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.

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.

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.

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

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.

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.

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.

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

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

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.

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.

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

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.

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.

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.

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

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.

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.

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

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.

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.

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.

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…

Dermatology on YouTube.

PubMed

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

2014-06-15

YouTube, reaches upwards of six billion users on a monthly basis and is a unique source of information distribution and communication. Although the influence of YouTube on personal health decision-making is well established, this study assessed the type of content and viewership on a broad scope of dermatology related content on YouTube. Select terms (i.e. dermatology, sun protection, skin cancer, skin cancer awareness, and skin conditions) were searched on YouTube. Overall, the results included 100 videos with over 47 million viewers. Advocacy was the most prevalent content type at 24% of the total search results. These 100 videos were "shared" a total of 101,173 times and have driven 6,325 subscriptions to distinct YouTube user pages. Of the total videos, 35% were uploaded by or featured an MD/DO/PhD in dermatology or other specialty/field, 2% FNP/PA, 1% RN, and 62% other. As one of the most trafficked global sites on the Internet, YouTube is a valuable resource for dermatologists, physicians in other specialties, and the general public to share their dermatology-related content and gain subscribers. However, challenges of accessing and determining evidence-based data remain an issue.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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

[What's new in clinical dermatology?

PubMed

Petit, A

2017-12-01

In addition to continuous medical education, medical journals offer to dermatologists a huge variety of news that differ by their content, validity, originality and clinical relevance. I collected here various articles relative to clinical dermatology that have been published between September, 2016 and September, 2017. These papers have been chosen in the aim of reflecting such diversity. I just excluded, as far as possible, articles dealing with other issues that the reader will find further in this booklet (such as research, pediatric, instrumental, oncologic or therapeutic dermatology, or dermatology and internal medicine). Space restriction required to skip some commentaries while keeping the references to the selected papers, which the reader will be able to read carefully in its original form. © 2017 Elsevier Masson SAS. Tous droits réservés.

Cyclosporine in veterinary dermatology.

PubMed

Palmeiro, Brian S

2013-01-01

Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

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.

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

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.

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.

Anxiety Sensitivity in Dermatological Patients.

PubMed

Dixon, Laura J; Lee, Aaron A; Viana, Andres G; McCowan, Nancye K; Brodell, Robert T; Tull, Matthew T

2016-01-01

Anxiety symptoms commonly occur in dermatological patients and can affect the severity of dermatological symptoms. Anxiety sensitivity (AS), defined as the fear of anxiety symptoms, is a well-supported cognitive vulnerability factor that may be particularly significant in these patients. This study compared the severity of AS between patients with psychodermatological (e.g., psoriasis) and nonpsychodermatological disorders (e.g., skin cancer). It was predicted that individuals with psychodermatological disorders would evidence significantly greater AS compared to individuals with nonpsychodermatological disorders. Adults presenting to outpatient dermatology clinics with psychodermatological (n = 63) and nonpsychodermatological (n = 52) conditions completed self-report questionnaires assessing sociodemographic characteristics, general anxiety, and AS. Individuals with psychodermatological conditions reported significantly greater AS compared to individuals with nonpsychodermatological conditions (p < 0.05). Social concerns of AS emerged as the only significant factor that differentiated these categories of dermatological diseases, odds ratio = 1.13, 95% CI: 1.02-1.24, after adjusting for general anxiety. These findings contribute to an advancing area of research linking AS and physical health problems. The results suggest that adjunctive cognitive-behavioral treatments targeting AS reductions could help patients with psychodermatological conditions. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Utility of Boron in Dermatology.

PubMed

Jackson, David G; Cardwell, Leah A; Oussedik, Elias; Feldman, Steven R

2017-08-09

Boron compounds are being investigated as therapies for dermatologic conditions. Several features of boron chemistry make this element an ideal component in dermatologic treatments. We review the published dermatologically-relevant clinical trials and case studies pertaining to boron compounds. PubMed was utilized to query terms boron, chemistry, drug, development, dermatology, atopic dermatitis, psoriasis, onychomycosis, tavaborole, AN 2690, crisaborole, and AN 2728. Clinical trials, case studies, animal studies and in vitro studies. pertaining to atopic dermatitis, psoriasis and onychomycosis were included. Crisaborole 2% topical solution reduced atopic dermatitis lesions by approximately 60% when compared to pre-treatment baseline. Crisaborole maintains its dose-dependent effect in treatment of psoriasis and significantly reduces psoriatic plaques when compared to controls. Adverse effects were mild, frequency of events varied between studies. Crisaborole was well tolerated when applied to sensitive skin. Topical tavaborole significantly reduced or eliminated onychomycosis with minimal side effects compared to placebo. Tavaborole was effective in treating recalcitrant onychomycosis. Boron-based compounds form stable interactions with enzyme targets and are safe medications for the treatment of atopic dermatitis, psoriasis, and onychomycosis. The mild and rare side effects of topical boron-based compounds may make them ideal treatments for individuals with sensitive skin and pediatric populations.

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.

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.

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.

[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.

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 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.

Homeopathy in dermatology.

PubMed

Smolle, Josef

2003-01-01

Alternative methods are commonly used in patients with dermatologic diseases, with homeopathy being one of the most common. Homeopathy was developed by Samuel Hahnemann (1755-1843) and is based on the law of similars and the law of infinitesimals. It is a regulatory therapy where high dilutions of particular compounds are thought to induce a counterreaction in the organism. In dermatology, homeopathy is often used in atopic dermatitis, other forms of eczema, psoriasis, and many other conditions. To date, however, there is no convincing evidence for a therapeutic effect. There are only a few controlled trials, most of them with negative results. The few studies with positive results have not been reproduced. Acceptance by the patient seems largely based on counseling and emotional care rather than on objective responses to the homeopathic drugs.

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.

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.

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)

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.

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.

Dermatologic emergencies.

PubMed

Chacon, Anna H

2015-02-01

Although dermatology may be regarded as a medical specialty with few emergencies, they do exist and range from primary cutaneous disorders to severe systemic conditions with skin manifestations. Prompt recognition for appropriate diagnosis and treatment often is necessary to improve a patient's prognosis and a single decision can mark the difference between life and death.

Ginseng in Dermatology: A Review.

PubMed

Sabouri-Rad, Sarvenaz; Sabouri-Rad, Sara; Sahebkar, Amirhossein; Tayarani-Najaran, Zahra

2017-01-01

Ginseng has gained fame as one of the most popular herbs originating from Eastern countries. Among different species which are known as ginseng, Panax ginseng C. A. Mey. (Korean or Asian ginseng) is the most frequently used one. Ginsenosides have been proposed to account for most of the biological activities of ginseng. The widely appreciated health-promoting effect of ginseng pertains to the beneficial effects of this plant against immune, cardiovascular and sexual diseases and cancer. In addition, there are some new aspects of the pharmacological activity of this plant which justify its use in dermatologic diseases. In dermatology, ginseng has been investigated mechanistically for its therapeutic effects in photoaging, wound and injury, skin cancer, dermatitis, hair loss, alopecia and cold hypersensitivity. Here, we reviewed experimental and clinical studies exploring the therapeutic efficacy of ginseng and ginsenosides in the field of dermatology. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

"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.

Public perception of dermatologic surgery in Saudi Arabia: an online survey.

PubMed

AlHargan, Abdullah H; Al-Hejin, Nujud R; AlSufyani, Mohammed A

2017-05-15

Dermatologic surgery is a well established subspecialty in dermatology, but observations suggest that the public may not be aware of this field. To explore the public perception of the nature and scope of dermatologic surgery Methods: A cross-sectional online-based survey consisting of two parts was used. The first part recorded demographic data. The second part presented a series of clinical scenarios in common surgical and cosmetic procedures performed by dermatologic surgeons to determine respondents' choice among three specialties: general surgery, plastic surgery, and dermatologic surgery. A total of 1,248 responses were recorded. Seventy-four percent of respondents were female, with 80.29% between the ages of 18 and 34 years. Forty-nine percent considered dermatologic surgeons to be specialized skin surgeons and 71.63% said they would consult dermatologic surgeons for skin tumor excisions. However, plastic surgeons emerged more favorably for cosmetic procedures. For office-based procedures, 80.85% and 87.18% of respondents chose plastic surgeons for fillers and Botox® injections, respectively, compared to 15.79% and 12.02% of respondents who chose dermatologic surgeons. Although the majority of participants showed no doubt about the surgical skills of dermatologic surgeons, the responses demonstrate that the public is not aware of the full scope and practice of dermatologic surgery, especially as it pertains to cosmetic procedures. Therefore, we must educate the public about the field and branches of dermatologic surgery.

[Dermatologic toxicities of immune checkpoint inhibitors].

PubMed

Sibaud, V; Boulinguez, S; Pagès, C; Riffaud, L; Lamant, L; Chira, C; Boyrie, S; Vigarios, E; Tournier, E; Meyer, N

2018-05-01

The development of immune checkpoint inhibitors (monoclonal antibodies targeting PD-1/PD-L1 or CTLA-4) represents a significant advance in the treatment of multiple cancers. Given their particular mechanism of action, which involves triggering CD4+/CD8+ T-cell activation and proliferation, they are associated with a specific safety profile. Their adverse events are primarily immune-related, and can affect practically all organs. In this context, dermatological toxicity is the most common, though it mostly remains mild to moderate and does not require discontinuation of treatment. More than a third of patients are faced with cutaneous adverse events, usually in the form of a maculopapular rash, pruritus or vitiligo (only in patients treated for melanoma). Much more specific dermatologic disorders, however, may occur such as lichenoid reactions, induced psoriasis, sarcoidosis, auto-immune diseases (bullous pemphigoid, dermatomyositis, alopecia areata), acne-like rash, xerostomia, etc. Rigorous dermatological evaluation is thus mandatory in the case of atypical, persistent/recurrent or severe lesions. In this article, we review the incidence and spectrum of dermatologic adverse events reported with immune checkpoint inhibitors. Finally, a management algorithm is proposed. Copyright © 2018. Published by Elsevier Masson SAS.

Dermatological adverse events with taxane chemotherapy

PubMed Central

Sibaud, Vincent; Lebœuf, Nicole R.; Roche, Henri; Belum, Viswanath R.; Gladieff, Laurence; Deslandres, Marion; Montastruc, Marion; Eche, Audrey; Vigarios, Emmanuelle; Dalenc, Florence; Lacouture, Mario E.

2017-01-01

Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel. PMID:27550571

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

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

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

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

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.

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.

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 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

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.

Serendipity and its Role in Dermatology

PubMed Central

Coondoo, Arijit; Sengupta, Sujata

2015-01-01

Serendipity is a pleasant surprise of finding a particularly useful information while not looking for it. Significant historic events occurring as a result of serendipity include the discovery of the law of buoyancy (Archimedes principle) by the Greek mathematician Archimedes, of the Americas by Christopher Columbus and of gravity by Sir Isaac Newton. The role of serendipity in science has been immensely beneficial to mankind. A host of important discoveries in medical science owe their origin to serendipity of which perhaps the most famous is the story of Sir Alexander Fleming and his discovery of Penicillin. In the field of dermatology, serendipity has been responsible for major developments in the therapy of psoriasis, hair disorders, aesthetic dermatology and dermatosurgery. Besides these many other therapeutic modalities in dermatology were born as a result of such happy accidents. PMID:25814699

Serendipity and its role in dermatology.

PubMed

Coondoo, Arijit; Sengupta, Sujata

2015-01-01

Serendipity is a pleasant surprise of finding a particularly useful information while not looking for it. Significant historic events occurring as a result of serendipity include the discovery of the law of buoyancy (Archimedes principle) by the Greek mathematician Archimedes, of the Americas by Christopher Columbus and of gravity by Sir Isaac Newton. The role of serendipity in science has been immensely beneficial to mankind. A host of important discoveries in medical science owe their origin to serendipity of which perhaps the most famous is the story of Sir Alexander Fleming and his discovery of Penicillin. In the field of dermatology, serendipity has been responsible for major developments in the therapy of psoriasis, hair disorders, aesthetic dermatology and dermatosurgery. Besides these many other therapeutic modalities in dermatology were born as a result of such happy accidents.

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.

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

Tropical dermatology: marine and aquatic dermatology.

PubMed

Haddad, Vidal; Lupi, Omar; Lonza, Juan Pedro; Tyring, Stephen K

2009-11-01

Dermatoses caused by marine organisms are frequently seen in dermatology clinics worldwide. Cutaneous injuries after exposure to marine environments include bacterial and fungal infections and lesions caused by aquatic plants and protists. Some of these diseases are well known by dermatologists, such as Vibrio vulnificus septicemia and erysipeloid, but others are uncommon, such as envenomation caused by ingestion or contact with certain dinoflagellates or cyanobacteria, which are associated with rashes that can begin within minutes after exposure. Many marine/aquatic invertebrates, such as sponges, cnidarians, echinoderms, crustaceans, and mollusks, are associated with different kinds of dermatologic lesions that can vary from irritant or allergic contact dermatitis to physical trauma and envenomations. These cutaneous lesions may result in mild local reactions or can be associated with severe systemic reactions. Invertebrate animals, such as cnidarians, sea urchins, and worms, and aquatic vertebrates, such as venomous fishes and stingrays, are commonly associated with skin lesions in many countries, where they can constitute occupational dermatoses among fishermen and scuba divers, but they can also be observed among persons who contact these animals in kitchens or beaches. The presence of unusual lesions, a recent travel history, and/or a report of contact with an aquatic environment (including ownership of a marine or freshwater aquarium) should alert the dermatologist to the etiology of the cutaneous problems. After completing this learning activity, participants should be able to recognize the cutaneous manifestations of marine/aquatic infections, bites, stings, and wounds, etc., treat the cutaneous manifestations of marine/aquatic injuries, and help prevent marine/aquatic injuries.

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.

[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.

Suicidal behaviors in the dermatology patient.

PubMed

Gupta, Madhulika A; Pur, Daiana R; Vujcic, Branka; Gupta, Aditya K

An assessment of suicidal behaviors in the dermatology patient may be necessary in several situations: (1) in the presence of psychiatric comorbidity (major depressive disorder, body dysmorphic disorder, substance use disorder, posttraumatic stress disorder), encountered in up to 30% of dermatology patients; (2) when dermatologic symptoms ("dysmorphophobia," dermatitis artefacta) represent psychiatric pathologic conditions; (3) when psychosocial stressors (bereavement, interpersonal violence) increase the risk of suicidal behavior and exacerbate stress-reactive dermatoses (psoriasis, acne); (4) in the presence of high disease burden (chronicity, increased disease severity); (5) in instances of significant pruritus or chronic sleep disruption; (6) in the presence of facial lesions or facial scarring; (7) when social exclusion or feelings of alienation arise secondary to the skin disorder; (8) with use of medications (retinoids, biologics) for which suicidal behavior has been implicated as a possible side effect; and (9) when treating psychiatric patients experiencing a serious reaction to psychotropic medications (eg, Stevens-Johnson syndrome and anticonvulsants). Suicide risk must be assessed within a demographic context because suicide rates rise rapidly in adolescents and young adults, among whom the prevalence of skin disorders associated with suicidal behaviors (acne, psoriasis, atopic dermatitis) is also high, and suicide rates are increasing among white men, who tend to be overrepresented in dermatology clinical trials. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

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.

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.

Resident guide to advocacy in dermatology.

PubMed

Park, Kelly K

2015-12-01

Many opportunities exist for residents to get involved in advocacy in dermatology, from national to grassroots levels. Residents also should be aware of opportunities to get involved in patient advocacy and become familiar with the myriad of patient advocacy groups that exist. These groups offer support and education for patients and initiate research efforts for specific dermatologic conditions that provide support for patients beyond what can be offered during a standard office visit. The value of resident involvement in advocacy also is discussed.

Esthetic and cosmetic dermatology.

PubMed

Wollina, Uwe; Goldman, Alberto; Berger, Uwe; Abdel-Naser, Mohammed Badawy

2008-01-01

The field of esthetic and cosmetic dermatology has gained remarkable interest all over the world. The major advantage of recent years is the high scientific levels of the most significant new developments in techniques and pharmacotherapy and other nonsurgical approaches. The present paper reviews selected fields of interest under this view. Sexual hormones are involved in the aging process of men and women. Skin function, in particular the epidermal barrier, is affected by a loss of endocrine activity. Hormone replacement therapy has only recently been introduced in treatment of aging males. This is an area of gender-medicine in dermatology with a strong well-aging attempt. Botulinum toxin therapy for hyperfunctional lines has become not only well-established but evidence-based medicine on its highest level. Recent advantages were gained in objective evaluation and monitoring the effect. Digital imaging techniques with various facets have been introduced to assess the achievements of treatment in the most objective way. This may become an example for other techniques as peeling, laser therapy, or radiofrequency in esthetic and cosmetic dermatology. Botulinum toxin has become a valuable tool for brow lifts. Details of the technique are discussed. Cellulite is a strongly female gender-related condition. During the past decades numerous treatments had been recommended but only recently a more critical scientific approach led to improvements in therapy of this common and disfiguring condition. Three major approaches are developed: (a) skin loosing with techniques such as subcision, (b) skin tightening with radiofrequency and other approaches, and (c) improving circulation in blood and lymphatic microvasculature using both physical treatments and pharmacotherapy. The last two chapters are devoted to body sculpturing by lipotransfer and lipolysis. Lipotransfer for facial or body sculpturing has a history of about 100 years. Nevertheless, recently the role of adult stem

Cell Therapy in Dermatology

PubMed Central

Petrof, Gabriela; Abdul-Wahab, Alya; McGrath, John A.

2014-01-01

Harnessing the regenerative capacity of keratinocytes and fibroblasts from human skin has created new opportunities to develop cell-based therapies for patients. Cultured cells and bioengineered skin products are being used to treat patients with inherited and acquired skin disorders associated with defective skin, and further clinical trials of new products are in progress. The capacity of extracutaneous sources of cells such as bone marrow is also being investigated for its plasticity in regenerating skin, and new strategies, such as the derivation of inducible pluripotent stem cells, also hold great promise for future cell therapies in dermatology. This article reviews some of the preclinical and clinical studies and future directions relating to cell therapy in dermatology, particularly for inherited skin diseases associated with fragile skin and poor wound healing. PMID:24890834

American Academy of Dermatology

MedlinePlus

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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.

Probiotics and prebiotics in dermatology.

PubMed

Baquerizo Nole, Katherine L; Yim, Elizabeth; Keri, Jonette E

2014-10-01

The rapid increase in the medical use of probiotics and prebiotics in recent years has confirmed their excellent safety profile. As immune modulators, they have been used in inflammatory skin conditions, such as atopic dermatitis. We review the literature regarding the use of probiotics and prebiotics in dermatology. Probiotics and prebiotics appear to be effective in reducing the incidence of atopic dermatitis in infants, but their role in atopic dermatitis treatment is controversial. Their role in acne, wound healing, and photoprotection is promising, but larger trials are needed before a final recommendation can be made. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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

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.

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.

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

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.

Dermatology facing autoinflammatory syndrome.

PubMed

Alecu, Mihail; Coman, Gabriela; Muşetescu, Alina; Cojoacă, Marian Emanuel; Coman, Oana Andreia

2015-01-01

Cutaneous symptoms are characteristic for the autoinflammatory disorders (AIDs), both in the classical autoinflammatory phenotype and in most disorders included in this syndrome, but they are not specific and inconstant. Several skin disorders (pyoderma gangrenosum and pustular acne) may be encountered either isolate or associated with autoinflammatory symptoms, forming well-defined clinical entities within the autoinflammatory syndrome. The high prevalence of cutaneous manifestations is an important characteristic of AIDs. The presence of cutaneous symptoms in AIDs opens the perspective of understanding the contribution of innate immunity mechanisms involved in skin pathology. It is possible that many diseases present the alteration, in various degrees, of the innate immune mechanisms. Recently, dermatology faced two challenges connected to AIDs. The first involves the diagnosis of skin symptoms in a clinical autoinflammatory setting and the investigative approach to identify a disorder classified as AID. The second is to identify the altered mechanisms of inborn immunity among the pathogenetic mechanisms of known dermatological diseases (e.g., neutrophilic dermatoses). On the other hand, cutaneous symptoms are in certain cases regarded as a criterion to asses the efficacy of specific or non-specific therapies with monoclonal antibodies in disorders included in AIDs. Dermatology mostly benefits from the identification and knowledge of AIDs due to the role of innate immunity in skin pathogeny and also due to the large extent of clinical forms resulting from the association of skin symptoms with other disorders included in this group.

Instruments to assess stigmatization in dermatology.

PubMed

Dimitrov, Dimitre; Szepietowski, Jacek C

2017-11-03

Stigmatization is the assignment of negative perceptions to an individual because of a perceived difference from the population at large. Skin conditions are frequently the reason of social rejection with a consequent negative influence on the personal and social life of patients. The aim of the current study was to review the available instruments that can be successfully utilized to measure the stigmatization level among dermatological patients. We performed our search on PubMed up to November 2016 and utilized combinations of key phrases containing such words as stigmatization, skin, dermatology, names of various skin conditions (psoriasis, vitiligo, acne, etc.), measurement. The search found a considerable number of articles - 548. After filtering them through a precise selection process, 58 articles remained. We concentrated only on the methodological aspects to assess stigmatization in various dermatoses. The review ascertained that there exist numerous instruments in the form of questionnaires. They were utilized in various researches in order to assess the stigmatization level in patients with skin problems. We divided them into two main groups: dermatology specific instruments (6 questionnaires) and dermatosis/disease specific ones (8 questionnaires). It is recommended to use dermatology-specific instruments to compare the stigmatization level in various skin conditions. They can be utilized as well as a first line tools to study the feeling of stigmatization in specific skin diseases; however, where it is possible, they should be supplemented with the disease-specific instrument for deeper analysis of both qualities of life and stigmatization.

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.

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.

[Evidence of dermatological effects of chamomile].

PubMed

Rügge, Simone Danty; Nielsen, Maiken; Jacobsen, Andreas Skovgård; Vang, Ole; Jemec, Gregor B E

2010-12-13

Recent years have seen a rise in the demand for dermatological herbal and plant products as well as products containing chamomile. Extracts and decoctions made from this plant are often recommended by laymen for treatment of a number of skin diseases e.g. inflammation, wounds and itching. This systematic review explores the evidence base of the dermatological effects of chamomile. While numerous beneficial effects of chamomile have been suggested no studies have so far been able to substantiate these claims significantly. The absence of evidence is primarily caused by the design and quality of the studies identified.

The use of antidepressant drugs in dermatology.

PubMed

Gupta, M A; Guptat, A K

2001-11-01

This paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post-traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e.g. cutaneous body image problems, dermatitis artefacta, neurotic excoriations and trichotillomania, or psychiatric syndromes may be comorbid with a primary dermatological disorder such as the association of major depressive disorder or social phobia with psoriasis and obsessive compulsive disorder with acne excoriee. Some of the salient pharmacological properties of the tricyclic antidepressants (TCAs) and the selective serotonin reuptake inhibitor (SSRI) antidepressants are reviewed. The review indicates that the SSRI antidepressants are potentially beneficial in the management of all the major psychiatric syndromes that are encountered in dermatological disorders. The generally more favourable side-effect profile of the SSRIs, such as lower cardiotoxicity in contrast to the TCAs, has made them the first-line agents for the treatment of depression. Furthermore, some of the pharmacological properties of the antidepressant agents that are not related to their antidepressant activity, such as the histamine H1 blocking effect of TCAs, such as doxepin, amitriptyline and trimipramine, are of benefit in dermatological conditions such as urticaria and pruritus. This paper reviews the general guidelines for use of antidepressants and salient drug-drug interactions resulting mainly from the inhibition of the cytochrome P450 (CYP) 2D6 and 3A3/4 isoenzymes by some of the SSRI antidepressants. Before prescribing an antidepressant agent, the specific guidelines, side-effect profile, drug

[Dermatology and skin color].

PubMed

Petit, Antoine

2010-09-01

Melanin is the pigment that is responsible for skin, hair and eye colours. Genetics and sun exposure are the two key factors that determine skin pigmentation. In dermatology, skin colours is significant, not only for semiology and diagnosis, but also for epidemiology and wounds healing.

[What's new in pediatric dermatology].

PubMed

Czernielewski, Justine; Hohl, Daniel

2015-04-01

Progress in paediatric dermatology is achieved in both research and therapeutic fields. In infectiology, scabies and bed bugs are a scourge for dermatologists, with an important recent outbreak. This article describes the fundamental clinical signs to look for, when suspecting such diagnosis. Hair dermatoscopy seems to be also very precious as a new tool for the diagnosis of ringworm. Regarding eczemas, atopic dermatitis is supported by S. Aureus's skin colonization, the target of eradication of new products in ongoing studies. We will also explain the role of Hemangiol, recently marketed in Switzerland for the treatment of haemangiomas. Alternative beta blockers have also a large number of ongoing projects in the dermatological vascular diseases field. Other various news is to be discovered....

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.

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 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.

[Dermatology consultations in an emergency department prior to establishment of emergency dermatology cover].

PubMed

Martínez-Martínez, M L; Escario-Travesedo, E; Rodríguez-Vázquez, M; Azaña-Defez, J M; Martín de Hijas-Santos, M C; Juan-Pérez-García, L

2011-01-01

an increasing number of patients seek emergency treatment for dermatologic complaints. The aim of this study was to assess the characteristics of skin complaints seen in an emergency department prior to establishment of specialist dermatology cover. a retrospective, descriptive study was undertaken using data on urgent dermatology cases seen by nonspecialist physicians in the emergency department of Hospital General Universitario de Albacete, Spain, in 2008. a total of 3662 patients with skin diseases were seen (2.59% of all emergency cases; approximately 10 patients per day). The mean age was 27.73 years and there was a slight predominance of female patients. Children and adolescents accounted for 5.85% of cases. A total of 96 different conditions were diagnosed and 84% of cases corresponded to one of 21 different diagnostic entities, urticaria being the most frequent (19.27%). The 96 diagnoses were grouped into 16 categories to facilitate analysis. According to this classification, most patients had infectious diseases (47.49%), followed by urticaria and angioedema (20.13%), "nonspecific diagnosis" (11.93%), and "descriptive diagnosis" (6.49%). In 4.8% of cases, the patient was admitted, most frequently for cellulitis. in nonspecialist emergency services, the number of different diagnoses is small in relation to the number of patients seen and the proportion of nonspecific and descriptive diagnoses is relatively large. In our opinion, an on-call dermatologist should be made available within emergency departments in order to offer a higher quality of care to patients with skin conditions. Copyright © 2010 Elsevier España, S.L. y AEDV. All rights reserved.

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.

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.

[LED lights in dermatology].

PubMed

Noé, C; Pelletier-Aouizerate, M; Cartier, H

2017-04-01

The use in dermatology of light-emitting diodes (LEDs) continues to be surrounded by controversy. This is due mainly to poor knowledge of the physicochemical phases of a wide range of devices that are difficult to compare to one another, and also to divergences between irrefutable published evidence either at the level of in vitro studies or at the cellular level, and discordant clinical results in a variety of different indications: rejuvenation, acne, wound healing, leg ulcers, and cutaneous inflammatory or autoimmune processes. Therapeutic LEDs can emit wavelengths ranging from the ultraviolet, through visible light, to the near infrared (247-1300 nm), but only certain bands have so far demonstrated any real value. We feel certain that if this article remains factual, then readers will have a different, or at least more nuanced, opinion concerning the use of such LED devices in dermatology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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.

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.

Synergy of understanding dermatologic disease and epidermal biology.

PubMed

Stanley, John R

2012-02-01

Dermatologic disease, although seldom life threatening, can be extremely disfiguring and interfere with the quality of life. In addition, as opposed to other organs, just the aging of skin and its adnexal structure the hair follicle can result in cosmetic concerns that affect most of us. The articles in this dermatology Review Series demonstrate recent progress in understanding the cell biology and molecular pathophysiology of the epidermis and hair follicles, which harbor keratinocyte and melanocyte stem cells. They reveal a dynamic relationship between research and clinical care: knowledge of dermatologic disease has facilitated the understanding of the biology of the epidermis and, in turn, progress in basic science has informed our understanding of disease. This type of synergy is a profound strength of clinical research of the type that the JCI is dedicated to publishing.

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.

Fruit and food eponyms in dermatology.

PubMed

Jindal, Nidhi; Jindal, Pooja; Kumar, Jeevan; Gupta, Sanjeev; Jain, V K

2015-01-01

Dermatology world is brimming with myriad of interesting clinical conditions, signs and syndromes. It is infinite, which has systemic clinical connotations too. Complicated pronunciations of diagnosis have always placed residents in an intricate state. Each one is trying his best to make this cumbersome subject comparatively more acceptable and convenient. The present paper is an attempt to further simplify the subject by correlating difficult conditions with commonly used and seen things such as fruit and food. A total of 45 dermatological conditions were found to be based on fruit and food eponyms. For example, strawberries can remind us of strawberry gums of Wegener's granulomatosis and strawberry nevus.

[The use of lasers in dermatology].

PubMed

Lecocq, C; Pirard, D; del Marmol, V; Berlingin, E

2013-01-01

Albert Einstein is undoubtedly the father of lasers. But it is not until 1964 that the first dermatological lasers were introduced. The Nd-YAG laser, the CO2 laser were developed by Kumar Patel. In a 40 year period lasers not only were diversified but have also become safer and miniaturized. This article hopes to strengthen general practionners' and specialist's knowledge of the different categories of available lasers. The most frequently used ones are ablative lasers (CO2-Erbium), vascular lasers (Nd-YAG, KTP, pulsed dye laser) and the pigment lasers (Q-Switched Nd-YAG, Alexandrite). A description of these lasers and their indications in dermatology will be discussed.

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.

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.

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

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.

[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.

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.

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.

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

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...

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

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.

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.

Mueller matrix imaging polarimetry in dermatology

NASA Astrophysics Data System (ADS)

Smith, Matthew H.; Burke, Paul D.; Lompado, Arthur; Tanner, Elizabeth A.; Hillman, Lloyd W.

2000-05-01

Recent studies have indicated that polarized light may be useful in the discrimination between benign and malignant moles. In fact, imaging polarimetry could provide noninvasive diagnosis of a range of dermatological disease states. However, in order to design an efficacious sensor for clinical use, the complete polarization-altering properties of a particular disease must be well understood. We present Mueller matrix imaging polarimetry as a technique for characterizing various dermatological diseases. Preliminary Mueller matrix imagery at 633 nm suggests that both malignant moles and lupus lesions may be identified through polarimetric measurements. Malignant moles are found to be less depolarizing than the surrounding tissue, and lupus lesions are found to have rapidly varying retardance orientation.

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.

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.

Dermatology for the Allergist

PubMed Central

Lockey, Richard

2010-01-01

Abstract: Allergists/immunologists see patients with a variety of skin disorders. Some, such as atopic and allergic contact dermatitis, are caused by abnormal immunologic reactions, whereas others, such as seborrheic dermatitis or rosacea, lack an immunologic basis. This review summarizes a select group of dermatologic problems commonly encountered by an allergist/immunologist. PMID:23268431

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

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

Storage and retrieval of digital images in dermatology.

PubMed

Bittorf, A; Krejci-Papa, N C; Diepgen, T L

1995-11-01

Differential diagnosis in dermatology relies on the interpretation of visual information in the form of clinical and histopathological images. Up until now, reference images have had to be retrieved from textbooks and/or appropriate journals. To overcome inherent limitations of those storage media with respect to the number of images stored, display, and search parameters available, we designed a computer-based database of digitized dermatologic images. Images were taken from the photo archive of the Dermatological Clinic of the University of Erlangen. A database was designed using the Entity-Relationship approach. It was implemented on a PC-Windows platform using MS Access* and MS Visual Basic®. As WWW-server a Sparc 10 workstation was used with the CERN Hypertext-Transfer-Protocol-Daemon (httpd) 3.0 pre 6 software running. For compressed storage on a hard drive, a quality factor of 60 allowed on-screen differential diagnosis and corresponded to a compression factor of 1:35 for clinical images and 1:40 for histopathological images. Hierarchical keys of clinical or histopathological criteria permitted multi-criteria searches. A script using the Common Gateway Interface (CGI) enabled remote search and image retrieval via the World-Wide-Web (W3). A dermatologic image database, featurig clinical and histopathological images was constructed which allows for multi-parameter searches and world-wide remote access.

Two years' experience with Web-based teleconsulting in dermatology.

PubMed

Massone, C; Soyer, H P; Hofmann-Wellenhof, R; Di Stefani, A; Lozzi, G P; Gabler, G; Dong, H; Argenziano, G; Ozdemir, F; Fink-Puches, R; Salmhofer, W; Zalaudek, I; Nunzi, E; Kerl, H

2006-01-01

A non-commercial teledermatology network based on store-and-forward operation was established in April 2002. The aim was to create an easy-to-use platform for teleconsultation services, where physicians could seek diagnostic advice in dermatology from a pool of expert consultants and where they could present and discuss challenging dermatology cases with special emphasis on diagnosis and therapy. An online moderated discussion forum was added in October 2003. During the first two years, 348 health-care professionals from 45 countries registered to use the Website. A total of 783 requests for consultations were answered; 285 requests concerned pigmented skin lesions, 440 requests were from the whole range of clinical dermatology and 58 requests were about non-melanoma skin cancer. Of a total of 133 requests analysed, 80 (60%) were answered within one day, 47 (35%) within one week, five (4%) within two weeks and one (1%) consultation was answered in more than two weeks. Our experience with a discretionary, non-commercial, multilingual Website for open-access teleconsulting in dermatology appears to be successful. The Website represents an example of user-generated content, together with active interaction between users, who can present and discuss cases with remote colleagues.

Zinc Therapy in Dermatology: A Review

PubMed Central

Mahajan, Vikram K.; Mehta, Karaninder S.; Chauhan, Pushpinder S.

2014-01-01

Zinc, both in elemental or in its salt forms, has been used as a therapeutic modality for centuries. Topical preparations like zinc oxide, calamine, or zinc pyrithione have been in use as photoprotecting, soothing agents or as active ingredient of antidandruff shampoos. Its use has expanded manifold over the years for a number of dermatological conditions including infections (leishmaniasis, warts), inflammatory dermatoses (acne vulgaris, rosacea), pigmentary disorders (melasma), and neoplasias (basal cell carcinoma). Although the role of oral zinc is well-established in human zinc deficiency syndromes including acrodermatitis enteropathica, it is only in recent years that importance of zinc as a micronutrient essential for infant growth and development has been recognized. The paper reviews various dermatological uses of zinc. PMID:25120566

Nurse prescriber-patient consultations: a case study in dermatology.

