[Acupoint catgut-embedding therapy: superiorities and principles of application].

PubMed

Zhang, Xuan-Ping; Jia, Chun-Sheng; Wang, Jian-Ling; Shi, Jing; Zhang, Xin; Li, Xiao-Feng; Xu, Xiao-Kang; Qin, Liang; Zhang, Mei-Ling; Kang, Su-Gang; Duan, Xiao-Dong

2012-10-01

To analyze the superiorities of acupoint catgut-embedding therapy, discuss its law of clinical application and provide scientific decision-making for clinical treatment. Literatures on acupoint catgut-embedding therapy in the recent 40 years were selected, input, examined and verified, picked up and analyzed by establishing database with the modern computer technology. (1) One thousand and seventy-five literatures were input. It shows that the acupoint catgut-embedding therapy has an extensive application in all departments, especially in the internal department, accounting for 48.54% (50/103) of the total disease category. It has the most extensive application on treatment of epigastric pain, with the frequency of 102 times, and obesity of 74 times. The next is surgery, accounting for 14.56% (15/103). The major application is on low back pain and leg pain with the frequency of 79 times. Psoriasis, with the frequency of 30 times, holds the major application in dermatological department. And blepharoplasty, with the frequency of 30 times, gains the most application in department of ophthalmology and otorhinolaryngology. (2) In the included literatures, selection of adjacent acupoints and distal acupoints are held as the major method of acupoint selection. The adjusted lumbar puncture needle is taken as the major tool for the acupoint catgut-embedding therapy. And catguts of different sizes are adopted for the operation. (3) Analysis of the therapeutic effect shows that acupoint catgut-embedding therapy has obvious effect in all departments, especially in surgery and dermatology, with the total effective rate over 90%. Epigastric pain, obesity, epilepsy, asthma, abdominal pain, facial paralysis and constipation of the internal medicine, low back pain and leg pain of the surgical department, psoriasis of the dermatological department and blepharoplasty of the department of ophthalmology and otorhinolaryngology are considered as the dominant diseases for acupoint catgut-embedding therapy.

Comprehensive Review of Tissue Adhesives.

PubMed

Jenkins, Lauren E; Davis, Loretta S

2018-06-19

Cyanoacrylates, also known as tissue adhesives or skin glues, are commonly used as sealants for lacerations and incisions and have found utility in excisional and cosmetic surgeries in both outpatient and operating room settings. To review the surgical literature on the utilities, advantages, disadvantages, and special uses of cyanoacrylates applicable to dermatology. PubMed was reviewed for relevant articles related to cyanoacrylates and their use in skin closures. Articles unrelated to cutaneous closures were excluded. Tissue adhesives polymerize to a water resistant, pliable film after application to approximated wound edges and have antibacterial properties. Adhesives slowly slough off as the wound heals, typically after 5 days. Compared with 5-0 nonabsorbable suture, adhesives provide similar tensile strength and similar patient and surgeon satisfaction. Although slightly more expensive than sutures, tissue adhesives obviate the need for wound dressings and suture removal. They do not perform as well as sutures for wounds under higher tension or in the setting of moisture and inadequate hemostasis. Cyanoacrylates serve as a safe and effective suture alternative in appropriate dermatologic surgeries and procedures.

ASDS Cosmetic Dermatologic Surgery Fellowship Milestones.

PubMed

Waldman, Abigail; Arndt, Kenneth A; Avram, Mathew M; Brown, Mariah R; Dover, Jeffrey S; Fabi, Sabrina G; Friedmann, Daniel P; Geronemus, Roy G; Goldberg, David J; Goldman, Mitchel P; Green, Jeremy B; Ibrahimi, Omar A; Jones, Derek H; Kilmer, Suzanne L; McDaniel, David H; Obagi, Suzan; Ortiz, Arisa E; Rohrer, Thomas E; Taylor, Mark B; Torres, Abel; Weinkle, Susan H; Weiss, Margaret A; Weiss, Eduardo T; Weiss, Robert A; Poon, Emily; Alam, Murad

2016-10-01

The American Council of Graduate Medical Education, which oversees much of postgraduate medical education in the United States, has championed the concept of "milestones," standard levels of achievement keyed to particular time points, to assess trainee performance during residency. To develop a milestones document for the American Society for Dermatologic Surgery (ASDS) Cosmetic Dermatologic Surgery (CDS) fellowship program. An ad hoc milestone drafting committee was convened that included members of the ASDS Accreditation Work Group and program directors of ASDS-approved Cosmetic Dermatologic Surgery (CDC) fellowship training programs. Draft milestones were circulated through email in multiple rounds until consensus was achieved. Thirteen milestones were developed in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas, with 8 of these being patient-care milestones. Additional instructions for milestone administration more specific to the CDS fellowship than general ACGME instructions were also approved. Implementation of semiannual milestones was scheduled for the fellowship class entering in July 2018. Milestones are now available for CDS fellowship directors to implement in combination with other tools for fellow evaluation.

Knowledge of Surgery-Related Allergic Contact Dermatitis among Florida Dermatological Surgeons

PubMed Central

Rouhani, Panta; Kirsner, Robert S.; Amado, Antoine; Fleming, Lora E.; Nouri, Keyvan

2009-01-01

Objective. To assess knowledge base and practice habits of dermatological surgeons regarding surgery-related allergic contact dermatitis. Design. Cross-sectional study. Setting. The Florida Society of Dermatologic Surgery served as the study group. Participants. Cohort of dermatological surgeons. Measurements. An anonymous, close-ended survey instrument eliciting common surgical practices as well as allergic contact dermatitis knowledge. Results. Among the 45 respondents, 87 percent reported performing surgery more than 10 times per week and only 14 percent of respondents reported using latex-free gloves in their practice. Nearly two-thirds (66%) of respondents reported diagnosing allergic contact dermatitis either among themselves, their surgical staff, and/or patients. Surgeons were noted to use the TRUE Test® to screen for adhesive allergy. While colophony can be found both in adhesive products and on the TRUE Test, the main adhesives found in perisurgical products, acrylates, cannot. Similarly, the TRUE Test does not screen for antiseptics, yet this group of respondents suspected antiseptics nearly one-fourth of the time and used the TRUE Test to screen for them. Lastly, six dermatological surgeons used the TRUE Test to screen for suture allergy. While only two used chromated cat gut (the TRUE Test screens for chromium), the other surgical components are not screened. Conclusion. Education among dermatological surgeons is needed regarding exposure to a potential allergen in the surgical setting and risk of developing allergic contact dermatitis. PMID:20725578

Common complementary and alternative therapies with potential use in dermatologic surgery: risks and benefits.

PubMed

Reddy, Kavitha K; Grossman, Lauri; Rogers, Gary S

2013-04-01

Ambulatory surgery patients often use complementary and alternative medicine (CAM) therapies. CAM therapies may create beneficial and detrimental perioperative conditions. We sought to improve knowledge of CAM effects in dermatologic surgery, allowing dermatologists to potentially capitalize on therapeutic actions and to mitigate complications. PubMed literature search of CAM therapies in dermatologic and surgical settings was performed. Common CAM therapies with possible effects on dermatologic surgery were selected. Beneficial and detri-mental effects were reviewed. A myriad of products may be used perioperatively by the patient. Therapies appearing to have some evidence for potential benefit include bromelain, honey, propolis, arnica, vitamin C and bioflavonoids, chamomile, aloe vera gel, grape seed extract, zinc, turmeric, calendula, chlorella, lavender oil, and gotu kola. Potential complications vary according to product and include platelet inhibition, contact dermatitis and, in rare cases, systemic toxicity. This review focuses on CAM having significant published studies evaluating efficacy for wound healing, anti-inflammatory, antipurpuric, or perioperative-related use. Most published studies have been small and often have design flaws. The scope of CAM is large and not all therapies are discussed. Selected CAM therapies have been reported to promote wound healing, reduce edema or purpura, and provide anti-inflammatory effects. Because of high rates of CAM use, surgeons should familiarize themselves with common uses, potential benefits, and complications. Further study of effects in the dermatologic surgery setting may improve the patient-doctor relationship and enhance outcomes. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence.

PubMed

Veale, David; Gledhill, Lucinda J; Christodoulou, Polyxeni; Hodsoll, John

2016-09-01

Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified. Copyright © 2016 Elsevier Ltd. All rights reserved.

A System Approach to Navy Medical Education and Training. Appendix 33. Competency Curriculum for Dermatology Assistant.

DTIC Science & Technology

1974-08-31

AO-AO185 902 TECI4NOMICS INC OAKTON VA F/* 5/9 SYSTEM APPROACH TO NAVY MEDICAL EDUCATION AND TRAINING. APPEN--ETC(U) AUG 74 N0001A69-C-024A...CURRICULUM FOR DERMATOLOGY ASSISTANT APPLICATION OF A SYSTEM APPROACH U.*S. NAVY MEDICAL DEPARTMENT EDUCATION AND TRAINING PROGRAMS FINAL REPORT Di b j c, L...Education and Training R&D Bureau of Medicine and Surgery (Code 71G) o docau’wn’t has bcvn appmved n k its UNCLASSIFIED sEcuptiry CLASSIFICArIoN OF TH4IS PAGE

The Effect of Financial Conflicts of Interest in Plastic Surgery Literature.

PubMed

Leavitt, Adam; Pace, Elizabeth; Reintgen, Christian; Mast, Bruce A

2016-06-01

Medical research has a long history of joint venture between commercial entities and nonindustry researchers. Significant concern exists among accrediting bodies for medical education and federal granting agencies that conflicts of interest (COIs) exist that affect the validity of the research. This study evaluates the legitimacy of this concern.All clinical breast and cosmetic articles in Plastic and Reconstructive Surgery and Annals of Plastic Surgery were reviewed for calendar year 2013. If a financial disclosure was present, the article was then reviewed to determine if the subject/findings were in favor of the commercial conflict and, if so, whether the study was valid. To assess plastic surgery versus other specialties, articles from Dermatology and Journal of Bone and Joint Surgery were similarly reviewed from January to April of 2013.Two hundred seventy-two clinical articles were reviewed. Only 15 (5.5%) had a true COI: the article's findings favored the commercial interest of at least 1 author: for each journal, Plastic and Reconstructive Surgery, 7.7%; Annals of Plastic Surgery, 3.3%; Dermatology, 2.2%; Journal of Bone and Joint Surgery, 7.5%. Conflicts of interest were not statistically significant between pooled articles of plastic surgery versus dermatology/orthopedics. However, COI was statistically greater (P = 0.05) in Plastic and Reconstructive Surgery compared with Annals and Dermatology.Despite public and regulatory concerns, this assessment demonstrates that the peer-review process of leading journals polices true COIs. Published articles provide sound research despite presumed COIs. As such, the integrity and validity of published research remain high.

Analysis of laser surgery in non-melanoma skin cancer for optimal tissue removal

NASA Astrophysics Data System (ADS)

Fanjul-Vélez, Félix; Salas-García, Irene; Arce-Diego, José Luis

2015-02-01

Laser surgery is a commonly used technique for tissue ablation or the resection of malignant tumors. It presents advantages over conventional non-optical ablation techniques, like a scalpel or electrosurgery, such as the increased precision of the resected volume, minimization of scars and shorter recovery periods. Laser surgery is employed in medical branches such as ophthalmology or dermatology. The application of laser surgery requires the optimal adjustment of laser beam parameters, taking into account the particular patient and lesion. In this work we present a predictive tool for tissue resection in biological tissue after laser surgery, which allows an a priori knowledge of the tissue ablation volume, area and depth. The model employs a Monte Carlo 3D approach for optical propagation and a rate equation for plasma-induced ablation. The tool takes into account characteristics of the specific lesion to be ablated, mainly the geometric, optical and ablation properties. It also considers the parameters of the laser beam, such as the radius, spatial profile, pulse width, total delivered energy or wavelength. The predictive tool is applied to dermatology tumor resection, particularly to different types of non-melanoma skin cancer tumors: basocellular carcinoma, squamous cell carcinoma and infiltrative carcinoma. The ablation volume, area and depth are calculated for healthy skin and for each type of tumor as a function of the laser beam parameters. The tool could be used for laser surgery planning before the clinical application. The laser parameters could be adjusted for optimal resection volume, by personalizing the process to the particular patient and lesion.

Photography in Dermatologic Surgery: Selection of an Appropriate Camera Type for a Particular Clinical Application.

PubMed

Chen, Brian R; Poon, Emily; Alam, Murad

2017-08-01

Photographs are an essential tool for the documentation and sharing of findings in dermatologic surgery, and various camera types are available. To evaluate the currently available camera types in view of the special functional needs of procedural dermatologists. Mobile phone, point and shoot, digital single-lens reflex (DSLR), digital medium format, and 3-dimensional cameras were compared in terms of their usefulness for dermatologic surgeons. For each camera type, the image quality, as well as the other practical benefits and limitations, were evaluated with reference to a set of ideal camera characteristics. Based on these assessments, recommendations were made regarding the specific clinical circumstances in which each camera type would likely be most useful. Mobile photography may be adequate when ease of use, availability, and accessibility are prioritized. Point and shoot cameras and DSLR cameras provide sufficient resolution for a range of clinical circumstances, while providing the added benefit of portability. Digital medium format cameras offer the highest image quality, with accurate color rendition and greater color depth. Three-dimensional imaging may be optimal for the definition of skin contour. The selection of an optimal camera depends on the context in which it will be used.

Incidence of complications in dermatological surgery of melanoma and non-melanoma skin cancer in patients with multiple comorbidity and/or antiplatelet-anticoagulants. Five year experience in our Hospital.

PubMed

Arguello-Guerra, Lilia; Vargas-Chandomid, Estefanía; Díaz-González, Jose Manuel; Méndez-Flores, Silvia; Ruelas-Villavicencio, Ana; Domínguez-Cherit, Judith

2018-01-01

Surgery is performed more frequently now at days, due to the increasing incidence of melanoma and no-melanoma skin cancer. There are different opinions among dermatologic surgeons between to continue or discontinue antithrombotic therapy prior to the procedure, which increases the risk of thromboembolic events. Prophylaxis with oral antibiotics in the postsurgical period is controversial. To report the safety of surgery without suspending antithrombotic therapy and without oral antibiotic prophylaxis in dermatology surgery of patients with multiple comorbidities and polypharmacy. We designed a retrospective study. We included a total of 655 patients; 96.6% had at least one comorbidity; 27.7% used aspirin and 4.3% some type of antithrombotic therapy. The most common type of skin tumor was basal cell carcinoma with 69.8% . The complication rate was 4.2%; the most was wound dehiscence (1.1%), followed by partial necrosis (0.9%), infection (0.9%), reaction to foreign body (0.6%), complete necrosis (0.3%), bleeding (0.2%) and fistulae (0.2%). Based on the literature and our experience, dermatologic surgery is safe without suspending antithrombotic therapy or antibiotic prophylaxis in patients with multiple comorbidity. Copyright: © 2018 Permanyer.

Dermatology Internet Yellow Page advertising.

PubMed

Francis, Shayla; Kozak, Katarzyna Z; Heilig, Lauren; Lundahl, Kristy; Bowland, Terri; Hester, Eric; Best, Arthur; Dellavalle, Robert P

2006-07-01

Patients may use Internet Yellow Pages to help select a physician. We sought to describe dermatology Internet Yellow Page advertising. Dermatology advertisements in Colorado, California, New York, and Texas at 3 Yellow Page World Wide Web sites were systematically examined. Most advertisements (76%; 223/292) listed only one provider, 56 listed more than one provider, and 13 listed no practitioner names. Five advertisements listed provider names without any credentialing letters, 265 listed at least one doctor of medicine or osteopathy, and 9 listed only providers with other credentials (6 doctors of podiatric medicine and 3 registered nurses). Most advertisements (61%; 179/292) listed a doctor of medicine or osteopathy claiming board certification, 78% (139/179) in dermatology and 22% (40/179) in other medical specialties. Four (1%; 4/292) claims of board certification could not be verified (one each in dermatology, family practice, dermatologic/cosmetologic surgery, and laser surgery). Board certification could be verified for most doctors of medicine and osteopathy not advertising claims of board certification (68%; 41/60; 32 dermatology, 9 other specialties). A total of 50 advertisements (17%) contained unverifiable or no board certification information, and 47 (16%) listed a physician with verifiable board certification in a field other than dermatology. All Internet Yellow Page World Wide Web sites and all US states were not examined. Nonphysicians, physicians board certified in medical specialties other than dermatology, and individuals without verifiable board certification in any medical specialty are advertising in dermatology Internet Yellow Pages. Many board-certified dermatologists are not advertising this certification.

Electronic collaboration in dermatology resident training through social networking.

PubMed

Meeks, Natalie M; McGuire, April L; Carroll, Bryan T

2017-04-01

The use of online educational resources and professional social networking sites is increasing. The field of dermatology is currently under-utilizing online social networking as a means of professional collaboration and sharing of training materials. In this study, we sought to assess the current structure of and satisfaction with dermatology resident education and gauge interest for a professional social networking site for educational collaboration. Two surveys-one for residents and one for faculty-were electronically distributed via the American Society for Dermatologic Surgery and Association of Professors of Dermatology (APD) listserves. The surveys confirmed that there is interest among dermatology residents and faculty in a dermatology professional networking site with the goal to enhance educational collaboration.

Photography in Dermatologic Surgery: Selection of an Appropriate Lighting Solution for a Particular Clinical Application.

PubMed

Chen, Brian R; Poon, Emily; Alam, Murad

2018-01-01

Lighting is an important component of consistent, high-quality dermatologic photography. There are different types of lighting solutions available. To evaluate currently available lighting equipment and methods suitable for procedural dermatology. Overhead lighting, built-in camera flashes, external flash units, studio strobes, and light-emitting diode (LED) light panels were evaluated with regard to their utility for dermatologic surgeons. A set of ideal lighting characteristics was used to examine the capabilities and limitations of each type of lighting solution. Recommendations regarding lighting solutions and optimal usage configurations were made in terms of the context of the clinical environment and the purpose of the image. Overhead lighting may be a convenient option for general documentation. An on-camera lighting solution using a built-in camera flash or a camera-mounted external flash unit provides portability and consistent lighting with minimal training. An off-camera lighting solution with studio strobes, external flash units, or LED light panels provides versatility and even lighting with minimal shadows and glare. The selection of an optimal lighting solution is contingent on practical considerations and the purpose of the image.

Needlestick and Sharps Injuries in Dermatologic Surgery: A Review of Preventative Techniques and Post-exposure Protocols

PubMed Central

Monroe, Holly; Orengo, Ida; Rosen, Theodore

2016-01-01

Background: Needlestickand sharps injuries are the leading causes of morbidity in the dermatologicfield. Among medical specialties, surgeons and dermatologists have the highest rates of needlestickand sharps injuries.The high rates of needlestickand sharps injuries in dermatology not only apply to physicians, but also to nurses, physician assistants, and technicians in the demnatologic field. Needlestickand sharps injuries are of great concern due to the monetary, opportunity, social, and emotional costs associated with their occurrence. Objective: A review of preventative techniques and post-exposure protocols for the majortypes of sharps injuries encountered in dermatologic practice. Design: The terms “needle-stick injuryT’sharps injuryTdermatologic surgery? “post-exposure prophylaxis,”and “health-care associated injury” were used in combinations to search the PubMed database. Relevant studies were reviewed for validity and included. Results The authors discuss the major types of sharps injuries that occur in the dermatologic surgery setting and summarize preventative techniques with respect to each type of sharps injury.The authors also summarize and discuss relevant post-exposure protocols in the event of a sharps injury. Conclusion: The adoption of the discussed methods, techniques, practices, and attire can result in the elimination of the vast majority of dermatologic sharps injuries. PMID:27847548

Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008.

PubMed

Wright, Tina I; Baddour, Larry M; Berbari, Elie F; Roenigk, Randall K; Phillips, P Kim; Jacobs, M Amanda; Otley, Clark C

2008-09-01

Antibiotic prophylaxis is an important component of dermatologic surgery, and recommendations in this area should reflect the updated 2007 guidelines of the American Heart Association, the American Dental Association with the American Academy of Orthopaedic Surgeons guidelines, and recent prospective studies on surgical site infection. To provide an update on the indications for antibiotic prophylaxis in dermatologic surgery for the prevention of infective endocarditis, hematogenous total joint infection, and surgical site infection. A literature review was performed, expert consensus was obtained, and updated recommendations were created, consistent with the most current authoritative guidelines from the American Heart Association and the American Dental Association with the American Academy of Orthopaedic Surgeons. For patients with high-risk cardiac conditions, and a defined group of patients with prosthetic joints at high risk for hematogenous total joint infection, prophylactic antibiotics are recommended when the surgical site is infected or when the procedure involves breach of the oral mucosa. For the prevention of surgical site infections, antibiotics may be indicated for procedures on the lower extremities or groin, for wedge excisions of the lip and ear, skin flaps on the nose, skin grafts, and for patients with extensive inflammatory skin disease. These recommendations are not based on multiple, large-scale, prospective trials. There is a strong shift away from administration of prophylactic antibiotics in many dermatologic surgery settings, based on updated authoritative guidelines. These recommendations provide guidance to comply with the most current guidelines, modified to address dermatology-specific considerations. Managing physicians may utilize these guidelines while individualizing their approach based on all clinical considerations.

Effectiveness and Safety of an Overnight Patch Containing Allium cepa Extract and Allantoin for Post-Dermatologic Surgery Scars.

PubMed

Prager, Welf; Gauglitz, Gerd G

2018-06-14

An occlusive overnight intensive patch medical device (OIP) containing onion extract and allantoin has been developed for preventing and treating dermatologic scars and keloids. Here, we examined the efficacy and safety of the OIP for post-dermatologic surgery scars. This was an intra-individual randomized, observer-blind, controlled study in adults with post-dermatologic surgery scars. Two scars per subject were randomized to no treatment or overnight treatment with the OIP for 12-24 weeks. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a Global Aesthetic Improvement Scale. A total of 125 subjects were included. The decrease in observer-assessed POSAS from baseline was significantly greater for treated than untreated scars at week 6 (p < 0.001) and 24 (p = 0.001). The decrease in patient-assessed POSAS was significantly greater for the treated scar than the untreated scar at week 12 (p = 0.017) and 24 (p = 0.014). Subject- and investigator-evaluated Global Aesthetic Improvement Scale scores were higher for the treated than the untreated scar at all visits. All subjects considered the global comfort of the OIP to be good or very good, and no safety concerns were identified. This study confirmed that the OIP safely promotes scar healing after minor dermatologic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Compact Reliable Laser Surgery Instrument

NASA Astrophysics Data System (ADS)

Zhuang, Dounan; Yu, Guiqiu; Chen, Taolue

1989-09-01

Now, more and more hospitals and doctors in the world are getting interested in laser medicine, more and more people are getting understanding on laser surgery operations and physical therapy. Following the cotinuous comprehensive investigation of laser medicine, the clinical applications of laser has been further expanded and per a lot of indications have been found. As is well known, CO2 laser is one of the most famous medical lasers. In recent years, we concentrate our at to it, a new minitype CO2 laser surgery instrument has been built after improving repeately, the improvement depends on the experiences of hundreds of doctors in hundreds of hospitals for curing ten thousands cases. Our new laser surgery instrument has been improved in five-main characters: 1) Expanding the range of adjustable power into 3-10 W; 2) Making the laser output flexible, dose from 0.1--105 W/cm2 for different cures; 3) Expanding its applications into about 50 indications of general surgery, dermatology, otolaryngology, and gynecology. Which have been proven effective or very effective.

Application of intense pulsed light in the treatment of dermatologic disease: a systematic review.

PubMed

Wat, Heidi; Wu, Douglas C; Rao, Jaggi; Goldman, Mitchel P

2014-04-01

The Food and Drug Administration (FDA) has approved intense pulsed light (IPL) devices for the treatment of a variety of benign pigmentary and vascular lesions, but the range of disease amenable to IPL treatment continues to expand, and there are no evidence-based clinical guidelines for its use in FDA-approved and off-label indications. To provide evidence-based recommendations to guide physicians in the application of IPL for the treatment of dermatologic disease. A literature search of the CENTRAL (1991 to May 6, 2013), EMBASE (1974 to May 6, 2013), and MEDLINE in-process and nonindexed citations and MEDLINE (1964 to present) databases was conducted. Studies that examined the role of IPL in primary dermatologic disease were identified, and multiple independent investigators extracted and synthesized data. Recommendations were based on the highest level of evidence available. Level 1 evidence was found for the use of IPL for the treatment of melasma, acne vulgaris, and telangiectasia. Level 2 evidence was found for the treatment of lentiginous disease, rosacea, capillary malformations, actinic keratoses, and sebaceous gland hyperplasia. Level 3 or lower evidence was found for the treatment of poikiloderma of Civatte, venous malformations, infantile hemangioma, hypertrophic scars, superficial basal cell carcinoma, and Bowen's disease. IPL is an effective treatment modality for a growing range of dermatologic disease and in some cases may represent a treatment of choice. It is typically well tolerated. Further high-quality studies are required. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Suture Products and Techniques: What to Use, Where, and Why.

PubMed

Regula, Christie G; Yag-Howard, Cyndi

2015-10-01

There are an increasing number of wound closure materials and suturing techniques described in the dermatologic and surgery literature. A dermatologic surgeon's familiarity with these materials and techniques is important to supplement his or her already established practices and improve surgical outcomes. To perform a thorough literature review of wound closure materials (sutures, tissue adhesives, surgical tape, and staples) and suturing techniques and to outline how and when to use them. A literature review was conducted using PubMed and other online search engines. Keywords searched included suture, tissue adhesive, tissue glue, surgical tape, staples, dermatologic suturing, and suturing techniques. Numerous articles outline the utility of various sutures, surgical adhesives, surgical tape, and staples in dermatologic surgery. In addition, there are various articles describing classic and novel suturing techniques along with their specific uses in cutaneous surgery. Numerous factors must be considered when choosing a wound closure material and suturing technique. These include wound tension, desire for wound edge eversion/inversion, desired hemostasis, repair type, patient's ability to care for the wound and return for suture removal, skin integrity, and wound location. Careful consideration of these factors and proper execution of suturing techniques can lead to excellent cosmetic results.

The public's perception of dermatologists as surgeons.

PubMed

Chung, Vinh; Alexander, Herb; Pavlis, Michelle; Alexander, Melissa; Veledar, Emir; Washington, Carl V; Chen, Suephy C

2011-03-01

Dermatologists perform more cutaneous surgical procedures than any other medical specialists, including plastic surgeons, especially for treating skin cancers, but anecdotal evidence suggests that the public may not identify dermatologists as surgeons. Our study was designed to assess the public's perception of expertise in surgery of the skin of three medical specialties: dermatology, plastic surgery, and general surgery. We also investigated whether the physician's specialty biases people when they assess the cosmetic appearance of a surgical scar. We administered an institutional review board-approved survey to individuals at the Emory Student Center and the Emory Dermatology Clinic. Participants rated the perceived skills and training of the different medical specialties and scored the cosmetic appearance of 16 surgical scars created by a fellowship-trained Mohs surgeon labeled as the work of different specialists. Results from 467 participants were overwhelmingly in favor of plastic surgeons (p<.001). The physician's specialty did not bias participants in assessing the cosmetic appearance of surgical scars. The study population had greater confidence in the surgical skills of plastic surgeons than in those of dermatologists, although participants were objective in rating the cosmesis of surgical scars, regardless of the purported surgeon's specialty. Although dermatologic surgeons must continually refine our surgical expertise, we must also educate the public about the breadth and depth of our work. The authors have indicated no significant interest with commercial supporters. © 2011 by the American Society for Dermatologic Surgery, Inc.

The Black Dermatologist: 1990—A Viewpoint

PubMed Central

Pierce, Harold E.

1982-01-01

Despite equivalent training in dermatology and dermatologic surgery, in a traditional sense black dermatologists are overtrained in the area of cancer surgery by virtue of the nature of their black practices. I believe that the survival of black dermatologists in the United States will one day depend upon the adjunctive dermatoplastic skills that they must develop, not only to meet the increasing demand for these procedures by their patients, but to assure a broadening of their economic base to meet their white competition. PMID:7120483

The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology

PubMed Central

Omi, Tokuya; Numano, Kayoko

2014-01-01

Background: Tremendous advances have been made in the medical application of the laser in the past few decades. Many diseases in the dermatological field are now indications for laser treatment that qualify for reimbursement by many national health insurance systems. Among laser types, the carbon dioxide (CO2) laser remains an important system for the dermatologist. Rationale: The lasers used in photosurgery have wavelengths that differ according to their intended use and are of various types, but the CO2 laser is one of the most widely used lasers in the dermatology field. With its wavelength in the mid-infrared at 10,600 nm, CO2 laser energy is wellabsorbed in water. As skin contains a very high water percentage, this makes the CO2 laser ideal for precise, safe ablation with good hemostasis. In addition to its efficacy in ablating benign raised lesions, the CO2 laser has been reported to be effective in the field of esthetic dermatology in the revision of acne scars as well as in photorejuvenation. With the addition of fractionation of the beam of energy into myriad microbeams, the fractional CO2 laser has offered a bridge between the frankly full ablative indications and the nonablative skin rejuvenation systems of the 2000s in the rejuvenation of photoaged skin on and off the face. Conclusions: The CO2 laser remains an efficient, precise and safe system for the dermatologist. Technological advances in CO2 laser construction have meant smaller spot sizes and greater precision for laser surgery, and more flexibility in tip sizes and protocols for fractional CO2 laser treatment. The range of dermatological applications of the CO2 laser is expected to continue to increase in the future. PMID:24771971

The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology.

PubMed

Omi, Tokuya; Numano, Kayoko

2014-03-27

Tremendous advances have been made in the medical application of the laser in the past few decades. Many diseases in the dermatological field are now indications for laser treatment that qualify for reimbursement by many national health insurance systems. Among laser types, the carbon dioxide (CO2) laser remains an important system for the dermatologist. The lasers used in photosurgery have wavelengths that differ according to their intended use and are of various types, but the CO2 laser is one of the most widely used lasers in the dermatology field. With its wavelength in the mid-infrared at 10,600 nm, CO2 laser energy is wellabsorbed in water. As skin contains a very high water percentage, this makes the CO2 laser ideal for precise, safe ablation with good hemostasis. In addition to its efficacy in ablating benign raised lesions, the CO2 laser has been reported to be effective in the field of esthetic dermatology in the revision of acne scars as well as in photorejuvenation. With the addition of fractionation of the beam of energy into myriad microbeams, the fractional CO2 laser has offered a bridge between the frankly full ablative indications and the nonablative skin rejuvenation systems of the 2000s in the rejuvenation of photoaged skin on and off the face. The CO2 laser remains an efficient, precise and safe system for the dermatologist. Technological advances in CO2 laser construction have meant smaller spot sizes and greater precision for laser surgery, and more flexibility in tip sizes and protocols for fractional CO2 laser treatment. The range of dermatological applications of the CO2 laser is expected to continue to increase in the future.

21 CFR 878.4630 - Ultraviolet lamp for dermatologic disorders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ultraviolet lamp for dermatologic disorders. 878.4630 Section 878.4630 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4630...

21 CFR 878.4630 - Ultraviolet lamp for dermatologic disorders.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ultraviolet lamp for dermatologic disorders. 878.4630 Section 878.4630 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4630...

21 CFR 878.4630 - Ultraviolet lamp for dermatologic disorders.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ultraviolet lamp for dermatologic disorders. 878.4630 Section 878.4630 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4630...

21 CFR 878.4630 - Ultraviolet lamp for dermatologic disorders.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ultraviolet lamp for dermatologic disorders. 878.4630 Section 878.4630 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4630...

21 CFR 878.4630 - Ultraviolet lamp for dermatologic disorders.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ultraviolet lamp for dermatologic disorders. 878.4630 Section 878.4630 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4630...

Predictive analysis of optical ablation in several dermatological tumoral tissues

NASA Astrophysics Data System (ADS)

Fanjul-Vélez, F.; Blanco-Gutiérrez, A.; Salas-García, I.; Ortega-Quijano, N.; Arce-Diego, J. L.

2013-06-01

Optical techniques for treatment and characterization of biological tissues are revolutionizing several branches of medical praxis, for example in ophthalmology or dermatology. The non-invasive, non-contact and non-ionizing character of optical radiation makes it specially suitable for these applications. Optical radiation can be employed in medical ablation applications, either for tissue resection or surgery. Optical ablation may provide a controlled and clean cut on a biological tissue. This is particularly relevant in tumoral tissue resection, where a small amount of cancerous cells could make the tumor appear again. A very important aspect of tissue optical ablation is then the estimation of the affected volume. In this work we propose a complete predictive model of tissue ablation that provides an estimation of the resected volume. The model is based on a Monte Carlo approach for the optical propagation of radiation inside the tissue, and a blow-off model for tissue ablation. This model is applied to several types of dermatological tumoral tissues, specifically squamous cells, basocellular and infiltrative carcinomas. The parameters of the optical source are varied and the estimated resected volume is calculated. The results for the different tumor types are presented and compared. This model can be used for surgical planning, in order to assure the complete resection of the tumoral tissue.

PhotoExam: adoption of an iOS-based clinical image capture application at Mayo Clinic.

PubMed

Wyatt, Kirk D; Willaert, Brian N; Pallagi, Peter J; Uribe, Richard A; Yiannias, James A; Hellmich, Thomas R

2017-12-01

Mayo Clinic developed an internal iOS-based, point-of-care clinical image capture application for clinicians. We aimed to assess the adoption and utilization of the application at Mayo Clinic. Metadata of 22,784 photos of 6417 patients taken by 606 users over 8040 clinical encounters between 3/1/2015 and 10/31/2015 were analyzed. A random sample of photos from 100 clinical encounters was assessed for quality using a five-item rubric. Use of traditional medical photography services before and after application launch were compared. The largest group of users was residents/fellows, accounting for 31% of users but only 18% of all photos. Attending physicians accounted for 29% of users and 30% of photos. Nurses accounted for 14% of users and 28% of photos. Surgical specialties had the most users (36% of users), followed by dermatology (14% of users); however, dermatology accounted for 54% of all photos, and surgery accounted for 26% of photos. Images received an average of 91% of possible points on the quality scoring rubric. Most frequent reasons for missing points were the location on the body not clearly being demonstrated (19% of encounters) and the perspective/scale not being clearly demonstrated (12% of encounters). There was no discernible pre-post effect of the application's launch on use of traditional medical photography services. Point-of-care clinical photography is a growing phenomenon with potential to become the new standard of care. Patient and provider attitudes and the impact on patient outcomes remain unclear. © 2017 The International Society of Dermatology.

Dermatologic Surgical Instruments: A History and Review.

PubMed

Gandhi, Sumul A; Kampp, Jeremy T

2017-01-01

Dermatologic surgery requires precision and accuracy given the delicate nature of procedures performed. The use of the most appropriate instrument for each action helps optimize both functionality and cosmetic outcome. To review the history of surgical instruments used in dermatology, with a focus on mechanism and evolution to the instruments that are used in current practice. A comprehensive literature search was conducted via textbook and journal research for historic references while review of current references was conducted online using multiple search engines and PubMed. There are a number of articles that review instruments in dermatology, but this article adds a unique perspective in classifying their evolution, while also presenting them as levers that serve to increase human dexterity during the course of surgery. Surgical instruments allow fine manipulation of tissue, which in turn produces optimal outcomes. Surgical tools have been around since the dawn of man, and their evolution parallels the extent to which human civilization has specialized over time. This article describes the evolution of instruments from the general surgical armamentaria to the specialized tools that are used today.

Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology.

PubMed

Thavarajah, M; Szamocki, S; Komath, D; Cascarini, L; Heliotis, M

2015-01-01

300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

[Dermatosurgery and other interventional techniques in dermatology: a more than 2000 year-history].

PubMed

Cribier, B

2016-12-01

Surgical dermatology has probably existed since the first steps of antique medicine, especially for cutaneous cancer excision and wound reparation. Wonderful descriptions of surgical flaps can be found in the Encyclopedy of Celse, a Roman doctor living in the first century AC. Major progresses in local anesthesy were achieved at the end of the XIXth century, allowing the first dermatologists of the XXth century to perform biopsies and cutaneous surgery with a good control of patient's pain. Electricity was introduced in medicine at the end of the XIXth century, and our ancestors dermatologists used it for electrocoagulation, cauterization and electric hair removal. In the « Pratique dermatologique », the first encyclopedy of dermatology published in 1900, many chapters show how important instrumental and surgical dermatology was. Pigmentary changes induced by surgery and other procedures were probably well known then but were less important than troubles due to scarring, which are mentioned in the early literature. Spontaneous or post-interventional cheloids are well discussed in the early works of Alibert, in the years 1810. This article shows that surgical dermatology is far more ancient than the creation of societies dedicated to it in the XXth century. © 2016 Elsevier Masson SAS. Tous droits réservés.

Abbreviations for device names: a proposed methodology with specific examples.

PubMed

Alam, Murad; Dover, Jeffrey S; Alam, Murad; Goldman, Mitchel P; Kaminer, Michael S; Orringer, Jeffrey; Waldorf, Heidi; Alam, Murad; Avram, Mathew; Cohen, Joel L; Draelos, Zoe Diana; Dover, Jeffrey S; Hruza, George; Kilmer, Suzanne; Lawrence, Naomi; Lupo, Mary; Metelitsa, Andrei; Nestor, Mark; Ross, E Victor

2013-04-01

Many devices used in dermatology lack generic names. If investigators use commercial device names, they risk the appearance of bias. Alternatively, reliance on ad-hoc names and abbreviations may confuse readers who do not recognize these. To develop a system for assigning abbreviations to denote devices commonly used in dermatology. Secondarily, to use this system to create abbreviations for FDA-approved neurotoxins and prepackaged injectable soft-tissue augmentation materials. The American Society for Dermatologic Surgery convened a Lexicon Task Force in March 2012. One charge of this Task Force was to develop criteria for assigning abbreviations to medical devices. A modified consensus process was used. Abbreviations to denote devices were to be: based on a standardized approach; transparent to the casual reader; markedly brief; and in all cases, different than the commercial names. Three-letter all caps abbreviations, some with subscripts, were assigned to denote each of the approved neurotoxins and fillers. A common system of abbreviations for medical devices in dermatology may avoid the appearance of bias while ensuring effective communication. The proposed system may be expanded to name other devices, and the ensuing abbreviations may be suitable for journal articles, continuing medical education lectures, or other academic or clinical purposes. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

[Evaluation of surgical treatment of keratoacanthoma].

PubMed

Bogdanowski, T; Rubisz-Brzezińska, J; Macura-Gina, M; Skrzypek-Wawrzyniak, K

1990-01-01

From 1973 to 1988 in the Dermatological Surgery Unit of the 1st Department of Dermatology of the Silesian School of Medicine in Katowice 82 patients were treated surgically for keratoacanthoma. In 76 patients the defect was closed by simple bringing closer the edges or by local plastic surgery, in 6 patients it was covered with free full-thickness skin grafts. The preparations of the excised tumors from various places were examined histologically. In three cases the texture of carcinoma spinocellulare was found in the base of the tumor. In 98% of the patients the wounds healed by first intention.

Growth of mobile applications in dermatology - 2017 update.

PubMed

Flaten, Hania K; St Claire, Chelsea; Schlager, Emma; Dunnick, Cory A; Dellavalle, Robert P

2018-02-15

More than 80% of households in the US have a smartphone. Growth of mobile applications (apps) has grown in parallel with access to smartphones. Mobile health apps are used in medical fields, including dermatology. These apps allow patients to access information regarding dermatology conditions as well as access physicians via teledermatology. To analyze changes in number of dermatology mobile apps since 2014 and discuss benefits and drawbacks of mobile application growth to dermatology. Apple, Android, and Windows were queried for dermatology-related apps. The apps were categorized by purpose and compared to previously published data to assess growth and change in dermatology apps. A total of 526 dermatology mobile apps were found corresponding to an 80.8% growth in dermatology apps since 2014. The market share of teledermatology increased from 11.0% in 2014 to 20.1% in 2017. Dermatology apps continue to grow at a comparable pace to general app growth. Teledermatology apps experienced significant growth from 2014 to 2017. This growth has allowed time-efficient and cost-effective access to dermatologists, especially in rural areas. The growth of dermatology apps targeting patients allows for patient autonomy but also can result in access to inaccurate information regarding dermatology conditions.

Laser therapy

MedlinePlus

... Remove tumors Lasers are also often used during skin surgery . ... 4. James WD, Berger TG, Elston DM. Cutaneous laser surgery. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 12th ed. Philadelphia, PA: Elsevier; 2016: ...

Virtual reality for dermatologic surgery: virtually a reality in the 21st century.

PubMed

Gladstone, H B; Raugi, G J; Berg, D; Berkley, J; Weghorst, S; Ganter, M

2000-01-01

In the 20th century, virtual reality has predominantly played a role in training pilots and in the entertainment industry. Despite much publicity, virtual reality did not live up to its perceived potential. During the past decade, it has also been applied for medical uses, particularly as training simulators, for minimally invasive surgery. Because of advances in computer technology, virtual reality is on the cusp of becoming an effective medical educational tool. At the University of Washington, we are developing a virtual reality soft tissue surgery simulator. Based on fast finite element modeling and using a personal computer, this device can simulate three-dimensional human skin deformations with real-time tactile feedback. Although there are many cutaneous biomechanical challenges to solve, it will eventually provide more realistic dermatologic surgery training for medical students and residents than the currently used models.

In vivo confocal microscopy in dermatology: from research to clinical application

NASA Astrophysics Data System (ADS)

Ulrich, Martina; Lange-Asschenfeldt, Susanne

2013-06-01

Confocal laser scanning microscopy (CLSM) represents an emerging technique for the noninvasive histomorphological analysis of skin in vivo and has shown its applicability for dermatological research as well as its value as an adjunct tool in the clinical management of skin cancer patients. Herein, we aim to give an overview on the current clinical indications for CLSM in dermatology and also highlight the diverse applications of CLSM in dermatological research.

The Sharpness of Blades Used in Dermatologic Surgery.

PubMed

Awadalla, Farah; Hexsel, Camile; Goldberg, Leonard H

2016-01-01

There are numerous blades available for use in dermatologic procedures. There are different advantages that are inhere.nt to different blades due to their shape and size. One aspect of the blade that is instrumental to its performance, but is not objectively defined, is sharpness. This information could be useful when choosing a blade for a particular procedure. This study aims to objectively define the sharpness of blades used in dermatologic surgery. The Sharpness Tester (Cutlery and Allied Trades Research Association, Sheffield, UK) was used to test the force in Newtons a blade requires to cut through a silicone cylinder. New blades were used to determine a standard for the sharpness of new blades. Blades used for surgery were tested to determine the sharpness after use. The sharpest blade is the double-edged razor blade (0.395 N) followed by the dermablade (0.46 N), plastic handled #15 (0.541 N), #15c (0.575 N), #10 (0.647 N), and the #15 blade (0.664 N). The sharpness of a blade is an important factor in its ability to perform a task and should be taken into account when choosing a particular blade for a particular procedure.

Factors associated with successful matching to dermatology residency programs by reapplicants and other applicants who previously graduated from medical school.

PubMed

Stratman, Erik J; Ness, Rachel M

2011-02-01

To identify factors associated with and not associated with successful matching and matriculation (hereinafter "matching") to dermatology residency programs for applicants who previously graduated from medical school and to distinguish which factors are within applicants' control. Observational cohort study. Six accredited academic dermatology residency training programs in the United States. A total of 221 residency applicants who previously graduated from medical school and who applied through standardized electronic application to 1 or more of the participating residency training programs. Matriculation to a dermatology residency program by August 2008 following the 2006 residency application period. Forty-six of 221 former medical school graduates included in this study matched to a dermatology residency program. Factors strongly associated with matching included United States Medical Licensing Examination Step 3 score; submission of letters written by dermatologists from institutions that train dermatology residents; completion of preliminary medicine internships rather than transitional or other internship types; listing of research experience; publishing of medical manuscripts; and completion of non-Accreditation Council for Graduate Medical Examination dermatology fellowships. Factors not associated with increased matching included volunteer work; PhD status; sex; number of posters or presentations at dermatology conferences; quality of journal publications; and first authorship. Most successful applicants limited personal statements to 1 page and did not mention previously failing to match. The study sample represented at least 86% of such nontraditional applicants who matched in 2006. For candidates seeking to match into dermatology residency programs after graduating from medical school, there are factors within their control that are associated with higher rates of match success. This study provides evidence to assist mentors who counsel such candidates. ©2011 American Medical Association. All rights reserved.

Reconstructive Surgery in the Thermally Injured Patient

DTIC Science & Technology

2012-01-01

Pedicle flaps • Reconstructive Surgery • Thermal injury • Z-plasties • Skin grafting AN INCREASED NEED FOR RECONSTRUCTIVE SURGERY Reconstruction is a...dermal structure and include the tendency for recurrent contractures. full-thickness skin graft s are usually reserved for reconstructions with...dermatologic surgery: review and update on full- and split thickness skin grafts , free cartilage grafts, and composite grafts. Dermatol Surg 2005;31

Patient perceptions of text-messages, email, and video in dermatologic surgery patients.

PubMed

Hawkins, Spencer D; Barilla, Steven; Williford, Phillip Williford M; Feldman, Steven R; Pearce, Daniel J

2017-04-14

We developed dermatology patient education videos and a post-operative text message service that could be accessed universally via web based applications. A secondary outcome of the study was to assess patient opinions of text-messages, email, and video in the health care setting which is reported here. An investigator-blinded, randomized, controlled intervention was evaluated in 90 nonmelanoma MMS patients at Wake Forest Baptist Dermatology. Patients were randomized 1:1:1:1 for exposure to: 1) videos with text messages, 2) videos only, 3) text messages-only, or 4) standard of care. Assessment measures were obtained by the use of REDCap survey questions during the follow up visit. 1) 67% would like to receive an email with information about the procedure beforehand 2) 98% of patients reported they would like other doctors to use educational videos as a form of patient education 3) 88% of our patients think it is appropriate for physicians to communicate to patients via text message in certain situations. Nearly all patients desired physicians to use text-messages and video in their practice and the majority of patients preferred to receive an email with information about their procedure beforehand.

High-Resolution Microscopy-Coil MR Imaging of Skin Tumors: Techniques and Novel Clinical Applications.

PubMed

Budak, Matthew J; Weir-McCall, Jonathan R; Yeap, Phey M; White, Richard D; Waugh, Shelley A; Sudarshan, Thiru A P; Zealley, Ian A

2015-01-01

High-resolution magnetic resonance (MR) imaging performed with a microscopy coil is a robust radiologic tool for the evaluation of skin lesions. Microscopy-coil MR imaging uses a small surface coil and a 1.5-T or higher MR imaging system. Simple T1- and T2-weighted imaging protocols can be implemented to yield high-quality, high-spatial-resolution images that provide an excellent depiction of dermal anatomy. The primary application of microscopy-coil MR imaging is to delineate the deep margins of skin tumors, thereby providing a preoperative road map for dermatologic surgeons. This information is particularly useful for surgeons who perform Mohs micrographic surgery and in cases of nasofacial neoplasms, where the underlying anatomy is complex. Basal cell carcinoma is the most common nonmelanocytic skin tumor and has a predilection to manifest on the face, where it can be challenging to achieve complete surgical excision while preserving the cosmetic dignity of the patient. Microscopy-coil MR imaging provides dermatologic surgeons with valuable preoperative anatomic information that is not available at conventional clinical examination. ©RSNA, 2015.

Dynamic optical projection of acquired luminescence for aiding oncologic surgery

NASA Astrophysics Data System (ADS)

Sarder, Pinaki; Gullicksrud, Kyle; Mondal, Suman; Sudlow, Gail P.; Achilefu, Samuel; Akers, Walter J.

2013-12-01

Optical imaging enables real-time visualization of intrinsic and exogenous contrast within biological tissues. Applications in human medicine have demonstrated the power of fluorescence imaging to enhance visualization in dermatology, endoscopic procedures, and open surgery. Although few optical contrast agents are available for human medicine at this time, fluorescence imaging is proving to be a powerful tool in guiding medical procedures. Recently, intraoperative detection of fluorescent molecular probes that target cell-surface receptors has been reported for improvement in oncologic surgery in humans. We have developed a novel system, optical projection of acquired luminescence (OPAL), to further enhance real-time guidance of open oncologic surgery. In this method, collected fluorescence intensity maps are projected onto the imaged surface rather than via wall-mounted display monitor. To demonstrate proof-of-principle for OPAL applications in oncologic surgery, lymphatic transport of indocyanine green was visualized in live mice for intraoperative identification of sentinel lymph nodes. Subsequently, peritoneal tumors in a murine model of breast cancer metastasis were identified using OPAL after systemic administration of a tumor-selective fluorescent molecular probe. These initial results clearly show that OPAL can enhance adoption and ease-of-use of fluorescence imaging in oncologic procedures relative to existing state-of-the-art intraoperative imaging systems.

Platelet-rich plasma, the ultimate secret for youthful skin elixir and hair growth triggering.

PubMed

Elghblawi, Ebtisam

2018-06-01

The clinical application of platelet-rich plasma (PRP) is based on the increase in the concentration of growth factors that are released from alpha-granule of the concentrated platelets and in the secretion of proteins which are able to capitalize on the healing process at the cellular level. It has been invented to restore the natural beauty by starting the natural rejuvenation process of the skin and aiming to make it function as a younger one and to keep the skin youthful and maintain it. Besides that, it is also emerged to include hairs as a new injectable procedure to enable stimulating hair growth locally and topically; preventing its fall; improving hair shaft, hair stem, and its caliber; increasing its shine, vitality, and pliability; and declining hair splitting and breakage. Thus, youth is in your blood as it has a magical power imposed in the platelet factors. There is, however, no standardization of the techniques besides insufficient description of the adopted procedures. Not long, autologous platelet-rich plasma (PRP) has surfaced strongly in diverse medical specialties including plastic, wound healing and diabetic ulcers, orthopedic, trauma, ocular surgery, dry eye for eyelid injection, urology for urinary incontinence, sexual wellness, cutaneous surgery, sport medicine, dentistry and dermatology, and aesthetic applications. PRP proved to promote wound healing and aid in facelift, volumetric skin, skin rejuvenation, regeneration, and reconstruction; improve wrinkling; stimulate hair growth; increase hair follicle viability and its survival rate; prevent apoptosis; increase and prolong the anagen hair growth stage; and delay the progression to catagen hair cycle stage with increased density in hair loss and hair transplantation. The aims of this extensive review were to cover all PRP application aspects that are carried out in aesthetic dermatology and to assess the literature on platelet-rich plasma outcomes on main aesthetic practices of general dermatology. A literature review was conducted by searching through PubMed, Biomedical Library database, Google Scholar, and Research Gate for the terms PRP, platelet-rich plasma, platelet-rich fibrin matrix, platelet preparations, platelet application therapy, platelet growth factors, platelet facial, platelet facial rejuvenation, platelet hairs, and platelet wound healing, from inception till 2017, and they were combined using Boolean operators. All those retrieved articles in English language were looked at and explored thoroughly. © 2017 Wiley Periodicals, Inc.

Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis.

PubMed

Ribeiro, Rafael Vilela Eiras

2017-08-01

The aim of the present study was to evaluate the prevalence of body dysmorphic disorder in plastic surgery and dermatology patients, by performing a systematic review of the literature and meta-analysis. The most relevant studies published originally in any language were analyzed. The literature search was performed using the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scielo databases. The final sample comprised 33 publications that were submitted to meta-analysis. The study verified that 15.04% of plastic surgery patients had body dysmorphic disorder (range 2.21-56.67%); patient mean age was 34.54 ± 12.41 years, and most were women (74.38%). Among dermatology patients, 12.65% (range 4.52-35.16%) had body dysmorphic disorder; patient mean age was 27.79 ± 9.03 years, and most were women (76.09%). Both plastic surgeons and dermatologists must adequately assess their patients to identify those with a higher likelihood of body dysmorphic disorder and should arrange multidisciplinary care for such individuals. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Clinical applications of computerized thermography

NASA Technical Reports Server (NTRS)

Anbar, Michael

1988-01-01

Computerized or digital, thermography is a rapidly growing diagnostic imaging modality. It has superseded contact thermography and analog imaging thermography which do not allow effective quantization. Medical applications of digital thermography can be classified in two groups: static and dynamic imaging. They can also be classified into macro thermography (resolution greater than 1 mm) and micro thermography (resolution less than 100 microns). Both modalities allow a thermal resolution of 0.1 C. The diagnostic power of images produced by any of these modalities can be augmented by the use of digital image enhancement and image recognition procedures. Computerized thermography has been applied in neurology, cardiovascular and plastic surgery, rehabilitation and sports medicine, psychiatry, dermatology and ophthalmology. Examples of these applications are shown and their scope and limitations are discussed.

Common Adult Skin and Soft Tissue Lesions

PubMed Central

Trost, Jeffrey G.; Applebaum, Danielle S.; Orengo, Ida

2016-01-01

A strong foundational knowledge of dermatologic disease is crucial for a successful practice in plastic surgery. A plastic surgeon should be able to identify and appreciate common dermatologic diseases that may require medical and/or surgical evaluation and management. In this article, the authors describe epidermal/dermal, infectious, pigmented, and malignant cutaneous lesions that are commonly encountered in practice. Descriptions include the epidemiology, pathogenesis, clinical course, and management options for each type of lesion. PMID:27478418

Dermatology on Snapchat.

PubMed

Patel, Ravi R; Yazd, N Kuseh Kalani; Dellavalle, Robert P

2017-07-15

Launched in 2011, Snapchat is one of the newest social media platforms with over 158 million active daily users. This study investigated the presence of dermatology-related content on Snapchat. We searched for Snapchat accounts for the top ten most popular dermatology journals, professional dermatological organizations, and dermatology-related patient advocate groups on social media. None of the above-mentioned entities were found on Snapchat. Plastic surgeons were found to primarily utilize the application, although one prominent dermatologist was also found. It was theorized that the brevity of the "snaps" was a contributing factor for dermatological organizations to not use the application. However, Snapchat in the right practice setting may be useful for dermatologists, not only to educate followers, but also as a marketing tool to Millennials.

Prophylactic antibiotics in dermatological surgery.

PubMed

Lee, Michael R; Paver, Robert

2016-05-01

This is a review of the common pathogens of surgical site infections, antibiotic coverage for particular anatomical sites, mechanisms by which surgical site infections occur and the latest data and recommendations for prophylactic antibiotics in the prevention of surgical site infections, infective endocarditis and haematogenous joint infections. Recent evidence-based guidelines on surgical prophylaxis is for restricted indications and a shorter duration of antibiotic prophylaxis in situations where no clinical benefit of prolonged therapy has been proven, in order to minimise the potential adverse ecological and clinical effects associated with antibiotic therapy. This review recommends the cautious use of prophylactic antibiotics in dermatological surgery to help prevent the growing problem of bacterial resistance as well as other morbidity and health-care costs. © 2015 The Australasian College of Dermatologists.

Medical Applications Of CO2 Laser Fiber Optics

NASA Astrophysics Data System (ADS)

McCord, R. C.

1981-07-01

In 1978, Hughes Laboratories reported development of fiber optics that were capable of transmitting CO2 laser energy. These fibers are now being tested for medical applications. Wide ranging medical investigation with CO2 lasers has occurred during the twelve years since the first observations of laser hemostasis. Specialists in ophthalmology, neurosurgery, urology, gynecology, otolaryngology, maxillo-facial/plastic surgery, dermatology, and oncology among others, have explored its use. In principle, all these specialists use CO2 laser radiation at 10.6 microns to thermally destroy diseased tissues. As such, CO2 lasers compare and compete with electrosurgical devices. The fundamental difference between these modalities lies in how they generate heat in treated tissue.

Practice and Educational Gaps in Cosmetic Dermatologic Surgery.

PubMed

Waldman, Abigail; Sobanko, Joseph F; Alam, Murad

2016-07-01

This article identifies gaps in the practice of cosmetic dermatology and cosmetics education, and how to overcome these limitations. There is a rapid development of new devices and procedures, with limited data, patient-reported outcomes, and comparative effectiveness research from which to develop best cosmetic practice. There is a need for increased research and funding dedicated to these goals, improved and convenient training for staff to adopt new devices/procedures, and continuous evolution of databases to pool outcome data and develop outcome sets. Resident education can be improved by dedicated resident cosmetic clinics, didactic teaching from visiting professors, attendance of cosmetic dermatology courses and meetings, and encouraging postresidency training. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan.

PubMed

Sugawara, Yuya; Narimatsu, Hiroto; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

2016-01-01

Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. This study examined Twitter usage by medical institutions. We reviewed all Japanese user accounts in which the names of medical institutions were described in the user's Twitter profile. We then classified medical institutions' tweets by content. We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties.

Secondary procedures in maxillofacial dermatology.

PubMed

Henderson, James M; Horswell, Bruce B

2005-05-01

Dermatologic secondary procedures involve careful preoperative planning and patient preparation, skillful execution of the appropriate procedure, and thorough postoperative wound care. Many modalities of treatment are used, including skin preparation through elimination of inflammatory conditions, resurfacing of skin, and improvement of patient health. Proper selection of incisional design, local or regional flaps, and grafting techniques is key to successful revisional surgery. Care of the revised lesion or wound through medications, dressings and resurfacing techniques will optimize the end result.

American Osteopathic College of Dermatology

MedlinePlus

... Board Certification Grand Rounds Resident Awards AOCD Residency Leadership Award A.P. Ulbrich Resident Research Award Daniel Koprince Award Resident Research Paper Award Surgery in the Outback CME CME Attestation ...

Securing an OTL-HNS residency: how competitive is it? Comparing medical student perceptions to actual Canadian statistics.

PubMed

Kay-Rivest, E; Varma, N; Scott, G M; Manoukian, J J; Desrosiers, M; Vaccani, J P; Nguyen, L H P

2017-02-27

The residency match is an important event in an aspiring physician's career. Otolaryngology - Head and Neck Surgery (OTL-HNS) is a surgical specialty that has enjoyed high numbers of applicants to its residency programs. However, recent trends in Canada show a decline in first-choice applicants to several surgical fields. Factors thought to influence a medical student's choice include role models, career opportunities and work-life balance. The notion of perceived competitiveness is a factor that has not yet been explored. This study sought to compare competitiveness of OTL-HNS, as perceived by Canadian medical students to residency match statistics published yearly by CaRMS (Canadian Residency Matching Service), with the hope of informing future decisions of surgical residency programs. An electronic survey was created and distributed to all medical students enrolled in the 17 Canadian medical schools. After gathering demographic information, students were asked to rank what they perceived to be the five most competitive disciplines offered by CaRMS. They were also asked to rank surgical specialties from most to least competitive. Publically available data from CaRMS was then collected and analyzed to determine actual competitiveness of admissions to Canadian OTL-HNS residency programs. 1194 students, from first to fourth year of medical school, completed the survey. CaRMS statistics over the period from 2008 to 2014 demonstrated that the five most competitive specialties were Plastic Surgery, Dermatology, Ophthalmology, Emergency Medicine and OTL-HNS. Among surgical disciplines, OTL-HNS was third most competitive, where on average 72% of students match to their first-choice discipline. When students were questioned, 35% ranked OTL-HNS amongst the top five most competitive. On the other hand 72%, 74% and 80% recognized Opthalmology, Dermatology and Plastic Surgery as being among the five most competitive, respectively. We found that fourth-year medical students were significantly more knowledgeable about the competitiveness of both OTL-HNS and Plastic Surgery compared to first-year students (p < 0.01). Overall, Canadian medical students may underestimate the competitiveness of OTL-HNS. Furthermore, competitiveness would appear to be a concept that resonates with medical students during the match process.

On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia

PubMed Central

Novoa, Mónica Paola; Eapen, Bell Raj

2018-01-01

Background The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies—sets of concepts that represent knowledge in a given domain—are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Objective Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. Methods A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. Results The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. Conclusions This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions. PMID:29785181

On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia.

PubMed

Sáenz, Juan Pablo; Novoa, Mónica Paola; Correal, Darío; Eapen, Bell Raj

2018-01-01

The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies-sets of concepts that represent knowledge in a given domain-are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.

The role of lasers and intense pulsed light technology in dermatology

PubMed Central

Husain, Zain; Alster, Tina S

2016-01-01

The role of light-based technologies in dermatology has expanded dramatically in recent years. Lasers and intense pulsed light have been used to safely and effectively treat a diverse array of cutaneous conditions, including vascular and pigmented lesions, tattoos, scars, and undesired hair, while also providing extensive therapeutic options for cosmetic rejuvenation and other dermatologic conditions. Dermatologic laser procedures are becoming increasingly popular worldwide, and demand for them has fueled new innovations and clinical applications. These systems continue to evolve and provide enhanced therapeutic outcomes with improved safety profiles. This review highlights the important roles and varied clinical applications that lasers and intense pulsed light play in the dermatologic practice. PMID:26893574

Dermatologic Surgery and Dermatologic Oncology as an Essential Part of the Modern Dermatology in Bulgaria.

