Objectives:To identify the dermatological system drugs that may be prescribed by Chinese dermatological nurses through expert consensus.Methods:A 2-round study,consisting of 32 medical and nursing exper ts,was conduct...Objectives:To identify the dermatological system drugs that may be prescribed by Chinese dermatological nurses through expert consensus.Methods:A 2-round study,consisting of 32 medical and nursing exper ts,was conducted using the Delphi method from September 2019 to June 2020.Microsoft Excel 2019 and IBM SPSS Ver.22 were used to analyze the results of the consultations.Results:A total of 63 drugs across 13 categories were identified as relevant to Chinese nurses working in dermatological departments.Among these drugs,1 drug was generally prescribed independently,17 drugs tended to be prescribed collaboratively,and 45 were prescribed either independently or in collaboration with others.Conclusions:This exper t consensus determines the prescription drugs that may be prescribed by dermatology nurses in China,which can be used as the key content of prescription drug training for dermatology nurses in future.The results of the study could provide a basis for the implementation of nurses'prescription rights in China in future and provide a reference for the formulation of relevant legislation on nurses'prescription rights.展开更多
Introduction: Autoimmune diseases are characterized by a very large clinical polymorphism that can lead to a diagnostic wandering. So, we aimed to determine their epidemiological profile outside the context of Dakar (...Introduction: Autoimmune diseases are characterized by a very large clinical polymorphism that can lead to a diagnostic wandering. So, we aimed to determine their epidemiological profile outside the context of Dakar (capital of Senegal) where the technical plateau is more elevated. Methodology: We conducted a retrospective descriptive and observational study from January 1, 2007 to December 31, 2017. All patients admitted or followed in outpatient in the Internal Medicine departments of the Saint Jean de Dieu and Regional Hospitals of Thiès as well as in the dermatology department of the CHRT (Regional Hospital Center of Thiès), and who met the MAI criteria (autoimmune diseases) have been included. The data were collected on a standardised sheet and analysed by EPI INFO version 7.2. Results: A total of 121 patients were included out of 25951 records i.e a prevalence of 0.46% in internal medicine departments. In dermatology, out of 31973 patients, 95 had MAIS (systemic autoimmune diseases): 0.29% as hospital prevalence. The average age was 40.7 years in internal medicine departments compared to 37.66 years 14.8 years in the dermatology department. Patients aged 30 to 59 years represented 57.89% of the study population. The sex ratio (H/F) was 0.3 in the internal medicine departments compared to 0.17 in the dermatology department. Circumstances of discovery were incidental in 16.52% and clinical in 3.30%. Biermer disease accounted for 29.75% of organ-specific MAI. Concerning systemic presentations, rheumatoid arthritis (RA) was present in 23.14%. Lupus was more representative in dermatology (65.2%) as well as systemic scleroderma (21%), dermatomyositis (6.3%). Cytopenia was found in 105 patients, showing in detail anemia (42.9%);leukopenia (14.8%);thrombocytopenia (2.4%). Autoantibodies were tested in 58 patients (47.9%). Skin histology was contributory in all cases of systemic scleroderma and in 5 cases of lupus. The main therapy prescribed was corticosteroid therapy alone or in combination with an immunosuppressant. Conclusion: In addition of infectious diseases, Subsaharan Africa is under the era of changing face of its epidemiology, and cardiovascular diseases shows signs of emergence, like auto-immune presentations. However, the difficult apprehension of these so subtle last diseases suggests that they are few reported. Technical tools in regions should be enhanced associated to a non-binding capacity building system targeting such diseases with an emphasis on good record keeping.展开更多
In the civilian dermatological setting, the top 5 skin diseases usually seen are eczema/dermatitis, acne, benign skin tumors, viral infections and pigmentary disorders. In comparison, the top 5 skin conditions encount...In the civilian dermatological setting, the top 5 skin diseases usually seen are eczema/dermatitis, acne, benign skin tumors, viral infections and pigmentary disorders. In comparison, the top 5 skin conditions encountered in the military sector are usually fungal infections, eczema/dermatitis, insect bite reactions, bacterial infections and acne. This is not surprising as military personnel, due to the special environment and vocations they are in, are prone to getting eczema as heat, sweating and wearing of the military uniform aggravate the condition. Fungal infections are common in those who wear the army boots. Insect bite reactions are not an uncommon sight among those who have to go to the jungle regularly for outfield training. Grass allergy or intolerance, contact dermatitis or acneiform eruption due to the application of military camouflage cream on the face, contact dermatitis to insect repellents, and military uniform allergy and intolerance are amongst the commonest dermatological problems encountered in the military field, and physicians should recognize them, investigate and manage these problems accordingly. Lastly, a diagnosis not to be missed in the military field is cutaneous melioidosis, especially when a military personnel presents with a non-healing ulcer.展开更多
Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-y...Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-year retrospective study on patients with dermatological conditions presenting to the Princess Alexandra Hospital ED in Brisbane, Australia was performed. Electronic medical records were used to compare demographics and admission status of the dermatology group and the total ED group presentations. A prospective survey was conducted on low priority triage (triage 4 and 5) patients identifying reasons presenting to the ED. RESULTS: Of a total 281,718 ED presentations, 11,748 dermatology presentations were identified between January 2012 to December 2016. Of the dermatology presentations, 41.5% were female and had an average age of 47. The most common dermatology presentations were cellulitis, abscess, rash unspecified, and ulcer. Of those admitted, 36% were female, average age was 53, mean length of stay of 294 minutes and 83.1% had an infectious aetiology. Of triage 4 and 5 presentations, 66% patients we approached had been seen by a health practitioner prior to coming to the ED. CONCLUSION: Within the population presenting with a skin related condition to the Princess Alexandra Hospital ED, characteristics associated with admission include male sex, older age, and an infectious etiology. This data may help ED clinicians decide on the discharge disposition of these patients. There may be a role for streamlined admissions for skin related infections, or improved hospital in the home services to support this group.展开更多