PubMed

Courtenay, Molly; Carey, Nicola; Stenner, Karen

2009-06-01

This paper is a report of a study exploring the content and processes in consultations between nurse prescribers and patients with dermatological conditions. Communication skills, consultation time, information and follow-up are central to the treatment and management of patients with dermatological conditions. The contribution nurses make to the care of these patients has great potential. A multiple case study was conducted with 10 practice settings across England in which nurses prescribed medicines for patients with dermatological conditions. Data were collected between June 2006 and September 2007 using semi-structured interviews (n = 40), patient questionnaires (n = 165/200) and videotaped observations of nurse consultations (n = 40). Data analysis included thematic analysis, descriptive statistics, chi-square and non-parametric tests. Nurses believed that their holistic approach to assessment, combined with their prescribing knowledge, improved prescribing decisions. Listening and explanation of treatments were aspects of nurse communication that were rated highly by patients. Listening and dealing sensitively with emotions were also aspects of the videotaped consultations that were rated highly by assessors. Nurses were less consistent in providing information about medicines. Triangulated data from this study suggest that nurse prescribing enhances the care of patients with dermatological conditions through improved prescribing decisions. If patients are to be more involved in this decision-making, nurses must give them more information about their medicines. The benefits of prescribing were most evident in the practices of dermatology specialist nurses. Further evidence is required to identify whether prescribing by specialist nurses offers similar benefits in other therapeutic areas.

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.

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.

Analysis of self-citation and impact factor in dermatology journals.

PubMed

Reiter, Ofer; Mimouni, Michael; Mimouni, Daniel

2016-09-01

Concerns have been raised regarding the impact factor's (IF) accuracy and credibility, which may be affected by different factors, including self-citations. To investigate the self-citation rate (SCR) of dermatology journals and its relationship to the IF. Data on all dermatology journals listed in the Journal Citation Reports (JCR) were retrieved, and the following parameters were analyzed: IF, total publications used to calculate the IF, total citations used to calculate the IF, self-citations used to calculate the IF, SCR, and IF without self-citations (corrected IF). The median SCR was 10.53% (0-50%), and the median IF and corrected IF, 1.54 (0.05-6.37) and 1.35 (0.03-5.84), respectively. There was an inverse correlation between the IF and the SCR. A statistically significant difference was noted in the SCR between general and subspecialty journals and between journals that offered a full English text and those that did not. In general, the IF of dermatology journals is not influenced by the SCR. However, journals with a lower IF tend to have a higher SCR. Subspecialty journals and foreign language journals have a higher SCR than general dermatology and English language journals, respectively, probably owing to their limited distribution and the difficulty experienced by international authors in accessing references in specific languages. © 2015 The International Society of Dermatology.

Evaluation of patient satisfaction in pediatric dermatology.

PubMed

Ahmed, Sarah; Miller, Jonathan; Burrows, James F; Bertha, Ben Khallouq; Rosen, Paul

2017-11-01

There remains a lack of investigation into which factors patients and families value the most in their experience at pediatric dermatology clinics. Most of the current literature on quality improvement in dermatology does not encompass the pediatric population. To determine the drivers that are most predictive of a positive patient experience, we observed the indirect relationship between several factors of the patient experience and their role in patient satisfaction. Patient satisfaction surveys were distributed after their visits to patients at four pediatric dermatology clinics in one children's academic health system. Data were collected and organized into the top 30 survey variables with which patients expressed satisfaction on a 5-point Likert scale. Pearson product-moment correlation coefficients (r) for each variable with regard to "likelihood of your recommending our practice to others" were calculated. A total of 516 families completed patient satisfaction surveys. Analyses of top box scores showed that the strongest predictors of patient satisfaction were the likelihood of recommending care provider (r = .77, P = <.001), cheerfulness of practice (r = .76, P = <.001), care provider spoke using clear language (r = .73, P = <.001), patient confidence in care provider (r = .70, P = <.001), and our sensitivity to patient needs (r = .70, P = <.001). The patient-physician relationship, along with the environment of the practice and its sensitivity to patients' personal needs, contributes most to the patient experience in pediatric dermatology. Identifying such variables that shape patients' assessments of their experience can guide future quality improvement plans in the specialty. © 2017 Wiley Periodicals, Inc.

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

Patient perspectives on medical photography in dermatology.

PubMed

Leger, Marie C; Wu, Timothy; Haimovic, Adele; Kaplan, Rachel; Sanchez, Miguel; Cohen, David; Leger, Elizabeth A; Stein, Jennifer A

2014-09-01

Clinical photography enhances medical care, research, and teaching. Empirical data are needed to guide best practices regarding dermatologic photography. To investigate patient opinion about clinical photography and identify demographic factors that influence these opinions. Four hundred patients representing a broad range of ages, self-identified ethnic/racial groups, and socioeconomic levels were recruited from 4 dermatology settings in New York City. Patients were administered a survey about perceptions of photography, willingness to allow photographs to be used in a variety of settings, preferences for photographer and photographic equipment, and methods of consent. Eighty-eight percent of patients agreed that photography enhanced their quality of care. Most patients would allow their photographs to be used for medical, teaching, and research purposes with significantly more acceptance when patients were not identifiable. Patients preferred photographs taken by a physician rather than a nurse or student, photographers of the same gender, clinic-owned cameras to personal cameras or cell phones, and written consent to verbal consent. There were significant racial/ethnicity and age-related variations in responses, with white and older patients being more permissive than other groups. We use the results of this study to recommend best practices for photography in dermatology.

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…

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.

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.

Updates on the use of vaccines in dermatological conditions.

PubMed

Hanna, Edith; Dany, Mohammed; Abbas, Ossama; Kreidieh, Firas; Kurban, Mazen

2018-05-22

Numerous vaccines are being actively developed for use in dermatologic diseases. Advances in the fields of immunotherapy, genetics and molecular medicine have allowed for the design of prophylactic and therapeutic vaccines with immense potential in managing infections and malignancies of the skin. This review addresses the different vaccines available for use in dermatological diseases and those under development for future potential use. The major limitation of our review is its complete reliance on published data. Our review is strictly limited to the availability of published research online through available databases. We do not cite any of the authors' previous publications nor have we conducted previous original research studies regarding vaccines in dermatology. Strength would have been added to our paper had we conducted original studies by our research team regarding the candidate vaccines delineated in the paper.

Cupping in dermatology: a critical review and update.

PubMed

Soliman, Yssra; Hamed, Nouran; Khachemoune, Amor

2018-06-01

Cupping is an ancient procedure that has been practiced for thousands of years. It has been used to treat a variety of medical conditions, including dermatological ones. Cupping has been described in the literature for the treatment of conditions such as acne and eczema. The procedure is fundamentally divided into dry cupping and wet cupping; however, there have been many modern adaptations. Adverse events related to the procedure have been reported in the literature and should be considered by patients. However, cupping has a promising role in helping manage dermatological conditions.

Achieving hemostasis in dermatology – Part 1: Preoperative, intraoperative, and postoperative management

PubMed Central

Kaur, Ravneet Ruby; Glick, Jaimie B.; Siegel, Daniel

2013-01-01

As dermatological procedures continue to become increasingly complex, improved methods and tools to achieve appropriate hemostasis become necessary. The methods for achieving adequate hemostasis are variable and depend greatly on the type of procedure performed and the unique characteristics of the individual patient. In Part 1 of this review, we discuss the preoperative, intraoperative, and postoperative management of patients undergoing dermatologic surgery. We address oral medications and supplements that affect hemostasis, hemostatic anesthesia, and intraoperative interventions such as suture ligation and heat-generating cautery devices. In Part 2 of this review, we will discuss topical hemostats. The authors conducted an extensive literature review using the following keywords: “hemostasis,” “dermatology,” “dermatological surgery,” “dermatologic sutures,” “electrosurgery,” “hemostatic anesthesia,” and “laser surgery.” Sources for this article were identified by searching the English literature in the Pubmed database for the time period from 1940 to March 2012. A thorough bibliography search was also conducted and key references were examined. PMID:23741660

Analysis of Dermatologic Events in Vemurafenib-Treated Patients With Melanoma

PubMed Central

Duvic, Madeleine; Hauschild, Axel; Prieto, Victor G.; Robert, Caroline; Schadendorf, Dirk; Kim, Caroline C.; McCormack, Christopher J.; Myskowski, Patricia L.; Spleiss, Olivia; Trunzer, Kerstin; Su, Fei; Nelson, Betty; Nolop, Keith B.; Grippo, Joseph F.; Lee, Richard J.; Klimek, Matthew J.; Troy, James L.; Joe, Andrew K.

2013-01-01

Background. Vemurafenib has been approved for the treatment of patients with advanced BRAFV600E-mutant melanoma. This report by the Vemurafenib Dermatology Working Group presents the characteristics of dermatologic adverse events (AEs) that occur in vemurafenib-treated patients, including cutaneous squamous cell carcinoma (cuSCC). Methods. Dermatologic AEs were assessed from three ongoing trials of BRAFV600E mutation-positive advanced melanoma. Histologic central review and genetic characterization were completed for a subset of cuSCC lesions. Results. A total of 520 patients received vemurafenib. The most commonly reported AEs were dermatologic AEs, occurring in 92%–95% of patients. Rash was the most common AE (64%–75% of patients), and the most common types were rash not otherwise specified, erythema, maculopapular rash, and folliculitis. Rash development did not appear to correlate with tumor response. Photosensitivity occurred in 35%–63% of patients, and palmar-plantar erythrodysesthesia (PPE) occurred in 8%–10% of patients. The severity of rash, photosensitivity, and PPE were mainly grade 1 or 2. In all, 19%–26% of patients developed cuSCC, mostly keratoacanthomas (KAs). The majority of patients with cuSCC continued therapy without dose reduction after resection. Genetic analysis of 29 cuSCC/KA samples demonstrated HRAS mutations in 41%. Conclusions. Dermatologic AEs associated with vemurafenib treatment in patients with melanoma were generally manageable with supportive care measures. Dose interruptions and/or reductions were required in <10% of patients. PMID:23457002

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.

[The lymphocyte transformation test in dermatology].

PubMed

Zinn, K; Braun-Falco, O

1976-03-01

At first, immunologie and methodic basies of the lymphocyte transformation test are discussed. Then the results gained by this test in several dermatologic diseases are summarized. Finally, practice of the lymphocyte transformation test is critically reviewed.

[Paediatric dermatology emergencies in a tertiary hospital].

PubMed

Baquero-Sánchez, E; Bernabéu-Wittel, J; Dominguez-Cruz, J J; Conejo-Mir, J

2015-12-01

In recent years, the increasing demand for dermatological consultations in the Emergency department has resulted in the publication of a variety of studies on this subject. However, most of them deal with the general population, without taking into account the changes in frequencies found in young children (ages 0-14). To determine the frequency of various dermatological diagnoses made by the on-call paediatrician in the Emergency Department, and after referral to Paediatric Dermatology. Firstly, a descriptive retrospective study was performed that included all patients aged between 0 and 14 years old who were seen after being referred to the emergency paediatric dermatologist by the on-call paediatrician from June 2010 to December 2013. Secondly, an analytical study was carried by calculating the kappa index calculus, in order to establish the diagnostic concordance between the emergency paediatrician and the paediatric dermatologist. A total of 861 patients, with a mean age of 4.5 years were included. More than half of the skin disorders analysed were eczema (27%) and infections (26%). The 5 main diagnoses were: atopic dermatitis (16%), acute prurigo simplex (5%), tinea (5%), pyogenic granuloma (4%), and molluscum contagiosum (4%). Additional tests were only required in 16% of the cases. The kappa index obtained was 0.206 (95% CI: 0.170-0.241). The dermatology consultations in the Emergency Department were shown to be frequent and mostly involved minor diseases. Collaboration between paediatricians and dermatologists resulted in a high treatment success rate, leading to a low percentage of additional tests required and a high rate of discharges. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. 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.

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.

Low-level light therapy (LLLT) for cosmetics and dermatology

NASA Astrophysics Data System (ADS)

Sawhney, Mossum K.; Hamblin, Michael R.

2014-02-01

Over the last few years, low-level laser (light) therapy (LLLT) has been demonstrated to be beneficial to the field of aesthetic medicine, specifically aesthetic dermatology. LLLT encompasses a broad spectrum of procedures, primarily cosmetic, which provide treatment options for a myriad of dermatological conditions. Dermatological disorders involving inflammation, acne, scars, aging and pigmentation have been investigated with the assistance of animal models and clinical trials. The most commercially successful use of LLLT is for managing alopecia (hair loss) in both men and women. LLLT also seems to play an influential role in procedures such as lipoplasty and liposuction, allowing for noninvasive and nonthermal methods of subcutaneous fat reduction. LLLT offers a means to address such conditions with improved efficacy versatility and no known side-effects; however comprehensive literature reports covering the utility of LLLT are scarce and thus the need for coverage arises.

Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

PubMed

Abedini, Robabeh; Matinfar, Amin; Sasani, Pardis; Salehi, Anahita; Daneshpazhooh, Maryam

2017-11-01

Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (P<0.001). A sampling bias may have occurred due to the time interval (three summer months) of the study. The majority of the patients did not require emergency consultation. Even the most prevalent acute conditions such as bite, urticaria, infections, and infestations could be diagnosed and easily managed by general practitioners. The presented data showed a need for improvement in the non-dermatologist physicians' knowledge of emergency dermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.

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

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.

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.

Trends in dermatology practices and the implications for the workforce.

PubMed

Ehrlich, Alison; Kostecki, James; Olkaba, Helen

2017-10-01

The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. To update the trends and current workforce issues for the field of dermatology. The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. The demand for dermatology services remains strong. Shifts in the practice setting may be related to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic.

PubMed

Rosenbaum, Brooke E; Klein, Rebecca; Hagan, Paa Gyasi; Seadey, Mark-Young; Quarcoo, Naa Larteley; Hoffmann, Rachel; Robinson, Maria; Lartey, Margaret; Leger, Marie C

2017-01-01

Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana.

Women in medicine and dermatology: history and advances*

PubMed Central

França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology. PMID:24626675

Women in medicine and dermatology: history and advances.

PubMed

França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

Community dermatology in Debre Markos: an attempt to define children's dermatological needs in a rural area of Ethiopia.

PubMed

Murgia, Vitalia; Bilcha, Kassahun Desalegn; Shibeshi, Dagnachew

2010-06-01

Skin diseases are very common in rural and urban areas in developing countries. Knowledge of the real frequency of the dermatological problems of Ethiopian children could help plan future intervention for early diagnosis and low cost "good practice" therapies. We involved in the project two primary Ethiopian schools, attended by 1765 children from grade 1 to grade 4, who were screened to assess their general skin health conditions. All children were examined naked in good day light. To record data we used an EPIinfo questionnaire. A total of 1104 children were screened. We registered a total number of 1086 dermatological problems, 876 of them were of infective origin mainly represented by fungal infections (36.1%). Tinea capitis represented 76% of the cases, tinea corporis 27% and tinea unguium 8%. Head lice affected 345 children. Viral infections accounted for 12%, most of them were warts. We think our work highlights the general health and living conditions of Ethiopian school children. The dermatological problems affecting most of the children could improve just by better skin hygiene conditions. The presence at the community level of health workers trained to perform a correct and early diagnosis and distribute efficacious, low-cost therapies would be a relevant step forward. We think this project could help draw attention and interest to these issues.

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.

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

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.

308nm Excimer Laser in Dermatology

PubMed Central

Mehraban, Shadi

2014-01-01

308nm xenon-chloride excimer laser, a novel mode of phototherapy, is an ultraviolet B radiation system consisting of a noble gas and halide. The aim of this systematic review was to investigate the literature and summarize all the experiments, clinical trials and case reports on 308-nm excimer laser in dermatological disorders. 308-nm excimer laser has currently a verified efficacy in treating skin conditions such as vitiligo, psoriasis, atopic dermatitis, alopecia areata, allergic rhinitis, folliculitis, granuloma annulare, lichen planus, mycosis fungoides, palmoplantar pustulosis, pityriasis alba, CD30+ lympho proliferative disorder, leukoderma, prurigo nodularis, localized scleroderma and genital lichen sclerosus. Although the 308-nm excimer laser appears to act as a promising treatment modality in dermatology, further large-scale studies should be undertaken in order to fully affirm its safety profile considering the potential risk, however minimal, of malignancy, it may impose. PMID:25606333

HIPAA, dermatology images, and the law.

PubMed

Scheinfeld, Noah; Rothstein, Brooke

2013-12-01

From smart phones to iPads, the world has grown increasingly reliant on new technology. In this ever-expanding digital age, medicine is at the forefront of these new technologies. In the field of dermatology and general medicine, digital images have become an important tool used in patient management. Today, one can even find physicians who use their cellular phone cameras to take patient images and transmit them to other physicians. However, as digital imaging technology has become more prevalent so too have concerns about the impact of this technology on the electronic medical record, quality of patient care, and medicolegal issues. This article will discuss the advent of digital imaging technology in dermatology and the legal ramifications digital images have on medical care, abiding by HIPAA, the use of digital images as evidence, and the possible abuses digital images can pose in a health care setting.

[Dermatology day-care: between official rules and reality].

PubMed

Ingen-Housz-Oro, S; Durand-Zaleski, I; Cosnes, A; Valeyrie-Allanore, L; Moreno, J-C; Chosidow, O; Wolkenstein, P

2012-11-01

Official rules published in 2006 and 2010 concerning ambulatory care rates in France led to artificial redistribution of this activity from day-care hospitalization to consultations. In our dermatological day-care establishment, we compared the financial costs engendered for patients admitted for day-care hospitalization and those seen at consultations. From 2011/01/10 to 2011/02/04, for each patient, we prospectively analyzed the following data: day-care hospitalization or consultation, age, sex, diagnosis, laboratory and radiological examination, non-dermatological consultations, time spent with the patient by doctors (interns, senior doctors) and nurses, with timing by a stop-watch. The hospital cost was the total for medical examinations (official nomenclature), non-dermatological consultations, physicians' and nurses' salaries and establishment overheads (216 €). The hospital revenue regarding the consultation group consisted of the sum of reimbursement for medical examination, dermatological and non-dermatological consultations, and regarding the day-care hospitalization group, the dermatology rate (670 €) or chemotherapy sessions (380 €). Results were compared using a Chi(2) test and a Student's t-test (P ≤ 0.05). One hundred and twenty-seven patients were included: 67 in the day-care hospitalization group and 60 in the consultation group. Patients in the day-care hospitalization group were older and had significantly more radiological examinations and non-dermatological consultations, but the number of laboratory examinations and skin biopsies did not differ between the two groups. The mean time spent by doctors was similar in both groups but the time spent by senior doctors without the help of interns was significantly greater and longer than the time for a standard consultation. Nurses spent a mean 72 minutes with each hospitalized patient and 35 minutes with consultation patients (P = 0.007). Hospital costs were identical in both groups at around

Academic dermatology manpower: issues of recruitment and retention.

PubMed

Loo, Daniel S; Liu, Chia-Ling; Geller, Alan C; Gilchrest, Barbara A

2007-03-01

To assess the total number, recruitment rate, departure rate, and growth rate of full-time academic dermatologists in the United States over the last decade. Mail survey. Academic dermatology departments in the United States. Respondents among 113 chairs or chiefs of academic dermatology departments or their designees. The total number of full-time academic dermatologists including departures and recruitments in 4 selected academic years (1994-1995, 1998-1999, 2001-2002, and 2003-2004). Of the 113 academic dermatology departments, 89 (79%) responded. During the 4 selected academic years, more dermatologists joined academia (n = 255) than departed (n = 200). Those recruited into academia were predominantly graduating fellows (35%), residents (30%), and in private practice (16%). Of those who left academia, their primary roles were clinician-educator (55%), followed by dermatologic surgeon (16%). Most of those who departed went into private practice (65%). From 1994-1995 to 2001-2002, the recruitment rate increased by 36% (from 10.1% to 13.7%), and the departure rate increased by 88% (from 5.8% to 10.9%), resulting in a 35% decrease in growth rate (from 4.3% to 2.8%). Retention of academic dermatologists is as important as recruitment. Our results confirm that insufficient retention has contributed to a substantial decrease in the growth rate of academic dermatologists. Future efforts to increase academic manpower must focus on retention as well as recruitment, particularly of clinician-educators. Specific strategies for improving retention include identifying or establishing funding sources for teaching/mentoring and clinical research. Recruitment efforts may be improved by focusing on fellows and private practitioners with academic affiliations.

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.

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.

[Trauma and psychological distress in dermatological patients].

PubMed

Lindner, M; Schröter, S; Friederich, H-C; Tagay, S

2015-12-01

Although seldom diagnosed, post-traumatic stress disorder (PTSD) has a high prevalence in primary and tertiary care. In a consecutive cross-sectional study, the prevalence of traumatic experiences and the severity of post-traumatic symptoms as well as specific characteristics of traumatized patients in the context of the dermatological treatment were examined. Standardized questionnaires for assessing general psychopathology (Brief Symptom Inventory, BSI), coping with dermatological diseases (Adjustment to Chronic Skin Diseases Questionnaire, MHF) and diagnosis of trauma (Essen Trauma-Inventory, ETI) were used in 221 patients with different skin diseases. In total, 85.1 % of the patients reported at least one potentially traumatic event in their lives, whereby psychometrically in 8.6 % of the cases the diagnostic criteria for a PTSD were met. Patients with suspected PTSD were more impacted by psychopathology, had more problems in coping with their skin diseases and attributed mental stress as having a greater influence on their skin disease than nontraumatized patients or traumatized patients without suspected PTSD. In addition, cumulative traumatization also leads to increased trauma symptomatology and greater difficulties in coping with skin diseases. The results emphasize the impact of a comorbid PTSD on a patient's ability to cope with skin diseases and underline the need for the inclusion of the differential diagnosis PTSD in dermatological treatment settings.

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

Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic

PubMed Central

Rosenbaum, Brooke E; Klein, Rebecca; Hagan, Paa Gyasi; Seadey, Mark-Young; Quarcoo, Naa Larteley; Hoffmann, Rachel; Robinson, Maria; Lartey, Margaret; Leger, Marie C

2017-01-01

Introduction Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. Methods We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Results Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Conclusion Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana. PMID:28533848

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.

HIV testing in dermatology - a national audit.

PubMed

Esson, Gavin A; Holme, S A

2018-05-01

Forty percent of individuals have late-stage HIV at the time of diagnosis, resulting in increased morbidity. Identifying key diseases which may indicate HIV infection can prompt clinicians to trigger testing, which may result in more timely diagnosis. The British HIV Association has published guidelines on such indicator diseases in dermatology. We audited the practice of HIV testing in UK dermatologists and General Practitioners (GPs) and compared results with the national guidelines. This audit showed that HIV testing in key indicator diseases remains below the standard set out by the national guidelines, and that GPs with special interest in dermatology have a lower likelihood for testing, and lower confidence when compared to consultants, registrars and associate specialists. Large proportions of respondents believed further training in HIV testing would be beneficial.

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.

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.

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.

Dermatologic surgery emergencies: Complications caused by systemic reactions, high-energy systems, and trauma.

PubMed

Minkis, Kira; Whittington, Adam; Alam, Murad

2016-08-01

While the overall incidence of emergencies in dermatologic surgery is low, emergent situations can occasionally pose a risk to patients undergoing such procedures. The clinical importance of several types of emergences related to systemic reactions, high energy systems, and trauma are reviewed, and relevant epidemiology, clinical manifestations, diagnosis, work-up, management, and prevention are discussed. Early detection of surgical emergencies can mitigate any associated adverse outcomes, thereby allowing the outstanding record of safety of dermatologic surgery to continue. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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.

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.

Dermatology within the UK podiatric literature: a content analysis (1989-2010)

PubMed Central

2013-01-01

Background Although dermatology, as a medical subject, has been a facet of the training and education of podiatrists for many years, it is, arguably, only in recent years that the speciality of podiatric dermatology has emerged within the profession. Some indication of this gradual development may be identified through a content analysis of the podiatric literature in the UK, spanning a 21 year timeframe. Method 6 key professional journals were selected for content analysis in order to provide a picture of the emergence and development of podiatric dermatology over a period extending from 1989 to 2010. Both syntactical and thematic unitization were deployed in the analysis, revealing both manifest and latent content. Categories were devised using a prior coding, a codebook produced to define relevant concepts and category characteristics, and the coding scheme subject to an assessment of reliability. Results 1611 units appeared in the 6 journals across a 21 year timeframe. 88% (n = 1417) occurred in one journal (Podiatry Now and its predecessors). Modal categories within all journals included course adverts (n = 673), commercial adverts (n = 562) and articles by podiatrists (n = 133). There was an overall rise from 40 per annum in 1989, to over 100 in 2010. A wider range of dermatological topics were addressed, ranging from fungal nail infections to melanoma. Conclusions It is evident from this analysis that there has been an increasing focus on dermatology as a topic within the main podiatric journals in the UK over the last 21 years, primarily reflecting a rise in commercial advertising and an increase in academic dermatology related publications. Whilst earlier publications tended to focus on warts and fungal infections, more recent publications address a broader spectrum of topics. Changes in prescribing rights may be relevant to these findings, as may the enhanced professional and regulatory body requirements on continuing professional

[Dermatological features of auto-inflammatory recurrent fevers].

PubMed

Escudier, A; Mauvais, F-X; Bastard, P; Boussard, C; Jaoui, A; Koskas, V; Lecoq, E; Michel, A; Orcel, M-C; Truelle, P-E; Wohrer, D; Piram, M

2018-02-01

Auto-inflammatory diseases are characterized by unexplained and recurrent attacks of systemic inflammation often involving the skin, joints, or serosal membranes. They are due to a dysfunction or dysregulation of the innate immunity, which is the first line of defense against pathogens. Early recognition of these diseases by the clinician, especially by pediatricians encountering such pathologies in pediatric patients, is primordial to avoid complications. Skin manifestations, common in most auto-inflammatory diseases, are helpful for prompt diagnosis. After a brief physiopathological review, we will describe auto-inflammatory recurrent fevers by their main dermatological presentations: urticarial lesions, neutrophilic dermatoses, panniculitis, other maculopapular eruptions, dyskeratosis, skin vasculitis, and oral aphthous. We finally suggest a decision tree to help clinicians better target genetic exams in patients with recurrent fevers and dermatological manifestations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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.

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.

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.

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

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.

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.

Perception and image of dermatology in the German general population 2002-2014.

PubMed

Augustin, M; Eissing, L; Elsner, P; Strömer, K; Schäfer, I; Enk, A; Reusch, M; Kaufmann, R

2017-12-01

In contrast to other European countries, dermatologists in Germany provide health care for a broad spectrum of diseases of the skin and mucous membranes. Current population-based data on the perception of dermatology were lacking to date. Analysis of the perception of dermatology from the general population's perspective with regard to utilization, satisfaction and responsibility. Nation-wide survey on awareness, utilization, rating and image of dermatology in October 2014 through computer-assisted telephone interviews on a representative sample of the adult general population (n = 1015), performed by the FORSA institute. Dermatologists as a medical specialist group are familiar to 88% of the population (2002: 65%), and approx. 82% of respondents underwent dermatological treatment in the past. Satisfaction with this treatment is high to very high in 80-90% of respondents. The majority (60-80%) name dermatologists as the desired primary provider of care for the largest share of common skin diseases. For allergic diseases, mucous membrane diseases, venous disorders and paediatric skin diseases, this rate is significantly below 50%. In Germany, dermatologists are perceived and valued as providers of care. In the case of skin cancer and chronic inflammatory skin diseases, they are experienced as primary care givers, whereas they are associated less frequently than their competence would justify with providing treatment for allergic and mucous membrane diseases and venous disorders. Further education of the general public and medical profession is required. © 2017 European Academy of Dermatology and Venereology.

Proceedings of the Inaugural Pediatric Dermatology Research Alliance (PeDRA) Conference

PubMed Central

Siegel, Dawn H.; Choate, Keith; Drolet, Beth A.; Frieden, Ilona J.; Teng, Joyce M.; Tom, Wynnis; Williams, Mary; Eichenfield, Lawrence F.; Paller, Amy S.

2014-01-01

Abstract/Statement of the problem Skin disease research involving children currently faces several major hurdles and as a result, many therapies are only available for off-label use in children and many of the most pressing clinical needs of our pediatric population remain unsolved. A strategic planning committee of the Society for Pediatric Dermatology (SPD) identified the need for an organized, inclusive research alliance to augment the resources of individual practitioners and pre-existing smaller collaborative groups and facilitate robust, multicenter basic, translational, and clinical research and therapeutic trials. A December 2011 National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Roundtable on Pediatric Dermatology further detailed the therapeutic gaps and barriers to translation of scientific advances to clinical practice. Building on these forums, in July 2012, a group of interested investigators met in Monterey, CA to develop the infrastructure for collaborative pediatric skin research, now called the Pediatric Dermatology Research Alliance (PeDRA). The vision of PeDRA is to create sustainable collaborative research networks to better understand, prevent, treat and cure dermatologic diseases in children. From that starting point, subcommittees and expert members were added, stakeholders identified, and seed funding garnered, with the first PeDRA stand-alone research meeting* realized in Chicago, IL in October 2013. PMID:25318428

Analysis of dermoscopy teaching modalities in United States dermatology residency programs

PubMed Central

Chen, Yun An; Rill, Joanne; Seiverling, Elizabeth V.

2017-01-01

The use of dermoscopy in dermatology residency programs is on the rise (over 94% of chief residents reported using a dermatoscope in 2013) [1]. Despite increased use (100% of our surveyed residents reported using a dermatoscope), dermoscopy training is one of the aspects of United States dermatology residency training with the lowest resident satisfaction [2]. Diagnostic accuracy with dermoscopy is highly correlated with the amount of dermoscopy training the user has undertaken [3]. We sought to analyze dermoscopy use in US Dermatology residencies to better understand resident dermoscopy utilization and teaching modalities. We found residents learn dermoscopy via multiple teaching modalities. The most commonly reported dermoscopy teaching modality was didactic lectures, followed by time in clinic with a dermoscopy expert. Of the different teaching modalities, time in the clinic with a dermoscopy expert was reported to be the most effective. We also found that the majority of dermatology residents receive didactic dermoscopy lectures and clinical dermoscopy training on the differentiation of benign nevi from melanoma using dermoscopy, the detection of basal cell carcinoma, and the identification of seborrheic keratosis. However, few residents receive dedicated training on the use of dermoscopy in the evaluation of inflammatory dermatoses and skin infections despite dermoscopy’s demonstrated value in both areas [4–7]. PMID:29085718

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.

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.

Feline dermatology at Cornell University: 1407 cases (1988-2003).

PubMed

Scott, Danny W; Miller, William H; Erb, Hollis N

2013-04-01

Medical records of 1407 cats with dermatologic diagnoses made at Cornell University teaching hospital from 1988 to 2003 were tabulated. We expressed the diagnoses as counts, percentages of the cats with dermatologic disease (1407) and percentages of all cats seen at the university hospital (22,135) during the same period. A total of 1887 diagnoses were made in the 1407 cats. We compared the age, sex and breed group of our cases with all those 22,135 cats in ('1-by-c') χ(2) tests in which the hospital population was considered a standard (rather than a 'sample'). The 10 most common dermatoses, their counts, and the proportions of dermatologic diagnoses and of the total cat population that the cats with these dermatoses represented were: allergy (298; 15.8%; 1.35%), atopic dermatitis (194; 10.3%; 0.88%), bacterial folliculitis/furunculosis (189; 10.0%; 0.85%), otodectic mange (115; 6.1%; 0.52%), flea infestation (99; 5.2%; 0.45%), feline acne (74; 3.9%; 0.33%), flea-bite allergy (70; 3.7%; 0.32%), cutaneous adverse drug reaction (56; 3.0%; 0.25%), idiopathic eosinophilic-granuloma complex (55; 2.9%; 0.25%) and abscess (51; 2.7%; 0.23%). Allergies of all types, combined, accounted for 32.7% of all the feline dermatoses. Relative to the standard of the total hospital population, cats <2 years old and females (both intact and spayed) were significantly under-represented (all P≤0.001) in the dermatologic case series. In contrast, Himalayans (compared with domestic short- or longhair, Persian, Siamese and other breeds) and males (both intact and neutered) were significantly over-represented (all P ≤0.001).

Google searches help with diagnosis in dermatology.

PubMed

Amri, Montassar; Feroz, Kaliyadan

2014-01-01

Several previous studies have tried to assess the usefulness of Google search as a diagnostic aid. The results were discordant and have led to controversies. To investigate how often Google search is helpful to reach correct diagnoses in dermatology. Two fifth-year students (A and B) and one demonstrator (C) have participated as investigators in this paper. Twenty-five diagnostic dermatological cases were selected from all the clinical cases published in the Web only images in clinical medicine from March 2005 to November 2009. The main outcome measure of our paper was to compare the number of correct diagnoses provided by the investigators without, and with Google search. Investigator A gave correct diagnoses in 9/25 (36%) cases without Google search, his diagnostic success after Google search was 18/25 (72%). Investigator B results were 11/25 (44%) correct diagnoses without Google search, and 19/25 (76%) after this search. For investigator C, the results were 12/25 (48%) without Google search, and 18/25 (72%) after the use of this tool. Thus, the total correct diagnoses provided by the three investigators were 32 (42.6%) without Google search, and 55 (73.3%) when using this facility. The difference was statistically significant between the total number of correct diagnoses given by the three investigators without, and with Google search (p = 0.0002). In the light of our paper, Google search appears to be an interesting diagnostic aid in dermatology. However, we emphasize that diagnosis is primarily an art based on clinical skills and experience.

PSYCHOSOMATIC ASPECTS IN PATIENTS WITH DERMATOLOGIC DISEASES.

PubMed

Tsintsadze, N; Beridze, L; Tsintsadze, N; Krichun, Y; Tsivadze, N; Tsintsadze, M

2015-06-01

The aim of our study was to find out the magnitude of anxiety and depression in our common dermatological patients and its correlation with age, sex. For this purpose, we used Hospital Anxiety and Depression Scale HADS. The psychometric validity of HADS has been established by validating the questionnaire against the structured psychiatric interviews. A study of anxiety and depression in patients with dermatologic diseases was conducted on the basis of outpatients department in 211 patients with dermatologic diseases; among them were 107 male and 104 female, aged 16 to 75 years. Among them were patients with Acne, Alopecia Areata, Psoriasis, Vitiligo, Neurodermatitis, Scabies, Eczema and Other diseases (Atopic Dermatitis, Chronic Urticaria, Lichen Planus, Herpes Zoster, Melasma, Warts and Etc.). Based on studies of patients reveals that 65.4% of them are anxiety, depression - 56.2%, both anxiety and depression in 24.7%, there figures higher than the dates of other authorizes. As a result of a direct link research risk disorder depressive spectrum with sex, age; in woman anxiety and depression occurs more frequently than men, and anxiety occurs more frequently in young age. Especially there are hight frequencies of manifestation of abuse in patients with Psoriasis (anxiety - 83.3%, depression - 69.4%, both - 38.8%), Eczema (anxiety - 73.3%, depression - 56.6%, both - 26.7%), Acne (anxiety - 78.4%, depression - 54%, both - 21.6%), Vitiligo (anxiety - 66.7%, depression - 60%, both - 33.3%). Our study noticed higher dates of anxiety and depression than the dates of other outhorizes.