PubMed

Tchernev, Georgi; Lozev, Ilia; Lotti, Torello; Wollina, Uwe; Gianfaldoni, Serena; Guarneri, Claudio; Lotti, Jacopo; França, Katlein; Batashki, Atanas; Chokoeva, Anastasiya

2017-07-25

Dermatosurgery and dermatooncology are an integral part of dermatology as a speciality, and this postulate is strictly respected in a high percentage of European dermatological units. Due to the fact that a number of other specialties interweave with the subject of therapy - the surgical treatment of the patient with skin tumors, the positioning of dermatosurgery as part of dermatology is generally controversial (according to some), and at the same time is often the subject of a number of debates and conflicts. These include maxillofacial surgeons, plastic surgeons, regenerative and reconstructive surgeons, surgical and medical oncologist, etc. The advantages of these specialities are mainly based on good medical practice and good surgical techniques that are applied. In contrast, their disadvantages are based on the lack of good awareness of the initial surgical approach as well as the need for time-adjusted and accurately performed additional surgical interventions which should befurthermore careful scheduled with the relevant oncology units. Losing this thread, in practice, it turns out that we are losing the patients themselves or, looking laconically, we are working with reduced efficiency and effectiveness. Although for the last 15 years the positions of these sub-sectors in Bulgaria had been underdeveloped, a certain ascent has been observed nowadays or from a couple of years ago. This advance is undoubtedly due to the influence of the German Dermatological School, presented by Prof. Dr. Uwe Wollina, Head of Department of Dermatology, Venereology and Allergology in Dresden, Germany, as well as due to other respected representative of the Italian Dermatological School - in the face of Prof. Dr. Torello Lotti, Head of the Dermatology Unit at G Marconi University of Rome, Italy.

Newer Hemostatic Agents Used in the Practice of Dermatologic Surgery

PubMed Central

Brewer, Jerry D.

2013-01-01

Minor postoperative bleeding is the most common complication of cutaneous surgery. Because of the commonality of this complication, hemostasis is an important concept to address when considering dermatologic procedures. Patients that have a bleeding diathesis, an inherited/acquired coagulopathy, or who are on anticoagulant/antiplatelet medications pose a greater risk for bleeding complications during the postoperative period. Knowledge of these conditions preoperatively is of the utmost importance, allowing for proper preparation and prevention. Also, it is important to be aware of the various hemostatic modalities available, including electrocoagulation, which is among the most effective and widely used techniques. Prompt recognition of hematoma formation and knowledge of postoperative wound care can prevent further complications such as wound dehiscence, infection, or skin-graft necrosis, minimizing poor outcomes. PMID:23997764

Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth.

PubMed

Li, Zheng Jun; Choi, Hye-In; Choi, Dae-Kyoung; Sohn, Kyung-Cheol; Im, Myung; Seo, Young-Joon; Lee, Young-Ho; Lee, Jeung-Hoon; Lee, Young

2012-07-01

Recently, autologous platelet-rich plasma (PRP) has attracted attention in various medical fields, including plastic and orthopedic surgery and dermatology, for its ability to promote wound healing. PRP has been tested during facelift and hair transplantation to reduce swelling and pain and to increase hair density. To investigate the effects of PRP on hair growth using in vivo and in vitro models. PRP was prepared using the double-spin method and applied to dermal papilla (DP) cells. The proliferative effect of activated PRP on DP cells was measured. To understand the mechanisms of activated PRP on hair growth, we evaluated signaling pathways. In an in vivo study, mice received subcutaneous injections of activated PRP, and their results were compared with control mice. Activated PRP increased the proliferation of DP cells and stimulated extracellular signal-regulated kinase (ERK) and Akt signaling. Fibroblast growth factor 7 (FGF-7) and beta-catenin, which are potent stimuli for hair growth, were upregulated in DP cells. The injection of mice with activated PRP induced faster telogen-to-anagen transition than was seen on control mice. Although few studies tested the effects of activated PRP on hair growth, this research provides support for possible clinical application of autologous PRP and its secretory factors for promotion of hair growth. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Emerging applications of eye-tracking technology in dermatology.

PubMed

John, Kevin K; Jensen, Jakob D; King, Andy J; Pokharel, Manusheela; Grossman, Douglas

2018-04-06

Eye-tracking technology has been used within a multitude of disciplines to provide data linking eye movements to visual processing of various stimuli (i.e., x-rays, situational positioning, printed information, and warnings). Despite the benefits provided by eye-tracking in allowing for the identification and quantification of visual attention, the discipline of dermatology has yet to see broad application of the technology. Notwithstanding dermatologists' heavy reliance upon visual patterns and cues to discriminate between benign and atypical nevi, literature that applies eye-tracking to the study of dermatology is sparse; and literature specific to patient-initiated behaviors, such as skin self-examination (SSE), is largely non-existent. The current article provides a review of eye-tracking research in various medical fields, culminating in a discussion of current applications and advantages of eye-tracking for dermatology research. Copyright © 2018 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

Current status of dermatology residency training in Saudi Arabia: trainees' perspectives.

PubMed

AlGhamdi, K M

2008-01-01

A cross-sectional survey was conducted to look at different aspects of dermatology residency programmes in Saudi Arabia from the residents' perspective. Self-administered questionnaires about future plans, academic activities, examinations, training, workload, surgical procedures, residents' rights and satisfaction were distributed to all 27 residents in all training centres during March-May 2004; 22 (81%) responded. The survey found that 50% of residents were not satisfied with their training and felt they were inadequately trained. Experience of performing certain procedures was much less than for residents in a similar study in the United States of America, and 50% of residents had not received any dermatologic surgery training. Moreover, 36% of residents had been verbally humiliated during their training.

American Society for Dermatologic Surgery

MedlinePlus

... the Choose Skin Health program. Thank you for making the 2017 ASDS Annual Meeting a success! It ... partnership opportunities available for 2017 that will maximize market potential by providing exceptional visibility, outreach and value. ...

Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan

PubMed Central

Sugawara, Yuya; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

2016-01-01

Background Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. Objective This study examined Twitter usage by medical institutions. Methods We reviewed all Japanese user accounts in which the names of medical institutions were described in the user’s Twitter profile. We then classified medical institutions’ tweets by content. Results We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Conclusions Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties. PMID:27227154

A national cross-sectional analysis of dermatology away rotations using the Visiting Student Application Service database.

PubMed

Cao, Severine Z; Nambudiri, Vinod E

2017-12-15

The highly competitive nature of the dermatology match requires applicants to undertake a variety of measures in the hopes of securing a residency position. Among the opportunities available to applicants is the chance to participate in away or "audition" rotations during their final year of undergraduate medical education. Away rotations are now performed by a majority of medical students applying into dermatology, but littleresearch has been done to describe the nature of this opportunity for interested applicants. An analysis of all dermatology electives offered in the Visiting Student Application Service (VSAS) database wasperformed. Results indicate that students have the option to pursue electives in a variety of subjects offered by 100 sponsoring institutions spread across a wide geographic distribution. Although manyopportunities exist, this analysis sheds light on several areas for improving the quality of this experience for interested applicants, including providing more electives in advanced subject matter, permitting more flexibility in scheduling, and promoting wider participation in VSAS.

Factors associated with biopsy site identification, postponement of surgery, and patient confidence in a dermatologic surgery practice.

PubMed

Zhang, Junqian; Rosen, Alex; Orenstein, Lauren; Van Voorhees, Abby; Miller, Christopher J; Sobanko, Joseph F; Shin, Thuzar M; Etzkorn, Jeremy R

2016-06-01

Biopsy site identification is critical to avoid wrong-site surgery and may impact patient-centered outcomes. We sought to evaluate risk factors for biopsy site misidentification, postponement of surgery, and patient confidence in surgical site selection and to assess the near-miss rate for wrong-site surgeries. This was a prospective observational cohort study. Near-miss wrong-site surgeries were detected and averted in 1.3% (3 of 239) of patients with biopsy site photographs. Risk factors for biopsy site misidentification by patients were 6 weeks or longer between biopsy and surgery (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.12-4.27; P = .028) and patient inability to see biopsy site (OR 3.95, 95% CI 1.50-10.37; P = .002). Risk factors for physician misidentification were 6 or more weeks between biopsy and surgery (OR 3.68, 95% CI 1.40-9.66; P = .007) and biopsy specimens from multiple sites (OR 4.39, 95% CI 1.67-11.54; P = .003). Postponement of surgery was associated with absence of a biopsy site photograph (OR 12.5, 95% CI 2.79-62.21; P < .001). Patient confidence in surgical site identification was associated with the presence of a biopsy site photograph (OR 5.48, 95% CI 1.96-15.30; P = .001). This was a single-site observational study. Biopsy site photography is associated with reduced rates of postponed surgeries and improved rates of patient confidence in surgical site selection. Risk factors for biopsy site misidentification should be considered before definitive treatment. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Future prospects in dermatologic applications of lasers, nanotechnology, and other new technologies.

PubMed

Boixeda, P; Feltes, F; Santiago, J L; Paoli, J

2015-04-01

We review novel technologies with diagnostic and therapeutic applications in dermatology. Among the diagnostic techniques that promise to become part of dermatologic practice in the future are optical coherence tomography, multiphoton laser scanning microscopy, Raman spectroscopy, thermography, and 7-T magnetic resonance imaging. Advances in therapy include novel light-based treatments, such as those applying lasers to new targets and in new wavelengths. Devices for home therapy are also appearing. We comment on the therapeutic uses of plasma, ultrasound, radiofrequency energy, total reflection amplification of spontaneous emission of radiation, light stimulation, and transepidermal drug delivery. Finally, we mention some basic developments in nanotechnology with prospects for future application in dermatology. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Informed Consent, Use, and Storage of Digital Photography Among Mohs Surgeons in the United States.

PubMed

Rimoin, Lauren; Haberle, Sasha; DeLong Aspey, Laura; Grant-Kels, Jane M; Stoff, Benjamin

2016-03-01

Digital photography is pervasive in dermatology. Potential uses include monitoring untreated disease, disease progression and treatment response, evaluating medical and cosmetic treatment, determining surgical sites, educating trainees and colleagues, and publishing reports in scientific journals. However, the nature of use, storage, and informed consent practices for digital photography among dermatologic surgeons has not been investigated. This study used a comprehensive survey to elucidate these elements to better define standard practice. A survey was created on SurveyMonkey. An email with the survey link was sent to all members of the American College of Mohs Surgery listserv with 2 follow-up emails. One hundred fifty-eight Mohs surgeons responded to the survey. Respondents indicated a wide variety in the type of camera and storage modality used for patient photographs. There was a variety of opinions on how to conceal a patient's identity when using photographs for educational purposes, and what features of a photo make it identifiable. Dermatologic surgeons vary widely on practices of photo storage and opinions of identifiability. Dermatology as a specialty may consider generating a consensus statement on appropriate use and storage of digital photography in dermatology practice.

Assessment of residents' loss of interest in academic careers and identification of correctable factors.

PubMed

Reck, Samuel J; Stratman, Erik J; Vogel, Curt; Mukesh, Bickol N

2006-07-01

To quantify interest in an academic career at the dermatology resident and residency applicant level. Cross-sectional survey. Dermatology residents attending a basic science course and residency applicants applying to a single residency program. Self-reported level of interest in an academic dermatology career, reasons for losing interest in academics, and area of desired primary academic contribution. One hundred nine of 230 dermatology applicants and 130 of 190 dermatology residents completed the survey. Seventy-nine applicants (72.5%) and 48 residents (36.9%) were interested in an academic career. Thirty-three of 47 residents (70.2%) and 63 of 79 applicants (79.8%) interested in an academic career hoped to make their primary academic contribution as teacher-clinicians, while only 7 residents (14.9%) and 15 applicants (19.0%) planned to primarily contribute through basic or clinical research. Thirty-eight resident respondents (29.2%) reported losing interest in academics for the following primary reasons: bureaucracy, 24 (63.2%); salary differential/financial issues, 20 (52.6%); lack of effective mentorship, role model, or professional guidance, 19 (50.0%); and location or practice environment, 10 (26.3%). Many residents report losing interest in pursuing a career in academic dermatology. Many reasons for this are not easy to correct. However, half of those residents primarily lose interest because of a lack of mentors, role models, and career guidance. Methods to improve this perception and experience should be sought. Strategies should also be developed to cultivate future teacher-clinicians, where most of the interest lies.

Modernizing dermatology interest groups in medical school: Certificate programs.

PubMed

Wang, Jordan V; Korta, Dorota Z; Keller, Matthew

2017-11-15

This commentary addresses the increasingly competitive nature of applying to dermatology residency programs and how both interest groups in medical schools and their dermatology departments can help to better prepare applicants. As previous literature argued that dermatology has been underemphasized in medical school curricula, we propose five fundamental options that interest groups can implement in order to offer increased exposure to our field in medical training. Furthermore, with therecent trend of many schools conferring certificates in various specialized concentrations, we also discuss interest groups pioneering certificate-grantingprograms in dermatology competency. The pros and cons of having a recognized certificate program in dermatology are presented.

Pakistani medical students' specialty preference and the influencing factors.

PubMed

Rehman, Anis; Rehman, Tariq; Shaikh, Muhammad Ateeb; Yasmin, Haleema; Asif, Ammara; Kafil, Hina

2011-07-01

To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad Medical College, were included in the cross-sectional survey during the period of July 2008 to Jan' 2009. After ethical acceptance, data was collected using convenient sampling technique. The questionnaire covered the following demographic details: 13 common specialties and 15 influencing factors. Questionnaires included in the analysis were 771. Most students gave preference to surgery and its associated sub-specialties (50.3%) followed by internal medicine (26.8%), paediatrics (23.2%), dermatology (16.7%), gynaecology and obstetrics (16.7%), psychiatry (13.1%), radiology (10.8%), ENT (8.8%), anaesthesiology (8.7%), administrative medicine (8.6%), orthopaedics (8.2%), ophthalmology (7.5%), and laboratory medicine (6.1%). The highly considered factors (regarding specialties) chosen by 70% of the medical students were: applicable to respective personalities of the individuals, prestige and respect, international opportunities, and time commitment. Surgical-skills, job availability, financial rating, academic performance, and a role model were moderately influencing factors. Hospital environment, parents, general practice, peer-pressure and personal health were the least influential. This trend suggests competition in surgery and its sub-specialties along with internal medicine, paediatrics, dermatology, gynaecology and obstetrics. Specialty suited to personality, time commitment, prestige/respect and international opportunity, influenced more than 70% of the students.

77 FR 8262 - Dermatologic and Ophthalmic Drugs Advisory Committee; Amendment of Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... (eye) pain in patients who have undergone ocular surgery. The portion of the meeting (Topic 2... cancelling (Topic 1), the portion of the meeting relating to the appropriate types of clinical evidence for...

Skin changes after bariatric surgery*

PubMed Central

Manzoni, Ana Paula Dornelles da Silva; Weber, Magda Blessmann

2015-01-01

Today, obesity is considered an epidemic all over the world and it is recognized as one of the major public health problems. Bariatric surgery is considered an appropriate therapeutic option for obesity with progressively increasing demands. The changes resulting from massive weight loss after bariatric surgery are related to numerous complications. This article will present the dermatological alterations that can be found after bariatric surgery. They will be subdivided into dermatoses that are secondary to metabolic and nutritional disorders, those derived from cutaneous structural modifications after major weight loss and the influence the latter may have in improving of certain dermatoses. PMID:25830984

Nitrogen Separation and Liquefaction Apparatus for Medical Applications and Its Thermodynamic Optimization

NASA Astrophysics Data System (ADS)

Chorowski, M.; Piotrowska, A.; Polinski, J.

2006-04-01

Low temperature medicine is becoming a widely appreciated method in surgery, dermatology, gynecology and rheumatology. The cryomedical equipment is usually supplied with liquid nitrogen LN2 stored in a dewar and transferred to a tip, where it is evaporated providing a cooling power. LN2 in quantities sufficient for cryo-surgical and cryo-therapeutical applications can be first separated from air and then liquefied using a system combining polymer membrane gas separation technology and a Joule-Thomson closed-cycle refrigerator filled with a nitrogen-hydrocarbons gas mixture. Nitrogen is separated from the compressed air, then liquefied and throttled to atmospheric pressure. The paper analyzes the demanded cooling capacity of the system resulting from cryomedical treatment requirements. Thermal design and flow scheme of the apparatus are given. The system is thermodynamically optimized.

Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the ear.

PubMed

Valesky, E M; Kaufmann, R; Meissner, M

2015-11-01

The plastic reconstruction of the ear after microscopically controlled tumor surgery is a particular challenge. The chondrocutaneous helix rim advancement flap (CHRAF) is perfectly suited for the repair of different defects of the helix and even defects beyond. Here, we describe two known and two new modifications of the CHRAF that enlarge the scope of application in tumor surgery of the ear. We demonstrate the different techniques and practical application of the repair and evaluate the benefits and limitations. The CHRAF and its modifications is an excellent method for repair of various defects of the helical region of the ear. The CHRAF and its modifications proves to be an good alternative to other methods of closure by preserving the anatomical contour and mechanical and acoustic functions in a single-staged procedure with excellent aesthetic results. The two new modifications we introduced here, enlarge the known armentarium for very large defects of the upper pole and the mid-helix of the ear. © 2014 European Academy of Dermatology and Venereology.

Laser applications in surgery

PubMed Central

Azadgoli, Beina

2016-01-01

In modern medicine, lasers are increasingly utilized for treatment of a variety of pathologies as interest in less invasive treatment modalities intensifies. The physics behind lasers allows the same basic principles to be applied to a multitude of tissue types using slight modifications of the system. Multiple laser systems have been studied within each field of medicine. The term “laser” was combined with “surgery,” “ablation,” “lithotripsy,” “cancer treatment,” “tumor ablation,” “dermatology,” “skin rejuvenation,” “lipolysis,” “cardiology,” “atrial fibrillation (AF),” and “epilepsy” during separate searches in the PubMed database. Original articles that studied the application of laser energy for these conditions were reviewed and included. A review of laser therapy is presented. Laser energy can be safely and effectively used for lithotripsy, for the treatment of various types of cancer, for a multitude of cosmetic and reconstructive procedures, and for the ablation of abnormal conductive pathways. For each of these conditions, management with lasers is comparable to, and potentially superior to, management with more traditional methods. PMID:28090508

Unconventional medicine in dermatology outpatients in Turkey.

PubMed

Gönül, Müzeyyen; Gül, Ulker; Cakmak, Seray Külcü; Kiliç, Selim

2009-06-01

Many people use unconventional therapies for health problems, but the extent and pattern of this use in dermatology have not been studied in detail. This article reports the first investigation on the use of unconventional therapies in dermatology in Turkey. To determine the prevalence and characteristics of unconventional therapies used by dermatology outpatients in Turkey. A questionnaire was employed to determine the use of unconventional therapies in patients attending a dermatology clinic in Ankara, Turkey. The patients were questioned about the number of attendances at dermatology clinics, whether they had ever used unconventional therapies and/or drugs without the suggestion of a medical doctor for the current dermatologic disorder, and the forms of unconventional therapies employed. The data were compared statistically with the age, sex, and education status of the patients. The respondents included 443 men and 563 women, with a total of 1006 patients. The mean age of the patients was 36.62 +/- 17.55 years. Of the 1006 patients, 337 (33.5%) had used at least one form of unconventional therapy. The most common diagnoses of the patients using unconventional therapy were acne, psoriasis, contact dermatitis, and fungal infections. The most frequent forms of unconventional therapy used by the patients were humectants, cologne, spiritual healing, and herbs. Unconventional therapy use according to the sex, age, and education status of the patients did not show any significant difference. A significant relationship was found between some forms of unconventional therapy and some skin disorders, including: generalized pruritus and application of cologne; warts and spiritual healing; fungal infections and application of henna; psoriasis and herbal therapy or spiritual healing; alopecia areata and application of garlic; acne and application of lemon juice, clay, or cosmetics. Regardless of patient age, sex, and education status, dermatology outpatients use unconventional therapies for their health. Dermatologists should be aware of the tendency of patients to use unconventional therapies and should guide patients towards the use of harmless treatments.

Pruritus-Ani

MedlinePlus

... Dermatology and Pruritis Ani”. Chapter in Beck, D. E., Roberts, P. L., Saclarides, T. J., Senagore, A. J., Stamos, M. J., Wexner, S. D., Eds. ASCRS Textbook of Colon and Rectal Surgery, 2nd Edition. Springer, New York, NY; 2011. American Society of Colon ...

Skin Aging: MedlinePlus Health Topic

MedlinePlus

... Specifics Bags Under Eyes (Mayo Foundation for Medical Education and Research) Also in Spanish Sagging Skin (American Society for Dermatologic Surgery) Clinical Trials ClinicalTrials.gov: Skin Aging (National Institutes of Health) Journal Articles References and abstracts from MEDLINE/PubMed (National ...

Misrepresentation of research publications among orthopedic surgery fellowship applicants: a comparison with documented misrepresentations in other fields.

PubMed

Patel, Manish V; Pradhan, Ben B; Meals, Roy A

2003-04-01

Study Design. A retrospective study was used to review fellowship applications over 3 years. Objectives. To assess the prevalence of research misrepresentation in orthopedic fellowship applications, and to compare such activity between subspecialties (e.g. spine, sports, hand). Summary of Background Data. Competition for orthopedic surgery fellowships is intense. The applicant pool includes orthopedic, plastic, and general surgeons, as well as neurosurgeons. Residency and fellowship training programs in other disciplines have documented shocking levels of misrepresentation in the curriculum vitae of prospective applicants. However, no study has looked at orthopedic residents applying for subspecialty fellowship programs. Methods. A retrospective analysis investigated 280 applications for fellowship positions in the department of orthopedic surgery at the authors' academic institution from 1996 to 1998 inclusively. To allow for press and publication delays, a minimum 24-month follow-up period was instituted. The listings of applicants' research publications were analyzed for evidence of misrepresentation through an exhaustive literature search. Only the most obvious confirmable discrepancies were labeled as misrepresentations. The results then were compared with those found in studies conducted in other fields: gastroenterology fellowship, emergency medicine residency, pediatric residency, dermatology residency, orthopedic residency, and medical faculty applications. Results. Among 280 (54%) applicants for orthopedic surgery candidates, 151 claimed journal publications. It was found that 16 (10.6%) of these 151 applicants had misrepresented their citations. This rate was highest in spine fellowship applicants (20%). However, considering the numbers available, this was not significantly different among the various subspecialty fellowship applicants (P>0.1). In addition, various demographic data did not correlate with the rate of misrepresentation (P>0.1). These results are comparable with those reported in other medical fields (P>0.1). Conclusions. Misrepresentation occurs in orthopedic fellowship applications at a rate comparable with that observed in other fields. This rate is not different among the various subspecialties in orthopedics. Policies that may lessen the incidence of falsification on curriculum vitae should be instituted in an attempt to curb such activity.

Integrative Dermatology – The Use of Herbals and Nutritional Supplements to Treat Dermatological Conditions

PubMed Central

Tirant, Michael; Lotti, Torello; Gianfaldoni, Serena; Tchernev, Georgi; Wollina, Uwe; Bayer, Philip

2018-01-01

From humble beginnings at the dawn of time to it’s advanced and successful status today, this essay traces the history of natural medicine and the development of integrated dermatology to what it is today. Some of the most well-known natural (international and Australian) products with an application in dermatology are discussed. The history and functions of the Psoriasis Eczema Clinic and the products developed by its founder, Prof. Michael Tirant, are explained. PMID:29484023

The residency interview is still paramount: results of a retrospective cohort study on concordance of dermatology residency applicant evaluators and influence of the applicant interview.

PubMed

Kamangar, Faranak; Davari, Parastoo; Azari, Rahman; Fitzmaurice, Sarah; Li, Chin-Shang; Eisen, Daniel B; Fazel, Nasim

2017-05-22

Application to dermatology residency is a highly competitive process. Although factors associated with successfully matching have been studied, less is known regarding the ability of admissions committees to screen applicants in a uniform manner or the importance of the interview in ranking applicants. Our goal was to retrospectively measure our admission committee evaluators' concordance regarding residency application credentials and interview performance, and ultimately the effects on final applicant ranking.

Thalidomide in Dermatology: Revisited

PubMed Central

Hassan, Iffat; Dorjay, Konchok; Anwar, Parvaiz

2015-01-01

The use of thalidomide in relation to dermatology is well- known and enough data is available in the literature about various aspects of thalidomide. Despite being an interesting and useful drug for many dermatoses, it is associated with many health hazards including the birth defects, phocomelia. We hereby present a comprehensive review about thalidomide and its application in dermatology. PMID:25814738

Interaction thresholds in Er:YAG laser ablation of organic tissue

NASA Astrophysics Data System (ADS)

Lukac, Matjaz; Marincek, Marko; Poberaj, Gorazd; Grad, Ladislav; Mozina, Janez I.; Sustercic, Dusan; Funduk, Nenad; Skaleric, Uros

1996-01-01

Because of their unique properties with regard to the absorption in organic tissue, pulsed Er:YAG lasers are of interest for various applications in medicine, such as dentistry, dermatology, and cosmetic surgery. The relatively low thermal side effects, and surgical precision of erbium medical lasers have been attributed to the micro-explosive nature of their interaction with organic tissue. In this paper, we report on preliminary results of our study of the thresholds for tissue ablation, using an opto-acoustic technique. Two laser energy thresholds for the interaction are observed. The lower energy threshold is attributed to surface water vaporization, and the higher energy threshold to explosive ablation of thin tissue layers.

Keeping up with the times: revising the dermatology residency curriculum in the era of molecular diagnostics and personalized medicine.

PubMed

LaChance, Avery; Murphy, Michael J

2014-11-01

The clinical use of molecular diagnostics, genomics, and personalized medicine is increasing and improving rapidly over time. However, medical education incorporating the practical application of these techniques is lagging behind. Although instruction in these areas should be expanded upon and improved at all levels of training, residency provides a concentrated period of time in which to hone in on skills that are practically applicable to a trainee's specialty of choice. Although residencies in some fields, such as pathology, have begun to incorporate practical molecular diagnostics training, this area remains a relative gap in dermatology residency programs. Herein, we advocate for the incorporation of training in molecular diagnostics and personalized medicine into dermatology residency programs and propose a basic curriculum template for how to begin approaching these topics. By incorporating molecular diagnostics into dermatology residency training, dermatologists have the opportunity to lead the way and actively shape the specialty's transition into the era of personalized medicine. © 2014 The International Society of Dermatology.

Diversity in Dermatology Residency Programs.

PubMed

Van Voorhees, Abby S; Enos, Clinton W

2017-10-01

Given the change in our population to one that is more racially and ethnically diverse, the topic of diversity in dermatology residency programs has gained attention. In a field that has become highly competitive, diversity is lagging behind. What are the reasons for this? The existing diversity among medical school matriculants is reflective of the applicant pool, and although modest, there has been an increase in applications and acceptances from minority populations. However, these proportions do not carry through to the population applying to dermatology residency. Making sense of this and planning how to recruit a more diverse applicant pool will improve the quality and cultural competency of future dermatologists. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Phenol intoxication in a child.

PubMed

Unlü, R Erkin; Alagöz, M Sahin; Uysal, A Caĝri; Orbay, Hakan; Kilinç, Hidir; Tekin, Fatih; Sensöz, Omer; Erk, Gülcan

2004-11-01

Phenol preparations are used in dermatology and plastic surgery for the treatment of acne and during chemical face peeling. At this institution, phenol peeling is used in addition to mechanical dermabrasion for the elimination of subclinical premalignant lesions of patients having xeroderma pigmentosum. As the phenol peel is performed, most surgeons concentrate on skin results, ignoring systemic complications. Local histological changes and systemic toxicity have been seen during applications. Cardiac arrhythmias and even sudden death have been reported. The high incidence of cardiac arrhythmias after topical application of phenol preparations is demonstrated. The case of an 11-year-old boy with a diagnosis of xeroderma pigmentosum who underwent mechanical dermabrasion and chemical peeling with phenol and then developed severe cardiac arrhythmias is reported. A serious systemic toxic effect on cardiac rhythm from cutaneously applied phenol occurred in this case.

Pentoxifylline and its applications in dermatology

PubMed Central

Hassan, Iffat; Dorjay, Konchok; Anwar, Parvaiz

2014-01-01

Pentoxifylline is a methyl-xanthine derivative with many anti inflammatory effects. Pentoxifylline has been found to be effective for many dermatological as well as non-dermatological conditions. It has been used both as primary drug as well as adjuvant and is a safe and relatively cost-effective alternative drug. In this article, we review the literature and highlight various important aspects of pentoxifylline. PMID:25396144

Applications of the 308-nm excimer laser in dermatology

NASA Astrophysics Data System (ADS)

Farkas, A.; Kemeny, L.

2006-05-01

Excimer lasers contain a mixture of a noble inert gas and a halogen, which form excited dimers only in the activated state. High-energy current is used to produce these dimers, which have a very short lifetime, and after their fast dissociation they release the excitation energy through ultraviolet photons. The application of these lasers proved to be successful in medicine, including the field of ophthalmology, cardiology, angiology, dentistry, orthopaedics, and, in recent years, dermatology. For medical purposes, the 193-nm argon fluoride, the 248-nm krypton fluoride, the 351-nm xenon fluoride, and the 308-nm xenon chloride lasers are used. Recently, the 308-nm xenon chloride laser has gained much attention as a very effective treatment modality in dermatological disorders. It was successfully utilized in psoriasis; later, it proved to be useful in handling other lightsensitive skin disorders and even in the treatment of allergic rhinitis. This review summarizes the possible applications of this promising tool in dermatology.

Incidence of infection after Mohs micrographic and dermatologic surgery before and after implementation of new sterilization guidelines.

PubMed

Liu, Austin; Lawrence, Naomi

2014-06-01

Clinical guidelines regarding surgical instrument sterilization established by accrediting organizations should be based on peer-reviewed scientific literature. Few data exist in the scientific literature to support the changes in sterilization protocols imposed by accrediting organizations. We sought to determine whether recently established guidelines for the sterilization of surgical instruments have had any clinical impact on postsurgical infection rates. Infections rates after excisional and Mohs micrographic surgery before and after implementation of new Joint Commission on the Accreditation of Healthcare Organizations sterilization guidelines were examined retrospectively. All surgeries were performed at an academic outpatient office. In all, 1415 patients underwent a total of 1688 surgeries. No significant differences were observed in mean patient age (P = .113), mean number of Mohs micrographic surgical levels (P = .067), final defect size (P = .305), patient gender (P = .072), repair type (P = .691), or infection rate (P = .453). No major differences in predisposing factors were identified in patients who developed postsurgical infections. This was a retrospective study conducted at a single academic institution. In our practice, recent changes in surgical instrument sterilization protocols have had no impact on postsurgical infection rates. The implementation of such guidelines places an additional burden on the health care system without providing any improvement in patient outcomes. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting.

PubMed

Gold, M H; Foster, T D; Adair, M A; Burlison, K; Lewis, T

2001-07-01

Topical silicone gel sheeting has been used for more than 20 years to help reduce the size of hypertrophic scars and keloids. Its clinical efficacy and safety is well established. To determine whether topical silicone gel sheeting can be used to prevent hypertrophic scars and keloids from forming following dermatologic skin surgery. Patients undergoing skin surgery were stratified into two groups: those with no history of abnormal scarring (low-risk group) and those with a history of abnormal scarring (high-risk group). Following the procedure, patients within each group were randomized to receive either routine postoperative care or topical silicone gel sheeting (48 hours after surgery). Patients were followed for 6 months. In the low-risk group, there were no statistical differences between individuals using routine postoperative care or using topical silicone gel sheets. In the high-risk group, there was a statistical difference (39% versus 71%) between patients who did not develop abnormal scars and used topical silicone gel sheeting and patients who developed abnormal scars after routine postoperative treatment. Those individuals having a scar revision procedure also showed a statistical difference if topical silicone gel sheeting was used following surgery. Topical silicone gel sheeting, with a 20-year history of satisfaction in dermatology, now appears to be useful in the prevention of hypertrophic scars and keloids in patients undergoing scar revision.

Evaluating Dermatology Residency Program Websites.

PubMed

Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

2016-03-16

Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms to improve their websites and provide adequate content to attract the top residents for their respective programs.

A review of general cosmetic surgery training in fellowship programs offered by the American Academy of Cosmetic Surgery.

PubMed

Handler, Ethan; Tavassoli, Javad; Dhaliwal, Hardeep; Murray, Matthew; Haiavy, Jacob

2015-04-01

We sought, first, to evaluate the operative experience of surgeons who have completed postresidency fellowships offered by the American Academy of Cosmetic Surgery (AACS), and second, to compare this cosmetic surgery training to other surgical residency and fellowship programs in the United States. Finally, we suggest how new and existing oral and maxillofacial surgeons can use these programs. We reviewed the completed case logs from AACS-accredited fellowships. The logs were data mined for 7 of the most common cosmetic operations, including the median total number of operations. We then compared the cosmetic case requirements from the different residencies and fellowships. Thirty-nine case logs were reviewed from the 1-year general cosmetic surgery fellowships offered by the AACS from 2007 to 2012. The fellows completed a median of 687 total procedures. The median number of the most common cosmetic procedures performed was 14 rhinoplasties, 31 blepharoplasties, 21 facelifts, 24 abdominoplasties, 28 breast mastopexies, 103 breast augmentations, and 189 liposuctions. The data obtained were compared with the minimum cosmetic surgical requirements in residency and fellowship programs. The minimum residency requirements were as follows: no minimum listed for plastic surgery, 35 for otolaryngology, 20 for oral and maxillofacial surgery, 28 for ophthalmology, 0 for obstetrics and gynecology, and 20 for dermatology. The minimum fellowship requirements were as follows: 300 for the AACS cosmetic surgery fellowship, no minimum listed for facial plastic surgery and reconstruction, no minimum listed for aesthetic surgery, 133 for oculoplastic and reconstructive surgery, and 0 for Mohs dermatology. Dedicating one's practice exclusively to cosmetic surgery requires additional postresidency training owing to the breadth of the field. The AACS created comprehensive fellowship programs to fill an essential part in the continuum of cosmetic surgeons' education, training, and experience. This builds on the foundation of their primary board residency program. The AACS fellowships are a valuable option for additional training for qualified surgeons seeking proficiency and competency in cosmetic surgery. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Risk management in dermatology: an analysis of data available from several British-based reporting systems.

PubMed

Gawkrodger, D J

2011-03-01

The elimination or reduction of risk is a prime requirement of all healthcare workers. The matter has come to the fore in dermatological practice recently with the widespread use of effective drugs that have significant side-effects (e.g. retinoids, cytotoxic drugs, biologics), the increase in skin surgery, especially for skin cancer, and the extensive use of phototherapies. To examine the available database from different agencies to which adverse events may be reported over at least a 5-year time frame, categorize the risks, look forward to where as yet unidentified risks might exist, and draw conclusions to improve the safety of dermatological practice. This work came about through a request from the National Patient Safety Agency [to the Joint Specialty Committee of the British Association of Dermatologists (BAD) and Royal College of Physicians] for information on risks to patients receiving treatment or investigation for skin disease. Organizations in the U.K. that receive information about adverse events, whether caused by drugs or procedures in dermatological treatments, were approached for information about reported events over a 5-year (or, in one case, 10-year) time frame up to 2009. Data were received from the National Patient Safety Agency, the Medicines and Healthcare Products Regulatory Agency, the National Health Service Litigation Authority, the Medical Protection Society and the Medical Defence Union. In addition, the results of a survey conducted in 2010 by the BAD of its members concerning potential critical incident reporting were included. The received information was analysed according to category of event and conclusions drawn about how best to manage the risks that were identified. Adverse events were divided into the following categories, listed in order of the number of reports received: drug side-effects (biologics and retinoids), phototherapy dosage, drug monitoring (including initial screening), pregnancy prevention programmes, skin cancer follow-up (including acting on reports), dermatopathological reporting and conduct of dermatological surgery (including management of complications, equipment problems, use of lasers, cosmetic procedures and cryotherapy). Critical incidents reported by BAD members often concerned follow-up failures, e.g. of patients receiving systemic drugs or of those with skin cancer. Several of the reported adverse events concern systemic failures. Recommendations for risk reduction include the following points: better systems for drug monitoring (including regularity of attendance, provision of sufficient follow-up appointments, acting on results and adequacy of pregnancy prevention programmes); staff training and record keeping for phototherapy; acting on skin cancer multidisciplinary team meeting outcomes (including provision of sufficient follow-up appointments); and adequate training of staff in dermatological surgery including cryotherapy. Regular monitoring of the occurrence of such reports is needed to ensure safe practice and to identify early areas of new risk. © 2011 The Author. BJD © 2011 British Association of Dermatologists.

Measuring impact of JAMA Dermatology Practice Gaps section on training in US dermatology residency programs.

PubMed

Britton, Kristina M; Stratman, Erik J

2013-07-01

JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.

Five-year economic evaluation of non-melanoma skin cancer surgery at the Costa del Sol Hospital (2006-2010).

PubMed

Aguilar-Bernier, M; González-Carrascosa, M; Padilla-España, L; Rivas-Ruiz, F; Jiménez-Puente, A; de Troya-Martín, M

2014-03-01

The cost associated with treatment of non-melanoma skin cancer is expected to rise considerably over the coming decades. This important public health problem is therefore expected to have an enormous economic impact for the various public health services. To estimate the cost of the surgical-care process of non-melanoma skin cancer at the Costa del Sol Hospital and seek areas to improve its efficiency, using the activity-based costing (ABC) method and the tools designed for decision analysis. To compare the costs for hospitalized patients obtained using the ABC method with the data published by the Spanish Ministry of Health, using the diagnosis-related groups (DRG) classification system. Retrospective analysis of the cost of non-melanoma skin cancer surgery at the Costa del Sol Hospital. The total estimated cost from 2006 to 2010 was 3 398 540€. Most of the episodes (47.3%) corresponded to minor outpatient surgery. The costs of the episodes varied greatly according to the type of admission: 423€ (minor outpatient surgery), 1267€ (major outpatient surgery), and 1832€ (inpatient surgery). The average cost of an inpatient episode varied significantly depending on the calculation system used (ABC: 2328€ vs. DRG: 5674€). The ABC cost analysis system favours standardization of the care process for these tumours and the detection of areas to improve efficiency. This would enable more reliable economic studies than those obtained using traditional methods, such as the DRG. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

Mesenchymal Stem Cells from Adipose Tissue in Clinical Applications for Dermatological Indications and Skin Aging.

PubMed

Gaur, Meenakshi; Dobke, Marek; Lunyak, Victoria V

2017-01-20

Operating at multiple levels of control, mesenchymal stem cells from adipose tissue (ADSCs) communicate with organ systems to adjust immune response, provide signals for differentiation, migration, enzymatic reactions, and to equilibrate the regenerative demands of balanced tissue homeostasis. The identification of the mechanisms by which ADSCs accomplish these functions for dermatological rejuvenation and wound healing has great potential to identify novel targets for the treatment of disorders and combat aging. Herein, we review new insights into the role of adipose-derived stem cells in the maintenance of dermal and epidermal homeostasis, and recent advances in clinical applications of ADSCs related to dermatology.

Mesenchymal Stem Cells from Adipose Tissue in Clinical Applications for Dermatological Indications and Skin Aging

PubMed Central

Gaur, Meenakshi; Dobke, Marek; Lunyak, Victoria V.

2017-01-01

Operating at multiple levels of control, mesenchymal stem cells from adipose tissue (ADSCs) communicate with organ systems to adjust immune response, provide signals for differentiation, migration, enzymatic reactions, and to equilibrate the regenerative demands of balanced tissue homeostasis. The identification of the mechanisms by which ADSCs accomplish these functions for dermatological rejuvenation and wound healing has great potential to identify novel targets for the treatment of disorders and combat aging. Herein, we review new insights into the role of adipose-derived stem cells in the maintenance of dermal and epidermal homeostasis, and recent advances in clinical applications of ADSCs related to dermatology. PMID:28117680

Application of 2-um wavelength holmium lasers for treatment of skin diseases

NASA Astrophysics Data System (ADS)

Shcherbakov, Ivan A.; Klimov, Igor V.; Tsvetkov, Vladimir B.; Nerobeev, Alexander I.; Sadovnikova, Lija B.; Eliseenko, Vladimir I.

1994-09-01

Theoretical and experimental analysis of the efficiency of application of 2 micrometers pulsed holmium laser for cosmetic and plastic surgery and dermatology is carried out. Preliminary experiments were carried out on rats. Solid state 2 micrometers pulsed laser was allowed to operate in free running mode with pulse energy up to 1.5 J and pulse repetition rate up to 5 Hz. To deliver emission to the object a flexible quartz fiber without further focusing of 2.5 m in length and 400 micrometers of the core diameter was used. The effect of the different power density emission on the skin was studied. The second stage was the study of the influence of 2 micrometers emission on human skin. The results of the removal of hemangioma, papilloma, telangiectasia, nevus, nevus acantholytic, xanthelasma palpebral, verruca, chloasma, pigmental spots, tattoos, etc. are presented. Precision, simplicity, efficiency, and the high cosmetic effect of these operations is noted.

Influence of hyaluronic acid on bacterial and fungal species, including clinically relevant opportunistic pathogens.

PubMed

Ardizzoni, Andrea; Neglia, Rachele G; Baschieri, Maria C; Cermelli, Claudio; Caratozzolo, Manuela; Righi, Elena; Palmieri, Beniamino; Blasi, Elisabetta

2011-10-01

Hyaluronic acid (HA) has several clinical applications (aesthetic surgery, dermatology, orthopaedics and ophtalmology). Following recent evidence, suggesting antimicrobial and antiviral properties for HA, we investigated its effects on 15 ATCC strains, representative of clinically relevant bacterial and fungal species. The in vitro system employed allowed to assess optical density of broth cultures as a measure of microbial load in a time-dependent manner. The results showed that different microbial species and, sometimes, different strains belonging to the same species, are differently affected by HA. In particular, staphylococci, enterococci, Streptococcus mutans, two Escherichia coli strains, Pseudomonas aeruginosa, Candida glabrata and C. parapsilosis displayed a HA dose-dependent growth inhibition; no HA effects were detected in E. coli ATCC 13768 and C. albicans; S. sanguinis was favoured by the highest HA dose. Therefore, the influence of HA on bacteria and fungi warrants further studies aimed at better establishing its relevance in clinical applications.

Overview of Facial Plastic Surgery and Current Developments

PubMed Central

Chuang, Jessica; Barnes, Christian; Wong, Brian J. F.

2016-01-01

Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques. PMID:28824978

Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology.

PubMed

Hensen, P; Fürstenberg, T; Luger, T A; Steinhoff, M; Roeder, N

2005-09-01

The changing healthcare environment world-wide is leading to extensive use of per case payment systems based on diagnosis-related groups (DRG). The aim of this study was to examine the impact of application of different DRG systems used in the German healthcare system. We retrospectively analysed 2334 clinical data sets of inpatients discharged from an academic dermatological inpatient unit in 2003. Data were regarded as providing high coding quality in compliance with the diagnosis and procedure classifications as well as coding standards. The application of the Australian AR-DRG version 4.1, the German G-DRG version 1.0, and the German G-DRG version 2004 was considered in detail. To evaluate more specific aspects, data were broken down into 11 groups based on the principle diagnosis. DRG cost weights and case mix index were used to compare coverage of inpatient dermatological services. Economic impacts were illustrated by case mix volumes and calculation of DRG payments. Case mix index results and the pending prospective revenues vary tremendously from the application of one or another of the DRG systems. The G-DRG version 2004 provides increased levels of case mix index that encourages, in particular, medical dermatology. The AR-DRG version 4.1 and the first German DRG version 1.0 appear to be less suitable to adequately cover inpatient dermatology. The G-DRG version 2004 has been greatly improved, probably due to proceeding calculation standards and DRG adjustments. The future of inpatient dermatology is subject to appropriate depiction of well-established treatment standards.

Effectiveness and Advantages of On-Site Pathology Services in the Care of Patients With Nonmelanoma Skin Cancer.

PubMed

Machan, Mac; Zitelli, John; Brodland, David

2016-01-01

On-site pathology services are an integral part of many dermatology and surgical dermatology practices in the United States. Assess the effectiveness and advantages of on-site pathology services. Biopsy data from 7 practices with on-site pathology services were reviewed to determine the diagnostic accuracy of malignancies from all lesional biopsies. Patient preference and convenience were queried and measured with satisfaction surveys. Of note, 1,052/1,379 (76.3%) of biopsies demonstrated a malignancy. Most patients underwent treatment of malignant lesions on a different day than the biopsy. Of the patients who scheduled a return visit for surgery on a later date, 42/246 (17.1%) reported incurring additional costs and 44/249 (17.7%) had a relative/friend who was inconvenienced. On-site pathology services provide efficient, effective, and convenient care for skin cancer patients. Fellowship-trained dermatologic surgeons use on-site pathology services to diagnose and treat clinically relevant nonmelanoma skin cancer.

[Evaluation of the results of surgical treatment of granuloma teleangiectodes].

PubMed

Bogdanowski, T; Rubisz-Brzezińska, J; Macura-Gina, M; Misiewicz, D

1990-01-01

In the clinic of dermatological surgery, I Department of Dermatology Silesian Medical Academy in Katowice 328 patients were treated surgically for granuloma teleangiectodes in the years 1973-1988. Two methods were used: excision of the lesion and curettage with electrocoagulation of the base of the lesion. After excision the wound was closed by approximation of its margins or local plastic procedure (285 cases) and by covering it with a free full-thickness skin graft (3 cases). Curettage and electrocoagulation was used in 43 cases, mainly due to the location of the lesion (in 90% on fingers). After granuloma excision no recurrences were observed, while after curettage and electrocoagulation recurrences developed in 20% of cases.

High frequency ultrasound with color Doppler in dermatology*

PubMed Central

Barcaui, Elisa de Oliveira; Carvalho, Antonio Carlos Pires; Lopes, Flavia Paiva Proença Lobo; Piñeiro-Maceira, Juan; Barcaui, Carlos Baptista

2016-01-01

Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology. PMID:27438191

Surgical lasers in dermatology

NASA Astrophysics Data System (ADS)

Szymanczyk, Jacek; Nowakowski, Wlodzimierz; Golebiowska, Aleksandra; Michalska, I.; Mindak, Marek K.

1997-10-01

Almost every laser for medical applications was first tried in dermatology. The efficiency of YAG, CO2, and Argon lasers on this area and their potential advantages over conventional methods were mostly evaluated by cosmetic effect of laser therapy. The indications for different laser treatment in such dermatological cases as: angiomas, telangiectasias, pigmented lesions, nevus flammeus congenitus, deep cavernous angiomas, skin neoplasms and condylomata acuminata are discussed in this paper and the results of the laser therapy are also presented.

Smartphone applications: A contemporary resource for dermatopathology

PubMed Central

Hanna, Matthew G.; Parwani, Anil V.; Pantanowitz, Liron; Punjabi, Vinod; Singh, Rajendra

2015-01-01

Introduction: Smartphone applications in medicine are becoming increasingly prevalent. Given that most pathologists and pathology trainees today use smartphones, an obvious modality for pathology education is through smartphone applications. “MyDermPath” is a novel smartphone application that was developed as an interactive reference tool for dermatology and dermatopathology, available for iOS and Android. Materials and Methods: “MyDermPath” was developed using Apple Xcode and Google Android SDK. Dermatology images (static and virtual slides) were annotated and configured into an algorithmic format. Each image comprised educational data (diagnosis, clinical information, histopathology, special stains, differential diagnosis, clinical management, linked PubMed references). Added functionality included personal note taking, pop quiz, and image upload capabilities. A website was created (http://mydermpath.com) to mirror the app. Results: The application was released in August 2011 and updated in November 2013. More than 1,100 reference diagnoses, with over 2,000 images are available via the application and website. The application has been downloaded approximately 14,000 times. The application is available for use on iOS and Android platforms. Conclusions: Smartphone applications have tremendous potential for advancing pathology education. “MyDermPath” represents an interactive reference tool for dermatology and dermatopathologists. PMID:26284155

Smartphone applications: A contemporary resource for dermatopathology.

PubMed

Hanna, Matthew G; Parwani, Anil V; Pantanowitz, Liron; Punjabi, Vinod; Singh, Rajendra

2015-01-01

Smartphone applications in medicine are becoming increasingly prevalent. Given that most pathologists and pathology trainees today use smartphones, an obvious modality for pathology education is through smartphone applications. "MyDermPath" is a novel smartphone application that was developed as an interactive reference tool for dermatology and dermatopathology, available for iOS and Android. "MyDermPath" was developed using Apple Xcode and Google Android SDK. Dermatology images (static and virtual slides) were annotated and configured into an algorithmic format. Each image comprised educational data (diagnosis, clinical information, histopathology, special stains, differential diagnosis, clinical management, linked PubMed references). Added functionality included personal note taking, pop quiz, and image upload capabilities. A website was created (http://mydermpath.com) to mirror the app. The application was released in August 2011 and updated in November 2013. More than 1,100 reference diagnoses, with over 2,000 images are available via the application and website. The application has been downloaded approximately 14,000 times. The application is available for use on iOS and Android platforms. Smartphone applications have tremendous potential for advancing pathology education. "MyDermPath" represents an interactive reference tool for dermatology and dermatopathologists.

Understanding the pediatric dermatology workforce shortage: mentoring matters.

PubMed

Admani, Shehla; Caufield, Maura; Kim, Silvia S; Siegfried, Elaine C; Friedlander, Sheila Fallon

2014-02-01

To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology. Copyright © 2014 Mosby, Inc. All rights reserved.

Performance assessment of 3D surface imaging technique for medical imaging applications

NASA Astrophysics Data System (ADS)

Li, Tuotuo; Geng, Jason; Li, Shidong

2013-03-01

Recent development in optical 3D surface imaging technologies provide better ways to digitalize the 3D surface and its motion in real-time. The non-invasive 3D surface imaging approach has great potential for many medical imaging applications, such as motion monitoring of radiotherapy, pre/post evaluation of plastic surgery and dermatology, to name a few. Various commercial 3D surface imaging systems have appeared on the market with different dimension, speed and accuracy. For clinical applications, the accuracy, reproducibility and robustness across the widely heterogeneous skin color, tone, texture, shape properties, and ambient lighting is very crucial. Till now, a systematic approach for evaluating the performance of different 3D surface imaging systems still yet exist. In this paper, we present a systematic performance assessment approach to 3D surface imaging system assessment for medical applications. We use this assessment approach to exam a new real-time surface imaging system we developed, dubbed "Neo3D Camera", for image-guided radiotherapy (IGRT). The assessments include accuracy, field of view, coverage, repeatability, speed and sensitivity to environment, texture and color.

Current evidence and applications of photodynamic therapy in dermatology

PubMed Central

Wan, Marilyn T; Lin, Jennifer Y

2014-01-01

In photodynamic therapy (PDT) a photosensitizer – a molecule that is activated by light – is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT. PMID:24899818

Local antimicrobial administration for prophylaxis of surgical site infections.

PubMed

Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

2012-11-01

Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

Pediatric surgeons and anesthesiologists expand the dialogue on the neurotoxicity question, rationale for early and delayed surgeries, and practice changes while awaiting definitive evidence.

PubMed

Byrne, Mary W; Casale, Pasquale; Garzon, Maria; Hyman, Joshua E; Lin, Albert Y; Lynch, Lisa R; Schleien, Charles L; Stylianos, Steven

2014-10-01

The Pediatric Anesthesia NeuroDevelopment Assessment team at Columbia University Medical Center Department of Anesthesiology convened its fourth biennial Symposium to address unresolved issues concerning potential neurotoxic effects of anesthetic agents and sedatives on young children and to assess study findings to date. Dialogue initiated at the third Symposium was continued between anesthesiologists, researchers, and a panel of expert pediatric surgeons representing general surgery and dermatology, orthopedic, and urology specialties. The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risks, practice changes while awaiting definitive answers, and importance of continued interprofessional dialogue.

Beyond Bitcoin: Potential Applications of Blockchain Technology in Dermatology.

PubMed

Tung, J K; Nambudiri, V E

2018-06-26

Since its initial popularization in 2008 as the underpinnings of the digital currency Bitcoin, blockchain has seen its implications spread beyond the financial industry. 1 The field of dermatology presents promising potential applications for this burgeoning technology. Blockchain facilitates communication on a peer-to-peer platform with users sharing data directly with each other (Figure). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Use of Nitrous Oxide in Dermatology: A Systematic Review.

PubMed

Brotzman, Erica A; Sandoval, Laura F; Crane, Jonathan

2018-05-01

Many dermatologic procedures are painful and can be distressing to patients. To determine whether nitrous oxide has been used in dermatology and whether literature supports its use in terms of providing analgesia and anxiety associated with dermatologic procedures. A search of PubMed and Cochrane databases was conducted through July 15, 2016, to identify studies involving nitrous oxide use in dermatology. Eight studies were identified and reviewed. The use of nitrous oxide/oxygen mixture resulted in a significant reduction in pain when used for photodynamic therapy, botulinum toxin therapy for hyperhidrosis of both the palms and axilla, aesthetic procedures involving various laser procedures, and in the treatment of bed sores and leg ulcers. However, pain scores were higher when nitrous oxide/oxygen was used in the debridement of chronic ulcers when compared with the use of topical anesthesia. In addition, nitrous oxide has been reported effective at reducing pain in hair transplants, dermabrasion, excision and repairs, and pediatric procedures. Current literature provides some evidence that nitrous oxide, used alone or as adjunct anesthesia, is effective at providing analgesia for many dermatologic procedures. Nitrous oxide has many potential applications in dermatology; however, further evidence from randomized controlled trials is needed.

A potential role for the dermatologist in the physical transformation of transgender people: A survey of attitudes and practices within the transgender community.

PubMed

Ginsberg, Brian A; Calderon, Marcus; Seminara, Nicole M; Day, Doris

2016-02-01

There are an estimated 700,000 or more transgender people in the United States, however their dermatologic needs are not fully established in the medical literature. Unique needs relate to hormone therapy, prior surgeries, and other aspects of physical transitioning. By examining attitudes and practices of transgender individuals, we aimed to identify areas for which dermatologists could contribute to their physical transformation. This cross-sectional study used an anonymous online survey, distributed via lesbian, gay, bisexual, and transgender organizations; social media; and at targeted locations and events. A total of 327 people completed the survey (63% men, 29% women, 9% other). Most transgender women indicated that their face was most imperative to have changed, whereas men noted their chest, in turn influencing procedures. Of women's facial procedures, hair removal predominated, followed by surgery then injectables, mostly performed by plastic surgeons. Hormone-induced facial effects varied, usually taking over 2 years for maximal effect. When choosing procedures, money was the major barrier and good aesthetic outcome the primary concern. Participants did not think that facial procedures necessitate the currently accepted prerequisites for chest and genital surgery. This study has limited size and convenience sampling. Dermatologists could contribute to the physical transformation of transgender patients through noninvasive procedures. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Highlights of Thirty-Year Experience of CO2 Laser Use at the Florence (Italy) Department of Dermatology

PubMed Central

Campolmi, Piero; Bonan, Paolo; Cannarozzo, Giovanni; Bassi, Andrea; Bruscino, Nicola; Arunachalam, Meena; Troiano, Michela; Lotti, Torello; Moretti, Silvia

2012-01-01

The CO2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave CO2 laser delivery system and the newer “superpulsed” and scanned CO2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital. PMID:22593693

Optical coherence tomography based microangiography: A tool good for dermatology applications (Conference Presentation)

NASA Astrophysics Data System (ADS)

Wang, Ruikang K.; Baran, Utku; Choi, Woo J.

2016-02-01

Optical coherence tomography (OCT) based microangiography (OMAG) is a new imaging technique enabling the visualization of blood flow within microcirculatory tissue beds in vivo with high resolution. In this talk, the concept and advantages of OMAG will be discussed and its potential clinical applications in the dermatology will be shown, demonstrating its usefulness in the clinical monitoring and therapeutic treatment of various skin pathologies, e.g. acne, port wine stain and wound healing.

WHY IS THE CENTER OF EVIDENCE-BASED DERMATOLOGY RELEVANT TO INDIAN DERMATOLOGY?

PubMed Central

Williams, Hywel

2009-01-01

Evidence-based dermatology is the application of high-quality evidence to the care of individual patients with skin diseases. The Centre of Evidence-Based Dermatology in the UK promotes activities in this field through its three interlinking cogs, composed of the international Cochrane Skin Group, the UK Dermatology Clinical Trials Network (UKDCTN), and the UK national electronic library for skin disorders. The Cochrane Skin Group summarises what is already known about health care interventions by supporting systematic reviews of relevant randomized controlled trials (RCTs). The UKDCTN then addresses the key research gaps identified in systematic reviews by coordinating and carrying out well-designed RCTs. The Skin Disorders specialist library then plays a key role in disseminating new knowledge from systematic reviews and RCTs to a community of clinical users. The electronic resources at the Centre of Evidence-Based Dermatology are all freely available to Indian Dermatologists who can use the resources in a way that could benefit their patients. Such new knoweldge only has value if it is shared and used. PMID:20101305

Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

PubMed

Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

2013-08-01

Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

Evaluation of the Readability of Dermatological Postoperative Patient Information Leaflets Across England.

PubMed

Hunt, William T N; McGrath, Emily J

2016-06-01

Postoperative patient information leaflets (PILs) provide important guidance to patients after skin surgery. Readability is a method of evaluating information for text comprehension. The recommended level for PIL readability is US grade ≤6. To evaluate the readability of public English dermatological postoperative PILs. All dermatology departments in England were requested to provide their postoperative PILs. Patient information leaflets were evaluated using Readability Studio (Oleander Software, Vandalia, OH). Two preselected parameters were also noted: whether the PIL was doctor or nurse-written, and whether the PIL was Information Standard hallmarked. Eighty-five of one hundred thirty (65.4%) of PILs were evaluated. Only 29.4% of the PILs were grade level ≤6 with Flesch-Kincaid. The mean readability levels were 7.8 for Flesch-Kincaid, 67 for Flesch reading ease, 10.5 for Simple Measure of Gobbledygook (SMOG), 9.4 for Gunning-Fog, 8 for Fry, and 9.8 for FORCAST. No instruments demonstrated a significant difference between doctor (6) and nurse-written (7) PILs. Two instruments found that the 3 Information Standard hallmarked PILs had a higher (harder) readability than ordinary PILs (n = 82) (Gunning-Fog, p = .029*; SMOG p = .049*). Most English postoperative dermatological PILs' readability levels exceed recommendations (US grade ≤6). Departmental PILs should be reviewed to ensure that they are comprehensible to their patients.

Reproducible high-resolution multispectral image acquisition in dermatology

NASA Astrophysics Data System (ADS)

Duliu, Alexandru; Gardiazabal, José; Lasser, Tobias; Navab, Nassir

2015-07-01

Multispectral image acquisitions are increasingly popular in dermatology, due to their improved spectral resolution which enables better tissue discrimination. Most applications however focus on restricted regions of interest, imaging only small lesions. In this work we present and discuss an imaging framework for high-resolution multispectral imaging on large regions of interest.

Tuberous Sclerosis Complex National Database

DTIC Science & Technology

2006-10-01

about conditions in the following areas (as applicable to the participant): academic, cardiac, cognitive, dental , dermatological, liver, neurological...Search Criteria Add To These Results With an Affected Area Academic Cardiac Dental Dermatological Liver Neurological...The Research Integrity Officer, with the assistance of counsel (if needed), will convene the first meeting of the investigation committee to review

Use of Smartphones in Hospitals.

PubMed

Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto

2015-01-01

Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies.

Excellent Aesthetic and Functional Outcome After Fractionated Carbon Dioxide Laser Skin Graft Revision Surgery: Case Report and Review of Laser Skin Graft Revision Techniques.

PubMed

Ho, Derek; Jagdeo, Jared

2015-11-01

Skin grafts are utilized in dermatology to reconstruct a defect secondary to surgery or trauma of the skin. Common indications for skin grafts include surgical removal of cutaneous malignancies, replacement of tissue after burns or lacerations, and hair transplantation in alopecia. Skin grafts may be cosmetically displeasing, functionally limiting, and significantly impact patient's quality-of-life. There is limited published data regarding skin graft revision to enhance aesthetics and function. Here, we present a case demonstrating excellent aesthetic and functional outcome after fractionated carbon dioxide (CO2) laser skin graft revision surgery and review of the medical literature on laser skin graft revision techniques.

Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes.

PubMed

Fransen, Frederike; Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

2018-01-17

To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King's template analysis. The e-learning program positively influenced students' level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, p<0.000). Interview data showed that the e-learning program stimulated students' learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.

Applications of the Excimer Laser: A Review.