Introduction: Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse reaction to drugs whose manifestation affect the skin and mucous membranes whose outcomes may be life threatening and fatal...Introduction: Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse reaction to drugs whose manifestation affect the skin and mucous membranes whose outcomes may be life threatening and fatal. Supportive management has been proven to be the mainstay with well executed nursing care resulting in quality clinical outcomes. The aim was to evaluate the nursing care interventions in management of patients with SJS/TEN in the dermatology unit. Methods: Qualitative design was used, data were collected through observation of nursing care activities, informant interviews and focus group discussion with the nurses. Qualitative data were recorded in audio tapes and transcribed. Qualitative content analysis was used for the analysis of the transcribed texts. Study was approved by KNH/ERC and informed written consent from participants. Funding was obtained from KNH through the Research and Programs department. Findings: 20 nurses participated in the study. The commonest nursing care interventions were described as routine tasks initiated at clinical diagnosis and routinely performed. They include aggressive skin care, wound care, mucosal and eye care, infection surveillance and prevention practices and general patient monitoring for complications. Skin and wound care were most challenging part of nursing care due to severe erosion or exfoliation. Nurses do not use any specific guidelines of care but consider their role a key in quality outcomes for patients with SJS/TEN in this hospital.展开更多
Background: Textbook conferences are widely used by dermatology residency programs in the United States to provide educational exposure to the specialty. Typically an entire textbook is reviewed each academic year. Ho...Background: Textbook conferences are widely used by dermatology residency programs in the United States to provide educational exposure to the specialty. Typically an entire textbook is reviewed each academic year. However, residents may be uncertain about mastery of the assigned readings. Since most dermatology textbooks do not provide questions about the material presented at the end of each chapter, an innovative senior resident from our program wrote questions about each chapter and offered them to the other residents prior to scheduled discussions of the assigned materials. Methods: A pilot study for resident generated quizzes about assigned textbook reading in general dermatology was developed, implemented, and assessed by anonymous completion of a Likert Scale by participants. Results: Participants indicated that quizzes better prepared them for the annual dermatology in-service examination and they thought that the additional creation of quiz materials in the subspecialty areas of dermatopathology and dermatologic surgery would be useful. Conclusion: Resident generated quizzes are a novel approach to the learning environment during dermatology residency for residency programs and may be useful for other residency programs that utilize textbook conferences. Additional research is needed.展开更多
Background: Evidence indicating the limited amount of hands-on experience in the current era of medical training has raised concern regarding students’ development and potential deficiencies in the performance of bas...Background: Evidence indicating the limited amount of hands-on experience in the current era of medical training has raised concern regarding students’ development and potential deficiencies in the performance of basic procedural skills. Studies have demonstrated the value of surgical workshops for medical students;however evaluation of improved student performance during future clerkships or residencies has yet to be assessed. We initiated and evaluated a resident-led surgical skills workshop for students through the Department of Dermatology. Methods: Participants received instructions on surgical tools/techniques followed by hands-on practice. Anonymous surveys administered to 24 medical and physician assistant students assessed their skill level, confidence level, and likelihood of using surgical skills in future practice preand post-workshop using a 1 - 5 Likert scale. Overall experience was also assessed. Non-parametric bivariate tests were used for analysis to account for non-normal distribution of the data. Results: There was a statistically significant change in skill (p = 0.0001) and confidence (p = 0.0001) level post workshop. There was no significant difference in utility. There were also no statistically significant differences based on the year of medical student training, medical student versus physician assistant student responses, or number of procedures performed prior to the workshop. Estimated cost per participant was $5.65. Conclusions: Research supports our finding that workshop learning experiences increase students’ ability to perform common procedural skills, their confidence, and desire to practice such skills. Further studies are necessary to determine the impact of these skills workshops on long-term clinical performance in future clerkships and residencies.展开更多
In the current era, information technology has boosted every field of life either business industry or healthcare to integrate the internal processes of it. Due to the demand of managing huge data related to these fie...In the current era, information technology has boosted every field of life either business industry or healthcare to integrate the internal processes of it. Due to the demand of managing huge data related to these fields numerous information systems play different roles in making the organizational processes robust and up to date. This paper discusses the integrated business intelligence implication specifically for healthcare to provide the fast and precise information on time. Therefore, this paper discusses the idea of building intelligent system based on Enterprise Resource Planning (ERP) databases using exclusively for dermatology diseases by applying data mining techniques. Firstly, classification mining has been applied for categorization data based on patient’s record. Then rules and patterns generated from the categorized data related to dermatology diseases, symptoms and treatments. The proposed system will retrieve the corresponding information related to the given symptoms along with medication and complete treatment. This research aims to integrate different ERP processes with centralized ERP database to provide business intelligence effectively for the dermatologists. The paper has provided with the comprehensive conceptual framework and each step has been discussed in detail.展开更多
Background: Traditional models for teaching surgical principles focus primarily on the apprenticeship theory;however there has been a trend in surgical education to certifying competency in a simulation environment pr...Background: Traditional models for teaching surgical principles focus primarily on the apprenticeship theory;however there has been a trend in surgical education to certifying competency in a simulation environment prior to working with patients. Many surgical models emphasize learning the technical and manual dexterity skills necessary to be a surgeon, yet few focus on obtaining the theoretical and abstract skills needed for planning complex cutaneous surgical repairs with flaps and grafts. We developed and evaluated a novel surgical flaps and grafts workshop for residents through the Department of Dermatology. Methods: Participants received a 60 minute PowerPoint lecture focusing on the basic principles of cutaneous repair with flaps and grafts, with examples and explanation of each of the four main types of flaps and grafts. The participants then received nine photocopies of Mohs micrographic surgery defects with instructions to design three repairs, focusing on functional and aesthetic outcome. Hypothetical and actual repair designs were then discussed in an open forum format. Anonymous surveys administered to 11 dermatology residents assessed their knowledge level, confidence level, and likelihood of using flaps and grafts pre- and post-workshop using Likert scales. Overall experience was also assessed. A paired sample Wilcoxon Signed Rank Test was used for analysis, since the data was non-parametrically distributed. Results: There was a statistically significant increase in confidence performing flaps post workshop (p = 0.0469). There was also an increase in knowledge of flaps and grafts, confidence in planning flaps and grafts, and confidence in performing grafts post workshop, but these findings did not reach statistical significance. The workshop had no effect on expected future use of flaps and grafts. Conclusions: The surgical workshop is a novel simulation teaching tool for learning basic principles and design of flaps and grafts in cutaneous surgery.展开更多
Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reporte...Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reported improvements in inflammatory skin conditions in individuals treated with FMT,but larger studies are needed to clarify this possible relationship between the skin and the gut microbiome.We conducted a single-center,retrospective chart review to assess changes in acne,dermatitis herpetiformis and/or celiac disease,eczema,and psoriasis.Due to the retrospective nature of this study and the limitations of the current electronic medical record,we were unable to adequately assess cases of these diseases in relation to FMT.However,this study informs us that improvements in retrospective data are needed to formally evaluate this possible association.The better,but more cumbersome,study design would be a prospective,observational study.We encourage others to pursue further interdepartmental research on the influence of the gut microbiome on inflammatory skin diseases.展开更多
Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded ...Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded with the inappropriate and irrational use of medicines. Therefore, periodic prescription audit in the form of prescribing patterns is away to improve irrational prescription. The objective of this study to assess the prescription patterns of dermatological agents in Borumeda hospital. Method: Hospital based retrospective cross sectional study in which prescribing patterns of dermatological agents are assessed. A total of 385 samples of patient record prescription from November/1/2016 to December/30/2016, and the sample were selected by systematic random sampling technique. Sample prescriptions were reviewed using structural data collection format. The Collected data was analyzed by using SPSS version 20. Result: Regarding rout of administration, the maximum number of drugs was prescribed topically (66.2%). Topical steroids were the most commonly prescribed drugs (25.3%). Use of generic prescribing in single drug prescribing was 81.7%. The prevalence of atopic dermatitis was higher (26.3%, 20.8%) in both male and female respectively followed by scabies in male with 12.2% and Acne vulgaris (12.9%) in female. Number of drugs per prescription was higher (2.46) than WHO standard (Conclusion: The current study reveals that topical corticosteroids were commonly prescribed drugs in the dermatology unit and the prescribing practice imitates incidence of polypharmacy.展开更多
Transdermal drug delivery systems(TDDs)have the advantages on good local targeting,controlled and sustainable drug delivery.Hoewever,the stratum corneum,as the main skin barrier,severely limits the transdermal penetra...Transdermal drug delivery systems(TDDs)have the advantages on good local targeting,controlled and sustainable drug delivery.Hoewever,the stratum corneum,as the main skin barrier,severely limits the transdermal penetration of drugs and reduces bioavailability,which also limits their application.Microneedles(MNS)penetrate the stratum corneum and create several reversible microchannels in a minimally invasive manner to significantly improve the penetration of therapeutic agents,and are considered a milestone for effective transdermal drug delivery.As an emerging drug delivery modality,microneedle transdermal drug delivery systems have the advantages of being minimally invasive,safe,efficient,economical and convenient.In addition to the extensive research on microneedles for improving transdermal drug delivery,there is a growing interest in using them to manage and treat dermatological conditions.Being the largest organ in the human body,the skin acts as a barrier between the body and the external environment,while having an immense influence on appearance and self-confidence.Indeed,there is now a considerable body of evidence on how dermatological conditions can lead to psychological problems and a reduced quality of life.The utilisation of microneedle transdermal drug delivery systems for the management and treatment of dermatological conditions is of great therapeutic and commercial value.The principleof microneedle transdermal drug delivery systems and the progress of its clinical application in dermatology are reviewed here.展开更多
BACKGROUND Cervical necrotizing fasciitis(CNF)is a rare,aggressive form of deep neck space infection with significant morbidity and mortality rates.Serial surgical debridement acts as the cornerstone of CNF treatment;...BACKGROUND Cervical necrotizing fasciitis(CNF)is a rare,aggressive form of deep neck space infection with significant morbidity and mortality rates.Serial surgical debridement acts as the cornerstone of CNF treatment;however,it often results in defects requiring complex reconstructions.CASE SUMMARY We report two cases in which the keystone flap(KF)was used for CNF defect coverage:Case 1,an 85-year-old patient with CNF in the anterior neck,and Case 2,a 54-year-old patient with CNF in the posterior neck.Both patients received empirical intravenous antibiotic therapy and underwent serial debridement,enabling adequate wound preparation and stabilization.The final defect size measured 5.5 cm×12 cm in Case 1 and 6 cm×11 cm in Case 2.For defect coverage,we employed an 8 cm×19 cm type II KF based on perforators from the superior thyroid artery in Case 1 and a 9 cm×18 cm type II KF based on perforators from the transverse cervical artery in Case 2.Both flaps showed complete survival.No postoperative complications occurred in both cases,and favorable outcomes were observed at 7-and 6-month follow-ups in case 1 and 2,respectively.CONCLUSION We effectively treated CNF-associated defects using the KF technique;KF is viable for covering CNF defects in carefully selected cases.展开更多
After more than 60 years of development,artificial intelligence(AI)has been widely used in various fields.Especially in recent years,with the development of deep learning,AI has made many remarkable achievements in th...After more than 60 years of development,artificial intelligence(AI)has been widely used in various fields.Especially in recent years,with the development of deep learning,AI has made many remarkable achievements in the medical field.Dermatology,as a clinical discipline with morphology as its main feature,is particularly suitable for the development of AI.The rapid development of skin imaging technology has helped dermatologists to assist in the diagnosis of diseases and has greatly improved the accuracy of diagnosis.Skin imaging data have natural big data attributes,which is important for AI research.The establishment of the Chinese Skin Image Database(CSID)has solved many problems such as isolated data islands and inconsistent data quality.Based on the CSID,many pioneering achievements have been made in the research and development of AI-assisted decision-making software,the establishment of expert organizations,personnel training,scientific research,and so on.At present,there are still many problems with AI in the field of dermatology,such as clinical validation,medical device licensing,interdisciplinary,and standard formulation,which urgently need to be solved by joint efforts of all parties.展开更多