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.

Use and potential of nanotechnology in cosmetic dermatology.

PubMed

Morganti, Pierfrancesco

2010-02-24

Biotechnology and nanotechnology are the key technologies of the twenty-first century, having enormous potential for innovation and growth. The academic and industrial goals for these technologies are the development of nanoscale biomolecular substances and analytical instruments for investigating cell biology at the cellular and molecular levels. Developments in nanotechnology will provide opportunities for cosmetic dermatology to develop new biocompatible and biodegradable therapeutics, delivery systems and more active compounds. Cosmetics have the primary function of keeping up a good appearance, changing the appearance, or correcting body odors, while maintaining the skin and its surroundings in good conditions. Thus cosmetic dermatology, recognizing the new realities of skin care products, has to emphasize the functional aspects of cosmetics through an understanding of their efficacy and safety in promoting good health. Nanoscience may help the scientific community to find more innovative and efficacious cosmetics. Understanding the physical model of the cell as a machine is essential to understand how all the cell components work together to accomplish a task. The efficacy and safety of new nanomaterials has to be deeply studied by ex vivo tests and innovative laboratory techniques. New delivery systems and natural nanocompounds, such as chitin nanofibrils for wound healing, are being used in cosmetic dermatology with good results, as are nanostructured TiO(2) and ZnO sunscreens. The challenge is open.

Posttraumatic stress disorder (PTSD) and the dermatology patient.

PubMed

Gupta, Madhulika A; Jarosz, Patricia; Gupta, Aditya K

Dermatologic symptoms can be associated with posttraumatic stress disorder (PTSD) in several situations: (1) as features of some core PTSD symptoms, such as intrusion symptoms manifesting as cutaneous sensory flashbacks, as autonomic arousal manifesting as night sweats and idiopathic urticaria, and as dissociation manifesting as numbness and dermatitis artefacta; (2) the cutaneous psychosomatic effects of emotional and physical neglect and sexual abuse (eg, infantile eczema, cutaneous self-injury, and body-focused repetitive behaviors such as trichotillomania and skin picking disorder) and eating disorders, which can have dermatologic effects; (3) the direct effect of physical or sexual abuse or catastrophic life events (eg, earthquakes) on the skin; and (4) as a result of significant alterations in hypothalamic-pituitary-adrenal and sympatho-adrenal medullary axes, which can affect neuroendocrine and immune functions, and can lead to exacerbations of stress-reactive inflammatory dermatoses such as psoriasis, chronic urticaria, and atopic dermatitis. Elevated levels of inflammatory biomarkers and impaired epidermal barrier function have been reported in situations involving sustained psychologic stress and sleep deprivation. Some PTSD patients show hypothalamic-pituitary-adrenal axis hyporesponsiveness and higher circulating T lymphocytes, which can exacerbate immune-mediated dermatologic disorders. PTSD should be considered an underlying factor in the chronic, recurrent, or treatment-resistant stress-reactive dermatoses and in patients with self-induced dermatoses. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Dermatology Residents are Prescribing Tanning Bed Treatment.

PubMed

Anderson, Kathryn L; Huang, Karen E; Huang, William W; Feldman, Steven R

2016-07-15

Although 90% of dermatologists discourage the use of tanning beds, about half of psoriasis patients report using tanning beds and most of these note improvement. The purpose of this investigation was to determine if dermatology residents are advocating the tanning bed use to their patients.

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

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

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.

A Concentrated Teaching Exercise for Introducing Clinical Dermatology

ERIC Educational Resources Information Center

Binford, Robert T.; And Others

1973-01-01

At Cornell University Medical College one 3-hour session in dermatology is required during the second year. A teaching exercise has been developed that combines a lecture, laboratory exercises, and presentations of patients. (Author)

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.

Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care

PubMed Central

Wyatt, Kirk D; Comfere, Nneka I; Bernard, Matthew E; North, Frederick

2017-01-01

Background PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)–based mobile devices. Objective The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. Methods Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant). Results During the study period, there were 1139 photo sessions on 1059 unique patients. Of the 1139 sessions, 395 (34.68%) sessions documented dermatologist input in the EHR via dermatology curbside consultation, eConsult, and in-person dermatology consult. Clinicians utilized curbside phone consults preferentially over eConsults for TD. By clinician type, nurse practitioners (NPs) and physician assistants (PAs) were more likely to utilize the PhotoExam for TD as compared with physicians. By specialty type, pediatric clinicians were more likely to utilize the PhotoExam for TD as compared with family medicine and internal medicine clinicians. A total of 108 (9.5%) photo sessions had a biopsy performed of the photographed site. Of these, 46 biopsies (42.6%) were performed by a primary care clinician, and 27 (25.0%) biopsies were interpreted as a malignancy. Of the 27 biopsies that revealed malignant findings, 6 (22%) had a TD consultation before biopsy, and 10 (37%) of these biopsies were obtained by primary care clinicians. Conclusions Clinicians primarily used the PhotoExam for non-TD purposes. Nurse

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.

Assessment of Online Patient Education Materials from Major Dermatologic Associations

PubMed Central

John, Ann M.; John, Elizabeth S.; Hansberry, David R.

2016-01-01

Objective: Patients increasingly use the internet to find medical information regarding their conditions and treatments. Physicians often supplement visits with written education materials. Online patient education materials from major dermatologic associations should be written at appropriate reading levels to optimize utility for patients. The purpose of this study is to assess online patient education materials from major dermatologic associations and determine if they are written at the fourth to sixth grade level recommended by the American Medical Association and National Institutes of Health. Design: This is a descriptive and correlational design. Setting: Academic institution. Participants/measurements: Patient education materials from eight major dermatology websites were downloaded and assessed using 10 readability scales. A one-way analysis of variance and Tukey’s Honestly Statistically Different post hoc analysis were performed to determine the difference in readability levels between websites. Results: Two hundred and sixty patient education materials were assessed. Collectively, patient education materials were written at a mean grade level of 11.13, with 65.8 percent of articles written above a tenth grade level and no articles written at the American Medical Association/National Institutes of Health recommended grade levels. Analysis of variance demonstrated a significant difference between websites for each reading scale (p<0.001), which was confirmed with Tukey’s Honestly Statistically Different post hoc analysis. Conclusion: Online patient education materials from major dermatologic association websites are written well above recommended reading levels. Associations should consider revising patient education materials to allow more effective patient comprehension. (J ClinAesthet Dermatol. 2016;9(9):23–28.) PMID:27878059

Assessment of Online Patient Education Materials from Major Dermatologic Associations.

PubMed

John, Ann M; John, Elizabeth S; Hansberry, David R; Lambert, William Clark

2016-09-01

Objective: Patients increasingly use the internet to find medical information regarding their conditions and treatments. Physicians often supplement visits with written education materials. Online patient education materials from major dermatologic associations should be written at appropriate reading levels to optimize utility for patients. The purpose of this study is to assess online patient education materials from major dermatologic associations and determine if they are written at the fourth to sixth grade level recommended by the American Medical Association and National Institutes of Health. Design: This is a descriptive and correlational design. Setting: Academic institution. Participants/measurements: Patient education materials from eight major dermatology websites were downloaded and assessed using 10 readability scales. A one-way analysis of variance and Tukey's Honestly Statistically Different post hoc analysis were performed to determine the difference in readability levels between websites. Results: Two hundred and sixty patient education materials were assessed. Collectively, patient education materials were written at a mean grade level of 11.13, with 65.8 percent of articles written above a tenth grade level and no articles written at the American Medical Association/National Institutes of Health recommended grade levels. Analysis of variance demonstrated a significant difference between websites for each reading scale (p<0.001), which was confirmed with Tukey's Honestly Statistically Different post hoc analysis. Conclusion: Online patient education materials from major dermatologic association websites are written well above recommended reading levels. Associations should consider revising patient education materials to allow more effective patient comprehension. (J ClinAesthet Dermatol. 2016;9(9):23-28.).

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.

Pharmacogenomic biomarkers in dermatologic drugs.

PubMed

Greenfield, Nava Pincus; Maibach, Howard

2013-12-01

Biomarkers are becoming increasingly important when considering the efficacy, toxicology, mechanism of action, and risk of adverse events in certain drugs. As availability of bio-genomic information increases, more treatments can be tailored to specific individuals, with a net effect of improved health outcomes. Many dermatology drugs have pharmacogenomic information on their labels. Knowing the risks and benefits associated with genomic biomarkers can aid physicians to make more knowledgeable decisions when identifying treatments for their patients.

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

Malassezia species in healthy skin and in dermatological conditions.

PubMed

Prohic, Asja; Jovovic Sadikovic, Tamara; Krupalija-Fazlic, Mersiha; Kuskunovic-Vlahovljak, Suada

2016-05-01

The genus Malassezia comprises lipophilic species, the natural habitat of which is the skin of humans and other warm-blooded animals. However, these species have been associated with a diversity of dermatological disorders and even systemic infections. Pityriasis versicolor is the only cutaneous disease etiologically connected to Malassezia yeasts. In the other dermatoses, such as Malassezia folliculitis, seborrheic dermatitis, atopic dermatitis, and psoriasis, these yeasts have been suggested to play pathogenic roles either as direct agents of infection or as trigger factors because there is no evidence that the organisms invade the skin. Malassezia yeasts have been classified into at least 14 species, of which eight have been isolated from human skin, including Malassezia furfur, Malassezia pachydermatis, Malassezia sympodialis, Malassezia slooffiae, Malassezia globosa, Malassezia obtusa, Malassezia restricta, Malassezia dermatis, Malassezia japonica, and Malassezia yamatoensis. Distributions of Malassezia species in the healthy body and in skin diseases have been investigated using culture-based and molecular techniques, and variable results have been reported from different geographical regions. This article reviews and discusses the latest available data on the pathogenicity of Malassezia spp., their distributions in dermatological conditions and in healthy skin, discrepancies in the two methods of identification, and the susceptibility of Malassezia spp. to antifungals. © 2015 The International Society of Dermatology.

[Quantitative analysis of drug expenditures variability in dermatology units].

PubMed

Moreno-Ramírez, David; Ferrándiz, Lara; Ramírez-Soto, Gabriel; Muñoyerro, M Dolores

2013-01-01

Variability in adjusted drug expenditures among clinical departments raises the possibility of difficult access to certain therapies at the time that avoidable expenditures may also exist. Nevertheless, drug expenditures are not usually applied to clinical practice variability analysis. To identify and quantify variability in drug expenditures in comparable dermatology department of the Servicio Andaluz de Salud. Comparative economic analysis regarding the drug expenditures adjusted to population and health care production in 18 dermatology departments of the Servicio Andaluz de Salud. The 2012 cost and production data (homogeneous production units -HPU-)were provided by Inforcoan, the cost accounting information system of the Servicio Andaluz de Salud. The observed drug expenditure ratio ranged from 0.97?/inh to 8.90?/inh and from 208.45?/HPU to 1,471.95?/ HPU. The Pearson correlation between drug expenditure and population was 0.25 and 0.35 for the correlation between expenditure and homogeneous production (p=0.32 and p=0,15, respectively), both Pearson coefficients confirming the lack of correlation and arelevant degree of variability in drug expenditures. The quantitative analysis of variability performed through Pearson correlation has confirmed the existence of drug expenditure variability among comparable dermatology departments. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

Use of facebook as a tool for knowledge dissemination in dermatology.

PubMed

Kim, Whan; Vender, Ronald

2014-10-01

The presence of dermatology-related platforms in social media has been acknowledged; however, the level of engagement of the public with these platforms has not been evaluated. To use the Engagement Rate to assess the level of engagement of the public with Facebook pages devoted to dermatology. A search on Facebook identified Facebook pages for dermatology academic journals, professional societies, and patient-centered groups with the highest number of Facebook likes. Then the Yearly Page Engagement Rate was calculated for each Facebook page. The robust average of the Yearly Page Engagement Rate was 0.673 for academic journals, 0.313 for professional societies, and 1.563 for patient-centered groups. Patient-centered groups engaged with their fans most effectively. Engagement is a key determinant of a fan's exposure to the contents of the page and hence a gauge of whether the fans who "liked" the page continue to remain engaged or not.

Dermatological manifestations in hemodialysis patients in Iran: A systematic review and meta-analysis.

PubMed

Asayesh, Hamid; Peykari, Niloofar; Pavaresh-Masoud, Mohammad; Esmaeili Abdar, Mohammad; Tajbakhsh, Ramin; Mousavi, Seyed Mojtaba; Djalalinia, Shirin; Noroozi, Mehdi; Qorbani, Mostafa; Mahdavi-Gorabi, Armita

2018-03-25

Dermatologic complications are common in patients with end-stage renal disease and also have a high diversity. This meta-analysis reviews prevalence of dermatological manifestations among hemodialysis patients in Iran. Using PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS as the main international electronic data sources, and Iran-Medex, Irandoc, and Scientific Information Database, as the main domestic databases with systematic search capability, we systematically searched surveys, papers, and reports on the prevalence of dermatological manifestations (until February 2016). Heterogeneity of reported prevalence's between studies was assessed using the Q test; overall prevalence of dermatological manifestations was estimated using random-effect meta-analysis model. We found 1229 records; from them, a total of eight studies comprising 917 hemodialysis patients were included. In all of studies, skin discoloration, pruritus and xerosis have the highest prevalence. According to random-effect meta-analysis model, the pooled prevalence of skin discoloration, pruritus, ecchymosis, xerosis, and half-and-half nail in hemodialysis patients were 48.03% (95% CI: 45.09-51.01), 52.85% (95%CI: 49.23-56.47), 19.88 (95% CI: 17.57-22.19), 51.14% (95% CI: 48.25-54.02), and 18.50% (95% CI: 16.0-21.0), respectively. his study shows that the prevalence of dermatological manifestations seems high among the hemodialysis patients in Iran, and skin discoloration, pruritus, and xerosis are more common. © 2018 Wiley Periodicals, Inc.

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.

A review of the use of tanning beds as a dermatological treatment.

PubMed

Radack, Kyle P; Farhangian, Michael E; Anderson, Kathryn L; Feldman, Steven R

2015-03-01

In-office phototherapy is an effective treatment for many dermatologic conditions, however, many patients are unable to adhere to the rigorous travel and time commitments sometimes needed. Tanning bed facilities are nearly ubiquitous in modern society and could represent a more convenient means to obtain ultraviolet (UV) exposure when office phototherapy is not feasible. The purpose of this study was to review available evidence on the use of tanning facilities as a treatment for dermatologic conditions. PubMed was searched on February 2015 for "tanning beds" and "phototherapy", and with some dermatologic conditions sensitive to UV light, including "psoriasis", "mycosis fungoides", "acne", "atopic dermatitis" and "eczema". From there, further articles were found using the reference sections of the initial papers. A similar methodology was used with the Google Scholar search engine. Only articles in English and prospective studies were included in this review. We found studies validating the use of tanning facilities for psoriasis treatment. Use as a treatment option for atopic dermatitis, mycosis fungoides, acne, scleroderma, vitiligo, and pruritus, as well as other UV sensitive dermatoses, may also be beneficial. This study is limited by the lack of double-blind, placebo-controlled trials, long-term follow-up studies, and meta-analyses for tanning facility use in dermatologic phototherapy, and by the lack of standardization of both tanning facilities and exposure dosing. Unsupervised sun exposure is a standard recommendation for some patients to obtain phototherapy. Selected use of commercial tanning beds in the treatment of dermatologic conditions may be another useful and effective treatment for those patients with an inability to access office-based or home-based phototherapy.

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.

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.

Aerospace Dermatology

PubMed Central

Arora, Sandeep

2017-01-01

Evolutionarily, man is a terrestrial mammal, adapted to land. Aviation and now space/microgravity environment, hence, pose new challenges to our physiology. Exposure to these changes affects the human body in acute and chronic settings. Since skin reflects our mental and physical well-being, any change/side effects of this environment shall be detected on the skin. Aerospace industry offers a unique environment with a blend of all possible occupational disorders, encompassing all systems of the body, particularly the skin. Aerospace dermatologists in the near future shall be called upon for their expertise as we continue to push human physiological boundaries with faster and more powerful military aircraft and look to colonize space stations and other planets. Microgravity living shall push dermatology into its next big leap-space, the final frontier. This article discusses the physiological effects of this environment on skin, effect of common dermatoses in aerospace environment, effect of microgravity on skin, and occupational hazards of this industry. PMID:28216729

Aerospace Dermatology.

PubMed

Arora, Sandeep

2017-01-01

Evolutionarily, man is a terrestrial mammal, adapted to land. Aviation and now space/microgravity environment, hence, pose new challenges to our physiology. Exposure to these changes affects the human body in acute and chronic settings. Since skin reflects our mental and physical well-being, any change/side effects of this environment shall be detected on the skin. Aerospace industry offers a unique environment with a blend of all possible occupational disorders, encompassing all systems of the body, particularly the skin. Aerospace dermatologists in the near future shall be called upon for their expertise as we continue to push human physiological boundaries with faster and more powerful military aircraft and look to colonize space stations and other planets. Microgravity living shall push dermatology into its next big leap-space, the final frontier. This article discusses the physiological effects of this environment on skin, effect of common dermatoses in aerospace environment, effect of microgravity on skin, and occupational hazards of this industry.

[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.

[The significance of dermatologic management in computer-assisted occupational dermatology consultation].

PubMed

Rakoski, J; Borelli, S

1989-01-15

At our occupational outpatient clinic, 230 patients were treated for about 15 months. With the help of a standardized questionary, we registered all the data regarding the relevant substances the patients contacted during their work as well as their various jobs since they left school. The patients were repeatedly seen and trained in procedures of skin care and skin protection. If required, we took steps to find new jobs for them within their employing company; this was done in cooperation with the trade cooperative association according to the dermatological insurance consultanship. If these proceedings did not work out, the patient had to change his profession altogether. All data were computerized. As an example for this computer-based documentation we present the data of barbers.

A Proposal for the Consolidation of Dermatology Services of Walter Reed Army Medical Center and the National Naval Medical Center

DTIC Science & Technology

1999-08-01

This includes the treatment of common skin conditions such as acne, dermatitis, psoriasis, vitiligo or alopecia to the more complex laser surgeries and...Phototherapy, Laser Surgery, Pediatric Dermatology, HIV Dermatology, Patch Testing, MOHS Micrographic Surgery, and Dermatologic Surgery. The entire...Dermatology Service is located on the first floor of the hospital. Minor surgical and MOHS Micrographic Surgery, ultraviolet treatment, and laser surgery

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

Use of eye movement desensitization and reprocessing (EMDR) in the treatment of dermatologic disorders.

PubMed

Gupta, Madhulika A; Gupta, Aditya K

2002-01-01

The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations. We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder. Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3-6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6-12 months after the end of EMDR therapy. All 4 patients experienced a marked improvement in their symptoms after 3-6 sessions of EMDR, within a period of dermatologic symptoms.

Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care.

PubMed

Pecina, Jennifer L; Wyatt, Kirk D; Comfere, Nneka I; Bernard, Matthew E; North, Frederick

2017-11-08

PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)-based mobile devices. The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant). During the study period, there were 1139 photo sessions on 1059 unique patients. Of the 1139 sessions, 395 (34.68%) sessions documented dermatologist input in the EHR via dermatology curbside consultation, eConsult, and in-person dermatology consult. Clinicians utilized curbside phone consults preferentially over eConsults for TD. By clinician type, nurse practitioners (NPs) and physician assistants (PAs) were more likely to utilize the PhotoExam for TD as compared with physicians. By specialty type, pediatric clinicians were more likely to utilize the PhotoExam for TD as compared with family medicine and internal medicine clinicians. A total of 108 (9.5%) photo sessions had a biopsy performed of the photographed site. Of these, 46 biopsies (42.6%) were performed by a primary care clinician, and 27 (25.0%) biopsies were interpreted as a malignancy. Of the 27 biopsies that revealed malignant findings, 6 (22%) had a TD consultation before biopsy, and 10 (37%) of these biopsies were obtained by primary care clinicians. Clinicians primarily used the PhotoExam for non-TD purposes. Nurse practitioners and PAs utilized the app for TD purposes more

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.

[Lifestyle diseases in dermatology].

PubMed

Harth, W; Hillert, A

2007-10-01

Psychosocial disorders and lifestyle trends have become more important in dermatology. Lifestyle diseases are a biopsychosocial phenomenon that can only be diagnosed and treated by paying attention to the quickly changing sociocultural aspects. The naming and popularization of the particular lifestyle diseases takes place by the media, but there is only an imprecise medical classification of these phenomena. This article gives an overview of the current situation and medical conditions of lifestyle diseases and try to assign them to an established psychosomatic diagnosis, based on the clinical symptomatic. Most often somatoform disorders, somatization disorders with a repeated presentation of physical symptoms which cannot be medically objectified or depressive disturbances are found.

Nanotechnology in Dermatology*

PubMed Central

Antonio, João Roberto; Antônio, Carlos Roberto; Cardeal, Izabela Lídia Soares; Ballavenuto, Julia Maria Avelino; Oliveira, João Rodrigo

2014-01-01

The scientific community and general public have been exposed to a series of achievements attributed to a new area of knowledge: Nanotechnology. Both abroad and in Brazil, funding agencies have launched programs aimed at encouraging this type of research. Indeed, for many who come into contact with this subject it will be clear the key role that chemical knowledge will play in the evolution of this subject. And even more, will see that it is a science in which the basic structure is formed by distilling different areas of inter-and multidisciplinary knowledge along the lines of new paradigms. In this article, we attempt to clarify the foundations of nanotechnology, and demonstrate their contribution to new advances in dermatology as well as medicine in general. Nanotechnology is clearly the future. PMID:24626657

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

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.

Nanotechnology and dermatology education in the United States: data from a pilot survey.

PubMed

Friedman, Adam; Nasir, Adnan

2011-09-01

Nanotechnology is a rapidly growing discipline with important implications for consumers, patients, physicians and investigators. In an era when nanotechnology is being both incorporated into educational requirements for medical fields such as radiology and oncology and vigorously pursued and developed by cosmeceutical companies, dermatology is falling behind. A survey was conducted to ascertain knowledge, attitudes and perception of nanotechnology in dermatology teaching programs. To ascertain baseline knowledge, attitudes and preceptions regarding nanotechnology among dermatology trainees, dermatology investigators and dermatology faculty in US academic medical centers, an online survey was sent out to random members of the dermatology community and data analyzed (100 participants, 23% response rate). Participants responded to a questionnaire on a five-point scale ranging from strongly disagree, disagree, uncertain, agree, to strongly agree. Due to the low response rate, strongly disagree/disagree and strongly agree/agree values were combined and compared to uncertain responses. Approximately equal numbers of faculty vs. chief residents responded to the survery (52% vs. 47.75%, respectively). The majority of respondents had not previously attended any educational activity on nanotechnology (69.57%). The majority of participants agreed that more education on nanotechnology for dermatologists is needed (78.26% agreed vs. 21.74% uncertain) and that it should be incorporated into the residency training curriculum (60.87% agree vs. 13.04% disagree). Participants mostly agreed that nanotechnology research can contribute to better fundamental understanding of skin disease (78.26%), to advances in the diagnosis of skin disease (73.91%) and to therapies (78.26%). Participants mostly agreed that more research is needed (82.60%) and that this research should be funded (78.26%). Not surprisingly, respondents were uncertain with respect to issues of nanotechnology safety both

Beyond Psoriasis: Novel Uses for Biologic Response Modifiers in Pediatric Dermatology.

PubMed

Bellodi-Schmidt, Fernanda; Shah, Kara N

2016-01-01

Dermatologists have witnessed the increasing availability of novel biologic response modifiers for the treatment of inflammatory and autoimmune diseases in recent years. The most common dermatologic indication for the use of biologic response modifiers in adults is psoriasis, but the U.S. Food and Drug Administration has not approved any of these agents for use in any dermatologic disease in children with the exception of omalizumab, and as such, use in this population is considered off-label. In this review, we focus on the use of these agents in children to treat inflammatory skin diseases other than psoriasis, including atopic dermatitis, hidradenitis suppurativa, pemphigus vulgaris, bullous pemphigoid, and toxic epidermal necrolysis, with an emphasis on the use of etanercept, infliximab, rituximab, omalizumab, and ustekinumab. By highlighting novel uses of these agents, particularly for the treatment of dermatologic conditions for which optimal therapies are yet to be established, we hope to raise awareness of the potential use of this class of medications to treat inflammatory skin diseases in children. © 2015 Wiley Periodicals, Inc.

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.

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.

Teledermatology as a means to improve access to inpatient dermatology care.

PubMed

Sharma, Priyank; Kovarik, Carrie L; Lipoff, Jules B

2016-07-01

Many hospitals have limited inpatient dermatology consultation access. Most dermatologists are outpatient-based and may find the distance and time to complete inpatient consultations prohibitive. Teledermatology may improve access to inpatient dermatology care by reducing barriers of distance and time. We conducted a prospective two-phase pilot study at two academic hospitals comparing time needed to complete inpatient consultations after resident dermatologists initially evaluated patients, called average handling time (AHT), and time needed to respond to the primary team, called time to response (TTR), with and without teledermatology with surveys to capture changes in dermatologist opinion on teledermatology. Teledermatology was only used in the study phase, and patients were seen in-person in both study phases. Teledermatology alone sufficiently answered consultations in 10 of 25 study consultations. The mean AHT in the study phase (sAHT) was 26.9 min compared to the baseline phase (bAHT) of 43.5 min, a 16.6 min reduction (p = 0.004). The 10 study cases where teledermatology alone was sufficient had mean study TTR (sTTR) of 273.3 min compared to a baseline TTR (bTTR) of 405.7 min, a 132.4 min reduction (p = 0.032). Teledermatology reduces the time required for an attending dermatologist to respond and the time required for a primary team to receive a response for an inpatient dermatology consultation in a subset of cases. These findings suggest teledermatology can be used as a tool to improve access to inpatient dermatology care. © The Author(s) 2015.

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.

Knowledge and Behavior Regarding Cosmetics in Koreans Visiting Dermatology Clinics

PubMed Central

Oh, Sohee; Kim, Nack In; Ro, Young Suck; Kim, Joung Soo; Park, Young Min; Park, Chun Wook; Lee, Weon Ju; Kim, Dong Kun; Lee, Dong Won; Lee, Sang Jun

2017-01-01

Background Cosmetics can affect the skin condition profoundly, and yet no survey has been performed in Koreans visiting dermatology clinics. Objective To assess knowledge and consumer behavior regarding cosmetics in Koreans visiting dermatology clinics. Methods A questionnaire consisting of 43 questions concerning demographics and use/knowledge/selection/purchase of cosmetics was given to patients and accompanying persons who visited dermatologic clinics in university and private clinic settings. Results In total 1,015 subjects (73.2% females, mean age 32.5 years) completed the survey. Education level was college or higher in 72.8%. Thirty-one percent had been diagnosed with a skin disorder, atopic dermatitis and seborrheic dermatitis being the most frequent diagnoses (33.7% and 16.8%, respectively). The frequency of makeup/sunscreen/functional cosmetics use, amount of sunscreen use, recognition of functional cosmetics, and knowledge of shelf life were significantly correlated with level of education. Among “functional cosmetics,” whitening products were used most frequently (29.2%). Regardless of education level, 79.2% purchased cosmetics without checking ingredients, and 85.7% were unaware of the all-ingredient-labelling regulations, and yet subjects considered ingredient the most important factor when purchasing a product. Conclusion Outpatient subjects in their twenties and thirties are the most knowledgeable about cosmetics in Korea. PMID:28392645

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

Use of optical skin phantoms for calibration of dermatological lasers

NASA Astrophysics Data System (ADS)

Wróbel, M. S.; Sekowska, A.; Marchwiński, M.; Galla, S.; Cenian, A.

2016-09-01

A wide range of dermatological diseases can be efficiently treated using laser heating. Nevertheless, before the new laser is introduced into clinical practice, its parameters and ability to interact with human skin have to be carefully examined. In order to do that optical skin phantoms can be used. Such phantoms closely imitate the scattering and absorption properties of real human skin tissue along with its thermal properties, such as capacitance and conductivity specific heat. We have fabricated a range of optical tissue phantoms based on polyvinylchloride-plastisol PVC-P with varying optical properties, including the absorption, scattering and density of the matrix material. We have utilized a pre-clinical dermatological laser system with a 975 nm diode laser module. A range of laser settings were tested, such as laser pulse duration, laser power and number of pulses. We have studied laser irradiation efficiency on fabricated optical tissue phantoms. Measurements of the temporal and spatial temperature distribution on the phantoms' surface were performed using thermographic imaging. The comparison of results between tissues' and phantoms' optical and thermal response prove that they can be used for approximate evaluation of laser heating efficiency. This study presents a viable approach for calibration of dermatological lasers which can be utilized in practice.

[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.

Medical emergencies in the dermatology office: incidence and options for crisis preparedness.

PubMed

Hazen, Paul G; Daoud, Shaza; Hazen, Brent P; Engstrom, Conley W; Turgeon, Karen L; Reep, Michael D; Tanphaichitr, Arthapol; Styron, Brandie T

2014-05-01

Medical emergencies may occur in any setting, including dermatology offices. We examined the incidence of medical emergencies in a survey of 34 dermatologists northeast Ohio. Fifty-five events occurred over 565 combined years of clinical practice, an incidence of 1 episode every 10.3 years. We also review options for better preparedness for medical emergencies in dermatology practices, ranging from an emergency action plan for emergency personnel, basic life support (BLS) certification, advanced cardiac life support (ACLS) certification, and on-site automatic electronic defibrillators (AEDs).

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.

Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

PubMed Central

Gorouhi, Farzam; Alikhan, Ali; Rezaei, Arash; Fazel, Nasim

2014-01-01

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. PMID:24772165

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates

PubMed Central

Barat, Atena; Goldacre, Michael J.

2018-01-01

Objective To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Methods Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. Results 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. Conclusion Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively. PMID:29785180

Clinical decision making in dermatology: observation of consultations and the patients' perspectives.

PubMed

Hajjaj, F M; Salek, M S; Basra, M K A; Finlay, A Y

2010-01-01

Clinical decision making is a complex process and might be influenced by a wide range of clinical and non-clinical factors. Little is known about this process in dermatology. The aim of this study was to explore the different types of management decisions made in dermatology and to identify factors influencing those decisions from observation of consultations and interviews with the patients. 61 patient consultations were observed by a physician with experience in dermatology. The patients were interviewed immediately after each consultation. Consultations and interviews were audio recorded, transcribed and their content analysed using thematic content analysis. The most common management decisions made during the consultations included: follow-up, carrying out laboratory investigation, starting new topical treatment, renewal of systemic treatment, renewal of topical treatment, discharging patients and starting new systemic treatment. Common influences on those decisions included: clinical factors such as ineffectiveness of previous therapy, adherence to prescribing guidelines, side-effects of medications, previous experience with the treatment, deterioration or improvement in the skin condition, and chronicity of skin condition. Non-clinical factors included: patient's quality of life, patient's friends or relatives, patient's time commitment, travel or transportation difficulties, treatment-related costs, availability of consultant, and availability of treatment. The study has shown that patients are aware that management decisions in dermatology are influenced by a wide range of clinical and non-clinical factors. Education programmes should be developed to improve the quality of decision making. Copyright © 2010 S. Karger AG, Basel.

Antimicrobial drug use in dermatology in a teaching hospital in western Nepal.

PubMed

Sarkar, C; Das, B; Sripathi, H

2002-05-01

Medical audit is supposed to oversee, monitor and analyse standards of medical treatment at all levels of the healthcare delivery system. This study was undertaken to monitor the prescribing of antimicrobial drugs for patients seeking treatment in the dermatology outpatient department of the Manipal Teaching Hospital in Nepal. A total of 292 dermatology prescriptions of patients attending the dermatology OPD were collected between July 2000 and June 2001. Prescriptions for antimicrobial agents were separated from the total prescriptions collected, and evaluated. There were more female patients (58.2%) than male (41.8%) in our study; most were in the 21-40 year age group. The commonest cutaneous infections were acne (15.8%) followed by fungal infections (14.8%). Of the 292 prescriptions audited, 149 contained antimicrobial agents, constituting 36% of the total number of drugs prescribed. Of 256 antimicrobials prescribed, 63% were topical and 37% systemic; 5% were generic, 29% were from the essential drug list of Nepal, and 15% were fixed-dose combinations. Most of the patients received one or two antimicrobials, 50% of which were antibacterials and 40% antifungals. Though the selection of antimicrobial drugs used in dermatology was largely rational, anomalies were observed, and these issues were discussed with clinicians in relation to various aspects of drug use. The results indicate there is scope for improving prescribing habits. A periodic audit of drug prescribing is desirable in rationalising prescribing practice.

Sandalwood Album Oil as a Botanical Therapeutic in Dermatology

PubMed Central

Levenson, Corey

2017-01-01

Many skin conditions and diseases are characterized by inflammation, infection, and hyperplasia. Safe and effective topical treatment options that can be used long-term are needed. Traditional botanical medicines, which are often complex mixtures that exert their biological activities via multiple mechanisms of action, are being studied as potential new active ingredients in dermatology. Sandalwood album oil (SAO), also known as East Indian sandalwood oil (EISO), is an essential oil distilled from the Santalum album tree and has demonstrated biological activity as an anti-inflammatory, anti-microbial, and anti-proliferative agent. Sandalwood album oil has also shown promise in clinical trials for treatment of acne, psoriasis, eczema, common warts, and molluscum contagiosum. The favorable safety profile, ease of topical use, and recent availability of pharmaceutical-grade sandalwood album oil support its broader use as the basis of novel therapies in dermatology. PMID:29344319

A software platform for the analysis of dermatology images

NASA Astrophysics Data System (ADS)

Vlassi, Maria; Mavraganis, Vlasios; Asvestas, Panteleimon

2017-11-01

The purpose of this paper is to present a software platform developed in Python programming environment that can be used for the processing and analysis of dermatology images. The platform provides the capability for reading a file that contains a dermatology image. The platform supports image formats such as Windows bitmaps, JPEG, JPEG2000, portable network graphics, TIFF. Furthermore, it provides suitable tools for selecting, either manually or automatically, a region of interest (ROI) on the image. The automated selection of a ROI includes filtering for smoothing the image and thresholding. The proposed software platform has a friendly and clear graphical user interface and could be a useful second-opinion tool to a dermatologist. Furthermore, it could be used to classify images including from other anatomical parts such as breast or lung, after proper re-training of the classification algorithms.

Sandalwood Album Oil as a Botanical Therapeutic in Dermatology.