PubMed

Beggs, Sarah; Short, Jack; Rengifo-Pardo, Monica; Ehrlich, Alison

2015-11-01

The 308-nm excimer laser has been approved by the Food and Drug Administration for the treatment of psoriasis and vitiligo. Its ability to treat localized areas has led to many studies determining its potential in the treatment of focal diseases with inflammation or hypopigmentation. To review the different applications of the 308-nm excimer laser for treating dermatologic conditions. An extensive literature review was conducted by searching PubMed, MEDLINE, and ClinicalKey to find articles pertaining to dermatologic conditions treated with the 308-nm excimer laser. Articles published that contributed to new applications of the excimer laser were included, as well as initial studies utilizing the excimer laser. The outcomes and results were compiled for different dermatologic conditions treated with the excimer laser. The 308-nm excimer laser has a wide range of uses for focal inflammatory and hypopigmented conditions. Treatment is generally well tolerated, with few adverse reactions. Larger studies and studies evaluating the long-term effects of the 308-nm excimer laser are needed.

Applications of nanotechnology in dermatology.

PubMed

DeLouise, Lisa A

2012-03-01

What are nanoparticles and why are they important in dermatology? These questions are addressed by highlighting recent developments in the nanotechnology field that have increased the potential for intentional and unintentional nanoparticle skin exposure. The role of environmental factors in the interaction of nanoparticles with skin and the potential mechanisms by which nanoparticles may influence skin response to environmental factors are discussed. Trends emerging from recent literature suggest that the positive benefit of engineered nanoparticles for use in cosmetics and as tools for understanding skin biology and curing skin disease outweigh potential toxicity concerns. Discoveries reported in this journal are highlighted. This review begins with a general introduction to the field of nanotechnology and nanomedicine. This is followed by a discussion of the current state of understanding of nanoparticle skin penetration and their use in three therapeutic applications. Challenges that must be overcome to derive clinical benefit from the application of nanotechnology to skin are discussed last, providing perspective on the significant opportunity that exists for future studies in investigative dermatology.

Applications of Nanotechnology in Dermatology

PubMed Central

DeLouise, Lisa A.

2014-01-01

What are nanoparticles and why are they important in dermatology? These questions are addressed by highlighting recent developments in the nanotechnology field that have increased the potential for intentional and unintended nanoparticle skin exposure. The role of environmental factors in the interaction of nanoparticles with skin and the potential mechanisms by which nanoparticles may influence skin response to environmental factors are discussed. Trends emerging from recent literature suggest that the positive benefit of engineered nanoparticles for use in cosmetics and as tools for understanding skin biology and curing skin disease, out weigh potential toxicity concerns. Discoveries reported in this journal are highlighted. This review begins with a general introduction to the field of nanotechnology and nanomedicine. This is followed by a discussion of the current state of understanding of nanoparticle skin penetration and their use in three different therapeutic applications. Challenges that must be overcome to derive clinical benefit from the application of nanotechnology to skin are discussed last, providing perspective on the significant opportunity that exists for future studies in investigative dermatology. PMID:22217738

[Rule of Clinical Application of Auricular Acupuncture Based on Data Mining].

PubMed

Bao, Na; Wang, Qiong; Sun, Yan-Hui; Shi, Jing; Li, Xiao-Feng; Xu, Jing; Xing, Hai-Jiao; Zhang, Xuan-Ping; Zhang, Xin; Du, Yu-Zhu; Li, Jun-Lei; Yang, Qing-Qing; Feng, Xin-Xin; Jia, Chun-Sheng; Wang, Jian-Ling

2017-02-25

To explore the rule of clinical application of auricular acupuncture therapy by data mining in order to guide clinical practice. The data base about single auricular acupuncture therapy for different clinical diseases was established by collection, sorting, screening, recording, collation, data extraction, statistic analysis on data samples from journals, academic theses dissertations published in near 60 years. The application rules of auricular therapy including its predominant diseases, stimulus modality, therapeutic effect, and angle of needling were summarized by data mining technique. Auricular acupuncture therapy has been widely and mostly used in the internal medicine department, accounting for 48.56%. Of stimulus modalities, auricular point paste and pressure is applied with the highest frequency, accounting for 64%. The highest effective rate is found in the surgery department diseases(81.41%). Pressure is the most effective stimulus in the internal medi-cine department, and bloodletting combined with paste and pressure in the surgery department, auricular point injection in the gynecology and pediatrics departments, bloodletting in the ophthalmology and otorhinolaryngology department, and auricular point incision in the dermatology department. Auricular point injection has remarkable effect. Bloodletting combined with paste and pressure has nearly the same effect as bloodletting in the same medical department except dematology department. Otherwise, angle of needling is rarely studied. Auricular therapy is widely used and has remarkable effect in treating diseases by using different stimulus modalities. Whereas the angle of needling is rarely studied and future investigation is needed.

Nose: Applied Aspects in Dermatology.

PubMed

Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

2016-01-01

Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents.

Mohs micrographic surgery for basal cell carcinomas: appropriateness of 'Rotterdam' criteria and predictive factors for three or more stages.

PubMed

Flohil, S C; van Dorst, A M J M; Nijsten, T; Martino Neumann, H A; Munte, K

2013-10-01

In the Netherlands basal cell carcinomas (BCC) are eligible for Mohs microscopic surgery (MMS) if certain criteria are fulfilled. To study the MMS indication criteria practised at the department of dermatology of the Erasmus University Medical Center, Rotterdam and to identify predictive factors for extensive subclinical tumour spread among BCCs eligible for MMS. Pre-operative patient and tumour characteristics were derived retrospectively between January 2nd 2006 and December 28th 2009 from 1174 patient records, accounting for 1464 BCCs. Multivariate logistic regression models were used to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for one vs. two or more stages and for narrow (≤ 2 stages) vs. extensive subclinical spread (≥ 3 stages). H-zone location [adjusted OR 1.51 (95% CI 1.16-1.96)], recurrent tumour [adjusted OR 1.50 (95% CI 1.11-2.02)], aggressive subtype [adjusted OR 1.25 (95% CI 1.01-1.56)] and tumour size ≥ 11 mm [adjusted OR 1.53 (95% CI 1.20-1.96)] were significantly associated with two or more stages. Predictive factors for extensive subclinical spread were recurrent tumour [adjusted OR 2.26 (95% CI 1.61-3.17)], tumour size ≥ 21 mm [adjusted OR 1.69 (95% CI 1.13-2.51)] and location in the H-zone [adjusted OR 1.68 (95% CI 1.15-2.46)]. 'Rotterdam' indication criteria used for MMS are appropriate. Predictors for extensive subclinical spread are important for patients' and surgeons' expectations prior to the operation about time span, defect size, reconstruction and possible associated morbidity. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Anxiety Among Patients Undergoing Nail Surgery and Skin Punch Biopsy: Effects of Age, Gender, Educational Status, and Previous Experience.

PubMed

Göktay, Fatih; Altan, Zeynep Müzeyyen; Talas, Anıl; Akpınar, Esma; Özdemir, Ekin Özge; Aytekin, Sema

2016-01-01

Patient anxiety about nail surgery relates mainly to pain associated with needle puncture, anesthetic flow during the procedure, and postoperative care, as well as possible past traumatic experience. The aims of this study were to compare anxiety levels among patients undergoing nail surgery and skin punch biopsy and to assess the effects of demographic characteristics on anxiety. Forty-eight consecutive patients who were referred to a dermatological surgery unit for nail surgery intervention (group 1) and 50 age- and sex-matched patients referred to the same unit for skin punch biopsy (group 2) were enrolled in the study. Patients' anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory. There was no significant difference in median anxiety level between group 1 (42.00; interquartile range, 6.50) and group 2 (41.00; interquartile range, 8.25) (P = .517). The demographic factors of patient sex, educational status, and prior surgery showed no significant effects on anxiety levels. Nail surgery does not seem to cause significantly greater anxiety than skin punch biopsy. © The Author(s) 2015.

Medical Surveillance Monthly Report (MSMR). Volume 15, Number 6, July-August 2008

DTIC Science & Technology

2008-08-01

subgroups were defi ned as: i) Physicians, medicine – aviation/aerospace, allergy, ER, anesthesia , dermatology, family medicine, pediatrics, 16 VOL. 15...urologic), podiatry; iii) Dentists – general / comprehensive / public health dentistry , end-, orth-, ped-, peri-, and prosthodontics, OMF surgery...administrators; v) Nurses, OR / surgical / anesthesia – nurse anesthetist, OR nurse, nurse midwife, critical care nurses; and vi) Biomedical science, allied

Histology of melanoma and nonmelanoma skin cancer.

PubMed

Müller, Cornelia S L

2014-01-01

Incidence of skin tumors is increasing among elderly patients, and the multi-morbidities which occur in the elderly are a great challenge for dermatologists. Basis of every treatment of skin cancer patients is a reliable diagnosis. Therefore, histopathology serves as the gold standard in clinical dermatooncology and dermatologic surgery. This chapter provides a comprehensive review on the main types of melanoma and nonmelanoma skin cancers, including precursor lesions.

Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes

PubMed Central

Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

2018-01-01

Objectives To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. Methods The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King’s template analysis. Results The e-learning program positively influenced students’ level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, p<0.000). Interview data showed that the e-learning program stimulated students’ learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. Conclusions This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.  PMID:29352748

Nose: Applied Aspects in Dermatology

PubMed Central

Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

2016-01-01

Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents. PMID:27057038

Dermatology Interest Groups in Medical Schools.

PubMed

Quirk, Shannon K; Riemer, Christie; Beers, Paula J; Browning, Richard J; Correa, Mark; Fawaz, Bilal; Lehrer, Michael; Mounessa, Jessica; Lofgreen, Seth; Oetken, Tara; Saley, Taylor P; Tinkey, Katherine; Tracey, Elisabeth H; Dellavalle, Robert; Dunnick, Cory

2016-07-15

Involvement in a Dermatology Interest Group (DIG) allows students to learn about dermatology, partake in service projects, get involved in research, and ask questions about the application process for residency programs. In this article, we review the activities and member involvement of DIGs from 11 medical schools. To our knowledge, this is the first descriptive analysis of DIGs across the United States. This comparison of DIGs is not only potentially helpful for medical schools interested in establishing a DIG, but it also offers insight into how previously established DIGs could improve and have a greater impact both in individual medical schools and in the community at-large.

Epidermal Growth Factor (EGF) Receptor Intron 1 CA Repeat Polymorphisms in African-American and Caucasian Males: Influence on Prostate Cancer Risk or Disease Progression and Interaction with Androgen Receptor CAG Repeat Polymorphisms

DTIC Science & Technology

2003-09-01

Adipose Stromal Cells from Tumescent Liposuction Procedures. American Society for Dermatologic Surgery, $15,000 direct, 11/01/01 -10/31/02. 1999...stromal cells from tumescent liposuction procedures" ASDS Annual Meeting, Chicago, IL, November 1,2002."Adult Multipotent Stem Cells", Coriell

A novel method to measure conspicuous facial pores using computer analysis of digital-camera-captured images: the effect of glycolic acid chemical peeling.

PubMed

Kakudo, Natsuko; Kushida, Satoshi; Tanaka, Nobuko; Minakata, Tatsuya; Suzuki, Kenji; Kusumoto, Kenji

2011-11-01

Chemical peeling is becoming increasingly popular for skin rejuvenation in dermatological esthetic surgery. Conspicuous facial pores are one of the most frequently encountered skin problems in women of all ages. This study was performed to analyze the effectiveness of reducing conspicuous facial pores using glycolic acid chemical peeling (GACP) based on a novel computer analysis of digital-camera-captured images. GACP was performed a total of five times at 2-week intervals in 22 healthy women. Computerized image analysis of conspicuous, open, and darkened facial pores was performed using the Robo Skin Analyzer CS 50. The number of conspicuous facial pores decreased significantly in 19 (86%) of the 22 subjects, with a mean improvement rate of 34.6%. The number of open pores decreased significantly in 16 (72%) of the subjects, with a mean improvement rate of 11.0%. The number of darkened pores decreased significantly in 18 (81%) of the subjects, with a mean improvement rate of 34.3%. GACP significantly reduces the number of conspicuous facial pores. The Robo Skin Analyzer CS 50 is useful for the quantification and analysis of 'pore enlargement', a subtle finding in dermatological esthetic surgery. © 2011 John Wiley & Sons A/S.

Towards advanced OCT clinical applications

NASA Astrophysics Data System (ADS)

Kirillin, Mikhail; Panteleeva, Olga; Agrba, Pavel; Pasukhin, Mikhail; Sergeeva, Ekaterina; Plankina, Elena; Dudenkova, Varvara; Gubarkova, Ekaterina; Kiseleva, Elena; Gladkova, Natalia; Shakhova, Natalia; Vitkin, Alex

2015-07-01

In this paper we report on our recent achievement in application of conventional and cross-polarization OCT (CP OCT) modalities for in vivo clinical diagnostics in different medical areas including gynecology, dermatology, and stomatology. In gynecology, CP OCT was employed for diagnosing fallopian tubes and cervix; in dermatology OCT for monitoring of treatment of psoriasis, scleroderma and atopic dermatitis; and in stomatology for diagnosis of oral diseases. For all considered application, we propose and develop different image processing methods which enhance the diagnostic value of the technique. In particular, we use histogram analysis, Fourier analysis and neural networks, thus calculating different tissue characteristics as revealed by OCT's polarization evolution. These approaches enable improved OCT image quantification and increase its resultant diagnostic accuracy.

Laser principles.

PubMed

Bogdan Allemann, Inja; Kaufman, Joely

2011-01-01

Since the construction of the first laser in the 1960s, the role that lasers play in various medical specialities, including dermatology, has steadily increased. However, within the last 2 decades, the technological advances and the use of lasers in the field of dermatology have virtually exploded. Many treatments have only become possible with the use of lasers. Especially in aesthetic medicine, lasers are an essential tool in the treatment armamentarium. Due to better research and understanding of the physics of light and skin, there is now a wide and increasing array of different lasers and devices to choose from. The proper laser selection for each indication and treatment requires a profound understanding of laser physics and the basic laser principles. Understanding these principles will allow the laser operator to obtain better results and help avoid complications. This chapter will give an in-depth overview of the physical principles relevant in cutaneous laser surgery. Copyright © 2011 S. Karger AG, Basel.

The utilization of a non-invasive fluorescence imaging system to follow clinical dermatological MAL-PDT

NASA Astrophysics Data System (ADS)

Tyrrell, Jessica; Campbell, Sandra; Curnow, Alison

2009-06-01

This study employed a commercially available, non-invasive, fluorescence imaging system (Dyaderm, Biocam, Germany), to measure protoporphyrin IX (PpIX) concentration at several different stages during clinical dermatological methyl aminolevulinate photodynamic therapy (MAL-PDT). We validated the system prior to use to ensure that the PpIX changes witnessed were accurate and not due to environmental or user induced artifacts. The system was then employed to acquire color (morphological) and fluorescent (physiological) images simultaneously during dermatological PDT. Clinical data was collected from a range of licensed dermatological conditions (actinic keratosis, Bowen's disease and superficial basal cell carcinoma) during initial and subsequent PDT treatment cycles. The initial clinical data indicated that each type of licensed lesion considered responded in a similar manner following the application of Metvix (Galderma, U.K.) and the subsequent light irradiation (Aktilite, Galderma, U.K.). Images acquired three hours after Metvix application showed a significant increase in PpIX concentration within the lesion (P < 0.05), whilst PpIX levels in the surrounding normal tissue remained unaltered. After irradiation, the PpIX concentration was significantly decreased and returned to a level similar to the initial concentration originally observed. Lesions that received subsequent treatment cycles accumulated significantly less PpIX (P < 0.05) prior to irradiation.

Non-thermal atmospheric pressure HF plasma source: generation of nitric oxide and ozone for bio-medical applications

NASA Astrophysics Data System (ADS)

Kühn, S.; Bibinov, N.; Gesche, R.; Awakowicz, P.

2010-01-01

A new miniature high-frequency (HF) plasma source intended for bio-medical applications is studied using nitrogen/oxygen mixture at atmospheric pressure. This plasma source can be used as an element of a plasma source array for applications in dermatology and surgery. Nitric oxide and ozone which are produced in this plasma source are well-known agents for proliferation of the cells, inhalation therapy for newborn infants, disinfection of wounds and blood ozonation. Using optical emission spectroscopy, microphotography and numerical simulation, the gas temperature in the active plasma region and plasma parameters (electron density and electron distribution function) are determined for varied nitrogen/oxygen flows. The influence of the gas flows on the plasma conditions is studied. Ozone and nitric oxide concentrations in the effluent of the plasma source are measured using absorption spectroscopy and electro-chemical NO-detector at variable gas flows. Correlations between plasma parameters and concentrations of the particles in the effluent of the plasma source are discussed. By varying the gas flows, the HF plasma source can be optimized for nitric oxide or ozone production. Maximum concentrations of 2750 ppm and 400 ppm of NO and O3, correspondingly, are generated.

The Impact of the Medicare-Eligible Retiree Health Care Fund on Navy Military Treatment Facilities’ Demand-to-Capacity Solution

DTIC Science & Technology

2012-03-01

Physical Therapy, Optometry, Audiology, Tele-Dermatology and Eyes, Nose & Throat (ENT); (3) Dental Care, i.e., General Dentistry , Oral Surgery...Physical Therapy, Chiropractic, Optometry, Audiology, Public Health and Eyes, Nose & Throat (ENT); (3) Dental Care, including General Dentistry ...guidelines. Version 3.2. Unified biostatistical utility. Retrieved September 14, 2010, from http://www.dtic.mil/whs/directives/corres/pdf/601517p.pdf

Update on primary mucosal melanoma.

PubMed

Tacastacas, Joselin D; Bray, Julie; Cohen, Yoon K; Arbesman, Joshua; Kim, Julian; Koon, Henry B; Honda, Kord; Cooper, Kevin D; Gerstenblith, Meg R

2014-08-01

Mucosal melanomas are aggressive cancers of mucosal surfaces with clinical and pathologic characteristics distinct from cutaneous melanomas, warranting different staging systems and treatment approaches. Surgical resection is performed frequently for the primary tumor, although the utility of lymph node surgery and radiation therapy is not established. Therapies targeted against C-KIT activating mutations, identified in many mucosal melanomas, are emerging as promising treatments. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Medical Surveillance Monthly Report (MSMR). Volume 21, Number 2, February 2014

DTIC Science & Technology

2014-02-01

surgery, 1 dermatology . Preventive medicine 11 2 5 7 . . . Hematology- oncologyd 4 2 1 . 4 . . Obstetrics- gynecology 2 . . . . 1 obstetrics...health surveillance purposes. All previous issues of the MSMR are available online at www.afh sc.mil. Subscriptions (electronic and hard copy) may be...requested online at www. afh sc.mil/msmrSubscribe or by contacting AFHSC at (301)319-3240. E-mail: usarmy.ncr.medcom-afh sc.mbx.msmr@mail.mil

Jojoba in dermatology: a succinct review.

PubMed

Pazyar, N; Yaghoobi, R; Ghassemi, M R; Kazerouni, A; Rafeie, E; Jamshydian, N

2013-12-01

Phytomedicine has been successfully used in dermatology horizon for thousands of years. Jojoba (Simmondsia chinensis) is a long-lived, drought resistant, perennial plant with interesting economic value as it is processed for liquid wax production. The jojoba plant produces esters of long-chain alcohols and fatty acids (waxes) as a seed lipid energy reserve. The liquid wax is an important substrate for a variety of industrial applications and is used in skin treatment preparations. The oil from the jojoba plant is the main biological source of wax esters and has a multitude of potential applications. The review of literatures suggest that jojoba has anti-inflammatory effect and it can be used on a variety of skin conditions including skin infections, skin aging, as well as wound healing. Moreover, jojoba has been shown to play a role in cosmetics formulas such as sunscreens and moisturizers and also enhances the absorption of topical drugs. The intention of the review is to summarize the data regarding the uses of jojoba in dermatology for readers and researchers.

Properties of skin stem cells and their potential clinical applications in modern dermatology.

PubMed

Niezgoda, Anna; Niezgoda, Piotr; Nowowiejska, Laura; Białecka, Agnieszka; Męcińska-Jundziłł, Kaja; Adamska, Urszula; Czajkowski, Rafał

2017-06-01

Stem cells play an important role in medical science, and scientists are investing large sums in order to perform sophisticated studies designed to establish potential clinical applications of stem cells. Growing experience has enabled researchers to determine the precise nature of stem cell division. Although the properties of this particular population of cells have been known and used for some time, mainly with regards to bone marrow-derived mesenchymal stem cell transplantation, we now face a significant challenge in implementing the practical use of skin-derived precursors, making it possible to avoid the necessity for patients to undergo invasive procedures in order to obtain stem cells from bone marrow. Multiple trials have so far been performed, bringing hope for the treatment of disorders previously considered untreatable. Patients suffering from a number of dermatological diseases, including malignant melanoma, systemic lupus erythematosus, vitiligo, alopecia or junctional epidermolysis bullosa, may benefit from treatment based on stem cells. The aim of this review is to summarize available data on stem cells and their potential applications in the treatment of dermatological disorders. The work described is based on data published up to the end of September 2016.

Effect of a single prophylactic preoperative oral antibiotic dose on surgical site infection following complex dermatological procedures on the nose and ear: a prospective, randomised, controlled, double-blinded trial.

PubMed

Rosengren, Helena; Heal, Clare F; Buttner, Petra G

2018-04-19

There is limited published research studying the effect of antibiotic prophylaxis on surgical site infection (SSI) in dermatological surgery, and there is no consensus for its use in higher-risk cases. The objective of this study was to determine the effectiveness of a single oral preoperative 2 g dose of cephalexin in preventing SSI following flap and graft dermatological closures on the nose and ear. Prospective double-blinded, randomised, placebo-controlled trial testing for difference in infection rates. Primary care skin cancer clinics in North Queensland, Australia, were randomised to 2 g oral cephalexin or placebo 40-60 min prior to skin incision. 154 consecutive eligible patients booked for flap or graft closure following skin cancer excision on the ear and nose. 2 g dose of cephalexin administered 40-60 min prior to surgery. Overall 8/69 (11.6%) controls and 1/73 (1.4%) in the intervention group developed SSI (p=0.015; absolute SSI reduction 10.2%; number needed to treat (NNT) for benefit 9.8, 95% CI 5.5 to 45.5). In males, 7/44 controls and 0/33 in the intervention group developed SSI (p=0.018; absolute SSI reduction 15.9%; NNT for benefit 6.3, 95% CI 3.8 to 19.2). SSI was much lower in female controls (1/25) and antibiotic prophylaxis did not further reduce this (p=1.0). There was no difference between the study groups in adverse symptoms attributable to high-dose antibiotic administration (p=0.871). A single oral 2 g dose of cephalexin given before complex skin closure on the nose and ear reduced SSI. ANZCTR 365115; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

PubMed Central

Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E.; Sanchez-Pozo, Adriana; Vidal, Milisen

2016-01-01

Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty. PMID:27519055

Laser Resurfacing: Full Field and Fractional.

PubMed

Pozner, Jason N; DiBernardo, Barry E

2016-07-01

Laser resurfacing is a very popular procedure worldwide. Full field and fractional lasers are used in many aesthetic practices. There have been significant advances in laser resurfacing in the past few years, which make patient treatments more efficacious and with less downtime. Erbium and carbon dioxide and ablative, nonablative, and hybrid fractional lasers are all extremely effective and popular tools that have a place in plastic surgery and dermatology offices. Copyright © 2016 Elsevier Inc. All rights reserved.

Treatment of reticular and telangiectatic leg veins: double-blind, prospective comparative trial of polidocanol and hypertonic saline.

PubMed

Peterson, Jennifer D; Goldman, Mitchel P; Weiss, Robert A; Duffy, David M; Fabi, Sabrina G; Weiss, Margaret A; Guiha, Isabella

2012-08-01

Sixty-three subjects' legs were randomized to receive treatment with polidocanol (POL) or hypertonic saline (HS) for telangiectasias and reticular leg veins. To compare the safety and efficacy of two sclerosing agents in three dermatologic surgery practices. After exclusion of saphenofemoral junction incompetence, each subject's veins were categorized (telangiectasias <1 mm and reticular veins 1-3 mm) and randomized. Telangiectasias were treated with POL 0.5% or 11.7% HS and reticular veins with POL 1% or 23.4% HS. An independent, blinded physician determined efficacy and adverse events. Subject satisfaction questionnaires were administered and global clinical improvement assessments performed. All patients completed four visits at 0, 1, 4, and 12 weeks. Patients reported significantly greater pain during treatment with HS (2.42) than POL (1.03) (p < .001). There were no significant differences in physician-assessed improvement of reticular leg veins or telangiectasias; subject- or physician-assessed overall improvement; or physician-assessed phlebitis, pigmentation, edema, or matting in either of the three practices or the entire cohort. Two subjects developed ulcerations with HS. No ulcerations or allergic reactions developed after POL injections. Both agents provided effective treatment, but HS caused 2.35 times as much pain during injections and resulted in two episodes of tissue necrosis. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

A review of toxicity from topical salicylic acid preparations.

PubMed

Madan, Raman K; Levitt, Jacob

2014-04-01

Topical salicylic acid is often used in dermatologic conditions because of its keratolytic, bacteriostatic, fungicidal, and photoprotective properties. The bioavailability of salicylic acid differs depending on the vehicle used and pH of transcellular fluids. Although rare, salicylic acid toxicity (salicylism) can occur from topical application. Physicians should be mindful of the potential for salicylism or even death from topically applied salicylic acid. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Botanicals With Dermatologic Properties Derived From First Nations Healing: Part 1-Trees.

PubMed

Colantonio, Sophia; Rivers, Jason K

First Nations people have a long history of working with medicinal plants used to treat skin diseases. The purpose was to assess the dermatologic therapeutic potential of western red cedar, white spruce, birch, balsam poplar, and black spruce. Based on expert recommendations, 5 trees were selected that were used in First Nations medicine for cutaneous healing and have potential and/or current application to dermatology today. We searched several databases up to June 12, 2014. Western red cedar's known active principal compound, β-thujaplicin, has been studied in atopic dermatitis. White spruce's known active principal compound, 7-hydroxymatairesinol, has anti-inflammatory activity, while phase II clinical trials have been completed on a birch bark emulsion for the treatment of actinic keratoses, epidermolysis bullosa, and the healing of split thickness graft donor sites. Balsam poplar has been used clinically as an anti-aging remedy. Black spruce bark contains higher amounts of the anti-oxidant trans-resveratrol than red wine. North American traditional medicine has identified important botanical agents that are potentially relevant to both cosmetic and medical dermatology. This study is limited by the lack of good quality evidence contributing to the review. The article is limited to 5 trees, a fraction of those used by First Nations with dermatological properties.

Pharmacogenetics in dermatology: a patient-centered update.

PubMed

Comfere, Nneka I; Ikediobi, Ogechi N; Peters, Margot S; el-Azhary, Rokea A; Gibson, Lawrence E

2013-08-01

The term pharmacogenetics is used to describe an evolving field that aims to understand the relationship between individual variations in genetic sequence and differences in the therapeutic and toxic response to medications. The promise of pharmacogenetics is empowerment of clinicians with information that will enable them to personalize drug therapy - to prescribe the right medication at the right dose for each patient, while minimizing adverse effects. Despite dramatic advances, wide application of pharmacogenetics to clinical practice has been slow for a number of reasons, including lack of evidence-based therapeutic guidelines as well as ethical concerns and cost. To illustrate applications to dermatology practice, we present three clinical scenarios that serve as a springboard for discussion of the principles of pharmacogenetics and how they can be used to guide treatment with azathioprine, 5-fluorouracil, and trastuzumab. The therapeutic and toxic effects of a given medication ultimately depend on its combined pharmacokinetic, pharmacodynamic, and pharmacogenetic properties in a given individual. Pharmacodynamic properties of individual medications must be correlated with single nucleotide polymorphisms. Test recommendations and standardization of therapy for specific disorders can then be established. © 2013 The International Society of Dermatology.

Validation of a quality-of-life instrument for patients with nonmelanoma skin cancer.

PubMed

Rhee, John S; Matthews, B Alex; Neuburg, Marcy; Logan, Brent R; Burzynski, Mary; Nattinger, Ann B

2006-01-01

To validate a disease-specific quality-of-life instrument--the Skin Cancer Index--intended to measure quality-of-life issues relevant to patients with nonmelanoma skin cancer. Internal reliability, convergent and divergent validity with existing scales, and factor analyses were performed in a cross-sectional study of 211 patients presenting with cervicofacial nonmelanoma skin cancer to a dermatologic surgery clinic. Factor analyses of the Skin Cancer Index confirmed a multidimensional scale with 3 distinct subscales-emotional, social, and appearance. Excellent internal validity of the 3 subscales was demonstrated. Substantial evidence was observed for convergent validity with the Dermatology Life Quality Index, Rosenberg Self-Esteem Scale, Lerman's Cancer Worry Scale, and Medical Outcomes Survey Short-Form 12 domains for vitality, emotion, social function, and mental health. These findings validate a new disease-specific quality-of-life instrument for patients with cervicofacial nonmelanoma skin cancer. Studies on the responsiveness of the Skin Cancer Index to clinical intervention are currently under way.

Lasers and wound healing.

PubMed

Nemeth, A J

1993-10-01

The advances in laser surgery over the past decade have been remarkable and have significantly altered the management of a host of dermatologic disorders. This article focuses on the CO2 laser as a cutting and vaporization tool and reviews the features that distinguish CO2 laser-induced wounds from those created by a scalpel. Tissue welding, wound management after skin treatment with the visible light lasers based on the principle of selective photothermolysis, as well as the controversial field of low-energy laser therapy (biostimulation) are also addressed.

The application of dermal papillary rings in dermatology by in vivo confocal laser scanning microscopy

NASA Astrophysics Data System (ADS)

Xiang, W. Z.; Xu, A. E.; Xu, J.; Bi, Z. G.; Shang, Y. B.; Ren, Q. S.

2010-08-01

Confocal laser scanning microscopy (CLSM) allows noninvasive visualization of human skin in vivo, without needing to fix or section the tissue. Melanocytes and pigmented keratinocytes at the level of the basal layer form bright dermal papillary rings which are readily amenable to identify in confocal images. Our purpose was to explore the role of dermal papillary rings in assessment of lesion location, the diagnosis, differential diagnosis of lesions and assessment of therapeutic efficacy by in vivo CLSM. Seventy-one patients were imaged with the VivaScope 1500 reflectance confocal microscope provided by Lucid, Inc. The results indicate that dermal papillary rings can assess the location of lesion; the application of dermal papillary rings can provide diagnostic support and differential diagnosis for vitiligo, nevus depigmentosus, tinea versicolor, halo nevus, common nevi, and assess the therapeutic efficacy of NBUVB phototherapy plus topical 0.1 percent tacrolimus ointment for vitiligo. In conclusion, our findings indicate that the dermal papillary rings play an important role in the assessment the location of lesion, diagnosis, differential diagnosis of lesions and assessment of therapeutic efficacy by in vivo CLSM. CLSM may be a promising tool for noninvasive examination in dermatology. However, larger studies are needed to expand the application of dermal papillary rings in dermatology.

[Medical and dental digital photography. Choosing a cheap and user-friendly camera].

PubMed

Chossegros, C; Guyot, L; Mantout, B; Cheynet, F; Olivi, P; Blanc, J-L

2010-04-01

Digital photography is more and more important in our everyday medical practice. Patient data, medico-legal proof, remote diagnosis, forums, and medical publications are some of the applications of digital photography in medical and dental fields. A lot of small, light, and cheap cameras are on the market. The main issue is to obtain good, reproducible, cheap, and easy-to-shoot pictures. Every medical situation, portrait in esthetic surgery, skin photography in dermatology, X-ray pictures or intra-oral pictures, for example, has its own requirements. For these reasons, we have tried to find an "ideal" compact digital camera. The Sony DSC-T90 (and its T900 counterpart with a wider screen) seems a good choice. Its small size makes it usable in every situation and its price is low. An external light source and a free photo software (XnView((R))) can be useful complementary tools. The main adjustments and expected results are discussed.

Ear keloids as a primary candidate for the application of mitomycin C after shave excision: in vivo and in vitro study.

PubMed

Chi, Seong Geun; Kim, Jun Young; Lee, Weon Ju; Lee, Seok-Jong; Kim, Do Won; Sohn, Mi Yeung; Kim, Gun Wook; Kim, Moon Bum; Kim, Byung Soo

2011-02-01

Although many methods have been developed to treat ear keloids, new therapeutic options are still needed. To determine the effects of topical mitomycin C (MC) on shave-removed wounds and fibroblasts of ear keloids. Fourteen ear keloids in 12 patients were shaved, and MC (1 mg/mL) was applied to the resected bed for 5 minutes. The application was repeated 3 weeks later. All patients were assessed 2, 4, and 6 months after the procedure to evaluate the cosmetic results, recurrence, and postsurgical complications. An in vitro study to determine the effects of MC on fibroblasts of the excised keloids was conducted using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the measurement of total cell counts, and immunoassay of DNA synthesis. Only one recurrence occurred (on the ear helix), and the patients were satisfied with the cosmetic outcomes. The results of the MTT assay, total cell counts, and DNA synthesis immunoassay confirmed the suppressive effects of MC on the keloid fibroblasts. The application of topical MC to the resected bed of shave-removed ear keloids was successful in preventing recurrences and providing an acceptable cosmetic outcome. © 2011 by the American Society for Dermatologic Surgery, Inc.

Fullerene nanoparticle in dermatological and cosmetic applications.

PubMed

Mousavi, S Zeinab; Nafisi, Shohreh; Maibach, Howard I

2017-04-01

Nanoparticles are equipped with exceptional properties which make them well suitable for diverse and novel applications. Fullerene is one of the nanomaterials that has valuable applications in the field of biomedicine. It possesses exceptional antioxidant capacity which has made it a promising core ingredient in many dermatological and skin care products. However, fullerene has the potentials to display a range of activities resulting in cell death or dysfunction. This review outlines the achievements made so far by reporting studies that have focused on incorporating fullerene in skin care products and cosmetics and assessed their beneficial effects. We have also documented reports that have assessed toxicity of this novel carbon allotrope toward skin cells and discussed its possible dermal reactions. Aside from pointing out the recent developments, areas that can benefit from further researches are identified. Copyright © 2016 Elsevier Inc. All rights reserved.

Discovering Black Soap: A Survey on the Attitudes and Practices of Black Soap Users.

PubMed

Lin, Ann; Nabatian, Adam; Halverstam, Caroline P

2017-07-01

OBJECTIVE: The purpose of this study was to discover the general attitudes and practices of black soap users with regard to amelioration of various dermatologic conditions. DESIGN: This was a prospective questionnaire-based study with a sample size of 100 black soap users. Setting: Outpatient dermatology clinics of Montefiore Medical Center and other Albert Einstein affiliated dermatology clinics in Bronx, New York. PARTICIPANTS: One hundred subjects who have used black soap were recruited. MEASUREMENTS: The participants evaluated and reported their attitudes and applications of black soap. Data on sociodemographic prevalence and user satisfactions of black soap were collected and analyzed. RESULTS: The age distribution of participants was uniform among the specified age categories: 1) 18 to 29 years; 2) 30 to 39 years, 3) 40 to 49 yesars, and 4) 50 years and older. The sex distribution favored women, comprising 74 percent of those surveyed. A significant number of participants were born in either Africa (23%) or the Caribbean (19%). Black soap usage was applied to mitigate many dermatologic conditions, including acne (23%), dark spots (20%), razor bumps (13%), eczema (7%), and fine lines (4%). The most popular usage was for overall skin care (70%). The vast majority of users found black soap helpful for their skin condition (51% very satisfied, and 40% somewhat satisfied). Conclusion: The survey results indicate widespread usage and satisfaction with black soap for reduction in symptoms of various dermatologic conditions. Further investigations are warranted to discover active ingredients present in black soap that may unveil future therapeutic options for various dermatologic conditions.

Operating in an eczematous surgical field: don't be rash, delay surgery to avoid infective complications.

PubMed

Beckett, K S; Gault, D T

2006-01-01

Prominent ear correction is a common operation. Complication as a result of infection has been quoted at between 3% and 5% [Calder JC, Nasaan A. Morbidity of otoplasty: a review of 562 consecutive cases. Br J Plast Surg 1994;47:170-4 and Jeffery SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588-90.]. We present two cases referred for ear reconstruction following catastrophic post-operative infection at the time of pinnaplasty, leaving each patient with significant helical rim deformities. Both patients displayed evidence of active post-auricular eczema at the time of their primary surgery. Dermatological research has highlighted the increased colonisation of Staphylococcus aureus in particular within areas of atopic eczema in comparison to normal skin. We advise delaying ear surgery in the presence of a rash in view of the potentially devastating complications that may result. This approach may be extended to all cutaneous surgery where treatment of the rash is advocated prior to embarking on an elective surgical procedure.

Hair restoration surgery: challenges and solutions

PubMed Central

Rose, Paul T

2015-01-01

Hair loss is a common problem affecting both men and women. The most frequent etiology is androgenetic alopecia, but other causes of hair loss such as trauma, various dermatologic diseases, and systemic diseases can cause alopecia. The loss of hair can have profound effects on one’s self esteem and emotional well-being, as one’s appearance plays a role in the work place and interpersonal relationships. It is therefore not surprising that means to remedy hair loss are widely sought. Hair transplant surgery has become increasingly popular, and the results that we are able to create today are quite remarkable, providing a natural appearance when the procedure is performed well. In spite of this, hair transplant surgery is not perfect. It is not perfect because the hair transplant surgeon is still faced with challenges that prevent the achievement of optimal results. Some of these challenges include a limit to donor hair availability, hair survival, and ways to conceal any evidence of a surgical procedure having taken place. This article examines some of the most important challenges facing hair restoration surgery today and possible solutions to these challenges. PMID:26203266

Silicone sheet containing all-trans retinoic acid and hydroquinone for the treatment of epidermal melanosis.

PubMed

Iida, Shoko; Takushima, Akihiko; Ohura, Norihiko; Sato, Suguru; Kurita, Masakazu; Harii, Kiyonori

2013-08-01

Although bleaching treatment using all-trans retinoic acid (RA) and hydroquinone (HQ) improves epidermal melanosis, the application of two medications and the irritant dermatitis induced by RA inconvenience patients. To overcome these problems, we developed a silicone sheet containing RA and HQ. To compare the efficacy of a silicone sheet containing RA and HQ with that of conventional bleaching treatment. Silicone sheets containing 1% RA and 5% HQ were applied at night during the bleaching phase of 4 weeks, followed by application of sheets containing 5% HQ during the healing phase of 4 weeks. Hemifacial epidermal melanosis, for which the sheets were applied, was compared with a contralateral face which was treated conventionally using RA and HQ. Twenty-four Japanese women who were enrolled in this study and followed up for more than 6 months were analyzed. RA/HQ sheets improved epidermal melanosis, as did the conventional bleaching method, but irritant dermatitis occurred less in patients treated using silicone sheets. RA/HQ sheets, which are easily applied to face skin, can improve epidermal melanosis to the same extent as conventional bleaching. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Dermatology Procedures

MedlinePlus

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Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

PubMed

Checketts, Jake X; Sims, Matthew Thomas; Vassar, Matt

2017-12-01

It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines. To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development. Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development. Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively. Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors from 2013 to 2015 was $7 701 681. Of the 40 authors receiving payments, 22 did not accurately disclose industry relationships. Authors received payments from companies with products directly related to the guideline topic. Violations to the Administrative Regulations were found. Dermatology clinical practice guideline authors received sizable industry payments and did not completely disclose these payments. The American Academy of Dermatology policies may benefit from stricter enforcement or the adoption of new standards.

Understanding the cost of dermatologic care: A survey study of dermatology providers, residents, and patients.

PubMed

Steen, Aaron J; Mann, Julianne A; Carlberg, Valerie M; Kimball, Alexa B; Musty, Michael J; Simpson, Eric L

2017-04-01

The American Academy of Dermatology recommends dermatologists understand the costs of dermatologic care. This study sought to measure dermatology providers' understanding of the cost of dermatologic care and how those costs are communicated to patients. We also aimed to understand the perspectives of patients and dermatological trainees on how cost information enters into the care they receive or provide. Surveys were systematically developed and distributed to 3 study populations: dermatology providers, residents, and patients. Response rates were over 95% in all 3 populations. Dermatology providers and residents consistently underestimated the costs of commonly recommended dermatologic medications but accurately predicted the cost of common dermatologic procedures. Dermatology patients preferred to know the cost of procedures and medications, even when covered by insurance. In this population, the costs of dermatologic medications frequently interfered with patients' ability to properly adhere to prescribed regimens. The surveyed population was limited to the northwestern United States and findings may not be generalizable. Cost estimations were based on average reimbursement rates, which vary by insurer. Improving dermatology providers' awareness and communication of the costs of dermatologic care might enhance medical decision-making, improve adherence and outcomes, and potentially reduce overall health care expenditures. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A skincare combined with combination of adapalene and benzoyl peroxide provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne.

PubMed

Bouloc, A; Roo, E; Imko-Walczuk, B; Moga, A; Chadoutaud, B; Dréno, B

2017-10-01

Acne in adult women is an increasing reason for dermatological consultations. The aim of this study was to assess in adult women with mild acne the efficacy and tolerance of a daily adjunctive application of a skincare (Normaderm ® , Laboratoires Vichy, France) to a fixed combination of adapalene/benzoyl peroxide daily or every other evening and a standard emollient. Subjects were randomized to receive the fixed combination applied either every evening or every other evening and a daily application of the standard emollient and the test care or a once daily application of the fixed combination and the standard emollient alone. Clinical evaluations at Day 0, Day 45 and Day 90 included the count of acne lesions, assessment of clinical improvement and local tolerance. The quantitative lipid profile of the stratum corneum of the forehead was also determined. After 90 days of application, acne had improved in all 299 subjects with a statistically significant difference in favour of the test care regimens (P < 0.05). Moreover, skin quality, subject satisfaction, skin discomfort and sebum composition were in favour of these regimens. In conclusion, the tested skincare combined with a fixed adapalene and benzoyl peroxide combination provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne. © 2017 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Teaching & Learning Tips 6: The flipped classroom.

PubMed

Shi, Connie R; Rana, Jasmine; Burgin, Susan

2018-04-01

Challenge: The "flipped classroom" is a pedagogical model in which instructional materials are delivered to learners outside of class, reserving class time for application of new principles with peers and instructors. Active learning has forever been an elusive ideal in medical education, but the flipped class model is relatively new to medical education. What is the evidence for the "flipped classroom," and how can these techniques be applied to the teaching of dermatology to trainees at all stages of their medical careers? © 2018 The International Society of Dermatology.

OCT in Dermatology

NASA Astrophysics Data System (ADS)

Holmes, John; Welzel, Julia

OCT is increasingly interesting for non-invasive skin imaging in Dermatology. Due to its resolution and imaging depth, OCT is already routinely established for diagnosis of nonmelanoma skin cancer, whereas for pigmented lesions, the resolution is still not high enough. OCT has also a high value for monitoring of treatment effects, for example to control healing after non-surgical topical treatment of basal cell carcinomas. In summary, there are several indications for applications of OCT to image skin diseases, and its importance will grow in the future due to further technical developments like speckle variance OCT.

Dermatology on instagram.

PubMed

Karimkhani, Chante; Connett, Jessica; Boyers, Lindsay; Quest, Tyler; Dellavalle, Robert P

2014-07-15

The novel photo-sharing social networking platform, Instagram, has an impressive following of 75 million daily users, with a predominantly younger and female demographic. This study investigated the presence of dermatology-related content on Instagram. The most popular professional dermatological organizations, dermatology journals, and dermatology related patient advocate groups on Facebook and Twitter, determined from a prior study, were searched for established profiles on Instagram. In addition, dermatology-related terms (i.e. dermatology, dermatologist, alopecia, eczema, melanoma, psoriasis, and skin cancer) and dermatology-related hashtags (i.e. #dermatology, #dermatologist, #melanoma, #acne, #psoriasis, and #alopecia) were searched. None of the top ten dermatological journals or professional dermatological organizations were found on Instagram. Although only one of the top ten patient advocate groups related to dermatology conditions, Melanoma Research Foundation, had an Instagram presence, there were many private offices, cosmetic products, and some patient advocacy groups. This novel social networking platform could grant dermatology journals and other professional organizations a unique opportunity to reach younger demographic populations, particularly women, with the potential for true educational and life-changing impact.

Anticoagulation management in the ambulatory surgical setting.

PubMed

Eisenstein, Diana Hill

2012-04-01

Many people receiving maintenance anticoagulation therapy require surgery each year in ambulatory surgery centers. National safety organizations focus attention toward improving anticoagulation management, and the American College of Chest Physicians has established guidelines for appropriate anticoagulation management to balance the risk of thromboembolism when warfarin is discontinued with the risk of bleeding when anticoagulation therapy is maintained. The guidelines recommend that patients at high or moderate risk for thromboembolism should be bridged with subcutaneous low-molecular-weight heparin or IV unfractionated heparin with the interruption of warfarin, and low-risk patients may require subcutaneous low-molecular-weight heparin or no bridging with the interruption of warfarin. The guidelines recommend the continuation of warfarin for patients who are undergoing minor dermatologic or dental procedures or cataract removal. The literature reveals, however, that there is not adequate adherence to these recommendations and guidelines. Management of anticoagulation therapy by a nurse practitioner may improve compliance and safety in ambulatory surgery centers. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

PubMed

Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

2015-01-01

Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

Application of cloud database in the management of clinical data of patients with skin diseases.

PubMed

Mao, Xiao-fei; Liu, Rui; DU, Wei; Fan, Xue; Chen, Dian; Zuo, Ya-gang; Sun, Qiu-ning

2015-04-01

To evaluate the needs and applications of using cloud database in the daily practice of dermatology department. The cloud database was established for systemic scleroderma and localized scleroderma. Paper forms were used to record the original data including personal information, pictures, specimens, blood biochemical indicators, skin lesions,and scores of self-rating scales. The results were input into the cloud database. The applications of the cloud database in the dermatology department were summarized and analyzed. The personal and clinical information of 215 systemic scleroderma patients and 522 localized scleroderma patients were included and analyzed using the cloud database. The disease status,quality of life, and prognosis were obtained by statistical calculations. The cloud database can efficiently and rapidly store and manage the data of patients with skin diseases. As a simple, prompt, safe, and convenient tool, it can be used in patients information management, clinical decision-making, and scientific research.

Infrared Imaging Tools for Diagnostic Applications in Dermatology.

PubMed

Gurjarpadhye, Abhijit Achyut; Parekh, Mansi Bharat; Dubnika, Arita; Rajadas, Jayakumar; Inayathullah, Mohammed

Infrared (IR) imaging is a collection of non-invasive imaging techniques that utilize the IR domain of the electromagnetic spectrum for tissue assessment. A subset of these techniques construct images using back-reflected light, while other techniques rely on detection of IR radiation emitted by the tissue as a result of its temperature. Modern IR detectors sense thermal emissions and produce a heat map of surface temperature distribution in tissues. Thus, the IR spectrum offers a variety of imaging applications particularly useful in clinical diagnostic area, ranging from high-resolution, depth-resolved visualization of tissue to temperature variation assessment. These techniques have been helpful in the diagnosis of many medical conditions including skin/breast cancer, arthritis, allergy, burns, and others. In this review, we discuss current roles of IR-imaging techniques for diagnostic applications in dermatology with an emphasis on skin cancer, allergies, blisters, burns and wounds.

Advances in the therapeutic use of mammalian target of rapamycin (mTOR) inhibitors in dermatology.

PubMed

Fogel, Alexander L; Hill, Sharleen; Teng, Joyce M C

2015-05-01

Significant developments in the use of mammalian target of rapamycin (mTOR) inhibitors (mTORIs) as immunosuppressant and antiproliferative agents have been made. Recent advances in the understanding of the mTOR signaling pathway and its downstream effects on tumorigenesis and vascular proliferation have broadened the clinical applications of mTORIs in many challenging disorders such as tuberous sclerosis complex, pachyonychia congenita, complex vascular anomalies, and inflammatory dermatoses. Systemic mTORI therapy has shown benefits in these areas, but is associated with significant side effects that sometimes necessitate drug holidays. To mitigate the side effects of systemic mTORIs for dermatologic applications, preliminary work to assess the potential of percutaneous therapy has been performed, and the evidence suggests that percutaneous delivery of mTORIs may allow for effective long-term therapy while avoiding systemic toxicities. Additional large placebo-controlled, double-blinded, randomized studies are needed to assess the efficacy, safety, duration, and tolerability of topical treatments. The objective of this review is to provide updated information on the novel use of mTORIs in the management of many cutaneous disorders. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Correlation of USMLE Step 1 scores with performance on dermatology in-training examinations.

PubMed

Fening, Katherine; Vander Horst, Anthony; Zirwas, Matthew

2011-01-01

Although United States Medical Licensing Examination (USMLE) Step 1 was not designed to predict resident performance, scores are used to compare residency applicants. Multiple studies have displayed a significant correlation among Step 1 scores, in-training examination (ITE) scores, and board passage, although no such studies have been performed in dermatology. The purpose of this study is to determine if this correlation exists in dermatology, and how much of the variability in ITE scores is a result of differences in Step 1 scores. This study also seeks to determine if it is appropriate to individualize expectations for resident ITE performance. This project received institutional review board exemption. From 5 dermatology residency programs (86 residents), we collected Step 1 and ITE scores for each of the 3 years of dermatology residency, and recorded passage/failure on boards. Bivariate Pearson correlation analysis was used to assess correlation between USMLE and ITE scores. Ordinary least squares regression was computed to determine how much USMLE scores contribute to ITE variability. USMLE and ITE score correlations were highly significant (P < .001). Correlation coefficients with USMLE were: 0.467, 0.541, and 0.527 for ITE in years 1, 2, and 3, respectively. Variability in ITE scores caused by differences in USMLE scores were: ITE first-year residency = 21.8%, ITE second-year residency = 29.3%, and ITE third-year residency = 27.8%. This study had a relatively small sample size, with data from only 5 programs. There is a moderate correlation between USMLE and ITE scores, with USMLE scores explaining ∼26% of the variability in ITE scores. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

From medical herbalism to phytotherapy in dermatology: back to the future.

PubMed

Dattner, Alan M

2003-01-01

Plant-based therapeutic preparations are cyclically returning to complement dermatologic therapy. They serve as therapeutic alternatives, safer choices, or in some cases, as the only effective treatment. Folk medicine tradition provides different indicators for use than the medical disease model. Advantages of multiple synergistic components of crude extracts are discussed, as well as herbs already used in dermatology. Bitter digestive stimulants are used for vitiligo. Bioflavinoids from buckwheat and horse chestnut are used for varicose veins, and silymarin is used for liver protection. Gotu kola and sarsaparilla are used for inflammatory skin conditions. Oregon grape root has synergistic antibacterial, anti-inflammatory, and bile-stimulating properties which make the crude extract useful in acne. Philosophical differences in herbology compared to medicine exist in the application of science toward improving elimination and strengthening the host as opposed to destroying the vector or manifestation of the disease.

Topical tar: Back to the future

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paghdal, K.V.; Schwartz, R.A.

2009-08-15

The use of medicinal tar for dermatologic disorders dates back to the ancient times. Although coal tar is utilized more frequently in modern dermatology, wood tars have also been widely employed. Tar is used mainly in the treatment of chronic stable plaque psoriasis, scalp psoriasis, atopic dermatitis, and seborrheic dermatitis, either alone or in combination therapy with other medications, phototherapy, or both. Many modifications have been made to tar preparations to increase their acceptability, as some dislike its odor, messy application, and staining of clothing. One should consider a tried and true treatment with tar that has led to clearingmore » of lesions and prolonged remission times. Occupational studies have demonstrated the carcinogenicity of tar; however, epidemiologic studies do not confirm similar outcomes when used topically. This article will review the pharmacology, formulations, efficacy, and adverse effects of crude coal tar and other tars in the treatment of selected dermatologic conditions.« less

Cosmetic dermatologic surgical training in US dermatology residency programs: identifying and overcoming barriers.

PubMed

Bauer, Bruce; Williams, Erin; Stratman, Erik J

2014-02-01

The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic dermatology procedures. Although almost every program provides hands-on cosmetic dermatology training, there are barriers to training, including patient preferences, costs of procedures and products, and PD attitudes toward cosmetic dermatology training. To promote patient safety, procedural competency is imperative.

Cross-sectional survey of awareness and behavioral pattern regarding acne and acne scar based on smartphone application.

PubMed

Park, Seon Yong; Park, Mi Youn; Suh, Dae Hun; Kwon, Hyuck Hoon; Min, Seonguk; Lee, Sang Joo; Lee, Weon Ju; Lee, Mi Woo; Ahn, Hyo Hyun; Kang, Hoon; Lee, Jee Bum; Ro, Young Suck; Ahn, Kyu Joong; Kim, Myeung Nam; Kim, Kwang Joong; Kim, Nack In

2016-06-01

Although acne scar is a permanent sequela that may be induced by improper management of active acne lesion, patient behavior patterns and awareness regarding acne are unclear. The aim of this study was to identify awareness and behavioral patterns concerning acne and acne scar of people having acne and differences between those with and without acne scars. The survey was performed via smartphone application for 900 participants in their second to fourth decade having current or previous acne lesions. They were further categorized into two groups based on the presence of acne scar (scar and scarless groups) with no statistical difference in demographic composition. The mean age of all participants was 24.6 ± 5.3. The scar group had a longer disease duration (4.9 years) than those of the scarless group (2.2 years). Participants in the scar group thought that acne scarring affected psychosocial aspects more negatively compared with those in the scarless group. Participants in the scarless group visited dermatology clinics earlier than those in the scar group. In the scar group, 62.1% of participants have never had their acne scars treated medically. Most (88.6%) participants from both groups believed that non-dermatologic treatment caused side effects or aggravated their acne. Participants with acne scars tended to treat their acne and acne scars improperly, which could negatively affect their daily lives. Acne scars are sequelae of acne and should be regarded as a distinct disease entity, requiring a patient's early visit to dermatologic clinics. © 2015 The International Society of Dermatology.

Digital image management project for dermatological health care environments: a new dedicated software and review of the literature.

PubMed

Rubegni, Pietro; Nami, Niccolò; Poggiali, Sara; Tataranno, Domenico; Fimiani, M

2009-05-01

Because the skin is the only organ completely accessible to visual examination, digital technology has therefore attracted the attention of dermatologists for documenting, monitoring, measuring and classifying morphological manifestations. To describe a digital image management system dedicated to dermatological health care environments and to compare it with other existing softwares for digital image storage. We designed a reliable hardware structure that could ensure future scaling, because storage needs tend to grow exponentially. For the software, we chose a client-web server application based on a relational database and with a 'minimalist' user interface. We developed a software with a ready-made, adaptable index of skin pathologies. It facilitates classification by pathology, patient and visit, with an advanced search option allowing access to all images according to personalized criteria. The software also offers the possibility of comparing two or more digital images (follow-up). The fact that the archives of years of digital photos acquired and saved on PCs can easily be entered in the program distinguishes it from the others in the market. This option is fundamental for accessing all the photos taken in years of practice in the program without entering them one by one. The program is available to any user connected to the local Intranet and the system may directly be available in the future from the Internet. All clinics and surgeries, especially those that rely on digital images, are obliged to keep up with technological advances. It is therefore hoped that our project will become a model for medical structures intending to rationalise digital and other data according to statutory requirements.

Identification of translational dermatology research priorities in the U.K.: results of an electronic Delphi exercise.

PubMed

Healy, E; Brown, S J; Langan, S M; Nicholls, S G; Shams, K; Reynolds, N J

2015-11-01

Translational research is the direct application of basic and applied research to patient care. It is estimated that there are at least 2000 different skin diseases; thus, there are considerable challenges in seeking to undertake research on each of these disorders. This electronic Delphi (e-Delphi) exercise was conducted in order to generate a list of translational dermatology research questions that are regarded as a priority for further investigations. During the first phase of the e-Delphi exercise, 228 research questions were generated by an expert panel that included clinical academic dermatologists, clinical dermatologists, nonclinical scientists, dermatology trainees and representatives from patient support groups. Following completion of the second and third phases, 40 questions on inflammatory skin disease, 20 questions on structural skin disorders/genodermatoses, 37 questions on skin cancer and eight miscellaneous questions were designated as priority translational dermatology research questions (PRQs). In addition to PRQs on a variety of disease areas (including multiple PRQs on psoriasis, eczema, squamous cell carcinoma and melanoma), there were a number of cross-cutting themes that identified a need to investigate mechanisms/pathogenesis of disease and the necessity to improve treatments for patients with skin disease. It is predicted that this list of PRQs will help to provide a strategic direction for translational dermatology research in the U.K. and that addressing this list of questions will ultimately provide clinical benefit for substantial numbers of patients with skin disorders. © 2015 British Association of Dermatologists.

Identification of Translational Dermatology Research Priorities in the UK; Results of an e-Delphi Exercise

PubMed Central

Healy, E.; Reynolds, N.J.

2016-01-01

Summary Background Translational research is the direct application of basic and applied research to patient care. It is estimated that there are at least 2,000 different skin diseases, thus there are considerable challenges in seeking to undertake research on each of these disorders. Objective This eDelphi exercise was conducted in order to generate a list of translational dermatology research questions which are regarded as a priority for further investigations. Results During the first phase of the eDelphi, 228 research questions were generated by an expert panel which included clinical academic dermatologists, clinical dermatologists, non-clinical scientists, dermatology trainees and representatives from patient support groups. Following completion of the second and third phases, 40 questions on inflammatory skin disease, 20 questions on structural skin disorders / genodermatoses, 37 questions on skin cancer and 8 miscellaneous questions were designated as priority translational dermatology research questions (PRQs). In addition to PRQs on a variety of disease areas (including multiple PRQs on psoriasis, eczema, squamous cell carcinoma (SCC) and melanoma), there were a number of cross-cutting themes which identified a need to investigate mechanisms / pathogenesis of disease and the necessity to improve treatments for patients with skin disease. Conclusion It is predicted that this list of PRQs will help to provide a strategic direction for translational dermatology research in the UK and that addressing this list of questions will ultimately provide clinical benefit for substantial numbers of subjects with skin disorders. PMID:26149834

Sirtuins in dermatology: applications for future research and therapeutics.

PubMed

Serravallo, Melissa; Jagdeo, Jared; Glick, Sharon A; Siegel, Daniel M; Brody, Neil I

2013-05-01

Sirtuins are a family of seven proteins in humans (SIRT1-SIRT7) that are involved in multiple cellular processes relevant to dermatology. The role of sirtuins in other organ systems is established. However, the importance of these proteins in dermatology is less defined. Recently, sirtuins gained international attention because of their role as "longevity proteins" that may extend and enhance human life. Sirtuins function in the cell via histone deacetylase and/or adenosine diphosphate ribosyltransferase enzymatic activity that target histone and non-histone substrates, including transcription regulators, tumor suppressors, structural proteins, DNA repair proteins, cell signaling proteins, transport proteins, and enzymes. Sirtuins are involved in cellular pathways related to skin structure and function, including aging, ultraviolet-induced photoaging, inflammation, epigenetics, cancer, and a variety of cellular functions including cell cycle, DNA repair and proliferation. This review highlights sirtuin-related cellular pathways, therapeutics and pharmacological targets in atopic dermatitis, bullous dermatoses, collagen vascular disorders, psoriasis, systemic lupus erythematosus, hypertrophic and keloid scars, cutaneous infections, and non-melanoma and melanoma skin cancer. Also discussed is the role of sirtuins in the following genodermatoses: ataxia telangiectasia, Cowden's syndrome, dyskeratosis congenita, Rubenstein-Taybi, Werner syndrome, and xeroderma pigmentosum. The pathophysiology of these inherited diseases is not well understood, and sirtuin-related processes represent potential therapeutic targets for diseases lacking suitable alternative treatments. The goal of this review is to bring attention to the dermatology community, physicians, and scientists, the importance of sirtuins in dermatology and provide a foundation and impetus for future discussion, research and pharmacologic discovery.

[Cutaneous manifestations of male breast cancer].

PubMed

Hali, Fouzia; Khadir, Khadija; Idhammou, Wassima; Bensardi, Fatima-Zahra; Lefriyekh, Mohamed-Rachid; Benider, Abdelatif; Zamiati, Soumia; Benchikhi, Hakima

2011-11-01

The appearance of skin symptoms in male breast is the main reason for consultation in our context. The aim of this study is to describe the various cutaneous manifestations of male breast cancer through a series of cases collected in a dermatology department. A retrospective study was conducted in the dermatology department at the CHU Ibn Rochd January 1988 to December 2009. All cases of male breast cancer initially diagnosed in dermatology were included. The various epidemiological, clinical, histological and therapeutic data were collected from medical records. Twenty cases were collected. The mean age was 61.25 years. Skin invasion by tumor was found in all patients, and it was the reason for consultation. It was a cutaneous involvement at the nipple and areola (17 cases) and at the periareolar skin (three cases). The clinical appearance of skin involvement was vegetative type in 12 cases, infiltrating with nipple retraction in five cases and nodule with skin change in three cases. The average period of consultation was 25 months. The axillary lymph nodes were noted in 11 patients and distant metastases in eight patients. The cutaneous metastases outside breast were noted in six patients. The histological types were: infiltrating ductal carcinoma in 15 cases (75%), papillary carcinoma in two cases (10%) and non-specific carcinoma in three cases (15%). The treatment was surgery in 14 patients and consisted of radical mastectomy with complete axillary nodal dissection according to Patey. Complementary therapies, chemotherapy or radiotherapy, were indicated in 14 patients. Our single-center study with dermatological recruitment illustrates the frequency and variety of skin disease in male breast cancer and demonstrates that they are still the main reason for consultation in our context. Better information for public and practitioners would allow earlier diagnosis and a more favourable prognosis. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

The Effects of Postoperative Intralesional Corticosteroids in the Prevention of Recurrent Earlobe Keloids: A Multispecialty Retrospective Review.