Platelet-rich fibrin(PRF)is a second-generation platelet concentrate obtained from autologous blood.PRF is composed of abundant platelets,leucocytes,and a high concentration of various growth factors and fibrinogen.Th...Platelet-rich fibrin(PRF)is a second-generation platelet concentrate obtained from autologous blood.PRF is composed of abundant platelets,leucocytes,and a high concentration of various growth factors and fibrinogen.The composition and three-dimensional structure of PRF enable it to effectively make cells migrate and proliferate,playing an important role in tissue repair.Furthermore,the easy preparation and low cost of PRF make it a good treatment option.Numerous articles have been published about the application of PRF in clinical practice,however,the application of PRF in dermatology has not been comprehensively reviewed.The objective of this review article was to discuss various applications of PRF in dermatology,including healing chronic wounds,treating androgenic alopecia,skin rejuvenation,autologous fat transplantation,and treating vitiligo.PRF is a promising dermatologic treatment,but lacks a standardized protocol regarding its methods of attainment and use,which needs more investigations.展开更多
Dr.Gtinter Burg from University of Zuerich,Dr.Anil Kumar Jha from Nepal Medical College Teaching Hospital,Dr.Mao—Qiang Man from Veterans Affairs Medical Center and University of California San Francisco,and Dr.Xiaole...Dr.Gtinter Burg from University of Zuerich,Dr.Anil Kumar Jha from Nepal Medical College Teaching Hospital,Dr.Mao—Qiang Man from Veterans Affairs Medical Center and University of California San Francisco,and Dr.Xiaolei Ding from Cologne University,were formally invited and agreed tojoin the editorial board of theInternational Journal ofDermatology and Venereology.The Journal is honored to have the four scholars as boardmembers and is looking forward to cooperation with them in promoting the development of the Journal.展开更多
Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL fre...Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL frequently involves examining how disease exerts a detrimental impact, diminishing the enjoyment and fulfilment experienced by the individual. Dermatological diseases have been found to exert a substantial negative influence on the QoL of dogs and their owners due to nuisance and stress related to the disease but also due to the caregiver burden. In the management of bacterial skin infections, topical therapy is commonly administered alongside systemic antibiotics. Nonetheless, the protracted duration of treatment and difficulties in ensuring owner compliance can introduce a significant caregiver burden, potentially exacerbating the challenges associated with these conditions. Purpose: This study aimed to evaluate the impact on the quality of life (QoL) of dogs with dermatologic diseases after fluorescent light energy (FLE) treatment. Methods: The study was an open, prospective, multicentric clinical trial that included dogs with various dermatological conditions. The dogs received FLE treatment once weekly until the clinical resolution was achieved. Owners completed a validated questionnaire to assess the QoL of their dogs before and after therapy. Results: Thirty-five dogs with deep pyoderma, interdigital furunculosis, pyotraumatic dermatitis, wounds and perianal fistulas were included. All dogs received two sessions of fluorescent light energy once a week. Median treatment duration was 9 weeks for perianal fistula, 7 weeks for interdigital furunculosis, 5 weeks for deep pyoderma, 3 weeks for wounds and 1.5 weeks for pyotraumatic dermatitis. Complete remission was noted in 86% of dogs, and 14% showed an improvement but partial remission. The majority of owners reported a positive impact on their dogs’ QoL after therapy, and 74% of the dogs showed at least a 50% reduction in QoL scores. Conclusion: Fluorescent light energy has been shown to exert beneficial effects on the healing of dermatological diseases and the quality of life (QoL) in dogs and their owners, whether used as a standalone treatment or in combination with standard care therapies. Additionally, it was well-tolerated by the dogs. This study emphasizes the significance of considering both the owner’s and dog’s QoL when evaluating the therapeutic efficacy of dermatological treatments.展开更多
BACKGROUND Basal cell carcinoma(BCC)is a slow-growing malignant tumor characterized by local invasiveness but an exceptionally rare metastatic potential.It ideally affects sun-exposed skin of older patients with more ...BACKGROUND Basal cell carcinoma(BCC)is a slow-growing malignant tumor characterized by local invasiveness but an exceptionally rare metastatic potential.It ideally affects sun-exposed skin of older patients with more propensity for the facial region.AIM To evaluate the different clinicopathological characteristics of the facial BCC and the efficacy and safety of diode laser for the treatment of these lesions.METHODS We retrospectively reviewed facial BCC lesions of<1.5 cm in diameter and subjected them to diode laser ablation during the period from September 2016 to August 2021 at Al-Ramadi Teaching Hospital,Ramadi City,Iraq.Data matching the age,gender,duration,site,and clinical and histological types were registered for every subject.The functional and aesthetic outcomes and complications following diode laser ablation for each patient were also recorded.RESULTS Of 67 patients with facial BCC,there was 65.67%from the age group≥60 years and 58.21%males.The mean duration of the lesions was 5.15±1.836 mo.The most involved location was the nose(29.85%).About half of the cases belong to the noduloulcerative type.Solid histological type comprises 40.3%of the cases,while the least was keratotic(13.4%).Moreover,65.2%of the solid cases were from the age group≤60 years and 38.6%of the adenoid type from the age group>60 years(P value=0.007).Excellent aesthetic and functional outcomes were reported in all cases after 6 mo of follow-up.Few complications were reported after diode laser ablation.CONCLUSION Facial BCC was mostly seen in the elderly and men.The mean duration was 5.15 mo.The nose was the commonest involved site.Noduloulcerative lesions were seen in approximately half of the lesions.The age of the patients determined the histological type of the lesion(solid type was mostly seen in the age group≤60 years,while,adenoid in the age group>60 years).Diode laser ablation showed excellent functional and aesthetic outcomes following a 6-mo follow-up.展开更多
The gut microbiome is an emerging area of interest in medicine. Imbalances in the gut microbiome have been linked to a number of disease states such as obesity and type 2 diabetes. The relationship between normally re...The gut microbiome is an emerging area of interest in medicine. Imbalances in the gut microbiome have been linked to a number of disease states such as obesity and type 2 diabetes. The relationship between normally residing intestinal bacteria(the gut microbiota) and their potential role in the pathogenesis of skin diseases is an area of research for which we are only beginning to understand. Small studies have demonstrated underlying changes in the gut microbiome of patients with certain dermatological diseases. Interestingly, studies suggest that probiotics may have a role in the treatment of atopic dermatitis. However, the concept of the "skin-gut axis" is a newly emerging and important avenue of investigation, still lacking in pathobiological explanations. This review will introduce and describe the intestinal microbiome as it relates to skin health in a complex communication network between the immune system, endocrine system, metabolic system, and nervous system.展开更多