PubMed

Moy, Ronald L; Levenson, Corey

2017-10-01

Many skin conditions and diseases are characterized by inflammation, infection, and hyperplasia. Safe and effective topical treatment options that can be used long-term are needed. Traditional botanical medicines, which are often complex mixtures that exert their biological activities via multiple mechanisms of action, are being studied as potential new active ingredients in dermatology. Sandalwood album oil (SAO), also known as East Indian sandalwood oil (EISO), is an essential oil distilled from the Santalum album tree and has demonstrated biological activity as an anti-inflammatory, anti-microbial, and anti-proliferative agent. Sandalwood album oil has also shown promise in clinical trials for treatment of acne, psoriasis, eczema, common warts, and molluscum contagiosum. The favorable safety profile, ease of topical use, and recent availability of pharmaceutical-grade sandalwood album oil support its broader use as the basis of novel therapies in dermatology.

Integrated modular teaching in dermatology for undergraduate students: A novel approach.

PubMed

Karthikeyan, Kaliaperumal; Kumar, Annapurna

2014-07-01

Undergraduate teaching in dermatology comprises didactic lectures and clinical classes. Integrated modular teaching is a novel approach, which integrates basic sciences with dermatology in the form of a module. Further the module also incorporates various teaching modalities, which facilitate active participation from students and promotes learning. The pre- and post-test values showed the effectiveness of the integrated module. The students feedback was encouraging. The aim of this study was to determine the acceptance and opinion of undergraduate students regarding integrated modular teaching as a new teaching aid in dermatology. This was a descriptive study. Varied teaching methodologies involving multiple disciplines were undertaken in six major undergraduate topics in dermatology for seventh and eighth semester students. A total of six modules were conducted over a period of 12 months for students of seventh and eighth semesters. The topics for the various modules were sexually transmitted diseases, acquired immunodeficiency syndrome, oral ulcers, leprosy, connective tissue disorders and psoriasis. Faculty members from different disciplines participated. Pre- and post-test were conducted before and after the modules respectively to gauge the effectiveness of the modules. It was found that almost every student had a better score on the posttest as compared to the pretest. General feedback obtained from the students showed that all of them felt that modular teaching was a more interesting and useful teaching learning experience than conventional teaching. Integrated modular teaching can be an effective adjunct in imparting theoretical and practical knowledge to the students. Further, various teaching methodologies can be used in integrated modules effectively with active student participation. Thus integrated modular teaching addresses two important issues in medical education, namely integration and active student participation.

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.

Current use of anti-infectives in dermatology.

PubMed

Fernandez-Obregon, Adolfo C; Rohrback, Janelle; Reichel, Michael Aaron; Willis, Carolyn

2005-08-01

Dermatologic diseases encompass a broad category of pathologic situations. Infection remains a significant aspect of the pathology faced in patient encounters, and it is natural to expect that anti-infectives play a major element in the armamentarium utilized by dermatologists. Aside from the treatment of the classic bacterial and fungal infections, there are now new uses for antiviral agents to help suppress recurrent disease, such as herpes simplex. There is also the novel approach of using anti-infectives, or agents that have been thought to have antimicrobial activity, to treat inflammatory diseases. This review describes anti-infectives, beginning with common antibiotics used to treat bacterial infections. The discussion will then cover the current use of antivirals. Finally, the description of antifungals will be separated, starting with the oral agents and ending with the topical antimycotics. The use of anti-infectives in tropical dermatology has been purposefully left out, and perhaps should be the subject of a separate review. Cutaneous bacterial infections consist chiefly of those microorganisms that colonize the skin, such as species of staphylococcus and streptococcus. Propionibacterium acnes and certain other anaerobes can be involved in folliculitis, pyodermas and in chronic conditions such as hidradenitis suppurativa.

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.

Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy.

PubMed

Murase, Jenny E; Heller, Misha M; Butler, Daniel C

2014-03-01

Dermatologists are frequently faced with questions about the safety of commonly prescribed topical and systemic medications during pregnancy and lactation from women of childbearing age who are pregnant, considering pregnancy, or breastfeeding. Safety data, particularly regarding medications that are unique to dermatology, can be difficult to locate and are not consolidated in a single reference guide for clinicians. Parts I and II of this continuing medical education article provide a capsule summary of key points for the most commonly prescribed dermatologic medications to facilitate patient medication risk counseling in pregnancy. A summary table details safety classification data for 3 primary international classification systems: the US Food and Drug Administration, the Swedish Catalogue of Approved Drugs, and the Australian Drug Evaluation Committee. In addition, this table includes an alternative pregnancy classification system developed by a consortium of active members of teratology societies in the US and Europe detailed in Drugs during Pregnancy and Lactation: Treatment Options and Risk Assessment and a safety classification system developed for breastfeeding mothers detailed in Medications and Mother's Milk. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

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.

Impact on facial rejuvenation with dermatological preparations

PubMed Central

Bowler, Patrick J

2009-01-01

The treatment options for facial rejuvenation using dermatological, nonsurgical techniques have dramatically increased in the past 10 years. This follows the introduction of botulinum toxin and a variety of dermal fillers. The public interest in noninvasive treatments has changed the market beyond recognition with more physicians involved in providing services to satiate the demand. The impact on the public and medical profession is discussed. PMID:19503770

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.

Probiotics, Prebiotics, and Synbiotics for the Treatment and Prevention of Adult Dermatological Diseases.

PubMed

Notay, Manisha; Foolad, Negar; Vaughn, Alexandra R; Sivamani, Raja K

2017-12-01

Probiotic, prebiotic, and synbiotic supplementation is becoming more prevalent nowadays. Clinical studies have demonstrated some of the medical benefits of probiotics, prebiotics, and synbiotics within dermatology but an evidence-based review of their effects in adults is needed. The aim of this study was to identify evidence for the use of supplementation with probiotics, prebiotics, or synbiotics for the prevention and treatment of dermatological diseases in adults. We conducted a search of the Ovid MEDLINE, Cochrane Central Register of Controlled trials and EMBASE electronic databases from 1 January 1946 to 11 January 2017. Trials examining supplementation in the treatment of dermatological diseases using oral or topical probiotics, synbiotics, and prebiotics in adults over the age of 18 years were selected. Of 315 articles, 12 met the inclusion criteria. Nutritional supplementation with probiotics and prebiotics was shown to improve atopic dermatitis (AD) symptomatology, quality of life, or clinical severity in six of nine studies. One study in psoriasis was shown to improve inflammatory markers, and one study suggested that probiotics could be used as adjunctive therapy in the treatment of acne. Preliminary studies are optimistic for the use of some strains of probiotics for symptomatic and clinical improvement in AD, and as adjunctive treatment with antibiotics for acne. Further research is necessary to better assess how probiotics and prebiotics may be used within dermatology.

Objective Structured Clinical Examination as an Assessment Tool for Clinical Skills in Dermatology.

PubMed

Saceda-Corralo, D; Fonda-Pascual, P; Moreno-Arrones, Ó M; Alegre-Sánchez, A; Hermosa-Gelbard, Á; Jiménez-Gómez, N; Vañó-Galván, S; Jaén-Olasolo, P

2017-04-01

Objective Structured Clinical Evaluation (OSCE) is an excellent method to evaluate student's abilities, but there are no previous reports implementing it in dermatology. To determine the feasibility of implementation of a dermatology OSCE in the medical school. Five stations with standardized patients and image-based assessment were designed. A specific checklist was elaborated in each station with different items which evaluated one competency and were classified into five groups (medical history, physical examination, technical skills, case management and prevention). A total of 28 students were tested. Twenty-five of them (83.3%) passed the exam globally. Concerning each group of items tested: medical interrogation had a mean score of 71.0; physical examination had a mean score of 63.0; management had a mean score of 58.0; and prevention had a mean score of 58.0 points. The highest results were obtained in interpersonal skills items with 91.8 points. Testing a small sample of voluntary students may hinder generalization of our study. OSCE is an useful tool for assessing clinical skills in dermatology and it is possible to carry it out. Our experience enhances that medical school curriculum needs to establish OSCE as an assessment tool in dermatology. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Adalimumab in dermatology

PubMed Central

Traczewski, Pawel; Rudnicka, Lidia

2008-01-01

Adalimumab is a biological agent, one of the tumour necrosis factor-alpha inhibitors. Pivotal studies evaluating its efficacy in plaque psoriasis (CHAMPION, REVEAL) and psoriatic arthritis (PsA) (ADEPT) were carried out in recent years. Adalimumab proved highly effective in psoriasis patients and in PsA patients previously unresponsive to nonsteroidal anti-inflammatory drugs. Results of smaller studies suggest therapy with the drug may be successful in psoriasis resistant to other biologics and PsA unresponsive to disease-modifying antirheumatic drugs. Adalimumab has also been shown to improve patients' quality of life significantly. Although they should be further extended as far as dermatological conditions are concerned, available data indicate adalimumab is safe and well tolerated. Numerous case reports featuring its off-label use suggest the drug could be helpful in treating hidradenitis suppurativa, pyoderma gangrenosum, Sweet's syndrome, cutaneous sarcoidosis, pemphigus, systemic vasculitides, multicentric reticulohistiocytosis and stomatitis. PMID:18754844

Adalimumab in dermatology.

PubMed

Traczewski, Pawel; Rudnicka, Lidia

2008-11-01

Adalimumab is a biological agent, one of the tumour necrosis factor-alpha inhibitors. Pivotal studies evaluating its efficacy in plaque psoriasis (CHAMPION, REVEAL) and psoriatic arthritis (PsA) (ADEPT) were carried out in recent years. Adalimumab proved highly effective in psoriasis patients and in PsA patients previously unresponsive to nonsteroidal anti-inflammatory drugs. Results of smaller studies suggest therapy with the drug may be successful in psoriasis resistant to other biologics and PsA unresponsive to disease-modifying antirheumatic drugs. Adalimumab has also been shown to improve patients' quality of life significantly. Although they should be further extended as far as dermatological conditions are concerned, available data indicate adalimumab is safe and well tolerated. Numerous case reports featuring its off-label use suggest the drug could be helpful in treating hidradenitis suppurativa, pyoderma gangrenosum, Sweet's syndrome, cutaneous sarcoidosis, pemphigus, systemic vasculitides, multicentric reticulohistiocytosis and stomatitis.

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

Publication bias in dermatology systematic reviews and meta-analyses.

PubMed

Atakpo, Paul; Vassar, Matt

2016-05-01

Systematic reviews and meta-analyses in dermatology provide high-level evidence for clinicians and policy makers that influence clinical decision making and treatment guidelines. One methodological problem with systematic reviews is the under representation of unpublished studies. This problem is due in part to publication bias. Omission of statistically non-significant data from meta-analyses may result in overestimation of treatment effect sizes which may lead to clinical consequences. Our goal was to assess whether systematic reviewers in dermatology evaluate and report publication bias. Further, we wanted to conduct our own evaluation of publication bias on meta-analyses that failed to do so. Our study considered systematic reviews and meta-analyses from ten dermatology journals from 2006 to 2016. A PubMed search was conducted, and all full-text articles that met our inclusion criteria were retrieved and coded by the primary author. 293 articles were included in our analysis. Additionally, we formally evaluated publication bias in meta-analyses that failed to do so using trim and fill and cumulative meta-analysis by precision methods. Publication bias was mentioned in 107 articles (36.5%) and was formally evaluated in 64 articles (21.8%). Visual inspection of a funnel plot was the most common method of evaluating publication bias. Publication bias was present in 45 articles (15.3%), not present in 57 articles (19.5%) and not determined in 191 articles (65.2%). Using the trim and fill method, 7 meta-analyses (33.33%) showed evidence of publication bias. Although the trim and fill method only found evidence of publication bias in 7 meta-analyses, the cumulative meta-analysis by precision method found evidence of publication bias in 15 meta-analyses (71.4%). Many of the reviews in our study did not mention or evaluate publication bias. Further, of the 42 articles that stated following PRISMA reporting guidelines, 19 (45.2%) evaluated for publication bias. In

Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

PubMed

Afifi, Ladan; Shinkai, Kanade

2017-03-01

Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

Dermatological image search engines on the Internet: do they work?

PubMed

Cutrone, M; Grimalt, R

2007-02-01

Atlases on CD-ROM first substituted the use of paediatric dermatology atlases printed on paper. This permitted a faster search and a practical comparison of differential diagnoses. The third step in the evolution of clinical atlases was the onset of the online atlas. Many doctors now use the Internet image search engines to obtain clinical images directly. The aim of this study was to test the reliability of the image search engines compared to the online atlases. We tested seven Internet image search engines with three paediatric dermatology diseases. In general, the service offered by the search engines is good, and continues to be free of charge. The coincidence between what we searched for and what we found was generally excellent, and contained no advertisements. Most Internet search engines provided similar results but some were more user friendly than others. It is not necessary to repeat the same research with Picsearch, Lycos and MSN, as the response would be the same; there is a possibility that they might share software. Image search engines are a useful, free and precise method to obtain paediatric dermatology images for teaching purposes. There is still the matter of copyright to be resolved. What are the legal uses of these 'free' images? How do we define 'teaching purposes'? New watermark methods and encrypted electronic signatures might solve these problems and answer these questions.

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.

The 2016 International League of Dermatological Societies' revised glossary for the description of cutaneous lesions.

PubMed

Nast, A; Griffiths, C E M; Hay, R; Sterry, W; Bolognia, J L

2016-06-01

In order to facilitate effective communication in dermatology, a clearly defined glossary with precise descriptions is essential. The International League of Dermatological Societies' (ILDS) 'Glossary of basic dermatology lesions' was first published in 1987. A quarter of a century later, the ILDS made the decision to revise and expand this nomenclature. Revision and expansion of an international nomenclature for the description of cutaneous lesions. The ILDS nominated a committee on nomenclature. Based on a review of the literature and major textbooks, the committee assembled a list of terms and definitions. National member societies of the ILDS were then invited to participate in a Delphi voting exercise (two rounds for basic descriptive terms, one round for additional terms). The committee reviewed and consolidated comments and consented the final version. The revised and expanded version of the ILDS nomenclature includes 13 basic terms and over 100 additional descriptive terms. Forty-six and then 34 national member societies participated in the first and second voting rounds, respectively. A unifying nomenclature is crucial for effective communication among dermatologists and those who care for skin diseases. The next step will be a roll-out programme to national member societies of the ILDS that will include translations into languages other than English and adaptations reflecting local circumstances. © 2016 International League of Dermatological Societies and the Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

Integrated modular teaching in dermatology for undergraduate students: A novel approach

PubMed Central

Karthikeyan, Kaliaperumal; Kumar, Annapurna

2014-01-01

Context: Undergraduate teaching in dermatology comprises didactic lectures and clinical classes. Integrated modular teaching is a novel approach, which integrates basic sciences with dermatology in the form of a module. Further the module also incorporates various teaching modalities, which facilitate active participation from students and promotes learning. The pre- and post-test values showed the effectiveness of the integrated module. The students feedback was encouraging. Aims: The aim of this study was to determine the acceptance and opinion of undergraduate students regarding integrated modular teaching as a new teaching aid in dermatology. Settings and Design: This was a descriptive study. Varied teaching methodologies involving multiple disciplines were undertaken in six major undergraduate topics in dermatology for seventh and eighth semester students. Materials and Methods: A total of six modules were conducted over a period of 12 months for students of seventh and eighth semesters. The topics for the various modules were sexually transmitted diseases, acquired immunodeficiency syndrome, oral ulcers, leprosy, connective tissue disorders and psoriasis. Faculty members from different disciplines participated. Pre- and post-test were conducted before and after the modules respectively to gauge the effectiveness of the modules. Results: It was found that almost every student had a better score on the posttest as compared to the pretest. General feedback obtained from the students showed that all of them felt that modular teaching was a more interesting and useful teaching learning experience than conventional teaching. Conclusions: Integrated modular teaching can be an effective adjunct in imparting theoretical and practical knowledge to the students. Further, various teaching methodologies can be used in integrated modules effectively with active student participation. Thus integrated modular teaching addresses two important issues in medical education

Evaluation of Dermatology Practice Online Reviews: Lessons From Qualitative Analysis.

PubMed

Smith, Robert J; Lipoff, Jules B

2016-02-01

Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care. To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites. A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015. Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation. Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P < .001). Qualitative themes centered on characteristics of the physician and the practice. Themes that emerged from the high-scoring and low-scoring reviews were similar in content but opposite in valence. Physician-specific themes included temperament, knowledge and competency, physical examination, communication abilities, and mindfulness of cost. Practice-specific themes included scheduling, staff temperament, office cleanliness, waiting

Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic.

PubMed

Grossberg, Anna L; Carranza, Dafnis; Lamp, Karen; Chiu, Melvin W; Lee, Catherine; Craft, Noah

2012-01-01

Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns in this population. Because the homeless population may be subject to increased sun exposure compared to the nonhomeless population, they also may be at increased risk for skin cancer. We sought to describe the spectrum of dermatologic diseases seen in a free clinic in Venice, California--the Venice Family Clinic (VFC)--as well as the differences in diagnoses between the homeless and nonhomeless patients seen at this clinic. A retrospective chart review was performed of dermatology patients (N = 82) seen at VFC throughout the 2006 calendar year. The homeless population (n = 22) was found to have more diagnoses of malignant/premalignant growths (25% [16/64] of all homeless diagnoses) compared to their nonhomeless (n = 60) counterparts (6.1% [8/132] of all nonhomeless diagnoses; P < .0001). This difference was sustained when ethnicity was controlled, with 29.6% [16/54] of diagnoses in the homeless white group consisting of malignant/ premalignant growths compared to 8.9% [4/45] of diagnoses in the nonhomeless white cohort (P < .005). Homeless patients may have a higher incidence of skin cancers and precancerous skin lesions due to increased sun exposure and/or limited access to dermatologic care.

[Tropical dermatology training in the Bundeswehr: Deployment in Manaus, Brazil].

PubMed

Fischer, M

2015-05-01

Training in tropical dermatology at the Fundação de Medicina tropical (FMT-AM) in Manaus, Brazil, offers an ideal opportunity to become familiar with the broad spectrum of tropical skin-diseases which are endemic in the tropical rainforest of the Amazon region. Besides frequently observed cases of cutaneous leishmaniasis of the new world, mucocutaneous forms of leishmaniasis and all entities of the different deep mycoses of South America are also regularly diagnosed. Of special importance in the dermatological care of the population is the early diagnosis of all clinical forms of leprosy and the long-term care of HIV patients. Modern diagnostics, including histopathology and molecular biology analytical methods, enable patients at the FMT-AM to be diagnosed without having to solely rely on clinical presentation and epidemiological data.

A Simple Instrument Designed to Provide Consistent Digital Facial Images in Dermatology

PubMed Central

Nirmal, Balakrishnan; Pai, Sathish B; Sripathi, Handattu

2013-01-01

Photography has proven to be a valuable tool in the field of dermatology. The major reason for poor photographs is the inability to produce comparable images in the subsequent follow ups. Combining digital photography with image processing software analysis brings consistency in tracking serial images. Digital photographs were taken with the aid of an instrument which we designed in our workshop to ensure that photographs were taken with identical patient positioning, camera angles and distance. It is of paramount importance in aesthetic dermatology to appreciate even subtle changes after each treatment session which can be achieved by taking consistent digital images. PMID:23723469

A simple instrument designed to provide consistent digital facial images in dermatology.

PubMed

Nirmal, Balakrishnan; Pai, Sathish B; Sripathi, Handattu

2013-05-01

Photography has proven to be a valuable tool in the field of dermatology. The major reason for poor photographs is the inability to produce comparable images in the subsequent follow ups. Combining digital photography with image processing software analysis brings consistency in tracking serial images. Digital photographs were taken with the aid of an instrument which we designed in our workshop to ensure that photographs were taken with identical patient positioning, camera angles and distance. It is of paramount importance in aesthetic dermatology to appreciate even subtle changes after each treatment session which can be achieved by taking consistent digital images.

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.

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.

Infectious Disease Practice Gaps in Dermatology.

PubMed

Hopp, Shelby; Quest, Tyler L; Wanat, Karolyn A

2016-07-01

The article highlights different educational and practice gaps in infectious diseases as they pertain to dermatology. These gaps include the use of antibiotics in relation to atopic dermatitis and acne vulgaris, treatment of skin and soft tissue infection, and diagnosis and treatment of onychomycosis. In addition, practice gaps related to use of imiquimod for molluscum contagiosum, risk of infections related to immunosuppressive medications and rates of vaccination, and the use of bedside diagnostics for diagnosing common infections were discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Incorporating social media into dermatologic education.

PubMed

Ko, Lauren N; Rana, Jasmine; Burgin, Susan

2017-10-15

In the current digital age, medical education has slowly evolved from the largely lecture-based teaching style of the past to incorporate more interactive pedagogical techniques, including use of social media. Already used readily by millennial trainees and clinicians, social media can also be used in innovative ways to teach trainees and facilitate continuing education among practicing clinicians. In this commentary, we discuss many learning benefits of social media and review potential pitfalls of employing social media in both trainee and physician dermatological education.

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

Dermatological and respiratory problems in migrant construction workers of Udupi, Karnataka.

PubMed

Banerjee, Mayuri; Kamath, Ramachandra; Tiwari, Rajnarayan R; Nair, Narayana Pillai Sreekumaran

2015-01-01

India being a developing country has tremendous demand of physical infrastructure and construction work as a result there is a raising demand of construction workers. Workers in construction industry are mainly migratory and employed on contract or subcontract basis. These workers face temporary relationship between employer and employee, uncertainty in working hours, contracting and subcontracting system, lack of basic continuous employment, lack basic amenities, and inadequacy in welfare schemes. To estimate the prevalence of respiratory and dermatological symptoms among migratory construction workers. This cross-sectional study was conducted in Manipal, Karnataka, among 340 male migratory construction workers. A standard modified questionnaire was used as a tool by the interviewer and the physical examination of the workers was done by a physician. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 15.0. Eighty percent of the workers belong to the age group of 18-30 years. The mean age of the workers was 26 ± 8.2 years. Most (43.8%) of the workers are from West Bengal followed by those from Bihar and Jharkhand. The rates of prevalence of respiratory and dermatological symptoms were 33.2% and 36.2%, respectively. The migrant construction workers suffer from a high proportion of respiratory and dermatological problems.

Continuity of care in dermatology residency programs in the United States.

PubMed

Loh, Tiffany; Vazirnia, Aria; Afshar, Maryam; Dorschner, Robert; Paravar, Taraneh

2017-05-15

As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States must participate in continuity clinic. This requirement may be achieved through multiple means, allowing for program variation. To better assess continuity clinic's role in resident learning, more data on this component of graduate medical education is needed. An anonymous online survey was distributed via the American Board of Dermatology list serv to all U.S. dermatology residents. Continuity clinic organization, setting, frequency, and patient and preceptor characteristics were assessed; resident satisfaction and learning were compared. Of 231 responses, 7.8% reported continuity clinic daily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were "resident-run with attending" and 11.3%were attending-run. The rest were "resident-run with no attending" (0.9%), both resident and attending run(3.0%), or "other" (4.8%). Trainees in resident-run clinics (with attendings) reported greater continuity of care than those in attending-run clinics (p<0.001).Residents reported better teaching with attending presence during patient encounters than when attendings were present only if concerns were raised(p<0.01).

Morgellons in dermatology.

PubMed

Harth, Wolfgang; Hermes, Barbara; Freudenmann, Roland W

2010-04-01

Delusional parasitosis (DP) is the most frequent delusional disorder in dermatology. In DP there is a fixed belief of a usually skin-related invasion or infestation by a number of alleged infectious species (usually parasites and bacteria), whose identity has varied over the decades. Since 2002 worldwide an increasing number of patients have complained of unverifiable fibers and filaments in or on the skin, associated with numerous nonspecific complaints (arthralgias, altered cognitive function and extreme fatigue). This entity has been named "Morgellons disease" by the patients themselves, although medical evidence for its existence is lacking. As an example, we discuss a 55-year-old woman who complained of Morgellons disease and was treated as if she had DP. Currently the delusional assumption of infestation with Morgellons should be considered as a new type of DP with some kind of inanimate material. We therefore recommend in case of DP including Morgellons the use of the broader term "delusional infestation".

Dermatological publications in the Gulf Cooperation Council countries. An analysis of 1966-2004 Medline papers.

PubMed

Al-Aboud, Fahad M; Al-Aboud, Khalid M; Al-Hawsawi, Khalid A; Ramesh, Venketshari

2004-11-01

To investigate the publications in dermatology cited in the Medline from 6 countries of the Gulf Cooperation Council (GCC) from 1966 to 2004. Medline was searched with the aid of Internet provider Pubmed using the same strategy at a given time for all countries. At the time of search, the Medline listed biomedical research papers from the GCC countries totaled 12837. Of these, 140 were in Dermatology. The Kingdom of Saudi Arabia followed by Kuwait was by far the most prolific contributor, whereas almost none were noted from Bahrain. The publications were highest during the year 2002 (19) followed by 2003 (13), most of them being in the English language in the International Journal of Dermatology (60 citations) and Pediatric Dermatology (13 citations). Though the GCC countries have seen a relatively small period in the history of development of medical research, data show that they are trying to keep pace with the rest of the developed world. What remains to be exploited is their good economy that should be directed to provide better infrastructure and improve the quality of training programs. Professional societies within the region must play an active role in ensuring optimum and judicious use of funds.

Discriminative power of visual attributes in dermatology.

PubMed

Giotis, Ioannis; Visser, Margaretha; Jonkman, Marcel; Petkov, Nicolai

2013-02-01

Visual characteristics such as color and shape of skin lesions play an important role in the diagnostic process. In this contribution, we quantify the discriminative power of such attributes using an information theoretical approach. We estimate the probability of occurrence of each attribute as a function of the skin diseases. We use the distribution of this probability across the studied diseases and its entropy to define the discriminative power of the attribute. The discriminative power has a maximum value for attributes that occur (or do not occur) for only one disease and a minimum value for those which are equally likely to be observed among all diseases. Verrucous surface, red and brown colors, and the presence of more than 10 lesions are among the most informative attributes. A ranking of attributes is also carried out and used together with a naive Bayesian classifier, yielding results that confirm the soundness of the proposed method. proposed measure is proven to be a reliable way of assessing the discriminative power of dermatological attributes, and it also helps generate a condensed dermatological lexicon. Therefore, it can be of added value to the manual or computer-aided diagnostic process. © 2012 John Wiley & Sons A/S.

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

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.

Changes in Retail Prices of Prescription Dermatologic Drugs From 2009 to 2015.

PubMed

Rosenberg, Miranda E; Rosenberg, Steven P

2016-02-01

Physicians from many specialties as well as primary care prescribe dermatologic medications; as insurance formularies become increasingly restrictive and more patients are covered with high-deductible insurance plans, many patients are forced to pay high retail prices to obtain their medications. To determine the changes in the prices of commonly prescribed dermatologic medications since 2009 and to identify trends in price increases for different classes of drugs. Four national chain pharmacies received surveys requesting price data on commonly prescribed dermatologic drugs in 2009, 2011, 2014, and 2015. The initial survey requested information on 72 brand-name drugs. Subsequent surveys increased to eventually include 120 additional brand-name drugs and their generic alternatives when available. Owing to the frequency of prescription, diseases treated, or unusual price increases, 19 brand-name drugs surveyed in all 4 years were selected for final price trend analysis, which was conducted from August 1 to 15, 2015. Retail prices of topical and systemic drugs for the treatment of various dermatologic conditions. Prices of surveyed brand-name drugs increased rapidly between 2009 and 2015. Of the 19 brand-name drugs analyzed, the retail prices of 7 drugs more than quadrupled during the study period. Among these 19 drugs, the mean price increase was 401% during the 6-year survey period, with the majority of the price increases occurring after 2011. Prices of topical antineoplastic drugs had the greatest mean absolute and percentage increase ($10,926.58 [1240%]). Prices of drugs in the antiinfective class had the smallest mean absolute increase ($333.99); prices of psoriasis medications had the smallest mean percentage increase (180%). Prices of acne and rosacea medications increased a mean of 195%, and prices of topical corticosteroids increased a mean of 290% during the study period. Selected generic drugs surveyed in 2011 and 2014 also increased a mean of 279% during

Drug sampling in dermatology.

PubMed

Reid, Erika E; Alikhan, Ali; Brodell, Robert T

2012-01-01

The use of drug samples in a dermatology clinic is controversial. Drug samples are associated with influencing physician prescribing patterns often toward costlier drugs, increasing health care costs, increasing waste, inducing potential conflicts of interest, and decreasing the quality of patient education. On the other hand, they have the potential to help those in financial need, to improve adherence and convenience, and to expose patients to better drugs. Although some academic centers have banned drug samples altogether, many academic and private practices continue to distribute drug samples. Given the controversy of the topic, physicians who wish to distribute drug samples must do so in an ethical manner. We believe, when handled properly, drug sampling can be used in an ethical manner. Copyright © 2012 Elsevier Inc. All rights reserved.

Dermatological and musculoskeletal assessment of diabetic foot: A narrative review.

PubMed

Arsanjani Shirazi, Azam; Nasiri, Morteza; Yazdanpanah, Leila

2016-01-01

Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot. In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities". In dermatological dimension, most studies focused on elucidated changes in skin temperature, color, hardiness and turgor as well as common skin disorders such as Diabetic Dermopathy (DD), Necrobiosis Lipoidica Diabeticorum (NLD) and Diabetic Bullae (DB), which are common in diabetic patients and have high potential for leading to limb-threatening problems such as ulceration and infection. In musculoskeletal dimension, most studies focused on range of motion and muscle strength, gait patterns and as well as foot deformities especially Charcot osteoarthropathy (COA), which is the most destructive musculoskeletal complication of diabetes. DFS as a common condition in DM patients lead to ulceration and lower limb amputation frequently unless a prompt and comprehensive assessment was taken. So that dermatological and musculoskeletal assessments are usually neglected in primary health care, these assessments should be done frequently to reduce the high risk of serious complications. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Lack of pregnancy warnings on over-the-counter dermatologic products containing potentially harmful hydroquinone.

PubMed

Bio, L L; Cies, J J

2017-07-01

To determine the presence of pregnancy warnings on over-the-counter (OTC) dermatologic products with hydroquinone, a potentially harmful ingredient. Data were obtained from the Food and Drug Administration National Drug Code Directory and Label Repository to identify OTC dermatologic products containing hydroquinone. Products were stratified based on pregnancy or general warning presence (WP) or absence (WA). Product characteristics were compared between groups: hydroquinone concentration, presence of external packaging, indication and warning statements. Of the 112 products studied, 21 had a pregnancy warning and 3 included a general warning against use: WP (n=24) and WA (n=88) group. External packaging was more prevalent in the WP group compared to WA (62.5% vs 29.5%, P=0.004). Majority of OTC dermatologic products containing hydroquinone did not have a pregnancy warning. This highlights the need for improved labeling and informs providers caring for pregnant women of OTC labeling limitations.

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.

Dermatological comorbidity in psoriasis: results from a large-scale cohort of employees.

PubMed

Zander, N; Schäfer, I; Radtke, M; Jacobi, A; Heigel, H; Augustin, M

2017-07-01

The field of dermatological comorbidity in psoriasis is only passively explored with contradictory results. Objective of this study was to further investigate the complex field of psoriasis and associated skin diseases by identifying skin comorbidity patterns in an extensive cohort of employees in Germany. Retrospective analysis of data deriving from occupational skin cancer screenings was conducted. From 2001 to 2014 German employees between 16 and 70 years from different branches underwent single whole-body screenings by trained dermatologists in their companies. All dermatological findings and need for treatment were documented. Point prevalence rates and their 95% confidence intervals were computed. Logistic regression analysis was performed to calculate odds ratios (OR) of single dermatological diseases to occur together with psoriasis controlled for age and sex. Data from 138,930 persons (56.5% male, mean age 43.2) were evaluated. Psoriasis point prevalence was 2.0%. Of those 20.6% had unmet treatment needs of their disease. Onychomycosis was the most frequent dermatological comorbidity with a prevalence of 7.8%. Regression analysis found rosacea (OR = 1.40, 95% CI 1.13-1.72) and telangiectasia (OR = 1.25, 95% CI 1.10-1.41) to be significantly associated with psoriasis. 17.2% of psoriasis patients had at least one further finding requiring treatment. The highest treatment needs were found for onychomycosis (3.4%), tinea pedis (3.1%), and verruca plantaris (1.0%). It can be concluded that persons with psoriasis are at increased risk to suffer from comorbid skin diseases, which should be considered in treatment regimens. Particular attention should be paid to fungal diseases of the feet.

Skin and mucous membranes’ manifestations of dermatological diseases within the genital area in females

PubMed Central

Plagens-Rotman, Katarzyna; Przybylska, Renata; Adamski, Zygmunt; Czarnecka-Operacz, Magdalena

2018-01-01

Introduction Lichen sclerosus et atrophicus (LSA) and an inversed type of psoriasis belong to a group of benign dermatoses usually located within the region of female external genitalia. The most common subjective symptoms reported by patients are itching, pain and changes in the color and structure of the skin. Aim This paper presents 3 cases of patients suffering from selected dermatoses located within the external female genitalia treated at the Department of Dermatology, Poznan University of Medical Sciences. Case reports Case 1. A 78-year-old patient admitted to the Department of Dermatology diagnosed with l ichen sclerosus and atrophic as well as scleroderma, which had already been confirmed by histopathological examination in 2014. Laboratory tests demonstrated an increased level of glycemia, elevated ESR and lymphopenia. In the treatment of TFX (Thymus factor X) therapy (immunomodulating treatment), vitamins A + E containing cream and Protopic 0.1% ointment twice daily were recommended. Case 2. A patient aged 49 was admitted to the Department of Dermatology due to exacerbation of skin inflammation in the course of psoriasis. She presented with severe erythematous and papular lesions covered with silvery scales, with the highest intensity within the palmar surfaces of both hands, in the folds of under the breasts, groins, and therefore, the clinical picture was characteristic of inversed psoriasis (psoriasis inversa). Case 3. A 20-year-old patient admitted to the Department of Dermatology in order to proceed with the treatment of a diffuse type of scleroderma. Clinical diagnosis has been already confirmed by the skin biopsy (typical histological features of scleroderma), however exclusion of other dermatoses such as LSA was not possible. Conclusions While analyzing the available scientific reports, the physician in charge must adjust therapeutic options individually, taking into account the clinical condition of the patient in case of dermatological diseases

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Al-Natour, Sahar H; Alghamdi, Waleed; Mubki, Thamer; Alzolibani, Abdulatif; Hafez, Dhafer Mohammed Y; AlDraibi, Mohammed

2015-01-01

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia. This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained. Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists. There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM. © The Author(s) 2015.

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...

Clinical utility of marketing terms used for over-the-counter dermatologic products.

