显着关系（p<0.0007）。18例患者（15.7％）需要对机会性感染筛查中发现的感染进行管理。这些感染是线虫病，结核病,类lioidosis和乙型肝炎
结论：围绕BT和热带感染存在显著的焦虑，包括澳大利亚南部各州的返回旅客。人们对线虫病感染特别感兴趣，因为dupilumab对Th2免疫机制起作用，对寄生虫感染反应至关重要。这次审计展示了在热带环境中皮肤科护理的独特体验，演示如何安全使用BT以及如何使用BT，当被识别时，这些热带感染可以成功管理。