The creeping verminous dermatitis or cutaneous larva migrans is a parasitosis caused by percutaneous penetration and migration of larval nematode parasites characterized by producing one or more serpiginous erythemato...The creeping verminous dermatitis or cutaneous larva migrans is a parasitosis caused by percutaneous penetration and migration of larval nematode parasites characterized by producing one or more serpiginous erythematous,indurated,raised and pruritic lesion.The most common cause of cutaneous larva migrans is the Ancytostoma braziliensc located in warm climate zones.In the present study,authors reported a case of cutaneous larva migrans with a characteristic clinical picture:erythematous-papnlar and vesicular lesion and serpiginous path,with progressive,and pruritic growth and it shown that a living area with immigration,tropical weather conditions and poverty may lead to this common infection.展开更多
文摘Objectives:To identify the dermatological system drugs that may be prescribed by Chinese dermatological nurses through expert consensus.Methods:A 2-round study,consisting of 32 medical and nursing exper ts,was conducted using the Delphi method from September 2019 to June 2020.Microsoft Excel 2019 and IBM SPSS Ver.22 were used to analyze the results of the consultations.Results:A total of 63 drugs across 13 categories were identified as relevant to Chinese nurses working in dermatological departments.Among these drugs,1 drug was generally prescribed independently,17 drugs tended to be prescribed collaboratively,and 45 were prescribed either independently or in collaboration with others.Conclusions:This exper t consensus determines the prescription drugs that may be prescribed by dermatology nurses in China,which can be used as the key content of prescription drug training for dermatology nurses in future.The results of the study could provide a basis for the implementation of nurses'prescription rights in China in future and provide a reference for the formulation of relevant legislation on nurses'prescription rights.
文摘Introduction: Autoimmune diseases are characterized by a very large clinical polymorphism that can lead to a diagnostic wandering. So, we aimed to determine their epidemiological profile outside the context of Dakar (capital of Senegal) where the technical plateau is more elevated. Methodology: We conducted a retrospective descriptive and observational study from January 1, 2007 to December 31, 2017. All patients admitted or followed in outpatient in the Internal Medicine departments of the Saint Jean de Dieu and Regional Hospitals of Thiès as well as in the dermatology department of the CHRT (Regional Hospital Center of Thiès), and who met the MAI criteria (autoimmune diseases) have been included. The data were collected on a standardised sheet and analysed by EPI INFO version 7.2. Results: A total of 121 patients were included out of 25951 records i.e a prevalence of 0.46% in internal medicine departments. In dermatology, out of 31973 patients, 95 had MAIS (systemic autoimmune diseases): 0.29% as hospital prevalence. The average age was 40.7 years in internal medicine departments compared to 37.66 years 14.8 years in the dermatology department. Patients aged 30 to 59 years represented 57.89% of the study population. The sex ratio (H/F) was 0.3 in the internal medicine departments compared to 0.17 in the dermatology department. Circumstances of discovery were incidental in 16.52% and clinical in 3.30%. Biermer disease accounted for 29.75% of organ-specific MAI. Concerning systemic presentations, rheumatoid arthritis (RA) was present in 23.14%. Lupus was more representative in dermatology (65.2%) as well as systemic scleroderma (21%), dermatomyositis (6.3%). Cytopenia was found in 105 patients, showing in detail anemia (42.9%);leukopenia (14.8%);thrombocytopenia (2.4%). Autoantibodies were tested in 58 patients (47.9%). Skin histology was contributory in all cases of systemic scleroderma and in 5 cases of lupus. The main therapy prescribed was corticosteroid therapy alone or in combination with an immunosuppressant. Conclusion: In addition of infectious diseases, Subsaharan Africa is under the era of changing face of its epidemiology, and cardiovascular diseases shows signs of emergence, like auto-immune presentations. However, the difficult apprehension of these so subtle last diseases suggests that they are few reported. Technical tools in regions should be enhanced associated to a non-binding capacity building system targeting such diseases with an emphasis on good record keeping.
文摘In the civilian dermatological setting, the top 5 skin diseases usually seen are eczema/dermatitis, acne, benign skin tumors, viral infections and pigmentary disorders. In comparison, the top 5 skin conditions encountered in the military sector are usually fungal infections, eczema/dermatitis, insect bite reactions, bacterial infections and acne. This is not surprising as military personnel, due to the special environment and vocations they are in, are prone to getting eczema as heat, sweating and wearing of the military uniform aggravate the condition. Fungal infections are common in those who wear the army boots. Insect bite reactions are not an uncommon sight among those who have to go to the jungle regularly for outfield training. Grass allergy or intolerance, contact dermatitis or acneiform eruption due to the application of military camouflage cream on the face, contact dermatitis to insect repellents, and military uniform allergy and intolerance are amongst the commonest dermatological problems encountered in the military field, and physicians should recognize them, investigate and manage these problems accordingly. Lastly, a diagnosis not to be missed in the military field is cutaneous melioidosis, especially when a military personnel presents with a non-healing ulcer.
文摘Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-year retrospective study on patients with dermatological conditions presenting to the Princess Alexandra Hospital ED in Brisbane, Australia was performed. Electronic medical records were used to compare demographics and admission status of the dermatology group and the total ED group presentations. A prospective survey was conducted on low priority triage (triage 4 and 5) patients identifying reasons presenting to the ED. RESULTS: Of a total 281,718 ED presentations, 11,748 dermatology presentations were identified between January 2012 to December 2016. Of the dermatology presentations, 41.5% were female and had an average age of 47. The most common dermatology presentations were cellulitis, abscess, rash unspecified, and ulcer. Of those admitted, 36% were female, average age was 53, mean length of stay of 294 minutes and 83.1% had an infectious aetiology. Of triage 4 and 5 presentations, 66% patients we approached had been seen by a health practitioner prior to coming to the ED. CONCLUSION: Within the population presenting with a skin related condition to the Princess Alexandra Hospital ED, characteristics associated with admission include male sex, older age, and an infectious etiology. This data may help ED clinicians decide on the discharge disposition of these patients. There may be a role for streamlined admissions for skin related infections, or improved hospital in the home services to support this group.