PubMed

Gold, Daniel A; Sheinin, Renee; Jacobsen, Gordon; Jones, Lamont R; Ozog, David M

2018-06-01

Effective treatment of keloids is challenging because the recurrence rate after surgical excision is high. Data on the best treatment practices are lacking. To investigate the recurrence rate after surgical excision of earlobe keloids based on a postoperative intralesional corticosteroid injection protocol. Retrospective chart review was performed from January 1, 2005, to March 31, 2016, of patients who had excision of ear keloids within the departments of dermatology, otorhinolaryngology, and plastic surgery. The number of postoperative injections was recorded, recurrence was reported by the patient, and the efficacy of an injection protocol was evaluated. There were 277 charts reviewed. Appropriate data were available for 184 patients. A statistically significant difference was found with recurrence associated with a lower number of injections (p < .001). Keloids were more likely to recur if they were not treated with a planned serial injection protocol (p < .001) or if they were treated outside the department of dermatology (p < .001). Intralesional corticosteroid injection after surgical excision of earlobe keloids statistically minimizes the risk of recurrence.

Social networking sites: emerging and essential tools for communication in dermatology.

PubMed

Amir, Mahsa; Sampson, Blake P; Endly, Dawnielle; Tamai, Jennifer M; Henley, Jill; Brewer, Ann Chang; Dunn, Jeffrey H; Dunnick, Cory A; Dellavalle, Robert P

2014-01-01

The use of social media by dermatology journals and professional and patient-centered dermatology organizations remains largely unknown and, to our knowledge, has yet to be fully evaluated. To evaluate and quantify the extent of involvement of dermatology journals, professional dermatology organizations, and dermatology-related patient advocate groups on social networking sites. We obtained an archived list of 102 current dermatology journals from SCImago on the World Wide Web and used the list to investigate Facebook, Twitter, and individual journal websites for the presence of social media accounts. We identified professional and patient-centered dermatology organization activity on social networks through queries of predetermined search terms on Google, Facebook, Twitter, and LinkedIn. The activity of each entity was documented by recording the following metrics of popularity: the numbers of Facebook "likes," Twitter "followers," and LinkedIn "members." The numbers of Facebook likes, Twitter followers, and LinkedIn members corresponding to each dermatology journal and each professional and patient-related dermatology organization. On July 17, 2012, of the 102 dermatology journals ranked by SCImago, 12.7% were present on Facebook and 13.7% on Twitter. We identified popular dermatology journals based on Facebook likes and Twitter followers, led by the Journal of the American Academy of Dermatology and Dermatology Times, respectively. Popular professional dermatology organizations included dermRounds Dermatology Network (11 251 likes on Facebook and 2900 followers on Twitter). The most popular dermatology patient-centered organizations were the Skin Cancer Foundation (20 119 likes on Facebook), DermaTalk (21 542 followers on Twitter), and the National Psoriasis Foundation (200 members on LinkedIn). Patient-centered and professional dermatology organizations use social networking sites; however, academic journals tend to lag behind significantly. Although some journals are active in social media, most have yet to recognize the potential benefits of fully embracing popular social networks.

Phrynoderma: a rare dermatologic complication of bariatric surgery.

PubMed

Ocón, Julia; Cabrejas, Carmen; Altemir, Jara; Moros, Manuel

2012-05-01

Biliopancreatic diversion is a predominantly malabsorptive bariatric procedure that can lead to the development of several nutrition complications, including fat-soluble vitamin deficiencies. Routine supplementation with vitamins and trace elements and a strict medical follow-up are essential to prevent these nutrition risks. Vitamin A deficiency is common after bariatric surgery but rarely causes clinical symptoms. Case reports have described ophthalmological and fetal complications associated with vitamin A deficiency after malabsorptive bariatric surgery. Phrynoderma is a type of follicular hyperkeratosis located on the extensor surfaces of the extremities whose main cause is vitamin A deficiency. The simultaneous occurrence of phrynoderma and ocular symptoms secondary to hypovitaminosis A after bariatric surgery is exceptional. The authors describe a man who presented follicular hyperkeratosis with nyctalopia and xerophthalmia that had appeared 1 year after biliopancreatic diversion. He admitted poor compliance with diet and daily supplementation of vitamins and oligoelements. Serum vitamin A levels were decreased. Treatment with high doses of vitamin A was associated with a clear improvement of cutaneous and ocular lesions with complete resolution after 2 months. The patient was readmitted 2 years later because of the reappearance of cutaneous lesions and micronutrient deficiency. Revisional bariatric surgery was performed. The authors review and discuss the relationship between phrynoderma, malnutrition, and vitamin A deficiency.

The effect of a corticosteroid cream and a barrier-strengthening moisturizer in hand eczema. A double-blind, randomized, prospective, parallel group clinical trial.

PubMed

Lodén, M; Wirén, K; Smerud, K T; Meland, N; Hønnås, H; Mørk, G; Lützow-Holm, C; Funk, J; Meding, B

2012-05-01

Hand eczema is a common and persistent disease with a relapsing course. Clinical data suggest that once daily treatment with corticosteroids is just as effective as twice daily treatment. The aim of this study was to compare once and twice daily applications of a strong corticosteroid cream in addition to maintenance therapy with a moisturizer in patients with a recent relapse of hand eczema. The study was a parallel, double-blind, randomized, clinical trial on 44 patients. Twice daily application of a strong corticosteroid cream (betamethasone valerate 0.1%) was compared with once daily application, where a urea-containing moisturizer was substituted for the corticosteroid cream in the morning. The investigator scored the presence of eczema and the patients judged the health-related quality of life (HRQoL) using the Dermatology Life Quality Index (DLQI), which measures how much the patient's skin problem has affected his/her life over the past week. The patients also judged the severity of their eczema daily on a visual analogue scale. Both groups improved in terms of eczema and DLQI. However, the clinical scoring demonstrated that once daily application of corticosteroid was superior to twice daily application in diminishing eczema, especially in the group of patients with lower eczema scores at inclusion. Twice daily use of corticosteroids was not superior to once daily use in treating eczema. On the contrary, the clinical assessment showed a larger benefit from once daily treatment compared with twice daily, especially in the group of patients with a moderate eczema at inclusion. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

Management of Pornography-seeking in an Online Dermatology Atlas: Adventures in the Skin Trade1

PubMed Central

Lehmann, Christoph U.; Cohen, Bernard A.; Kim, George R.

2005-01-01

The escalating competition between online pornography - seeking and disseminating behaviors and technologies that attempt to reduce them creates technical, semantic and legal barriers to the legitimate discussion of and education about sensitive health issues involving sexuality, anatomy and pathology, especially when image-based knowledge is used. The effects of this competition on the use and management of an online dermatology atlas are described with a discussion on the importance of anticipating, addressing and controlling this problem while developing and maintaining image-based digital libraries and other e-Health applications. PMID:16779077

Sub-nanosecond lasers for cosmetics and dermatology

NASA Astrophysics Data System (ADS)

Tarasov, Aleksandr A.; Chu, Hong

2018-02-01

We report about the development of two new subnanosecond solid-state laser models for application in dermatology and cosmetics. One model uses subnanosecond Nd: YAG microchip laser as a master oscillator and includes Nd: YAG double- and single-pass amplifiers. At 10 Hz this laser produces more than 600 mJ pulse energy with duration 500 +/- 5 ps. Another model (under development) is gain-switched Ti: Sapphire laser with short cavity. This laser produces 200 mJ, 560 ps pulses at 790 nm and uses standard Q-Switched Nd: YAG laser with nanosecond pulse duration as a pumping sourse.

Application of protease technology in dermatology: rationale for incorporation into skin care with initial observations on formulations designed for skin cleansing, maintenance of hydration, and restoration of the epidermal permeability barrier.

PubMed

Del Rosso, James Q

2013-06-01

This article reviews background on proteases and their functions, their physiological significance in skin, and the potential implications of incorporating specific proteases and protease blends into dermatological products, including skin care formulations. The history of protease blend formulations used in wound model studies and for other disorders is reviewed. In vitro data with use of a specific 3-protease blend with evaluation of the impact on various skin proteins and peptides is also discussed in this article.

Hospital Dermatology, Introduction.

PubMed

Fox, Lindy P

2017-03-01

Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

From the Medical Board of the National Psoriasis Foundation: Perioperative management of systemic immunomodulatory agents in patients with psoriasis and psoriatic arthritis.

PubMed

Choi, Young M; Debbaneh, Maya; Weinberg, Jeffrey M; Yamauchi, Paul S; Van Voorhees, Abby S; Armstrong, April W; Siegel, Michael; Wu, Jashin J

2016-10-01

Treatment with systemic immunomodulatory agents is indicated for patients with moderate to severe plaque psoriasis and psoriatic arthritis. In these patients, surgery may confer an increased risk of infectious or surgical complications. We conducted a literature review to examine studies addressing the use of methotrexate, cyclosporine, and targeted immunomodulatory agents (tumor necrosis factor-alfa inhibitors, interleukin [IL]-12/23 inhibitors, IL-17 inhibitors) in patients undergoing surgery. We examined 46 total studies; the majority were retrospective studies in patients with rheumatoid arthritis and inflammatory bowel disease. One study in patients with psoriasis and psoriatic arthritis reviewed 77 procedures and did not find an elevated risk of postoperative complications with tumor necrosis factor-alfa and IL-12/23 inhibitors even with major surgeries. Based on level III evidence, infliximab, adalimumab, etanercept, methotrexate, and cyclosporine can be safely continued through low-risk operations in patients with psoriasis and psoriatic arthritis. For moderate- and high-risk surgeries, a case-by-case approach should be taken based on the patient's individual risk factors and comorbidities. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: a controlled simulation study.

PubMed

Arefiev, Katharine; Warycha, Melanie; Whiting, Dennis; Alam, Murad

2012-10-01

Surgical fires are a rare, but serious complication of dermatologic procedures involving electrosurgical and laser devices. Given the lack of data regarding basic fire safety principles, many dermatologists remain unaware of this potential risk. We evaluated the flammability of topical preparations and surgical drapes commonly encountered in the immediate operative field during cutaneous and laser surgery. Surgical dressings, drapes, and pork belly skin were examined for fire risk upon exposure to isopropyl alcohol, chlorhexidine gluconate, and aluminum chloride under dry, saturated, and damp conditions. Both electrosurgery and a carbon-dioxide laser were used as ignition sources. At least some char was observed in 86 of 126 simulated conditions (68%). Flames occurred in 2 test conditions: dry underpad drapes and cotton balls exposed to the carbon-dioxide laser. In general, drapes and dressings dampened or saturated with isopropyl alcohol failed to ignite with electrofulguration or electrodessication, although sparks and moderate char developed on pork belly skin and the underpad drape. Materials dampened or saturated with chlorhexidine gluconate, which contains isopropyl alcohol, generated less smoke and char compared with materials exposed to aluminum chloride, which does not contain alcohol. Future studies may assess the flammability of materials in the setting of oxygen supplementation. In common cutaneous surgical environments, electrosurgery or ablative laser may lead to char and rarely to fire. Char may be seen in up to two thirds of simulated conditions, and in a minute proportion of conditions, fire is observed. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Lasers in Medicine.

ERIC Educational Resources Information Center

Hill, P. D.

1989-01-01

Described are the characteristics of the laser and its effects on the body. Discussed are examples of laser treatments, including angioplasty, ophthalmology, and dermatology. A discussion of lasers of clinical interest and their applications is presented. (YP)

[Telemedicine in dermatological practice: teledermatology].

PubMed

Danis, Judit; Forczek, Erzsébet; Bari, Ferenc

2016-03-06

Technological advances in the fields of information and telecommunication technologies have affected the health care system in the last decades, and lead to the emergence of a new discipline: telemedicine. The appearance and rise of internet and smart phones induced a rapid progression in telemedicine. Several new applications and mobile devices are published every hour even for medical purposes. Parallel to these changes in the technical fields, medical literature about telemedicine has grown rapidly. Due to its visual nature, dermatology is ideally suited to benefit from this new technology and teledermatology became one of the most dynamically evolving fields of telemedicine by now. Teledermatology is not routinely practiced in Hungary yet, however, it promises the health care system to become better, cheaper and faster, but we have to take notice on the experience and problems faced in teledermatologic applications so far, summarized in this review.

Review of applications of microneedling in dermatology

PubMed Central

Iriarte, Christopher; Awosika, Olabola; Rengifo-Pardo, Monica; Ehrlich, Alison

2017-01-01

Microneedling (MN) is a novel therapeutic modality in dermatology. Through physical trauma from needle penetration, MN induces a wound healing cascade with minimal damage to the epidermis. This allows for enhancement in the absorption of mainstay topical therapies across the thick stratum corneum. MN has become increasingly utilized over the last several years as it is a relatively simple procedure that is cost-effective, well tolerated, and offers both cosmetic and therapeutic benefits. The ability to treat localized areas of disease has led to numerous studies gauging its potential in focal diseases of inflammation, dyschromia, and photodamage. This review discusses the principles and evidence behind the expanding applications of MN. It has shown promising results as an adjuvant therapy for enhanced drug delivery in the treatment of atrophic scars, alopecia, actinic keratoses, and disorders of pigmentation such as melasma. The efficacy in treatment of vitiligo remains limited. Overall, the procedure has few adverse sequelae compared to other therapies, is highly efficacious, and is a viable resurfacing option for skin of color. Future research is needed to determine the frequency, interval, and specific device settings that foster optimal results. Additionally, large controlled trials are needed to shed light on the utility of MN as an evidence-based regimen for the treatment of various dermatologic conditions. PMID:28848356

Biopolymers as transdermal drug delivery systems in dermatology therapy.

PubMed

Basavaraj, K H; Johnsy, George; Navya, M A; Rashmi, R; Siddaramaiah

2010-01-01

The skin is considered a complex organ for drug delivery because of its structure. Drug delivery systems are designed for the controlled release of drugs through the skin into the systemic circulation, maintaining consistent efficacy and reducing the dose of the drugs and their related side effects. Transdermal drug delivery represents one of the most rapidly advancing areas of novel drug delivery. The excellent impervious nature of the skin is the greatest challenge that must be overcome for successful drug delivery. Today, polymers have been proven to be successful for long-term drug delivery applications as no single polymer can satisfy all of the requirements. Biopolymers in the field of dermal application are rare and the mechanisms that affect skin absorption are almost unknown. Biopolymers are widely used as drug delivery systems, but as such the use of biopolymers as drug delivery systems in dermatologic therapy is still in progress. Commonly used biopolymers include hydrocolloids, alginates, hydrogels, polyurethane, collagen, poly(lactic-co-glycolic acid), chitosan, proteins and peptides, pectin, siRNAs, and hyaluronic acid. These new and exciting methods for drug delivery are already increasing the number and quality of dermal and transdermal therapies. This article reviews current research on biopolymers and focuses on their potential as drug carriers, particularly in relation to the dermatologic aspects of their use.

Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

PubMed Central

Quave, Cassandra L; Pieroni, Andrea; Bennett, Bradley C

2008-01-01

Background Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications. Methods Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy. Results We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia. Conclusion The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature. PMID:18254949

Student loan burden and its impact on career decisions in dermatology.

PubMed

Nguyen, Jannett; Song, Eingun; Liu, Michael A; Lee, Patrick K; Truong, Sam

2017-12-01

Dermatology departments in the United States face difficulties in recruiting dermatologists to academic positions, raising concerns for the future of dermatology education and research. This preliminary study aimed to explore the impact of student loan burden on career plans in dermatology and to determine if the Public Service Loan Forgiveness (PSLF) program can be used as a recruitment tool for academic positions in dermatology. Results from this electronic survey, which was distributed to dermatology residents and attending physicians, revealed that debt burden may influence career decisions in dermatology. Dermatologists may not be fully educated on loan repayment options. With increased awareness, the PSLF can potentially be used as a recruitment tool for academic positions in dermatology.

Application of Multiphoton Microscopy in Dermatological Studies: a Mini-Review

PubMed Central

Yew, Elijah; Rowlands, Christopher

2014-01-01

This review summarizes the historical and more recent developments of multiphoton microscopy, as applied to dermatology. Multiphoton microscopy offers several advantages over competing microscopy techniques: there is an inherent axial sectioning, penetration depths that compete well with confocal microscopy on account of the use of near-infrared light, and many two-photon contrast mechanisms, such as second-harmonic generation, have no analogue in one-photon microscopy. While the penetration depths of photons into tissue are typically limited on the order of hundreds of microns, this is of less concern in dermatology, as the skin is thin and readily accessible. As a result, multiphoton microscopy in dermatology has generated a great deal of interest, much of which is summarized here. The review covers the interaction of light and tissue, as well as the various considerations that must be made when designing an instrument. The state of multiphoton microscopy in imaging skin cancer and various other diseases is also discussed, along with the investigation of aging and regeneration phenomena, and finally, the use of multiphoton microscopy to analyze the transdermal transport of drugs, cosmetics and other agents is summarized. The review concludes with a look at potential future research directions, especially those that are necessary to push these techniques into widespread clinical acceptance. PMID:25075226

Graduates-of-foreign-dermatology residencies and military dermatology residencies and women in academic dermatology.

PubMed

Wu, Jashin J; Davis, Kristy F; Ramirez, Claudia C; Alonso, Carol A; Berman, Brian; Tyring, Stephen K

2009-05-15

It is well known that there is a growing shortage of academic dermatologists in the U.S. The number of graduates of foreign dermatology residencies (GFDR) and graduates of military dermatology residencies (GMDR) who take full-time academic dermatology positions are currently unknown. It is likely that a higher proportion of GFDRs and GMDRs are more likely to enter academics and practice medical dermatology. The percentage of women in academic dermatology has not been reported since 1994. To determine the total number of GFDRs, GMDRs, and women who are full-time faculty members at U.S. dermatology residency programs. The educational background of all full-time faculty members of the 107 U.S. dermatology residency programs that were active as of December 2004 were determined through extensive Internet searches, telephone, and email correspondences with residency coordinators and faculty members. Pure PhDs, physicians who did not complete a dermatology residency program at an allopathic school, PharmDs, DDSs, and FNPs were excluded. The University of Puerto Rico was not considered a foreign residency program. As of December 2004, there were 988 full-time dermatology faculty members in the US, 813 of which met our inclusion criteria. There were 30 GFDRs, accounting for 3.7 percent of full-time academic dermatologists. There were 29 GMDRs, accounting for 3.6 percent of all full-time academic dermatologists. Women accounted for 44.42 percent of academic dermatologists and 15.9 percent (14/107) of dermatology chairs/chiefs. GFDRs, GMDRs, and women comprise important proportions of full-time faculty members at U.S. dermatology residency programs.

Terminal Deoxynucleotidyl Transferase-Mediated Deoxyuridine Triphosphate Nick End Labeling (TUNEL) Assay to Characterize Histopathologic Changes Following Thermal Injury

PubMed Central

Lee, Ji Min; Park, Ji Hyun; Kim, Bo Young

2018-01-01

Background Despite the wide application of lasers and radiofrequency (RF) surgery in dermatology, it is difficult to find studies showing the extent of damage dependent on cell death. Objective We evaluated histopathologic changes following in vivo thermal damage generated by CO2 laser, 1,444 nm long-pulsed neodymium:yttrium-aluminum-garnet (LP Nd:YAG) laser and RF emitting electrosurgical unit. Methods Thermal damage was induced by the above instruments on ventral skin of rat. Specimens were stained with hematoxylin and eosin, along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay, to highlight the degree of irreversible cellular injury. Results The volume of vaporization was largest with the CO2 laser. Area of cell death area identified by TUNEL assay, when arranged from widest to narrowest, was 1,444 nm LP Nd:YAG laser, CO2 laser, and RF emitting electrosurgical unit. Conclusion This histopathologic evaluation of the acute characterization of injury across devices may be advantageous for attaining better treatment outcomes. PMID:29386831

Effect of quantum therapy on pork quality

PubMed Central

Bodnár, Martin; Nagy, Jozef; Popelka, Peter; Koréneková, Beáta; Mačanga, Ján; Nagyová, Alena

2011-01-01

In this study the impact of quantum therapy on meat quality of slaughtered pigs was investigated. For this purpose the pigs were treated with different doses of magnet-infrared-laser (MIL) radiation. Animals were divided into four groups according to radiation doses (4096, 512, and 64 Hz, and control without application), which were applied in the lumbar area of musculus longissimus dorsi (loin) at various time intervals prior to the slaughter (14 d, 24 h, and 1 h). Animals were slaughtered and the meat quality was evaluated by determining of pH value (1, 3, and 24 h post slaughter), drip loss, colour, and lactic acid and phosphoric acid amounts. MIL therapy can be used in various fields of veterinary medicine as are surgery and orthopaedics, internal medicine, dentistry, pulmonology, gastroenterology, gynaecology, urology, nephrology, and dermatology. The results achieved showed that MIL radiation used in a short period before slaughter (1 h) can cause a change in the meat quality, as reflected by the non-standard development of pH values, increases in drip loss, and changes of meat colour. PMID:22042653

A multilayered polyurethane foam technique for skin graft immobilization.

PubMed

Nakamura, Motoki; Ito, Erika; Kato, Hiroshi; Watanabe, Shoichi; Morita, Akimichi

2012-02-01

Several techniques are applicable for skin graft immobilization. Although the sponge dressing is a popular technique, pressure failure near the center of the graft is a weakness of the technique that can result in engraftment failure. To evaluate the efficacy of a new skin graft immobilization technique using multilayered polyurethane foam in vivo and in vitro. Twenty-six patients underwent a full-thickness skin graft. Multiple layers of a hydrocellular polyurethane foam dressing were used for skin graft immobilization. In addition, we created an in vitro skin graft model that allowed us to estimate immobilization pressure at the center and edges of skin grafts of various sizes. Overall mean graft survival was 88.9%. In the head and neck region (19 patients), mean graft survival was 93.6%. Based on the in vitro outcomes, this technique supplies effective pressure (<30 mmHg) to the center region of the skin graft. This multilayered polyurethane foam dressing is simple, safe, and effective for skin graft immobilization. © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Dermatology consultations significantly contribute quality to care of hospitalized patients: a prospective study of dermatology inpatient consults at a tertiary care center.

PubMed

Galimberti, Fabrizio; Guren, Lauren; Fernandez, Anthony P; Sood, Apra

2016-10-01

Cutaneous abnormalities are common in hospitalized patients but are frequently missed or misdiagnosed by admitting teams. Inpatient dermatology consultations provide important information to help diagnose and manage these patients. However, few studies have analyzed dermatology inpatient consultations and their effect. We prospectively collected information for 691 consecutive dermatology consultations from November 2013 to November 2014. Patients ranged in age from newborns to 97 years old. The internal medicine service requested the most consultations (45%). Only 6.5% of consultations were requested within 24 hours of appearance of cutaneous findings. Before consultation, 70.3% of patients did not receive treatment for or based on their cutaneous findings. Dermatology consultation resulted in treatment change in 81.9% of patients. The most common diagnoses were drug rash and contact dermatitis. Biopsies confirmed 71.7% of the initial bedside diagnoses by the dermatology consultation team. Common skin diseases were responsible for the majority of dermatology consultations. Most patients were not treated for their cutaneous conditions before the dermatology consultation. Dermatology consultations resulted in treatment changes in the majority of cases. © 2016 The International Society of Dermatology.

Pediatric dermatology training survey of United States dermatology residency programs.

PubMed

Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B

2014-01-01

Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p < 0.001, respectively). Residents in programs with no full-time pediatric dermatologist were the only residents who were somewhat or extremely dissatisfied with their pediatric training. Residency program directors were more satisfied with their curriculums when there was one or more pediatric dermatologist on staff (p < 0.01). Residents in programs with pediatric dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p < 0.001). The results of this survey support the need for dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.

[Gorlin-Goltz syndrome--a case report].

PubMed

Debski, Tomasz; Jethon, Józef

2010-06-01

The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome-NBCCS) is an autosomal dominant syndrome caused by mutations found on chromosome 9. The syndrome is characterized by increased predisposition to develop a basal cell carcinoma and associated with multiorgan anomalies. To present a case of GGS and explain modern standards of care for patients with this syndrome. Authors report the case of a 36-year-old patient who was admitted to the Plastic Surgery Clinic due to numerous basal cell carcinomas. Previously patient underwent an orthopaedic, neurologic, dermatologic, stomatologic and surgery treatment due to particular anomalies which characterize this syndrome. Comprehensive interview and broadening of the diagnostics enabled to diagnose GGS and to introduce the appropriate treatment. GGS is a multidisciplinary problem and widespread knowledge of this syndrome could accelerate the diagnosis process. Early diagnosis of GGS allows to introduce the secondary prophylaxis and to apply the appropriate treatment to slow the progress of the syndrome.

[Evaluation of the external tissue extender (Ete) in secondary wound closure].

PubMed

Zutt, Markus; Beckmann, Iris; Kretschmer, Lutz

2003-09-01

For surgical closure of large skin defects, elaborate reconstructive plastic surgery or other methods such as internal subcutaneous balloon tissue expanders are required in order to avoid tension on the closure margins. Here we point to the benefits and disadvantages of an improved and simple method of secondary wound closure by secondary sutures. We employed a system called External Tissue Extender (ETE), which consists of silicone strings and plastic stoppers pulling the corresponding surgical sites together and evenly distributing the tension. Possible indications in dermatologic surgery and our experiences with this technique are outlined. Implantation and handling of the ETE are very easy and fast. The functional results are good and the cosmetic outcome satisfactory. More invasive surgical procedures can be avoided by using this method. A major disadvantage is the possibility of developing necrosis under the plastic stoppers. According to our experience, the ETE is a useful alternative indicated in certain dermatosurgical situations.

Legal and medical aspects of body dysmorphic disorder.

PubMed

Nachshoni, Tali; Kotler, Moshe

2007-12-01

Body Dysmorphic Disorder (BDD), a preoccupation with an imagined defect in physical appearance has a rich clinical history, but officially appeared with diagnostic criteria only in the DSM-III-R classification system. Prevalence of BDD in plastic and cosmetic dermatology ranges between 7-15% due to the obsession with imagined imperfections. The emotional "defect" causes dissatisfaction with nonpsychiatric medical procedures, and often recourse into legal action. We present a case study of BDD developing after cosmetic surgery and debate whether this is an actual possibility and the legal consequences of this possibility. We question whether surgery was a traumatic event and its relationship to the patient's premorbid "eggshell personality". The difficulty in determining causation of psychiatric disorders for the purpose of deciding issues of compensation is discussed. A practical algorithm is offered in order to avoid litigation and to maintain the legitimate medical ideal of "first do no harm".

Nitroglycerin: a review of its use in the treatment of vascular occlusion after soft tissue augmentation.

PubMed

Kleydman, Kate; Cohen, Joel L; Marmur, Ellen

2012-12-01

Skin necrosis after soft tissue augmentation with dermal fillers is a rare but potentially severe complication. Nitroglycerin paste may be an important treatment option for dermal and epidermal ischemia in cosmetic surgery. To summarize the knowledge about nitroglycerin paste in cosmetic surgery and to understand its current use in the treatment of vascular compromise after soft tissue augmentation. To review the mechanism of action of nitroglycerin, examine its utility in the dermal vasculature in the setting of dermal filler-induced ischemia, and describe the facial anatomy danger zones in order to avoid vascular injury. A literature review was conducted to examine the mechanism of action of nitroglycerin, and a treatment algorithm was proposed from clinical observations to define strategies for impending facial necrosis after filler injection. Our experience with nitroglycerin paste and our review of the medical literature supports the use of nitroglycerin paste on the skin to help improve flow in the dermal vasculature because of its vasodilatory effect on small-caliber arterioles. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands*

PubMed Central

de Rezende, Rebeca Maffra; Luz, Flávio Barbosa

2014-01-01

Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. Objective: The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities. PMID:25387499

"Pseudo" conditions in dermatology: need to know both real and unreal.

PubMed

Kudur, Mohan H; Hulmani, Manjunath

2012-01-01

There are 'n' number of names and terminologies in dermatology. The real and unreal names lead to lot of confusion to the residents and practitioners of dermatology. The word 'pseudo' means 'unreal', 'false' or 'fake', and it has deep roots in dermatology providing herculean task to differentiate and understand the real conditions/diseases/signs in dermatology. We have made an attempt to list and describe the pseudo and associated real conditions in dermatology.

Medical devices in dermatology using DLP technology from Texas Instruments

NASA Astrophysics Data System (ADS)

Kock, M.; Lüllau, F.

2012-03-01

The market of medical devices is growing continuously worldwide. With the DLP™ technology from Texas Instruments Lüllau Engineering GmbH in Germany has realized different applications in the medical discipline of dermatology. Especially a new digital phototherapy device named skintrek™ PT5 is revolutionizing the treatment of skin diseases like psoriasis , Vitiligo and other Eczema. The functions of the new phototherapy device can only be realized through DLP™ technology which is not only be used for the selective irradiation process. In combination with other optical systems DLP™ technology undertakes also other functionalities like 3D-topology calculation und patient movement compensation.

[The dermatological indications of laser: beyond cosmetic target.

PubMed

Abosaleh, Marem; Boehncke, Wolf-Henning; Laubach, Hans

2017-01-11

During the last 30 years, the use of lasers in dermatology has gone far beyond the spectrum of aesthetic and cosmetic applications. Techniques are more than simple removal by CO2 Laser. Increasing knowledge, understanding, and experience have helped to effectively treat numerous important skin diseaes by the use of lasers. However, high-quality clinical trials are sparse in this domain. Consequently, so far only the treatment of hemangiomas and warts is a laser indication reimbursed by insurance companies. This article discusses three types of skin diseases where substantial progress has been reported in the scientific literature in 2016, namely pigmentary disorders, vascular diseases, and inflammatory dermatoses.

Teledermatology Applications in Skin Cancer Diagnosis.

PubMed

Walocko, Frances M; Tejasvi, Trilokraj

2017-10-01

Teledermatology has drawn interest in the dermatologic community, because it allows for earlier detection of skin cancer in patients with poor access to health care. Using a combination of dermoscopy and digital photography, teledermatology has demonstrated acceptable concordance with face-to-face clinical diagnoses in multiple settings for pigmented skin lesions. Additional studies on using teledermatology to assess nonpigmented skin lesions are needed. Future advances in mobile teledermatology may help make this technology more widespread and affordable. Although teledermatology is not a replacement for regular total body skin examinations, it is a useful tool to significantly reduce the burden of dermatologic malignancies. Published by Elsevier Inc.

Dermatology on Reddit: elucidating trends in dermatologic communications on the world wide web.

PubMed

Buntinx-Krieg, Talayesa; Caravaglio, Joseph; Domozych, Renee; Dellavalle, Robert P

2017-07-15

Platforms of social media, including the website Reddit, have become increasingly popular sites for users to communicate medical information. A study investigating dermatology content on Reddit has not been performed in the current literature. The purpose of this study is to enumerate the dermatology subreddits, quantify subscribers, and characterize posts to estimate the presence of dermatology-related content on Reddit. A Reddit search of the fourteen most common skin diseases globally was performed. Additionally, the terms "dermatology", and "skin" were searched in order to identify more subreddits relevant to the field. Dermatology-related subreddits that had ≥1000 subscribers were evaluated for content and categorized for analysis. We identified 38 subreddits related to dermatology with subscriber numbers ranging from 52 to 209,973. For 17 of the 38 subreddits that were further analyzed, most posts fell under the category of "seeking health/cosmetic advice." Reddit serves as a communication stage for individuals to discuss, engage, and connect on dermatologic topics. Furthermore, the platform offers an opportunity for medical professionals to distribute evidence-based information concerning dermatologic conditions.

Dermatology Medical Education: A Multicenter Survey Study of the Undergraduate Perspective of the Dermatology Clinical Clerkship.

PubMed

Davari, Parastoo; Millsop, Jillian W; Johnson, Mary Ann N; Takahashi, Stefani R; Peng, David H; Badger, Joanna; Bahr, Brooks A; Shinkai, Kanade; Li, Chin-Shang; Fazel, Nasim

2017-12-15

Limited data are available regarding the undergraduate dermatology clinical clerkship curriculum in the United States. Our primaryaim is to assess medical students' perspectives of the dermatology clinical clerkship. A multicenter survey study was conducted, which included four California dermatology academic programs. A 17-item questionnaire was designed to investigate medical student perception with regard tothe overall educational value of the various teaching aspects of the dermatology clinical clerkship. A total of 152 medical student surveys were completed. Over half of the medical students felt proficient in diagnosing the most commondermatologic conditions. Eighty-seven percent of medical students were very satisfied with the dermatology clerkship. Ninety-one percent of students felt the length of the clerkship was appropriate. The vast majority of medical students reported a high level of proficiency in the treatment and diagnosis of common skin disorders. In contrast, our findings suggest that medical students may not begaining sufficient hands-on experience in conducting certain dermatologic procedures following the dermatology clerkship. Overall, medical studentperception of the dermatology clinical clerkship was mostly positive.

Low Rates of Dermatologic Care and Skin Cancer Screening Among Inflammatory Bowel Disease Patients.

PubMed

Anderson, Alyce; Ferris, Laura K; Click, Benjamin; Ramos-Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael; Barrie, Arthur; Schwartz, Marc; Regueiro, Miguel; Binion, David G

2018-04-30

Dermatologic manifestations of inflammatory bowel disease (IBD) are common, and certain IBD medications increase the risk of skin cancer. To define the rates of care and factors associated with dermatologic utilization with a focus on skin cancer screening. We utilized a prospective, natural history IBD research registry to evaluate all outpatient healthcare encounters from 2010 to 2016. Gastrointestinal, dermatologic and primary care visits per individual were identified. We calculated the proportion of patients obtaining care, categorized primary indications for dermatologic visits, determined the incidence of melanoma and non-melanoma skin cancers, and used logistic regression to determine factors associated with dermatology utilization. Of the 2127 IBD patients included, 452 (21.3%) utilized dermatology over the study period, and 55 (2.6%) had a total body skin examination at least once. The 452 patients incurred 1633 dermatology clinic visits, 278 dermatologic procedures, and 1108 dermatology telephone encounters. The most frequent indication was contact dermatitis or dermatitis. Factors associated with dermatology use were family history of skin cancer, employment, systemic steroids, longer disease duration, emergency room use, and the number of IBD-related clinic visits. Between 8.3 and 11% of IBD patients recommended for skin cancer screening visited dermatology each year, and the resulting incidence of non-melanoma skin cancer was 35.4/10,000 [95% CI 23.3-51.5] and melanoma was 6.56/10,000 [95% CI 2.1-15.3]. Less than one in ten IBD patients obtain dermatologic care. Given the increased risk of skin cancers among IBD patients, an emphasis on education, prevention, and screening merits attention.

Inpatient Consultative Dermatology.

PubMed

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.

Research Techniques Made Simple: Web-Based Survey Research in Dermatology: Conduct and Applications.

PubMed

Maymone, Mayra B C; Venkatesh, Samantha; Secemsky, Eric; Reddy, Kavitha; Vashi, Neelam A

2018-07-01

Web-based surveys, or e-surveys, are surveys designed and delivered using the internet. The use of these survey tools is becoming increasingly common in medical research. Their advantages are appealing to surveyors because they allow for rapid development and administration of surveys, fast data collection and analysis, low cost, and fewer errors due to manual data entry than telephone or mailed questionnaires. Internet surveys may be used in clinical and academic research settings with improved speed and efficacy of data collection compared with paper or verbal survey modalities. However, limitations such as potentially low response rates, demographic biases, and variations in computer literacy and internet access remain areas of concern. We aim to briefly describe some of the currently available Web-based survey tools, focusing on advantages and limitations to help guide their use and application in dermatologic research. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Establishing a multidisciplinary academic cosmetic center.

PubMed

Rao, Venkat K; Schmid, Daniel B; Hanson, Summer E; Bentz, Michael L

2011-12-01

The demand for cosmetic services has risen rapidly in recent years, but has slowed down with the current economic downturn. Managed care organizations and Medicare have been steadily reducing their reimbursements for physician services. The payment for reconstructive surgical procedures has been decreasing and is likely to worsen with healthcare reform, and many plastic surgery residency programs are facing fiscal challenges. An adequate volume of patients needing cosmetic services is necessary to recruit and train the best candidates to the residency programs. Self-pay patients will help ensure the fiscal viability of plastic surgery residency programs. Attracting patients to an academic healthcare center will become more difficult in a recession without the appropriate facilities, programs, and pricing strategies. Setting up a modern cosmetic services program at an academic center has some unique challenges, including funding, academic politics, and turf. The authors opened a free-standing academic multidisciplinary center at their medical school 3 years ago. The center is an off-site, 13,000-sq ft facility that includes faculty from plastic surgery, ear, nose, and throat, dermatology, and vascular surgery. In this article, the authors discuss the process of developing and executing a plan for starting an aesthetic services center in an academic setting. The financing of the center and factors in pricing services are discussed. The authors show the impact of the center on their cosmetic surgery patient volumes, resident education, and finances. They expect that their experience will be helpful to other plastic surgery programs at academic medical centers.

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial.

PubMed

Williams, Hywel C; Bath-Hextall, Fiona; Ozolins, Mara; Armstrong, Sarah J; Colver, Graham B; Perkins, William; Miller, Paul S J

2017-03-01

We previously reported modest clinical 3-year benefit for topical imiquimod compared with surgery for superficial or nodular basal cell carcinoma at low-risk sites in our noninferiority randomized controlled SINS trial. Here we report 5-year data. Participants were randomized to imiquimod 5% cream once daily (superficial basal cell carcinoma, 6 weeks; nodular basal cell carcinoma, 12 weeks) or excisional surgery (4-mm margin). The primary outcome was clinical absence of initial failure or signs of recurrence at the 3-year dermatology review. Five-year success was defined as 3-year success plus absence of recurrences identified through hospital, histopathology, and general practitioner records. Of 501 participants randomized, 401 contributed to the modified intention-to-treat analyses at year 3 (primary outcome), 383 (96%) of whom had data at year 5. Five-year success rates for imiquimod were 82.5% (170/206) compared with 97.7% (173/177) for surgery (relative risk of imiquimod success = 0.84, 95% confidence interval = 0.77-0.91, P < 0.001). These were comparable to year 3 success rates of 83.6% (178/213) and 98.4% (185/188) for imiquimod and surgery, respectively. Most imiquimod treatment failures occurred in year 1. Although surgery is clearly superior to imiquimod, this study shows sustained benefit for lesions that respond early to topical imiquimod. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

[Certificate "Tropical and Travel Dermatology (DDA)": quality-assured medical education for dermatologists with a "migration perspective"].

PubMed

Elsner, P; Nenoff, P; Schliemann, S; Tittelbach, J; Reinel, D

2014-10-01

Under the conditions of economic pressure in the medical system and the DRG system for hospitals in Germany, so-called "uneconomic" services and fields of specialized dermatologic competence such as pediatric dermatology, trichology, occupational dermatology and tropical dermatology are increasingly being neglected. While hospitals tend to train fewer residents in these subspecialties, there is a demand for additional high-quality training opportunities that are certified by the German Dermatologic Academy (DDA). Tropical and travel-related skin diseases are more frequently observed in Germany which can be explained by the increased world-wide travel activities, but also by the international migration from developing countries into Europe. Furthermore, dermatologists trained in Germany are working more and more also internationally. Thus, they require knowledge and experience in tropical and travel-related dermatology. The certificate "Tropical and Travel Dermatology (DDA)" was developed and published in 2013 in a cooperation between the International Society for Dermatology in the Tropics in cooperation with the German Academy of Dermatology (DDA). It consists of 3 full day teaching modules (basic, additional and special seminar). The first seminar cycle in 2013/2014 showed a high demand from dermatologists in hospitals and private practices. While the basic and the special seminars were held in Germany, the additional seminar took place in cooperation with the Regional Dermatology Training Center (RDTC) in Moshi, Tanzania. Many attending dermatologists fulfilling the requirements for the new certificate have practiced in developing countries or plan to do so. In order to gain practical experience on the basis of the knowledge acquired in the qualifying seminars, the International Society for Dermatology in the Tropics supports dermatologists to find internships and work placements in dermatological units in developing countries.

Review of patient registries in dermatology.

PubMed

DiMarco, Gabriella; Hill, Dane; Feldman, Steven R

2016-10-01

Patient registries are datasets containing information on patients with a particular disease or patients who are undergoing a specific treatment. Our objective was to search for and catalog the types of registries being used in dermatology and investigate their characteristics and uses. We searched Google, the Registry of Patient Registries, Orphanet, and ClinicalTrials.gov to compile a list of dermatology disease registries. We also conducted a literature review on the uses of dermatology registries using PubMed. We identified 48 dermatology patient registries, with 23 distinct diseases represented. We also identified 11 registries used for postmarketing surveillance of skin disease. Our search was limited to registries in English. Registries are commonly used for the study of rare dermatologic diseases and for postsurveillance monitoring of systemic therapies in more common dermatologic diseases, such as psoriasis. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The science of dermocosmetics and its role in dermatology.

PubMed

Dreno, B; Araviiskaia, E; Berardesca, E; Bieber, T; Hawk, J; Sanchez-Viera, M; Wolkenstein, P

2014-11-01

Our increased knowledge of normal skin physiology has ushered in a subtle revolution in cosmetic science. Originally designed as preparations to enhance personal appearance by direct application on to the skin, cosmetics have now taken on a new role in dermatology, through the support of the management of many skin disorders. This evolving role of cosmetics in skin care is primarily due to scientific and technological advancements that have changed our understanding of normal skin physiology and how cosmetics modify its appearance both physically and biologically. The vast array of techniques currently available to investigate skin responsivity to multiple stimuli has brought about a new era in cosmetic and dermocosmetic development based on a robust understanding of skin physiology and its varied responses to commonly encountered environmental insults. Most cosmetic research is undertaken on reconstructed skin models crucial in dermatological research, given the strict ban imposed by the European Union on animal testing. In addition, the design and conduct of trials evaluating cosmetics now follow rules comparable to those used in the development and evaluation of pharmaceutical products. Cosmetic research should now aim to ensure all trials adhere to strictly reproducible and scientifically sound methodologies. The objective of this review is to provide an overview of the multidisciplinary scientific approach used in formulating dermocosmetics, and to examine the major advances in dermocosmetic development and assessment, the safety and regulatory guidelines governing their production and the exciting future outlook for these dermocosmetic processes following good practice rules. © 2014 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of the European Academy of Dermatology and Venereology.

Frequency of undiagnosed psoriatic arthritis among psoriasis patients in Australian dermatology practice.

PubMed

Spelman, L; Su, J C; Fernandez-Peñas, P; Varigos, G A; Cooper, A J; Baker, C S; Lee, M; Ring, J M; Thirunavukkarasu, K

2015-11-01

Psoriatic arthritis commonly develops in psoriasis patients and, if undiagnosed, can lead to potentially avoidable joint damage and an increased risk of comorbidity and mortality. Increased awareness of PsA symptoms among dermatologists provides an opportunity for earlier diagnosis, more timely therapy and prevention of disability. To provide Australian epidemiological data on the frequency of undiagnosed PsA among psoriasis patients in dermatology practice, and to investigate the impact of psoriasis on quality of life and work productivity. Nine tertiary centre dermatology practices enrolled patients presenting with plaque psoriasis and no prior rheumatologist-confirmed PsA diagnosis. Patients were screened using the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire and were referred to a rheumatologist for assessment of PsA status using CASPAR criteria if they had a PASE score ≥44. Based on the composite and sequential application of PASE and CASPAR criteria, undiagnosed PsA among psoriasis patients in this study is 9% [95% CI: 6, 12]. The PPV of PASE in this setting is 26% [95% CI: 19, 34]. Nail involvement and chronic large plaque psoriasis were identified as independent positive predictors of PsA, whereas scalp psoriasis was an independent negative predictor of PsA. Patients with moderate-to-severe psoriasis (PASI ≥15) had lower quality of life scores than patients with less severe psoriasis. In this study, the frequency of undiagnosed PsA in Australian dermatology practice was 9% among plaque psoriasis patients with no prior PsA diagnosis. Compared with psoriasis alone, the impact of undiagnosed PsA on health-related quality of life of psoriasis patients is substantial. © 2015 European Academy of Dermatology and Venereology.

Pictorial Representation of Illness and Self Measure (PRISM): A novel visual instrument to measure quality of life in dermatological inpatients.

PubMed

Mühleisen, Beda; Büchi, Stefan; Schmidhauser, Simone; Jenewein, Josef; French, Lars E; Hofbauer, Günther F L

2009-07-01

To validate the PRISM (Pictorial Representation of Illness and Self Measure) tool, a novel visual instrument, for the assessment of health-related quality of life in dermatological inpatients compared with the Dermatology Life Quality Index (DLQI) and the Skindex-29 questionnaires and to report qualitative information on PRISM. In an open longitudinal study, PRISM and Skindex-29 and DLQI questionnaires were completed and HRQOL measurements compared. Academic dermatological inpatient ward. The study population comprised 227 sequential dermatological inpatients on admission. Patients completed the PRISM tool and the Skindex-29 and DLQI questionnaires at admission and discharge. PRISM Self-Illness Separation (SIS) score; Skindex-29 and DLQI scores; and qualitative PRISM information by Mayring inductive qualitative context analysis. The PRISM scores correlated well with those from the Skindex-29 (rho = 0.426; P < .001) and DLQI (rho = 0.304; P < .001) questionnaires. Between PRISM and Skindex-29 scores, the highest correlations were for dermatitis (rho = 0.614) and leg ulcer (rho = 0.554), and between PRISM and DLQI scores, the highest correlations were for psoriasis (rho = 0.418) and tumor (rho = 0.399). The PRISM tool showed comparable or higher sensitivity than quality of life questionnaires to assess changes in the burden of suffering during hospitalization. Inductive qualitative context analysis revealed impairment of adjustment and self-image as major aspects. Patients overall expected symptomatic and functional improvement. In patients with psoriasis and leg ulcers, many expected no treatment benefit. The PRISM tool proved to be convenient and reliable for health-related quality of life assessment, applicable for a wide range of skin diseases, and correlated with DLQI and Skindex-29 scores. With the PRISM tool, free-text answers allow for the assessment of individual information and potentially customized therapeutic approaches.

[What's new in instrumental dermatology?].

PubMed

Amici, J-M

2014-12-01

This "What's new in instrumental dermatology" focuses on cutaneous oncologic surgery, base on a review of the 2012-2014 literature. First, the ability of dermatologists to make a good "oncologic reading of tumors" is the key of radical surgical treatment. Advantages and disadvantages of the biopsy are discussed. Then, the second message is the management of anticoagulants, that should not be interrupted for skin surgery. Despite recommendations, this practice is not followed in 40% of cases; this point is critical because bleeding complications are minor compared to potential morbidity of thrombotic events when stopping these medications. Regarding infection, nasal carriage of Staphylococcus aureus is identified as a risk factor for wound infection. A preoperative shower with chlorhexidine and mupirocin topical decolonization of nostril reduces this risk. Surgical techniques are trying to reach minimalism, by reducing undermining and scarring. On the trunk, using deep slow resorbable sutures improve scarring. In addition using adhesive sutures (strip) reduce the wideness of scar. On the face, the lower third of the nose is the most challenging because of the free edges, which are deformable. In this location bilobed or trilobed transposition flap offer the advantage of remaining in the nasal aesthetic unit and not disturbing the free edges of the nasal orifices. Regarding scarring, early hypertrophic scar is now well defined and linked with transposition flaps of the nasal region. An early treatment with intralesional corticosteroid injection appears to be effective. Finally, the biological mechanism of the effectiveness of compression in the prevention and treatment of dystrophic scar is now clear. The mechanotransduction explain how a mechanical stress of the skin activates biological cell pathways, which regulate the quality of collagen synthesis and the arrangement of skin fibrosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Comparison and use of 3D scanners to improve the quantification of medical images (surface structures and volumes) during follow up of clinical (surgical) procedures

NASA Astrophysics Data System (ADS)

Tokkari, Niki; Verdaasdonk, Rudolf M.; Liberton, Niels; Wolff, Jan; den Heijer, Martin; van der Veen, Albert; Klaessens, John H.

2017-02-01

It is difficult to obtain quantitative measurements as to surface areas and volumes from standard photos of the body parts of patients which is highly desirable for objective follow up of treatments in e.g. dermatology. plastic, aesthetic and reconstructive surgery. Recently, 3-D scanners have become available to provide quantification. Phantoms (3-D printed hand, nose and ear, colored bread sculpture) were developed to compare a range from low-cost (Sense), medium (HP Sprout) to high end (Artec Spider, Vectra M3) scanners using different 3D imaging technologies, as to resolution, working range, surface color representation, user friendliness. The 3D scans files (STL, OBJ) were processed with Artec studio and GOM software as to deviation compared to the high resolution Artec Spider scanner taken as `golden' standard. The HP Spout, which uses a fringe projection, proved to be nearly as good as the Artec, however, needs to be converted for clinical use. Photogrammetry as used by the Vectra M3 scanner is limited to provide sufficient data points for accurate surface mapping however provides good color/structure representation. The low performance of the Sense is not recommended for clinical use. The Artec scanner was successfully used to measure the structure/volume changes in the face after hormone treatment in transgender patients. 3D scanners can greatly improve quantitative measurements of surfaces and volumes as objective follow up in clinical studies performed by various clinical specialisms (dermatology, aesthetic and reconstructive surgery). New scanning technologies, like fringe projection, are promising for development of low-cost, high precision scanners.

Measuring Cutaneous Lesions: Trends in Clinical Practice.

PubMed

Zhang, Shali; Blalock, Travis W

2018-03-01

Knowing the size of a cutaneous lesion can be important for tracking its progression over time, selecting the proper treatment modality, surgical planning, determining prognosis, and accurate billing. However, providers vary in their consistency, accuracy, and methods of measuring cutaneous lesions. To investigate the clinical practices of US dermatologists and dermatologic surgeons regarding how they determine the size of cutaneous lesions. A survey was electronically distributed to members of the American Society for Dermatologic Surgery. Four hundred twenty-six dermatologists completed the online survey. When a lesion is suspected to be malignant, 85% of respondents obtained exact measurements most, if not all, of the time; however, only 8% did for benign lesions. Most providers determined lesion sizes themselves rather than delegating to staff. When performing visual estimation, approximately three-quarters believed that they were accurate to within 1 to 2 mm. The top reasons for obtaining exact measurements were for tracking atypical pigmented lesions, determining treatment pathways, and accurate billing. The majority of respondents believed that lesion size affected management decisions; however, the need for exact measurement remains controversial, particularly for benign lesions. Future studies may investigate whether taking exact versus estimated measurements has an effect on outcomes.

Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases.

PubMed

Gehl, Julie; Sersa, Gregor; Matthiessen, Louise Wichmann; Muir, Tobian; Soden, Declan; Occhini, Antonio; Quaglino, Pietro; Curatolo, Pietro; Campana, Luca G; Kunte, Christian; Clover, A James P; Bertino, Giulia; Farricha, Victor; Odili, Joy; Dahlstrom, Karin; Benazzo, Marco; Mir, Lluis M

2018-03-25

Electrochemotherapy is now in routine clinical use to treat cutaneous metastases of any histology, and is listed in national and international guidelines for cutaneous metastases and primary skin cancer. Electrochemotherapy is used by dermatologists, surgeons, and oncologists, and for different degrees and manifestations of metastases to skin and primary skin tumours not amenable to surgery. This treatment utilises electric pulses to permeabilize cell membranes in tumours, thus allowing a dramatic increase of the cytotoxicity of anti-cancer agents. Response rates, often after only one treatment, are very high across all tumour types. The most frequent indications are cutaneous metastases from malignant melanoma and breast cancer. In 2006, standard operating procedures (SOPs) were written for this novel technology, greatly facilitating introduction and dissemination of the therapy. Since then considerable experience has been obtained treating a wider range of tumour histologies and increasing size of tumours which was not originally thought possible. A pan-European expert panel drawn from a range of disciplines from dermatology, general surgery, head and neck surgery, plastic surgery, and oncology met to form a consensus opinion to update the SOPs based on the experience obtained. This paper contains these updated recommendations for indications for electrochemotherapy, pre-treatment information and evaluation, treatment choices, as well as follow-up.

From the Test Tube to the Treatment Room: Fundamentals of Boron-containing Compounds and their Relevance to Dermatology.

PubMed

Del Rosso, James Q; Plattner, Jacob J

2014-02-01

The development of new drug classes and novel molecules that are brought to the marketplace has been a formidable challenge, especially for dermatologic drugs. The relative absence of new classes of antimicrobial agents is also readily apparent. Several barriers account for slow drug development, including regulatory changes, added study requirements, commercial pressures to bring drugs to market quickly by developing new generations of established compounds, and the greater potential for failure and higher financial risk when researching new drug classes. In addition, the return on investment is usually much lower with dermatologic drugs as compared to the potential revenue from "blockbuster" drugs for cardiovascular or gastrointestinal disease, hypercholesterolemia, and mood disorders. Nevertheless, some researchers are investigating new therapeutic platforms, one of which is boron-containing compounds. Boron-containing compounds offer a wide variety of potential applications in dermatology due to their unique physical and chemical properties, with several in formal phases of development. Tavaborole, a benzoxaborole compound, has been submitted to the United States Food and Drug Administration for approval for treatment of onychomycosis. This article provides a thorough overview of the history of boron-based compounds in medicine, their scientific rationale, physiochemical and pharmacologic properties, and modes of actions including therapeutic targets. A section dedicated to boron-based compounds in development for treatment of various skin disorders is also included.

Photobiomodulation with non-thermal lasers: Mechanisms of action and therapeutic uses in dermatology and aesthetic medicine.

PubMed

Nestor, Mark; Andriessen, Anneke; Berman, Brian; Katz, Bruce E; Gilbert, Dore; Goldberg, David J; Gold, Michael H; Kirsner, Robert S; Lorenc, Paul Z

2017-08-01

Non-thermal laser therapy in dermatology, is a growing field in medical technology by which therapeutic effects are achieved by exposing tissues to specific wavelengths of light. The purpose of this review was to gain a better understanding of the science behind non-thermal laser and the evidence supporting its use in dermatology. A group of dermatologists and surgeons recently convened to review the evidence supporting the use of non-thermal laser for body sculpting, improving the appearance of cellulite, and treating onychomycosis. The use of non-thermal laser for body sculpting is supported by three randomized, double-blind, sham-controlled studies (N = 161), one prospective open-label study (N = 54), and two retrospective studies (N = 775). Non-thermal laser application for improving the appearance of cellulite is supported by one randomized, double-blind, sham-controlled study (N = 38). The use of non-thermal laser for the treatment of onychomycosis is supported by an analysis of three non-randomized, open-label studies demonstrating clinical improvement of nails (N = 292). Non-thermal laser is steadily moving into mainstream medical practice, such as dermatology. Although present studies have demonstrated the safety and efficacy of non-thermal laser for body sculpting, cellulite reduction and onychomycosis treatment, studies demonstrating the efficacy of non-thermal laser as a stand-alone procedure are still inadequate.

Dermatology hospital fellowships: present and future.

PubMed

Sun, Natalie Z; Fox, Lindy P

2017-03-01

The question of what makes a successful dermatology hospitalist has risen to the forefront due to the rapidly increasing number of these providers. Inpatient dermatology fellowships have formed as a direct consequence. Though mostly in their infancy, these programs have primary or secondary goals to train providers in the dermatologic care of the hospitalized patient. This article presents a brief synopsis of the history of traditional hospitalist fellowships and extrapolates these findings to existing hospitalist dermatology fellowships. As more of these programs arise, these fellowships are poised to revolutionize dermatologic inpatient care from a systems perspective. ©2017 Frontline Medical Communications.

Experience of a year of adult hospital dermatology consultations.

PubMed

Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P

2015-10-01

Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.

Lasers in tattoo and pigmentation control: role of the PicoSure(®) laser system.

PubMed

Torbeck, Richard; Bankowski, Richard; Henize, Sarah; Saedi, Nazanin

2016-01-01

The use of picosecond lasers to remove tattoos has greatly improved due to the long-standing outcomes of nanosecond lasers, both clinically and histologically. The first aesthetic picosecond laser available for this use was the PicoSure(®) laser system (755/532 nm). Now that a vast amount of research on its use has been conducted, we performed a comprehensive review of the literature to validate the continued application of the PicoSure(®) laser system for tattoo removal. A PubMed search was conducted using the term "picosecond" combined with "laser", "dermatology", and "laser tattoo removal". A total of 13 articles were identified, and ten of these met the inclusion criteria for this review. The majority of studies showed that picosecond lasers are an effective and safe treatment mode for the removal of tattoo pigments. Several studies also indicated potential novel applications of picosecond lasers in the removal of various tattoo pigments (eg, black, red, and yellow). Adverse effects were generally mild, such as transient hypopigmentation or blister formation, and were rarely more serious, such as scarring and/or textural change. Advancements in laser technologies and their application in cutaneous medicine have revolutionized the field of laser surgery. Computational modeling provides evidence that the optimal pulse durations for tattoo ink removal are in the picosecond domain. It is recommended that the PicoSure(®) laser system continue to be used for safe and effective tattoo removal, including for red and yellow pigments.

Impact of a dermatology wiki website on dermatology education.

PubMed

Karimkhani, Chante; Boyers, Lindsay N; Ellis, Lixia Z; Brice, Sylvia; Chen, David L; Dunnick, Cory A; Dellavalle, Robert P

2015-01-15

The Dermatology Education Wiki (dermwiki) website serves as a resource platform for medical students and residents. The readily accessible interface provides dermatology articles, survival guides, didactic lectures, and links to faculty talks as well as research opportunities. To assess medical student and resident satisfaction with the dermwiki website. Fourth-year medical students taking a dermatology elective were provided with a temporary password to access relevant dermwiki information. A satisfaction survey was created to assess whether medical students found the website helpful. Second- and third-year dermatology residents were also surveyed to compare satisfaction scores prior to and after the introduction of the dermwiki website. End-of-rotation medical student exam scores were tabulated and compared to the average scores from years prior to the development of the dermwiki website. Medical students rated the dermatology elective with the dermwiki website higher than rotations without a wiki (8.12 vs 7.31). Students planning to go into dermatology were more satisfied with the dermwiki website, reported accessing the website more frequently (11 times vs 9.5 times), and reported more time spent studying (12.2 hours vs 6.7 hours) than students not going into dermatology. End-of-rotation medical student exam scores did not differ from those prior to the development of the demwiki website. Ten second- and third-year dermatology residents unanimously stated that they were more satisfied with the program after the institution of the dermwiki website. Overall, addition of the dermwiki website to the dermatology elective curriculum has improved medical student and resident satisfaction scores. The improvement is greater among students planning to enter the field of dermatology. This study serves as a model for the incorporation of internet-based interactive tools to transform and supplement the learning environment.

Online learning in a dermatology clerkship: piloting the new American Academy of Dermatology Medical Student Core Curriculum.

PubMed

Cipriano, Sarah D; Dybbro, Eric; Boscardin, Christy K; Shinkai, Kanade; Berger, Timothy G

2013-08-01

Multiple studies have shown that both current and future primary care providers have insufficient education and training in dermatology. To address the limitations and wide variability in medical student dermatology instruction, the American Academy of Dermatology (AAD) created a standardized, online curriculum for both dermatology learners and educators. We sought to determine the impact of the integration of the AAD online curriculum into a 2-week introductory dermatology clerkship for fourth-year medical students. In addition to their clinical duties, we assigned 18 online modules at a rate of 1 to 3 per day. We evaluated knowledge acquisition using a 50-item, multiple-choice pretest and posttest. Postmodule and end-of-course questionnaires contained both closed and open-ended items soliciting students' perceptions about usability and satisfaction. All 51 participants significantly improved in their dermatology knowledge (P < .001). The majority of students found the modules easy to navigate (95%) and worth their time (93%). All respondents supported the continuation of the modules as part of the dermatology clerkship. Without a control group who did not experience the online curriculum, we are unable to isolate the specific impact of the online modules on students' learning. This study demonstrates the successful integration of this educational resource into a 2-week, university-based dermatology clerkship. Students' perceptions regarding usability and satisfaction were overwhelmingly positive, suggesting that the online curriculum is highly acceptable to learners. Widespread use of this curriculum may be a significant advancement in standardized dermatology learning for medical students. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study.