PubMed

Boozalis, Emily; Patel, Shivani

2018-05-08

Cosmetic products are commonly marketed using dermatologic terms such as 'hypoallergenic', 'non-comedogenic', 'fragrance-free', etc. The clinical relevance of these claims can be confusing to both patients and clinicians. A systematic review was performed via a PubMed search of published articles from January 1985 to October 2017 to further describe and elucidate the clinical utility of a predefined list of common dermatologic terms used by pharmaceutical companies to market over-the-counter products. The terms 'fragrance-free', 'hypoallergenic', 'non-comedogenic', and 'oil-free' on cosmetic product labels are not regulated by any governing body and provide varied clinical utility. Products labeled as having 'natural ingredients' are not necessarily safer or less irritating to patients with atopy or a history of allergic contact dermatitis. Despite the increasing popularity of 'paraben-free' cosmetics, parabens are safe for patients in the quantities used in cosmetic products and can be safely used in patients who do not exhibit contact dermatitis to this preservative. A working knowledge of common cosmetic ingredients may help dermatologists to counsel patients on which products to avoid for their specific dermatologic conditions.

Technology and Technique Standards for Camera-Acquired Digital Dermatologic Images: A Systematic Review.

PubMed

Quigley, Elizabeth A; Tokay, Barbara A; Jewell, Sarah T; Marchetti, Michael A; Halpern, Allan C

2015-08-01

Photographs are invaluable dermatologic diagnostic, management, research, teaching, and documentation tools. Digital Imaging and Communications in Medicine (DICOM) standards exist for many types of digital medical images, but there are no DICOM standards for camera-acquired dermatologic images to date. To identify and describe existing or proposed technology and technique standards for camera-acquired dermatologic images in the scientific literature. Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed in January 2013 using photography and digital imaging, standardization, and medical specialty and medical illustration search terms and augmented by a gray literature search of 14 websites using Google. Two reviewers independently screened titles of 7371 unique publications, followed by 3 sequential full-text reviews, leading to the selection of 49 publications with the most recent (1985-2013) or detailed description of technology or technique standards related to the acquisition or use of images of skin disease (or related conditions). No universally accepted existing technology or technique standards for camera-based digital images in dermatology were identified. Recommendations are summarized for technology imaging standards, including spatial resolution, color resolution, reproduction (magnification) ratios, postacquisition image processing, color calibration, compression, output, archiving and storage, and security during storage and transmission. Recommendations are also summarized for technique imaging standards, including environmental conditions (lighting, background, and camera position), patient pose and standard view sets, and patient consent, privacy, and confidentiality. Proposed standards for specific-use cases in total body photography, teledermatology, and dermoscopy are described. The literature is replete with descriptions of obtaining photographs of skin disease, but universal imaging standards have not been developed

Identifying randomized clinical trials in Spanish-language dermatology journals.

PubMed

Sanclemente, G; Pardo, H; Sánchez, S; Bonfill, X

2015-06-01

The necessary foundation for good clinical practice lies in knowledge derived from clinical research. Evidence from randomized clinical trials (RCTs) is the pillar on which decisions about therapy are based. To search exhaustively and rigorously to identify RCTs in dermatology journals published in Spanish. We located dermatology journals through the following search engines and indexes: PubMed, LILACS, SciELO, Periódica, Latindex, Índice Médico Español, C-17, IBECS, EMBASE, and IMBIOMED. We also sought information through dermatology associations and dermatologists in countries where Spanish was the usual language of publication, and we searched the Internet (Google). Afterwards we searched the journals electronically and manually to identify RCTs in all available volumes and issues, checking from the year publication started through 2012. Of 28 journals identified, we included 21 in the search. We found a total of 144 RCTs published since 1969; 78 (54%) were in Latin American journals and 66 (46%) were in Spanish journals. The most frequent disease contexts for RCTs in Spanish journals were psoriasis, mycoses, and acne vulgaris. In Latin American journals, the most frequent disease contexts were common warts, mycoses, acne vulgaris, and skin ulcers on the lower limbs. Manual searches identified more RCTs than electronic searches. Manual searches found a larger number of RCTs. Relatively fewer RCTs are published in Spanish and Latin American journals than in English-language journals. Internet facilitated access to full texts published by many journals; however, free open access to these texts is still unavailable and a large number of journal issues are still not posted online. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

[Epidemiology of S. aureus cross-infections in dermatological wards].

PubMed

Barrière, H; Géraut, C; Audurier, A; Litoux, P; Courtieu, A L

1976-01-01

Over a three-year period, 196 of 3115 patients admitted in a dermatological department became infected with S. aureus (6,2 %). 205 strains of S. aureus were isolated. Serologic typing, phage-typing and antibiotic sensitivity tests revealed 3 epidemic and 2 endemic strains. The 3 epidemic strains infected 24 patients: 12 from july to november 1972 were infected with a serotype 66438 S. aureus resistant to fusidic acid. 6 patients (male) were infected with a serotype III in february and march 1972; 8 patients were contaminated with a serotype 18 S. aureus from december 1973 to february 1974, after staying in a surgical department. Of the 2 endemic strains 1, phage-pattern 53/79, is non-typable by serologic-typing; this strain has been observed only in the dermatological department and 20 patients were infected with, from january to october 1974. The second endemic strain, phage-pattern 81/+ serotype I, cross-infected 16 patients during this three-year survey; 12 of them were admitted repeatedly. During this three-year survey, it could be proved that, at least, 1 out of 3 patients is infected with an epidemic or an endemic strain. We can suggest that the factors enhancing cross-infection in dermatological department are: the sex of patients (80 % were male); presence of a tween splitting enzyme by S. aureus promotes growth of Staphylococci on the skin; patients transfered from a department to another or repeatedly admitted are more often infected. But, as they are source of some outbreaks, they need special measures (asepsis and hygiene); corticoïds or immunodepressors enhance cross-infection; antibiotics must not be only limited but varied too.

New concepts in antimalarial use and mode of action in dermatology.

PubMed

Kalia, Sunil; Dutz, Jan P

2007-01-01

Although chloroquine, hydroxychloroquine and quinacrine were originally developed for the treatment of malaria, these medications have been used to treat skin disease for over 50 years. Recent clinical data have confirmed the usefulness of these medications for the treatment of lupus erythematosus. Current research has further enhanced our understanding of the pharmacologic mechanisms of action of these drugs involving inhibition of endosomal toll-like receptor (TLR) signaling limiting B cell and dendritic cell activation. With this understanding, the use of these medications in dermatology is broadening. This article highlights the different antimalarials used within dermatology through their pharmacologic properties and mechanism of action, as well as indicating their clinical uses. In addition, contraindications, adverse effects, and possible drug interactions of antimalarials are reviewed.

Effectiveness of a modified tutorless problem-based learning method in dermatology - a pilot study.

PubMed

Kaliyadan, F; Amri, M; Dhufiri, M; Amin, T T; Khan, M A

2012-01-01

Problem-Based Learning (PBL) is a student-centred instructional strategy in which students learn in a collaborative manner, the learning process being guided by a facilitator. One of the limitations of conventional PBL in medical education is the need for adequate resources in terms of faculty and time. Our study aimed to compare conventional PBL in dermatology with a modified tutorless PBL in which pre-listed cues and the use of digital media help direct the learning process. Thirty-one-fifth year medical students were divided into two groups: the study group comprising 16 students were exposed to the modified PBL, whereas the control group comprising 15 students were given the same scenarios and triggers, but in a conventional tutor-facilitated PBL. Knowledge acquisition and student feedback were assessed using a post-test and a Likert scale-based questionnaire, respectively. The post-test marks showed no significant statistical differences between the two groups. The general feedback regarding the modified PBL was positive and the students felt comfortable with the module. The learning objectives were met satisfactorily in both groups. Modified tutorless PBL modules might be an effective method to incorporate student-centred learning in dermatology without constraints in terms of faculty resources or time. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

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.

[Increased revenues from secondary diagnoses : A comparison from dermatology, ophthalmology, and infectious diseases].

PubMed

Blaschke, V; Brauns, B; Khaladj, N; Schmidt, C; Emmert, S

2018-02-27

Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. However, it is vastly unknown if the revenues generated by the coders do indeed exceed their incurred costs. Coding data from the departments of dermatology, ophthalmology, and infectious diseases from Rostock University Hospital from 2007-2016 were analyzed for the effects of secondary diagnoses on the resulting DRG, i. e., hospital charges. Ophthalmological case were highly resistant to the addition of secondary diagnoses. In contrast, adding secondary diagnoses to cases from infectious diseases resulted in 15% higher revenues. Although dermatological and infectious cases share the same sensitivity to secondary diagnoses, higher revenues could only rarely be realized in dermatology, probably owing to a younger, less multimorbid patient population. Except for ophthalmology, trusting specialized coders with clinical coding generates additional revenues through the coding of secondary diagnoses which exceed the costs for employing these coders.

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.

Dermatologic manifestations of endocrine disorders

PubMed Central

Lause, Michael; Kamboj, Alisha

2017-01-01

The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual’s health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. In acromegaly, glycosaminoglycan deposition contributes to a thickening of skin and soft tissue, which manifests as coarsening and enlargement of facial and acral structures. Stimulation of the thyrotropin receptor in hyperthyroidism results in mesenchymal tissue proliferation and consequent pretibial myxedema; other associated cutaneous features include onycholysis, and hyperhidrosis. Individuals with hypothyroidism exhibit cold, dry skin and brittle hair as well as a jaundice-like appearance due to carotene excess. The cutaneous features of diabetes mellitus (DM), mediated to a large extent by hyperglycemia and hyperinsulinemia, include necrobiosis lipoidica diabeticorum (NLD), diabetic dermopathy, and acanthosis nigricans. Pediatric patients with Cushing’s syndrome almost invariably present with truncal obesity and growth retardation; disruption of collagen formation and the catabolic effects of hypercortisolism result in skin atrophy and purple abdominal striae. In patients with Addison’s disease, generalized hyperpigmentation, secondary to elevated levels of melanocyte-stimulating hormone (MSH), is most prominent in sun-exposed areas. Due to hyperandrogenism, individuals with polycystic ovarian syndrome (PCOS) often exhibit hirsutism, acne vulgaris, and androgenetic alopecia. In multiple endocrine neoplasia (MEN) syndromes, specific gene mutations may lead to angiofibromas, lichen amyloidosis, and ganglioneuromas. Disruptions of immune regulation result in autoimmune polyglandular syndromes (APS) and associated clinical features including chronic mucocutaneous

The U.S. Pediatric Dermatology Workforce: An Assessment of Productivity and Practice Patterns.

PubMed

Fogel, Alexander L; Teng, Joyce M C

2015-01-01

Pediatric dermatology has always played an important role in children's healthcare, but there has been a shortage of pediatric dermatologists nationwide for more than a decade, and few metrics of productivity and practice patterns exist. This study sought to provide insight into these and other factors of the pediatric dermatology workforce. Electronic surveys were distributed to all 226 U.S. board-certified pediatric dermatologists. A total of 108/226 (48%) of the electronic surveys were returned. Sixty percent of respondents were employed full- or part-time in academic environments and 81% were salaried. Respondents reported that children constituted 79.5% of their practice, and the average respondent spent 3.8 days/week treating 92.6 patients, considerably lower than the 136.3 patients/week that the average general dermatologist sees. The academic practice environment was associated with children constituting a larger proportion of the practice (p < 0.001), fewer patients seen per week (85.9, p < 0.001), and longer median new patient wait times (60 vs 15 days) than in other practice environments. Private practitioners saw significantly more patients per week than those in academic environments (112.7, p = 0.005). Male and female practitioners reported approximately equal patient care days per week, similar wait times, and similar proportions of children in their practices. This assessment revealed productivity and practice pattern differences between the various pediatric dermatology practice environments and between pediatric and general dermatology. This study provides important information for workforce planning and care availability assessments and baseline information for future studies. © 2015 Wiley Periodicals, Inc.

Knowledge and attitude regarding human immunodeficiency virus/acquired immunodeficiency syndrome in dermatological outpatients.

PubMed

Kouznetsov, L; Kuznetsov, A V; Ruzicka, T; Matterne, U; Wienecke, R; Zippel, S A

2009-08-01

Dermatologists are often the first-line specialists who recognize and diagnose human immunodeficiency virus (HIV) infection because of pathognomic skin signs. It is therefore important to investigate attitudes and knowledge regarding HIV/acquired immunodeficiency syndrome (AIDS) amongst dermatological patients in order to provide information for dermatologists and to draw their attention to the issues. Awareness of HIV/AIDS, its prevention, and hypothetical behaviour were surveyed in dermatological outpatients. The anonymous cross-sectional survey was conducted with consecutive German-speaking outpatients aged 18-65 years, who registered at the dermatological outpatient's clinic (excluding venereology, genitourinary or HIV medicine) of the University of Munich (Germany). Three hundred forty-seven (77.5%) questionnaires were accepted for analysis. Most of the patients knew about HIV incurability (89.4%), HIV transmissibility during needle sharing (95.3%), or vaginal (87.4%) and anal intercourse (79.5%), as well as about HIV prevention by condom use (97.8%), and use of single needles (76.2%). However, knowledge gaps and misconceptions were detected regarding the risk of HIV transmission during oral sex, and the efficacy of sexual fidelity and avoidance of blood transfusions in HIV prevention. The lowest knowledge level (< 50% correct answers) was detected in patients aged 50-59 years, in unemployed, divorced/widowed, and in those without or with incomplete school education. Patient education about HIV/AIDS in dermatological ambulant settings should be performed differentially with regard to socio-demographic factors, and focused on the topic of oral sexual HIV transmission and on some other specific misconceptions.

Dermatologic infestations.

PubMed

Shmidt, Eugenia; Levitt, Jacob

2012-02-01

Head lice are transmitted by head to head contact. Optimal therapy includes malathion lotion 0.5% repeated in one week left on for 30 minutes to 8 hours. Spinosad topical suspension 0.9% repeated in one week left on for 10 minutes is another option. Scabies is transmitted mainly by direct contact but also via heavily infested fomites due to crusted scabies. Permethrin 5% cream to the body repeated in four days is often sufficient; however, scalp treatment with malathion lotion 0.5% is helpful in crusted scabies and in infested children. Oral ivermectin 200 mcg/kg is another option, repeated in four days. For scabies more than lice, fomites should be placed in a drier at 60 °C for 10 minutes to kill the arthropods. Treatment of close contacts in both cases will control outbreaks and repeated infestations. Both have been associated with methicillin-resistant Staphylococcus aureus infection. Bed bugs are a common cause for papular urticaria. Identification of the insect in the mattress or bedding confirms the diagnosis. Prevention involves encasing the mattress in a sealed plastic cover and extermination. Delusions of parasitosis is a diagnosis of exclusion that is best treated with an antipsychotic. © 2012 The International Society of Dermatology.

Somatization disorders in dermatology.

PubMed

Gupta, Madhulika A

2006-02-01

This paper reviews a wide range of somatization-related symptoms that are encountered in dermatology. These include the unexplained cutaneous sensory syndromes especially the cutaneous dysesthesias associated with pain, numbness and pruritus; traumatic memories in post-traumatic stress disorder (PTSD) which are experienced on a sensory level as 'body memories' and may present as local or generalized pruritic states, urticaria and angioedema; and unexplained flushing reactions and profuse perspiration, in addition to unexplained exacerbations of stress-reactive dermatoses such as psoriasis and atopic eczema secondary to the autonomic hyperarousal in PTSD; classic 'pseudoneurologic' symptoms associated with dissociation including unexplained loss of touch or pain, in addition to the self-induced dermatoses such as dermatitis artefacta and trichotillomania that are encountered with dissociative states; and body dysmorphic disorder where the patient often presents with a somatic preoccupation involving the skin or hair.

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

Oxygen saturation and perfusion changes during dermatological methylaminolaevulinate photodynamic therapy.

PubMed

Tyrrell, J; Thorn, C; Shore, A; Campbell, S; Curnow, A

2011-12-01

Methylaminolaevulinate (MAL)-photodynamic therapy (PDT) is a successful topical treatment for a number of (pre)cancerous dermatological conditions. In combination, light of the appropriate wavelength, the photosensitizer protoporphyrin IX (PpIX) and tissue oxygen result in the production of singlet oxygen and reactive oxygen species inducing cell death. This study investigates real-time changes in localized tissue blood oxygen saturation and perfusion in conjunction with PpIX fluorescence monitoring for the first time during dermatological MAL-PDT. Oxygen saturation, perfusion and PpIX fluorescence were monitored noninvasively utilizing optical reflectance spectroscopy, laser Doppler perfusion imaging and a fluorescence imaging system, respectively. Patients attending for standard dermatological MAL-PDT were recruited to this ethically approved study and monitored prior to, during and after light irradiation. Significant reductions in mean blood oxygen saturation (P < 0·005) and PpIX fluorescence (P < 0·001) were observed within the first minute of irradiation (4·75 J cm(-2) ) while, in contrast, perfusion was observed to increase significantly (P < 0·01) during treatment. The changes in oxygen saturation and PpIX fluorescence were positively correlated during the initial phase of treatment (r(2) = 0·766). Rapid reductions in the localized blood oxygen saturation have been observed for the first time to occur clinically within the initial minutes of light irradiation and positively correlate with the concurrent PpIX photobleaching. Furthermore, perfusion increases, suggesting that the microvasculature compensates for the PDT-induced oxygen depletion. © 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011.

Prevalence of actinic keratosis among dermatology outpatients in Spain.

PubMed

Ferrándiz, C; Plazas, M J; Sabaté, M; Palomino, R

2016-10-01

Actinic keratoses (AKs) are common skin lesions associated with an increased risk of developing squamous cell carcinoma. Few studies in Europe have focused on AK prevalence. To determine the point prevalence of AKs in a dermatology outpatient population in Spain, to describe the clinical characteristics of these lesions and to characterise the profile of AK patients. Observational, cross-sectional, multicentre study conducted in 19 hospitals (dermatology outpatient services) around Spain. A total of 204 consecutive patients per hospital who were ≥45 years old were screened for the presence of AKs. 3877 patients were assessed and the overall AKs prevalence was 28.6%. Prevalence was significantly higher in men than women (38.4% vs. 20.8%, p<0.0001) and increased with age for both sexes (45.2% in 71-80 years). Scalp and ear lesion locations were significantly more frequent in men (51.9% vs. 2.7% and 16.9% vs. 2.4%, respectively, p<0.0001 both cases) and the cheek, nose and neckline in women (46.3% vs. 34.0% [p<0.0001], 43.0% vs. 24.8% [p<0.0001] and 5.3% vs. 1.8% [p=0.002]). Men showed a significantly higher frequency of ≥2 affected areas than women (42.7% vs. 20.3%, p<0.0001). Among patients with AK lesions, only 65% confirmed that they were the reason for the visit to the clinic. Approximately a quarter of the dermatology outpatient population in Spain aged ≥45 years old have AKs, with the prevalence rate being highest in men and in older age groups. AK is underdiagnosed and a proactive strategy is needed for the diagnosis and early treatment of these lesions. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Comparative study of the prevalence of sepsis in patients admitted to dermatology and internal medicine wards*

PubMed Central

Almeida, Luiz Maurício Costa; Diniz, Michelle dos Santos; Diniz, Lorena dos Santos; Machado-Pinto, Jackson; Silva, Francisco Chagas Lima

2013-01-01

BACKGROUND Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively. PMID:24173179

Computer-assisted instruction versus traditional lecture for medical student teaching of dermatology morphology: a randomized control trial.

PubMed

Jenkins, Sasha; Goel, Ruchika; Morrell, Dean S

2008-08-01

The effectiveness of computer-assisted instruction is unproven. To evaluate the effectiveness of an online computerized dermatology module compared to traditional lecture-based teaching to medical students. Medical students were randomized to two groups. Group 1 of 37 students had access to a computer-based dermatology tutorial. Group 2 of 36 students attended a lecture on skin morphology, identical to the tutorial, given by a dermatology faculty member. The main outcome was the total number of correct answers on a multiple-choice morphologic terminology final examination. The mean number of questions answered correctly was 16.14 and 14.89 for group 1 and group 2, respectively. Unpaired statistical t tests showed the difference in mean scores between the two groups to be 1.25 (95% confidence interval: -0.70 to 3.20, p value = .20). The study was small, with a small amount of material, and was brief in duration. Within the limits of our study, computer-assisted instruction is at least as effective as traditional lecture teaching of dermatology morphology to medical students.

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.

Analysis of dermatology resident self-reported successful learning styles and implications for core competency curriculum development.

PubMed

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

2008-01-01

There are different teaching styles for delivering competency-based curricula. The education literature suggests that learning is maximized when teaching is delivered in a style preferred by learners. To determine if dermatology residents report learning style preferences aligned with adult learning. Dermatology residents attending an introductory cutaneous biology course completed a learning styles inventory assessing self-reported success in 35 active and passive learning activities. The 35 learning activities were ranked in order of preference by learners. Mean overall ratings for active learning activities were significantly higher than for passive learning activities (P = 0.002). Trends in dermatology resident learning style preferences should be considered during program curriculum development. Programs should integrate a variety of curriculum delivery methods to accommodate various learning styles, with an emphasis on the active learning styles preferred by residents.

Television depictions about dermatology and skin diseases in Seinfeld.

PubMed

Vickers, Jennifer L; Uchida, Tatsuo; Wagner, Richard F

2010-12-15

The iconic television situation comedy Seinfeld frequently referenced dermatologists and topics involving the integument, using satire for comedic effect. However, selecting satire to portray an already misunderstood and unknown subject matter may perpetuate incorrect public beliefs and stereotypes about those with skin diseases and diminish cultural sensitivity towards people who have dermatologic conditions and their caregivers.

Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence.

PubMed

Aldridge, R Benjamin; Maxwell, Susanne S; Rees, Jonathan L

2012-07-09

Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer services in many healthcare systems. The majority of such physicians receive very limited formal undergraduate or postgraduate dermatology training. The British Association of Dermatologists (BAD) has produced guidelines that list the lesions that students should be able to diagnose on graduation and the majority of UK medical schools' operate curricula in keeping with these. There is, however, virtually no evidence as to whether these competencies are being achieved. We set out to determine students' competence at skin lesion diagnosis and to quantify their clinical exposure to examples of such lesions during their dermatology attachment. Three linked studies were undertaken. In the first, students' competence was tested by randomized slideshows of images containing the 16 lesions recommended in the UK guidelines. Students' accuracy was tested at the beginning (Day 1) and end (Day 10) of their clinical placement, with a random sample of students retested 12 months later. Secondly, students' exposure to these lesions was recorded during their attachments. Finally a survey of the additional dermatological resources used by the students was undertaken. Study 1: Students' diagnostic accuracy increased from 11% on Day 1 to 33% on Day 10 (effect size +2.72). After 12 months half of this effect had disappeared and the students accuracy had dropped to 24%. Study 2: Students' exposure to the recommended lesions was poor with 82% not even witnessing a single example of each of the 3 major skin cancers. Despite these measurements, only a minority of students reported that they were not confident at diagnosing skin tumours. Study 3: The majority of students use additional resources to supplement their learning. In the light of what we know about learning in

Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence

PubMed Central

2012-01-01

Background Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer services in many healthcare systems. The majority of such physicians receive very limited formal undergraduate or postgraduate dermatology training. The British Association of Dermatologists (BAD) has produced guidelines that list the lesions that students should be able to diagnose on graduation and the majority of UK medical schools’ operate curricula in keeping with these. There is, however, virtually no evidence as to whether these competencies are being achieved. We set out to determine students’ competence at skin lesion diagnosis and to quantify their clinical exposure to examples of such lesions during their dermatology attachment. Methods Three linked studies were undertaken. In the first, students’ competence was tested by randomized slideshows of images containing the 16 lesions recommended in the UK guidelines. Students’ accuracy was tested at the beginning (Day 1) and end (Day 10) of their clinical placement, with a random sample of students retested 12 months later. Secondly, students’ exposure to these lesions was recorded during their attachments. Finally a survey of the additional dermatological resources used by the students was undertaken. Results Study 1: Students’ diagnostic accuracy increased from 11% on Day 1 to 33% on Day 10 (effect size +2.72). After 12 months half of this effect had disappeared and the students accuracy had dropped to 24%. Study 2: Students’ exposure to the recommended lesions was poor with 82% not even witnessing a single example of each of the 3 major skin cancers. Despite these measurements, only a minority of students reported that they were not confident at diagnosing skin tumours. Study 3: The majority of students use additional resources to supplement their learning

Screening for Body Dysmorphic Disorder in a Dermatology Outpatient Setting at a Tertiary Care Centre

PubMed Central

Thanveer, Fibin; Khunger, Niti

2016-01-01

Context: A distressing pre-occupation with an imagined or slight defect in appearance with a marked negative effect on the patient's life is the core symptom of body dysmorphic disorder (BDD). Aim: To screen the patients attending a dermatology clinic at a tertiary care centre for BDD using the BDD-dermatology version (DV) questionnaire. Settings and Design: This cross-sectional study enrolled 245 consecutive patients from the dermatology outpatients clinic. Methods: The demographic details were collected and the DV of BDD screening questionnaire was administered. A 5-point Likert scale was used for objective scoring of the stated concern and patients who scored ≥3 were excluded from the study. Statistical Analysis Used: The results were statistically analysed. Differences between the groups were investigated by Chi-square analysis for categorical variables, and Fisher exact test wherever required. Results: A total of 177 patients completed the study, and of these, eight patients screened positive for BDD. The rate of BDD in patients presenting with cosmetic complaints was 7.5% and in those with general dermatology, complaints were 2.1%, with no significant difference between the two groups (P = 0.156). Facial flaws (62.5%) were the most common concern followed by body asymmetry (25%). Conclusion: The rates of BDD found in this study are comparable but at a lower rate than that reported in literature data. PMID:27761090

Trends in National Institutes of Health Funding of Principal Investigators in Dermatology Research by Academic Degree and Sex.

PubMed

Cheng, Michelle Y; Sukhov, Andrea; Sultani, Hawa; Kim, Kyoungmi; Maverakis, Emanual

2016-08-01

National Institutes of Health (NIH) grants are becoming increasingly competitive in the academic research arena. Identifying NIH funding disparities is an important step in improving academic diversity. To examine recent NIH funding trends in dermatology. Retrospective study with linear regression analysis and repeated-measures analysis of variance of all NIH grants awarded to departments of dermatology from fiscal year 2009 to 2014. Funding data were exported from the NIH Research Portfolio Online Reporting Tools Expenditures and Results. Publication data were drawn from Scopus. All NIH-funded principal investigators in dermatology were categorized by their academic degree and sex. The NIH funding trends were compared by investigator degree (MD, PhD, or MD/PhD) and sex. A total of 1292 NIH-funded grants were awarded to dermatology research from fiscal year 2009 through 2014. Adjusted NIH funding for dermatologic research diminished by 4.6% from $67.3 million in 2009 to $64.2 million in 2014, with a nadir of $58.6 million in 2013. Funding for the NIH's Research Project Grant Program (R01) decreased by 21.0% from $43.9 million to $34.7 million during this period. The dollar amount of NIH funding significantly trended down for investigators with an MD degree by $1.35 million per year from $23.6 million in 2009 to $18.4 million in 2014 (P = .02) while there was no significant change in NIH funding for MD/PhD (from $17.6 million in 2009 to $19.8 million in 2014; P = .44) and PhD investigators (from $26.1 million in 2009 to $25.9 million in 2014; P = .74). Similarly, the total dollar amount of R01 grants awarded to principal investigators with only an MD degree trended down by $1.4 million per year from $13.2 million in 2009 to $6.0 million in 2014 (P < .001). The number of female investigators with NIH grants in dermatology trended down significantly compared with the trend of their male counterparts (from 49 women in 2009 to 43 women in 2014 vs from 84

Dermatological emergencies: a comparative study of activity in 2000 and 2010.

PubMed

Mirkamali, A; Ingen-Housz-Oro, S; Valeyrie-Allanore, L; Bouvresse, S; Duong, T-A; Chosidow, O; Wolkenstein, P

2013-07-01

Studies of dermatological emergencies (DE) are few. We evaluated the activity in our DE unit in a 1-month retrospective study and compared the results with a similar study performed in the same department in 2000. We reviewed the charts of all outpatients seen in the DE unit in January 2010, collecting data on age, sex, place of residence, referral mode, day and hour of consultation, true emergency or non-emergency, diagnosis and follow-up. In January 2010, we serviced 605 patients (58% males, mean age 40 ± 21 years), 21% more than in 2000; 43.5% were seen during off-duty hours vs. 49% in 2000 (P = 0.066), 49% were considered true emergencies vs. 43% in 2000 (P = 0.046), and 14% were referred by a physician vs. 23% in 2000 (P = 0.0001). In total, 35.2% of cases were infectious dermatoses in 2010 vs. 29% in 2000 (P = 0.026). Other diagnoses were eczema, urticaria and drug-related eruptions. Follow-up was suggested to 53.3% of the patients. Our DE unit satisfies a genuine need. Its activity increased over 10 years, most likely because of the decrease in the number of dermatologists in France. Although our results are close to those reported in the literature, comparison with previously published studies is difficult because of the heterogeneity of the definition of DE. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Fillers in dermatology: from past to present.

PubMed

Chacon, Anna H

2015-11-01

Injectable fillers were introduced in dermatology as a method for reconstructing facial deformities and restoring the aging face. Although fillers have become a popular option among cosmetic patients, clinical experience has shown that fillers must be used with caution, as complications can occur. This article provides a brief review of the history of filler agents currently available for soft tissue augmentation. Although no single filler is ideal for all patients, indications, and situations, residents should be aware of the properties and characteristics that make each product unique.

A retrospective review of the dermatologic manifestations of chronic arsenic poisoning in the Philippines.

PubMed

Sy, Sheena Maureen T; Salud-Gnilo, Charissa M; Yap-Silva, Claudine; Tababa, Erin Jane L

2017-07-01

The Section of Dermatology of the University of the Philippines, Philippine General Hospital, reported a case of chronic arsenic poisoning from a community in Luzon island to the Department of Health resulting in the conduct of two health and environmental assessment missions in December 2014. To describe the demographic profile and cutaneous manifestations of chronic arsenic poisoning among affected residents in Luzon, Philippines. A review of the medical records of 116 residents screened during the health assessment missions in December 2014 was conducted. Among the 116 residents screened, 81 (70%) had clinically confirmed arsenic keratoses and hyperpigmentation. Among them, 52 were males and 29 were females with age range of 4-82 years. Two cases of squamous cell carcinoma in situ were detected through skin biopsy. High levels of arsenic in the tap water and topsoil supported the occurrence of an epidemic of chronic arsenic poisoning. Specific dermatologic findings of arsenic keratoses and pigmentation were common among the residents screened. Significantly higher occurrence of arsenic keratoses was seen in adults. © 2017 The International Society of Dermatology.

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

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.

Prevalence of adverse food reactions in 130 dogs in Italy with dermatological signs: a retrospective study.

PubMed

Proverbio, D; Perego, R; Spada, E; Ferro, E

2010-07-01

To determine the prevalence of adverse food reactions (AFRs) in dogs with dermatological signs presented to the referral dermatological clinic of the University of Milan. The medical records of dogs with dermatological signs were reviewed. Prevalence of AFRs was calculated. Owner and clinician pruritus scores were compared. Breed, sex and age predisposition were statistically tested, as was the association between AFR and selected clinical features. The prevalence of AFRs in dogs with dermatological signs was 12% (16 of 130). AFR was diagnosed in 26% of dogs with allergic disease and 48% of those subjected to a dietary trial. There was a significant association between AFRs and early onset of clinical signs (< 1 year) (OR=3.8; P=0.0221, 95% CI=1.27 to 11.16). There was a significant association between AFRs and both otitis externa (OR=5.9; P=0.0015, 95% CI=2 to 17.9) and perianal fistula (OR=26.1; P=0.0058, 95% CI=2.52 to 269.4), although all dogs with perianal fistulas were German shepherd dogs. The prevalence of AFRs in the study population was higher than most reported values. Further studies are warranted to investigate the true prevalence of AFR and its possible association with perianal fistula and other potential markers.

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

Clinical photography in dermatology using smartphones: An overview

PubMed Central

Ashique, K. T.; Kaliyadan, Feroze; Aurangabadkar, Sanjeev J.

2015-01-01

The smartphone is one of the biggest revolutions in the era of information technology. Its built in camera offers several advantages. Dermatologists, who handle a specialty that is inherently visual, are most benefited by this handy technology. Here in this article, we attempt to provide an overview of smartphone photography in clinical dermatology in order to help the dermatologist to get the best out of the available camera for clinical imaging and storage PMID:26009708

The Danish Nonmelanoma Skin Cancer Dermatology Database.

PubMed

Lamberg, Anna Lei; Sølvsten, Henrik; Lei, Ulrikke; Vinding, Gabrielle Randskov; Stender, Ida Marie; Jemec, Gregor Borut Ernst; Vestergaard, Tine; Thormann, Henrik; Hædersdal, Merete; Dam, Tomas Norman; Olesen, Anne Braae

2016-01-01

The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen's disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen's disease, and 173 keratoakanthomas. The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance.

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.

Dermatologic manifestations of solid organ transplantation-associated graft-versus-host disease: A systematic review.

PubMed

Kim, Grace Y; Schmelkin, Leah A; Davis, Mark D P; El-Azhary, Rokea A; Farrell, Ann M; Meves, Alexander; Lehman, Julia S

2018-06-01

Graft-versus-host-disease (GVHD) after solid organ transplantation (SOT) is extremely rare. To investigate the dermatologic manifestations and clinical outcomes of SOT GVHD. Systematic literature review of SOT GVHD. After full-text article review, we included 61 articles, representing 115 patients and 126 transplanted organs. The most commonly transplanted organ was the liver (n = 81). Among 115 patients, 101 (87.8%) developed skin involvement. The eruption appeared an average of 48.3 days (range, 3-243 days) posttransplant and was pruritic in 5 of 101 (4.9%) cases. The eruption was described as morbilliform in 2 patients (1.9%), confluent in 6 (5.9%), and desquamative in 4 (3.9%) cases. In many cases, specific dermatologic descriptions were lacking. The mortality rate was 72.2%. Relative time of death was reported in 23 patients who died during the follow-up period. These patients died an average of 99.2 days (range, 22-270 days) posttransplant, or 50.9 days after the appearance of dermatologic symptoms. Frequent causes of death were sepsis and multiorgan failure. Incomplete descriptions of skin findings and potential publication bias resulting in publication of only the most severe cases. GVHD is a potentially fatal condition that can occur after SOT and often presents with a skin rash. We recommend that dermatologists have a low threshold to consider and pursue this diagnosis in the setting of post-SOT skin eruption. Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Tyrosine kinases in inflammatory dermatologic disease

PubMed Central

Paniagua, Ricardo T.; Fiorentino, David; Chung, Lorinda; Robinson, William H.