文摘Introduction: Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse reaction to drugs whose manifestation affect the skin and mucous membranes whose outcomes may be life threatening and fatal. Supportive management has been proven to be the mainstay with well executed nursing care resulting in quality clinical outcomes. The aim was to evaluate the nursing care interventions in management of patients with SJS/TEN in the dermatology unit. Methods: Qualitative design was used, data were collected through observation of nursing care activities, informant interviews and focus group discussion with the nurses. Qualitative data were recorded in audio tapes and transcribed. Qualitative content analysis was used for the analysis of the transcribed texts. Study was approved by KNH/ERC and informed written consent from participants. Funding was obtained from KNH through the Research and Programs department. Findings: 20 nurses participated in the study. The commonest nursing care interventions were described as routine tasks initiated at clinical diagnosis and routinely performed. They include aggressive skin care, wound care, mucosal and eye care, infection surveillance and prevention practices and general patient monitoring for complications. Skin and wound care were most challenging part of nursing care due to severe erosion or exfoliation. Nurses do not use any specific guidelines of care but consider their role a key in quality outcomes for patients with SJS/TEN in this hospital.
文摘Background: Textbook conferences are widely used by dermatology residency programs in the United States to provide educational exposure to the specialty. Typically an entire textbook is reviewed each academic year. However, residents may be uncertain about mastery of the assigned readings. Since most dermatology textbooks do not provide questions about the material presented at the end of each chapter, an innovative senior resident from our program wrote questions about each chapter and offered them to the other residents prior to scheduled discussions of the assigned materials. Methods: A pilot study for resident generated quizzes about assigned textbook reading in general dermatology was developed, implemented, and assessed by anonymous completion of a Likert Scale by participants. Results: Participants indicated that quizzes better prepared them for the annual dermatology in-service examination and they thought that the additional creation of quiz materials in the subspecialty areas of dermatopathology and dermatologic surgery would be useful. Conclusion: Resident generated quizzes are a novel approach to the learning environment during dermatology residency for residency programs and may be useful for other residency programs that utilize textbook conferences. Additional research is needed.
文摘Background: Evidence indicating the limited amount of hands-on experience in the current era of medical training has raised concern regarding students’ development and potential deficiencies in the performance of basic procedural skills. Studies have demonstrated the value of surgical workshops for medical students;however evaluation of improved student performance during future clerkships or residencies has yet to be assessed. We initiated and evaluated a resident-led surgical skills workshop for students through the Department of Dermatology. Methods: Participants received instructions on surgical tools/techniques followed by hands-on practice. Anonymous surveys administered to 24 medical and physician assistant students assessed their skill level, confidence level, and likelihood of using surgical skills in future practice preand post-workshop using a 1 - 5 Likert scale. Overall experience was also assessed. Non-parametric bivariate tests were used for analysis to account for non-normal distribution of the data. Results: There was a statistically significant change in skill (p = 0.0001) and confidence (p = 0.0001) level post workshop. There was no significant difference in utility. There were also no statistically significant differences based on the year of medical student training, medical student versus physician assistant student responses, or number of procedures performed prior to the workshop. Estimated cost per participant was $5.65. Conclusions: Research supports our finding that workshop learning experiences increase students’ ability to perform common procedural skills, their confidence, and desire to practice such skills. Further studies are necessary to determine the impact of these skills workshops on long-term clinical performance in future clerkships and residencies.
文摘In the current era, information technology has boosted every field of life either business industry or healthcare to integrate the internal processes of it. Due to the demand of managing huge data related to these fields numerous information systems play different roles in making the organizational processes robust and up to date. This paper discusses the integrated business intelligence implication specifically for healthcare to provide the fast and precise information on time. Therefore, this paper discusses the idea of building intelligent system based on Enterprise Resource Planning (ERP) databases using exclusively for dermatology diseases by applying data mining techniques. Firstly, classification mining has been applied for categorization data based on patient’s record. Then rules and patterns generated from the categorized data related to dermatology diseases, symptoms and treatments. The proposed system will retrieve the corresponding information related to the given symptoms along with medication and complete treatment. This research aims to integrate different ERP processes with centralized ERP database to provide business intelligence effectively for the dermatologists. The paper has provided with the comprehensive conceptual framework and each step has been discussed in detail.
文摘Background: Traditional models for teaching surgical principles focus primarily on the apprenticeship theory;however there has been a trend in surgical education to certifying competency in a simulation environment prior to working with patients. Many surgical models emphasize learning the technical and manual dexterity skills necessary to be a surgeon, yet few focus on obtaining the theoretical and abstract skills needed for planning complex cutaneous surgical repairs with flaps and grafts. We developed and evaluated a novel surgical flaps and grafts workshop for residents through the Department of Dermatology. Methods: Participants received a 60 minute PowerPoint lecture focusing on the basic principles of cutaneous repair with flaps and grafts, with examples and explanation of each of the four main types of flaps and grafts. The participants then received nine photocopies of Mohs micrographic surgery defects with instructions to design three repairs, focusing on functional and aesthetic outcome. Hypothetical and actual repair designs were then discussed in an open forum format. Anonymous surveys administered to 11 dermatology residents assessed their knowledge level, confidence level, and likelihood of using flaps and grafts pre- and post-workshop using Likert scales. Overall experience was also assessed. A paired sample Wilcoxon Signed Rank Test was used for analysis, since the data was non-parametrically distributed. Results: There was a statistically significant increase in confidence performing flaps post workshop (p = 0.0469). There was also an increase in knowledge of flaps and grafts, confidence in planning flaps and grafts, and confidence in performing grafts post workshop, but these findings did not reach statistical significance. The workshop had no effect on expected future use of flaps and grafts. Conclusions: The surgical workshop is a novel simulation teaching tool for learning basic principles and design of flaps and grafts in cutaneous surgery.