PubMed

Dalenc, F; Ribet, V; Rossi, A B; Guyonnaud, J; Bernard-Marty, C; de Lafontan, B; Salas, S; Ranc Royo, A-L; Sarda, C; Levasseur, N; Massabeau, C; Levecq, J-M; Dulguerova, P; Guerrero, D; Sibaud, V

2018-01-01

This study investigated the efficacy of post-treatment hydrotherapy as supportive care for management of persistent/long-lasting dermatologic adverse events (dAEs) induced in breast cancer survivors by adjuvant therapy, and its impact on quality of life (QoL). Patients in complete remission after standardised (neo)adjuvant chemotherapy, surgery and radiotherapy combination treatment for infiltrating HR+/HER2-breast carcinoma were enrolled in this randomised, multicentre controlled study 1-5 weeks after completing radiotherapy. The control group (CG, n = 33) received best supportive care and the treatment group (HG, n = 35) received 3-weeks of specific hydrotherapy. The primary criterion was change in QoL (QLQ-BR23) after hydrotherapy. Clinical grading of dAEs, cancer-related QoL (QLQ-C30), dermatologic QoL (DLQI) and general psychological well-being (PGWBI) were assessed. Significant dAEs were found at inclusion in both groups (n = 261). Most items showed significantly greater improvement in the HG versus CG group: QLQ-BR23 (breast [p = .0001] and arm symptoms [p = .0015], systemic therapy side effects [p = .0044], body image [p = .0139]), some dAE grading, DLQI (p = .0002) and PGWBI (p = .0028). Xerosis (88% of patients at inclusion) completely healed in all HG patients. Specific hydrotherapy is an effective supportive care for highly prevalent and long-lasting dAEs occurring after early breast cancer treatment, including chemotherapy, and leads to improved QoL and dermatologic toxicities. © 2017 John Wiley & Sons Ltd.

How competitive is the match for radiology residency? Present view and historical perspective.

PubMed

Chen, Jim Y; Heller, Matthew T

2014-05-01

Interest in radiology as a career among US medical students has changed. The aim of this study was to investigate the recent and historical trends in residency applications and how they have affected competitiveness in obtaining a position. Statistics published by the National Resident Matching Program in "Results and Data: Main Residency Match" for 1991 to 2013 were analyzed. The number of radiology residency positions has trended upward over the past 23 years; however, the number of applicants from US medical schools has been widely variable. The number of applicants peaked in 2009 but has since decreased every year. The number of positions per US senior applicant (PPUSA) is a judge of specialty competitiveness on a supply-and-demand basis. A lower PPUSA indicates a more competitive specialty. Radiology saw its most competitive year in 2001, with only 0.91 PPUSA. PPUSA has been on the rise every year since 2009. From 2009 to 2013, the number of residency positions increased by 56, but there were 241 fewer US senior medical students preferring radiology. In 2013, there were 1,143 residency positions available for only 845 US senior medical students who preferred the specialty. The PPUSA was 1.35, making 2013 the least competitive year in obtaining a radiology residency position since 1998. Over the past 23 years, 5.5% of all US senior medical students have applied to radiology for residency. Interest reached an all-time high in 2009, at almost 7%. In 2013, only 4.8% of all US seniors preferred radiology, the lowest since 1999. The historical (1991-2013), current (2011-2013), and most recent (2013) PPUSAs for radiology were 1.19, 1.29, and 1.35, respectively. For comparison, the current PPUSAs for the following specialties were: 0.74 for plastic surgery, 0.83 for orthopedic surgery, 0.95 for dermatology, 1.10 for general surgery, 1.24 for obstetrics and gynecology, 1.31 for anesthesiology, 1.42 for pediatrics, and 1.80 for internal medicine (1.80). Although radiology residency positions have continued to increase, interest among US seniors has dropped every year since 2009. The 2013 match was the least competitive since 1998. Over the past 3 years, the competitiveness of matching radiology on a supply-and-demand basis has been close to that of obstetrics and gynecology and anesthesiology. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Periocular Skin Cancer in Solid Organ Transplant Recipients.

PubMed

Perry, Julian D; Polito, Sara C; Chundury, Rao V; Singh, Arun D; Fritz, Michael A; Vidimos, Allison T; Gastman, Brian R; Koyfman, Shlomo A

2016-01-01

To determine the proportion of solid organ transplant recipients developing periocular nonmelanoma skin cancer and to describe the morbidity of these cancers in transplant recipients. Cohort study. Consecutive patients undergoing solid organ transplantation at the Cleveland Clinic between 1990 and 2008. The charts of all patients receiving a solid organ transplant from 1990-2008 evaluated in the dermatology department for a subsequent biopsy-proven head and neck malignancy through April 2015 were reviewed. Patients with a periocular region nonmelanoma skin cancer (NMSC) or a nonperiocular NMSC causing a complication requiring eyelid surgery were included. Charts were reviewed for demographic data; transplant date, type, and source; immunosuppressive agents received at diagnosis; and type of NMSC, number of nonperiocular NMSCs, ophthalmologic findings, and periocular sequelae after the repair. Primary outcome measures included the type, location, final defect size, tumor-node-metastasis classification, presence of perineural invasion, and reconstruction technique(s) used for each periocular NMSC. Secondary outcome measures included the type and treatment of ocular sequelae due to nonperiocular facial NMSC. A total of 3489 patients underwent solid organ transplantation between 1990 and 2008. Of these, 420 patients were evaluated in the dermatology clinic for biopsy-proven NMSC of the head and neck during the study period, and 11 patients (15 malignancies) met inclusion criteria. Nine patients developed 12 periocular malignancies and 3 patients required eyelid surgery for facial malignancies outside the periocular zone. All 11 patients developed a squamous cell carcinoma (14 malignancies), and 1 patient (1 malignancy) also developed a periocular basal cell carcinoma. There was orbital invasion in 4 cases and paranasal and/or cavernous sinus invasion in 3 cases. Two patients underwent exenteration. Seven cases required reconstruction with a free flap or graft. Periocular sequelae included lower eyelid ectropion (6 malignancies), dry eye and/or exposure symptoms (8 malignancies), unilateral vision loss (3 malignancies), and facial nerve paresis (5 malignancies). Squamous cell carcinoma affecting the periocular region represents a risk of solid organ transplantation and may produce significant ocular morbidity, including the need for major eyelid reconstruction, globe loss, and disfiguring surgery. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

[The Status, Change and Health Issues of Inpatients' Sixth Vital Sign in a Medical Center].

PubMed

Lin, Li-Ying; Huang, Ya-Hui; Hung, Chung-Lung; Chen, Ya-Mei; Kuo, Ching-Ju; Ku, Yan-Chiou

2017-04-01

Hospitalized patients generally have elevated levels of emotional distress. Gaining a better under-standing of the problem of emotional distress among hospitalized patients is conducive to providing appropriate emotional care and promoting their recovery. To analyze the scores for the "sixth vital sign" (i.e., emotional distress), diversification, and the health-related problems of hospitalized patients at a medical center in Taiwan. The results may offer an important reference for providing effective emotional care to hospitalized patients. A retrospective descriptive research design was used. Data were collected from all of the 27,885 inpatients that were registered at the target hospital in 2013. Further, a total of 245,814 attendance records were assessed to extract the data that were relevant to emotional distress. The findings revealed that 58.3% of hospitalized patients had earned a sixth vital sign score ≥ 1 and that 0.8% of these patients had earned a score ≥ 4. On the whole, the sixth vital sign scores of hospitalized patients were found to decrease progressively with the number of hospitalization days except for hematology and oncology, neurosurgery, and plastic surgery patients. The highest emotional distress scores were found among family medicine, dermatology, and plastic surgery patients. Moreover, emotional distress scores were significantly higher in patients who had health problems that involved pain, anxiety, or sleep disorder. The present study suggests that improving the emotional care of hematology, oncology, neurosurgery, family medicine, dermatology, and plastic surgery patients and of patients with health problems involving pain, anxiety, or sleep disorder may significantly improve the quality of inpatient holistic healthcare. Only 0.8% of the subjects in the present study had an emotional distress score ≥ 4, which is significantly lower than the level reported in other similar studies. Our findings suggest that related education and training for nursing staffs may improve their assessment and care practices in caring for patients with emotional distress. Furthermore, using more appropriate words, methods, and environments to evaluate the emotional distress of patients holds the potential to improve assessment and care for these patients.

Outpatient dermatology consultation impacts the diagnosis and management of pediatric oncology patients: A retrospective study.

PubMed

Song, Hannah; Robinson, Sarah N; Huang, Jennifer T

2017-11-01

The impact of dermatology consultation on the care of children with oncologic conditions is unknown. To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients. Retrospective review of pediatric oncology patients with outpatient dermatology visits at a tertiary care center from 2008 to 2015. The most common dermatologic diagnoses in 516 patients were skin infections (21.3%) and nonmalignant skin eruptions (33.4%). A diagnosis of significant impact (ie, malignancy, adverse cutaneous drug reaction, graft-versus-host disease, varicella-zoster virus, or herpes simplex virus infection), was made at the dermatology clinic in 14.7% of visits. Consultation resulted in a change in diagnosis in 59.8% of patients, change in dermatologic management in 72.4% of patients, and change in management of noncutaneous issues in 12.4% of patients. The use of electronic medical records, the nongeneralizable study population, and the retrospective design represent potential limitations. Outpatient dermatology consultation can affect the care of pediatric oncology patients with respect to diagnosis and treatment of skin conditions and management of nondermatologic issues. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Incidence of skin diseases diagnosed in a public institution: comparison between 2003 and 2014.

PubMed

Miguel, Livia Maria Zanardi; Jorge, Marilia Formentini Scotton; Rocha, Bruna; Miot, Hélio Amante

2017-01-01

Epidemiology of diseases is influenced by population socio-demographic circumstances. Therefore it can be modified along the time. There are no studies exploring epidemiological transition in dermatology. This study investigated the incidence of dermatoses in new patients from a Brazilian country town public service in 2003 and 2014. There was a significant increase in the incidence of sexually transmitted diseases, leprosy, melasma, pruritus and hidradenitis suppurativa. However, a prominent reduction in scheduling of appointments for surgeries of benign lesions, drug reactions, urticaria and superficial mycoses was detected. The identification of epidemiological trends guides the dimensioning of health system and professional qualification policies.

Integrated clinical workstations for image and text data capture, display, and teleconsultation.

PubMed

Dayhoff, R; Kuzmak, P M; Kirin, G

1994-01-01

The Department of Veterans Affairs (VA) DHCP Imaging System digitally records clinically significant diagnostic images selected by medical specialists in a variety of hospital departments, including radiology, cardiology, gastroenterology, pathology, dermatology, hematology, surgery, podiatry, dental clinic, and emergency room. These images, which include true color and gray scale images, scanned documents, and electrocardiogram waveforms, are stored on network file servers and displayed on workstations located throughout a medical center. All images are managed by the VA's hospital information system (HIS), allowing integrated displays of text and image data from all medical specialties. Two VA medical centers currently have DHCP Imaging Systems installed, and other installations are underway.

Instruction in teaching and teaching opportunities for residents in US dermatology programs: Results of a national survey.

PubMed

Burgin, Susan; Homayounfar, Gelareh; Newman, Lori R; Sullivan, Amy

2017-04-01

Dermatology residents routinely teach junior co-residents and medical students. Despite the importance of teaching skills for a successful academic career, no formal teaching instruction programs for dermatology residents have been described to our knowledge, and the extent of teaching opportunities for dermatology residents is unknown. We sought to describe the range of teaching opportunities and instruction available to dermatology residents and to assess the need for additional teaching training from the perspective of dermatology residency program directors nationwide. A questionnaire was administered to 113 US dermatology residency program directors or their designees. Descriptive statistics were used to analyze questionnaire item responses. The response rate was 55% (62/113). All program directors reported that their residents teach; 59% (33/56) reported offering trainees teaching instruction; 11% (7/62) of programs offered a short-term series of formal sessions on teaching; and 7% (4/62) offered ongoing, longitudinal training. Most program directors (74%, 40/54) believed that their residents would benefit from more teaching instruction. Response rate and responder bias are potential limitations. Dermatology residents teach in a broad range of settings, over half receive some teaching instruction, and most dermatology residency program directors perceive a need for additional training for residents as teachers. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

What Influences Medical Students to Apply or Not to Apply for Dermatology Residency Programs?

ERIC Educational Resources Information Center

Matheny, Pamela M.

2016-01-01

Medical students apply for dermatology residency program acceptance and, after completing training, become eligible to take the American Board of Dermatology examination. Some recent dermatologist practice trends concern dermatology leaders in academia. Changing the workforce trends may begin with changing the workforce. Academic dermatology…

Dermatologic Practice: Implications for a Primary Care Residency Curriculum.

ERIC Educational Resources Information Center

Branch, William T., Jr.; And Others

1983-01-01

The problems encountered, diagnostic procedures performed, and treatments prescribed in dermatology were studied in a primary care practice and in a dermatology clinic. It is proposed that the findings of this study be the basis for designing a curriculum in dermatology for residents in primary care medicine. (Author/MLW)

Refining the Eye: Dermatology and Visual Literacy

ERIC Educational Resources Information Center

Zimmermann, Corinne; Huang, Jennifer T.; Buzney, Elizabeth A.

2016-01-01

In 2014 the Museum of Fine Arts Boston and Harvard Medical School began a partnership focused on building visual literacy skills for dermatology residents in the Harvard Combined Dermatology Residency Program. "Refining the Eye: Art and Dermatology", a four session workshop, took place in the museum's galleries and utilized the Visual…

The use of quality benchmarking in assessing web resources for the dermatology virtual branch library of the National electronic Library for Health (NeLH).

PubMed

Kamel Boulos, M N; Roudsari, A V; Gordon, C; Muir Gray, J A

2001-01-01

In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health. They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health. It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for Health service. Furthermore, by promoting the application of agreed quality guidelines and codes of ethics by all health information providers and not just within the National electronic Library for Health, the overall quality of the Web will improve with time and the Web will ultimately become a reliable and integral part of the care space.

The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace.

PubMed

Hines, J; Wilkinson, S M; John, S M; Diepgen, T L; English, J; Rustemeyer, T; Wassilew, S; Kezic, S; Maibach, H I

2017-01-01

Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness. © 2016 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology

PubMed Central

Gianfaldoni, Serena; Gianfaldoni, Roberto; Wollina, Uwe; Lotti, Jacopo; Tchernev, Georgi; Lotti, Torello

2017-01-01

For more than a century, radiotherapy has been an effective treatment for oncologic patients. The Authors report a brief history of the radiation therapy and its actual indication for the treatments of cutaneous malignant diseases. PMID:28785349

Advancement of women in dermatology.

PubMed

Murrell, Dedee F; Ryan, Terence J; Bergfeld, Wilma F

2011-05-01

This article reviews the special role that women dermatologists have played in the improvement of skin care for women and children, as well as the role of the Women's Dermatological Society (WDS) in providing networking, mentoring and leadership opportunities for female dermatologists. Women leaders within the International League of Dermatology Societies (ILDS) have influenced WHO directives to assign higher priorities to areas of women's health. Maria Duran and her legacy at the International Society for Dermatology (ISD) has recognized leaders in the area of dermatology education and mentorship. Volunteerism and the promotion of equal access to health care by women and children are other key activities by women dermatologists. © 2011 The International Society of Dermatology.

Near infrared low level laser therapy and cell proliferation: the emerging role of redox sensitive signal transduction pathways.

PubMed

Migliario, Mario; Sabbatini, Maurizio; Mortellaro, Carmen; Renò, Filippo

2018-05-02

Lasers devices are widely used in various medical fields (e.g. surgery, dermatology, dentistry, rehabilitative medicine, etc) for different applications, ranging from surgical ablation of tissues to biostimulation and pain relief. Laser is an electromagnetic radiation which effects on biological tissues strongly depends on a number of physical parameters. Laser wavelength, energy output, irradiation time and modality, temperature and tissue penetration properties have to be set up according to the clinical target tissue and the desired effect. A less than optimal operational settings, in fact, could result in a null or even lethal effect. According to the first law of photobiology, light absorption requires the presence of a specific photoacceptor that after excitation could induce the activation of downstream signaling pathways. Low level lasers operating in the red/near infrared portion of the light spectra are generally used for biostimulation purposes, a particular therapeutic application based on the radiant energy ability to induce non-thermal responses in living cells. Biostimulation process generally promotes cell survival and proliferation. Emerging evidences support a low level laser stimulation mediated increase in "good" ROS (reactive oxygen species), able to activate redox sensitive signal transduction pathways such as Nrf-2, NF-kB, ERK which act as key redox checkpoints. This article is protected by copyright. All rights reserved.

Bioterrorism: Preparing the Plastic Surgeon

PubMed Central

Chopra, Karan; Conde-Green, Alexandra; Folstein, Matthew K.; Knepp, Erin K.; Christy, Michael R.; Singh, Devinder P.

2011-01-01

Introduction: Many medical disciplines, such as emergency medicine, trauma surgery, dermatology, psychiatry, family practice, and dentistry have documented attempts at assessing the level of bioterrorism preparedness in their communities. Currently, there is neither such an assessment nor an existing review of potential bioterrorism agents as they relate to plastic surgery. Therefore, the purpose of this article is to present plastic surgeons with a review of potential bioterrorism agents. Methods: A review of the literature on bioterrorism agents and online resources of the Centers for Disease Control and Prevention was conducted. Category A agents were identified and specific attention was paid to the management issues that plastic surgeons might face in the event that these agents are used in an attack. Results: Disease entities reviewed were smallpox, anthrax, plague, viral hemorrhagic fever, tularemia, and botulism. For each agent, we presented the microbiology, pathophysiology, clinical presentation, potential for weaponization, medical management, and surgical issues related to the plastic surgeon. Conclusion: This article is the first attempt at addressing preparedness for bioterrorism in the plastic surgery community. Many other fields have already started a similar process. This article represents a first step in developing evidence-based consensus guidelines and recommendations for the management of biological terrorism for plastic surgeons. PMID:22132252

ASDS Guidelines Task Force: Consensus Recommendations Regarding the Safety of Lasers, Dermabrasion, Chemical Peels, Energy Devices, and Skin Surgery During and After Isotretinoin Use.

PubMed

Waldman, Abigail; Bolotin, Diana; Arndt, Kenneth A; Dover, Jeffrey S; Geronemus, Roy G; Chapas, Anne; Iyengar, Sanjana; Kilmer, Suzanne L; Krakowski, Andrew C; Lawrence, Naomi; Prather, Heidi B; Rohrer, Thomas E; Schlosser, Bethanee J; Kim, John Y S; Shumaker, Peter R; Spring, Leah K; Alam, Murad

2017-10-01

Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this standard because of concerns regarding reports of sporadic adverse events and increased risk of scarring. To develop expert consensus regarding the safety of skin procedures, including resurfacing, energy device treatments, and incisional and excisional procedures, in the setting of concurrent or recent isotretinoin use. The American Society for Dermatologic Surgery authorized a task force of content experts to review the evidence and provide guidance. First, data were extracted from the literature. This was followed by a clinical question review, a consensus Delphi process, and validation of the results by peer review. The task force concluded that there is insufficient evidence to justify delaying treatment with superficial chemical peels and nonablative lasers, including hair removal lasers and lights, vascular lasers, and nonablative fractional devices for patients currently or recently exposed to isotretinoin. Superficial and focal dermabrasion may also be safe when performed by a well-trained clinician.

A Survey Comparing Delegation of Cosmetic Procedures Between Dermatologists and Nondermatologists.

PubMed

Austin, Molly B; Srivastava, Divya; Bernstein, Ira H; Dover, Jeffrey S

2015-07-01

How delegation of procedures varies among cosmetic specialties in the United States is not well described. To better describe current practices in delegation of procedures to nonphysicians among physicians of different cosmetic specialties in the United States. An Internet-based survey was administered to physician members of the American Society for Dermatologic Surgery (ASDS), the American Society for Aesthetic Plastic Surgery (ASAPS), and the American Society for Laser Medicine and Surgery (ASLMS). A total of 823 responses were collected. Two hundred ninety-one of the 521 dermatologists (55.9%) reported delegating cosmetic procedures compared with 223 of the 302 nondermatologists (73.8%) (p < .05). When delegation occurred, dermatologists were more likely than nondermatologists to delegate the following procedures to higher level non-physician providers (NPP): chemical peels, neuromodulator and filler injections, laser hair removal, pulsed dye laser, tattoo removal, intense pulsed light, nonablative fractional laser, and sclerotherapy. No difference in delegation rate was noted between dermatologists and non-dermatologist physicians with respect to microdermabrasion, ablative fractional laser, cryolipolysis, radiofrequency skin tightening, focused ultrasound skin tightening, and focused ultrasound fat reduction. Dermatologists delegate procedures to NPP less frequently than non-dermatologist physicians, and when they do, it is typically to higher level NPP.

Career trajectory and job satisfaction trends in Mohs micrographic surgeons.

PubMed

Tierney, Emily P; Hanke, C William; Kimball, Alexa Boer

2011-09-01

Although many residents and fellows in Mohs surgery express an interest in academics, departure from academics occurs for many trainees or junior faculty. We designed a survey, issued to all American College of Mohs Surgeons (ACMS) members in 2009, to assess reasons for practice selection. A response rate of 65.0% (n=455) was obtained. Of all ACMS members, 33.9% started in academic positions, and 66.1% started in private practice. Retention rates in private practice (61.2%) were significantly higher than in academics (28.0%) (p<.001). The rationale for selection of an academic career included referral base and teaching and research opportunities. Reasons for selection of a private practice career were higher salary, autonomy over resources, and geographic flexibility. There were high rates of departure from academics early on; reasons for departure included lack of support from the academic chair and lack of autonomy over resources. Surgeons leaving academia were able to perform Mohs surgery and continue interests in research and teaching with benefits of greater autonomy over resources in private practice. Novel efforts to retain academic Mohs surgeons are needed to ensure continued success and evolution of the specialty. © 2011 by the American Society for Dermatologic Surgery, Inc.

Relevance of psychiatry in dermatology: Present concepts

PubMed Central

Basavaraj, K. H.; Navya, M. A; Rashmi, R.

2010-01-01

Skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli. Dermatological practice involves a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. Psychodermatology addresses the interaction between mind and skin. It is divided into three categories according to the relationship between skin diseases and mental disorders. This article reviews different dermatological conditions under each of the three categories namely psychosomatic disorders, dermatological conditions due to primary and secondary psychiatric disorders. Dermatological conditions resulting from psychiatric conditions like stress/depression and those caused by psychiatric disorders are discussed. This review intends to present the relationship between the ‘skin’ and the ‘mind’ specifically from the dermatology point of view. The effects on the quality of life as a result of psychodermatological conditions are highlighted. A multidisciplinary approach for treatment from both dermatologic and psychiatric viewpoints are suggested. PMID:21180416

Relevance of psychiatry in dermatology: Present concepts.

PubMed

Basavaraj, K H; Navya, M A; Rashmi, R

2010-07-01

Skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli. Dermatological practice involves a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. Psychodermatology addresses the interaction between mind and skin. It is divided into three categories according to the relationship between skin diseases and mental disorders. This article reviews different dermatological conditions under each of the three categories namely psychosomatic disorders, dermatological conditions due to primary and secondary psychiatric disorders. Dermatological conditions resulting from psychiatric conditions like stress/depression and those caused by psychiatric disorders are discussed. This review intends to present the relationship between the 'skin' and the 'mind' specifically from the dermatology point of view. The effects on the quality of life as a result of psychodermatological conditions are highlighted. A multidisciplinary approach for treatment from both dermatologic and psychiatric viewpoints are suggested.

Nonhuman primate dermatology: a literature review

PubMed Central

Bernstein, Joseph A.; Didier, Peter J.

2015-01-01

In general, veterinary dermatologists do not have extensive clinical experience of nonhuman primate (NHP) dermatoses. The bulk of the published literature does not provide an organized evidence-based approach to the NHP dermatologic case. The veterinary dermatologist is left to extract information from both human and veterinary dermatology, an approach that can be problematic as it forces the clinician to make diagnostic and therapeutic decisions based on two very disparate bodies of literature. A more cohesive approach to NHP dermatology – without relying on assumptions that NHP pathology most commonly behaves similarly to other veterinary and human disease – is required. This review of the dermatology of NHP species includes discussions of primary dermatoses, as well as diseases where dermatologic signs represent a significant secondary component, provides a first step towards encouraging the veterinary community to study and report the dermatologic diseases of nonhuman primates. PMID:19490576

Dermatology training and practice in Australia.

PubMed

Sebaratnam, Deshan F; Murrell, Dédée F

2014-10-01

Dermatology is a relatively young discipline in Australia compared to other specialities within the medical fraternity. From its humble beginnings, the profession has evolved significantly over the decades and is now represented by the Australasian College of Dermatologists which is charged with training the next generation of dermatologists and advocating for and advancing the profession. The authors reviewed and describe the history of dermatology training and practice in Australia. Despite the progress in education, there are only 415 dermatologists serving a population of 23.3 million (1 per 58 000) and yet it has the highest incidence and prevalence of skin cancer in the world. The scope of clinical practice is wide in Australia, with clinicians well versed in medical and procedural dermatology. It is hoped that Australian dermatology will continue to bolster the dermatology profession globally. © 2014 The International Society of Dermatology.

The Use of a Fresh-Tissue Cadaver Model for the Instruction of Dermatological Procedures: A Laboratory Study for Training Medical Students.

PubMed

Cervantes, Jose A; Costello, Collin M; Maarouf, Melody; McCrary, Hilary C; Zeitouni, Nathalie C

2017-09-01

A realistic model for the instruction of basic dermatologic procedural skills was developed, while simultaneously increasing medical student exposure to the field of dermatology. The primary purpose of the authors' study was to evaluate the utilization of a fresh-tissue cadaver model (FTCM) as a method for the instruction of common dermatologic procedures. The authors' secondary aim was to assess students' perceived clinical skills and overall perception of the field of dermatology after the lab. Nineteen first- and second-year medical students were pre- and post-tested on their ability to perform punch and excisional biopsies on a fresh-tissue cadaver. Students were then surveyed on their experience. Assessment of the cognitive knowledge gain and technical skills revealed a statistically significant improvement in all categories (p < .001). An analysis of the survey demonstrated that 78.9% were more interested in selecting dermatology as a career and 63.2% of participants were more likely to refer their future patients to a Mohs surgeon. An FTCM is a viable method for the instruction and training of dermatologic procedures. In addition, the authors conclude that an FTCM provides realistic instruction for common dermatologic procedures and enhances medical students' early exposure and interest in the field of dermatology.

Dermatologic Features of Classic Movie Villains: The Face of Evil.

PubMed

Croley, Julie Amthor; Reese, Vail; Wagner, Richard F

2017-06-01

Dichotomous dermatologic depictions of heroes and villains in movies have been used since the silent film age. To evaluate the hero-villain skin dichotomy in film by (1) identifying dermatologic findings of the all-time top 10 American film villains, (2) comparing these dermatologic findings to the all-time top 10 American film heroes quantitatively and qualitatively, and (3) analyzing dermatologic portrayals of film villains in depth. In this cross-sectional study, dermatologic findings for film heroes and villains in mainstream media were identified and compared quantitatively using a χ2 test with α < .05, as well as qualitatively. The all-time top 10 American film villains and heroes were obtained from the American Film Institute 100 Greatest Heroes and Villains List. Primary outcomes include identification and frequencies of dermatologic findings of the top 10 film villains and of the top 10 film heroes. Six (60%) of the all-time top 10 American film villains have dermatologic findings, including cosmetically significant alopecia (30%), periorbital hyperpigmentation (30%), deep rhytides on the face (20%), multiple facial scars (20%), verruca vulgaris on the face (20%), and rhinophyma (10%). The top 10 villains have a higher incidence of significant dermatologic findings than the top 10 heroes (60% vs 0%; P = .03). Dermatologic findings of the all-time top 10 American villains are used in film to highlight the dichotomy of good and evil, which may foster a tendency toward prejudice in our society directed at those with skin disease.

The State of Ethnic Dermatology in Canada.

PubMed

Ogunyemi, Boluwaji; Miller-Monthrope, Yvette

Approximately 30% of Canadians will be members of a visible minority by 2031. When dermatology became an independent medical discipline in the late 18th and early 19th centuries, most residents of Canada and the United States were of Northern European descent. Morphology and descriptions of dermatoses are based on patients with light skin. Skin of colour dermatology refers to a unique field in dermatology dedicated to the diagnosis and management of disorders that are more prevalent in patients with moderately to richly pigmented skin. Important differences in the presentation of common dermatoses such as seborrheic dermatitis and acne exist in patients with darker skin types. The effect of traditional treatments for common and uncommon dermatoses is also an important consideration in managing patients with skin of colour. Such treatments may result in adverse effects such as postinflammatory hyperpigmentation or keloid scarring at a higher rate. Most respondents from a 2013 UK study of dermatology residents and consultants agreed that individuals with 'ethnic skin' had specific and unique dermatological problems. The Royal College of Physician and Surgeons of Canada's Objectives of Training in Dermatology states that residents must demonstrate the requisite knowledge, skills, and attitudes for effective patient-centred care and service to a diverse population. Future steps include creating a national society of dermatologists interested in clinical and academic aspects of ethnic dermatology. As well, presentations on skin of colour dermatology could be encouraged at major Canadian dermatology meetings.

Ten-year publication trends in dermatology in mainland China.

PubMed

Xin, Shujun; Mauro, Jacqueline A; Mauro, Theodora M; Elias, Peter M; Man, Mao-Qiang

2014-10-01

China has been experiencing huge changes in all aspects, including dermatologic research, since its reform in 1978. However, it is not known how the economic and intellectual development has influenced the publication trends in the field of dermatology, which could mirror the scientific development in other medical disciplines. In the present study, we analyzed publication trends from dermatology departments in mainland China from 2002 to 2011. All publication data were obtained from www.pubmed.com. Only papers published from dermatology departments in mainland China were used for analysis. The number of publications increased 10-fold over this 10-year period. A total of 1231 articles were published in English in 251 journals between 2002 and 2011. A total of 129 journals published only one paper from dermatology departments in mainland China. Over 60% of articles were original research, and 21.7% were case reports. Among these 251 journals, foremost was the Journal of Clinical Experimental Dermatology, which published 5.9% of all papers from mainland China; 2.7% of papers were published in the Journal of Investigative Dermatology. The number of publications positively correlated with the changes in gross domestic product per capita during the study period. These results suggest that the number of publications in the dermatology field has increased markedly in mainland China over the last 10 years. This dramatic increase in publications could be attributed, at least partially, to the significant improvement in economic conditions in mainland China. © 2013 The International Society of Dermatology.

Inpatient dermatology: profile of patients and characteristics of admissions to a tertiary dermatology inpatient unit in São Paulo, Brazil.

PubMed

de Paula Samorano-Lima, Luciana; Quitério, Ligia M; Sanches, José A; Neto, Cyro Festa

2014-06-01

Dermatology is primarily an outpatient clinical and surgical specialty, but substantial numbers of patients are admitted to hospital for inpatient treatment in dermatology wards. We performed a retrospective study of patients admitted to dermatology beds between September 1, 2002, and September 30, 2010. Patient data were analyzed for age, gender, ethnicity, length of stay (LoS), dermatologic disease, comorbidities, hospital-acquired infection (HAI), transfer to the intensive care unit (ICU), and mortality. A total of 3308 patients admitted during this 8-year period were identified for analysis. The most frequent admissions were for eczema/dermatitis (17.5%) and cutaneous infections (15.9%). The mean LoS was 13.0 days. The mean ± standard deviation (SD) number of comorbidities per patient was 1.0 ± 1.2, among the most frequent of which were hypertension and diabetes mellitus. The rate of HAI was 6.2%; bloodstream infection was regarded as the most commonly acquired type and Staphylococcus aureus as the infectious agent most commonly found in culture. Of the patients admitted, 3.7% were transferred to the ICU and 2.5% died. In these latter two groups, the most common dermatologic diagnoses were immunobullous diseases, and the mean hospital LoS and rate of HAI were higher than in the total admissions cohort. Higher value should be placed on dermatology inpatient services in order to expand the availability of dermatology beds, mainly in tertiary hospitals, in view of the potentially high severity of the dermatologic diseases found in many patients referred to this type of service. © 2013 The International Society of Dermatology.

Prevalence survey of dermatological conditions in mountainous north India.

PubMed

Grills, Nathan; Grills, Claire; Spelman, Tim; Stoove, Mark; Hellard, Margaret; El-Hayek, Carol; Singh, Rajesh

2012-05-01

Dermatological conditions account for a substantial proportion of the global burden of disease in low and middle income countries (Bickers D, Lim H, Margolis D, et al. The burden of skin diseases: 2004. A joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol 2006; 55: 490-500) and place major pressures on primary healthcare centers (Satimia F, McBride S, Leppard B. Prevalence of skin disease in rural Tanzania and factors influencing the choice of health care, modern or traditional. Arch Dermatol 1998; 134: 1363-1366). In mountainous North India, where limited resources are available for skin care, no dermatological data exists on prevalence, treatment patterns, or associations. The study aimed to measure prevalence and treatment of dermatological conditions and associated factors in Uttarakhand so to inform delivery of dermatological care and prevention programs in India. Single stage cluster randomized sampling generated seven cluster units or villages. Household members (n = 1275) from each cluster were interviewed, and where possible, examined and offered treatment. Dermatological conditions were prevalent (45.3%), with 33% being of infectious etiology. Atopic dermatitis (9.2%), scabies (4.4%), tinea corporis (4.1%), and pityriasis alba (3.6%) were most prevalent. Multivariate analysis showed that cohabitation with animals (OR = 1.62, 95% CI-1.35, 1.95) was a predictor of any skin diseases. A health practitioner was not consulted in 64.7% of dermatological conditions, and where consulted, approximately 69% received inappropriate or ineffective treatments. Excessive spending on dermatological care was commonplace. Limitations associated with cross-sectional cluster methodology included the underrepresentation of seasonal conditions and conditions of short duration. Caste proved difficult to randomize across clusters given villages were often composed according to caste. These results demonstrate a high prevalence of dermatological conditions and a pattern of conditions somewhat distinctive to this mountainous area of North India. These findings will assist development of appropriate and cost-effective dermatological services in these mountainous regions. © 2012 The International Society of Dermatology.

Protection afforded by controlled application of a barrier cream: a study in a workplace setting.

PubMed

Sadhra, S S; Kurmi, O P; Mohammed, N I; Foulds, I S

2014-10-01

Skin protective creams (PCs) are used widely in industrial work environments to prevent irritant contact dermatitis. However, workplace studies remain equivocal in terms of their effectiveness, which may be partly owing to whether the PC remains on the skin. To assess the practicability of using skin occlusion testing in a workplace as a method to determine whether PCs applied under controlled conditions can reduce skin damage against known irritants. This study also compares two methods of skin evaluation: clinical dermatological assessment and bioengineering techniques. Daily occlusion testing for 1 h (over two consecutive weeks) was conducted in an engineering company on the volar forearm of 21 healthy volunteer engineers with sodium lauryl sulfate (SLS) and a PC that was used on site. The engineers conducted their normal work activities during the occlusion testing period. The skin areas tested were assessed using transepidermal water loss (TEWL), Chroma Meter and by visual dermatological scoring. Testing with PC and SLS together showed that PC does not prevent irritant contact dermatitis but significantly reduced skin damage compared with SLS alone (P < 0.01). The changes in skin were evident earlier with the biophysical measurements when compared with the dermatological assessment. Occlusion testing is a useful method for assessing the potential effectiveness of protective creams and can be used in a workplace without affecting work practices. TEWL and the Chroma Meter provide useful objective information and should be used in combination with dermatological examinations. © 2014 British Association of Dermatologists.

Mobile medical apps for patient education: a graded review of available dermatology apps.

PubMed

Masud, Aisha; Shafi, Shahram; Rao, Babar K

2018-02-01

The utilization of mobile applications (apps) as educational resources for patients highlights the need for an objective method of evaluating the quality of health care-related mobile apps. In this study, a quantified rubric was developed to objectively grade publicly available dermatology mobile apps with the primary focus of patient education. The rubric included 5 criteria thought to be most important in evaluating the adequacy of these apps in relaying health information to patients: educational objectives, content, accuracy, design, and conflict of interest. A 4-point scale was applied to each criterion. The use of this objective rubric could have implications in the evaluation and recommendation of mobile health care apps as a vital educational resource for patients.

Induced Pluripotent Stem Cells in Dermatology: Potentials, Advances, and Limitations

PubMed Central

Bilousova, Ganna; Roop, Dennis R.

2014-01-01

The discovery of methods for reprogramming adult somatic cells into induced pluripotent stem cells (iPSCs) has raised the possibility of producing truly personalized treatment options for numerous diseases. Similar to embryonic stem cells (ESCs), iPSCs can give rise to any cell type in the body and are amenable to genetic correction by homologous recombination. These ESC properties of iPSCs allow for the development of permanent corrective therapies for many currently incurable disorders, including inherited skin diseases, without using embryonic tissues or oocytes. Here, we review recent progress and limitations of iPSC research with a focus on clinical applications of iPSCs and using iPSCs to model human diseases for drug discovery in the field of dermatology. PMID:25368014

The convergence of medicine and neurotoxins: a focus on botulinum toxin type A and its application in aesthetic medicine--a global, evidence-based botulinum toxin consensus education initiative: part II: incorporating botulinum toxin into aesthetic clinical practice.

PubMed

Carruthers, Jean; Fournier, Nathalie; Kerscher, Martina; Ruiz-Avila, Javier; Trindade de Almeida, Ada R; Kaeuper, Gina

2013-03-01

The new world of safe aesthetic injectables has become increasingly popular with patients. Not only is there less risk than with surgery, but there is also significantly less downtime to interfere with patients' normal work and social schedules. Botulinum toxin (BoNT) type A (BoNTA) is an indispensable tool used in aesthetic medicine, and its broad appeal has made it a hallmark of modern culture. The key to using BoNTA to its best effect is to understand patient-specific factors that will determine the treatment plan and the physician's ability to personalize injection strategies. To present international expert viewpoints and consensus on some of the contemporary best practices in aesthetic BoNTA, so that beginner and advanced injectors may find pearls that provide practical benefits. Expert aesthetic physicians convened to discuss their approaches to treatment with BoNT. The discussions and consensus from this meeting were used to provide an up-to-date review of treatment strategies to improve patient results. Information is presented on patient management and assessment, documentation and consent, aesthetic scales, injection strategies, dilution, dosing, and adverse events. A range of product- and patient-specific factors influence the treatment plan. Truly optimized outcomes are possible only when the treating physician has the requisite knowledge, experience, and vision to use BoNTA as part of a unique solution for each patient's specific needs. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Photodynamic Therapy and Skin Appendage Disorders: A Review

PubMed Central

Megna, Matteo; Fabbrocini, Gabriella; Marasca, Claudio; Monfrecola, Giuseppe

2017-01-01

Photodynamic therapy (PDT) is a noninvasive treatment that utilizes light treatment along with application of a photosensitizing agent. In dermatology, PDT is commonly used and approved for the treatment of oncological conditions such as actinic keratosis, Bowen disease and superficial basal cell carcinoma. In the last 2 decades however, PDT has also been used for the treatment of several nonneoplastic dermatological diseases. The present review summarizes published data on PDT application in skin appendage disorders. Our literature review shows that: (a) PDT may be a suitable treatment for acne, folliculitis decalvans, hidradenitis suppurativa, nail diseases, and sebaceous hyperplasia; (b) there is a lack of agreement on PDT features (type, concentrations and incubation period of used substances, number and frequency of PDT sessions, optimal parameters of light sources, and patient characteristics [e.g., failure to previous treatments, disease severity, body surface area involved, etc.] which should guide PDT use in these diseases); (c) further research is needed to establish international guidelines helping dermatologists to choose PDT for the right patient at the right time. PMID:28232927

Research Techniques Made Simple: Single-Cell RNA Sequencing and its Applications in Dermatology.

PubMed

Wu, Xiaojun; Yang, Bin; Udo-Inyang, Imo; Ji, Suyun; Ozog, David; Zhou, Li; Mi, Qing-Sheng

2018-05-01

RNA sequencing is one of the most highly reliable and reproducible methods of assessing the cell transcriptome. As high-throughput RNA sequencing libraries at the single cell level have recently developed, single cell RNA sequencing has become more feasible and popular in biology research. Single cell RNA sequencing allows investigators to evaluate cell transcriptional profiles at the single cell level. It has become a very useful tool to perform investigations that could not be addressed by other methodologies, such as the assessment of cell-to-cell variation, the identification of rare populations, and the determination of heterogeneity within a cell population. So far, the single cell RNA sequencing technique has been widely applied to embryonic development, immune cell development, and human disease progress and treatment. Here, we describe the history of single cell technology development and its potential application in the field of dermatology. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Medical ultrasound: imaging of soft tissue strain and elasticity

PubMed Central

Wells, Peter N. T.; Liang, Hai-Dong

2011-01-01

After X-radiography, ultrasound is now the most common of all the medical imaging technologies. For millennia, manual palpation has been used to assist in diagnosis, but it is subjective and restricted to larger and more superficial structures. Following an introduction to the subject of elasticity, the elasticity of biological soft tissues is discussed and published data are presented. The basic physical principles of pulse-echo and Doppler ultrasonic techniques are explained. The history of ultrasonic imaging of soft tissue strain and elasticity is summarized, together with a brief critique of previously published reviews. The relevant techniques—low-frequency vibration, step, freehand and physiological displacement, and radiation force (displacement, impulse, shear wave and acoustic emission)—are described. Tissue-mimicking materials are indispensible for the assessment of these techniques and their characteristics are reported. Emerging clinical applications in breast disease, cardiology, dermatology, gastroenterology, gynaecology, minimally invasive surgery, musculoskeletal studies, radiotherapy, tissue engineering, urology and vascular disease are critically discussed. It is concluded that ultrasonic imaging of soft tissue strain and elasticity is now sufficiently well developed to have clinical utility. The potential for further research is examined and it is anticipated that the technology will become a powerful mainstream investigative tool. PMID:21680780

Evaluation of Cohen's cross-section trichometer for measuring hair quantity.

PubMed

Hendriks, Maria A E; Geerts, Paulus A F; Dercksen, Marcus W; van den Hurk, Corina J G; Breed, Wim P M

2012-04-01

Until now, there has been no reliable, simple method available for measuring hair quantity that is suitable in clinical practice. Recently, the cross-section trichometer by Cohen has been introduced. This study was designed to test its clinical utility. The hair mass index (HMI) is ratio of the cross-sectional area of an isolated bundle of hair and the premeasured area of skin from which it was taken using the trichometer device. The intra- and interobserver reproducibility of measurements at the same location and after relocation were evaluated. For intraobserver reproducibility, the HMI ranged from 3 to 120 (mean difference .2, 95% confidence interval [CI] = -4.7-5.1, correlation coefficient [r] = .99. For interobserver reproducibility, the HMI ranged from 18 to 119 (mean difference -.4, 95% CI = -8,0-7,2, r = .98). With relocation, the HMI ranged from 2 to 113 (mean difference -1.0, 95% CI = -10.1-8.1, r = .97). Measurements took 5-10 minutes per area. Measurements were simple to perform, and the data showed high reproducibility. The trichometer is a promising technology for hair quantity measurements and has multiple clinical and research applications. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

[How to optimize scarring in dermatologic surgery?

PubMed

Amici, J M; Chaussade, V

2016-12-01

Scarring is the response elicited by the skin surface to injury and loss of tissue material. Wound healing takes place through a complex natural repair system consisting of vascular, inflammatory and proliferative phenomena, followed by a remodelling and cell apoptosis phase. This incredible repair system is inevitable, but sometimes unpredictable due to individual differences based on multiple factors. The scar is the objective criterion of a skin surgery, both for the patient and the dermsurgeon. It is therefore crucial to establish with the patient during the preoperative consultation, the size and positioning of the expected scar, taking into account the oncologic, anatomic and surgical constraints. Scars can ideally blend into normal skin, but may also give rise to various abnormalities. We can manage and prevent these abnormalities by mastering initial inflammation, that may induce hyperpigmentation and hypertrophy. Early massage using cortocosteroid topic or anti-inflammatory moisturizers may be effective. Random individual scarring may be minimized by a dynamic personalized accompanying scarring. © 2016 Elsevier Masson SAS. Tous droits réservés.

Introduction: "The Napkin Area and its Dermatoses" symposium proceedings, World Congress of Pediatric Dermatology, September 2013.

PubMed

Torrelo, Antonio

2016-07-01

Dr Antonio Torrelo, President of the 12(th) World Congress of Pediatric Dermatology, introduces the supplement as providing an opportunity for readers to access the lectures and related presentations delivered at the World Congress of Pediatric Dermatology held September 25-27, 2013, in Madrid. © 2016 The International Society of Dermatology.

Eponymous signs in dermatology

PubMed Central

Madke, Bhushan; Nayak, Chitra

2012-01-01

Clinical signs reflect the sheer and close observatory quality of an astute physician. Many new dermatological signs both in clinical and diagnostic aspects of various dermatoses are being reported and no single book on dermatology literature gives a comprehensive list of these “signs” and postgraduate students in dermatology finds it difficult to have access to the description, as most of these resident doctor do not have access to the said journal articles. “Signs” commonly found in dermatologic literature with a brief discussion and explanation is reviewed in this paper. PMID:23189246

Increasing medical student exposure to clinical dermatology through participation in volunteer clinics.

PubMed

Beroukhim, Kourosh; Nguyen, Catherine; Danesh, Melissa; Lee, Kristina; Liao, Wilson

2015-10-16

Over the previous decade, several innovative teaching methods have been introduced to overcome the decreasing allotment of time dedicated to dermatology in U.S. medical school curricula. We report our experience of increasing medical student exposure to clinical dermatology thorough involvement in an extracurricular, volunteer-driven dermatology clinic. The clinic was well received by students and faculty. Our experience demonstrates that volunteer-driven dermatology clinics may be an effective method of teaching and engendering a culture of community outreach among medical students and faculty.

Trends in types of dermatology books available over the last ten years.

PubMed

Aquino, Lisa L; Wu, Jashin J

2009-06-15

Shifts in interest toward cosmetic and surgical dermatology and away from medical and academic dermatology have been observed in recent years. We hypothesized that this trend would be evident in the types of books available for purchase from a major medical textbook supplier. Books published from 1998-2008 were categorized by type and statistical testing was performed to determine if this trend has been reflected in books published. The percentage of medical dermatology books decreased over time, whereas the percentage of cosmetic and surgical dermatology books increased over time.

Continuing Dermatology Education for Rural Physician Assistants in Ghana: An Assessment of Needs and Effectiveness.

PubMed

Truong, Amanda; Cobb, Nadia M; Hawkes, Jason E; Adjase, Emmanuel T; Goldgar, David E; Powell, Douglas L; Lewis, Bethany K H

2018-03-01

To assess the effectiveness of lectures for continuing medical education (CME) in dermatology in a global health setting and to determine provider and patient demographics of physician assistants (PAs) practicing in rural Ghana. Physician assistants from Ghana who attended dermatology lectures at the International Seminar for Physician Assistants in 2011 or 2014 were included in this study. Surveys were administered to participants to determine dermatology resource availability, commonly encountered skin diseases, and management practices. Quizzes were administered before and after CME dermatology lectures to assess short-term retention of lecture material. In all, 353 PAs participated in this study. Physician assistants reported seeing an average of 55 patients per day. The most commonly seen skin diseases were infections, with antifungals and antibiotics being the most commonly prescribed medications. Dermatology-related complaints represented 9.5% of total clinic visits. Among practicing PAs, 23.2% reported having internet access. A total of 332 PAs completed the quizzes, and a statistically significant increase in test scores was noted in postlecture quizzes. This study reinforces the importance of dermatology education for PAs practicing in rural areas of Ghana and lends insight to critical topics for dermatology curriculum development. In addition, the increase in test scores after CME sessions suggests that lectures are an effective tool for short-term retention of dermatology-related topics. Our study indicates that as the need for health workers increases globally and a paradigm shift away from the traditional physician model of care occurs, dermatology training of PAs is not only important but also achievable.

Esthetic dermatology and emotional well-being according to gender.

PubMed

Martínez-González, Maria Covadonga; Martínez-González, Raquel-Amaya; Guerra-Tapia, Aurora

2018-06-01

There has been an increase in the demand for esthetic dermatology treatments within the general population. The purpose of this study was to analyze, within the scope of general population, the relationship between people's perception of esthetic dermatology treatments and emotional well-being, as well as for differences in gender. The Aesthetic Dermatology and Emotional Well-Being (DEBIE) Scale, [Journal of Cosmetic Dermatology vol. 13 (2014) 336-345] was applied to 770 Spanish people over 18 years old. The scale is structured according to six factors and classified into two dimensions: (1) Emotional Well-Being and (2) Perception of Aesthetic Dermatology. Cronbach alpha for the total scale was very high (0.90). Data analysis includes the following: (1) bivariate correlations with Pearson's coefficient; (2) gender differences through Student's t test, and (3) the effect size through R 2 and Cohen's d. A statistically significant relationship which is directly proportional has been identified between the degree of emotional well-being of people (self-esteem and assertiveness, optimism, and motivation) and the knowledge and attitude toward Aesthetic Dermatology. There are statistically significant differences according to gender: Women have a lower level of emotional well-being than men, as well as greater knowledge and more positive attitude toward Aesthetic Dermatology. People who are familiar with Aesthetic Dermatology and have a better attitude toward it, are also more self-confident, more optimistic and more motivated; with emotional strength. Regarding gender, it is expected that women may seek more consultation and esthetic dermatology treatments than men do. © 2017 Wiley Periodicals, Inc.

Dermatologic Features of Classic Movie Villains

PubMed Central

Reese, Vail; Wagner, Richard F.

2017-01-01

Importance Dichotomous dermatologic depictions of heroes and villains in movies have been used since the silent film age. Objective To evaluate the hero-villain skin dichotomy in film by (1) identifying dermatologic findings of the all-time top 10 American film villains, (2) comparing these dermatologic findings to the all-time top 10 American film heroes quantitatively and qualitatively, and (3) analyzing dermatologic portrayals of film villains in depth. Design, Setting, and Participants In this cross-sectional study, dermatologic findings for film heroes and villains in mainstream media were identified and compared quantitatively using a χ2 test with α < .05, as well as qualitatively. The all-time top 10 American film villains and heroes were obtained from the American Film Institute 100 Greatest Heroes and Villains List. Main Outcomes and Measures Primary outcomes include identification and frequencies of dermatologic findings of the top 10 film villains and of the top 10 film heroes. Results Six (60%) of the all-time top 10 American film villains have dermatologic findings, including cosmetically significant alopecia (30%), periorbital hyperpigmentation (30%), deep rhytides on the face (20%), multiple facial scars (20%), verruca vulgaris on the face (20%), and rhinophyma (10%). The top 10 villains have a higher incidence of significant dermatologic findings than the top 10 heroes (60% vs 0%; P = .03). Conclusions and Relevance Dermatologic findings of the all-time top 10 American villains are used in film to highlight the dichotomy of good and evil, which may foster a tendency toward prejudice in our society directed at those with skin disease. PMID:28384669

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

PubMed

Yadav, Geeta; Goldberg, Hanna R; Barense, Morgan D; Bell, Chaim M

2016-01-01

Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05). Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4-3.4), followed by Urgent care (9.0 weeks; IQR = 2.1-12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

The use of Mohs micrographic surgery (MMS) for melanoma in situ (MIS) of the trunk and proximal extremities.

PubMed

Stigall, Landon E; Brodland, David G; Zitelli, John A

2016-11-01

Evaluation of the entire surgical margin results in high rates of complete excision, low local recurrence rates, and maximal tissue conservation. Although well recognized for melanoma of the head and neck, few studies have focused exclusively on the trunk and proximal extremities. We sought to evaluate the efficacy of Mohs micrographic surgery for melanoma in situ (MIS) of the trunk and proximal extremities, and determine adequate excision margins for MIS when total margin evaluation is not used. Long-term outcomes in 882 cases of MIS treated with Mohs micrographic surgery were analyzed and compared with historical controls. Rates of complete excision were determined for increasing surgical margin intervals. One local recurrence occurred in our cohort (0.1%). Only 83% of MIS were excised with a 6-mm margin. Margins of 9 mm were needed to excise 97% of MIS, statistically equivalent to thin melanomas. We used a nonrandomized, single-institution, retrospective design. Mohs micrographic surgery may cure the 17% of MIS that exceed traditional excision margins of 5 mm and is a valuable option for these patients. Surgical margins of at least 0.9 cm should be considered for MIS of the trunk and extremities when total margin evaluation is not used. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The Cadaveric Skin Biopsy Project: description and student evaluation of an innovative approach to dermatology instruction in the preclerkship medical school curriculum.

PubMed

Baker, Mary Grace; Bradley, Elizabeth B; McCollum, Melanie A; Russell, Mark A

2014-08-01

Dermatology can develop creative ways of participating in the preclerkship medical school curriculum. We sought to describe and report student survey results of a novel collaborative learning activity for medical students, directed by dermatology, histology, and gross anatomy faculty, which used cadavers to replicate the process of skin lesion biopsy and provided a realistic setting in which to learn normal-appearing and abnormal skin histology. First-year medical students were surveyed regarding the impact of this activity on their understanding of skin histology and their appreciation of dermatology and dermatologic procedures. Students were appreciative of the opportunity to perform biopsies and discover the link between the clinical presentation of a lesion and its underlying histopathology. They were less impressed with the ability of the activity to improve their understanding of the characteristics of benign versus malignant lesions. This is an early feasibility trial at 1 institution. This project represents one approach to introducing students to dermatology and dermatologic procedures and achieves institutional, Liaison Committee on Medical Education, and Association of American Medical Colleges educational goals. Overall, students highly valued the opportunities to practice clinical procedures and found it aided their understanding and appreciation of dermatology. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

International educational opportunities for dermatology residents.

PubMed

Chacon, Anna H

2015-05-01

International resident opportunities in dermatology allow residents to become immersed in different systems of medical care and expose physicians to different dermatologic conditions, cultures, and traditions that are prevalent in each country. Due to the prevalence of some dermatologic conditions in only certain regions, international opportunities expose residents to a variety of skin pathology and disease as well as a rich and diverse experience abroad.

No Difference in Psychotropic Medication Use in Cosmetic and General Dermatology Patients.

PubMed

Hamilton, Heather K; Lilly, Evelyn; Arndt, Kenneth A; Dover, Jeffrey S

2016-07-01

Patients presenting for appearance-related concerns are often perceived as being more difficult (ie, more needy, more difficult to satisfy) than patients presenting for medical dermatologic problems. While the reasons for this perception are many, some hypothesize that this may be related to a higher rate of anxiety, depression, or body image issues among these patients.
To determine the prevalence of psychotropic medication use in cosmetic dermatology patients compared to the prevalence of such medication use in general dermatology patients.
METHODS & The study was a retrospective chart review of female patients, 18 or older, new to a private practice. Exclusion criteria included dermatologic disorders with known psychosocial comorbidity. Psychotropic medication use was recorded.
The percentage of subjects in the medical group (n=156) who reported using psychotropic medications was 22.2% compared to 26.8% in the cosmetic group (n=154; P=0.09).
The prevalence of psychotropic medication use among all dermatology patients in our practice was relatively high, but there was no statistically significant difference in the rate of psychotropic medication use in cosmetic dermatology patients compared to general dermatology patients.

J Drugs Dermatol. 2016;15(7):858-861.

Need and greed in dermatology: disease and outcome measures in dermatological healthcare planning.

PubMed

Dalgard, Florence; Finlay, Andrew Y

2006-01-01

Assessing dermatological needs in the population and our ability to meet them is a challenge. The choice of outcome measures is central in dermatological healthcare planning. The concept of ill health and its relationship to dermatological outcome measures is described. Outcome measures used should provide information on these issues in order to gain insight into genuine needs and illness behavior in the population and to ensure quality of healthcare. Nevertheless, the dilemma of assigning priorities in healthcare planning remains; outcome measures in dermatology should be perceived as appropriate by patients as well as by caregivers and policy makers. It is important to stimulate research to develop and refine person-focused outcome measures. Their use is essential to assess dermatological health needs and to understand illness behavior. The information they can provide can enable provision and evaluation of healthcare quality and contribute to the challenge of making appropriate priority decisions in healthcare. Copyright (c) 2006 S. Karger AG, Basel.

Optimizing education on the inpatient dermatology consultative service.

PubMed

Afifi, Ladan; Shinkai, Kanade

2017-03-01

A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models. In addition, consultative dermatology curricula should utilize a blended curriculum model comprised of patient care and active learning and self-study modalities. Specific educational methods will discuss 2 strategies: (1) direct patient-care activities (ie, bedside teaching rounds) and (2) nonpatient care activities (ie, case presentations, didactic sessions, online modules, and reading lists). ©2017 Frontline Medical Communications.

Local injection of botulinum toxin A: an alternative therapy for axillary osmidrosis.

PubMed

Xie, Aiguo; Nie, Lanjun; Tan, Qian

2014-02-01

The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6-20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n = 76). The patients were followed up for 1-3 months to analyze the therapeutic effect and complications of the two methods. The curative effect in patients with mild and moderate axillary osmidrosis was not significantly different between the botulinum toxin A injection group and operation group. However, for patients with severe axillary osmidrosis, surgery treatment seemed to be superior to botulinum toxin A treatment (P = 0.005). There was also no significant difference in the modified Dermatology Life Quality Index between the two treatments. Two cases showed complications related to hemorrhage and incision infection in the operation group. In conclusion, local injection of botulinum toxin A is a safe, fast and effective treatment for mild and moderate axillary osmidrosis, but the long-term effect remains to be further investigated. © 2014 Japanese Dermatological Association.

Trends in malpractice premiums for dermatologists: results of a national survey.

PubMed

Resneck, Jack S

2006-03-01

To analyze professional liability premiums in dermatology and factors associated with premium variation. This study examines data from a survey of dermatologists conducted in 2004. Survey respondents (n = 1095) reported mean medical liability premiums of $10,898 in 2004 (95% confidence interval, $10,295-$11,501). Premiums increased by 24.4% in 2003 and 16.7% in 2004. There was substantial variation by state, and mean premiums were higher in American Medical Association (AMA)-declared "crisis states" than in those states listed as "currently OK" ($11,669 vs $9527; P = .03). Premium growth from 2002 through 2004 was higher in AMA crisis states and in states without $250 000 caps in place for noneconomic damages. Even when excluding payment for cosmetic riders, premium levels were higher for dermatologists spending more than 10% of their time in cosmetic practice ($13,816 vs $10,185; P<.001) or more than 30% of their time in noncosmetic surgery ($12,551 vs $10,453; P = .01). While premiums paid by dermatologists for professional liability insurance in 2004 were well below those experienced by higher-risk specialties, geographic factors and state tort law variation seem to be affecting dermatology premiums in much the same way they affect the field of medicine as a whole.

Consumer Empowerment in Dermatology

PubMed Central

Hoch, Heather E.; Busse, Kristine L.; Dellavalle, Robert P.

2009-01-01

Summary Health care consumers increasingly confront and collaborate with their medical providers. We describe consumer success in other medical fields and in dermatology, especially dermatologic disease advocacy and improving dermatologist-patient interactions. PMID:19254661

Non-Optical Applications of Photonic Crystal Structures

DTIC Science & Technology

2005-02-23

antenna created by covering a metallic ground plane with a periodic band-gap structure. By incorporating varactor diodes into the structure, they have...defects can be created in alumina band-gap materials by use of laser machining. (a) 1ncalizcd A 1II Cavity Fig 10 - (a) Schematics of propagation of...The primary applications are in dentistry and dermatology . The scale length of Terahertz devices simplifies the problems of fabrication and

[Physical principles and general considerations].

PubMed

Alfageme Roldán, F; Mollet Sánchez, J; Cerezo López, E

2015-11-01

Cutaneous ultrasound is based on the application of the physical properties of ultrasound to the skin and cutaneous adnexae. Knowledge of ultrasound semiology, artifacts and the application of Doppler examination allows deeper study of the biology and diseases of the skin and its adnexae. Copyright © 2015 Academia Española de Dermatología y Venereología. Published by Elsevier España, S.L.U. All rights reserved.

The dermatology acting internship.

PubMed

Stephens, John B; Raimer, Sharon S; Wagner, Richard F

2011-07-15

Acting internships are an important component of modern day medical school curriculum. Several specialties outside of internal medicine now offer acting internship experiences to fourth year medical students. We have found that a dermatology acting internship is a valuable experience for fourth year medical students who are interested in pursuing a residency in dermatology. Our experience with the dermatology acting internship over the 2010-2011 academic year is described.

Physics of light and lasers.