2010-01-01

Tyrosine kinases are enzymes that catalyze the phosphorylation of tyrosine residues on protein substrates. They are key components of signaling pathways that drive an array of cellular responses including proliferation, differentiation, migration, and survival. Specific tyrosine kinases have recently been identified as critical to the pathogenesis of several autoimmune and inflammatory diseases. Small-molecule inhibitors of tyrosine kinases are emerging as a novel class of therapy that may provide benefit in certain patient subsets. In this review, we highlight tyrosine kinase signaling implicated in inflammatory dermatologic diseases, evaluate strategies aimed at inhibiting these aberrant signaling pathways, and discuss prospects for future drug development. PMID:20584561

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.

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.

Medical ethical standards in dermatology: an analytical study of knowledge, attitudes and practices.

PubMed

Mostafa, W Z; Abdel Hay, R M; El Lawindi, M I

2015-01-01

Dermatology practice has not been ethically justified at all times. The objective of the study was to find out dermatologists' knowledge about medical ethics, their attitudes towards regulatory measures and their practices, and to study the different factors influencing the knowledge, the attitude and the practices of dermatologists. This is a cross-sectional comparative study conducted among 214 dermatologists, from five Academic Universities and from participants in two conferences. A 54 items structured anonymous questionnaire was designed to describe the demographical characteristics of the study group as well as their knowledge, attitude and practices regarding the medical ethics standards in clinical and research settings. Five scoring indices were estimated regarding knowledge, attitude and practice. Inferential statistics were used to test differences between groups as indicated. The Student's t-test and analysis of variance were carried out for quantitative variables. The chi-squared test was conducted for qualitative variables. The results were considered statistically significant at a P > 0.05. Analysis of the possible factors having impact on the overall scores revealed that the highest knowledge scores were among dermatologists who practice in an academic setting plus an additional place; however, this difference was statistically non-significant (P = 0.060). Female dermatologists showed a higher attitude score compared to males (P = 0.028). The highest significant attitude score (P = 0.019) regarding clinical practice was recorded among those practicing cosmetic dermatology. The different studied groups of dermatologists revealed a significant impact on the attitude score (P = 0.049), and the evidence-practice score (P < 0.001). Ethical practices will improve the quality and integrity of dermatology research. © 2014 European Academy of Dermatology and Venereology.

Non-dermatological complications and genetic aspects of the Rothmund-Thomson syndrome.

PubMed

Starr, D G; McClure, J P; Connor, J M

1985-01-01

We report two new cases of Rothmund-Thomson syndrome which emphasize the less well-known non-dermatological complications, namely: hypodontia, soft tissue contractures, proportionate short stature, hypogonadism, anaemia and osteogenic sarcoma. Genetic analysis of these and previously reported pedigrees supports autosomal recessive inheritance.

Tofacitinib, an Oral Janus Kinase Inhibitor: Perspectives in Dermatology.

PubMed

Kostovic, Kresimir; Gulin, Sandra J; Mokos, Zrinka B; Ceovic, Romana

2017-05-31

Tofacitinib (formerly known as CP-690,550, CP690550, tasocitinib), a novel selective immunosuppressant, is a small molecule classified as Janus kinase inhibitor. The aim of this review article is to present updated data summary on the tofacitinib in the field of dermatology. We undertook a structured search of bibliographic databases for peer-reviewed scientific articles, including review articles, original research articles as well as case report articles based on inclusion/exclusion criteria. Technical reports on tofacitinib from U.S. Food and Drug Administration and European Medical Agency were also included. Forty-three papers were included in this review. We report current data on tofacitinib chemical properties, pharmacology, non-clinical toxicity, as well as efficacy and safety in potential new indications in dermatology: psoriasis, alopecia areata, vitiligo, atopic dermatitis and nail dystrophy associated with alopecia areata. JAK/STAT pathway has an important role in the pathogenesis of psoriasis, alopecia areata, atopic dermatitis, and vitiligo. Despite encouraging efficacy, due to concerns about the overall safety profile of tofacitinib, additional studies will have to determine the adequate risk-to-benefit ratio. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The beginnings of dermatopathology and dermatologic microbiology in Spain.

PubMed

del Río, E

2014-03-01

Crisóstomo Martínez from Valencia was a pioneering microscopist in 17th-century Europe. The first microscopic representations of skin in Spain appeared in an 18th-century work by Martín Martínez. Microbiology and histopathology progressed considerably in the late 19th century thanks to anatomists like Maestre de San Juan and surgeons like Federico Rubio Galí. The first Spanish pathologist to specialize in dermatology was Antonio Mendoza, a colleague of José Eugenio de Olavide at the Hospital San Juan de Dios in Madrid. Claudio Sala and Juan de Azúa also made significant contributions, including the description of pseudoepithelioma. Several disciples of Santiago Ramón y Cajal and Jorge FranciscoTello, such as Lorenzo Ruiz de Arcaute and Guillermo de la Rosa King, consolidated the dermatology laboratory, but the Civil War sent many into exile or deprived them of their professional status. Juan Rubió in Barcelona and Julio Rodríguez Puchol in Madrid were the immediate predecessors of today's dermatopathologists. Copyright © 2012 Elsevier España, S.L. y AEDV. All rights reserved.

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

Facticious disorders in dermatology.

PubMed

Harth, Wolfgang; Taube, Klaus-Michael; Gieler, Uwe

2010-05-01

Facticious Disorders are self inflicted skin lesions and includes the creation of physical or psychiatric symptoms in oneself or other reference persons. In dermatology frequently, there are mechanical injuries by pressures, friction, occlusion, biting, cutting, stabbing, thermal burns or self-inflicted infections with wound-healing impairment, abscesses, mutilations or damages by acids and other toxic to the skin. The current classification differentiates between four groups: 1. Dermatitis artefacta syndrome in the narrower sense as unconscious/dissociated self-injury, 2. Dermatitis paraartefacta syndrome: Disorders of impulse control, often as manipulation of an existing specific dermatosis (often semi-conscious, admitted - self-injury), 3. Malingering: consciously simulated injuries and diseases to obtain material gain, 4. special forms, such as the Gardner Diamond Syndrome, Münchhausen Syndrome and Münchhausen-by-Proxy Syndrome. This categorization is helpful in understanding the different pathogenic mechanisms and the psychodynamics involved, as well as in developing various therapeutic avenues and determining the prognosis.

New Described Dermatological Disorders

PubMed Central

Cevirgen Cemil, Bengu; Keseroglu, Havva Ozge; Kaya Akis, Havva

2014-01-01

Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are “circumferential skin creases Kunze type” and “unusual type of pachyonychia congenita or a new syndrome”; autoinflammatory diseases include “chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome,” “pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH) syndrome,” and “pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH) syndrome”; tumors include “acquired reactive digital fibroma,” “onychocytic matricoma and onychocytic carcinoma,” “infundibulocystic nail bed squamous cell carcinoma,” and “acral histiocytic nodules”; unclassified disorders include “saurian papulosis,” “symmetrical acrokeratoderma,” “confetti-like macular atrophy,” and “skin spicules,” “erythema papulosa semicircularis recidivans.” PMID:25243162

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

A Map of Clinical Dermatology Research Centers in Spain: Results of the MaIND Study.

PubMed

Molina-Leyva, A; Descalzo, M A; García-Doval, I

2017-11-01

Bibliometric indicators and analyses of clinical research articles can help to quantify the scientific production of hospitals and institutions and identify their main areas of research. The aim of this study was to draw up a bibliometric map of clinical research in dermatology by Spanish hospitals and institutions through an analysis of quantitative, qualitative, and topic-based variables. Bibliometric study of clinical research articles that met the inclusion criteria and had a definitive publication date between 2005 and 2014 in PubMed or Embase in which the corresponding author's affiliation was a Spanish dermatology department or institution. Barcelona and Madrid were the provinces with the highest number of articles and citations. The centers with the most articles and citations were Hospital Clínic and Instituto Valenciano de Oncología. Those 2 hospitals also produced the highest number of articles on the most common research topic identified: melanoma. Because the articles were selected on the basis of the affiliation of the corresponding author to a Spanish dermatology center, this analysis does not include collaborative studies or clinical research studies led by nondermatology centers. We have created a bibliometric map of clinical dermatology research in Spain that shows the distribution of scientific production and the main areas of research by province and hospital/institution. This map could be useful for education and research purposes. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. 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.

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.

A retrospective analysis of the Dermatology Foundation's Career Development Award Program.

PubMed

Boris, Chris; Lessin, Stuart R; Wintroub, Bruce U; Yancey, Kim B

2012-11-01

To provide research support that develops and retains leaders, educators, and investigators in dermatology and cutaneous biology, the Dermatology Foundation (DF) has designed and implemented a comprehensive Career Development Award (CDA) Program. To assess the impact of the DF's 3-year CDA, a comprehensive survey of recipients who received this mechanism of support between 1990 and 2007 was performed. Of 196 individuals receiving a DF CDA, 181 were identified and asked to complete a comprehensive questionnaire concerning their career status, employment history, professional rank, and record of independent research funding (private foundation, federal, other). A personal assessment of the impact of this funding on these individuals' career trajectory was also requested. Eighty percent of 181 CDA recipients identified currently hold full- or part-time positions in academic medicine. The faculty rank of 112 survey respondents included 46 assistant professors (41%), 41 associate professors (37%), 18 professors (16%), and 7 division or departmental chairs (6%). Of respondents, 84% reported that they have received subsequent independent research funding; 95 of these individuals (86%) have received funding from a federal agency (235 federal grants awarded to date with funding >$318M). The study was retrospective and self-reported; some awardees did not respond to the survey. The DF's CDA Program has succeeded in supporting the early career development of talented investigators, educators, and leaders; fostered the promotion and retention of these individuals in academic medicine; and nucleated numerous investigative careers that have successfully acquired independent research funding. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Hair and Scalp Disorders in a Tuscan Pediatric Dermatological Outpatient Clinic: A Clinical and Epidemiological Evaluation.

PubMed

Conti, Rossana; Colucci, Roberta; Arunachalam, Meena; Berti, Samantha; Fabroni, Caterina; De Martino, Maurizio; Dragoni, Federica; Lazzeri, Linda; Pisaneschi, Lisa; Moretti, Silvia

2016-01-01

The aim of this study was to evaluate the clinical and epidemiological profile of hair and scalp disorders in children referred to the Pediatric Dermatology Outpatient Clinic. We performed a retrospective study of children with hair loss problems or scalp diseases who turned to the Pediatric Dermatology Service, Anna Meyer Pediatric Hospital, Florence, Italy, from January 1, 2009, to December 31, 2009. Demographics, personal and familial medical history, laboratory tests, clinical examination, final diagnosis and therapeutic interventions were obtained from the manual chart review. Of the 2,640 children who had access to the Pediatric Dermatology Service, 190 (7.19%) had a hair or scalp disorder. Among the 190 children, 60 (31.57%) presented with nonscarring alopecia, 56 (29.47%) had benign neoplasias, hamartomas or vascular malformations of the scalp, 51 (26.84%) had scalp inflammatory diseases, 14 (7.36%) had scarring alopecia, 5 (2.63%) had infections and 2 (1.05%) had infestation of the scalp. A case of constitutional hypertrichosis (0.52%) and also a case (0.52%) of lamellar ichthyosis were diagnosed. Our results underline that hair and scalp diseases represent an important percentage of admittances to a dermatological pediatric outpatient clinic. The variety and complexity of the diseases observed in this study included diseases commonly found also in adulthood. © 2015 S. Karger AG, Basel.

Dermatologic Reactions to Immune Checkpoint Inhibitors : Skin Toxicities and Immunotherapy.

PubMed

Sibaud, Vincent

2018-06-01

The development of immune checkpoint inhibitors [monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1)] represents a major breakthrough in cancer therapy. Although they present a favorable risk/benefit ratio, immune checkpoint blockade therapies have a very specific safety profile. Due to their unique mechanism of action, they entail a new spectrum of adverse events that are mostly immune related [immune-related adverse events (irAEs)], notably mediated by the triggering of cytotoxic CD4+/CD8+ T cell activation. Cutaneous toxicities appear to be one of the most prevalent irAEs, both with anti-PD-1 and anti-CTLA-4 agents or with the newly developed anti-PD-L1 agents, which corresponds to a class effect. They are observed in more than one-third of the treated patients, mainly in the form of a maculopapular rash (eczema-like spongiotic dermatitis) and pruritus. A wide range of other dermatologic manifestations can also occur, including lichenoid reactions, psoriasis, acneiform rashes, vitiligo-like lesions, autoimmune skin diseases (e.g., bullous pemphigoid, dermatomyositis, alopecia areata), sarcoidosis or nail and oral mucosal changes. In addition, the use of anti-CTLA-4 and anti-PD-1 therapies in combination is associated with the development of more frequent, more severe and earlier cutaneous irAEs compared to single agents. In most cases, these dysimmune dermatologic adverse events remain self-limiting and readily manageable. Early recognition and adequate management, however, are critical to prevent exacerbation of the lesions, to limit treatment interruption and to minimize quality of life impairment. This review describes the variable clinical and histopathologic aspects of dermatologic irAEs induced by immune checkpoint inhibitors. Appropriate treatment and counseling are also proposed, with a step-by-step approach for optimized management by both

Body dysmorphic disorder and cosmetic dermatology: more than skin deep

PubMed Central

Castle, David J; Phillips, Katharine A; Dufresne, Raymond G

2006-01-01

Summary Body dysmorphic disorder (BDD) is relatively common in cosmetic practise, yet it remains under-recognized. BDD patients are unnaturally concerned with minimal or non-existent flaws, most commonly in the skin (e.g. facial acne or scarring) and hair (e.g. hair loss). Many patients develop social avoidance and suffer occupational or academic impairment. More severely ill patients may become housebound or even attempt suicide. Despite the minimal or non-existent nature of the perceived appearance flaws, patients with BDD may request dermatological treatments such as isotretinoin or dermabrasion. Although treatment outcome has received little investigation, it appears that most patients are dissatisfied with dermatological treatment and, even if the outcome is objectively acceptable, they do not worry any the less about their appearance afterwards. In contrast, a majority of patients respond to serotonin reuptake inhibitors or cognitive behavioural therapy. Treatment of these patients is best given by an experienced health professional. This may be a mental health professional or a dermatologist with an interest in psychological medicine. PMID:17147563

Pain and pain management in dermatology.

PubMed

Beiteke, Ulrike; Bigge, Stefan; Reichenberger, Christina; Gralow, Ingrid

2015-10-01

It is estimated that 23 million Germans suffer from chronic pain. A recent survey has revealed that 30 % of chronic pain patients are dissatisfied with their pain management. Furthermore, five million Germans suffer from neuropathic pain, 20 % of whom are inadequately treated. Pain is also a symptom of many dermatologic diseases, which is mostly somatic and may be classified as mild in the majority of cases. Nevertheless, research on the quality of life (QoL) has increasingly shown a marked impairment of QoL by moderate pain such as in psoriatic arthritis. -Severe pain is associated with herpes zoster (shingles), leg ulcers, and pyoderma gangrenosum. This article addresses the basics of pain classification and, in a short excerpt, pain transduction/transmission and modulation. The use of standardized diagnostic -scales is recommended for the purpose of recording and monitoring pain intensity, which allows for the optimization of therapy and consistent interdisciplinary -communication. Any dermatology residency program includes the acquisition of knowledge and skills in pain management. This review therefore aims to present fundamental therapeutic concepts based on the expanded WHO analgesic ladder, and describes a step-wise therapeutic approach and combination therapies. The article focuses on the pain management of the above-mentioned severely painful, conservatively treated dermatoses. Besides well-established therapeutic agents and current -therapeutic standards, it discusses specific options based on guidelines (where available). Current knowledge on peri- and postoperative pain management is briefly outlined. This article addresses: ▸ The fundamentals of the classification and neurophysiology of pain; ▸ Standards for pain documentation in children and adults; ▸ General standards for pharmaceutical pain management; ▸ Current specific treatment options for postherpetic neuralgia, leg ulcers, and -pyoderma gangrenosum in conjunction with the expanded WHO

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.

Willingness to Donate Human Samples for Establishing a Dermatology Research Biobank: Results of a Survey.

PubMed

Gross, Durdana; Schmitz, Arndt A; Vonk, Richardus; Igney, Frederik H; Döcke, Wolf-Dietrich; Schoepe, Stefanie; Sterry, Wolfram; Asadullah, Khusru

2011-09-01

There is a rising need for biomaterial in dermatological research with regard to both quality and quantity. Research biobanks as organized collections of biological material with associated personal and clinical data are of increasing importance. Besides technological/methodological and legal aspects, the willingness to donate samples by patients and healthy volunteers is a key success factor. To analyze the theoretical willingness to donate blood and skin samples, we developed and distributed a questionnaire. Six hundred nineteen questionnaires were returned and analyzed. The willingness to donate samples of blood (82.5%) and skin (58.7%) is high among the population analyzed and seems to be largely independent of any expense allowance. People working in the healthcare system, dermatological patients, and higher qualified individuals seem to be in particular willing to donate material. An adequate patient insurance as well as an extensive education about risks and benefits is requested. In summary, there is a high willingness to donate biological samples for dermatological research. This theoretical awareness fits well with our own experiences in establishing such a biobank.

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.

Chronic hand eczema: perception and knowledge in non-affected individuals from general and dermatological practice.

PubMed

Letulé, Valerie; Herzinger, Thomas; Schirner, Astrid; Hertrich, Frank; Lange, Dirk; Ruzicka, Thomas; Molin, Sonja

2014-11-01

Misunderstanding and stigmatisation are common problems encountered by patients with hand eczema. Various misconceptions about the disease circulate in the general population. Although hand eczema has gained more attention in dermatology during the past years, information on public perception of the disease is still lacking. The aim of our study was to investigate perception of and level of knowledge on the subject hand eczema. There were 624 patients included from 2 general medicine practices and 2 dermatological practices. A self-administered questionnaire was filled out by the participants, covering issues on history of hand eczema, level of knowledge and attitude towards a clinical photograph of hand eczema. We found that a larger proportion of individuals from dermatological practice were more familiar with hand eczema as a disease than those from general medical practice. Women knew significantly more about and had a more positive perception of the disease than men. Our results imply that the level of knowledge on hand eczema in the general public is rather low and influenced by prejudice.

Dermatological Feasibility of Multimodal Facial Color Imaging Modality for Cross-Evaluation of Facial Actinic Keratosis

PubMed Central

Bae, Youngwoo; Son, Taeyoon; Nelson, J. Stuart; Kim, Jae-Hong; Choi, Eung Ho; Jung, Byungjo

2010-01-01

Background/Purpose Digital color image analysis is currently considered as a routine procedure in dermatology. In our previous study, a multimodal facial color imaging modality (MFCIM), which provides a conventional, parallel- and cross-polarization, and fluorescent color image, was introduced for objective evaluation of various facial skin lesions. This study introduces a commercial version of MFCIM, DermaVision-PRO, for routine clinical use in dermatology and demonstrates its dermatological feasibility for cross-evaluation of skin lesions. Methods/Results Sample images of subjects with actinic keratosis or non-melanoma skin cancers were obtained at four different imaging modes. Various image analysis methods were applied to cross-evaluate the skin lesion and, finally, extract valuable diagnostic information. DermaVision-PRO is potentially a useful tool as an objective macroscopic imaging modality for quick prescreening and cross-evaluation of facial skin lesions. Conclusion DermaVision-PRO may be utilized as a useful tool for cross-evaluation of widely distributed facial skin lesions and an efficient database management of patient information. PMID:20923462

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.

[The satisfied patient in aesthetic dermatology. Consensus work on patient satisfaction in botulinum toxin A treatment].

PubMed

Kreyden, O P; Rzany, B; Becker-Wegerich, P; Boudny-Frey, C; Carrozza-Merlani, P; Hess-Schmid, M; Schlagenhauff, B

2015-02-01

Patient satisfaction is an important factor for successful therapy. Many consensus reports have been published regarding correct treatment with botulinum toxin A (BTX-A). However, the focus of most of these publications has been on technical aspects and the important topic of patient satisfaction was often only one aspect among others. The Swiss Group of Esthetic Dermatology and Skincare (SGEDS) pursued these questions in a two-day consensus meeting. Patients of aesthetic dermatology are healthy and therefore place higher demands in contrast to ill patients of medical dermatology. This demands a great deal of the physician, the practice staff and the conditions in the practice to accommodate the special requirements of aesthetic clients. Informative consultation and patient education are of major importance; this also holds true for clinical performance and care before, during and after treatment with BTX-A. This publication aims at finding ways to gain greater patient satisfaction in daily practice.

Representation and treatment allocation of racial groups in dermatologic therapy trials: A 2-year review of the literature.

PubMed

Park, Christina K; Alhusayen, Raed

2018-02-15

Although most investigators would agree that including minority races in clinical trials is important, recruitment and retention may differ among these populations. The objective of this review was to perform an audit of phase III dermatologic therapy trials to determine representation for minority groups and to explore the possibility of racial allocation bias. In this review of 11 dermatology or general medicine journals in 2015-16, we did not find evidence of systemic racial allocation bias. We did however note variation in the proportion of minority races included in studies; whereas some trials had high success in recruiting minorities, many did not. Furthermore, most studies did not provide information on individual racial groups and rather presented an 'other' category. This supports findings from previous reviews of dermatologic therapy trials that suggest that most participants are white, race data are not included for many studies, and there is underrepresentation of some racial groups. We conclude that although there is no evidence of racial allocation bias in the previous two years, there remains a need for standardization in the reporting of racial groups and for increased participant diversity in dermatologic therapy trials.

A gender-based comparison of promotion and research productivity in academic dermatology.

PubMed

John, Ann M; Gupta, Arjun B; John, Elizabeth S; Lopez, Santiago A; Lambert, William Clark

2016-04-18

Gender disparities within academic promotion have been reported in several medical specialties. Female representationin association with research productivity has not been reported among academic dermatologists. As research productivity is a heavily weighted factor in determining promotion, we sought to determine whether gender disparities in academic rank and scholarly impact, measured by the h-index, exist in academic dermatology. In 2015, the authors determined gender and academic rank using academic dermatology department websites. H- index and publication range were determined using the Scopus database. Rank, h-index, and publication range were compared between male and female academic dermatologists. The h-index of academic dermatologists increased with successive academic rank from Assistant Professor through Professor (p<0.001), although no significant difference existed between Chairs and Professors. Publication range also increased with each successive rank from Assistant Professor through Professor (p<0.001), with no statistical significant difference between publication range of Chairs and Professors. Overall, men had higher h-indices than female colleagues (p<0.001). This difference was maintained when controlling for academic rank among Assistant Professors, Professors, and Chairs and when controlling for publication range in years. Women in academic dermatology are underrepresented among senior academic ranks. The difference in scholarly productivity between male and female academic dermatologists may contribute to this disparity. Recommendation for earlyinvolvement in research activities may help minimize this gap.

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.

A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans.

PubMed

Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha

2015-10-16

In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.

[The characteristics of medical manpower of dermatologic venereal service at the territorial level].

PubMed

Jyltsova, Ye Ye; Konovalov, O Ye

2013-01-01

The article presents the medical social characteristics of medical manpower af dermatologic venereal services of Ryazan, Tula and Lipetsk oblasts from the position of quality of specialized medical care of population.

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.

Manual search approaches used by systematic reviewers in dermatology.

PubMed

Vassar, Matt; Atakpo, Paul; Kash, Melissa J

2016-10-01

Manual searches are supplemental approaches to database searches to identify additional primary studies for systematic reviews. The authors argue that these manual approaches, in particular hand-searching and perusing reference lists, are often considered the same yet lead to different outcomes. We conducted a PubMed search for systematic reviews in the top 10 dermatology journals (January 2006-January 2016). After screening, the final sample comprised 292 reviews. Statements related to manual searches were extracted from each review and categorized by the primary and secondary authors. Each statement was categorized as either "Search of Reference List," "Hand Search," "Both," or "Unclear." Of the 292 systematic reviews included in our sample, 143 reviews (48.97%) did not report a hand-search or scan of reference lists. One-hundred thirty-six reviews (46.58%) reported searches of reference lists, while 4 reviews (1.37%) reported systematic hand-searches. Three reviews (1.03%) reported use of both hand-searches and scanning reference lists. Six reviews (2.05%) were classified as unclear due to vague wording. Authors of systematic reviews published in dermatology journals in our study sample scanned reference lists more frequently than they conducted hand-searches, possibly contributing to biased search outcomes. We encourage systematic reviewers to routinely practice hand-searching in order to minimize bias.

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.

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.

24th European Academy of Dermatology and Venereology.

PubMed

Rasch, Anja C

2016-01-01

The 24th European Academy of Dermatology and Venereology was held in Copenhagen, Denmark, from 7-11 October 2015. It has become Europe's biggest meeting of its kind with roughly 10,000 participants, approximately 3000 abstracts and about 180 exhibitors from all over the world. The organizers offer a venue for the latest cutting edge research and newest developments. Thus, their goal is to foster progress in clinical care and promote scientific excellence related to dermatovenereology for the benefit of patients with skin diseases.

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology

PubMed Central

Schussler-Raymakers, Florine ML; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd WM; Bruijnzeel-Koomen, Carla AFM; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-01-01

Background The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. Objectives This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. Methods The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Results Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Conclusions Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. PMID:28874336

Case Histories of Intense Pulsed Light Phototherapy in Dermatology - the HPPL™ and IFL™ Technologies

PubMed Central

Martella, Alessandro; Raichi, Mauro

2017-01-01

The intense pulsed light (IPL) and laser technologies are widely used for skin rejuvenation and for treating several dermatological disorders such as skin dyschromia and acne, and for non-ablative dermal remodeling of rhytides and hypertrophic scars. Technological evolution is rapid. The High Power Pulsed Light™ [HPPL™] and Incoherent Fast Light™ technologies [IFL™, Novavision Group S.p.A., 20826 Misinto (MB), Italy] are recent innovations in the field of IPL technologies; IFL™ is a further evolution of the already advanced HPPL™ system. The paper presents a selection of case histories of dermatological lesions treated with the HPPL™ and IFL™ technologies. All study materials were appropriately peer-reviewed for ethical problems. PMID:28652908

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.

Botanicals With Dermatologic Properties Derived From First Nations Healing: Part 2-Plants and Algae.

PubMed

Colantonio, Sophia; Rivers, Jason K

Plants and algae have played a central role in the treatment of skin conditions in both traditional First Nations healing and in modern dermatology. The objective of this study was to examine the evidence supporting the dermatological use of seaweed, witch hazel, bearberry, and mayapple. Four plants and algae used in traditional First Nations treatments of skin disease were selected based on expert recommendations. Several databases were searched to identify relevant citations without language restrictions. Seaweed has potential clinical use in the treatment of acne and wrinkles and may be incorporated into biofunctional textiles. Witch hazel is an effective and well-tolerated treatment of inflammation and diaper dermatitis. Bearberry leaves contain arbutin, a skin-lightening agent that is an alternative for the treatment of hyperpigmentation. Mayapple contains podophyllotoxin, a treatment for condyloma accuminata, molluscum contagiosum, and recalcitrant palmoplantar warts. Common plants and algae are replete with bioactive agents that may have beneficial effects on the skin. Further research will open the door to new and innovative products in the future. Limitations of this study include that the scope of our study is limited to 4 plants and algae, a small sample of the breadth of plants used by First Nations for dermatological treatments.

Sports Dermatology: Part 1 of 2 Traumatic or Mechanical Injuries, Inflammatory Conditions, and Exacerbations of Pre-existing Conditions

PubMed Central

Sivek, Rachel; Marciniak, Brian

2015-01-01

Competitive athletes endure extreme bodily stress when participating in sports-related activities. An athlete’s skin is particularly susceptible to a wide array of repetitive physical and environmental stressors that challenge the skin’s protective function. Many unique dermatoses are well-known to the serious athlete due to countless hours of intense physical training, but are frequently unrecognized by many healthcare professionals. Sports dermatology is a distinctive, budding field of dermatology that focuses on dermatoses frequently encountered in athletes. Athletic skin problems are notoriously infectious in nature due to the inherent environment of close-contact physical activity. Nonetheless, other skin conditions can manifest or worsen with recurring mechanical or traumatic injury or exposure to environmental hazards. Additionally, sports-related activities may exacerbate other pre-existing dermatological conditions that may possibly be unknown to the athlete or clinician. The objective of this two-part review is to arm the astute physician with the fundamental knowledge of the range of dermatological conditions distinct to the competitive athlete. Knowledge of these cutaneous conditions in the context of specific sporting events will permit the clinician to manage these unique patients most effectively. Part one will focus on traumatic or mechanical injuries, inflammatory conditions, and exacerbations of pre-existing conditions frequently seen in athletes. PMID:26060516

[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.

Dermatology practice management assures practice development and efficiency.

PubMed

Wagener, D L

2000-09-01

This article provides an overview of the disciplines involved in managing a dermatology practice today. Several key management processes, including strategic planning, financial analysis, advertising and public relations, information systems management, and compliance program development and monitoring are addressed. This article explores several possible tactics that can be used to help guide your practice in the right direction without overtaxing your resources. Also offered are possible solutions for creating an organization that is poised for success, and a management team capable of steering the practice through the sea of change ahead.

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

Contraindications to Athletic Participation. Spinal, Systemic, Dermatologic, Paired-Organ, and Other Issues.

ERIC Educational Resources Information Center

Moeller, James L.

1996-01-01

The second of a two-part series on contraindications to athletic activity, this article examines the sensory, spinal, gastrointestinal, systemic, hematologic, and dermatologic conditions that warrant activity disqualification and provides guidelines about when it is safe to participate. Activity considerations for individuals who have lost a…

76 FR 30176 - Dermatologic and Ophthalmic Drugs Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Dermatologic and Ophthalmic Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration... Food and Drug Administration (FDA). The meeting will be open to the public. Name of Committee...

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 aspects of tularaemia: a study of 168 cases.

PubMed

Polat, M; Karapınar, T; Sırmatel, F

2018-05-14

Tularaemia is a zoonotic infectious disease caused by Francisella tularensis, an aerobic, uncapsulated, gram-negative coccobacillus. Several case reports have appeared on the dermatological manifestations of tularaemia, but relatively few longer-term studies are available. To identify skin features of tularaemia that aid in its diagnosis. In total, 168 patients (68 male, 100 female) diagnosed with tularaemia were retrospectively examined. All dermatological data for these patients were evaluated. Of the 168 patients, 149 (88.69%) had tularaemia of the oropharyngeal type, 12 (7.73%) had the ulceroglandular type, 5 (2.9%) had the oculoglandular type and 2 (0.59%) had the pulmonary type. Secondary skin manifestations were found in 26 patients (15.47%). Sweet syndrome (SS) was found in 11 patients (6.54%), most of whom presented with the oropharyngeal form, while erythema nodosum (EN) was found in 7 patients (4.16%), dermatitis in 2 (1.19%), urticaria in 2 (1.19%), acneiform eruptions in 1 (0.59%), vasculitis-like eruptions in 1 (0.59%) and SS + EN in 1 (0.59%). Patients with the oropharyngeal form had a statistically significant (P < 0.001) higher number of skin findings than patients with the other forms. In clinical practice, tularaemia may present with various cutaneous manifestations, and dermatologists who work in endemic regions must be aware of the possibility of this disease. © 2018 British Association of Dermatologists.

Low rate of dermatology outpatient visits in Asian-Americans: an initial survey study for associated patient-related factors

PubMed Central

2014-01-01

Background Asian-Americans represent the fastest growing minority group in the United States, but are under-represented patients in outpatient dermatology clinics. At the same time, skin cancer rates in individuals of Asian descent are increasing, but skin cancer detection appears to be delayed in Asian-Americans compared to white individuals. Some health-care provider related factors for this phenomenon have been reported in the literature, but the patient-related factors are unclear. Methods This exploratory study to identify patient-related factors associated with dermatology visits in Asian-Americans was performed after Institutional Review Board (IRB) approval. An anonymous, online survey utilizing validated items was conducted on adults who self-identified as Asian-American in Northern California. Univariate and multivariate logistic regression for dermatology visits as indicated by responses to the question of “ever having had skin checked by a dermatologist” were performed on survey responses pertaining to demographic information, socioeconomic factors, acculturation, knowledge of melanoma warning signs and SSE belief and practice. Results 89.7% of individuals who opened the online survey completed the items, with 469 surveys included in the analysis. Only 60% reported ever performing a SSE, and only 48% reported ever having a skin examination by a dermatologist. Multivariate models showed that “ever performing SSE” (p < 0.0001), marital status (p = 0.02), family history of skin cancer (p = 0.03) and generation in the United States (p = 0.02) were significant predictors of the primary outcome of “ever had skin checked by a dermatologist”. Conclusions Identification of patient-related factors that associate with dermatology clinic visits in Asian-Americans is important so that this potential gap in dermatologic care can be better addressed through future studies. PMID:25085260

Strategic Plan for the Spanish Academy of Dermatology and Venerology (AEDV): FuturAEDV 2013-2017.

PubMed

Ribera Pibernat, M; Moreno Jiménez, J C; Valcuende Cavero, F; Soto de Delás, J; Vázquez Veiga, H; Lázaro Ochaíta, P; Giménez Arnau, A

2014-09-01

The Spanish Academy of Dermatology and Venereology (AEDV) has decided that a Strategic Plan is needed to help the association adapt to new circumstances and anticipate future developments. 1) To position the AEDV as a medical association that can exert an influence in everything related to dermatology. 2) To contribute to the development of the specialty, strengthening the prestige and reputation of dermatology and dermatologists. 3) To establish a model for operating and strategic thinking that can be handed on to successive Boards of Directors and will enable the Academy to identify future challenges. The approach used to develop the Strategic Plan was as follows: analysis of trends in the health care system; assessment of the current situation of AEDV and of dermatology in general through an internal analysis based on surveys and interviews with academics; analysis of strengths, weaknesses, opportunities, and threats; preparation of a mission statement; and identification, development, and implementation of a strategy map prioritizing strategic lines of action. The strategy map set out 16 general goals grouped into 4 main topics (achieving the vision, internal and external customers, internal processes, and innovation) and detailed in an action plan with 19 initiatives, each with specific actions. The plan will be monitored by the Strategic Plan Monitoring Committee, which is made up of the members of the Standing Committee and the chairs of the 9 Technical Committees responsible for implementing the initiatives. The Functional Plan should guide the management of AEDV until 2017, and its implementation will enable the association to contribute to the development and prestige of the specialty and position itself as a reference in terms of its functional model. Copyright © 2014 Elsevier España, S.L.U. y AEDV. All rights reserved.

History of phototherapy in dermatology.