文摘Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reported improvements in inflammatory skin conditions in individuals treated with FMT,but larger studies are needed to clarify this possible relationship between the skin and the gut microbiome.We conducted a single-center,retrospective chart review to assess changes in acne,dermatitis herpetiformis and/or celiac disease,eczema,and psoriasis.Due to the retrospective nature of this study and the limitations of the current electronic medical record,we were unable to adequately assess cases of these diseases in relation to FMT.However,this study informs us that improvements in retrospective data are needed to formally evaluate this possible association.The better,but more cumbersome,study design would be a prospective,observational study.We encourage others to pursue further interdepartmental research on the influence of the gut microbiome on inflammatory skin diseases.
文摘Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded with the inappropriate and irrational use of medicines. Therefore, periodic prescription audit in the form of prescribing patterns is away to improve irrational prescription. The objective of this study to assess the prescription patterns of dermatological agents in Borumeda hospital. Method: Hospital based retrospective cross sectional study in which prescribing patterns of dermatological agents are assessed. A total of 385 samples of patient record prescription from November/1/2016 to December/30/2016, and the sample were selected by systematic random sampling technique. Sample prescriptions were reviewed using structural data collection format. The Collected data was analyzed by using SPSS version 20. Result: Regarding rout of administration, the maximum number of drugs was prescribed topically (66.2%). Topical steroids were the most commonly prescribed drugs (25.3%). Use of generic prescribing in single drug prescribing was 81.7%. The prevalence of atopic dermatitis was higher (26.3%, 20.8%) in both male and female respectively followed by scabies in male with 12.2% and Acne vulgaris (12.9%) in female. Number of drugs per prescription was higher (2.46) than WHO standard (Conclusion: The current study reveals that topical corticosteroids were commonly prescribed drugs in the dermatology unit and the prescribing practice imitates incidence of polypharmacy.
基金Yunnan Provincial Science and Technology Department University Joint Project:Effect and mechanism of microneedle transdermal administration of Periplaneta Americana extract on aging skin of mice(202001BA070001-214).
文摘Transdermal drug delivery systems(TDDs)have the advantages on good local targeting,controlled and sustainable drug delivery.Hoewever,the stratum corneum,as the main skin barrier,severely limits the transdermal penetration of drugs and reduces bioavailability,which also limits their application.Microneedles(MNS)penetrate the stratum corneum and create several reversible microchannels in a minimally invasive manner to significantly improve the penetration of therapeutic agents,and are considered a milestone for effective transdermal drug delivery.As an emerging drug delivery modality,microneedle transdermal drug delivery systems have the advantages of being minimally invasive,safe,efficient,economical and convenient.In addition to the extensive research on microneedles for improving transdermal drug delivery,there is a growing interest in using them to manage and treat dermatological conditions.Being the largest organ in the human body,the skin acts as a barrier between the body and the external environment,while having an immense influence on appearance and self-confidence.Indeed,there is now a considerable body of evidence on how dermatological conditions can lead to psychological problems and a reduced quality of life.The utilisation of microneedle transdermal drug delivery systems for the management and treatment of dermatological conditions is of great therapeutic and commercial value.The principleof microneedle transdermal drug delivery systems and the progress of its clinical application in dermatology are reviewed here.
文摘BACKGROUND Cervical necrotizing fasciitis(CNF)is a rare,aggressive form of deep neck space infection with significant morbidity and mortality rates.Serial surgical debridement acts as the cornerstone of CNF treatment;however,it often results in defects requiring complex reconstructions.CASE SUMMARY We report two cases in which the keystone flap(KF)was used for CNF defect coverage:Case 1,an 85-year-old patient with CNF in the anterior neck,and Case 2,a 54-year-old patient with CNF in the posterior neck.Both patients received empirical intravenous antibiotic therapy and underwent serial debridement,enabling adequate wound preparation and stabilization.The final defect size measured 5.5 cm×12 cm in Case 1 and 6 cm×11 cm in Case 2.For defect coverage,we employed an 8 cm×19 cm type II KF based on perforators from the superior thyroid artery in Case 1 and a 9 cm×18 cm type II KF based on perforators from the transverse cervical artery in Case 2.Both flaps showed complete survival.No postoperative complications occurred in both cases,and favorable outcomes were observed at 7-and 6-month follow-ups in case 1 and 2,respectively.CONCLUSION We effectively treated CNF-associated defects using the KF technique;KF is viable for covering CNF defects in carefully selected cases.
基金supported by the Fundamental Research Funds for the Central Universities[Grant No:3332019163]the Beijing Municipal Science and Technology Commission Medicine Collaborative Science and Technology Innovation Research Project[Grant No:Z191100007719001].
文摘After more than 60 years of development,artificial intelligence(AI)has been widely used in various fields.Especially in recent years,with the development of deep learning,AI has made many remarkable achievements in the medical field.Dermatology,as a clinical discipline with morphology as its main feature,is particularly suitable for the development of AI.The rapid development of skin imaging technology has helped dermatologists to assist in the diagnosis of diseases and has greatly improved the accuracy of diagnosis.Skin imaging data have natural big data attributes,which is important for AI research.The establishment of the Chinese Skin Image Database(CSID)has solved many problems such as isolated data islands and inconsistent data quality.Based on the CSID,many pioneering achievements have been made in the research and development of AI-assisted decision-making software,the establishment of expert organizations,personnel training,scientific research,and so on.At present,there are still many problems with AI in the field of dermatology,such as clinical validation,medical device licensing,interdisciplinary,and standard formulation,which urgently need to be solved by joint efforts of all parties.
基金the Fundamental Research Funds for the Central Universities(No.3332020062).