PubMed

Absten, G T

1991-09-01

Because most laser procedures use the heating effect of the light and given the number of parameters that may be varied--such as power density, power, pulsing, and heating of fiber tips and probes--significant overlap in applications of the various lasers can result. This is readily apparent in the conflicting claims of laser manufacturers seen in promotional materials. Despite this, each type has its strengths. The CO2 laser is a specialty instrument, particularly for microscopic applications in neurosurgery, otolaryngology, and gynecology. Its hemostasis and vaporizing abilities allow its use in dermatology and in general surgery for tumor resection and hemostasis. In gynecology it seems best for colposcopy (cervical and vaginal) and, through a micromanipulator, for laparotomy. The beam is focused and delivered by handpieces and micromanipulators on microscopes. Through the laparoscope, it requires the use of a special laser coupler on a special laser laparoscope to allow for line-of-sight delivery of the beam through the operating channel. Waveguide delivery systems have been introduced for CO2 laser laparoscopy using standard laparoscopes. These function as hollow, slender tubes through which the beam is transmitted by means of hundreds of glancing internal reflections in the tube, which emits the beam at its tip. This eliminates many of the alignment problems of coupler cube-type systems and allows the beam to be delivered close to the target. The Nd:YAG laser is the primary endoscopic instrument in pulmonology, gastroenterology, and urology. The use of contact tips, though not a panacea, increases its applications, particularly in general surgery. Its primary use in gynecology is for endometrial ablation with bare fibers for deep coagulation. Its use for laparoscopy with contact probes or sculpted fibers is quickly growing. Green light lasers (argon and KTP) are color-selective photocoagulators and may be used to cut tissue. They are fiberoptically delivered like the Nd:YAG laser. Their best use in gynecology appears to be a versatile instruments for operative laparoscopy and the simple treatment of endometriosis. A standard quartz fiber with these lasers is usually more versatile than a contact tip with an Nd:YAG laser when used for cutting.

The reporting of observational research studies in dermatology journals: a literature-based study.

PubMed

Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

2010-05-01

To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care

PubMed Central

Yadav, Geeta; Goldberg, Hanna R.; Barense, Morgan D.; Bell, Chaim M.

2016-01-01

Background Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. Methods A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Results Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05). Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4–3.4), followed by Urgent care (9.0 weeks; IQR = 2.1–12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4–16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Interpretation Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care. PMID:27632206

Possibilities of Nd: YAG laser utilization in medicine

NASA Astrophysics Data System (ADS)

Frank, Frank

The thermic effect caused by the shrinkage and the drying of the tissues is used for cutting, denaturation, and coagulation of tissues with simultaneous filling of the blood and lymphatic vessels. The surgical Nd:YAG lasers, whose utilization is based on photothermic effects, have 120 W power and are used in neurosurgery, dermatology, gastroenterology, gynecology, urology, lung sickness, and jaw and vessel surgery. The treatment of tumors is particularly interesting because of the total destruction of the ill tissue, the homogeneity of the necrose and the obturation of the blood and lymphatic vessels. In all cases, the laser is a better solution for the patients and allows a shorter stay in hospital.

Frequency of ICD-10 factitious disorder: survey of senior hospital consultants and physicians in private practice.

PubMed

Fliege, Herbert; Grimm, Anne; Eckhardt-Henn, Annegret; Gieler, Uwe; Martin, Katharina; Klapp, Burghard F

2007-01-01

The authors surveyed physicians for frequency estimates of factitious disorder among their patients. Twenty-six physicians in independent practice and 83 senior hospital consultants in internal medicine, surgery, neurology, and dermatology participated. They completed a questionnaire including the estimated 1-year prevalence of factitious disorder among their patients. Frequency estimates averaged 1.3% (0.0001%-15%). The number of patients treated correlated negatively with frequency estimates. Dermatologists and neurologists gave the highest estimations. One-third of the physicians rated themselves as insufficiently informed. Frequency estimations did not differ by information level. The estimated frequency is substantial and comparable to earlier findings. Authors discuss clinical implications.

Integrated clinical workstations for image and text data capture, display, and teleconsultation.

PubMed Central

Dayhoff, R.; Kuzmak, P. M.; Kirin, G.

1994-01-01

The Department of Veterans Affairs (VA) DHCP Imaging System digitally records clinically significant diagnostic images selected by medical specialists in a variety of hospital departments, including radiology, cardiology, gastroenterology, pathology, dermatology, hematology, surgery, podiatry, dental clinic, and emergency room. These images, which include true color and gray scale images, scanned documents, and electrocardiogram waveforms, are stored on network file servers and displayed on workstations located throughout a medical center. All images are managed by the VA's hospital information system (HIS), allowing integrated displays of text and image data from all medical specialties. Two VA medical centers currently have DHCP Imaging Systems installed, and other installations are underway. PMID:7949899

Enhancing dermatology education: resident presentation opportunities.

PubMed

Park, Kelly K

2015-09-01

Dermatology residency is a time to maximize educational experiences, which include opportunities to attend academic meetings and present research and clinical cases. In this article, resident presentation opportunities at major academic dermatology meetings are reviewed.

10 Year Publication Trends in Dermatology in Mainland China

PubMed Central

Xin, Shujun; Mauro, Jacqueline A; Mauro, Theodora M; Elias, Peter M; Man, Mao-Qiang

2013-01-01

Background China has been experiencing huge changes in all aspects including dermatologic research since its reform in 1978. However, how the economic and intellectual development has influenced the publication trends in the field of dermatology, which could mirror the scientific development in other medical disciplines, is unknown. In the present study, we analyzed the publication trends from departments of dermatology in mainland China from 2002 to 2011. Materials and Methods All publication data were obtained from www.pubmed.com. Only papers published from dermatology departments of mainland China were used for analysis. Results The number of publications increased 10-fold over this 10 year period. A total 1,231 of articles were published in English in 251 journals between 2002 and 2011. A total of 129 journals published only one paper from dermatology departments of mainland China. Over 60% of articles were original research and 21.7% were case reports. Among these 251 journals, foremost was the Journal of Clinical Experimental Dermatology, which published 5.9% of all papers from mainland China. 2.7% papers were published in the Journal of Investigative Dermatology. The number of publications positively correlated with the changes in gross domestic product per capita during the study period. Conclusions These results suggest that the number of publications in the dermatology field has increased markedly in mainland China over the last 10 years. This dramatic increase in publications could be, at least partially, attributed to the significant improvement in economic conditions in mainland China. PMID:23968296

High frequencies of dermatological complications in children using insulin pumps or sensors.

PubMed

Berg, Anna Korsgaard; Olsen, Birthe Susanne; Thyssen, Jacob P; Zachariae, Claus; Simonsen, Anne Birgitte; Pilgaard, Kasper; Svensson, Jannet

2018-06-01

Dermatological complications in children and adolescents that are related to continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) have not been well-characterized. This study examined the prevalence and characteristics of different types of dermatological complications. Online questionnaires regarding dermatological complications related to CSII and/or CGM were returned from a total of 144 children and adolescents, aged 2 to 20 years. Both previous and current skin problems were reported along with their clinical characteristics. Descriptive statistics, χ 2 tests, and multivariate analyses were used to evaluate the data. Of 143 patients using CSII, 90% had previous and 63% reported current dermatological complications. Non-specific eczema was most frequently reported and was currently present in 25.7% of the patients. These results were independent of age and current CGM use. Among the 76 patients using CGM, 46% reported current dermatological complications. A history of atopy was associated with dermatological complications in individuals using CSII, but not CGM. The patients rated CGM-related dermal issues as significantly worse than those associated with CSII (P < .05). Dermatological complications can be a serious problem in treating pediatric and adolescent patients of all ages with CSII and/or CGM. Only a few clinical characteristics associated with these complications were identified in this study, highlighting the need for prospective studies that might lead to improvements in the prevention and treatment of dermatological problems. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

What are the learning outcomes of a short postgraduate training course in dermatology for primary care doctors?

PubMed Central

2011-01-01

Background There are increasing expectations on primary care doctors to shoulder a bigger share of care for patients with common dermatological problems in the community. This study examined the learning outcomes of a short postgraduate course in dermatology for primary care doctors. Methods A self-reported questionnaire developed by the research team was sent to the Course graduates. A retrospective design was adopted to compare their clinical practice characteristics before and after the Course. Differences in the ratings were analysed using the nonparametric Wilcoxon signed rank test to evaluate the effectiveness of the Course in various aspects. Results Sixty-nine graduates replied with a response rate of 42.9% (69/161). Most were confident of diagnosing (91.2%) and managing (88.4%) common dermatological problems after the Course, compared to 61.8% and 58.0% respectively before the Course. Most had also modified their approach and increased their attention to patients with dermatological problems. The number of patients with dermatological problems seen by the graduates per day showed significant increase after the Course, while the average percentage of referrals to dermatologists dropped from 31.9% to 23.5%. The proportion of graduates interested in following up patients with chronic dermatological problems increased from 60.3% to 77.9%. Conclusions Graduates of the Course reported improved confidence, attitudes and skills in treating common dermatological problems. They also reported to handle more patients with common dermatological problems in their practice and refer fewer patients. PMID:21575191

Representing and Inferring Visual Perceptual Skills in Dermatological Image Understanding

ERIC Educational Resources Information Center

Li, Rui

2013-01-01

Experts have a remarkable capability of locating, perceptually organizing, identifying, and categorizing objects in images specific to their domains of expertise. Eliciting and representing their visual strategies and some aspects of domain knowledge will benefit a wide range of studies and applications. For example, image understanding may be…

Standardized methods for photography in procedural dermatology using simple equipment.

PubMed

Hexsel, Doris; Hexsel, Camile L; Dal'Forno, Taciana; Schilling de Souza, Juliana; Silva, Aline F; Siega, Carolina

2017-04-01

Photography is an important tool in dermatology. Reproducing the settings of before photos after interventions allows more accurate evaluation of treatment outcomes. In this article, we describe standardized methods and tips to obtain photographs, both for clinical practice and research procedural dermatology, using common equipment. Standards for the studio, cameras, photographer, patients, and framing are presented in this article. © 2017 The International Society of Dermatology.

An updated assessment of social media usage by dermatology journals and organizations.

PubMed

Patel, Ravi R; Hill, Mary K; Smith, Mallory K; Seeker, Paige; Dellavalle, Robert P

2018-02-15

Despite the increasing prevalence of social media usage, the activity of dermatology journals and professional and patient-centered organizations on top social media platforms has not been investigated since 2012. We investigated a total of 124 dermatology journals, 242 professional organizations, and 78 patient-centered organizations to assess their presence and popularity on social media. Searches were conducted to identify journals and organizations on Facebook and Twitter. Similar searches were done for organizations on LinkedIn. The number of Facebook likes, Twitter followers, and LinkedIn followers of the dermatological entities were quantified. There were 22 (17.7%) dermatology journals active on Facebook and 21 (16.9%) on Twitter. Amongst the professional organizations, 114 (47.1%) were on Facebook, 69 (28.5%) on Twitter, and 50 (20.7%) on LinkedIn. In comparison, 68 (87.2%) patient-centered organizations were on Facebook, 56 (71.8%) on Twitter, and 56 (71.8%) on LinkedIn. Our results demonstrate that the popularity of dermatology journals and professional and patient-centered organizations on top social networking sites has grown markedly since 2012. Although the number of dermatology journals on social media has increased since 2012, their presence continues to trail behind professional and patient-centered dermatological organizations, suggesting underutilization of a valuable resource.

Dermatology on pinterest.

PubMed

Whitsitt, Jacob; Mattis, Daiva; Hernandez, Melia; Kollipara, Ramya; Dellavalle, Robert P

2015-01-15

Pinterest is a social media internet service utilized by individuals, organizations, and businesses to collect and share ideas related to projects or interests. The literature related to dermatology-related content on Pinterest is scarce. This study aims to investigate the presence of dermatology related content available on Pinterest. Investigators searched five terms related to dermatology in the "pins" and "boards" search categories of pinterest. The first 20 results were evaluated for content and assigned to a content group of "advocacy," "informative," or "home remedies." Boards were also categorized as being posted by an MD or professional society versus others. The top ten dermatology journals were also searched for under the boards category. Informative pins were the most common (49%) followed by advocacy (37%) and home remedies (14%). Informative boards were the most common (53%) followed by home remedies (31%) and advocacy (16%).We identified that only 24% of boards were created by either M.D.s or advocacy organizations. The top ten dermatology journals identified by prior studies had little presence, with only one board posted by JAMA Dermatology. Our study contributes to a growing body of data that dermatology organizations are relatively absent from new social media sites, and Pinterest represents a potential outlet for targeted intervention in high-risk groups for skin disease.

The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

PubMed

Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

2015-02-01

As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics.

PubMed

Dixon, Anthony J; Dixon, Mary P; Askew, Deborah A; Wilkinson, David

2006-06-01

The study aimed to identify wound sites/procedures where infection incidence was over 5%, such that these circumstances may warrant wound infection antibiotic prophylaxis. We undertook a 3-year prospective study of 5,091 lesions (predominantly nonmelanoma skin cancer) treated on 2,424 patients from July 2002 to June 2005. No patient was given prophylactic antibiotics, and no patient ceased warfarin or aspirin. Overall infection incidence was 1.47%. Individual procedures had the following infection incidence: curettage 0.73% (3/412); skin flap repairs 2.94% (47/1601); simple excision and closure 0.54% (16/2974); skin grafts 8.70% (6/69); and wedge excision 8.57% (3/35). Analysis of regions of the body demonstrated that surgery below the knee (n = 448) had an infection incidence of 6.92% (31/448) (p < .0001). Subanalysis demonstrated that all regions below the knee were at high infection risk. Elsewhere, groin excisional surgery had an infection incidence of 10% (1/10) (p = .027). No other body site demonstrated an infection incidence beyond 5% of statistical significance. Procedures on the face demonstrated an infection incidence of 0.81% (18/2,209). Diabetic patients, those on warfarin and/or aspirin, and smokers showed no difference in infection incidence. Based on a prediction of infection incidence over 5%, the following cutaneous oncologic procedures warrant consideration of oral antibiotic wound infection prophylaxis: all procedures below the knee, wedge excisions of lip and ear, all skin grafts, and lesions in the groin. Other than under these circumstances, surgery to the nose, ear, fingers, lips, skin flap surgery, and surgery on diabetics, smokers, and those on anticoagulants have previously been considered for wound infection prophylaxis but do not warrant such intervention based on our data. The authors have indicated no significant interest with commercial supporters.

Surface enhanced Raman spectroscopy in the presence of hydroquinone assisted by gold nanorods

NASA Astrophysics Data System (ADS)

Cabrera Alonso, R.; Guevara, Edgar; Ramírez Elías, Miguel G.; González, Francisco Javier

2017-08-01

Hydroquinone is an aromatic organic molecule found in skin lightening creams for dermatological melasma treatment. The absorbance of this substance at high concentrations can be the cause of skin diseases. Nowadays most of the methods used for medical diagnosis for dermatological diseases consist on invasive methods such as biopsies. In recent years non-invasive techniques based on the properties of light and the interaction with biological samples have come to a new way for medical diagnosis. By means of Raman spectroscopy is of great interest the detection of hydroquinone for future medical applications. Due to the low Raman signal that the biological samples present, it is necessary to make use of nanotechnology. Making biosensors (SERS substrates) that allow us to amplify the electromagnetic field for the biological Raman signals.

Cyanoacrylate Skin Surface Stripping and the 3S-Biokit Advent in Tropical Dermatology: A Look from Liège

PubMed Central

Piérard, Gérald E.; Piérard-Franchimont, Claudine; Paquet, Philippe; Hermanns-Lê, Trinh; Delvenne, Philippe

2014-01-01

In the dermatopathology field, some simple available laboratory tests require minimum equipment for establishing a diagnosis. Among them, the cyanoacrylate skin surface stripping (CSSS), formerly named skin surface biopsy or follicular biopsy, represents a convenient low cost procedure. It is a minimally invasive method collecting a continuous sheet of stratum corneum and horny follicular casts. In the vast majority of cases, it is painless and is unassociated with adverse events. CSSS can be performed in subjects of any age. The method has a number of applications in diagnostic dermatopathology and cosmetology, as well as in experimental dermatology settings. A series of derived analytic procedures include xerosis grading, comedometry, corneofungimetry, corneodynamics of stratum corneum renewal, corneomelametry, corneosurfametry, and corneoxenometry. PMID:25177726

The Use of Quality Benchmarking in Assessing Web Resources for the Dermatology Virtual Branch Library of the National electronic Library for Health (NeLH)

PubMed Central

Roudsari, AV; Gordon, C; Gray, JA Muir

2001-01-01

Background In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health . They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. Objectives This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health . It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. Methods Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. Results Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. Conclusions Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for Health service. Furthermore, by promoting the application of agreed quality guidelines and codes of ethics by all health information providers and not just within the National electronic Library for Health, the overall quality of the Web will improve with time and the Web will ultimately become a reliable and integral part of the care space. PMID:11720947

Diversity in the dermatology workforce.

PubMed

Hinojosa, Jorge A; Pandya, Amit G

2016-12-01

The United States is becoming increasingly diverse, and minorities are projected to represent the majority of our population in the near future. Unfortunately, health disparities still exist for these groups, and inequalities have also become evident in the field of dermatology. There is currently a lack of diversity within the dermatology workforce. Potential solutions to these health care disparities include increasing cultural competence for all physicians and improving diversity in the dermatology workforce. ©2016 Frontline Medical Communications.

Pediatric dermatology workforce shortage: perspectives from academia.

PubMed

Craiglow, Brittany G; Resneck, Jack S; Lucky, Anne W; Sidbury, Robert; Yan, Albert C; Resnick, Steven D; Antaya, Richard J

2008-12-01

The pediatric dermatology workforce has not been systematically evaluated since recent changes in board certification requirements. To quantify and characterize the workforce of academic pediatric dermatologists and examine issues related to training, hiring, and retention. Dermatology chairpersons and residency directors in the United States and Canada completed a 30-question survey. Eighty of 132 programs (61%) responded to the survey. More than two thirds of programs (56/80) employed a pediatric dermatologist, and 34 programs were recruiting a pediatric dermatologist. The number of residents that pursue careers in pediatric dermatology is significantly associated with the number of pediatric dermatologists on faculty at their institution. Self-reported data, which may have been reflected by recall bias, and 61% response rate. At a majority of academic centers, the current pool of pediatric dermatology faculty is neither adequate to meet academic nor clinical demands. Methods to increase exposure to pediatric dermatology among medical students and residents must be sought.

Complementary and alternative medicine use in dermatology in the United States.

PubMed

Landis, Erin T; Davis, Scott A; Feldman, Steven R; Taylor, Sarah

2014-05-01

Complementary and alternative medicine (CAM) has an increasing presence in dermatology. Complementary therapies have been studied in many skin diseases, including atopic dermatitis and psoriasis. This study sought to assess oral CAM use in dermatology relative to medicine as a whole in the United States, using the National Ambulatory Medical Care Survey. Variables studied include patient demographic characteristics, diagnoses, and CAM documented at the visits. A brief literature review of the top 5 CAM treatments unique to dermatology visits was performed. Most CAM users in both dermatology and medicine as a whole were female and white and were insured with private insurance or Medicare. Fish oil, glucosamine, glucosamine chondroitin, and omega-3 were the most common complementary supplements used in both samples. CAM use in dermatology appears to be part of a larger trend in medicine. Knowledge of common complementary therapies can help dermatologists navigate this expanding field.

Complementary and Alternative Medicine Use in Dermatology in the United States

PubMed Central

Landis, Erin T.; Davis, Scott A.; Taylor, Sarah

2014-01-01

Abstract Background: Complementary and alternative medicine (CAM) has an increasing presence in dermatology. Complementary therapies have been studied in many skin diseases, including atopic dermatitis and psoriasis. Objectives: This study sought to assess oral CAM use in dermatology relative to medicine as a whole in the United States, using the National Ambulatory Medical Care Survey. Design: Variables studied include patient demographic characteristics, diagnoses, and CAM documented at the visits. A brief literature review of the top 5 CAM treatments unique to dermatology visits was performed. Results: Most CAM users in both dermatology and medicine as a whole were female and white and were insured with private insurance or Medicare. Fish oil, glucosamine, glucosamine chondroitin, and omega-3 were the most common complementary supplements used in both samples. Conclusions: CAM use in dermatology appears to be part of a larger trend in medicine. Knowledge of common complementary therapies can help dermatologists navigate this expanding field. PMID:24517329

An innovative approach to enhance dermatology competencies for advanced practice nurses: service–learning with a migrant farm worker health clinic.

PubMed

Downes, Elizabeth A; Connor, Ann; Howett, Maeve

2014-12-01

The purpose of this article is to describe a novel service–learning opportunity for graduate nursing students that promotes competency in dermatology. A hybrid service–learning course with online didactic content is described, along with tools for evaluation of dermatology competencies. Student evaluation of the course is discussed, and selected research articles are reviewed. Advanced practice nursing and medical education frequently does not adequately prepare primary care providers to be competent in the assessment and management of dermatologic conditions. Embedding dermatology content in a service–learning program can optimize the provision of care, strengthen competencies in dermatology and inter-professional care, and allow students to gain a deeper understanding of the population with which they work. The innovative service–learning program presented is a model for advanced practice nursing education. Tools for evaluating clinical competency and courses often need validation. Copyright 2014, SLACK Incorporated.

A practical approach to the assessment of psychosocial and psychiatric comorbidity in the dermatology patient.

PubMed

Gupta, Madhulika A; Gupta, Aditya K

2013-01-01

It is well recognized that the clinical course of many dermatologic disorders is the result of a complex and sometimes reciprocal interaction between biological, psychiatric/psychological, and social factors that can have a predisposing, precipitating, and/or perpetuating role for the dermatologic disorder. Assessment of psychiatric and psychosocial comorbidity, which can be present in up to 30% of dermatology patients, is an important component of the overall clinical evaluation of the patient. This paper discusses a practical approach to the assessment of psychosocial and psychiatric factors, including suicide risk and parasuicidal behaviors in the dermatology patient. The approach further classifies these factors as predisposing, precipitating, and/or perpetuating, in order to aid the clinician with the possible secondary and tertiary prevention of some dermatologic disorders by management of their psychosocial and psychiatric comorbidity. Copyright © 2013 Elsevier Inc. All rights reserved.

The suitability of gray-scale electronic readers for dermatology journals.

PubMed

Choi, Jae Eun; Kim, Dai Hyun; Seo, Soo Hong; Kye, Young Chul; Ahn, Hyo Hyun

2014-12-01

The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students. The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology. All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale. The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities. In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers.

The Suitability of Gray-Scale Electronic Readers for Dermatology Journals

PubMed Central

Choi, Jae Eun; Kim, Dai Hyun; Seo, Soo Hong; Kye, Young Chul

2014-01-01

Background The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students. Objective The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology. Methods All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale. Results The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities. Conclusion In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers. PMID:25473221

The frequency of body dysmorphic disorder in dermatology and cosmetic dermatology clinics: a study from Turkey.

PubMed

Dogruk Kacar, S; Ozuguz, P; Bagcioglu, E; Coskun, K S; Uzel Tas, H; Polat, S; Karaca, S

2014-06-01

Body dysmorphic disorder (BDD) is a distressing and impairing preoccupation with a slight or imagined defect in appearance. There are few reports on the prevalence of BDD in the Turkish population. To investigate the frequency of BDD in dermatology settings, and to compare the results from cosmetic dermatology with those from general dermatology settings. This cross-sectional study recruited 400 patients from cosmetic dermatology (CD) (n = 200) and general dermatology (GD) clinics (n = 200). A mini-survey was used to collect demographic and clinical characteristics, and the dermatology version of a brief self-report BDD screening questionnaire was administered. A five-point Likert scale was used for objective scoring of the stated concern, which was performed by dermatologists, and patients who scored ≥ 3 were excluded from the study. In total, 318 patients (151 in the CD group and 167 in the GD group) completed the study, and of these, 20 were diagnosed with BDD. The CD group had a higher rate of BDD (8.6%) than the GD group (4.2%) but this was not significant (P = 0.082). The major concern focused on body and weight (40.0%), followed by acne (25.0%). The number of cosmetic procedures in dermatology practices is increasing Therefore, it is becoming more important to recognize patients with BDD. Although the rates of BDD found in the present study are in agreement with the literature data, population-based differences still exist between this study and previous studies. © 2014 British Association of Dermatologists.

Evaluation of the educational climate for specialty trainees in dermatology.

PubMed

Goulding, J M R; Passi, V

2016-06-01

Dermatology specialty trainees (STs) in the United Kingdom (UK) are few in number and will join a thinly spread national consultant body. It is of paramount importance to deliver training programmes of the highest quality for these doctors, central to which is the establishment and maintenance of an educational climate conducive to learning. To conduct a pilot study to evaluate the educational climate for dermatology STs in one UK deanery (West Midlands). Secondary analysis of published data was performed, from the UK's General Medical Council (GMC) national training survey, and the Job Evaluation Survey Tool (JEST) administered by the West Midlands deanery. A modified online version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was circulated among dermatology STs. The GMC's survey data show that UK dermatology STs rated their training highly in comparison with undifferentiated UK postgraduate trainees. West Midlands dermatology STs (n = 22) scored very similarly to UK dermatology STs. The JEST gave broadly encouraging results, with 21/22 (95%) happy to recommend their posts to colleagues. The modified PHEEM yielded a global mean score of 96.5/152, attracting the descriptor 'more positive than negative but room for improvement'. Despite inherent methodological limitations, the GMC, JEST and modified PHEEM surveys have revealed useful comparative triangulated data which allows the conclusion that West Midlands dermatology STs seem to be training in a favourable educational climate. This represents an important facet of the quality assurance process for medical education, and allows insight into areas which may require improvement. © 2015 European Academy of Dermatology and Venereology.

Biomechanics in dermatology: Recent advances and future directions.

PubMed

Lewinson, Ryan T; Haber, Richard M

2017-02-01

Biomechanics is increasingly being recognized as an important research area in dermatology. To highlight only a few examples, biomechanics has contributed to the development of novel topical therapies for aesthetic and medical purposes, enhanced our understanding of the pathogenesis of plantar melanoma, and provided insight into the epidemiology of psoriatic disease. This article summarizes the findings from recent studies to demonstrate the important role that biomechanics may have in dermatologic disease and therapy and places these biomechanical findings in a clinical context for the practicing physician. In addition, areas for future biomechanics research and development in dermatology are discussed. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Scientific production of Brazilian dermatology: analysis of abstracts submitted at the Annual Meeting of the American Academy of Dermatology (2005 to 2013) and those eventually published*

PubMed Central

Holmo, Nicole França; Orasmo, Cinthia Rosane; Marques, Silvio Alencar

2016-01-01

In the last decade the presence of Brazilian physicians in International Meetings of Dermatology has been expressive. In parallel it has also been expressive the submission of poster abstracts in those Meetings. Considering the meetings from 2005 to 2013, 379 posters were presented in meetings of the American Academy of Dermatology. Brazilian universities were the origin of 59.9%. The Brazilian Society of Dermatology's recognized residency programs were the origin of 69.9% of the presented posters. Considering the period from 2005 to 2010 (n = 165 posters) the papers effectively published were 19 (11.5%). PMID:28099621

Factors affecting academic leadership in dermatology.

PubMed

Martires, Kathryn J; Aquino, Lisa L; Wu, Jashin J

2015-02-01

Although prior studies have examined methods by which to recruit and retain academic dermatologists, few have examined factors that are important for developing academic leaders in dermatology. This study sought to examine characteristics of dermatology residency programs that affect the odds of producing department or division chairs/chiefs and program directors (PDs). Data regarding program size, faculty, grants, alumni residency program attended, lectures, and publications for all accredited US dermatology residency programs were collected. Of the 103 programs examined, 46% had graduated at least 1 chair/chief, and 53% had graduated at least 1 PD. Results emphasize that faculty guidance and research may represent modifiable factors by which a dermatology residency program can increase its graduation of academic leaders.

Common skin problems in children.

PubMed

Sethuraman, Gomathy; Bhari, Neetu

2014-04-01

Childhood dermatological problems contribute about one-third of all consultations in the setting of both pediatrics and dermatology outpatient services. Skin disorders in children may cause anxiety to parents. General Practitioners should be familiar with the common prevalent skin problems as immediate pediatric dermatology consultation may not be possible. Infections, infestations and dermatitis are the most prevalent diseases among Indian children. The scope of this review is to briefly highlight these common and other important dermatological problems in children.

Identifying an Education Gap in Wound Care Training in United States Dermatology.

PubMed

Ruiz, Emily Stamell; Ingram, Amber; Landriscina, Angelo; Tian, Jiaying; Kirsner, Robert S; Friedman, Adam

2015-07-01

As restoration of the integument is paramount to wound healing, dermatologists should be central to managing wounds; yet this is often not the case. If a training gap exists during residency training, this may account for the observed discrepancy. To identify United States (US) dermatology residents' impressions regarding their preparedness to care for wounds, and to assess the amount and type of training devoted to wound care during residency. An online survey among current US dermatology residents enrolled in a residency training program. The primary goal was to determine whether dermatology residents believe more wound care education is needed, evaluate preparedness to care for wounds, and identify future plans to manage wounds. Responses were received from 175 of 517 (33.8%) US Dermatology residents contacted. The majority of residents did not feel prepared to manage acute (78.3%) and chronic (84.6%) wounds. Over three quarters (77.1%) felt that more education is needed. Fewer than half (49.1% and 35.4%) of residents planned to care for acute and chronic wounds, respectively, when in practice. There is a gap in wound care education in US dermatology residency training. This translates to a low percentage of dermatology residents planning to care for wounds in future practice. Dermatology residents need to receive focused wound care training in order to translate the underpinnings of wound healing biology and ultimately better serve patients.

Floaters in Mohs micrographic surgery.

PubMed

Alam, Murad; Shah, Anjali D; Ali, Sana; Rauf, Mutahir; Nodzenski, Michael; Ibrahim, Omer

2013-09-01

Floaters are dislodged pieces of tumor tissue than can obscure Mohs micrographic surgery (MMS) frozen sections and confound their interpretation. To understand the common causes of floaters and identify management strategies. An initial virtual consensus conference of Mohs surgeons based on a 60-item questionnaire. Data were validated in interviews with randomly selected Mohs surgeons. Based on retrospective reporting of 230 surgeon-years and 170,404 cases of MMS by 26 surgeons, the mean rate of floaters per tumor treated was 1.8%, and the rate of floaters per tissue block was 0.70%. Not wiping blades between cuts when a stage is separated into subunits can predispose to floaters. There was also strong consensus that basal cell carcinomas, ulcerated tumors, and tissue from the first stage were more likely to yield floaters. There is little consensus on how to manage floaters, with possibilities including taking additional sections, taking an additional stage, or simply noting the floater. Floaters are not rare and can complicate MMS margin assessment. There is significant expert consensus regarding the causes of floaters and the tissue features that may predispose to them. Floaters may be prevented by minimizing their likely causes. There is less consensus on what to do with a floater. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

[Basic Regularities and Characteristics of Compound Reinforcing--reducing Manipulation of Acu- puncture Revealed by Data Mining].

PubMed

Yang, Qing-qing; Jia, Chun-sheng; Wang, Jian-ling; Li, Jun-lei; Feng, Xin-xin; Tan, Zhan-na; Li, Bo-ying; Zhu, Xue-liang; Shi, Jing; Sun, Yan-hui; Li, Xiao-feng; Xu, Jing; Zhang, Xuan-ping; Zhang, Xin; Du, Yu-zhu; Bao, Na; Wang, Qiong

2016-04-01

To explore the regularities and features of compound reinforcing-reducing manipulation of acupuncture filiform needles in the treatment of clinical conditions or diseases by using data mining technique, so as to guide clinical practice. At first, the data base about the reinforcing-reducing manipulation (CRRM) of filiform needles for different clinical problems was established by collection, sorting, screening, recording, collation, data extraction of the related original papers published in journals and conferences and related academic dissertations from Jan. 1 of 1950 to Jan. 31 of 2015 by using key words of "acupuncture" "moxibustion" "needling" "filiform needle", and according to the included and excluded standards. A total of 130 835 papers met the included standards were collected. Outcomes of data mining in the present study showed that (1) the ORRM is most frequently applied in the internal medicine, followed by surgery, gynecology, ophthalmology and otorhinolaryngology, dermatology, and pediatrics, successively, mostly for lumbago and leg pain; (2) the heat-producing needling manipulation is the most frequently applied technique, followed by cool-producing needling, dragon-tiger warring, yang occluding in yin, yin occluding in yang techniques; (3) the highest effective rate of CRRM is for problems of the pediatrics, followed by those of the internal medicine, surgery, ophthalmology and otorhinolaryngology, dermatology, and gynecology; (4) the most fre- quently used acupoints are Zusanli (ST 36), then Sanyinjiao (SP 6), stimulated by heat-producing needling, and Zusanli (ST 36), then Quchi (LI 11), stimulated by cool-producing needling, and Huantiao (GB 30), stimulated by dragon-tiger warring needling. The compound reinforcing-reducing manipulation of acupuncture is most frequently applied to problems in the inter- nal medicine, predominately for lumbago and leg pain, and the best effectiveness is for pediatric conditions. The heat-producing needling and cool-producing needling are most frequently applied at Zusanli (ST 36) and the dragon-tiger warring manipulation is most frequently applied at Huantiao (GB 30).

Determination of optimal glycerol concentration for optical tissue clearing

NASA Astrophysics Data System (ADS)

Youn, Eungjun; Son, Taeyoon; Kim, Han-Sung; Jung, Byungjo

2012-02-01

The laser scattering in tissue is significant in diagnostic and therapeutic purposes of laser. Many studies have been conducted to minimize laser scattering in tissue and therefore, to maximize the clinical efficacy by enhancing photon density. Optical clearing agents (OCAs) have been employed for optical tissue clearing (OTC). This study was aimed to investigate the optimal concentration of an OCA, glycerol, in topical application,, so that it can be utilized for clinical diagnosis and therapy in dermatology. Glycerol was topically applied to avoid possible edema caused by dermal injection. The effect of OTC was quantitatively evaluated as a function of the concentration of glycerol with various methods. Optical methods such as optical coherence tomography (OCT) and an integrating sphere were used to assess the enhancement of light penetration depth and refractive index matching. In addition, a non-optical method, ultrasound scanner, was utilized to evaluate quantitatively collagen dissociation. The results revealed that 70 % glycerol was the optimal concentration of OTC for topical application. This study may provide a guideline regarding to the use of glycerol for optimal diagnostic and therapeutic effects in dermatology.

Comparative study of biological activity of four botulinum toxin type A preparations in mice.

PubMed

Chung, Myung Eun; Song, Dae Heon; Park, Joo Hyun

2013-01-01

Units of available botulinum toxin preparations are not interchangeable, and the dose-conversion ratios between such preparations remain controversial. To compare the efficacy and safety of four botulinum toxin type A preparations. Murine gastrocnemius compound muscle action potentials (CMAPs) were recorded before and after injecting the four botulinum toxin preparations (onabotulinumtoxinA, abobotulinumtoxinA, new botulinum toxin, and incobotulinumtoxinA). In all preparations, CMAP amplitudes decreased until 4 days after receiving the injection and then gradually recovered. On postinjection day 84, the amplitudes returned to baseline in all groups except the high-dose groups. CMAP amplitude in the contralateral limb also decreased up to postinjection days 4 to 7 and then gradually returned to baseline by postinjection day 28. The dose-conversion ratio between onabotulinumtoxinA and abobotulinumtoxinA was determined to be 1:2.6; previous reports of 1:3 were considered too high. A dose-conversion ratio between onabotulinumtoxinA and new botulinum toxin of 1:1 was deemed appropriate. OnabotulinumtoxinA and incobotulinumtoxinA demonstrated a dose-conversion ratio of 1:1.07. The efficacy of incobotulinumtoxinA was slightly lower than that of onabotulinumtoxinA. These dose-conversion ratios are applicable solely from an efficacy standpoint and not for safety. This study was conducted in mice, so it may not translate perfectly to human applications. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

United Nations and nongovernmental organizations. Healthy skin for all.

PubMed

Ryan, T J

1994-10-01

The International League of Dermatologic Societies, the International Foundation for Dermatology, and the International Society of Dermatology: Tropical, Ecological, and Geographic, are the leading nongovernmental dermatology organizations that communicate with United Nations agencies such as the World Health Organization and UNESCO. The common goal of health for all must include healthy skin for all, and it therefore must include concepts such as primary health care, disability, wound healing, and advancement of women as well as the control and elimination of specific diseases such as leprosy.

Task Shifting in Dermatology: A Call to Action.

PubMed

Brown, Danielle N; Langan, Sinéad M; Freeman, Esther E

2017-11-01

Can task shifting be used to improve the delivery of dermatologic care in resource-poor settings worldwide? Task shifting is a means of redistributing available resources, whereby highly trained individuals train an available workforce to provide necessary care in low-resource settings. Limited evidence exists for task shifting in dermatology; however, studies from psychiatry demonstrate its efficacy. In the field of dermatology there is a need for high-quality evidence including randomized clinical trials to validate the implementation of task shifting in low-resource settings globally.

[History of the German-Japanese Society of Dermatology].

PubMed

Nishioka, Kiyoshi

2017-03-01

The relationships between German and Japanese dermatology are traditionally very strong. This fact led Professor Hornstein and Professor Nishiyama to organize joint meetings of dermatologists from both countries. The first meeting of the German-Japanese Society of Dermatology was held in Erlangen, Germany, following the 16th World Congress of Dermatology in 1967. Since then, meetings have been held alternating between Germany and Japan. These meetings were successfully organized by professors from both countries. In this article, I present memorable photos from these joint meetings.

A discrete speech recognition system for dermatology: 8 years of daily experience in a medical dermatology office.

PubMed

Smith, Kevin C

2002-09-01

A discrete speech recognition system was customized to recognize approximately 9,000 phrases and terms commonly used in dermatology, and has been used on a daily basis since 1984 to produce as many as 65 consult and follow up letters daily. The systems and procedures necessary for the practical use of this system are described, together with a discussion of the advantages and disadvantages of using this system to automate the transcription of dermatological dictation.

Comparison of publication trends in dermatology among Japan, South Korea and Mainland China.

PubMed

Man, Huibin; Xin, Shujun; Bi, Weiping; Lv, Chengzhi; Mauro, Theodora M; Elias, Peter M; Man, Mao-Qiang

2014-01-09

We previously showed that the number of publications in dermatology is increasing year by year, and positively correlates with improved economic conditions in mainland China, a still developing Asian country. However, the characteristics of publications in dermatology departments in more developed Asian countries such as Japan and South Korea are unknown. In the present study, publications from 2003 through 2012 in dermatology in Japan, South Korea and mainland China were characterized. All data were obtained from http://www.pubmed.com. Dermatology departments in Japan published 4,094 papers, while mainland China and South Korea published 1528 and 1,758 articles, respectively. 48% of articles from dermatology in Japan were original research and 36% were case reports; The number of publications in Japan remained stable over time, but the overall impact factors per paper increased linearly over the last 10 year period (p < 0.05). In mainland China, 67% of articles from dermatology were original research, while 19% were case reports; The number of publications and their impact factors per paper increased markedly. In South Korea, 65% of articles from dermatology were original research and 20% were case reports. The impact factors per paper remained unchanged, despite of the fact that the number of publications increased over the last 10 year period (r2 = 0.6820, p = 0.0032). Only mainland China showed a positive correlation of the number of publications with gross domestic product per capita during this study period. These results suggest that the total number of publications in dermatology correlates with economic conditions only in developing country, but not in more developed countries in Asia. The extent of economic development could determine both the publication quantity and quality.

Comparison of publication trends in dermatology among Japan, South Korea and Mainland China

PubMed Central

2014-01-01

Background We previously showed that the number of publications in dermatology is increasing year by year, and positively correlates with improved economic conditions in mainland China, a still developing Asian country. However, the characteristics of publications in dermatology departments in more developed Asian countries such as Japan and South Korea are unknown. Methods In the present study, publications from 2003 through 2012 in dermatology in Japan, South Korea and mainland China were characterized. All data were obtained from http://www.pubmed.com. Results Dermatology departments in Japan published 4,094 papers, while mainland China and South Korea published 1528 and 1,758 articles, respectively. 48% of articles from dermatology in Japan were original research and 36% were case reports; The number of publications in Japan remained stable over time, but the overall impact factors per paper increased linearly over the last 10 year period (p < 0.05). In mainland China, 67% of articles from dermatology were original research, while 19% were case reports; The number of publications and their impact factors per paper increased markedly. In South Korea, 65% of articles from dermatology were original research and 20% were case reports. The impact factors per paper remained unchanged, despite of the fact that the number of publications increased over the last 10 year period (r2 = 0.6820, p = 0.0032). Only mainland China showed a positive correlation of the number of publications with gross domestic product per capita during this study period. Conclusions These results suggest that the total number of publications in dermatology correlates with economic conditions only in developing country, but not in more developed countries in Asia. The extent of economic development could determine both the publication quantity and quality. PMID:24405832

Clinic teaching made easy: a prospective study of the American Academy of Dermatology core curriculum in primary care learners.

PubMed

McCleskey, Patrick E

2013-08-01

Dermatology instruction for primary care learners is limited, and the American Academy of Dermatology (AAD) has developed a new core curriculum for dermatology. This study sought to prospectively evaluate short-term knowledge acquisition and long-term knowledge retention after using the AAD core curriculum during a clinical dermatology clerkship. Resident physicians and physician assistant students performing clerkships at military dermatology clinics were given access to the AAD core curriculum teaching modules before their public availability. Knowledge acquisition was measured with pretests and posttests, and a follow-up quiz was given up to a year after the dermatology rotation to assess knowledge retention. In all, 82 primary care learners met inclusion criteria. Knowledge improved significantly from pretest to posttest (60.1 vs 77.4, P < .01). Of the 10 factors evaluated, only high use of the World Wide Web site was significantly associated with improved posttest scores (70.8 vs 82.2, P = .003). Long-term follow-up scores available from 38 participants were only slightly lower than their posttest scores (70.5 vs 78.9, P < .01) at a median time of 6.8 months after the clerkship. Students found the online modules clear, engaging, and worth their time and preferred them to other teaching methods such as textbook reading and lectures. The nonrandomized study was voluntary, so individual performance may be influenced by selection bias. The more learners used the online curriculum, the better they scored on the posttest. This demonstrates the efficacy of the AAD core curriculum in teaching its goals and objectives for primary care learners performing a dermatology clerkship. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology.

PubMed

Adamič, M; Pavlović, M D; Troilius Rubin, A; Palmetun-Ekbäck, M; Boixeda, P

2015-09-01

Lasers and non-coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. Although laser and light sources are very popular due to their non-invasive nature, caution should be considered by practitioners and patients to avoid permanent side-effects. The aim of these guidelines is to give evidence-based recommendations for the use of lasers and IPLS in the treatment of vascular lesions. These guidelines were produced by a Consensus Panel made up of experts in the field of vascular laser surgery under the auspices of the European Society of Laser Dermatology. Recommendations on the use of vascular lasers and IPLS were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. Lasers and IPLS are very useful and sometimes the only available method to treat various vascular lesions. It is of a paramount importance that the type of laser or IPLS and their specific parameters are adapted to the indication but also that the treating physician is familiar with the device to be used. The crucial issue in treating vascular lesions is to recognize the immediate end-point after laser treatment. This is the single most important factor to ensure both the efficacy of the treatment and avoidance of serious side-effects. © 2015 European Academy of Dermatology and Venereology.

A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation

PubMed Central

Mosser, Joy; Lee, Grace; Pootrakul, Llana; Harfmann, Katya; Fabbro, Stephanie; Faith, Esteban Fernandez; Carr, David; Plotner, Alisha; Zirwas, Matthew; Kaffenberger, Benjamin H.

2016-01-01

Background: In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014–2015 resident application cycle. Objective: A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Methods: Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014–2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Results: Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (p<0.0001), has less exaggeration of applicants’ positive traits (p<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (p<0.0001) and provide more information about the writer’s background or writer-applicant relationship than narrative letters of recommendation (p<0.001). Limitations: This study was completed at a single institution. Conclusions: The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (J Clin Aesthet Dermatol. 2016;9(9):36–2.) PMID:27878060

75 FR 36101 - Dermatologic and Ophthalmic Drugs Advisory Committee; Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Dermatologic and Ophthalmic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Dermatologic and Ophthalmic Drugs Advisory Committee...

Probiotics in dermatologic practice.

PubMed

Fuchs-Tarlovsky, Vanessa; Marquez-Barba, María Fernanda; Sriram, Krishnan

2016-03-01

Probiotics are live microorganisms that beneficially affect the host when administered in adequate amounts. They have an excellent safety profile. Probiotics have been used as immunomodulators in inflammatory skin conditions, such as atopic dermatitis. The aim of this study was to summarize the available evidence concerning the use of different strains of probiotics in dermatology practice. We conducted a literature review of English and Spanish publications listed in standard databases (PubMed, Ovid, Google Scholar, Medline, and EBSCO), between 1994 and 2015 using the words "probiotics" and "dermatology." We found ∼70 studies containing these criteria and selected 42 in which probiotics were used for dermatologic purposes. We found enough evidence to recommend the use of probiotics in specific conditions in dermatology practice, especially in children with atopic dermatitis. Further well-designed, large population based trials are needed to validate the use of probiotics in dermatology practice, including innovative therapies to rebuild skin barrier defects, protection against microbial colonization, and restoration of immunologic balance. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of an Image Colorimeter for Noncontact Skin Color Measurement and Application to the Dermatological Treatment

NASA Astrophysics Data System (ADS)

Akimoto, Makio; Chen, Yu; Miyazaki, Michio; Yamashita, Toyonobu; Miyakawa, Michio; Hata, Mieko

The skin is unique as an organ that is highly accessible to direct visual inspection with light. Visual inspection of cutaneous morphology is the mainstay of clinical dermatology, but relies heavily on subjective assessment by the skilled dermatologists. We present an imaging colorimeter of non-contact skin color measuring system and some experimented results using such instrument. The system is comprised by a video camera, light source, a real-time image processing board, magneto optics disk and personal computer which controls the entire system. The CIE-L*a*b* uniform color space is used. This system is used for monitoring of some clinical diagnosis. The instrument is non-contact, easy to operate, and has a high precision unlike the conventional colorimeters. This instrument is useful for clinical diagnoses, monitoring and evaluating the effectiveness of treatment.

A generic, web-based clinical information system architecture using HL7 CDA: successful implementation in dermatological routine care.

PubMed

Schuler, Thilo; Boeker, Martin; Klar, Rüdiger; Müller, Marcel

2007-01-01

The requirements of highly specialized clinical domains are often underrepresented in hospital information systems (HIS). Common consequences are that documentation remains to be paper-based or external systems with insufficient HIS integration are used. This paper presents a solution to overcome this deficiency in the form of a generic framework based on the HL7 Clinical Document Architecture. The central architectural idea is the definition of customized forms using a schema-controlled XML language. These flexible form definitions drive the user interface, the data storage, and standardized data exchange. A successful proof-of-concept application in a dermatologic outpatient wound care department has been implemented, and is well accepted by the clinicians. Our work with HL7 CDA revealed the need for further practical research in the health information standards realm.

Garlic in dermatology

PubMed Central

Pazyar, Nader; Feily, Amir

2011-01-01

Garlic (Allium sativum L. fam. Alliaceae) is one of the best-researched, best-selling herbal remedies and is also commonly used for treating various health problems. Garlic is widely known for its biological properties and plays an important role as an antioxidant. The purpose of this review is to gather and summarize all dermatologic-oriented in vitro and in-vivo experiments and clinical trials on garlic preparations. Extensive literatures search was carried out and twenty three studies were included. The results suggest that oral administration of garlic is effective on immunologic properties, cutaneous microcirculation, protection against UVB and cancer treatment. Additionally, topical application of garlic extract can potentially be effective on psoriasis, alopecia areata, keloid scar, wound healing, cutaneous corn, viral and fungal infection, leishmaniasis, skin aging and rejuvenation. Clinical effectiveness of oral and topical garlic extract is not sufficiently and meticulously explored as so far. PMID:25386259

[THE ROLE OF PRESSURE ULCER SURROUNDING SKIN PREPARATION PRIOR TO THE APPLICATION OF WOUND DRESSING].

PubMed

Kulišić, S Marinović

2016-01-01

Pressure ulcer develops as a result of many factors, primarily pressure, tensile forces and ischemia with immobility and incontinence. Targeted and properly designed preventive measures reduce the incidence and complications of pressure ulcers, among which the most common are infections. An important preventive measure is protection of the surrounding skin before the application of wound dressings. Skin changes dictate the use of emollients and topical therapy according to dermatological status.

Photodynamic therapy for infections: clinical applications.

PubMed

Kharkwal, Gitika B; Sharma, Sulbha K; Huang, Ying-Ying; Dai, Tianhong; Hamblin, Michael R

2011-09-01

Photodynamic therapy (PDT) was discovered over 100 years ago by its ability to kill various microorganisms when the appropriate dye and light were combined in the presence of oxygen. However it is only in relatively recent times that PDT has been studied as a treatment for various types of localized infections. This resurgence of interest has been partly motivated by the alarming increase in drug resistance amongst bacteria and other pathogens. This review will focus on the clinical applications of antimicrobial PDT. The published peer-reviewed literature was reviewed between 1960 and 2011. The basics of antimicrobial PDT are discussed. Clinical applications of antimicrobial PDT to localized viral infections caused by herpes and papilloma viruses, and nonviral dermatological infections such as acne and other yeast, fungal and bacterial skin infections are covered. PDT has been used to treat bacterial infections in brain abscesses and non-healing ulcers. PDT for dental infections including periodontitis and endodontics has been well studied. PDT has also been used for cutaneous Leishmaniasis. Clinical trials of PDT and blue light alone therapy for gastric Helicobacter pylori infection are also covered. As yet clinical PDT for infections has been mainly in the field of dermatology using 5-aminolevulanic acid and in dentistry using phenothiazinium dyes. We expect more to see applications of PDT to more challenging infections using advanced antimicrobial photosensitizers targeted to microbial cells in the years to come. Copyright © 2011 Wiley-Liss, Inc.

A casemix study of patients seen by a dermatology trainee in rural and urban outpatient settings.

PubMed

Tilakaratne, Dev; Warren, Lachlan; Menz, Jennifer

2016-02-01

For 8 years South Australian dermatologists have provided an outreach service to the Northern Territory (NT), including rural and remote areas. In 2012 and 2013, a trainee accompanied a dermatologist on these outreach visits. This is the first prospective study that documents the spectrum of dermatological diseases requiring outpatient specialist input in various settings in the NT, and also the first study to compare the clinical experience of one Australian dermatology trainee in urban and rural settings. Characteristics of patients managed primarily by the outreach dermatology registrar were recorded prospectively from February 2013 to July 2013. The data from the trainee's urban encounters were compared to that of the rural centres. The spectrum of conditions seen in these two settings was placed in the disease categories specified in the Australasian College of Dermatologists (ACD) curriculum. The Royal Adelaide Hospital outpatient experience provided greater exposure to skin neoplasms, lymphoproliferative and myeloproliferative disorders and non-infectious neutrophilic/eosinophilic disorders. The outreach sites provided greater exposure to infections, adnexal diseases and genodermatoses. Both urban and rural experiences provided a broad exposure to the disease categories outlined in the ACD curriculum. The spectrum of disease requiring specialist dermatology input varies between urban South Australia and rural NT. The inclusion of dermatology trainees in outreach visits broadens their clinical exposure. It is recommended that other dermatology service providers in Australia consider documenting clinical casemix comparisons to assess dermatology demand, outcomes and trainee exposure. © 2014 The Australasian College of Dermatologists.

The wound/burn guidelines - 1: Wounds in general.

PubMed

Inoue, Yuji; Hasegawa, Minoru; Maekawa, Takeo; Le Pavoux, Andres; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Ito, Takaaki; Isei, Taiki; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kodera, Masanari; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kukino, Ryuichi; Kono, Takeshi; Sakai, Keisuke; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hashimoto, Akira; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Tachibana, Takao; Ihn, Hironobu

2016-04-01

The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders. © 2016 Japanese Dermatological Association.

[Application of portfolio in teaching dermatology clinic: an experience in teaching of medicine].

PubMed

de Cabalier, M E; Chalub, D M

2009-01-01

We present a learning experience conducted in the Chair of Dermatology Clinic of the Faculty of Medical Sciences, National University of Cordoba in the context of curriculum change. For comprehension,present a theoretical framework and practical from the conceptualization of the "portfolio" teaching and its role teaching and learning paradigms sustained constructivist medical education. The portfolio Teach-ing is not a collection of papers, but a coherent set of experiences led thoughtful learning between teachers and students. This resource allows to account for the "qualitative achievements" of students from their work produced, sorted and evaluated in a carefully planned sequence of experiences and case Dermatology Clinic. To introduce the teaching portfolio, the planned new student grouping shapes and a sequence of learning experiences for the construction of this resource, namely: "The development of theoretical material iconographic resources and working guidelines for students. "The clinical reasoning on a case or laboratory experience-Clinical case Discussion and bibliography. -The development of records to from observation of patients. "The study of clinical cases: diagnosis and evolution of clinical cases. Interconsultations-Registration and referrals. "The magazine room and sharing experiences. In each of these, production, tutorial feedback Team teaching and assessment tasks allowed assessment approach to learning and improving he achievements of the students to the approval of the subject.

Safety Assessment and Biological Effects of a New Cold Processed SilEmulsion for Dermatological Purpose

PubMed Central

Salgado, Ana; Gonçalves, Lídia; Pinto, Pedro C.; Urbano, Manuela; Ribeiro, Helena M.

2013-01-01

It is of crucial importance to evaluate the safety profile of the ingredients used in dermatological emulsions. A suitable equilibrium between safety and efficacy is a pivotal concern before the marketing of a dermatological product. The aim was to assess the safety and biological effects of a new cold processed silicone-based emulsion (SilEmulsion). The hazard, exposure, and dose-response assessment were used to characterize the risk for each ingredient. EpiSkin assay and human repeat insult patch tests were performed to compare the theoretical safety assessment to in vitro and in vivo data. The efficacy of the SilEmulsion was studied using biophysical measurements in human volunteers during 21 days. According to the safety assessment of the ingredients, 1,5-pentanediol was an ingredient of special concern since its margin of safety was below the threshold of 100 (36.53). EpiSkin assay showed that the tissue viability after the application of the SilEmulsion was 92 ± 6% and, thus considered nonirritant to the skin. The human studies confirmed that the SilEmulsion was not a skin irritant and did not induce any sensitization on the volunteers, being safe for human use. Moreover, biological effects demonstrated that the SilEmulsion increased both the skin hydration and skin surface lipids. PMID:24294598

Safety assessment and biological effects of a new cold processed SilEmulsion for dermatological purpose.

PubMed

Raposo, Sara; Salgado, Ana; Gonçalves, Lídia; Pinto, Pedro C; Urbano, Manuela; Ribeiro, Helena M

2013-01-01

It is of crucial importance to evaluate the safety profile of the ingredients used in dermatological emulsions. A suitable equilibrium between safety and efficacy is a pivotal concern before the marketing of a dermatological product. The aim was to assess the safety and biological effects of a new cold processed silicone-based emulsion (SilEmulsion). The hazard, exposure, and dose-response assessment were used to characterize the risk for each ingredient. EpiSkin assay and human repeat insult patch tests were performed to compare the theoretical safety assessment to in vitro and in vivo data. The efficacy of the SilEmulsion was studied using biophysical measurements in human volunteers during 21 days. According to the safety assessment of the ingredients, 1,5-pentanediol was an ingredient of special concern since its margin of safety was below the threshold of 100 (36.53). EpiSkin assay showed that the tissue viability after the application of the SilEmulsion was 92 ± 6% and, thus considered nonirritant to the skin. The human studies confirmed that the SilEmulsion was not a skin irritant and did not induce any sensitization on the volunteers, being safe for human use. Moreover, biological effects demonstrated that the SilEmulsion increased both the skin hydration and skin surface lipids.

Spotlighting the role of photodynamic therapy in cutaneous malignancy: an update and expansion.

PubMed

Ross, Kate; Cherpelis, Basil; Lien, Mary; Fenske, Neil

2013-12-01

Topical photodynamic therapy (PDT) is an option for the treatment of cutaneous malignancy. To present an update and expansion on a previous review of the use of PDT in the current literature in the treatment of actinic keratoses (AK), superficial and nodular basal cell carcinoma (sBCC, nBCC), squamous cell carcinoma (SCC), Bowen's disease, cutaneous T cell lymphoma (CTCL), malignant melanoma, and its use in chemoprevention. Extensive PubMed search January 2013. We find sufficient evidence to recommend the use of PDT in certain patients in the treatment of AK, Bowen's disease, sBCC, and nBCC. It is especially useful in those with contraindications to surgery, widespread areas of involvement, and large lesions. Not only can it be considered superior to other therapies as far as recovery time, tolerance, and cosmetic outcomes, but it also should be considered, when indicated, as first-line treatment in the above conditions. Investigations continue for the use of PDT in the treatment of melanoma, SCC, chemoprevention, and CTCL. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

A new evidence-based risk stratification system for cutaneous squamous cell carcinoma into low, intermediate, and high risk groups with implications for management.

PubMed

Baum, Christian L; Wright, Adam C; Martinez, Juan-Carlos; Arpey, Christopher J; Brewer, Jerry D; Roenigk, Randall K; Otley, Clark C

2018-01-01

Most primary cutaneous squamous cell carcinomas are cured with surgery. A subset, however, may develop local and nodal metastasis that may eventuate in disease-specific; death. This subset has been variably termed high risk. Herein, we review; an emerging body of data on the risks of these outcomes and propose an evidence-based; risk stratification for low-, intermediate-, and high-risk tumors that takes into; account both tumor and patient characteristics. Finally, we discuss a framework for; management of these tumors on the basis of data, when available, and our; recommendations when data are sparse. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

[The skin and the digestive tract].

PubMed

Orozco-Topete, Rocío

2006-01-01

Dermatology and Gastroenterology are medical subspecialties close related. There are diseases with same physiopathological mechanisms. When these diseases express it is possibly to see internal and external sings. In this review we analyzed different dermatological pathologies related to gastroenterology diseases. Knowing those dermatological clinical manifestations it is possible to make gastroenterological diseases diagnosis.

Phase II Study of a HER-2/neu (HER2) Intracellular Domain (ICD) Peptide-Based Vaccine Administered to Stage IIIB and IV HER2 Positive Breast Cancer Patients Receiving Trastuzumab Monotherapy

DTIC Science & Technology

2008-05-01

eczema 12006 Dermatology/Skin Dermatology/Skin - Other (Specify, __) 1 1 Abrasion, secondary dog claw 12006 Dermatology/Skin Dermatology/Skin...a MUGA scan be allowed as a means of monitoring cardiac function for the study. However, the one condition of this is that the results must be...gastrointestinal events such as severe diarrhea, (3) pulmonary events, (4) change in kidney function such as a change in creatinine or (5) cardiotoxicity

Imaging findings in systemic childhood diseases presenting with dermatologic manifestations.

PubMed

Fink, Adam Z; Gittler, Julia K; Nakrani, Radhika N; Alis, Jonathan; Blumfield, Einat; Levin, Terry L

Many childhood diseases often present with skin abnormalities with which radiologists are largely unfamiliar. Knowledge of associated dermatologic manifestations may aid the radiologist in confirming the diagnosis and recommending targeted imaging of affected organs. We review the imaging findings in childhood diseases associated with dermatologic manifestations. Diseases include dermatologic findings which herald underlying malignancy (Neuroblastoma, leukemia/lymphoma, Langerhans cell histiocytosis),are associated with risk of malignancy (Epidermolysis Bullosa, basal cell nevus syndrome, Cowden's syndrome, Tuberous Sclerosis),or indicate a systemic inflammatory/immune disorder (Kawasaki's disease, Henoch Schonlein Purpura, systemic lupus erythematosus, scleroderma, sarcoidosis, dermatomyositis and immune thrombocytopenic purpura). Familiarity with pertinent findings in childhood diseases presenting with dermatologic manifestations in childhood diseases aids the radiologist in confirming the diagnosis and guiding imaging workup. Copyright © 2017 Elsevier Inc. All rights reserved.

Characteristics of research tracks in dermatology residency programs: a national survey.

PubMed

Narala, Saisindhu; Loh, Tiffany; Shinkai, Kanade; Paravar, Taraneh

2017-12-15

Pursuing research is encouraged in dermatology residency programs. Some programs offer specific research or investigative tracks. Currently, there is little data on the structure or scope of research tracks in dermatology residency programs. An anonymous online survey was distributed to the Association of Professors of Dermatology listserve in 2016. Program directors of dermatology residency programs in the United States were asked to participate and 38 of the 95 program directors responded. The survey results confirmed that a 2+2 research track, which is two years of clinical training followed by two years of research, was the most common investigator trackmodel and may promote an academic career at the resident's home institution. Further studies will help determine the most effective research track models to promote long-term outcomes.