PubMed

Hönigsmann, Herbert

2013-01-01

Over many centuries, treatment with sunlight or "heliotherapy" was used in the treatment of skin diseases. More than 3500 years ago, ancient Egyptian and Indian healers used the ingestion of plant extracts or seeds in addition to sunlight for treating "leucoderma". Modern phototherapy began with Nobel Prize winner Niels Finsen who developed a "chemical rays" lamp with which he treated patients with skin tuberculosis. However, it took several decades until phototherapy was introduced anew into the dermatological armamentarium. It was the development of photochemotherapy (PUVA) in 1974 that marked the beginning of a huge upsurge in photodermatology. The subsequent development of high intensity UV sources with defined spectra facilitated an optimized therapy for psoriasis and led to an expansion of indications for photo(chemo)therapy also in combination with topical and systemic agents. The introduction of extracorporeal photopheresis in 1987 for cutaneous T-cell lymphoma and of topical photodynamic therapy widely expanded the therapeutic possibilities in dermato-oncology.

Quantitative evaluation of dermatological antiseptics.

PubMed

Leitch, C S; Leitch, A E; Tidman, M J

2015-12-01

Topical antiseptics are frequently used in dermatological management, yet evidence for the efficacy of traditional generic formulations is often largely anecdotal. We tested the in vitro bactericidal activity of four commonly used topical antiseptics against Staphylococcus aureus, using a modified version of the European Standard EN 1276, a quantitative suspension test for evaluation of the bactericidal activity of chemical disinfectants and antiseptics. To meet the standard for antiseptic effectiveness of EN 1276, at least a 5 log10 reduction in bacterial count within 5 minutes of exposure is required. While 1% benzalkonium chloride and 6% hydrogen peroxide both achieved a 5 log10 reduction in S. aureus count, neither 2% aqueous eosin nor 1 : 10 000 potassium permanganate showed significant bactericidal activity compared with control at exposure periods of up to 1 h. Aqueous eosin and potassium permanganate may have desirable astringent properties, but these results suggest they lack effective antiseptic activity, at least against S. aureus. © 2015 British Association of Dermatologists.

Preparing patients for biologic medications for dermatologic and rheumatic diseases.

PubMed

Smith, Benjamin J; Nuccio, Brigitta C; Graves, Katelyn Y; McMillan, Victor M

2018-06-01

Psoriasis, psoriatic arthritis, and rheumatoid arthritis are prevalent conditions that often require a team of primary care and specialist healthcare professionals for the most optimum patient outcomes. Primary care providers can facilitate referrals to dermatology and rheumatology specialists by obtaining the needed screening workup for patients who need treatment with immunosuppressive therapies. This article reviews tuberculosis screening, hepatitis screening, and vaccinations to be administered before patients begin biologic medications.

Effect of Teledermatology on Access to Dermatology Care Among Medicaid Enrollees.

PubMed

Uscher-Pines, Lori; Malsberger, Rosalie; Burgette, Lane; Mulcahy, Andrew; Mehrotra, Ateev

2016-08-01

Access to specialists such as dermatologists is often limited for Medicaid enrollees. Teledermatology has been promoted as a potential solution; however, its effect on access to care at the population level has rarely been assessed. To evaluate the effect of teledermatology on the number of Medicaid enrollees who received dermatology care and to describe which patients were most likely to be referred to teledermatology. Claims data from a large California Medicaid managed care plan that began offering teledermatology as a covered service in April 2012 were analyzed. The plan enrolled 382 801 patients in California's Central Valley, including 108 480 newly enrolled patients who obtained coverage after the implementation of the Affordable Care Act. Rates of dermatology visits by patients affiliated with primary care practices that referred patients to teledermatology and those that did not were compared. Data were collected from April 1, 2012, through December 31, 2014, and assessed from March 1 to October 15, 2015. The percentage of patients with at least 1 visit to a dermatologist (including in-person and teledermatology visits) and total visits with dermatologists (including in-person and teledermatology visits) per 1000 patients. Of the 382 801 patients enrolled for at least 1 day from 2012 to 2014, 8614 (2.2%) had 1 or more visits with a dermatologist. Of all patients who visited a dermatologist, 48.5% received care via teledermatology. Among the patients newly enrolled in Medicaid, 75.7% (1474 of 1947) of those who visited a dermatologist received care via teledermatology. Primary care practices that engaged in teledermatology had a 63.8% increase in the fraction of patients visiting a dermatologist (vs 20.5% in other practices; P < .01). Compared with in-person dermatology, teledermatology served more patients younger vs older than 17 years (2600 of 4427 [58.7%] vs 1404 of 4187 [33.5%]), male patients (1849 of 4427 [41.8%] vs 1526 of 4187 [36

Diagnostic microbiology in veterinary dermatology: present and future.

PubMed

Guardabassi, Luca; Damborg, Peter; Stamm, Ivonne; Kopp, Peter A; Broens, Els M; Toutain, Pierre-Louis

2017-02-01

The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team. The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including the identification (ID) and antimicrobial susceptibility testing (AST) of key pathogens in veterinary dermatology. The Study Group for Veterinary Microbiology (ESGVM) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) identified scientific, technological, educational and regulatory issues impacting the predictive value of AST and the quality of the service offered by microbiology laboratories. The advent of mass spectrometry has significantly reduced the time required for ID of key pathogens such as Staphylococcus pseudintermedius. However, the turnaround time for validated AST methods has remained unchanged for many years. Beyond scientific and technological constraints, AST methods are not harmonized and clinical breakpoints for some antimicrobial drugs are either missing or inadequate. Small laboratories, including in-clinic laboratories, are usually not adequately equipped to run up-to-date clinical microbiologic diagnostic tests. ESGVM recommends the use of laboratories employing mass spectrometry for ID and broth micro-dilution for AST, and offering assistance by expert microbiologists on pre- and post-analytical issues. Setting general standards for veterinary clinical microbiology, promoting antimicrobial stewardship, and the development of new, validated and rapid diagnostic methods, especially for AST, are among the missions of ESGVM. © 2017 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the ESVD and ACVD.

Ethinylestradiol/Chlormadinone acetate for use in dermatological disorders.

PubMed

Gómez Vázquez, Mercedes; Navarra Amayuelas, Ramón; Lamarca, Marta; Baquedano, Laura; Romero Ruiz, Sebastián; Vilar-Checa, Eduardo; Iniesta, Maria D

2011-09-06

The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology.

PubMed

Ariens, Lieneke Fm; Schussler-Raymakers, Florine Ml; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd Wm; Bruijnzeel-Koomen, Carla Afm; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-09-05

The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. ©Lieneke FM Ariens, Florine ML Schussler-Raymakers, Cynthia

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.

Fusidic acid in dermatology.

PubMed

Wilkinson, J D

1998-12-01

Fusidic acid is an antibiotic that belongs to a group of its own, the fusidanes. The molecule has a steroid-like structure but does not possess any steroid activity. The structure is thought to be responsible for the steroid-like high penetration, and for the fact that no cross-resistance or cross-allergy has been seen with other antibiotics in routine clinical use. The anti-microbial activity of fusidic acid is specifically aimed at the most common skin pathogens, including Staphylococcus aureus, towards which it is one of the most potent antibiotics. The place of fusidic acid in dermatology is in the treatment of mild to moderately severe skin and soft-tissue infections, e.g. impetigo, folicullitis, erythrasma, furunculosis, abscesses and infected traumatic wounds, whereas it is of less use in conditions such as hidradenitis suppurativa, chronic leg ulcers, burns and pressure sores. The topical combinations of fusidic acid with either betamethasone or hydrocortisone are extremely useful in the treatment of atopic dermatitis/eczema whenever staphylococcal/secondary infection is suspected, and in more persistent cases of eczema where staphylococcal superantigen may be playing an important exacerbating role.

Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India.

PubMed

Narahari, Saravu R; Ryan, Terence J; Bose, Kuthaje S; Prasanna, Kodimoole S; Aggithaya, Guruprasad M

2011-03-01

Globally, governments have recognized the growing popularity of Complementary and Alternative Medicines and the possibility of their combined use with biomedicine. Decisions within the Government of India have led to a conducive environment for conducting clinical studies, to achieve integration of more than one system of medicine, so that their combined benefits can be brought to bear on chronic, difficult-to-treat conditions. To develop integrative dermatology treatment protocols for patients with long-standing skin diseases who have received treatment from many centers. A team of doctors from modern dermatology, Ayurveda, yoga therapy, and homeopathy studied recruited patients to develop mutual orientation on each therapeutic system and a working knowledge of approach to their clinical diagnosis. Six-hundred thirty-eight patients affected by lower limb lymphedema requiring skin care as a major part of treatment were treated integrating modern dermatology and Ayurveda. Three-hundred eighty-one vitiligo patients were examined and treated to understand the clinical presentations and treatment options in Ayurveda. A two-step cluster analysis performed by SPSS Version 16 showed average volume reductions of 13.3% and 23% on day 14, 19.7% and 31.1% on day 45, and 23.4% and 39.7% on day 90 of treatment in small and large lymphedematous limbs. Inflammatory episodes before the onset on this treatment was reported by 79.5% of our lymphedema patients, and 9.4% reported this at the end of three months after our treatment. Among vitiligo patients, we found that 39.6% of patients had kapha, 39.8% pitta, 10.8% had vatha and 0.52% has tridoshaja presentation. There are over 100 treatment options available in Ayurveda to treat vitiligo. Each system of medicine recognizes the same disease albeit with minor difference in description. Skin care procedures like washing and emollients restore the barrier function and skin health. We have converged Ayurvedic skin care with that of

A Prototype Lip Balm: Summary of Three Dermatological Studies Demonstrating Safety and Acceptability for Sensitive Skin.

PubMed

Nisbet, Stephanie

Data were generated from three studies to assess the tolerability and acceptability of a prototype cosmetic lip balm. Dermatological assessments of topical compatibility (primary and cumulative irritability and sensitization), photoirritant and topical photosensitizer potential, and acceptability for safe use of a prototype cosmetic lip balm on sensitive skin are summarized. In Study 1, the product was applied to the volunteers' backs under a semiocclusive patch followed by patch removal/reapplication over 6 weeks to assess the irritant and allergic potential of the product. Dermatological assessments were performed at the beginning and end of the study or when there was evidence of positivity or adverse event. Study 2 was conducted by applying the product to the volunteers' backs under a semiocclusive patch, followed by patch removal/reapplication and irradiation of the test area with ultraviolet A (UVA) radiation at various intervals over 5 weeks. Dermatological assessments were performed to assess the product's role in the induction of photoirritancy and photosensitization. Clinical and subjective assessments for acceptability were obtained during Study 3 in volunteers with a diagnosis of sensitive skin and those who used the product as per instructions for use during the study period. The data generated from the three studies demonstrated no evidence of primary or cumulative dermal irritation or of dermal sensitization. In addition, no photoirritation potential or photosensitization potential was observed. As assessed by dermatologic monitoring and subject diary entries, the prototype lip balm did not cause irritation or sensitization reactions when used for 28 days in volunteers with a diagnosis of sensitive skin. Based on these findings, the prototype lip balm can be considered suitable for use for people with sensitive skin.

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.

The path to modernity: a personal testimony to the restructuring of the Department of Dermatology, Vargas Hospital, Caracas, Venezuela.

PubMed

Kerdel-Vegas, Francisco

2014-01-01

In the late 1950s and early1960s, there was a concerted effort to modernize teaching, training, and patient care in the Vargas Hospital of Caracas, Venezuela. The above included the development of research in the frame of postgraduate training. This effort was to be helped by USA funds and institutions but could only be achieved by the work of Venezuelans, sharing a vision of progress. Dermatology spearheaded this initiative, and the fruit of this was the exponential development of Venezuelan Dermatology and the creation of the National Institute of Dermatology on the grounds of the Vargas Hospital. The purpose of this contribution is to review these events that happened more than half a century ago from my own perspective. I sincerely hope that these lines could serve as an inspiration to the younger generations that toil today under less-than-favorable conditions. © 2014 Elsevier Inc. All rights reserved.

Japanese version of the Family Dermatology Life Quality Index: Translation and validation.

PubMed

Higaki, Yuko; Tanaka, Masaru; Futei, Yuko; Kamo, Toshiko; Basra, Mohammad Khurshid Azam; Finlay, Andrew Yule

2017-08-01

Skin conditions affect the quality of life (QoL) of patients and their family. To assess family members' QoL, a questionnaire uniquely designed for family members is necessary. We translated the Family Dermatology Life Quality Index (FDLQI), originally created and validated by Basra et al., into Japanese, and evaluated its reliability and validity. For psychometric evaluations, 150 dermatology patients and their family members were included. The Japanese version of the FDLQI showed high test-retest reliability (intraclass correlation coefficient = 0.95) and internal consistency reliability (Cronbach's alpha = 0.86). FDLQI scores significantly correlated with DLQI scores (r = 0.58, P < 0.01, Spearman's rho) and global question (GQ) which measured the patient's skin condition on a visual analog scale (r = 0.36, P < 0.01). Family members of patients with inflammatory skin diseases showed higher FDLQI scores than those with isolated lesions, but the difference was not statistically significant (P = 0.062, Mann-Whitney U-test). Responsiveness to change was demonstrated in a group in which the patient's skin condition was assessed as improved (n = 37, r = 0.46, P < 0.01) but not in that in which it became worse. The difference of the change between the two groups was statistically significant (P < 0.01). Additionally, the change in FDLQI scores and GQ were significantly correlated (r = 0.40, P < 0.01). Exploratory factor analysis suggested essential unidimensionality of the instrument. We showed acceptable validity and responsiveness of this Japanese version of FDLQI. Further clinical epidemiological studies are required to confirm this. © 2017 Japanese Dermatological Association.

Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors' Group of the Spanish Academy of Dermatology and Venereology (AEDV).

PubMed

Casanova, J M; Pujol, R M; Ferrándiz, C; Betlloch, I; Bosch, R J; Fernández, V; Martí, R M; Requena, L; Moreno, J C; Alegre, V; Vilata, J J; Vilar, N; Jaén, P; Bielsa, I; Querol, I; Azón, T; Borrego, L; Mascaró, J M; Alsina, M; Díaz, R M; Suarez, R; García-Bustinduy, M; García-Patos, V; Estrach, T

2016-03-01

Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain. Copyright © 2014. Published by Elsevier España, S.L.U.

Quality of life among dermatology patients: a systematic review of investigations using qualitative methods.

PubMed

Singh, Sanminder; Ehsani-Chimeh, Nazanin; Kornmehl, Heather; Armstrong, April W

2017-07-13

Quality of life may be assessed using quantitative or qualitative methods. Quantitative methods are commonly used in research settings; however, they may fail to capture the full range of patient experiences and impact on quality of life. Qualitative methods may be used to address this limitation. In this systematic review, we aim to synthesize data from articles utilizing qualitative methods to assess quality of life in dermatology patients. We performed a systematic review search using the MEDLINE, EMBASE, and SCOPUS databases. The search was conducted using the following search criteria: ("Dermatology" [MeSH]) AND ("Quality of Life" [MeSH]), AND ("Qualitative Research" [MeSH]), searching literature spanning from January 1, 1946- October 5, 2016. The systematic review of 15 articles included 533 dermatology patients. Patients expressed frustration over the unpredictability of disease symptoms and having to compensate for the subsequent limitations by altering their daily routines. Patients also reported profound helplessness due to chronic skin disease and social isolation in an effort to hide their disease. Patients noted the patient-provider relationship as a source of support and information exchange, with the goal to form easy to use treatment plans that met both physician and patient expectations. Qualitative assessment of patient quality of life can provide new insights into the patient experience and the impact of their skin disease. Qualitative methodology may capture meaningful information that may be overlooked by quantitative methods, and it should be included in quality of life research.

[Preliminary approach to the mental component in dermatologic patients].

PubMed

Di Prima, T M; De Pasquale, R; Gilotta, S M; Cravotta, A

1989-04-01

The aim of this study was to approach on a psychical point of view 27 patients suffering from chronic idiopathic urticaria (14), pruritus sine materia (6), alopecia areata (3), pathomimia (4), in order to examine the possibility that psychic disorders could act as triggering or aggravating the dermatological affection. Psychical assessment was evaluated by colloquy and by the administration of some psychodiagnostic tests: EPI, MMPI, Zung. The role of psychogenic factors in skin diseases is emphasized and the results obtained from the use of antidepressant and minor tranquilizer drugs are discussed.

Patient perceptions of antibiotic use and resistance at a single university dermatology clinic.

PubMed

Goettsche, Lainee S; Weig, Emily A; Chung, Jina; Hoff, Brian M; Ince, Dilek; Wanat, Karolyn A

2018-05-21

Antibiotic resistance is an important problem that requires continued patient education and important prescribing stewardship. Dermatologists prescribe the most antibiotics per provider in comparison to other specialties and have an important role to play in the campaign of mindful prescribing. Data on the dermatology patients' knowledge and perception regarding antibiotic resistance is lacking and could play a role in providers' continuation of medications. We conducted a single institution survey of 512 dermatology clinic patients to understand patient's knowledge and potential gaps. Overall, our results demonstrated an overall higher level of knowledge than expected, there were still several knowledge gaps identified. Ninety-one percent of respondents were aware of the term 'antibiotic resistance'. However, 65% of participants believed that a short course of antibiotics could not cause resistance. While our patients have awareness of antibiotic resistance, it is imperative to continue to assess patients' knowledge about antibiotic resistance and provide education whenever possible in order to continue to practice antibiotic stewardship.

Causality or Relatedness Assessment in Adverse Drug Reaction and Its Relevance in Dermatology.

PubMed

Pande, Sushil

2018-01-01

Causality assessment essentially means finding a causal association or relationship between a drug and drug reaction. Identifying the culprit drug or drugs can be lifesaving or helpful in preventing the further damage caused by the drug to our body systems. In dermatology practice, when it comes to cutaneous adverse drug reaction, this is much more important and relevant because many aetiologies can produce a similar cutaneous manifestation. There are multiple criteria or algorithms available as of now for establishing a causal relationship in cases of adverse drug reaction (ADR), indicating that none of them is specific or complete. Most of these causality assessment tools (CATs) use four cardinal principles of diagnosis of ADR such as temporal relationship of drug with the drug reaction, biological plausibility of the drug causing a reaction, dechallenge, and rechallenge. The present study reviews some of the established or commonly used CATs and its implications or relevance to dermatology in clinical practice.

Transcending the language barrier--creation of a multilingual dermatology website.

PubMed

Ali, Saba M; Hinckley, Michael R; Feldman, Steven R

2007-05-01

In a linguistically diverse society, healthcare professionals must overcome the daunting task of effectively communicating with patients who speak a different language. In effort to aid healthcare professionals and their patients, an on-line dermatology patient education resource was created with links to various skin related topics in over 30 languages. The development of the on-line resource, key features of the information available on the website, and limitations experienced during its creation are discussed in the article.

[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.

Quality of life before and 6 weeks after treatment in a dermatological outpatient treatment unit.

PubMed

Maroti, M; Ulff, E; Wijma, B

2006-10-01

Dermatological disease affects quality of life to a great extent. Treatments are time-consuming and many patients have problems adhering to treatment. Attending an outpatient unit regularly during an intensive treatment period may enable patients to cope with their illness, adhere to treatment and thus improve their quality of life. To study the effect on quality of life of 6 weeks of regular treatment in the outpatient unit in the County Hospital of Jönköping, by means of a questionnaire and interviews. The Dermatology Life Quality Index (DLQI) was distributed to 50 consecutive patients with psoriasis, atopic dermatitis or pruritus attending our outpatient treatment unit. Nine of the patients were interviewed during treatment about factors that might influence their quality of life. The DLQI scores before treatment indicated a low quality of life. Women were more affected than men. After 6 weeks of treatment there was a clear improvement, with a 57% reduction in the scores. The answers from the interviews indicated important areas of concern such as withdrawal from public places, adoption of special clothing habits and concern about personal relationships. Dermatological diseases have an important influence on patients' quality of life. Attending an outpatient treatment unit was in this series of cases associated with improved quality of life as measured with the DLQI.

Preliminary reliability and validity of Persian version of the Family Dermatology Life Quality Index (FDLQI).

PubMed

Safizadeh, H; Nakhaee, N; Shamsi-Meymandi, S; Pourdamghan, N; Basra, M K A

2014-04-01

Family Dermatology Life Quality Index (FDLQI) is an instrument for assessing the quality of life of family members of dermatologic patients. The aim of this study was to describe the cultural adaptation of this questionnaire and to assess psychometric properties of the Persian version. At first, the questionnaire was translated into Persian, and then back-translation was performed. The whole cycle was repeated until a consensus was reached about the optimal translation. In the next step, cognitive debriefing was performed, and after approval of the Persian version by FDLQI developers, it was distributed among 100 family members of dermatological patients in order to evaluate its validity and reliability. Mean age of participants was 37.1 years (±12.3). Mean score of FDLQI was 15.4 (±5.5) with maximum and minimum scores of 30 and 6, respectively. The quality of life of studied participants showed no significant difference based on age-group, sex, educational level and the family relationship. Cronbach's alpha was calculated as 0.87. Exploratory factor analysis revealed a one-factor solution that accounted for 40.7 % of the variance. The unidimensional model was supported by confirmatory factor analysis. The results of the present study showed that the Persian version of FDLQI has acceptable factorial validity and internal consistency reliability.

[Anti-TNF alpha in dermatology].

PubMed

Mahe, E; Descamps, V

2002-12-01

The discovery of the major role of TNF alpha in the physiopathology of certain inflammatory diseases and notably in rheumatoid arthritis and Crohn's disease has led to the development of anti-TNF alpha drugs. These new therapeutic arms issued from bio-technology have rapidly demonstrated their efficacy in the treatment of these two diseases. The anti-TNF alpha arsenal is currently dominated by etanercept, a fusion protein composed of a soluble TNF alpha receptor, and infliximab, a chimeric monoclonal antibody. However, new molecules will soon enrich this arsenal. TNF alpha is a major cytokine of inflammatory diseases of the skin. Many dermatological diseases will probably benefit from these new treatments. Two studies have already demonstrated their interest in cutaneous and articular psoriasis. Encouraging sporadic results suggest other potential indications (Behcet's disease, bullous dermatitis, neutrophilic dermatitis, toxic epidermal necrolysis, systemic vascularitis,.). These promising new treatments, although expensive, and with yet unknown long term side effects, justify rigorous assessment of their efficacy and tolerance in each indication. Here again the dermatologist has a major role to play in post-marketing pharmacovigilance.

A review of phosphodiesterase-inhibition and the potential role for phosphodiesterase 4-inhibitors in clinical dermatology.

PubMed

Moustafa, Farah; Feldman, Steven R

2014-05-16

Phosphodiesterase inhibitors are commonly used drugs. Specific phosphodiesterase inhibitors with anti-inflammatory properties are being assessed as dermatological treatments. To describe important aspects of phosphodiesterase inhibition and the safety and efficacy of 2 phosphodiesterase- 4 inhibitors being studied for the treatment of dermatologic diseases We did a non-systematic analysis of literature on phosphodiesterase inhibition followed by a review of published information on apremilast and topical AN2728 and their use for psoriasis and atopic dermatitis. Apremilast and topical AN2728 have modest efficacy in treatment of psoriasis. Apremilast achieved PASI-75 scores ranging from 24-33%. In phase 2 studies, AN2728 had modest efficacy for psoriasis (40% of patients achieved a ≥ 2 grade improvement as assessed by the Overall target Plaque Severity Score). In phase 2 studies of AN2728 use in atopic dermatitis, subjects achieved a 71% improvement from baseline Atopic Dermatitis Severity Index. In all studies, most adverse effects were minimal. The limitations of this paper are the limited number of published studies, the lack of long-term data, and the lack of head -to - head trials directly comparing phosphodiesterase inhibitors with other treatments. Phosphodiesterase inhibitors constitute a widely used class of drugs that may see growing use for inflammatory dermatologic diseases.

Dermatological disease in the older age group: a cross-sectional study in aged care facilities.

PubMed

Deo, Maneka S; Kerse, Ngaire; Vandal, Alain C; Jarrett, Paul

2015-12-23

To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease. 2 large aged care facilities in Auckland, New Zealand, each providing low and high level care. All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited-66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years). Primary--presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary--functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score). 81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment. A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer). Those with less significant physical impairment were found to be at greater risk of inflammatory

[Activity report on a rapid post-emergency consultation for the management of dermatological emergencies [corrected

PubMed

Ingen-Housz-Oro, S; Mirkamali, A; Valeyrie-Allanore, L; Chosidow, O; Wolkenstein, P

2010-01-01

Dermatological emergencies generally consist of infection and inflammation, including cutaneous drug reactions. Most patients are either not seen again or else are followed by their GP, but it may be a long time before they see a dermatologist once more, even if monitoring is necessary. We created a rapid post-emergency consultation reserved for these patients alone requiring short-term reevaluation, and we report the results of the new consultation herein. One consultation per week is exclusively for patients seen in dermatological emergency units requiring rapid reassessment (i.e. within two weeks) for follow-up or in cases of uncertainty in the diagnosis. Between June 2008 and June 2009, 40 consultations were carried out, with 370 patients being enrolled and 214 attending the consultation (40% absenteeism), i.e. 3% of emergency unit patients. The mean time from the emergency consultation was 9.2 days and the reasons for consultation were: 34% infectious dermatoses, 36% inflammatory dermatoses, 7.5% cutaneous drug reactions and 19% miscellaneous diagnosis, with 4.2% uncertainty about diagnosis. The outcome after the emergency consultation was favourable in 76% of cases (complete healing or improvement). A follow-up consultation was proposed in 41.5% of cases, with 77.5% of patients attending. While the creation of this consultation did not significantly reduce the number of patients returning to the emergency service, it was welcomed by all dermatologists in charge of such dermatological emergency services. This rapid post-emergency consultation forms a small part of the activities of the dermatological emergency unit but is positive in the view of the dermatologists in charge of emergency consultations since it means patients can be given appointments soon after initial treatment, thus avoiding the need to return to the emergency unit. The diseases seen at this unit are similar to those seen in the emergency unit. While absenteeism is considerable, this type of

Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0.

PubMed

Chen, Alice P; Setser, Ann; Anadkat, Milan J; Cotliar, Jonathan; Olsen, Elise A; Garden, Benjamin C; Lacouture, Mario E

2012-11-01

Dermatologic adverse events to cancer therapies have become more prevalent and may to lead to dose modifications or discontinuation of life-saving or prolonging treatments. This has resulted in a new collaboration between oncologists and dermatologists, which requires accurate cataloging and grading of side effects. The Common Terminology Criteria for Adverse Events Version 4.0 is a descriptive terminology and grading system that can be used for uniform reporting of adverse events. A proper understanding of this standardized classification system is essential for dermatologists to properly communicate with all physicians caring for patients with cancer. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Profile of patients admitted to a triage dermatology clinic at a tertiary hospital in São Paulo, Brazil*

PubMed Central

Bertanha, Fernanda; Nelumba, Erica Judite Pimentel; Freiberg, Alyne Korukian; Samorano, Luciana Paula; Festa Neto, Cyro

2016-01-01

Background Knowledge of epidemiological data on skin diseases is important in planning preventive strategies in healthcare services. Objective To assess data from patients admitted to a triage dermatology clinic. Methods A retrospective study was performed of patients admitted over a one-year period to the Triage Dermatology Clinic at the Hospital das Clínicas of the University of São Paulo Medical School. Data were obtained from record books. The variables analyzed were: patient age, gender, dermatologic disease (initial diagnosis), origin (from where the patient was referred) and destination (where the patient was referred to). Results A total of 16,399 patients and 17,454 diseases were identified for analysis. The most frequent skin disorders were eczema (18%), cutaneous infections (13.1%), erythematous squamous diseases (6.8%) and malignant cutaneous neoplasms (6.1%). Atopic dermatitis was the most common disease in children. Acne was more common among children and adults, as were viral warts. Basal cell carcinoma and squamous cell carcinoma were more common in the elderly. Contact dermatitis and acne predominated in women. The most frequent origins were: the primary/secondary health system (26.6%), other outpatient specialties (25.5%), emergency care (14.9%); while the destinations were: discharged (27.5%), follow-up in our Dermatology Division (24.1%), return (14.1%) and the primary/secondary health system (20.7%). Conclusion Understanding the incidence of skin diseases is fundamental in making decisions regarding resource allocation for clinical care and research. Thus, we believe our findings can contribute to improving public health policies. PMID:27438199

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 .

Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

PubMed

Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

2018-05-01

Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

The evaluation of family impact of recessive dystrophic epidermolysis bullosa using the Italian version of the Family Dermatology Life Quality Index.

PubMed

Sampogna, F; Tabolli, S; Di Pietro, C; Castiglia, D; Zambruno, G; Abeni, D

2013-09-01

Severe skin diseases, such as epidermolysis bullosa (EB), may have a strong impact not only on patients but also on caregivers. A specific questionnaire evaluating the family impact of dermatological conditions has been created, the Family Dermatology Life Quality Index (FDLQI), but it has not yet been translated in Italian and validated. To evaluate the burden of recessive dystrophic EB on family caregivers, using for the first time the Italian version of the FDLQI, and to validate the instrument. Patients with recessive dystrophic EB participated in a postal survey enquiring about the burden of EB on family caregivers. They completed the Family Strain Questionnaire and the FDLQI and they marked on a silhouette of the human body the skin lesion distribution. Data on 62 family caregivers were collected. The overall mean FDLQI score was 9.8. The most frequently reported problems were the time spent on looking after the patient, emotional distress, physical well-being, and increased household expenditure. FDLQI scores were higher in family caregivers of patients between 10 and 20 years. The Italian FDLQI showed high internal consistency, construct and convergent validity. Factor analysis revealed the presence of one factor structure underlying the items of the FDLQI, which explained 51.5% of the total variance, very similar to the original questionnaire (55.8%). The Italian version of the FDLQI seems to be a useful tool to evaluate the impact of EB on family caregivers. Further studies are necessary to test this instrument in other dermatological conditions. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Reflections on relationships between national and world events and development of dermatology. Venezuela as a model.

PubMed

Goihman-Yahr, Mauricio

2013-11-01

From a personal vantage, the author tries to understand evolution of medicine and dermatology as relating to political, ideological,and economic factors.He analyzes the evolution of Venezuelan Dermatology research and practice from 1936 to present, relating it to the events that have taken place in that country during this period and integrating the latter to events in the world. There is a close relationship between Venezuelan and US history particularly since the late nineteen-thirties.Physicians in general and dermatologists in particular should not dismiss or just bear the events that take place in the society as a whole. They should try to influence them by acting in harmony with forces that propitiate freedom, rule of law, free inquiry, and meritocracy.

Towards a decision support system for hand dermatology.

PubMed

Mazzola, Luca; Cavazzina, Alice; Pinciroli, Francesco; Bonacina, Stefano; Pigatto, Paolo; Ayala, Fabio; De Pità, Ornella; Marceglia, Sara

2014-01-01

The complexity of the medical diagnosis is faced by practitioners relying mainly on their experiences. This can be acquired during daily practices and on-the-job training. Given the complexity and extensiveness of the subject, supporting tools that include knowledge extracted by highly specialized practitioners can be valuable. In the present work, a Decision Support System (DSS) for hand dermatology was developed based on data coming from a Visit Report Form (VRF). Using a Bayesian approach and factors significance difference over the population average for the case, we demonstrated the potentiality of creating an enhanced VRF that include a diagnoses distribution probability based on the DSS rules applied for the specific patient situation.

Predictive values of diagnostic codes for identifying serious hypocalcemia and dermatologic adverse events among women with postmenopausal osteoporosis in a commercial health plan database.

PubMed

Wang, Florence T; Xue, Fei; Ding, Yan; Ng, Eva; Critchlow, Cathy W; Dore, David D

2018-04-10

Post-marketing safety studies of medicines often rely on administrative claims databases to identify adverse outcomes following drug exposure. Valid ascertainment of outcomes is essential for accurate results. We aim to quantify the validity of diagnostic codes for serious hypocalcemia and dermatologic adverse events from insurance claims data among women with postmenopausal osteoporosis (PMO). We identified potential cases of serious hypocalcemia and dermatologic events through ICD-9 diagnosis codes among women with PMO within claims from a large US healthcare insurer (June 2005-May 2010). A physician adjudicated potential hypocalcemic and dermatologic events identified from the primary position on emergency department (ED) or inpatient claims through medical record review. Positive predictive values (PPVs) and 95% confidence intervals (CIs) quantified the fraction of potential cases that were confirmed. Among 165,729 patients with PMO, medical charts were obtained for 40 of 55 (73%) potential hypocalcemia cases; 16 were confirmed (PPV 40%, 95% CI 25-57%). The PPV was higher for ED than inpatient claims (82 vs. 24%). Among 265 potential dermatologic events (primarily urticaria or rash), we obtained 184 (69%) charts and confirmed 128 (PPV 70%, 95% CI 62-76%). The PPV was higher for ED than inpatient claims (77 vs. 39%). Diagnostic codes for hypocalcemia and dermatologic events may be sufficient to identify events giving rise to emergency care, but are less accurate for identifying events within hospitalizations.

Arthropathy in Dermatology: A Comprehensive Review

PubMed Central

Jagadeesan, Soumya; Shenoy, Padmanabha

2017-01-01

Dermatology and rheumatology are two specialties that deal with significant overlap. In this context, it is important that the dermatologists acquaint themselves with conditions presenting with arthropathy. As the first step, it is essential to know whether the origin of musculoskeletal symptom is articular or extra-articular; inflammatory or noninflammatory; acute or chronic; oligo- or poly-articular. This will help in narrowing down the differential diagnoses as well as in better correlation with the cutaneous symptoms. In this review, we discuss the skin and articular manifestations of common inflammatory and noninflammatory arthropathies including rheumatoid arthritis, spondyloarthropathies, connective tissue disorders, vasculitis, crystal arthropathies, infective arthritis, arthritis associated with degenerative, endocrine and metabolic conditions, etc. We have also added a section on the common cutaneous features associated with the treatment of rheumatologic diseases. A basic understanding of the joint pathologies and associated skin changes will help a long way in the better management of these conditions. PMID:28405546

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.

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

Outpatient Dermatological Diagnoses in Spain: Results From the National DIADERM Random Sampling Project.