European trends in the frequency of original research in acne vulgaris, rosacea, dermatitis, psoriasis, skin cancer, and skin infections, 1970-2010.

PubMed

Choi, Young M; Garcha, Jaspreet K; Wu, Jashin J

2015-04-16

We analyzed trends in the frequency of original publications into common dermatologic topics in two premier European journals, the British Journal of Dermatology and the Journal of the European Academy of Dermatology and Venereology. Most notably, we found that psoriasis publications peaked around the mid-to-late 1980's as well as demonstrated an upward trend since the 21st century. Skin cancer research witnessed a gradual increase in the frequency of publications since 1970. These findings were consistent with a prior study analyzing trends in two American dermatology journals. We attempted to analyze these results from a historical perspective as well as provide an outlook on the future of research into these common dermatologic topics.

Dermatology hospitalists: a multicenter survey study characterizing the infrastructure of consultative dermatology in select American hospitals.

PubMed

Ko, Lauren N; Kroshinsky, Daniela

2018-05-01

Although considered an outpatient specialty, dermatology plays an important role in inpatient medicine. We characterized the activity and structure of dermatology consultation services in select U.S. hospitals. In this cross sectional study, a 31-question survey was distributed in person to 32 board-certified dermatologists at the 2017 Society of Dermatology Hospitalists meeting. Thirty participants completed the survey (yield 93.8%). Most dermatology hospitalists spend 41-52 weeks on service (50%), with 37% spending between 11 and 30 weeks. Coverage was organized by continuous weeks (68%) or months (21%). While on service, hospitalists staffed an average of 4 outpatient clinics per week. Consultative teams also included internal medicine residents (43%), medical students (47%), pediatric residents (10%), and fellows from other specialties (27%). Consultation services saw approximately 3.7 new inpatients and 4.2 follow-up inpatients per day, with daily rounds lasting approximately 2.6 hours. The results suggest that hospital dermatologists in the U.S. consider inpatient care their niche and devote a majority of their time staffing consults over clinic. The diverse composition of inpatient teams and the number of academic duties held by these physicians suggests they play an important role in medical education. © 2018 The International Society of Dermatology.

Transforming Dermatologic Imaging for the Digital Era: Metadata and Standards.

PubMed

Caffery, Liam J; Clunie, David; Curiel-Lewandrowski, Clara; Malvehy, Josep; Soyer, H Peter; Halpern, Allan C

2018-01-17

Imaging is increasingly being used in dermatology for documentation, diagnosis, and management of cutaneous disease. The lack of standards for dermatologic imaging is an impediment to clinical uptake. Standardization can occur in image acquisition, terminology, interoperability, and metadata. This paper presents the International Skin Imaging Collaboration position on standardization of metadata for dermatologic imaging. Metadata is essential to ensure that dermatologic images are properly managed and interpreted. There are two standards-based approaches to recording and storing metadata in dermatologic imaging. The first uses standard consumer image file formats, and the second is the file format and metadata model developed for the Digital Imaging and Communication in Medicine (DICOM) standard. DICOM would appear to provide an advantage over using consumer image file formats for metadata as it includes all the patient, study, and technical metadata necessary to use images clinically. Whereas, consumer image file formats only include technical metadata and need to be used in conjunction with another actor-for example, an electronic medical record-to supply the patient and study metadata. The use of DICOM may have some ancillary benefits in dermatologic imaging including leveraging DICOM network and workflow services, interoperability of images and metadata, leveraging existing enterprise imaging infrastructure, greater patient safety, and better compliance to legislative requirements for image retention.

Development of a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees.

PubMed

Murphy, Michael J; Shahriari, Neda; Payette, Michael; Mnayer, Laila; Elaba, Zendee

2016-10-01

Results of molecular studies are redefining the diagnosis and management of a wide range of skin disorders. Dermatology training programs maintain a relative gap in relevant teaching. To develop a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees at our institution. The aim is to provide trainees with a specialty-appropriate, working knowledge in clinical molecular dermatology. The Departments of Dermatology and Pathology and Laboratory Medicine collaborated on the design and implementation of educational objectives and teaching modalities for the new curriculum. A multidisciplinary curriculum was developed. It comprises: (i) assigned reading from the medical literature and reference textbook; (ii) review of teaching sets; (iii) two 1 hour lectures; (iv) trainee presentations; (v) 1-week rotation in a clinical molecular pathology and cytogenetics laboratory; and (vi) assessments and feedback. Residents who participated in the curriculum to date have found the experience to be of value. Our curriculum provides a framework for other dermatology residency programs to develop their own specific approach to molecular diagnostics education. Such training will provide a foundation for lifelong learning as molecular testing evolves and becomes integral to the practice of dermatology. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Initiatives to increase the efficiency of dermatological patient care].

PubMed

van de Kerkhof, P C M

2006-08-26

The number of tasks required of dermatologists has increased in the last decade. This article discusses potential ways to enhance the efficiency ofdermatological patient care and prevent problems of capacity. A study conducted in the UK found that, for the top 10 skin disorders, the accessibility of general practitioners with special expertise in dermatology was better than that of the dermatology clinic. Waiting times were considerably shorter with the general practitioners, but care was more expensive. Outcomes were similar for these skin disorders in terms of disease-specific quality of life. The study made no comment on the actual diagnostic ability of the specialised general practitioners. Teledermatology can reduce the number of referrals to a dermatologist by half. However, a considerable percentage of teledermatological consultations result in a different diagnosis than that obtained during a standard 'in vivo' consultation. Teledermatology can be a useful option for the follow-up of patients with ulcus cruris. The efficiency of dermatological care can be increased by working in teams. Dermatological nurses can be trained and conduct their own consultations under the supervision of a dermatologist. Dermatological care can also be organised in regional cooperative groups with general practitioners. Within these groups, teledermatology and specialised dermatology training for general practitioners can be useful innovations.

Fractional photothermolysis laser treatment of male pattern hair loss.

PubMed

Kim, Won-Serk; Lee, Hye In; Lee, Jin Woong; Lim, Yun Young; Lee, Seung Jae; Kim, Beom Joon; Kim, Myeung Nam; Song, Kye Yong; Park, Won Serk

2011-01-01

Various trials have been conducted on the management of male pattern hair loss (MPHL). A variety of laser and light sources have been used for the treatment of MPHL. To understand the effects of a 1,550-nm fractional erbium-glass laser on the hair cycle in an alopecia mouse model and to study the clinical effects of the same laser used as treatment for MPHL. Irradiation was applied to the shaved skin of C3H/HeN mice using various energy and density settings and varied irradiation intervals. In a clinical pilot study involving human subjects, 20 participants were treated over five sessions at 2-week intervals. A fractional photothermolysis laser was used at the energy of 5 mJ and a total density of 300 spots/cm(2). In the animal study, the hair stimulation effects were dependent upon the energy level, density, and irradiation interval. The anagen conversion of hair and the increase in Wnt 5a, β-catenin signals were observed. In the human pilot study, incremental improvements in hair density and growth rate were observed. This pilot study showed that a 1,550-nm fractional erbium-glass laser might induce hair growth, but more intensive studies are required to clarify the clinical applications of this treatment. © 2010 by the American Society for Dermatologic Surgery, Inc.

An observation of ablation effect of soft biotissue by pulsed Er:YAG laser

NASA Astrophysics Data System (ADS)

Zhang, Xianzeng; Xie, Shusen; Ye, Qing; Zhan, Zhenlin

2007-02-01

Because of the unique properties with regard to the absorption in organic tissue, pulsed Er:YAG laser has found most interest for various application in medicine, such as dermatology, dentistry, and cosmetic surgery. However, consensus regarding the optimal parameters for clinical use of this tool has not been reached. In this paper, the laser ablation characteristics of soft tissue by Er:YAG laser irradiation was studied. Porcine skin tissue in vitro was used in the experiment. Laser fluences ranged from 25mJ/mm2 to 200mJ/mm2, repetition rates was 5Hz, spot sizes on the tissue surface was 2mm. The ablation effects were assessed by the means of optical microscope, ablation diameters and depths were measured with reading microscope. It was shown that the ablation of soft biotissue by pulsed Er:YAG laser was a threshold process. With appropriate choice of irradiation parameters, high quality ablation with clean, sharp cuts following closely the spatial contour of the incident beam can be achieved. The curves of ablation crater diameter and depth versus laser fluence were obtained, then the ablation threshold and ablation yield were calculated subsequently, and the influence of the number of pulses fired into a crater on ablation crater depth was also discussed.

Implementation of fluorescence confocal mosaicking microscopy by ``early adopter'' Mohs surgeons and dermatologists: recent progress

NASA Astrophysics Data System (ADS)

Jain, Manu; Rajadhyaksha, Milind; Nehal, Kishwer

2017-02-01

Confocal mosaicking microscopy (CMM) enables rapid imaging of large areas of fresh tissue ex vivo without the processing that is necessary for conventional histology. When performed in fluorescence mode using acridine orange (nuclear specific dye), it enhances nuclei-to-dermis contrast that enables detection of all types of basal cell carcinomas (BCCs), including micronodular and thin strands of infiltrative types. So far, this technique has been mostly validated in research settings for the detection of residual BCC tumor margins with high sensitivity of 89% to 96% and specificity of 99% to 89%. Recently, CMM has advanced to implementation and testing in clinical settings by "early adopter" Mohs surgeons, as an adjunct to frozen section during Mohs surgery. We summarize the development of CMM guided imaging of ex vivo skin tissues from bench to bedside. We also present its current state of application in routine clinical workflow not only for the assessment of residual BCC margins in the Mohs surgical setting but also for some melanocytic lesions and other skin conditions in clinical dermatology settings. Last, we also discuss the potential limitations of this technology as well as future developments. As this technology advances further, it may serve as an adjunct to standard histology and enable rapid surgical pathology of skin cancers at the bedside.

Fingolimod Hydrochloride Gel for Dermatological Applications: Optimization of Formulation Strength and Effect of Colloidal Oatmeal (Aveeno®) as Penetration Enhancer.

PubMed

Tamakuwala, M; Stagni, G

2016-08-01

Fingolimod (FNGL) is an immune-modulatory agent prescribed for relapsing forms of multiple sclerosis. Because of its mechanism of action, FNGL is potentially a treatment for chronic, non-curable T-lymphocyte-driven inflammatory skin diseases (TLDISD) such as psoriasis and atopic dermatitis. Since severe side effects limit the systemic administration of FNGL, the objective of this study is to develop a hydroxypropyl cellulose (2%) FNGL gel for dermatological applications. First, the effect of FNGL strength (0.05%, 0.10%, 0.50%, and 1.00%) on skin permeability and retention was investigated. We carried out several permeation studies with vertical Franz diffusion cells and (i) cellulose or (ii) excised dorsal porcine ear skin (EDPES) as membrane. We also quantified FNGL in the stratum corneum and in dermis with the tape-stripping method. Permeability parameters as well as the amount retained in skin increased significantly (p < 0.01) with strength; however, there was no statistically significant difference between the 0.50% and 1.00% gels for both cellulose and EDPES. Therefore, we selected the 0.50% gel to investigate the effect of colloidal oatmeal (0%, 1%, 3%, 6%, and 10%) on FNGL in vitro permeability and skin retention. Colloidal oatmeal has beneficial dermatological properties for TLDISD and may complement FNGL activity. Permeability increased significantly (p < 0.001) with colloidal oatmeal at the 6% and 10% strength with an enhancement ratio of 3.5 and 2.4, respectively, whereas the amount retained in the skin decreased significantly (p < 0.001) compared to the base gel. In conclusion, the 0.50% FNGL(.)HCL gel with 6% Aveeno® has very promising permeability characteristics for delivery of FNGL to the skin.

Influence of high dose tumescent local anaesthesia with prilocaine on systemic interleukin (IL)-6, IL-8 and tumour necrosis factor-α.

PubMed

Schmittner, M D; Faulhaber, J; Kemler, B; Koenen, W; Thumfart, J O; Weiss, C; Neumaier, M; Beck, G C

2010-12-01

Tumescent local anaesthesia (TLA) with high prilocaine doses leads to formation of methemoglobin (MHb) which is known to be a potent activator of pro-inflammatory endothelial cell response in vitro. As TLA is widely used for large dermatological resections, the aim of this study was to investigate the effects of high prilocaine doses on the systemic inflammatory response in vivo and its clinical relevance. This prospective study examines the influence of MHb on serum interleukin (IL)-6, IL-8 and tumour necrosis tumour necrosis (TNF)-α levels up to 72 h after application of TLA with prilocaine in doses higher than 600 mg. A total of 30 patients received prilocaine in a median dose of 1500 mg (range: 880-4160 mg) for large resections. Peak prilocaine serum concentration was reached 4 h (0.72 ± 0.07 μg/mL), the maximum concentration of MHb (7.43 ± 0.87%) and IL-6 (28.4 ± 4.1 U/L) 12 h after TLA application. TNF-α and IL-8 release were not found significantly increased. Three patients developed MHb concentrations >15%. This clinical study shows for the first time that a high prilocaine serum concentration leads in vivo to elevated systemic levels of IL-6 but not of IL-8 and TNF-α because of initial high MHb levels. Because of possible and unpredictable high MHb concentrations, TLA should only be performed with prilocaine in doses of 2.5 mg/kg. In general, new solutions of TLA are necessary to achieve adequate anaesthesia for large dermatological resections to decrease the risk of methemoglobinaemia. © 2010 The Authors. Journal compilation © 2010 European Academy of Dermatology and Venereology.

A gender gap in the dermatology literature? Cross-sectional analysis of manuscript authorship trends in dermatology journals during 3 decades.

PubMed

Feramisco, Jamison D; Leitenberger, Justin J; Redfern, Shelley I; Bian, Aihua; Xie, Xian-Jin; Resneck, Jack S

2009-01-01

Despite a dramatic influx of female dermatologists during the last 30 years, women in academic dermatology departments remain relatively clustered in junior faculty positions. Research in other specialties showing a disparity in the academic productivity of women has led to many hypotheses regarding factors that may place them at a competitive disadvantage. It is unknown, however, whether similar differences in academic productivity might also serve as barriers to advancement in dermatology, or whether any productivity gap actually exists in this specialty that experienced a more substantial entry of women. Because publication in peer-reviewed journals is one of the core measures of academic productivity used in the promotion process, we evaluated trends in the prevalence of female authorship in top dermatology journals during the last 3 decades. We conducted an observational study of trends in the sex distribution of US authors in 3 prestigious general dermatology journals (in 1976, 1986, 1996, and 2006) and 3 subspecialty dermatology journals (in 2006 only). Journals were chosen based on published impact factors and citation half-lives. During the last 3 decades, the proportion of women authoring manuscripts in the 3 major general dermatology journals increased from 12% to 48% of US-affiliated first authors (P < .001) and from 6.2% to 31% of US-affiliated senior authors (P < .001). Separate analyses by journal and by article type showed similar increases. The prevalence of female authors in subspecialty journals in 2006 was slightly more variable. Although the publications selected for this study capture many of the most respected US journals in dermatology, they may not be representative of all journals in which dermatologists publish. Female dermatologists are authoring publications in growing numbers that match or exceed their prevalence in the academic and overall workforce. This suggests that other factors (differences in productivity outside of the publishing arena, differences in job descriptions or opportunities, differences in career aspirations, a lack of institutional support or flexibility, or gender bias) may be associated with the ongoing reduced advancement of women to senior academic dermatology ranks relative to their male colleagues, and further research is warranted to explore these possibilities.

Are We Cutting Enough? A Five-Year Audit of Melanoma Excision Margins in the South East of Ireland.

PubMed

Cronin, Catherine Tracy; Allen, Jack; Patterson, Ken; O'Donoghue, Gerrard

2018-01-05

Malignant melanoma is the fifth commonest invasive cancer in Ireland. The British Association of Dermatology (BAD) guidelines are currently the recognized standard for melanoma related surgery. The aim was to examine adherence to BAD guidelines and establish contributing factors resulting in non-adherence to guidelines in a group of melanoma patients in the South East Region of Ireland. A retrospective review of a prospectively maintained melanoma registry of all patients undergoing surgery in the South East Region of Ireland from January 2011 to 2016 was performed. Data were analyzed using SPSS statistical software. Univariate analysis using logistic regression was performed to examine factors associated with not meeting the BAD margin excision guidelines Data with a p < 0.05 was analyzed using a multivariate logistic regression model. 459 patients underwent surgery for invasive cutaneous melanoma. 314 (68.4%) surgeries had excision margins adequately recorded and of these 234(74.5%) fulfilled the BAD guidelines. 267(58.2%) patients (2011-2016 inclusive) qualified for sentinel lymph node biopsy (SNLB) with a cancer staging of pT1b or higher. Of these patients 100(37%) agreed to proceed to a SNLB following informed discussion. 33 had a positive sentinel node. On multivariate analysis inadequate margins were independently associated with tumor thickness 2.01-4.00 mm (p = 0.0001) and >4.00 mm (p = 0.0001) and head and neck location (p < 0.0001). Adherence to BAD guidelines in the South East is good but requires optimization since centralization of melanoma treatment in 2013 to a single specialized center. It is important that Clinicians are fully aware of the implications of not achieving adequate excision margins in surgery. Improvements in melanoma data management is needed to fully evaluate current practices in Ireland.

Development of lengths of stay and DRG cost weights in dermatology from 2003 to 2006.

PubMed

Wenke, Andreas; Müller, Marcel L; Babapirali, Judith; Rompel, Rainer; Hensen, Peter

2009-08-01

The G-DRG per case payments are calculated annually on the basis of present output and cost data provided from German hospitals. The economic valuation of dermatology-related DRGs depends largely on inpatients' length of stay. At present, longitudinal analyses of dermatologic hospital data considering the development of length of stay under DRG conditions are not available. A multicenter, longitudinal study of clinical data from hospitals with different care levels was performed (n = 23). Frequent and relevant dermatologic diagnoses were grouped and analyzed over a time period of four years (2003-2006). The development of lengths of stay and of G-DRG cost weights were studied in detail. Descriptive statistical methods were applied. After introduction of DRG, the data reveal a) reduction of length of stay in inpatient dermatology and b) after an initial abrupt rise, DRG valuation of dermatologic groups moderately decreased over time. Both trends changed most rapidly in the early years but reached a stable niveau in 2006. The study furthermore points out that not only length of stay, but also other type of costs influence DRG calculations. German dermatology reflects the international trend showing reductions of length of stay after introduction of a DRG-based hospital funding system. The DRG calculation and valuation of inpatient services depend on the duration of hospital stay. However, increasing per diem costs resulting from higher performances of every inpatient bed day are also taken into account. Further reduction of length of stay must not threaten the quality of inpatient care in dermatology.

Clinical profile of dermatological emergencies and intensive care unit admissions in a tertiary care center - an Indian perspective.

PubMed

Samudrala, Suvarna; Dandakeri, Sukumar; Bhat, Ramesh M

2018-05-01

Although dermatology is largely considered as an outpatient specialty, dermatological conditions comprise 5-8% of cases presenting to the emergency department. The need for a dermatological intensive care unit is widely acknowledged due to the increasing incidence of acute skin failure. Very few studies have been done to characterize the common conditions seen in the emergency department and intensive care units. We undertook this study to analyze the spectrum of dermatological conditions presenting to the emergency department and the clinical profile of patients admitted to the intensive care unit. A prospective study was conducted for 9 months. Patients requiring primary dermatological consultation in the emergency department and patients admitted in the dermatology intensive care unit were examined, and their clinical variables were statistically analyzed. A total of 248 cases were seen in the emergency department, out of which 72 (29.1%) cases were admitted and 176 (70.9%) were treated in the emergency department on an outpatient basis. The most common condition seen in non-admitted patients was acute urticaria (28.9%). The most common cause for admission in patients presenting to the emergency department was erythroderma (23.6%). Sixty-two patients were admitted to the intensive care unit, the most common diagnosis being erythroderma (40.3%). This prospective study aimed to provide an insight into the types of cases evaluated in the emergency department by dermatologists in a large tertiary care hospital in coastal Karnataka in South India. © 2018 The International Society of Dermatology.

Benchmarking US Department of Veterans Affairs dermatologic services: results from a national survey.

PubMed

Krause, L Kendall; Townsend, Leilani; Orser, Michael L; Mulhausen, Jennifer; Duke, Jodi; Waxweiler, Weston T; Dellavalle, Robert P

2012-03-01

How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature. We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA. Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed. Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained dermatology residents (72%) and medical students (80%). One third of services reported significant research involvement. Qualitative analysis revealed the academic environment, patient population, and decreased business management responsibilities as the 3 most commonly cited advantages to VA employment. The most commonly listed disadvantages included low salaries, bureaucracy, and lack of resources. The survey data were self-reported and not independently verified. Not all services returned the survey. Outpatient VA dermatology services accomplish significant primary care and preventive services (eg, sun safety counseling, skin cancer screening, and treatment). However, the small number of dedicated dermatology services, their irregular geographic distribution, and the lack of staffing and resources may adversely affect optimal patient care. Dermatologist responses regarding the positive and negative aspects of working in the VA system may lead to improved management strategies to better retain and recruit dermatologists to provide patient care, medical education, and medical research despite dramatically lower dermatologist salaries within the VA system compared with private practice. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Streptococcal vulvovaginitis.

PubMed

Heymann, Warren R

2009-07-01

Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely topics. Commentaries from Dialogues Editor-in-Chief Warren R. Heymann, MD, are provided after each discussion as a topic summary and are provided hear as a special service to readers of the Journal of the American Academy of Dermatology.

The Canadian Dermatology Workforce Survey: implications for the future of Canadian dermatology--who will be your skin expert?

PubMed

Maguiness, Sheilagh; Searles, Gordon E; From, Lynn; Swiggum, Susan

2004-01-01

To survey Canadian dermatologists for specialty-specific physician resource information including demographics, workload and future career plans. In 2001, the Canadian Dermatology Association (CDA) surveyed 555 dermatologists in Canada to gain specialty-specific physician resource information. Three hundred and seventy-one dermatologists (69%) provided information about themselves, their workloads and their future career goals. The average Canadian dermatologist is 52 years old and 35% of practicing dermatologists are over the age of 55. Eighty-nine percent of dermatologists practice in an urban setting, 19% include practice in a rural setting while less than 0.5% practice in remote areas. Canadian dermatologists spend 61% of their clinical time providing services in Medical Dermatology. Within 5 years, 50% of dermatologists reported that they plan to reduce their practices or retire. The Canadian Dermatology Workforce Survey provides a snapshot of the current practice of dermatology in Canada. It also serves to highlight the critical shortage of dermatologists, which will continue to worsen without immediate, innovative planning for the future.

Vedolizumab is an effective alternative in inflammatory bowel disease patients with anti-TNF-alpha therapy-induced dermatological side effects.

PubMed

Pijls, Philippe A R R; Gilissen, Lennard P L

2016-11-01

The treatment of patients with inflammatory bowel diseases has been revolutionized by the introduction of biological therapy with TNF-alpha blockers. However, TNF-alpha blockers are also associated with a wide variety of dermatological side effects, such as local skin infections, psoriasis and eczema. A new biological therapy, targeting the gut-specific adhesion molecule alpha4beta7 integrin, is the humanized monoclonal IgG1 antibody vedolizumab. Vedolizumab prevents leukocyte migration to the gastrointestinal tract, thereby reducing inflammation. This gut-specific therapy has the potential to reduce systemic side effects, including dermatological ones. We describe 3 inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects, consisting of hidradenitis suppurativa, a folliculitis, scalp psoriasis and a dissecting folliculitis. In all patients, anti-TNF-alpha therapy-induced dermatological side effects diminished after switching to vedolizumab. Vedolizumab may be a viable alternative biological therapy in inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

E-learning program for medical students in dermatology

PubMed Central

Silva, Cristiana Silveira; Souza, Murilo Barreto; Filho, Roberto Silveira Silva; de Medeiros, Luciana Molina; Criado, Paulo Ricardo

2011-01-01

INTRODUCTION: Dermatological disorders are common in medical practice. In medical school, however, the time devoted to teaching dermatology is usually very limited. Therefore, online educational systems have increasingly been used in medical education settings to enhance exposure to dermatology. OBJECTIVE: The present study was designed to develop an e-learning program for medical students in dermatology and evaluate the impact of this program on learning. METHODS: This prospective study included second year medical students at the University of Technology and Science, Salvador, Brazil. All students attended discussion seminars and practical activities, and half of the students had adjunct online seminars (blended learning). Tests were given to all students before and after the courses, and test scores were evaluated. RESULTS: Students who participated in online discussions associated with face-to-face activities (blended learning) had significantly higher posttest scores (9.0±0.8) than those who only participated in classes (7.75±1.8, p <0.01). CONCLUSIONS: The results indicate that an associated online course might improve the learning of medical students in dermatology. PMID:21655756

The logistics of an inpatient dermatology service.

PubMed

Rosenbach, Misha

2017-03-01

Inpatient dermatology represents a unique challenge as caring for hospitalized patients with skin conditions is different from most dermatologists' daily outpatient practice. Declining rates of inpatient dermatology participation are often attributed to a number of factors, including challenges navigating the administrative burdens of hospital credentialing, acclimating to different hospital systems involving potential alternate electronic medical records systems, medical-legal concerns, and reimbursement concerns. This article aims to provide basic guidelines to help dermatologists establish a presence as a consulting physician in the inpatient hospital-based setting. The emphasis is on identifying potential pitfalls, problematic areas, and laying out strategies for tackling some of the challenges of inpatient dermatology including balancing financial concerns and optimizing reimbursements, tracking data and developing a plan for academic productivity, optimizing workflow, and identifying metrics to document the impact of an inpatient dermatology consult service. ©2017 Frontline Medical Communications.

Social Media Use in Pediatric Dermatology.

PubMed

Fogel, Alexander L; Teng, Joyce M C

2016-01-01

Social media is predicted to become increasingly important in dermatology because of its potential to serve as a platform for public health campaigns, aid in participant recruitment for clinical trials, increase public engagement in health care, and facilitate scientific discourse. No study of social media use in pediatric dermatology has been performed, so we analyzed the use of the seven leading social media platforms in pediatric dermatology, with a focus on patient advocacy groups, professional societies, research journals, and research institutions. We observed that 89% of patient advocacy groups, 100% of professional societies, 62.5% of research journals, and 0% of academic pediatric dermatology departments maintained one or more social media accounts. Our observations suggest that all stakeholder groups, and in particular members of the research community, have the potential to further their engagement, connections, and communications through social media. © 2016 Wiley Periodicals, Inc.

A study investigating the association of dermatological and infusion reactions to infliximab and infliximab trough levels

PubMed Central

Huang, Vivian Wai-Mei; Dhami, Neil; Fedorak, Darryl; Prosser, Connie; Shalapay, Carol; Kroeker, Karen Ivy; Halloran, Brendan Phillip; Dieleman, Levinus Albert; Fedorak, Richard Neil

2015-01-01

BACKGROUND: Although infliximab is an effective therapy for inflammatory bowel disease (IBD), it is associated with dermatological events and infusion reactions. It is not known whether a relationship between these adverse events (AEs) and infliximab trough levels (ITLs) exists. OBJECTIVES: To report the prevalence of infliximab-associated AEs in IBD patients receiving stable maintenance infliximab therapy, and to correlate ITLs with dermatological and infusion reactions to infliximab. METHODS: Adult IBD patients receiving stable maintenance infliximab therapy were recruited from the University of Alberta Infusion Clinic (Edmonton, Alberta). ITLs were measured in blood samples collected before infusion, and the patients’ records were reviewed for dermatological and infusion reactions to infliximab. RESULTS: One-quarter (18 of 71 [25.4%]) of patients experienced dermatological or infusion reactions to infliximab: nine (12.7%) dermatological events and nine (12.7%) infusion reactions. The median ITL was similar among patients with and without these AEs (7.2 μg/mL [interquartile range (IQR) 2.0 μg/mL to 13.3 μg/mL] versus 6.6 μg/mL [IQR 3.2 μg/mL to 12.7 μg/mL]; P=0.648). The median ITL of patients who experienced infusion reactions (2.0 μg/mL [IQR 0.1 μg/mL to 5.7 μg/mL]) was lower than that of patients who experienced no such AEs (6.6 μg/mL [IQR 3.2 μg/mL to 12.7 μg/mL]; P=0.008]) and lower than that of patients who experienced dermatological AEs (13.3 μg/mL [IQR 8.8 μg/mL to 17.4 μg/mL]; P<0.001). CONCLUSION: One-quarter of IBD outpatients receiving stable maintenance infliximab therapy experienced dermatological and infusion reactions. Low ITLs were correlated with infusion reactions, and normal or high ITLs with dermatological events. PMID:25706572

Dermatologic emergencies in a tertiary hospital: A descriptive study.

PubMed

Bancalari-Díaz, D; Gimeno-Mateos, L I; Cañueto, J; Andrés-Ramos, I; Fernández-López, E; Román-Curto, C

2016-10-01

Dermatology in-house call is uncommon in the Spanish national health system. The objective of the present study was to define the groups of dermatologic diseases and conditions most frequently seen in the emergency department and to evaluate the need for dermatology in-house call in the training of medical residents. We performed a descriptive study of all patients who attended the emergency department with a skin complaint during a 1-year period (June 2013 to May 2014) and were assessed by 9 dermatology residents. The study variables were date/day, sex, age, diagnosis, special surgical procedures, additional laboratory tests, and need for hospitalization and/or follow-up. We also evaluated patients attending their first scheduled visit to the dermatologist between January and June 2014 in order to compare the most frequent conditions in both groups. A total of 3084 patients attended the emergency room with a skin complaint (5.6% of all visits to the emergency department), and 152 different diagnoses were made. The most frequent groups of diseases were infectious diseases (23%) and eczema (15.1%). The specific conditions seen were acute urticaria (7.6%), contact dermatitis (6.1%), and drug-induced reactions (4.6%). By contrast, the most frequent conditions seen in the 1288 patients who attended a scheduled dermatology appointment were seborrheic keratosis (11.9%), melanocytic nevus (11.5%), and actinic keratosis (8%). A follow-up visit was required in 42% of patients seen in the emergency department. Fourth-year residents generated the lowest number of follow-up visits. We found that infectious diseases and eczema accounted for almost 40% of all emergency dermatology visits. Our results seem to indicate that the system of in-house call for dermatology residents is very useful for the hospital system and an essential component of the dermatology resident's training program. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases

PubMed Central

Milani-Nejad, Nima; Zhang, Myron

2017-01-01

Importance The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. Objective To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. Design, Setting, and Participants We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center. A total of 413 patients with a primary inflammatory skin condition discharge diagnosis and 647 patients with primary inflammatory skin condition admission diagnosis were selected. Main Outcomes and Measures Hospital length of stay and 1-year readmission with inflammatory skin conditions. Results The 413 patients with a primary inflammatory skin condition discharge diagnosis were 61.0% female and had a mean (SD) age of 55.1 (16.4) years. The 647 patients with primary inflammatory skin condition admission diagnosis were 50.8% female and had a mean (SD) age of 57.8 (15.9) years. Multivariable modeling showed that dermatology consultations were associated with a reduction of 1-year inflammatory skin condition readmissions among patients who were discharged primarily with an inflammatory skin condition (readmission probability, 0.0025; 95% CI, 0.00020-0.030 with dermatology consult vs 0.026; 95% CI, 0.0065-0.10 without; odds ratio, 0.093; 95% CI, 0.010-0.840; P = .03). No other confounding variable was associated with reduction in readmissions. Multivariable modeling also showed that dermatology consultations were associated with a reduction in the adjusted hospital length of stay by 2.64 days (95% CI, 1.75-3.53 days; P < .001). Conclusions and Relevance Dermatology consultations were associated with improvements of outcomes among hospitalized patients. The expansion of the role of dermatology consultation services may improve patient care in a cost-effective manner. PMID:28296992

Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases.

PubMed

Milani-Nejad, Nima; Zhang, Myron; Kaffenberger, Benjamin H

2017-06-01

The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center. A total of 413 patients with a primary inflammatory skin condition discharge diagnosis and 647 patients with primary inflammatory skin condition admission diagnosis were selected. Hospital length of stay and 1-year readmission with inflammatory skin conditions. The 413 patients with a primary inflammatory skin condition discharge diagnosis were 61.0% female and had a mean (SD) age of 55.1 (16.4) years. The 647 patients with primary inflammatory skin condition admission diagnosis were 50.8% female and had a mean (SD) age of 57.8 (15.9) years. Multivariable modeling showed that dermatology consultations were associated with a reduction of 1-year inflammatory skin condition readmissions among patients who were discharged primarily with an inflammatory skin condition (readmission probability, 0.0025; 95% CI, 0.00020-0.030 with dermatology consult vs 0.026; 95% CI, 0.0065-0.10 without; odds ratio, 0.093; 95% CI, 0.010-0.840; P = .03). No other confounding variable was associated with reduction in readmissions. Multivariable modeling also showed that dermatology consultations were associated with a reduction in the adjusted hospital length of stay by 2.64 days (95% CI, 1.75-3.53 days; P < .001). Dermatology consultations were associated with improvements of outcomes among hospitalized patients. The expansion of the role of dermatology consultation services may improve patient care in a cost-effective manner.

Access to inpatient dermatology care in Pennsylvania hospitals.

PubMed

Messenger, Elizabeth; Kovarik, Carrie L; Lipoff, Jules B

2016-01-01

Access to care is a known issue in dermatology, and many patients may experience long waiting periods to see a physician. In this study, an anonymous online survey was sent to all 274 Pennsylvania hospitals licensed by the US Department of Health in order to evaluate current levels of access to inpatient dermatology services. Although the response rate to this survey was limited, the data suggest that access to inpatient dermatology services is limited and may be problematic in hospitals across the United States. Innovation efforts and further studies are needed to address this gap in access to care.

Use of optical skin phantoms for preclinical evaluation of laser efficiency for skin lesion therapy

PubMed Central

Wróbel, Maciej S.; Jędrzejewska-Szczerska, Malgorzata; Galla, Stanislaw; Piechowski, Leszek; Sawczak, Miroslaw; Popov, Alexey P.; Bykov, Alexander V.; Tuchin, Valery V.; Cenian, Adam

2015-01-01

Abstract. Skin lesions are commonly treated using laser heating. However, the introduction of new devices into clinical practice requires evaluation of their performance. This study presents the application of optical phantoms for assessment of a newly developed 975-nm pulsed diode laser system for dermatological purposes. Such phantoms closely mimic the absorption and scattering of real human skin (although not precisely in relation to thermal conductivity and capacitance); thus, they can be used as substitutes for human skin for approximate evaluation of laser heating efficiency in an almost real environment. Thermographic imaging was applied to measure the spatial and temporal temperature distributions on the surface of laser-irradiated phantoms. The study yielded results of heating with regard to phantom thickness and absorption, as well as laser settings. The methodology developed can be used in practice for preclinical evaluations of laser treatment for dermatology. PMID:26263414

Total-body photography in skin cancer screening: the clinical utility of standardized imaging.

PubMed

Rosenberg, Alexandra; Meyerle, Jon H

2017-05-01

Early detection of skin cancer is essential to reducing morbidity and mortality from both melanoma and nonmelanoma skin cancers. Total-body skin examinations (TBSEs) may improve early detection of malignant melanomas (MMs) but are controversial due to the poor quality of data available to establish a mortality benefit from skin cancer screening. Total-body photography (TBP) promises to provide a way forward by lowering the costs of dermatologic screening while simultaneously leveraging technology to increase patient access to dermatologic care. Standardized TBP also offers the ability for dermatologists to work synergistically with modern computer technology involving algorithms capable of analyzing high-quality images to flag concerning lesions that may require closer evaluation. On a population level, inexpensive TBP has the potential to increase access to skin cancer screening and it has several specific applications in a military population. The utility of standardized TBP is reviewed in the context of skin cancer screening and teledermatology.

The Children's Dermatology Life Quality Index (CDLQI): linguistic and cultural validation in Serbian.

PubMed

Janković, Slavenka; Vukićević, Jelica; Djordjević, Sanja; Janković, Janko; Marinković, Jelena; Erić, Miloš

2013-01-01

The Children's Dermatology Life Quality Index (CDLQI) evaluates the impact of skin diseases on the patient's quality of life. The purpose of the study was to translate and to validate the CDLQI into Serbian. The CDLQI was translated into Serbian following international recommendations for translation and cultural adaptation. The validation study was carried out on a large cohort of secondary schoolchildren who self-reported acne. Translating the CDLQI consisted of forward translation, reconciliation, back translation, back-translation review, and cognitive debriefing. The good internal consistency of the scale was demonstrated with a Cronbach alpha coefficient of 0.87. A Spearman correlation coefficient of 0.66 between the CDLQI and the Cardiff Acne Disability Index (CADI) was deemed satisfactory to demonstrate concurrent validity. The translation, cross-cultural adaptation, and psychometric qualities of the CDLQI were satisfactory, enabling its application in clinical practice and future studies.

Teaching resources for dermatology on the WWW--quiz system and dynamic lecture scripts using a HTTP-database demon.

PubMed Central

Bittorf, A.; Diepgen, T. L.

1996-01-01

The World Wide Web (WWW) is becoming the major way of acquiring information in all scientific disciplines as well as in business. It is very well suitable for fast distribution and exchange of up to date teaching resources. However, to date most teaching applications on the Web do not use its full power by integrating interactive components. We have set up a computer based training (CBT) framework for Dermatology, which consists of dynamic lecture scripts, case reports, an atlas and a quiz system. All these components heavily rely on an underlying image database that permits the creation of dynamic documents. We used a demon process that keeps the database open and can be accessed using HTTP to achieve better performance and avoid the overhead involved by starting CGI-processes. The result of our evaluation was very encouraging. Images Figure 3 PMID:8947625

Photodynamic therapy in dermatology: past, present, and future

NASA Astrophysics Data System (ADS)

Darlenski, Razvigor; Fluhr, Joachim W.

2013-06-01

Photodynamic therapy (PDT) is a noninvasive therapeutic method first introduced in the field of dermatology. It is mainly used for the treatment of precancerous and superficial malignant skin tumors. Today PDT finds new applications not only for nononcologic dermatoses but also in the field of other medical specialties such as otorhinolaryngology, ophthalmology, neurology, gastroenterology, and urology. We are witnessing a broadening of the spectrum of skin diseases that are treated by PDT. Since its introduction, PDT protocol has evolved significantly in terms of increasing method efficacy and patient safety. In this era of evidence-based medicine, it is expected that much effort will be put into creating a worldwide accepted consensus on PDT. A review on the current knowledge of PDT is given, and the historical basis of the method's evolution since its introduction in the 1900s is presented. At the end, future challenges of PDT are focused on discussing gaps that exist for research in the field.

Practical applications of hand-held computers in dermatology.

PubMed

Goldblum, Orin M

2002-09-01

For physicians, hand-held computers are gaining popularity as point of care reference tools. The convergence of hand-held computers, the Internet, and wireless networks will enable these devices to assume more essential roles as mobile transmitters and receivers of digital medical Information. In addition to serving as portable medical reference sources, these devices can be Internet-enabled, allowing them to communicate over wireless wide and local area networks. With enhanced wireless connectivity, hand-held computers can be used at the point of patient care for charge capture, electronic prescribing, laboratory test ordering, laboratory result retrieval, web access, e-mail communication, and other clinical and administrative tasks. Physicians In virtually every medical specialty have begun using these devices in various ways. This review of hand-held computer use in dermatology illustrates practical examples of the many different ways hand-held computers can be effectively used by the practicing dermatologist.

Delivering value in dermatology: insights from skin cancer detection in routine clinical visits.

PubMed

Enamandram, Monica; Duncan, Lyn M; Kimball, Alexandra B

2015-02-01

There are increasing demands to demonstrate and report on outcomes in dermatology. Skin cancer diagnosis through skin examination has been well studied, and is promising as a value-delivering intervention. This study seeks to identify the rate of skin cancer diagnosis during routine visits to a large tertiary dermatology clinic. Medical records of patients presenting for routine dermatologic care at Massachusetts General Hospital between March 28 and September 28, 2012, were retrospectively reviewed. All patients given a diagnosis of nonmelanoma skin cancer (NMSC) confirmed on biopsy specimen were identified. Billing data were used to identify the total number of patients evaluated during the study period. NMSC was diagnosed in 1266 skin biopsy specimens from 1047 (7.0%) of the 14,829 patients who presented for routine care. In all, 55% of patients with NMSC were men (mean age 70 years). Chief symptoms of patients with NMSC included general dermatologic concerns (37%), routine cancer screening (43%), and specific lesion(s) of concern (19%). Retrospective design and restriction to a single institution may limit the generalizability of our findings. The incidence of NMSC in routine dermatology is high; these findings validate the value of care provided by dermatologists and highlight the likely increasing need for their diagnostic skills as the population ages in the United States. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Measuring the impact of dermatological conditions on family and caregivers: a review of dermatology-specific instruments.

PubMed

Sampogna, F; Finlay, A Y; Salek, S S; Chernyshov, P; Dalgard, F J; Evers, A W M; Linder, D; Manolache, L; Marron, S E; Poot, F; Spillekom-van Koulil, S; Svensson, Å; Szepietowski, J C; Tomas-Aragones, L; Abeni, D

2017-09-01

The patient is the centre of a web of relationships, and the impact of his/her disease on family members and caregivers must be taken into account. The aim of this study was to identify the specific instruments that measure the impact of a dermatological disease on the quality of life (QoL) of family members, by performing a systematic search of the literature. Fifteen papers were identified, describing the creation and validation of nine instruments. Four of them concerned atopic dermatitis (Dermatitis Family Index, DFI; Parents' Index QoL Atopic Dermatitis, PiQoL-AD; QoL in primary caregivers of children with atopic dermatitis, QPCAD; Childhood Atopic Dermatitis Impact Scale, CADIS), two measured the impact of psoriasis in family members (Psoriasis Family Index, PFI; FamilyPso), one the impact of epidermolysis bullosa (Epidermolysis Bullosa Burden of Disease, EB-BoD), one of ichthyosis (Family Burden Ichthyosis, FBI), and one was generic for dermatological conditions (Family Dermatology Life Quality Index, FDLQI). The European Academy of Dermatology and Venereology quality of life taskforce recommends that the impact of a skin disease on family and caregivers should be measured as part of any thorough evaluation of the burden of a disease. Guidelines are given to choose the most appropriate instruments. © 2017 European Academy of Dermatology and Venereology.

Aesthetic dermatology and emotional well-being questionnaire.

PubMed

Martínez-González, M Covadonga; Martínez-González, Raquel-Amaya; Guerra-Tapia, Aurora

2014-12-01

In recent years, there has been a great development of esthetic dermatology as a subspecialty of dermatology. It is important to know to which extent the general population regard this branch of medical surgical specialty as being of interest and contributing to emotional well-being. To analyze the technical features of a questionnaire which has been designed to reflect such perception of the general population about esthetic dermatology and its contribution to emotional well-being. Production and psychometric analysis of a self-filled in questionnaire in relation to esthetic dermatology and emotional well-being (DEBIE). This questionnaire is made of 57 items and has been applied to a sample of 770 people within the general population. The drawing-up process of the questionnaire is described to provide content validity. Items analysis was carried out together with exploratory and confirmatory factor analysis to assess the structure and construct validity of the tool. The extent of internal consistency (reliability) and concurrent validity has also been verified. DEBIE questionnaire (Spanish acronym for Aesthetic Dermatology and Emotional Well-being) revolves around six factors explaining 53.91% of the variance; there is a high level of internal consistency (Cronbach's α 0.90) and reasonable criterion validity. DEBIE questionnaire brings together adequate psychometric properties that can be applied to assess the perception that the general population have in relation to esthetic dermatology and its contribution to their emotional well-being. © 2014 Wiley Periodicals, Inc.

Dermatology in Doximity.

PubMed

Ashack, Kurt A; Burton, Kyle A; Dellavalle, Robert P

2016-02-17

Doximity, currently the largest online social networking service for United States (US) health care professionals and medical students, provides a wide variety of content to a large audience. In fact, its database includes 1,078,305 physicians in the US. It is therefore important to evaluate this content from time to time. Our objective is to analyze both the residency rankings and news content presented in Doximity, with respect to dermatology. The study compared the residency rankings created by Doximity to another dermatology residency ranking system that used a different algorithm. In terms of dermatology content, seven dermatology-related search terms were entered into the Doximity search query and data was collected on the first 20 "relevant" articles. Our study evaluated a total of 140 articles. The search term "skin cancer" yielded the most articles totaling 6,001. Informative articles were the most common type of article for each content item searched except for "dermatology", yielding research articles as the most common content type (70%). The search term "melanoma awareness" had the largest number of shares (19,032). In comparing dermatology residency rankings on Doximity with another ranking system that accounted for scholarly achievement, there was 50% overlap. In conclusion, it is vital to evaluate content on social media websites that are utilized by US medical students and health care professionals. We hope this information presented provides an up-to-date analysis on the quality of one particular social media platform.

Dermatology education and the Internet: traditional and cutting-edge resources.

PubMed

Hanson, Anne H; Krause, L Kendall; Simmons, Rachel N; Ellis, Jeffrey I; Gamble, Ryan G; Jensen, J Daniel; Noble, Melissa N; Orser, Michael L; Suarez, Andrea L; Dellavalle, Robert P

2011-10-01

The number and variety of dermatological medical resources available online has grown exponentially over the past decade. Internet-based resources allow for immediate and easy access to information for both medical education and reference purposes. Although clinicians continue to turn to the Internet for clinical information and still images, tech-savvy medical students are currently accessing a variety of exciting new resources, including discussion boards, wikis, streaming video, podcasts, journal clubs, online communities, and interactive diagnostic experiences to augment their medical education. The objective of this study was to identify traditional and cutting-edge online dermatology resources. We present a sampling of the top dermatology Internet resources, as assessed by a group of medical students in our university dermatology research lab. These resources were ranked by using a matrix derived from the Silberg Criteria, which assessed authorship, attribution, disclosure, currency, and content. Results indicate comparable ranking and approval of cutting-edge resources as traditional online sources. The ranked resources in each category are provided with URLs for readers' use. These cutting-edge online dermatology resources represent excellent sources for continuing education for students and clinicians alike. Resources such as these likely represent the future of medical education, as they allow for self-directed and supplementary education as well as remote access. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

The human genome: Mutating from science fiction to reality.

PubMed

Heymann, Warren R

2008-01-01

Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely topics. Commentaries from Dialogues Editor-in-Chief Warren R. Heymann, MD, are provided after each discussion as a topic summary and are provided here as a special service to readers of the Journal of the American Academy of Dermatology.

Layout and flow of dermatology clinics: principles from operations management.

PubMed

Wang, Jordan V

2018-04-15

Dermatology is a medical specialty that experiences high patient demand and long patient wait times. Dermatology clinics should look for ways to improve efficiency through the incorporation of principles from operations management. Addressing the layout and flow of a clinic can lead to operational efficiency. An ideal layout may lead to increased patient volume, satisfaction, and retention.

Incorporating resident research into the dermatology residency program.

PubMed

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.

Beyond the Dose-Limiting Toxicity Period: Dermatologic Adverse Events of Patients on Phase 1 Trials of the Cancer Therapeutics Evaluation Program

PubMed Central

Drilon, Alexander; Eaton, Anne A.; Schindler, Katja; Gounder, Mrinal M.; Spriggs, David R.; Harris, Pamela; Ivy, S. Percy; Iasonos, Alexia; Lacouture, Mario E.; Hyman, David M.

2017-01-01

BACKGROUND Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. METHODS Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. RESULTS In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P <.001) and differed by dose level (P <.001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P <.001). CONCLUSIONS A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. PMID:26916138

Beyond the dose-limiting toxicity period: Dermatologic adverse events of patients on phase 1 trials of the Cancer Therapeutics Evaluation Program.

PubMed

Drilon, Alexander; Eaton, Anne A; Schindler, Katja; Gounder, Mrinal M; Spriggs, David R; Harris, Pamela; Ivy, S Percy; Iasonos, Alexia; Lacouture, Mario E; Hyman, David M

2016-04-15

Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P < .001) and differed by dose level (P < .001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P < .001). A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. © 2016 American Cancer Society.

Incorporating resident research into the dermatology residency program

PubMed Central

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

Practice gaps in patient safety among dermatology residents and their teachers: a survey study of dermatology residents.

PubMed

Swary, Jillian Havey; Stratman, Erik J

2014-07-01

Curriculum and role modeling adjustments are necessary to address patient safety gaps occurring during dermatology residency. To identify the source of clinical practices among dermatology residents that affect patient safety and determine the best approach for overcoming gaps in knowledge and practice patterns that contribute to these practices. A survey-based study, performed at a national medical dermatology meeting in Itasca, Illinois, in 2012, included 142 dermatology residents from 44 residency programs in the United States and Canada. Self-reported rates of dermatology residents committing errors, identifying local systems errors, and identifying poor patient safety role modeling. Of surveyed dermatology residents, 45.2% have failed to report needle-stick injuries incurred during procedures, 82.8% reported cutting and pasting a previous author's patient history information into a medical record without confirming its validity, 96.7% reported right-left body part mislabeling during examination or biopsy, and 29.4% reported not incorporating clinical photographs of lesions sampled for biopsy in the medical record at their institution. Residents variably perform a purposeful pause ("time-out") when indicated to confirm patient, procedure, and site before biopsy, with 20.0% always doing so. In addition, 59.7% of residents work with at least 1 attending physician who intimidates the residents, reducing the likelihood of reporting safety issues they witness. Finally, 78.3% have witnessed attending physicians purposefully disregarding required safety steps. Our data reinforce the need for modified curricula, systems, and teacher development to reduce injuries, improve communication with patients and between physicians, residents, and other members of the health care team, and create an environment free of intimidation.

Medical color displays and their calibration

NASA Astrophysics Data System (ADS)

Fan, Jiahua; Roehrig, Hans; Dallas, W.; Krupinski, Elizabeth

2009-08-01

Color displays are increasingly used for medical imaging, replacing the traditional monochrome displays in radiology for multi-modality applications, 3D representation applications, etc. Color displays are also used increasingly because of wide spread application of Tele-Medicine, Tele-Dermatology and Digital Pathology. At this time, there is no concerted effort for calibration procedures for this diverse range of color displays in Telemedicine and in other areas of the medical field. Using a colorimeter to measure the display luminance and chrominance properties as well as some processing software we developed a first attempt to a color calibration protocol for the medical imaging field.

Current Quality-of-Life Tools Available for Use in Contact Dermatitis.

PubMed

Swietlik, Jacquelyn; Reeder, Margo

2016-01-01

Contact dermatitis is a common dermatologic condition that can cause significant impairment in patients' overall quality of life (QoL). This impact is separate and potentially more clinically relevant than one's disease "severity" in contact dermatitis and should be consistently addressed by dermatologists. Despite this, QoL tools specific to contact dermatitis are lacking, and there is little consistency in the literature regarding the tool used to evaluate clinical response to therapies. Measurements currently available to evaluate disease-related QoL in contact dermatitis fit into 1 of the following 3 general types: generic health-related QoL measures, dermatology-related QoL measures, or specific dermatologic disease-related QoL measures. This article reviews the strengths and weaknesses of existing QoL tools used in contact dermatitis including: Short Form Survey 36, Dermatology Life Quality Index, Skindex-29, Skindex-16, Dermatology-Specific Quality of Life, and Fragrance Quality of Life Index.

Fast evaluation of 69 basal cell carcinomas with ex vivo fluorescence confocal microscopy: criteria description, histopathological correlation, and interobserver agreement.

PubMed

Bennàssar, Antoni; Carrera, Cristina; Puig, Susana; Vilalta, Antoni; Malvehy, Josep

2013-07-01

Fluorescence confocal microscopy (FCM) represents a first step toward a rapid "bedside pathology" in the Mohs surgery setting and in other fields of general pathology. To describe and validate FCM criteria for the main basal cell carcinoma (BCC) subtypes and to demonstrate the overall agreement with classic pathologic analysis of hematoxylin-eosin-stained samples. DESIGN A total of 69 BCCs from 66 patients were prospectively imaged using ex vivo FCM. Confocal mosaics were evaluated in real time and compared with classic pathologic analysis. Department of Dermatology, Hospital Clínic of Barcelona, Barcelona, Spain, between November 2010 and July 2011. Patients with BCC attending the Mohs Surgery Unit. Presence or absence of BCC and histological subtype (superficial, nodular, and infiltrating) in the confocal mosaics. Eight criteria for BCC were described, evaluated, and validated. Although there were minor differences among BCC subtypes, the most BCC-defining criteria were peripheral palisading, clefting, nuclear pleomorphism, and presence of stroma. These criteria were validated with independent observers (κ values >0.7 [corrected] for most criteria). We herein propose, describe, and validate FCM criteria for BCC diagnosis. Fluorescence confocal microscopy is an attractive alternative to histopathologic analysis of frozen sections during Mohs surgery because large areas of freshly excised tissue can be assessed in real time without the need for tissue processing while minimizing labor and costs.

Team physicians in college athletics.

PubMed

Steiner, Mark E; Quigley, D Bradford; Wang, Frank; Balint, Christopher R; Boland, Arthur L

2005-10-01

There has been little documentation of what constitutes the clinical work of intercollegiate team physicians. Team physicians could be recruited based on the needs of athletes. A multidisciplinary team of physicians is necessary to treat college athletes. Most physician evaluations are for musculoskeletal injuries treated nonoperatively. Descriptive epidemiology study. For a 2-year period, a database was created that recorded information on team physician encounters with intercollegiate athletes at a major university. Data on imaging studies, hospitalizations, and surgeries were also recorded. The diagnoses for physician encounters with all undergraduates through the university's health service were also recorded. More initial athlete evaluations were for musculoskeletal diagnoses (73%) than for general medical diagnoses (27%) (P < .05). Four percent of musculoskeletal injuries required surgery. Most general medical evaluations were single visits for upper respiratory infections and dermatologic disorders, or multiple visits for concussions. Football accounted for 22% of all physician encounters, more than any other sport (P < .05). Per capita, men and women sought care at an equal rate. In contrast, 10% of physician encounters with the general pool of undergraduates were for musculoskeletal diagnoses. Student athletes did not require a greater number of physician encounters than did the general undergraduate pool of students on a per capita basis. Intercollegiate team physicians primarily treat musculoskeletal injuries that do not require surgery. General medical care is often single evaluations of common conditions and repeat evaluations for concussions.

[Undiagnosed hereditary angioedema in a patient undergoing emergency caesarean section].

PubMed

Tomita, Yukihiko; Kamei, Masataka; Jyujou, Satoshi; Horiuchi, Chinami; Katsuragi, Shinji; Onishi, Yoshihiko

2012-12-01

Hereditary angioedema (HAE) is characterized by acute, recurrent attacks of localized edema. Surgical procedures, trauma, and infections have been considered as potential triggers of HAE. Although HAE is a rare genetic disorder, approximately 50-60% of all HAE patients are involved with at least one occurrence of upper airway obstruction. The airway trouble is the most life-threating complication in HAE patients because HAE-related edema does not respond to typical treatment, such as administration of epinephrine, antihistamines, or glucocorticoids. Indeed, mortality rates of laryngeal attack are estimated around 25% to 40%. Here we describe a case of undiagnosed HAE patient undergoing emergency caesarean section under neuraxial blockade. A 31-year-old woman showed multiple regions at her lip margin during surgery and rapidly developed lip swelling after admission to the ward. Neither respiratory nor hemodynamic instability was found during and after surgery. Immediately, in order to assess whether HAE caused these dermatological manifestations, we measured values of both complement component 4 (C4) and functional activity of C1-esterase inhibitor (C1-inh), a protein of the complement system. These laboratory data showed low levels, which were compatible with HAE definition. After commencement of C1-inhibitor replacement therapy, her lip swelling and erythema gradually disappeared without adverse drug reactions. The patient was finally discharged from our institution 10 days after surgery.

Short antimicrobial peptides as cosmetic ingredients to deter dermatological pathogens.

PubMed

Rahnamaeian, Mohammad; Vilcinskas, Andreas

2015-11-01

Antimicrobial peptides (AMPs) are components of the innate immune system in many species of animals. Their diverse spectrum of activity against microbial pathogens, both as innate defense molecules and immunomodulators, makes them attractive candidates for the development of a new generation of antibiotics. Although the potential immunogenicity of AMPs means they are not suitable for injection and their susceptibility to digestive peptidases is likely to reduce their oral efficacy, they are ideal for topical formulations such as lotions, creams, shampoos, and wound dressings and could therefore be valuable products for the cosmetic industry. In this context, short AMPs (<20 amino acids) lacking disulfide bonds combine optimal antimicrobial activity with inexpensive chemical synthesis and are therefore more compatible with large-scale production and the modifications required to ensure stability, low toxicity, and microbial specificity. Proof-of-concept for the application of AMPs as novel anti-infectives has already been provided in clinical trials. This perspective considers the anti-infective properties of short AMPs lacking disulfide bonds, which are active against dermatologically important microflora. We consider the challenges that need to be addressed to facilitate the prophylactic application of AMPs in personal care products.

New telemedicine techniques in dermatology - evaluation with reflectance confocal microscopy via cloud-based platform.

PubMed

Łudzik, Joanna; Witkowski, Alexander Michael; Roterman-Konieczna, Irena

Dermoscopically equivocal skin lesions may present a diagnostic challenge in daily clinical practice and are regularly sent for second expert opinion. We present a new approach to handling these cases in a consultation referral system that enables communication between the initial doctor at the image upload site and dermatology experts at a distance via cloud-based telemedicine. In our study we retrospectively evaluated 100 equivocal cases with complete digital dermoscopy-reflectance confocal microscopy image sets and compared suggested management of the initial doctor to a second expert confocal reader. We evaluated the effect of reader concordance on final management of these lesions resulting in a single reader overall sensitivity of 89% and specificity of 66% and double reader concordance method sensitivity of 98% and specificity of 54%. In conclusion, we found that application of double reader evaluation of these image sets with automatic referral of lesions for removal in the case of discordant diagnosis between two doctors improved the sensitivity of diagnosis in this subset of lesions and may increase the safety threshold of management choice reducing potential misdiagnosis in telemedicine settings. This paper concerns the application of telemedicine in practical medicine.

760nm: a new laser diode wavelength for hair removal modules

NASA Astrophysics Data System (ADS)

Wölz, Martin; Zorn, Martin; Pietrzak, Agnieszka; Kindsvater, Alex; Meusel, Jens; Hülsewede, Ralf; Sebastian, Jürgen

2015-02-01

A new high-power semiconductor laser diode module, emitting at 760 nm is introduced. This wavelength permits optimum treatment results for fair skin individuals, as demonstrated by the use of Alexandrite lasers in dermatology. Hair removal applications benefit from the industry-standard diode laser design utilizing highly efficient, portable and light-weight construction. We show the performance of a tap-water-cooled encapsulated laser diode stack with a window for use in dermatological hand-pieces. The stack design takes into account the pulse lengths required for selectivity in heating the hair follicle vs. the skin. Super-long pulse durations place the hair removal laser between industry-standard CW and QCW applications. The new 760 nm laser diode bars are 30% fill factor devices with 1.5 mm long resonator cavities. At CW operation, these units provide 40 W of optical power at 43 A with wall-plug-efficiency greater than 50%. The maximum output power before COMD is 90 W. Lifetime measurements starting at 40 W show an optical power loss of 20% after about 3000 h. The hair removal modules are available in 1x3, 1x8 and 2x8 bar configurations.

Accuracy and completeness of patient information in organic World-Wide Web search for Mohs surgery: a prospective cross-sectional multirater study using consensus criteria.

PubMed

Miller, Christopher J; Neuhaus, Isaac M; Sobanko, Joseph F; Veledar, Emir; Alam, Murad

2013-11-01

Many patients obtain medical information from the Internet. Inaccurate information affects patient care and perceptions. To assess the accuracy and completeness of information regarding Mohs micrographic surgery (MMS) on the Internet. Prospective cross-sectional Internet-based study reviewing 30 consecutive organic results from three U.S. urban areas on "Mohs surgery" using Google. Text was assessed using a consensus-derived rating scale that quantified necessary and additional or supplementary information about MMS, as well as wrong information. Websites were classified according to type of sponsor. Ninety-one percent of sites conveyed basic information about MMS. There was variation in the mean amount of additional information items (range 0-9) according to website type: 8.4, medical societies; 6.7, academic practices; 5.9, web-based medical information resources; 4.7, private practices; and 4.4, other (p < .001). Cumulatively, academic practices and professional societies (mean 7.42) provided more additional information than private practices and web-based sources (mean 5.11, p < .001). There were no differences based on geographic location. Wrong items included misspelling Mohs (10%), indicating that only plastic surgeons could reconstruct (7%), and noting MMS was never cost-effective (7%). High-ranking websites provide basic information about MMS. Academic practice and professional society sites provide more-comprehensive information, but private practice sites and web-based medical information sources also provide additional information. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Dermatology and pathology arrangements: navigating the compliance risks.

PubMed

Wood, Jane Pine; Cougevan, Bridget; McGovern, Jenny

2013-12-01

Purchased service arrangements, establishing in-house professional pathology services, conducting technical component histology within a dermatology practice, and electronic medical records technology donations are ways that dermatology practices are responding to the current health care delivery and payment changes. This article will provide a general framework for navigating the compliance risks and structure considerations associated with these relationships between dermatologists and pathologists.

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

PubMed

Nestor, M S

2000-09-01

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

Teledermatology as an educational tool for teaching dermatology to residents and medical students.

PubMed

Boyers, Lindsay N; Schultz, Amanda; Baceviciene, Rasa; Blaney, Susan; Marvi, Natasha; Dellavalle, Robert P; Dunnick, Cory A

2015-04-01

Although teledermatology (TD) is regarded as a tool to improve patient access to specialty healthcare, little has been done to evaluate its role in medical education. We describe the TD program at the Denver (CO) Department of Veterans Affairs Medical Center and evaluate its use as an educational tool for teaching dermatology to dermatology residents and medical students. Dermatology residents manage TD consultations and review all cases with a faculty preceptor; medical students participate as observers when possible. This study assessed dermatology resident (n=14) and medical student (n=16) perceptions of TD and its usefulness in teaching six core clinical competencies. Both residents (79%) and medical students (88%) "strongly agree" or "agree" that TD is an important educational tool. In general, medical students were slightly more satisfied than residents across all of the core competencies assessed except for patient care. Medical students and residents were most satisfied with the competencies of practice-based learning and improvement and medical knowledge, whereas they were least satisfied with those of interpersonal and communication skills and professionalism. Overall, TD is valued as a teaching tool for dermatology in the areas of patient care, medical knowledge, practice-based learning and improvement, and systems-based practice.

Dermatology discharge continuity clinic enhances resident autonomy and insight into transitions-of-care competencies: a cross-sectional survey study.

PubMed

Rana, Jasmine; Mostaghimi, Arash

2017-05-15

Dermatology residents perform consults on hospitalized patients, but are often limited in their ability to follow-up with these patients after discharge, leading to inadequate follow-up and understanding of post-discharge transitions of care. In 2013, a discharge continuity clinic (DCC) staffed by the inpatient consult dermatology resident and attending dermatologist was established at one of the four adult hospital sites residents rotate through in the Harvard Combined Dermatology Residency Program. Resident perceptions about the DCC and their educational experience on inpatient consult rotations with a DCC and without a DCC were obtained using a cross-sectional survey instrument in June 2016. Self-reported data from a multi-year cohort of dermatology residents (n = 14 of 20, 70% response rate) reveals that the DCC enabled resident autonomy and resident satisfaction in care of their patients,insight into the disease-related challenges and the broader social context during transitions of care from inpatient to outpatient settings, and more enriching learning experiences than inpatient consult rotations without a DCC. Dermatology residents self-report participation in an inpatient consult rotation with aDCC supports their autonomy and achievement of post-discharge transitions-of-care competencies.

Cutaneous hypersensitivity reactions to freshwater cyanobacteria – human volunteer studies

PubMed Central

Stewart, Ian; Robertson, Ivan M; Webb, Penelope M; Schluter, Philip J; Shaw, Glen R

2006-01-01

Background Pruritic skin rashes associated with exposure to freshwater cyanobacteria are infrequently reported in the medical and scientific literature, mostly as anecdotal and case reports. Diagnostic dermatological investigations in humans are also infrequently described. We sought to conduct a pilot volunteer study to explore the potential for cyanobacteria to elicit hypersensitivity reactions. Methods A consecutive series of adult patients presenting for diagnostic skin patch testing at a hospital outpatient clinic were invited to participate. A convenience sample of volunteers matched for age and sex was also enrolled. Patches containing aqueous suspensions of various cyanobacteria at three concentrations were applied for 48 hours; dermatological assessment was made 48 hours and 96 hours after application. Results 20 outpatients and 19 reference subjects were recruited into the study. A single outpatient produced unequivocal reactions to several cyanobacteria suspensions; this subject was also the only one of the outpatient group with a diagnosis of atopic dermatitis. No subjects in the reference group developed clinically detectable skin reactions to cyanobacteria. Conclusion This preliminary clinical study demonstrates that hypersensitivity reactions to cyanobacteria appear to be infrequent in both the general and dermatological outpatient populations. As cyanobacteria are widely distributed in aquatic environments, a better appreciation of risk factors, particularly with respect to allergic predisposition, may help to refine health advice given to people engaging in recreational activities where nuisance cyanobacteria are a problem. PMID:16584576

From the Test Tube to the Treatment Room

PubMed Central

Del Rosso, James Q.; Plattner, Jacob J.

2014-01-01

The development of new drug classes and novel molecules that are brought to the marketplace has been a formidable challenge, especially for dermatologic drugs. The relative absence of new classes of antimicrobial agents is also readily apparent. Several barriers account for slow drug development, including regulatory changes, added study requirements, commercial pressures to bring drugs to market quickly by developing new generations of established compounds, and the greater potential for failure and higher financial risk when researching new drug classes. In addition, the return on investment is usually much lower with dermatologic drugs as compared to the potential revenue from “blockbuster” drugs for cardiovascular or gastrointestinal disease, hypercholesterolemia, and mood disorders. Nevertheless, some researchers are investigating new therapeutic platforms, one of which is boron-containing compounds. Boron-containing compounds offer a wide variety of potential applications in dermatology due to their unique physical and chemical properties, with several in formal phases of development. Tavaborole, a benzoxaborole compound, has been submitted to the United States Food and Drug Administration for approval for treatment of onychomycosis. This article provides a thorough overview of the history of boron-based compounds in medicine, their scientific rationale, physiochemical and pharmacologic properties, and modes of actions including therapeutic targets. A section dedicated to boron-based compounds in development for treatment of various skin disorders is also included. PMID:24578778

[Caffeine: traditional and new therapeutic indications and use as a dermatological model drug].

PubMed

Bors, Luca; Bajza, Ágnes; Kocsis, Dorottya; Erdő, Franciska

2018-03-01

Coffee consumption had already been described in the 15th century. The spreading of coffee drinking was not only a consequence of its delicious aromatic taste, but also of its pharmacological effects, especially due to its caffeine content. In this review, the mechanisms behind its complex stimulatory effects and the latest studies on the possible new therapeutic indications of caffeine are summarized. Several papers reported the neuroprotective (in Alzheimer's and Parkinson's disease) and hepatoprotective profiles of caffeine, and we show the most promising new results about its preventive properties in dermal malignancies. These findings were described both in cell cultures and in vivo. The application of caffeine and coffee in cosmetology and dermatological products is based on their antioxidant property and on the above-mentioned beneficial effects. Caffeine is also presented here as a dermatological model drug due to its hydrophilic profile. It can be used for designing and comparing different novel drug formulations, although beside the transcellular route, the follicular and transappendageal pathways play also important roles in its skin penetration. Taken together, caffeine molecule has many recently discovered beneficial pharmacological effects, but one should be careful with its excessive consumption. It can result in several adverse events if overdosed and in case of regular intake of high doses, after abandonment, withdrawal symptoms may appear. Orv Hetil. 2018; 159(10): 384-390.

Dangers of dermatologic surgery: protect your feet.

PubMed

Barr, Jerome; Siegel, Daniel

2004-12-01

Dermatologists frequently utilize scalpels, which are reported to be to culprit in around seven percent of the 385,000 sharps-related injuries sustained by healthcare personnel a year. Injuries from sharp devices are associated with the occupational transmission of more than 20 pathogens. Dropped scalpels may penetrate unprotected lower extremity skin, and there is no published data regarding what a shoe's actual degree of protection is against the danger of falling sharps. The purpose of this study was to evaluate and determine which types of shoes will protect their wearers. Although every shoe decreased falling sharp's degree of penetration into the feet, shoes cannot be relied on to prevent injury. More than half of the shoes allowed the scalpel blade to pass through the shoes and penetrate into the meat.

Reporting of harm and safety results in randomized controlled trials published in 5 dermatology journals.

PubMed

Haddad, Cynthia; Sigha, Odette Berline; Lebrun-Vignes, Bénédicte; Chosidow, Olivier; Fardet, Laurence

2017-07-01

Randomized controlled trials (RCTs) are considered the gold standard for assessing efficacy and short-term harm of medicines. However, several studies have come to the conclusion that harm is less well reported than efficacy outcomes. To describe harm reporting in publications on dermatological RCTs and assess parameters that could influence the quality of harm reporting. Methodologic systematic review of dermatologic RCTs published from 2010 to 2014 in 5 dermatological journals. Among 110 assessed publications on RCTs, 80 (73%) adequately reported harm and 52% adequately reported its severity. Overall, 40% of the assessed manuscripts perfectly reported and discussed harm. The adequate reporting of harm was significantly associated with the type of trial (odds ratio [OR] 4.41, 95% confidence interval [CI] 1.60-12.35 for multicenter compared with monocentric trials) and having a predefined method for collecting harm data (OR 5.93, 95% CI 2.26-15.56). Reporting of harm severity was better in pharmacologic trials (OR 6.48, 95% CI 2.00-21.0) compared with nonpharmacologic trials and in trials for which a method for collecting harm (OR 5.65, 95% CI 2.00-16.4) and its severity (OR 3.60, 95% CI 1.00-12.8) was defined before the study onset. Assessment was restricted to RCTs and 5 dermatological journals. Harm is quite well reported in dermatologic journals. Efforts should be made on reporting severity of harm. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

[Quality assessment of dermatology in the G-DRG system 2004].

PubMed

Fürstenberg, T; Hensen, P; Rompel, R; Roeder, N

2004-11-01

Since January 2004, all German hospitals have been obliged to operate with a new hospital funding system based on DRGs. For the DRG system to serve as a fair basis for reimbursement requires that the dermatologic services be adequately covered in the classification system. The German Dermatologic Society (DDG) in cooperation with the DRG-Research Group of the University Hospital Muenster carried out a DRG evaluation study. Based on these results, suggestions for the adjustment of the G-DRG system were proposed by the DDG in the G-DRG adaptation round for 2004. Based on data of the DRG evaluation project (14,555 dermatological cases from 19 hospitals) the homogeneity in the G-DRG system 2004 was examined and compared with the quality of depiction in the G-DRG version 1.0. The correlation between expenditure and case mix index in the hospitals improved in the G-DRG system 2004. Most proposals submitted by the German Dermatologic Society for the adaptation into the G-DRG system 2004 were accepted. Some fundamental problems such as reimbursement of high cost drugs and special services, as well as the reimbursement of high and low outliers, were only marginally addressed. The G-DRG system 2004 will need to be continuously adapted in the field of dermatology. Based on this work, the German Dermatologic Society has made suggestions to be adapted in the G-DRG system 2005 and submitted them to the German DRG Institute.

Dermatological Manifestations in Patients Undergoing In Vitro Fertilisation: A Prospective Study.

PubMed

Sood, Aradhana; Sahu, Suvash; Karunakaran, Sandeep; Joshi, Rajneesh K; Raman, Deep Kumar

Changing sociodemographic patterns with an increase in the age of childbirth have affected fertility rates worldwide. With advancing reproductive medicine, assisted reproductive techniques (ARTs) are becoming common. While dermatological manifestations in normal pregnancies have been well documented, there is a paucity of data regarding cutaneous manifestations in patients undergoing ART. The objectives of our study were to estimate the incidence and types of dermatological manifestations in patients undergoing in vitro fertilisation (IVF) and to study their associations with age, type of infertility, and outcome of the procedure. A prospective cohort of 200 patients undergoing IVF in a tertiary care centre was observed for occurrence of any dermatological manifestations from initiation of the IVF protocol to the outcome of the procedure at 3 weeks after embryo transfer. Dermatological manifestations were seen in 27% of the study group, with urticaria being the most common cutaneous finding seen in 13.5%, followed by acneform eruptions (3%). Twenty-six (96.3%) of patients who manifested with urticaria were on progesterone. No statistically significant association was found between the occurrence of dermatological manifestations and the outcome of IVF, type of infertility, history of ART, and ovum donation in our study. Association between the age of the patient and the outcome of IVF cycle was statistically significant. Dermatological manifestations are seen in almost one-quarter of patients undergoing IVF, with progesterone-induced urticaria being the most common. Occurrence of cutaneous manifestations has no significant association with the outcome of IVF.

Craniofacial Wound Healing with Photobiomodulation Therapy: New Insights and Current Challenges.

PubMed

Arany, P R

2016-08-01

The fundamental pathophysiologic response for the survival of all organisms is the process of wound healing. Inadequate or lack of healing constitutes the etiopathologic basis of many oral and systemic diseases. Among the numerous efforts to promote wound healing, biophotonics therapies have shown much promise. Advances in photonic technologies and a better understanding of light-tissue interactions, from parallel biophotonics fields such as in vivo optical imaging and optogenetics, are spearheading their popularity in biology and medicine. Use of high-dose lasers and light devices in dermatology, ophthalmology, oncology, and dentistry are now popular for specific clinical applications, such as surgery, skin rejuvenation, ocular and soft tissue recontouring, and antitumor and antimicrobial photodynamic therapy. However, a less well-known clinical application is the therapeutic use of low-dose biophotonics termed photobiomodulation (PBM) therapy, which is aimed at alleviating pain and inflammation, modulating immune responses, and promoting wound healing and tissue regeneration. Despite significant volumes of scientific literature from clinical and laboratory studies noting the phenomenological evidence for this innovative therapy, limited mechanistic insights have prevented rigorous and reproducible PBM clinical protocols. This article briefly reviews current evidence and focuses on gaps in knowledge to identify potential paths forward for clinical translation with PBM therapy with an emphasis on craniofacial wound healing. PBM offers a novel opportunity to examine fundamental nonvisual photobiological processes as well as develop innovative clinical therapies, thereby presenting an opportunity for a paradigm shift from conventional restorative/prosthetic approaches to regenerative modalities in clinical dentistry. © International & American Associations for Dental Research 2016.

Lasers in private dermatologic practice.

PubMed

Eastern, J S

1986-04-01

The author has collected and evaluated data from 464 cutaneous laser procedures performed on 315 patients over two and one-half years. All procedures were performed under local anesthesia in a private dermatology office. The quality of results obtained, the advantages and disadvantages of laser treatment for the treatment of cutaneous problems, comparison with more conventional therapies, and the future of the laser in dermatologic private practice are discussed.

Localized morphea after breast implant for breast cancer: A case report.

PubMed

Moretti, A; Bianchi, F; Abbate, I V; Gherardi, G; Bonavita, M; Passoni, E; Nazzaro, G; Bramati, A; Dazzani, M C; Piva, S; Paternò, E; Frungillo, N; Farina, G; La Verde, N

2018-03-01

Early breast cancer follow-up guidelines for patients who underwent surgery suggest a regular and accurate clinical examination of the breast area, for an early identification of cutaneous or subcutaneous breast cancer relapse. Nonetheless, breast skin lesions arising in patients treated with mastectomy for breast cancer can be caused by several diseases. A series of diagnostic hypotheses should be considered, not only focusing on cutaneous metastasis, but also on dermatologic and systemic diseases. In February 2015, a 37-year-old patient underwent a right subcutaneous mastectomy for stage IIA breast cancer. Five months after beginning adjuvant chemotherapy, she noted hyperpigmentation and thickening of the skin on the right breast. Differential diagnosis included local relapse, skin infection, lymphoma, or primary cutaneous disease, and a skin biopsy was performed. The histopathologic specimen showed full-thickness sclerosis, with features of localized morphea. Therapy with clobetasol was prescribed, with progressive resolution of the thickness. The collaboration between many professionals in a multidisciplinary team (oncologist, dermatologist, plastic surgeon, and pathologist) was crucial to achieving the diagnosis. In the literature, some articles describe correlation between connective tissue diseases and silicone breast implants, but the pathogenetic mechanisms are unknown. We report a rare case of breast morphea after positioning a silicone implant in a patient who had undergone mastectomy. This clinical report represents an interesting model of multidisciplinary management of a patient with breast cancer who developed an uncommon dermatologic disease. Further studies are needed to clarify the association between silicone implants and breast morphea.

Internship training adequately prepares South African medical graduates for community service - with exceptions.

PubMed

Nkabinde, T C; Ross, A; Reid, S; Nkwanyana, N M

2013-09-30

The 2-year internship period for medical graduates began in South Africa in 2005 and has never been formally evaluated. This study assessed the perceptions of community service medical officers (COSMOs) working at district hospitals (DHs) in KwaZulu-Natal (KZN) to determine whether the 2-year internship programme had adequately prepared them for community service (CS). A cross-sectional descriptive study was conducted regarding the perceptions of COSMOs working at 22 district hospitals in KZN. Data were collected in July 2012, using a questionnaire based on the core skills and knowledge detailed in the Health Professions Council of South Africa intern log book. All eight domains were self-assessed and a score of 4 out of 5 indicated an ability to work independently. Of the COSMOs, 78% (60 out of 89) completed the questionnaire. Most felt well-prepared for CS in all disciplines, but critical gaps in knowledge and skills were identified in paediatrics, orthopaedics, anaesthetics and obstetrics. In addition, 75% of respondents (45 out of 60) expressed a need for additional training in the disciplines of ear, nose and throat (ENT), urology, ophthalmology and dermatology. The 2-year internship has provided the basis for independent medical practice in DHs. However, certain critical skill gaps need urgent attention, particularly in obstetrics and anaesthesia. Areas of weakness in ENT, urology, ophthalmology and dermatology could be addressed by including these specialities as a compulsory rotation in surgery, medicine or family medicine during internship training.

Dyslipidemia in Dermatological Disorders

PubMed Central

Shenoy, Chetana; Shenoy, Manjunath Mala; Rao, Gururaja K.

2015-01-01

Dyslipidemias are one of the common metabolic disorders. A link between dermatological disorders like psoriasis and dyslipidemia has been established in the recent past. Many dermatological disorders could have a systemic inflammatory component which explains such association. Chronic inflammatory dermatological disorders could also have other metabolic imbalances that may contribute to dyslipidemia. Presence of such abnormal metabolism may justify routine screening of these disorders for associated dyslipidemia and other metabolic abnormalities and early treatment of such comorbidities to improve quality of life. Some of the drugs used by dermatologists such as retinoids are also likely to be a cause of dyslipidemia. Hence, it is imperative that the dermatologists obtain scientific knowledge on the underlying mechanisms involved in dyslipidemia and understand when to intervene with therapies. A systematic review of the English language literature was done by using Google Scholar and PubMed. In this review, attempts are made to list the dermatological disorders associated with dyslipidemia; to simplify the understanding of underlying mechanisms; and to give a brief idea about the interventions. PMID:26713286

Assessing Quality of Life in Older Adult Patients with Skin Disorders

PubMed Central

Farage, Miranda A.; Miller, Kenneth W.; Sherman, Susan N.; Tsevat, Joel

2012-01-01

Significance for Public Health The global population is aging. In the industrial world, adults over 65 outnumber children and comprise almost 20% of the population in some countries. Older adults experience a number of skin diseases and disorders that substantially affect their quality of life. Opportunity exists for developing and validating health-related quality of life (HRQoL) measures specifically for dermatological conditions most pertinent to older patients. Older adults experience a number of skin diseases and disorders that substantially affect quality of life. In the last two decades, a number of instruments have been developed for use among general dermatology patients to assess the effects of treatment and disease progression, perceptions of well-being, and the value that patients place on their dermatologic state of health. This chapter reviews some health-related quality of life (HRQoL) (HRQoL) measures developed and validated specifically for dermatological conditions. However, opportunity exists for developing and validating HRQoL measures specifically for dermatological conditions most pertinent to older patients. PMID:22980159

[The Dermatological University Hospital during National Socialism. A Contribution to the History of Dermatology].

PubMed

Kapp, T; Bondio, M G

2011-03-01

During the period of National Socialism, many politically motivated changes occurred in Germany in all areas of medicine and consequently in the field of dermatology as well. Most of the Jewish dermatologists were removed from their positions; many of the chair reshuffles were executed for political causes. These changes caused decline of dermatology in the time of National Socialism. This report gives an overview of the developments and changes in the Dermatological University Hospital (DUH) at Greifswald between 1933 and 1945. 3000 medical records were evaluated and archival data and literature reviewed. With these data we were able to reconstruct historical, medical and political aspects. We found a rapid increase in the number of patients suffering from venereal diseases during World War II and an increase in compulsory treatment as well as in forced sterilization. In six cases, the DUH was involved in the practice of compulsory sterilization. Research was performed with mustard gas in patients at the DUH.

Ranking predatory journals in dermatology: distinguishing the bad from the ugly.

PubMed

Tosti, Antonella; Maddy, Austin J

2017-07-01

The scientific community depends on high-quality peer-reviewed research, which is being polluted with pseudoscience published in fake journals that have exploited the open-access model. This "predatory publishing" has made its way into the field of dermatology. In a recent study, we identified and listed these journals. The "predatory rate" was calculated for 76 journals in order to rank the journals based on specific criteria associated with unethical publishing. Of the 76 journals, 89.5% were classified as predatory journals and the remaining as journals involved in predatory practices. The field of dermatology is not immune to predatory publishers. This study validates Beall's list as well as other previous studies. Strategies to a solution include spreading awareness throughout academic institutions and dermatology departments as well as avoiding publishers that are involved in predatory practices. However, some journals may be able to make necessary adjustments and become legitimate contributors to the field. © 2017 The International Society of Dermatology.

Elective time during dermatology residency: A survey of residents and program directors.

PubMed

Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

2017-12-15

Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

Attachment Styles of Dermatological Patients in Europe: A Multi-centre Study in 13 Countries.

PubMed

Szabó, Csanád; Altmayer, Anita; Lien, Lars; Poot, Françoise; Gieler, Uwe; Tomas-Aragones, Lucía; Kupfer, Jörg; Jemec, Gregor B E; Misery, Laurent; Linder, M Dennis; Sampogna, Francesca; van Middendorp, Henriët; Halvorsen, Jon Anders; Balieva, Flora; Szepietowski, Jacek C; Romanov, Dmitry; Marron, Servando E; Altunay, Ilknur K; Finlay, Andrew Y; Salek, Sam S; Dalgard, Florence

2017-07-06

Attachment styles of dermatological outpatients and satisfaction with their dermatologists were investigated within the framework of a multicentre study conducted in 13 European countries, organized by the European Society for Dermatology and Psychiatry. Attachment style was assessed with the Adult Attachment Scale. Patient satisfaction with the dermatologist was assessed with an 11-degree scale. A total of 3,635 adult outpatients and 1,359 controls participated in the study. Dermatological outpatients were less able to depend on others, were less comfortable with closeness and intimacy, and experienced similar rates of anxiety in relationships as did the controls. Participants who had secure attachment styles reported stressful life events during the last 6 months significantly less often than those who had insecure attachment styles. Patients with secure attachment styles tended to be more satisfied with their dermatologist than did insecure patients. These results suggest that secure attachment of dermatological outpatients may be a protective factor in the management of stress.

Fibre-optic sensors in health care

NASA Astrophysics Data System (ADS)

Grazia Mignani, Anna; Baldini, Francesco

1997-05-01

Biomedical fibre-optic sensors are attractive for the measurement of physical, chemical and biochemical parameters and for spectral measurements directly performed on the patient. An overview of fibre-optic sensors for in vivo monitoring is given, with particular attention paid to the advantages that these sensors are able to offer in different application fields such as cardiovascular and intensive care, angiology, gastroenterology, ophthalmology, oncology, neurology, dermatology and dentistry.

The radiofrequency frontier: a review of radiofrequency and combined radiofrequency pulsed-light technology in aesthetic medicine.

PubMed

Sadick, Neil; Sorhaindo, Lian

2005-05-01

Radiofrequency (RF) and combined RF light source technologies have established themselves as safe and effective treatment modalities for several dermatologic procedures, including skin tightening, hair and leg vein removal, acne scarring, skin rejuvenation, and wrinkle reduction. This article reviews the technology, clinical applications, and recent advances of RF and combined RF light/laser source technologies in aesthetic medicine.

DRG benchmarking: analysis of service structures and -differences in dermatology departments.

PubMed

Fürstenberg, Torsten; Gierling, Patrick; Irps, Sebastian; Gollnick, Harald; Kaufmann, Roland; Stadler, Rudolf; Rompel, Rainer; Hensen, Peter

2014-07-01

In the context of DRG-based hospital funding, the analysis of services provided in dermatologic inpatient care is highly relevant. We analyzed and compared clinical service structures and varieties in dermatologic hospitals through a benchmarking technique. For this multicenter cross-sectional study, routine data from 46 German dermatologic clinics and departments were collected, processed, and analyzed. In total, 95 257 data sets from 2011 were available. The data were grouped according to the G-DRG-system 2013 version. The average length of stay for all cases was 6.3 days (DRG "inliers": 5.7 days), and average patient age was 52 years. In total, 55 % of all cases were grouped to medical, 45 % to surgical DRGs. 71 % of all hospitals provide services within or close to this average value (± 10 %). No association was found between the number of hospital beds and the variety of clinical services provided in our sample. We found huge varieties in several parameters assessing the coding quality. The results reflect the heterogeneous reality in German inpatient dermatology. The varieties in dermatologic service range still depend on patient-related factors as well as infrastructural conditions and the resources available at each site. © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Dermatological moulage collections in the Nordic countries.

PubMed

Worm, A-M; Sinisalo, H; Eilertsen, G; Åhrén, E; Meyer, I

2018-04-01

The art of producing and acquiring dermatological wax models, moulages, flourished all over Europe in the beginning of the twentieth century, whereas very little is known about the existence of moulage collections in the Nordic countries. The aim of this study was to elucidate the presence, the origin, the production place, the use and the condition of dermatological moulage collections in the Nordic countries. In each Nordic country, an extensive survey was undertaken during spring 2016. Dermatological departments, museums with medical collections, persons assumed to have specific information about wax moulages as well as secondary sources were contacted and interviewed. Several hitherto undescribed collections have survived in each country, most, however, damaged and in disrepair. One Danish and part of a Finnish collection have been restored. Only few moulages are exhibited and some have been photographed and digitalized. Denmark and Sweden have had a local moulage production. Responses to the survey indicate that the result covers all collections of dermatological moulages in the Nordic countries, though some moulages may remain in private collections unknown to the authors, or uncatalogued in museums. Moulages are medical gems from bygone days before modern technology facilitated new means of communication. Restoration and appropriate storing should be considered for at least selected items from the Nordic collections. © 2017 European Academy of Dermatology and Venereology.

Teledermatology as an Educational Tool for Teaching Dermatology to Residents and Medical Students

PubMed Central

Boyers, Lindsay N.; Schultz, Amanda; Baceviciene, Rasa; Blaney, Susan; Marvi, Natasha; Dellavalle, Robert P.

2015-01-01

Abstract Although teledermatology (TD) is regarded as a tool to improve patient access to specialty healthcare, little has been done to evaluate its role in medical education. We describe the TD program at the Denver (CO) Department of Veterans Affairs Medical Center and evaluate its use as an educational tool for teaching dermatology to dermatology residents and medical students. Dermatology residents manage TD consultations and review all cases with a faculty preceptor; medical students participate as observers when possible. This study assessed dermatology resident (n=14) and medical student (n=16) perceptions of TD and its usefulness in teaching six core clinical competencies. Both residents (79%) and medical students (88%) “strongly agree” or “agree” that TD is an important educational tool. In general, medical students were slightly more satisfied than residents across all of the core competencies assessed except for patient care. Medical students and residents were most satisfied with the competencies of practice-based learning and improvement and medical knowledge, whereas they were least satisfied with those of interpersonal and communication skills and professionalism. Overall, TD is valued as a teaching tool for dermatology in the areas of patient care, medical knowledge, practice-based learning and improvement, and systems-based practice. PMID:25635528

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates.

PubMed

Barat, Atena; Goldacre, Michael J; Lambert, Trevor W

2018-01-01

To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. In all, 40,412 doctors (58% of graduates) responded in year 1, 31,466 (64%) in year 3, and 24,970 (67%) in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005-15), particularly for women (from 2.1% in year 1 to 0.8% in year 5) compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was "hours/working conditions": in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%), 10 years after qualifying, had made their future career decision by year 5. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

Nanotechnology applications in plastic and reconstructive surgery: a review.

PubMed

Parks, Joe; Kath, Melissa; Gabrick, Kyle; Ver Halen, Jon Peter

2012-01-01

Although nanotechnology is a relatively young field, there are already countless biomedical applications. Plastic and reconstructive surgery has significantly benefited from nanoscale refinements of diagnostic and therapeutic techniques. Plastic surgery is an incredibly diverse specialty, encompassing craniofacial surgery, hand surgery, cancer/trauma/congenital reconstruction, burn care, and aesthetic surgery. In particular, wound care, topical skin care, implant and prosthetic design, tissue engineering, regenerative medicine, and drug delivery have all been influenced by advances in nanotechnology. Nanotechnology will continue to witness growth and expansion of its biomedical applications, especially those in plastic surgery.

Systemic antibiotic use for nonbacterial dermatological conditions among referring providers.

PubMed

Haynes, Dylan; Lasarev, Michael; Keller, Jesse

2018-05-01

As usage of systemic antibiotic therapies has increased, so too has bacterial resistance. Antibiotic stewardship thus rests in part on judicious use of empiric treatment. The specific factors which underlie erroneous prescription patterns for dermatological conditions have not yet been well elucidated. The objective of this study was to identify whether a predefined group of dermatologic conditions under the heading "pseudobacterial"-including eczematous conditions, arthropod assault, herpes zoster, neurodermatoses, autoimmune blistering disorders, and neutrophilic dermatoses-are associated with increased antibiotic use prior to dermatology referral. This observational prospective study included 207 participants referred to an academic dermatology referral center for acute skin conditions which were ultimately deemed to be of a nonbacterial cause. Preceding antibiotic prescription, final diagnosis, and patient, and provider characteristics were reviewed. Antibiotic prescription were provided to 31/207 individuals. Patients with pseudobacterial diagnoses (66/207 individuals) had 4.79 (95% CI, 2.03-11.3) times the odds of empiric antibiotic treatment compared to all others. Rural referring providers (OR, 8.54; 95% CI, 1.81-40.3) and referring providers in areas with a low density of medical specialists (OR, 3.70; 95% CI, 1.43-10.0) also displayed increased odds of empiric antibiotic prescription for nonbacterial skin disease, though the former finding may be limited by the low number of rural vs. urban providers (7 vs. 200) included in the study. Patients with noninfectious pseudobacterial dermatological conditions experienced greater odds for unnecessary exposure to antibiotics. Additional independent risk factors included rural settings and diminished access to specialist care. © 2018 The International Society of Dermatology.

Drug samples in dermatology: special considerations and recommendations for the future.

PubMed

Alikhan, Ali; Sockolov, Mary; Brodell, Robert T; Feldman, Steven R

2010-06-01

The use of drug samples is a controversial issue in medicine. We sought to determine the pros and cons of drug sampling, and how drug sampling in general medicine differs from dermatology. Literature searches were conducted on PubMed, Google, and Yahoo!. Articles were found pertaining to drug sampling in general, and for dermatology specifically. Numerous pros and cons for drug sampling were found in the literature search. We divided these by cost-related issues, such as the industry-wide cost of sampling and the use of sampling to assist the underinsured and poor, and quality of care issues, such as adherence, patient education, and safety considerations. Articles also suggested that dermatology may differ from general medicine as topical treatments have fewer side effects, are more complicated to use, and come in different vehicles. We identified few studies specifically focused on issues relevant to sampling in dermatology. There are strong arguments for and against drug sampling involving both cost and quality of care issues. Dermatology-specific medications clearly differ from oral medications in several regards. We ultimately conclude that the benefits of drug sampling outweigh the risks, but give recommendations on how drug sampling can be done ethically and effectively, including limiting personal use, not selling samples, properly documenting sample release, teaching patients about proper use, teaching students and residents ethical use of samples, working with pharmaceutical representatives in an ethical manner, prescribing the drug that is best for the patient, and securing samples appropriately to prevent theft and misuse. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

A Retrospective Analysis of Complication Rates in Mohs Micrographic Surgery Patients With Clinically Large Tumors and Tumors With Aggressive Subclinical Extension.

PubMed

Cowan, Natasha; Goldenberg, Alina; Basu, Pallavi; Eilers, Robert; Hau, Jennifer; I Brian Jiang, Shang

2018-05-01

Clinically large cutaneous tumors and those with aggressive subclinical extension (ASE) often require wider margins and increased operative time during Mohs micrographic surgery (MMS). Our goal is to improve dermatologic surgeons' counseling information on complication risks for aggressive tumors. To examine the incidence of postoperative complications in MMS patients, with a focus on differences between aggressive and non-aggressive tumors. We performed a retrospective cross-sectional chart review of 4151 MMS cases at the University of California, San Diego. A postoperative complication was defined as an adverse event directly related to MMS reported within 6 weeks of the procedure. Clinically, large tumors had 50 times the odds of postoperative complication as compared to all other tumors (P less than 0.001). ASE was not found to be significantly associated with higher rates of postoperative complications when controlled for other factors. Clinically, large tumors may be at higher risk for complications following MMS due to their increased size and need for repair with methods other than linear closures. Tumors with ASE were not found to be at higher risk for postoperative complications. J Drugs Dermatol. 2018;17(5):511-515.

Practice Patterns and Job Satisfaction of Mohs Surgeons.

PubMed

Kohli, Nita; Golda, Nicholas

2018-01-01

There is a paucity of data on Mohs surgery workforce patterns. To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016. Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of men and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings. Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons-knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.

The Effect of Work Characteristics on Dermatologic Symptoms in Hairdressers

PubMed Central

2014-01-01

Objectives Hairdressers in Korea perform various tasks and are exposed to health risk factors such as chemical substances or prolonged duration of wet work. The objective of this study is to provide descriptive statistics on the demographics and work characteristics of hairdressers in Korea and to identify work-related risk factors for dermatologic symptoms in hairdressers. Methods 1,054 hairdressers were selected and analyzed for this study. Independent variables were exposure to chemical substances, the training status of the hairdressers, and the main tasks required of them, and the dependent variable was the incidence of dermatologic symptoms. The relationships between work characteristics and dermatologic symptoms were evaluated by estimating odds ratios using multiple logistic regression analysis. Results Among the 1,054 study subjects, 212 hairdressers (20.1%) complained of dermatologic symptoms, and the symptoms were more prevalent in younger, unmarried or highly educated hairdressers. The main tasks that comprise the majority of the wet work were strictly determined by training status, since 96.5% of staff hairdressers identified washing as their main task, while only 1.5% and 2.0% of master and designer hairdressers, respectively, identified this as their main task. Multiple logistic regressions was performed to estimate odds ratios. While exposure to hairdressing chemicals showed no significant effect on the odds ratio for the incidence of dermatologic symptoms, higher odds ratios of dermatologic symptoms were shown in staff hairdressers (2.70, 95% CI: 1.32 - 5.51) and in hairdressers who perform washing as their main task (2.03, 95% CI: 1.22 - 3.37), after adjusting for general and work characteristics. Conclusions This study showed that the training status and main tasks of hairdressers are closely related to each other and that the training status and main tasks of hairdressers are related to the incidence of dermatologic symptoms. This suggests that in the future, regulations on working conditions and health management guidelines for hairdressers should be established. PMID:25028609

Using Network Oriented Research Assistant (NORA) Technology to Compare Digital Photographic With In-Person Assessment of Acne Vulgaris.

PubMed

Singer, Hannah M; Almazan, Timothy; Craft, Noah; David, Consuelo V; Eells, Samantha; Erfe, Crisel; Lazzaro, Cynthia; Nguyen, Kathy; Preciado, Katy; Tan, Belinda; Patel, Vishal A

2018-02-01

Teledermatology has undergone exponential growth in the past 2 decades. Many technological innovations are becoming available without necessarily undergoing validation studies for specific dermatologic applications. To determine whether patient-taken photographs of acne using Network Oriented Research Assistant (NORA) result in similar lesion counts and Investigator's Global Assessment (IGA) findings compared with in-person examination findings. This pilot reliability study enrolled consecutive patients with acne vulgaris from a single general dermatology practice in Los Angeles, California, who were able to use NORA on an iPhone 6 to take self-photographs. Patients were enrolled from January 1 through March 31, 2016. Each individual underwent in-person and digital evaluation of his or her acne by the same dermatologist. A period of at least 1 week separated the in-person and digital assessments of acne. All participants were trained on how to use NORA on the iPhone 6 and take photographs of their face with the rear-facing camera. Reliability of patient-taken photographs with NORA for acne evaluation compared with in-person examination findings. Acne assessment measures included lesion count (total, inflammatory, noninflammatory, and cystic) and IGA for acne severity. A total of 69 patients (37 male [54%] and 32 female [46%]; mean [SD] age, 22.7 [7.7] years) enrolled in the study. The intraclass correlation coefficients of in-person and photograph-based acne evaluations indicated strong agreement. The intraclass correlation coefficient for total lesion count was 0.81; for the IGA, 0.75. Inflammatory lesion count, noninflammatory lesion count, and cyst count had intraclass correlation coefficients of 0.72, 0.72, and 0.82, respectively. This study found agreement between acne evaluations performed in person and from self-photographs with NORA. As a reliable telehealth technology for acne, NORA can be used as a teledermatology platform for dermatology research and can increase access to dermatologic care.

Psoriasis - resources

MedlinePlus

Resources - psoriasis ... The following organizations are good resources for information about psoriasis : American Academy of Dermatology -- www.aad.org/skin-conditions/dermatology-a-to-z/psoriasis National Institute of ...

Achieving consistent color and grayscale presentation on medial color displays

NASA Astrophysics Data System (ADS)

Fan, Jiahua; Roehrig, Hans; Dallas, William; Krupinski, Elizabeth A.

2008-03-01

Color displays are increasingly used for medical imaging, replacing the traditional monochrome displays in radiology for multi-modality applications, 3D representation applications, etc. Color displays are also used increasingly because of wide spread application of Tele-Medicine, Tele-Dermatology and Digital Pathology. At this time, there is no concerted effort for calibration procedures for this diverse range of color displays in Telemedicine and in other areas of the medical field. Using a colorimeter to measure the display luminance and chrominance properties as well as some processing software we developed a first attempt to a color calibration protocol for the medical imaging field.

Myofibrosarcoma treated with Mohs micrographic surgery.

PubMed

Chiller, Katarina; Parker, Douglas; Washington, Carl

2004-12-01

Myofibrosarcoma is a rare malignant mesenchymal tumor composed predominantly of differentiated myofibroblasts. These tumors occur in both children and adults alike and are most commonly located on the head and neck. Recurrences rates range from 44% to 75%, and metastatic disease has been reported in up to 44% of cases. The objective was to present a case of a myofibrosarcoma treated with Mohs micrographic surgery and discuss the use of ultrastructural evaluation in the diagnosis of this rare tumor. A 31-year-old African American woman who presented to the Emory University Dermatologic Surgery Clinic with a 4-month history of a 2.5 x 2.5-cm indurated firm painful right upper lateral thigh nodule. A prior biopsy revealed a proliferation of somewhat bland spindled cells with large zones of necrosis with prominent mitotic figures, changes compatible with a cellular dermatofibroma. Because the lesion exhibited clinically suspicious characteristics such as rapid growth and deep infiltration, the patient was subsequently referred to Emory for further evaluation. There was no evidence of lymphadenopathy and a chest X-ray was unremarkable. A two-staged (five and four sections, respectively) uneventful Mohs micrographic surgery procedure was performed resulting in a defect measuring 3.5 x 3.5 x 1.0 cm. Primary closure was achieved with no complication, and the final scar measured 10 cm. Because of the suspicious clinical behavior of this tumor debulking specimen was sent for permanent section. Histopathologic interpretation of these sections was consistent with a fibrosarcoma with myofibroblastic differentiation. No clinical recurrence noted after 14-month follow-up. Mohs micrographic surgery is a technique that has been shown to provide superior cure rates in the treatment of many mesenchymal tumors. Here, we report the first case of myofibrosarcoma treated with Mohs micrographic surgery. Myofibrosarcoma is a rare but aggressive tumor that can be difficult to distinguish from other somewhat less aggressive malignancies such as dermatofibrosarcoma protuberans or malignant fibrous histiocytoma. Specific histopathologic criteria are reviewed. We recommend including Mohs micrographic surgery in the armamentarium for the treatment of this rare tumor.

Hippocrates on Pediatric Dermatology.

PubMed

Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George

2015-01-01

Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. © 2015 Wiley Periodicals, Inc.

Skin in aviation and space environment.

PubMed

Grover, Sanjiv

2011-01-01

The aerospace environment is a dynamic interaction between man, machine and the environment. Skin diseases are not particularly significant aeromedically, yet they could permanently affect an aviator's status for continued flying duty. A number of dermatological conditions lend themselves to flying restrictions for the aviator. Aircrew and ground crew are exposed to a myriad of elements that could also adversely impact their flying status. Inflight stresses during flights as well as space travel could impact certain behaviors from a dermatological standpoint. With the advent of space tourism, dermatological issues would form an integral part of medical clearances. With limited literature available on this subject, the review article aims to sensitize the readers to the diverse interactions of dermatology with the aerospace environment.

Extracellular Vesicles as Biomarkers and Therapeutics in Dermatology: A Focus on Exosomes.

PubMed

McBride, Jeffrey D; Rodriguez-Menocal, Luis; Badiavas, Evangelos V

2017-08-01

Extracellular vesicles (exosomes, microvesicles, and apoptotic bodies) are ubiquitous in human tissues, circulation, and body fluids. Of these vesicles, exosomes are of growing interest among investigators across multiple fields, including dermatology. The characteristics of exosomes, their associated cargo (nucleic acids, proteins, and lipids), and downstream functions are vastly different, depending on the cell origin. Here, we review concepts in extracellular vesicle biology, with a focus on exosomes, highlighting recent studies in the field of dermatology. Furthermore, we highlight emerging technical issues associated with isolating and measuring exosomes. Extracellular vesicles, including exosomes, have immediate potential for serving as biomarkers and therapeutics in dermatology over the next decade. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Clinical translation of photobiomodulation therapy using evidences from precision molecular pathway analyses (Conference Presentation)

NASA Astrophysics Data System (ADS)

Arany, Praveen

2017-02-01

Can `light' be a Drug? To satisfy this definition as a pharmaceutical agent, light must be absorbed and change bodily function. Much evidence from our understanding of our visual cycle and Vitamin D metabolism have all noted this phenomenon. Advances in optophotonic technologies along with a better understanding of light-tissue interactions, especially in in vivo optical imaging and optogenetics, are spearheading the popularity of biophotonics in biology and medicine. The use of lasers and light devices at high doses in dermatology, ophthalmology, oncology and dentistry are now considered mainstream for certain clinical applications such as surgery, skin rejuvenation, ocular and soft tissue recontouring, anti-tumor and anti-microbial photodynamic therapy. In contrast, therapeutic use of low dose biophotonics devices is called Low Level Light / Laser Therapy (LLLT), now termed Photobiomodulation (PBM) Therapy. This therapy is defined as a non-thermal use of non-ionizing forms of electromagnetic radiation to alleviate pain, inflammation, modulating the immune responses and promoting wound healing and tissue regeneration. Surprisingly, despite vast volumes of scientific literature from both clinical and laboratory studies noting the phenomenological evidences for this innovative therapy, limited mechanistic insights have prevented the development of rigorous, reproducible clinical protocols. This presentation will outline our current efforts at ongoing efforts in our group to assess molecular pathways and precisely define clinical treatment variables to enable clinical translation with PBM therapies.

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa.

PubMed

Seyed Jafari, S Morteza; Knüsel, Evelyne; Cazzaniga, Simone; Hunger, Robert E

2018-05-14

Hidradenitis suppurativa (HS) is one of the most distressing conditions observed in dermatology and has a substantial negative effect on the quality of life of affected persons. The aim of this study was to evaluate different treatment strategies in patients with HS. In a retrospective cohort, all patients with HS (July 2015 to March 2017) were reviewed. Collected data consisted of patients' demographics, clinical characteristics, psychosocial situation, and previous and current treatments. In addition, therapy response to the most recent prescribed treatments was assessed. 102 patients (38 females, 64 males; median age 37.5 years) were included in this study. 68.4% of patients had BMI ≥25, and 76.5% of patients were current smokers. Hurley stages I, II, and III were detected in 13.5, 53.1, and 33.3% of patients, respectively. The most commonly administered treatments were surgery (67.6%), nonantibiotic topical therapies (72.5%), antibiotic topical therapies (55.9%), systemic antibiotics (88.2%), and biologics in 11.8% of the patients. 84.6% of the patients showed a response (27.5 and 47.1% partial and complete response, respectively) to the treatments. HS as a chronic, recurrent inflammatory skin disease is associated with smoking and obesity. Application of systemic antibiotics is the most frequent treatment strategy for this disease. However, surgical intervention seems to be the most effective treatment strategy. © 2018 S. Karger AG, Basel.

Determining the mechanical properties of rat skin with digital image speckle correlation.

PubMed

Guan, E; Smilow, Sarah; Rafailovich, Miriam; Sokolov, Jonathan

2004-01-01

Accurate measurement of the mechanical properties of skin has numerous implications in surgical repair, dermal disorders and the diagnosis and treatment of trauma to the skin. Investigation of facial wrinkle formation, as well as research in the areas of skin aging and cosmetic product assessment can also benefit from alternative methodologies for the measurement of mechanical properties. A noncontact, noninvasive technique, digital image speckle correlation (DISC), has been successfully introduced to measure the deformation field of a skin sample loaded by a material test machine. With the force information obtained from the loading device, the mechanical properties of the skin, such as Young's modulus, linear limitation and material strength, can be calculated using elastic or viscoelastic theory. The DISC method was used to measure the deformation of neonatal rat skin, with and without a glycerin-fruit-oil-based cream under uniaxial tension. Deformation to failure procedure of newborn rat skin was recorded and analyzed. Single skin layer failures were observed and located by finding the strain concentration. Young's moduli of freshly excised rat skin, cream-processed rat skin and unprocessed rat skin, 24 h after excision, were found with tensile tests to be 1.6, 1.4 and 0.7 MPa, respectively. Our results have shown that DISC provides a novel technique for numerous applications in dermatology and reconstructive surgeries. Copyright 2004 S. Karger AG, Basel

Implementation of fluorescence confocal mosaicking microscopy by “early adopter” Mohs surgeons and dermatologists: recent progress

PubMed Central

Jain, Manu; Rajadhyaksha, Milind; Nehal, Kishwer

2017-01-01

Abstract. Confocal mosaicking microscopy (CMM) enables rapid imaging of large areas of fresh tissue ex vivo without the processing that is necessary for conventional histology. When performed in fluorescence mode using acridine orange (nuclear specific dye), it enhances nuclei-to-dermis contrast that enables detection of all types of basal cell carcinomas (BCCs), including micronodular and thin strands of infiltrative types. So far, this technique has been mostly validated in research settings for the detection of residual BCC tumor margins with high sensitivity of 89% to 96% and specificity of 99% to 89%. Recently, CMM has advanced to implementation and testing in clinical settings by “early adopter” Mohs surgeons, as an adjunct to frozen section during Mohs surgery. We summarize the development of CMM guided imaging of ex vivo skin tissues from bench to bedside. We also present its current state of application in routine clinical workflow not only for the assessment of residual BCC margins in the Mohs surgical setting but also for some melanocytic lesions and other skin conditions in clinical dermatology settings. Last, we also discuss the potential limitations of this technology as well as future developments. As this technology advances further, it may serve as an adjunct to standard histology and enable rapid surgical pathology of skin cancers at the bedside. PMID:28199474

[Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Dermatology in Traditional Chinese Medicine].

PubMed

Wang, Yue-Xi; Liu, Meng-Yu; Wang, Li-Ying; Shi, Nan-Nan; Zhao, Xue-Yao; Liu, Yu-Qi; Wang, Yan-Ping; Han, Xue-Jie

2017-09-01

To assess the quality and application effect of Guidelines for Diagnosis and Treatment of Common Diseases of Dermatology in Traditional Chinese Medicine(Guidelines) through the applicability and applicability evaluation respectively. The questionnaire survey was adopted to evaluate the applicability of the Guidelines, including the utilization, quality, and clinical application conditions. The results showed that the familiarity rate and utilization rate of the Guidelines were 85.37%, 48.78%, respectively. The data showed that the familiarity and the utilization rates were different in the working staff with different professional titles. The evaluation level was the lowest given by the staff with junior professional title (70.97%, 29.03%) in comparison. The assessment showed the overall quality of the Guideline was good and slightly low level for the rationality scores of the other therapeutic methods as well as for the recuperation and prevention (80.49%, 85.37%), which was in line with the clinical compliance of the Guideline. The perspective observation of clinical cases was used for the applicability evaluation, including clinical compliance of the Guideline, effect evaluation, and comprehensive assessment, et al. The results showed that the safety score was the highest, followed by the economic issue and efficacy. For the comprehensive evaluation of the applicability, complete applicability accounted for 29.27%, and the general applicability accounted for 87.80%. It was showed in the three index scores of the applicability evaluation that the accumulative score 7-9 scores were 75.65%, 73.89%, 71.12%. Through the applicability and applicability evaluation, the Guideline was satisfactory in the overall quality, high in the safety of clinical application and good in efficacy and economic issues. There are some limits on the development method and technical issues in the Guideline, which is required to be supplemented in the revision. Additionally, the strategy study on the promotion of the Guideline should be enhanced so as to expedite the recognition and utilization of the Guideline. Copyright© by the Chinese Pharmaceutical Association.

Prevalence and characterization of neonatal skin disorders in the first 72h of life.

PubMed

Reginatto, Flávia Pereira; DeVilla, Damie; Muller, Fernanda M; Peruzzo, Juliano; Peres, Letícia P; Steglich, Raquel B; Cestari, Tania F

To determine the prevalence of neonatal dermatological findings and analyze whether there is an association between these findings and neonatal and pregnancy characteristics and seasonality. Newborns from three maternity hospitals in a Brazilian capital city were randomly selected to undergo dermatological assessment by dermatologists. 2938 neonates aged up to three days of life were randomly selected, of whom 309 were excluded due to Intensive Care Unit admission. Of the 2530 assessed neonates, 49.6% were Caucasians, 50.5% were males, 57.6% were born by vaginal delivery, and 92.5% of the mothers received prenatal care. Some dermatological finding was observed in 95.8% of neonates; of these, 88.6% had transient neonatal skin conditions, 42.6% had congenital birthmarks, 26.8% had some benign neonatal pustulosis, 2% had lesions secondary to trauma (including scratches), 0.5% had skin malformations, and 0.1% had an infectious disease. The most prevalent dermatological findings were: lanugo, which was observed in 38.9% of the newborns, sebaceous hyperplasia (35%), dermal melanocytosis (24.61%), skin desquamation (23.3%), erythema toxicum neonatorum (23%), salmon patch (20.4%), skin erythema (19%), genital hyperpigmentation (18.4%), eyelid edema (17.4%), milia (17.3%), genital hypertrophy (12%), and skin xerosis (10.9%). Dermatological findings are frequent during the first days of life and some of them characterize the newborn's skin. Mixed-race newborns and those whose mothers had some gestational risk factor had more dermatological findings. The gestational age, newborn's ethnicity, gender, Apgar at the first and fifth minutes of life, type of delivery, and seasonality influenced the presence of specific neonatal dermatological findings. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The association between question type and the outcomes of a Dermatology eConsult service.

PubMed

O'Toole, Ashley; Joo, Jiyeh; DesGroseilliers, Jean-Pierre; Liddy, Clare; Glassman, Steven; Afkham, Amir; Keely, Erin

2017-08-01

eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults. The time it took the PCP to receive a reply and the amount of time reported by the specialist to answer eConsult were proactively recorded and analyzed. A subset of 154 most recent eConsults was categorized for dermatology content and question type (e.g. diagnosis or management) using a validated taxonomy. A total of 965 eConsults were directed to dermatology from 217 unique PCPs. The majority of eConsults (64%) took the specialist between 10 and 15 minutes to answer. The overall value of this service to the provider was rated as very good or excellent in 95% of cases. In 49%, traditional in-person assessments were avoided. In the subset of the most recent cases, diagnosis was the most common question type asked (65.2%) followed by management (29%) and drug treatment (10.6%). The top five subject areas (40%) were: Dermatitis, Infections, Neoplasm, Nevi, and Pruritus. eConsults was feasible and well received by PCPs, which improves access to dermatology care with a potential to reduce wait times for traditional consultation. © 2017 The International Society of Dermatology.

Design of Highly Articulated Mechanism for Surgical Applications

DTIC Science & Technology

2016-08-31

Army including surgery in the field and surgical bomb disarming. The views, opinions and/or findings contained in this report are those of the...many applications important to the Army including surgery in the field and surgical bomb disarming. We use minimally invasive surgery as a focal point...have many applications important to the Army including surgery in the field and surgical bomb disarming. We use minimally invasive surgery as a focal

Determination of the impact of melanoma surgical timing on survival using the National Cancer Database.

PubMed

Conic, Ruzica Z; Cabrera, Claudia I; Khorana, Alok A; Gastman, Brian R

2018-01-01

The ideal timing for melanoma treatment, predominantly surgery, remains undetermined. Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery. To assess the impact of time to definitive melanoma surgery on overall survival. Patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified by using the National Cancer Database (N = 153,218). The t test and chi-square test were used to compare variables. Cox regression was used for multivariate analysis. In a multivariate analysis of patients in all stages who were treated between 90 and 119 days after biopsy (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.18) and more than 119 days (HR, 1.12; 95% CI, 1.02-1.22) had a higher risk for mortality compared with those treated within 30 days of biopsy. In a subgroup analysis of stage I, higher mortality risk was found in patients treated within 30 to 59 days (HR, 1.05; 95% CI, 1.01-1.1), 60 to 89 days (HR, 1.16; 95% CI, 1.07-1.25), 90 to 119 days (HR, 1.29; 95% CI, 1.12-1.48), and more than 119 days after biopsy (HR, 1.41; 95% CI, 1.21-1.65). Surgical timing did not affect survival in stages II and III. Melanoma-specific survival was not available. Expeditious treatment of stage I melanoma is associated with improved outcomes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Surgery under general anaesthesia in severe hidradenitis suppurativa: a study of 363 primary operations in 113 patients.

PubMed

Blok, J L; Boersma, M; Terra, J B; Spoo, J R; Leeman, F W J; van den Heuvel, E R; Huizinga, J; Jonkman, M F; Horváth, B

2015-08-01

Treatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure. To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia. A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013. Patient satisfaction was retrospectively investigated with questionnaires. A total of 482 operations (363 primary operations and 119 re-operations) were performed during the study period. The proportion of women in the included population was 68%. The median diagnostic delay (patient's and doctor's delay) was 6.5 years. Relapses occurred after 29.2% of primary operations. Women had higher relapse rates than men [odds ratio 2.85 (1.07;7.61)]. Hypergranulation of the wound was the most common complication and occurred in 7% of all operations. The median score patients attributed to the medical effect of surgery was eight of 10 (zero corresponding to very dissatisfied and 10 to very satisfied). The diagnostic delay in HS is long due to a lack of knowledge in both patients and health care professionals, indicating that there is a need for education. Deroofing and the STEEP are effective surgical procedures in severe cases of HS and lead to a relatively high patient satisfaction. The postoperative relapse risk is higher in women. Prospective studies are required for the development of clear guidelines on the appropriate choice of surgery. © 2015 European Academy of Dermatology and Venereology.

[Bioequivalence of dermatological topical medicines:the Brazilian scenario and the challenges for health surveillance].

PubMed

Soares, Kelen Carine Costa; Moraes, Marcelo Vogler; Gelfuso, Guilherme Martins; Gratieri, Taís

2015-11-01

The comparative evaluation required for the registration of generic topical medicines in Brazil is conducted by means of a pharmaceutical equivalence study, which merely assesses the physical/chemical and microbiological parameters of the formulations. At the international level, clinical or pharmacodynamic studies are now being required to prove the efficacy and safety of semisolid topical generic formulations. This work presents a comparison of the different requirements for the registration of topical formulations, taking into consideration the various regulatory authorities, and presents a survey of topical medicines registered in Brazil prior to 2013. The survey revealed that in comparison with the USA there were many more copies of these formulations registered in Brazil. This fact, together with the large number of studies in the literature showing the lack of bioequivalence of topical medication, is clear proof of the major importance of the need to realign Brazilian legislation with respect to the technical requirements for the registration of generic and similar medication for dermatological topical application in Brazil.

An Overview of Laser in Dermatology: The Past, the Present and … the Future (?)

PubMed Central

Gianfaldoni, Serena; Tchernev, Georgi; Wollina, Uwe; Fioranelli, Massimo; Roccia, Maria Grazia; Gianfaldoni, Roberto; Lotti, Torello

2017-01-01

The authors discuss a brief history of lasers and their use in dermatology. Although the excellent results achieved by the use of laser in dermatology, this special treatment modality is in continuous evolution. At present, new devices have been under development for the therapy of different kind of diseases, while lasers, already in use, has been changing, in order to be more secure, effective and be useful in many others disorders. PMID:28785350

[From scabies room to modern specialty department. 90 years Ludwigshaven Dermatology Clinic].

PubMed

Voigtländer, V; Boslet, W; Tully, G

2000-12-01

The dermatology clinic Ludwigshafen was founded in 1910. Dr. Siegfried Fuss was head of the clinic for almost 40 years. The clinic's history reflects the rapid industrial growth of the city, the destruction of two world wars and the progress of dermatology during this century. Today, the clinic is an academic teaching hospital affiliated with the University of Mainz with 45 beds and offers a broad spectrum of modern dematological diagnostic procedures and therapies.

An Overview of Laser in Dermatology: The Past, the Present and … the Future (?).

PubMed

Gianfaldoni, Serena; Tchernev, Georgi; Wollina, Uwe; Fioranelli, Massimo; Roccia, Maria Grazia; Gianfaldoni, Roberto; Lotti, Torello

2017-07-25

The authors discuss a brief history of lasers and their use in dermatology. Although the excellent results achieved by the use of laser in dermatology, this special treatment modality is in continuous evolution. At present, new devices have been under development for the therapy of different kind of diseases, while lasers, already in use, has been changing, in order to be more secure, effective and be useful in many others disorders.

Body dysmorphic concerns, social adaptation, and motivation for psychotherapeutic support in dermatological outpatients.

PubMed

Ritter, Viktoria; Fluhr, Joachim W; Schliemann-Willers, Sibylle; Elsner, Peter; Strauß, Bernhard; Stangier, Ulrich

2016-09-01

Dermatologists are increasingly confronted with patients affected by body dysmorphic disorder (BDD). BDD is characterized by excessive preoccupation with one or more perceived defect(s) or flaw(s) in physical appearance which are not observable or appear slight to others. So far, there have been only few studies examining the prevalence of BDD in dermatological outpatients. In addition, the need for psychotherapeutic support in dermatological outpatients with body dysmorphic concerns has not yet been systematically examined. The objective of the present study was therefore to investigate the frequency of body dysmorphic concerns as well as social adaptation and the need for psychotherapeutic support in the aforementioned patient group. A total of 252 dermatological outpatients seen at a German university hospital were consecutively enrolled, and examined using the Dysmorphic Concerns Questionnaire, the Social Adaptation Self-Evaluation Scale, and the German version of the University of Rhode Island Change Assessment Scale. 7.9 % of all outpatients (unselected sample) showed positive test results, suggesting clinically relevant body dysmorphic concerns. Patients with clinically relevant body dysmorphic concerns exhibited poor social adaptation. Contrary to expectations, these patients revealed a high motivation for change, indicating the necessity for psychotherapeutic support. Our findings confirm previous prevalence rates of BDD in dermatological outpatients, and highlight the need for providing psychotherapeutic support to dermatological patients. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

A four-phase strategy for the implementation of reflectance confocal microscopy in dermatology.

PubMed

Hoogedoorn, L; Gerritsen, M J P; Wolberink, E A W; Peppelman, M; van de Kerkhof, P C M; van Erp, P E J

2016-08-01

Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome was the diagnosis of psoriasis and differentiation of stable from unstable psoriatic plaques by means of the 'hands on' protocol, derived from the strategy. We used a four-phased model; an exploring phase, a systematic literature search, a clinical approach and, finally, an integration phase to develop a clinical guideline for RCM in psoriasis. Receiver operating characteristic curve statistics was applied to define the accuracy for the diagnosis of unstable psoriasis. A general strategy for further implementation of RCM and practical approach was developed to examine psoriasis by RCM and to distinguish stable from unstable psoriasis. Unstable psoriasis was diagnosed by epidermal inflammatory cell counts with a sensitivity and specificity of 91.7% and 98.3%, respectively, and with an accuracy of 0.92 (area under the curve). In addition, a monitoring model was proposed. This is the first study that shows a method for implementation of RCM in dermatology. The strategy and hands on protocol for psoriasis may serve as a model for other dermatological entities and additionally may lead to specialized ready-to-use RCM protocols for clinical dermatological practice. © 2016 European Academy of Dermatology and Venereology.