PubMed

Buendía-Eisman, A; Arias-Santiago, S; Molina-Leyva, A; Gilaberte, Y; Fernández-Crehuet, P; Husein-ElAhmed, H; Viera-Ramírez, A; Fernández-Peñas, P; Taberner, R; Descalzo, M Á; García-Doval, I

2018-06-01

Dermatologists perform most of their work in outpatient or private clinics. Data on the diagnoses made by dermatologists in these settings are lacking, however, as outpatient activity, unlike hospital activity, is difficult to code. The aim of this study was to analyze the diagnoses made by members of the Spanish Academy of Dermatology and Venereology (AEDV) at dermatology clinics in Spain. We selected a random sample of AEDV dermatologists drawn from the AEDV list and stratified by geographic area. The selected dermatologists received instructions on how to collect the data required. Each participant recorded the diagnosis reached and other data for patients seen during 2 specified periods: 3 days in January and 3 days in May. The diagnoses were subsequently coded by a dermatologist expert in applying the International Classification of Diseases (10th revision). In view of the complex nature of the sample, data were analyzed with standard error and finite population corrections. The sample consisted of 124 dermatologists. Of these, 65% participated in the first phase of the study and 59% in the second. An estimated 621 562 patients (95% CI, 368 130-874 995) visit the dermatologist every month in Spain. This is the equivalent of 28 (25-31) patients per day per clinic. The most common diagnosis recorded was actinic keratosis, followed by basal cell carcinoma and melanocytic nevus. The vast majority of visits took place at the clinic, but 1% of patients (0.3%-3%) were assessed using teledermatology. This is the first study in Spain to analyze diagnoses made by AEDV members at outpatient dermatology clinics. Our findings show a high volume of activity and will be useful for guiding health care planning, resource use, and future studies. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Dermatological spectrum of hand, foot and mouth disease from classical to generalized exanthema.

PubMed

Hubiche, Thomas; Schuffenecker, Isabelle; Boralevi, Franck; Léauté-Labrèze, Christine; Bornebusch, Laure; Chiaverini, Christine; Phan, Alice; Maruani, Annabel; Miquel, Juliette; Lafon, Marie-Edith; Lina, Bruno; Del Giudice, Pascal

2014-04-01

Hand, foot and mouth disease (HFMD) is classically defined as a childhood fever accompanied by a rash with vesicles or erosions of the oral mucosa, hands, feet and sometimes the buttocks. Severe neurological complications are associated with enterovirus 71 outbreaks in Asia. Recently, it has been suggested that HFMD is related to coxsackie virus A6 (CV-A6) when there is an atypical rash. The objective of the study is to determine the dermatological pattern of HFMD and to identify the virus serotypes associated with a specific dermatological pattern. A prospective, cross-sectional study was conducted in 7 pediatric dermatology units in France from March 2010 to February 2012. All children with clinically suspected diagnosis of HFMD were included. Clinical data were collected and swabs from the nasopharynx and vesicles were taken for reverse transcription polymerase chain reaction and genotyping. Only children with confirmed HFMD--defined by clinical diagnosis of HFMD and positive enterovirus polymerase chain reaction results--were included for analysis. One hundred and four children consulted for suspected HFMD, including 89 (mean age: 25.7 months; sex ratio M/F 1.54) with confirmed HFMD. Seventy-eight (87.6%) had skin lesions on sites other than hand, feet and mouth. Thirty-seven (41.5%) had 5 or more anatomical sites involved (hand, feet and mouth, buttocks, legs, arms and trunk) considered as widespread exanthema. Widespread vesicular exanthema was observed with both CV-A6 and CV-A16. Peri-oral rash was associated with CV-A6 (P < 0.001). HFMD has a clinical spectrum ranging from classical to generalized vesicular exanthema. Generalized and atypical exanthema were observed with both CV-A6 and CV-A16 infections. CV-A6 is associated with peri-oral rash.

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.

The relative ease of obtaining a dermatologic appointment in Boston: how methods drive results.

PubMed

Weingold, David Howard; Lack, Michael Dweight; Yanowitz, Karen Leslie

2009-06-01

Recent reports have indicated long wait times for dermatologic appointments even for changing moles. Our objective was to determine the wait time for a person willing to make multiple calls and accept an appointment from any dermatologist at any satellite location for a changing mole from a dermatologist who advertised in a Boston, MA, telephone book. We telephoned each practice listed in a Boston, MA, telephone book. Patients making one call to each dermatologic practice on average obtained an appointment in 18 days. Patients calling two practices were offered an appointment on average in 7 days. Patients calling 3 practices were also offered an appointment in 1 week. We only telephoned practices listed in a Boston, MA, telephone book and we only surveyed one urban area. These results suggest that a reasonable concerned patient who was willing to make multiple calls to different providers in Boston, MA, can be seen in a timely fashion.

Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?

PubMed

Shenefelt, Philip D

2003-01-01

Biofeedback can improve cutaneous problems that have an autonomic nervous system component. Examples include biofeedback of galvanic skin resistance (GSR) for hyperhidrosis and biofeedback of skin temperature for Raynaud's disease. Hypnosis may enhance the effects obtained by biofeedback. Cognitive-behavioral methods may resolve dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermatologic therapy. Responsive diseases include acne excoriée, atopic dermatitis, factitious cheilitis, hyperhidrosis, lichen simplex chronicus, needle phobia, neurodermatitis, onychotillomania, prurigo nodularis, trichotillomania, and urticaria. Hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioral methods. Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures.

[Factitious disorders in dermatology: Value of the dissociative state concept].

PubMed

Fekih-Romdhane, F; Homri, W; Labbane, R

2016-03-01

Factitious disorders in dermatology consist of intentionally self-inflicted skin lesions that vary in morphology and distribution and occur on surfaces readily accessible to the patient's hands. They tend to be a chronic condition that waxes and wanes according to the circumstances of the patient's life. Patient management poses a particular challenge to the clinician and the prognosis is considered poor. The aetiopathogenesis of factitious disorders in dermatology is not completely understood. We present a case in which we suggested the occurrence of factitious behaviour during a dissociative state, and we briefly describe our diagnostic and therapeutic approach. A 48-year-old unemployed woman was referred to our department of psychiatry by her dermatologist for suspected factitious disorder. The patient was diagnosed with diabetes mellitus type 1 and had been hospitalized repeatedly for confirmed diabetic ketoacidosis. The onset of the disease was related to marital discord with her spouse. Numerous skin lesions had appeared on her face, arms, legs, neck and back. These lesions resulted in multiple hospital admissions and in amputation of her left leg. The condition had worsened considerably after her separation from her husband. During the initial conversation, the patient was unable to provide a clear history of the disease. She denied any knowledge of the circumstances in which these skin lesions appeared, and she did not admit self-infliction. Her mood was depressed and her speech was slow. We suspected that our patient was herself causing her skin lesions while in a dissociative state. Several arguments militate in favour of our hypothesis, particularly her history of childhood maltreatment and the association of traumatic life events with simultaneous deterioration of the skin. The explanation of the dissociative mechanism helped us to strengthen the therapeutic relationship. Within a few days, we noted a slow regression of the lesions, but the patient was

Nurse prescribing in dermatology: doctors' and non-prescribing nurses' views.

PubMed

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2009-04-01

This paper is a report of a study conducted to explore doctor and non-prescribing nurse views about nurse prescribing in the light of their experience in dermatology. The cooperation of healthcare professionals and peers is of key importance in enabling and supporting nurse prescribing. Lack of understanding of and opposition to nurse prescribing are known barriers to its implementation. Given the important role they play, it is necessary to consider how the recent expansion of nurse prescribing rights in England impacts on the views of healthcare professionals. Interviews with 12 doctors and six non-prescribing nurses were conducted in 10 case study sites across England between 2006 and 2007. Participants all worked with nurses who prescribed for patients with dermatological conditions in secondary or primary care. Thematic analysis was conducted on the interview data. Participants were positive about their experiences of nurse prescribing having witnessed benefits from it, but had reservations about nurse prescribing in general. Acceptance was conditional upon the nurses' level of experience, awareness of their own limitations and the context in which they prescribed. Fears that nurses would prescribe beyond their level of competence were expected to reduce as understanding and experience of nurse prescribing increased. Indications are that nurse prescribing can be acceptable to doctors and nurses so long as it operates within recommended parameters. Greater promotion and assessment of standards and criteria are recommended to improve understanding and acceptance of nurse prescribing.

[One-hundred fifty English words and expressions in dermatology that present difficulties or pitfalls for translation into Spanish].

PubMed

Navarro, F A

2008-06-01

Every year, thousands of technical neologisms are coined in English and must be rapidly imported into the Spanish language with the utmost precision, clarity, rigor, and linguistic correctness for Spanish to remain useful as a language of culture and learning that allows us to express the medicine of today. In 1999, the author published an extensive Glossary of Doubts in English-Spanish Translation of Dermatology that contained more than 500 words and expressions in dermatology that present difficulties in translation. Nine years later, the original glossary has been extended to include new English words and expressions that were not covered at that time. The author compiles and discusses 150 dermatological neologisms and technical terms in English that present problems for translation into Spanish or generate doubts regarding their use in that language, and offers reasoned proposals for their translation. The proposed translations are well founded and reflect the necessity for accuracy and clarity that should characterize all scientific language. In most cases, they are accompanied by detailed comments on normal usage among physicians, orthographic rules in Spanish, and official guidelines based on standardized nomenclature and the recommendations of the main international organizations.

Molecular Phylogenetic Diversity of Dermatologic and Other Human Pathogenic Fusaria from Hospitals in Northern Italy

USDA-ARS?s Scientific Manuscript database

Fifty-eight fusaria isolated from 52 Italian patients between 2004 and 2007 were subject to multilocus DNA sequence typing to characterize the spectrum of species and circulating sequence types (STs) associated with dermatological infections, especially onychomycoses and paronychia, and other fusari...

Actinic keratosis: a cross-sectional study of disease characteristics and treatment patterns in Danish dermatology clinics.

PubMed

Erlendsson, Andrés M; Egekvist, Henrik; Lorentzen, Henrik F; Philipsen, Peter A; Stausbøl-Grøn, Birgitte; Stender, Ida M; Haedersdal, Merete

2016-03-01

The incidence of actinic keratosis (AK) is increasing, and several treatment options are available. The aim of this study was to describe clinical characteristics and treatment patterns in patients with AK treated by Danish dermatologists. A multicenter, non-interventional, cross-sectional study was conducted. Three dermatology hospital departments and seven private dermatology clinics enrolled eligible AK patients consecutively during one week. A total of 312 patients were included. Non-melanoma skin cancer (NMSC) was previously reported in 51.0% of patients and currently suspected in 9.4% of AK-affected anatomical regions. Lesions of AK were located primarily on the face (38.6%), scalp (12.8%), and hands (11.2%). Actinic keratosis commonly presented with multiple AK lesions (38.6%) and field cancerization (38.5%). The treatments used most frequently were cryotherapy (57.7%) and photodynamic therapy (PDT) with methyl aminolevulinate (17.1%) and imiquimod (11.2%). The likelihood of receiving cryotherapy was higher for men (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.10-2.47) and increased with age (2.2% per year, 0.4-4.0%). PDT represented the most frequently applied treatment for severe actinic damage and was more likely to be prescribed to women (OR 4.08, 95% CI 2.22-7.47) and young patients (OR 0.97 per year, 95% CI 0.95-0.99). The prevalence of severe actinic damage (17.3% versus 9.6%) and intake of immunosuppressive medication (29.0 versus 2.0) were higher among hospital patients compared with those treated in private practices (P < 0.0001). The majority of AK patients in Danish dermatology clinics have a history of skin cancer, and NMSC is suspected in almost 10% of AK-affected regions. Cryotherapy is the most frequently used treatment overall, except in instances of severe actinic damage, in which PDT is the first-choice treatment. © 2015 The International Society of Dermatology.

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

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.

Clinical Research in Dermatology and Venereology in Spanish Research Centers in 2005 Through 2014: Results of the MaIND Study.

PubMed

Molina-Leyva, A; Descalzo, M A; García-Doval, I

Bibliometric indicators provide a useful measure of the number of clinical research articles published in scientific journals and their quality. This study aimed to assess the amount and quality of research carried out in Spanish dermatology centers and to describe the research topics. Bibliometric study of clinical research articles that met the inclusion criteria and had a definitive publication date between 2005 and 2014 in MEDLINE or Embase in which the corresponding author's affiliation was a Spanish hospital dermatology department or other center. Of 8,617 articles found, 1,104 (12.81%) met the inclusion criteria. The main reason for excluding articles was that they did not have an evidence level of 4 or better. The main vehicle for reporting was the journal Actas Dermosifiliográficas, which published 326 articles (29.53%). Melanoma, the disease the researchers studied most often, accounted for 134 articles (12.13%). A limitation to bear in mind when interpreting the results is that we relied on the corresponding author's affiliation to identify articles reflecting research from a Spanish dermatology center. Thus, studies in which dermatologists participated would not be recognized if they were directed by other specialists. Only a small portion of articles published from Spanish dermatology centers can be considered clinical research, mainly because many publications provide a low level of scientific evidence. Most publications are case reports. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Dermatological diseases in patients with chronic kidney disease.

PubMed

Gagnon1, Amy L; Desai, Tejas

2013-04-01

There are a variety of dermatological diseases that are more commonly seen in patients with chronic kidney disease (CKD) and renal transplants than the general population. Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched. Some cutaneous diseases are clearly unique to this population. Of them, Lindsay's Nails, xerosis cutis, dryness of the skin, nephrogenic systemic fibrosis and acquired perforating dermatosis have been described in chronic kidney disease patients. The most common malignancy found in all transplant recipients is non-melanoma skin cancer. It is important for patients and physicians to recognize the manifestations of skin disease in patients suffering from chronic kidney disease to mitigate the morbidity associated with these conditions.

Strengths and Limitations of Evidence-Based Dermatology

PubMed Central

Williams, Hywel C

2014-01-01

The need for understanding and reflecting on evidence-based dermatology (EBD) has never been greater given the exponential growth of new external evidence to inform clinical practice. Like any other branch of medicine, dermatologists need to acquire new skills in constructing answerable questions, efficiently searching electronic bibliographic databases, and critically appraising different types of studies. Secondary summaries of evidence in the form of systematic reviews (SR), that is, reviews that are conducted in a systematic, unbiased and explicit manner, reside at the top of the evidence hierarchy, because they are less prone to bias than traditional expert reviews. In addition to providing summaries of the best external evidence, systematic reviews and randomized controlled trials (RCTs) are also powerful ways of identifying research gaps and ultimately setting the agenda of future clinical research in dermatology. But like any paradigm, EBD can have its limitations. Wrong application, misuse and overuse of EBD can have serious consequences. For example, mindless pooling together of data from dissimilar studies in a meta-analysis may render it a form of reductionism that does not make any sense. Similarly, even highly protocolised study designs such as SRs and RCTs are still susceptible to some degree of dishonesty and bias. Over-reliance on randomized controlled trials (RCT) may be inappropriate, as RCTs are not a good source for picking up rare but important adverse effects such as lupus syndrome with minocycline. A common criticism leveled against SRs is that these frequently conclude that there is lack of sufficient evidence to inform current clinical practice, but arguably, such a perception is grounded more on the interpretation of the SRs than anything else. The apparent absence of evidence should not paralyze the dermatologist to adopt a state of therapeutic nihilism. Poor primary data and an SR based on evidence that is not up-to-date are also

Willingness to pay in dermatology: assessment of the burden of skin diseases.

PubMed

Seidler, Anne M; Bayoumi, Ahmed M; Goldstein, Mary K; Cruz, Ponciano D; Chen, Suephy C

2012-07-01

Willingness to pay (WTP) is a monetary, preference-based, burden-of-disease measure with a potential role in dermatology, where many conditions are temporary and/or mild, and many treatments are inexpensive and one might be able to imagine paying out of pocket. We assessed construct validity by interviewing 254 consecutive dermatology patients at Stanford Medical Center, Grady Hospital, and Parkland Hospital. Instruments asked about an individual's own health status and elicited WTP, time-trade-off (TTO) utilities, and health status quality of life (QOL). We measured WTP cure (short treatment course to eliminate disease) and WTP control (lifelong medication). Our data indicate greater construct validity in non-Medicaid (n=163) than Medicaid (n=91) patients. Non-Medicaid subjects had greater WTP as percent of income for cure (median: 2%) than control (median: 1.6%), P<0.01; Medicaid WTP amounts for control and cure did not differ. Non-Medicaid subjects with verrucae had little QOL impact, no measurable burden by TTO, and a correspondingly low WTP. Medicaid subjects with basal cell carcinoma had a strong, negative QOL impact and high burden by TTO, but had relatively moderate WTP. WTP appears promising in certain income categories. More studies are needed for conclusions about specific diagnoses.

Telemedicine in dermatology during external operations.

PubMed

Morand, J J

2017-11-01

Telemedicine makes it possible to refer clinical, laboratory, and radiological questions to distant experts, sometimes in real time. This study examines a selection of internet messages sent by physicians carrying out overseas missions or assigned to remote locations and analyzes the interest but also the limitations of teleconsultations in dermatology. The effectiveness of the response depended on the quality of the message, including correct symptom descriptions, thorough history-taking, and the definition of the attached images, as well as the field experience of the specialists receiving the message. Feedback is also of fundamental importance in improving remote expert assessment. The main problem is that conclusive diagnosis is often prevented by the lack of equipment and follow-up available in the field, i.e., inability to perform confirmatory testing or obtain sufficient follow-up information to evaluate the outcome of trial treatments. Training of doctors and nurses in the French Army Medical Service in telemedicine and in clearer better structured messages can contribute to the effectiveness of this mode of communication.

Practice management for academic dermatology departments.

PubMed

Eaglstein, W H

2000-09-01

Practice management in the academic medical center (AMC) is different than in other environments. Practice is only a part of the practitioner's mission within an AMC. Practice revenue will be subject to a tax or overhead by both the school and the department. Contract and practice guidelines cannot be tailored to the needs of the dermatology practice, because contracts and guidelines are negotiated globally for all of the practices within the AMC. Personnel, on which the practice depends, may report to hospitals and clinics rather than to the practice's management. Even control of the practice's manager may be diluted by a dual or "dotted line" reporting relationship between the department manager and the school practice manager. Although more constraints exist within the AMC, there are some strategic and operational choices that affect a practice's success. Among these are: (1) selection of services offered; (2) creation of satellites; (3) stimulation of faculty effort; (4) enhancement of faculty billing knowledge; and (5) creation of a "tie" between staff and the practice.

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.

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran

PubMed Central

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-01-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers (P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine (P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients. PMID:28446027

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran.

PubMed

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-10-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine ( P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

Overview of Common Sleep Disorders and Intersection with Dermatologic Conditions.

PubMed

Walia, Harneet K; Mehra, Reena

2016-04-30

Sleep disorders are very common, often under-recognized and therefore undertreated, are associated with a myriad of medical conditions and could lead to significant impairment of quality of life. This review provides an up-to-date synopsis of common sleep disorders encompassing insufficient sleep syndrome, insomnia, circadian rhythm disorders and obstructive sleep apnea with a brief overview of epidemiology, screening, diagnostic testing and treatment. We also emphasize the emerging area of the intersection of sleep disorders and dermatologic conditions and present compelling data regarding underlying mechanisms including sleep dysfunction in relation to disorders of skin inflammation, aging and skin cancer.

Updated recommendations on the use of hydroxychloroquine in dermatologic practice.

PubMed

Fernandez, Anthony P

2017-06-01

Hydroxychloroquine has unique immunomodulatory properties and an attractive adverse effect profile. Over the past 10 years, research has led to significant updates in clinical recommendations concerning the optimal use of hydroxychloroquine and monitoring of patients taking it. We discuss updated recommendations concerning hydroxychloroquine daily dosing, retinopathy screening, serologic monitoring, use in smokers, use in pregnant women, and adverse effect risk and monitoring. This review can hopefully serve as an aid to dermatologists and help ensure they continue using hydroxychloroquine safely and effectively. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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 use of stem cells in aesthetic dermatology and plastic surgery procedures. A compact review of experimental and clinical applications.

PubMed

Nowacki, Maciej; Kloskowski, Tomasz; Pietkun, Katarzyna; Zegarski, Maciej; Pokrywczyńska, Marta; Habib, Samy L; Drewa, Tomasz; Zegarska, Barbara

2017-12-01

The aim of this paper was to collect currently available data related to the use of stem cells in aesthetic dermatology and plastic surgery based on a systemic review of experimental and clinical applications. We found that the use of stem cells is very promising but the current state of art is still not effective. This situation is connected with not fully known mechanisms of cell interactions, possible risks and side effects. We think that there is a big need to create and conduct different studies which could resolve problems of stem cells use for implementation into aesthetic dermatology and plastic surgery.

Dermatological diseases in patients with chronic kidney disease

PubMed Central

Gagnon1, Amy L.; Desai, Tejas

2013-01-01

Context: There are a variety of dermatological diseases that are more commonly seen in patients with chronic kidney disease (CKD) and renal transplants than the general population. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched. Results: Some cutaneous diseases are clearly unique to this population. Of them, Lindsay’s Nails, xerosis cutis, dryness of the skin, nephrogenic systemic fibrosis and acquired perforating dermatosis have been described in chronic kidney disease patients. The most common malignancy found in all transplant recipients is non-melanoma skin cancer. Conclusions: It is important for patients and physicians to recognize the manifestations of skin disease in patients suffering from chronic kidney disease to mitigate the morbidity associated with these conditions. PMID:24475435

TNF-alpha inhibitors in dermatology.

PubMed

Cordoro, K M; Feldman, S R

2007-09-01

To date, the US FDA has approved three tumor necrosis factor (TNF)-a inhibitors for use in dermatology. Etanercept (Enbrel, Amgen-Wyeth), a fully human fusion protein of TNF receptor II bound to the Fc component of human IgG1, is approved for use in psoriasis (2004) and psoriatic arthritis (2002). Infliximab (Remicade, Centocor) is a chimeric monoclonal antibody that is approved for use in psoriasis (2006) and psoriatic arthritis (2005), and adalimumab (Humira, Abbott Laboratories), a fully human monoclonal antibody, is approved for use in psoriatic arthritis (2005). While data regarding the efficacy and safety of these therapies is abundant, it proves nearly impossible to objectively compare and contrast agents as there are no head-to-head trials. Clinical experience and post-marketing reporting has allowed dermatologists to identify the relative strengths and limitations of each agent. The well-founded enthusiasm for these agents, because of their excellent initial efficacy and safety profile, is reasonably tempered by concerns about declining efficacy over time, the risk of infection, lymphoma and demyelinating disorders, and cost. The distinct and targeted mechanism of action of the TNF inhibitors allows dermatologists to customize therapy to match the individual needs and characteristics of patients who are candidates for systemic or phototherapy.

Nutritional clinical studies in dermatology.

PubMed

Liakou, Aikaterini I; Theodorakis, Michael J; Melnik, Bodo C; Pappas, Apostolos; Zouboulis, Christos C

2013-10-01

Nutrition has long been associated with skin health, beauty, integrity and aging through multiple pathways and cofactors implicated in skin biology. The onset and clinical course of various common skin diseases, especially acne, psoriasis, atopic dermatitis, and hair loss, have been suggested to be critically affected by nutrition patterns and habits. The relationship between acne and diet, predominantly the role of high glycemic load diets and dairy consumption have recently gained increased interest. Abnormal nutritional conditions such as obesity or malnutrition often manifest themselves by specific cutaneous features and altered skin function. Skin photoprotection, rendered by various nutrients, is well documented and appropriate nutritional supplementation has been shown to exert beneficial effects upon impaired skin integrity, restore its appearance and promote skin health. It is our intention to provide a comprehensive review of the most recent information on the role of nutrition for common skin diseases and regulation of skin biology. Nutritional clinical studies in dermatology have been reviewed using the MedLine literature source and the terms "diet" or "nutrition" and "skin". The data on the relationship between nutrition and skin are until now controversial and much more work is needed to be done to clarify possible etiological correlations.

Role of dermatology in pharmacogenomics: drug-induced skin injury.

PubMed

Borroni, Riccardo G

2015-01-01

Different individuals may respond diversely to the same drug, in terms of efficacy and toxicity. Adverse drug reactions cause about 6% of all hospital admissions and account for up to 9% of hospitalization costs. Drug-induced skin injury (DISI) is the most common presentation of adverse drug reactions, ranging from maculopapular eruptions to severe adverse cutaneous drug reactions (SCARs) with mortality of up to 40%. Specific genetic polymorphisms confer susceptibility to different types of DISI. Identifying patients genetically at risk for SCARs is one of the goals of pharmacogenomics. In this article, the aspects of clinical dermatology relevant to the pharmacogenetics of DISI are reviewed. Many SCARs are now preventable, with consequent reduction of morbidity, mortality and healthcare costs.

The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial.

PubMed

Arakaki, Ryan Y; Strazzula, Lauren; Woo, Elaine; Kroshinsky, Daniela

2014-10-01

Cellulitis is a common and costly problem, often diagnosed in the outpatient setting. Many cutaneous conditions may clinically mimic cellulitis, but little research has been done to assess the magnitude of the problem. To determine if obtaining dermatology consultations in the outpatient primary care setting could assist in the diagnosis of pseudocellulitic conditions and reduce the rate of unnecessary antibiotic use. Nonblinded randomized clinical trial of competent adults who were diagnosed as having cellulitis by their primary care physicians (PCPs), conducted at outpatient internal medical primary care offices affiliated with a large academic medical center. Outpatient dermatology consultation. Primary outcomes were final diagnosis, antibiotic use, and need for hospitalization. A total of 29 patients (12 male and 17 female) were enrolled for participation in this trial. Nine patients were randomized to continue with PCP management (control group), and 20 patients were randomized to receive a dermatology consultation (treatment group). Of the 20 patients in the dermatology consultation group, 2 (10%) were diagnosed as having cellulitis. In the control group, all 9 patients were diagnosed as having cellulitis by PCPs, but dermatologist evaluation determined that 6 (67%) of these patients had a psuedocellulitis rather than true infection. All 9 patients (100%) in the control group were treated for cellulitis with antibiotics vs 2 patients (10%) in the treatment group (P < .001). One patient in the control group was hospitalized. All patients in the treatment group reported improvement of their cutaneous condition at the 1-week follow-up examination. Dermatology consultation in the primary care setting improves the diagnostic accuracy of suspected cellulitis and decreases unnecessary antibiotic use in patients with pseudocellulitic conditions. Obtaining an outpatient dermatology consultation may be a cost-effective strategy that improves quality of care

Comparison of quality of life among cardiac, hepatic, cancer, and dermatological patients.

PubMed

Dogar, Imtiaz Ahmad; Haider, Nighat; Ahmad, Maqsood; Naseem, Shazia; Bajwa, Asma

2012-03-01

To assess the level of quality of life (QOL) in patients suffering from various cardiac, cancer, hepatic, and dermatological diseases. A total of 339 patients of cardiac, cancer, hepatic, and dermatological diseases from DHQ/Allied hospitals of Faisalabad participated in this study through purposive convenient sampling technique. Quality of life was measured by WHO QOL-BREF (Validated Urdu Version) while demographic variables were recorded on a demographic sheet. The results were obtained by using analysis of variance (ANOVA) on SPSS 13. Out of 339, 156 (46%) patients were males while 183 (54%) patients were females. Of the total, 99 (29.2%) belonged to the lower socio economic status, 113 (33.3%) belonged to the lower middle, 62 (18.3%) belonged to the middle, and 65 (19.2%) belonged to the upper middle socio economic status. In terms of education, 49 (14.5%) were illiterate, 110 (32.3%) had primary level education, 118 (34.8%) had middle level education, 21 (6.2%) had done matriculation, 17 (5%) had intermediate, 14 (4.1%) were graduates, 8 (2.4%) had done masters. Of the whole lot, only 2 (0.6%) patients were professionals. Results showed that the quality of life was most deteriorated in the domain of physical health; while psychological health was the second most deteriorated domain. Social relationship was the least affected domain, while environment was the second least affected area. Quality of life of hepatic patients was significantly lower than dermatological patients with respect to physical health and environment, lower than cancer patients in relation to psychological health, and lower than cardiac patients in the social relationship domain. The quality of life of cardiac patients was noted to be significantly higher than the other three categories in the domains of psychological health and environment. In the face of the evidence of high deterioration in the quality of life of the patients in terms of physical and psychological health, medical units

Median dermatology base incomes in senior academia and practice are comparable, but a significant income gap exists at junior levels.

PubMed

Tierney, Emily; Kimball, Alexa Boer

2006-08-01

The perception that dermatologists in practice have substantially higher incomes than in academics is often cited as the primary reason people choose to practice outside academic institutions. We sought to compare the incomes of dermatologists in academics versus various practice settings. Data from various surveys of dermatologists from 2002 to 2004 were adjusted for annual inflation to the year 2004 and compared. Benefits and bonuses were not included. The income level of clinical instructors, who are 7.0% of all academic dermatology faculty, were not available for inclusion. Median dermatology faculty income (combined average of assistant, associate, and professor levels) was 192,267 dollars, 12.0% less than the median practice income of 215,303 dollars. There was substantial variation across regions, institutions, and types of nonacademic practice. Median starting incomes for dermatology residency graduates were comparable in practice across multiple data sources (182,116 dollars-200,000 dollars) and private universities (189,336 dollars); however, both were significantly higher than median starting incomes in public universities (83,349 dollars). This study relied on self-reported data. Although all attempts were made to use comparable information, variances in how data were collected and classified may exist. Initial income for those entering practice is equivalent to those entering academia in private universities; however, incomes for both of these groups are 2- to 3-fold higher than those entering academia in public universities. This discrepancy may discourage some recent trainees, some of whom have high debt and high expenses, from entering the field of academic dermatology. Because incomes in academia increase predictably with increasing rank, overall self-reported incomes for established dermatologists in practice and senior academia are comparable.

'Eczema school' to improve compliance in an occupational dermatology clinic.

PubMed

Kalimo, K; Kautiainen, H; Niskanen, T; Niemi, L

1999-12-01

From the beginning of 1990 a trained nurse has been employed at our Department of Dermatology to give information about skin care, allergen avoidance and skin protection to the patients. To find out the possible benefit obtained by this patient education, a questionnaire was sent out to 540 patients who had been diagnosed with an occupational skin disease established at the Department of Dermatology between 1985 and 1992. It is evident that direct comparison in this kind of longitudinal follow-up must be carried out with great criticism, since changes in patients' work exposure and socioeconomical situation during the follow-up time will also affect the prognosis. In this study, 424 patients returned the questionnaire, 252 who had been examined before 1990 and 172 later. According to the answers, it appeared that during the last 12 months, the majority (65%) had suffered from dermatitis, 13% from constant and 52% from periodic symptoms. However, when the diagnosis had been irritant contact dermatitis without allergens found, the prognosis was significantly better (p<0.008) among those who had received "extra education" and none had persistent dermatitis. Patients with contact allergy to metals or synthetic resins had also managed better, as compared to those who had received traditional treatment (p<0.002, p<0.003). Other factors such as personal motivation and possibilities for work reorganization were also important for the prognosis. 60% of patients were not initially aware of the decision given by the insurance companies, although 94% of their skin diseases had been accepted as occupational dermatoses. Generally, the patients were satisfied with the extra information given by the nurse.

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.

The use of stem cells in aesthetic dermatology and plastic surgery procedures. A compact review of experimental and clinical applications

PubMed Central

Nowacki, Maciej; Kloskowski, Tomasz; Pietkun, Katarzyna; Zegarski, Maciej; Pokrywczyńska, Marta; Habib, Samy L.; Drewa, Tomasz

2017-01-01

The aim of this paper was to collect currently available data related to the use of stem cells in aesthetic dermatology and plastic surgery based on a systemic review of experimental and clinical applications. We found that the use of stem cells is very promising but the current state of art is still not effective. This situation is connected with not fully known mechanisms of cell interactions, possible risks and side effects. We think that there is a big need to create and conduct different studies which could resolve problems of stem cells use for implementation into aesthetic dermatology and plastic surgery. PMID:29422816

Maintenance of Certification in dermatology: requirements for diplomates.

PubMed

Stratman, Erik; Kirsner, Robert S; Horn, Thomas D

2013-07-01

Since 2006, after completing a cognitive certifying or recertifying examination, dermatologists are automatically enrolled into Maintenance of Certification (MOC) and can access a personalized electronic table (at www.abderm.org) that presents the requirements over the 10-year cycle. On this web site, diplomates can also pay the annual fee and attest to completion of the various components. Clicking on hyperlinks in the table launches explanations of the requirements. A hyperlink below the table takes the reader to the various resources approved for completion of the MOC requirements. There is a login tab in the upper left corner with a login help feature below. Clicking on the MOC tab will bring up the table. The timeline is specific to the individual. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Dermatologic radiotherapy and thyroid cancer. Dose measurements and risk quantification.

PubMed

Goldschmidt, H; Gorson, R O; Lassen, M

1983-05-01

Thyroid doses for various dermatologic radiation techniques were measured with thermoluminescent dosimeters and ionization rate meters in an Alderson-Rando anthropomorphic phantom. The effects of changes in radiation quality and of the use or nonuse of treatment cones and thyroid shields were evaluated in detail. The results indicate that the potential risk of radiogenic thyroid cancer is very small when proper radiation protection measures are used. The probability of radiogenic thyroid cancer developing and the potential mortality risk were assessed quantitatively for each measurement. The quantification of radiation risks allows comparisons with risks of other therapeutic modalities and the common hazards of daily life.

Variability of pulsed energy outputs from three dermatology lasers during multiple simulated treatments.

PubMed

Britton, Jason

2018-01-20

Dermatology laser treatments are undertaken at regional departments using lasers of different powers and wavelengths. In order to achieve good outcomes, there needs to be good consistency of laser output across different weeks as it is custom and practice to break down the treatments into individual fractions. Departments will also collect information from test patches to help decide on the most appropriate treatment parameters for individual patients. The objective of these experiments is to assess the variability of the energy outputs from a small number of lasers across multiple weeks at realistic parameters. The energy outputs from 3 lasers were measured at realistic treatment parameters using a thermopile detector across a period of 6 weeks. All lasers fired in single-pulse mode demonstrated good repeatability of energy output. In spite of one of the lasers being scheduled for a dye canister change in the next 2 weeks, there was good energy matching between the two devices with only a 4%-5% variation in measured energies. Based on the results presented, clinical outcomes should not be influenced by variability in the energy outputs of the dermatology lasers used as part of the treatment procedure. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Nickel levels in female dermatological patients].

PubMed

Schwegler, U; Twardella, D; Fedorov, M; Darsow, U; Schaller, K-H; Habernegg, R; Behrendt, H; Fromme, H

2009-07-01

Nickel levels in urine were determined among 163 female dermatological patients aged 18 to 46 years. Data on life-style factors were collected in parallel via a questionnaire. Urinary nickel excretion was in the normal range of the German female population (0.2-46.1 microg Ni/g creatinine). The 95th percentile (3.9 microg Ni/l urine) exceeded the German reference value (3.0 microg Ni/l urine). In the multivariate regression analyses we found a statistically significant increase of ln-transformed nickel levels with increase in age and in women using dietary supplements. The following variables were not associated with Nickel urine levels: suffering from nickel eczema, smoking, drinking stagnated water, eating foods with high nickel contents and using nickel-containing kitchen utensils as, for example, an electric kettle with an open heater coil. We conclude that personal urinary levels should be assessed with simultaneous consideration of habits and life-style factors. A German national survery would be useful. Those patients who experience the exacerbation of their eczema in cases of oral provocation, for example, by a high nickel diet should be aware of potential sources of nickel, such as supplements.