文摘Platelet-rich fibrin(PRF)is a second-generation platelet concentrate obtained from autologous blood.PRF is composed of abundant platelets,leucocytes,and a high concentration of various growth factors and fibrinogen.The composition and three-dimensional structure of PRF enable it to effectively make cells migrate and proliferate,playing an important role in tissue repair.Furthermore,the easy preparation and low cost of PRF make it a good treatment option.Numerous articles have been published about the application of PRF in clinical practice,however,the application of PRF in dermatology has not been comprehensively reviewed.The objective of this review article was to discuss various applications of PRF in dermatology,including healing chronic wounds,treating androgenic alopecia,skin rejuvenation,autologous fat transplantation,and treating vitiligo.PRF is a promising dermatologic treatment,but lacks a standardized protocol regarding its methods of attainment and use,which needs more investigations.
文摘Dr.Gtinter Burg from University of Zuerich,Dr.Anil Kumar Jha from Nepal Medical College Teaching Hospital,Dr.Mao—Qiang Man from Veterans Affairs Medical Center and University of California San Francisco,and Dr.Xiaolei Ding from Cologne University,were formally invited and agreed tojoin the editorial board of theInternational Journal ofDermatology and Venereology.The Journal is honored to have the four scholars as boardmembers and is looking forward to cooperation with them in promoting the development of the Journal.
文摘Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL frequently involves examining how disease exerts a detrimental impact, diminishing the enjoyment and fulfilment experienced by the individual. Dermatological diseases have been found to exert a substantial negative influence on the QoL of dogs and their owners due to nuisance and stress related to the disease but also due to the caregiver burden. In the management of bacterial skin infections, topical therapy is commonly administered alongside systemic antibiotics. Nonetheless, the protracted duration of treatment and difficulties in ensuring owner compliance can introduce a significant caregiver burden, potentially exacerbating the challenges associated with these conditions. Purpose: This study aimed to evaluate the impact on the quality of life (QoL) of dogs with dermatologic diseases after fluorescent light energy (FLE) treatment. Methods: The study was an open, prospective, multicentric clinical trial that included dogs with various dermatological conditions. The dogs received FLE treatment once weekly until the clinical resolution was achieved. Owners completed a validated questionnaire to assess the QoL of their dogs before and after therapy. Results: Thirty-five dogs with deep pyoderma, interdigital furunculosis, pyotraumatic dermatitis, wounds and perianal fistulas were included. All dogs received two sessions of fluorescent light energy once a week. Median treatment duration was 9 weeks for perianal fistula, 7 weeks for interdigital furunculosis, 5 weeks for deep pyoderma, 3 weeks for wounds and 1.5 weeks for pyotraumatic dermatitis. Complete remission was noted in 86% of dogs, and 14% showed an improvement but partial remission. The majority of owners reported a positive impact on their dogs’ QoL after therapy, and 74% of the dogs showed at least a 50% reduction in QoL scores. Conclusion: Fluorescent light energy has been shown to exert beneficial effects on the healing of dermatological diseases and the quality of life (QoL) in dogs and their owners, whether used as a standalone treatment or in combination with standard care therapies. Additionally, it was well-tolerated by the dogs. This study emphasizes the significance of considering both the owner’s and dog’s QoL when evaluating the therapeutic efficacy of dermatological treatments.
文摘BACKGROUND Basal cell carcinoma(BCC)is a slow-growing malignant tumor characterized by local invasiveness but an exceptionally rare metastatic potential.It ideally affects sun-exposed skin of older patients with more propensity for the facial region.AIM To evaluate the different clinicopathological characteristics of the facial BCC and the efficacy and safety of diode laser for the treatment of these lesions.METHODS We retrospectively reviewed facial BCC lesions of<1.5 cm in diameter and subjected them to diode laser ablation during the period from September 2016 to August 2021 at Al-Ramadi Teaching Hospital,Ramadi City,Iraq.Data matching the age,gender,duration,site,and clinical and histological types were registered for every subject.The functional and aesthetic outcomes and complications following diode laser ablation for each patient were also recorded.RESULTS Of 67 patients with facial BCC,there was 65.67%from the age group≥60 years and 58.21%males.The mean duration of the lesions was 5.15±1.836 mo.The most involved location was the nose(29.85%).About half of the cases belong to the noduloulcerative type.Solid histological type comprises 40.3%of the cases,while the least was keratotic(13.4%).Moreover,65.2%of the solid cases were from the age group≤60 years and 38.6%of the adenoid type from the age group>60 years(P value=0.007).Excellent aesthetic and functional outcomes were reported in all cases after 6 mo of follow-up.Few complications were reported after diode laser ablation.CONCLUSION Facial BCC was mostly seen in the elderly and men.The mean duration was 5.15 mo.The nose was the commonest involved site.Noduloulcerative lesions were seen in approximately half of the lesions.The age of the patients determined the histological type of the lesion(solid type was mostly seen in the age group≤60 years,while,adenoid in the age group>60 years).Diode laser ablation showed excellent functional and aesthetic outcomes following a 6-mo follow-up.
文摘The gut microbiome is an emerging area of interest in medicine. Imbalances in the gut microbiome have been linked to a number of disease states such as obesity and type 2 diabetes. The relationship between normally residing intestinal bacteria(the gut microbiota) and their potential role in the pathogenesis of skin diseases is an area of research for which we are only beginning to understand. Small studies have demonstrated underlying changes in the gut microbiome of patients with certain dermatological diseases. Interestingly, studies suggest that probiotics may have a role in the treatment of atopic dermatitis. However, the concept of the "skin-gut axis" is a newly emerging and important avenue of investigation, still lacking in pathobiological explanations. This review will introduce and describe the intestinal microbiome as it relates to skin health in a complex communication network between the immune system, endocrine system, metabolic system, and nervous system.
文摘The creeping verminous dermatitis or cutaneous larva migrans is a parasitosis caused by percutaneous penetration and migration of larval nematode parasites characterized by producing one or more serpiginous erythematous,indurated,raised and pruritic lesion.The most common cause of cutaneous larva migrans is the Ancytostoma braziliensc located in warm climate zones.In the present study,authors reported a case of cutaneous larva migrans with a characteristic clinical picture:erythematous-papnlar and vesicular lesion and serpiginous path,with progressive,and pruritic growth and it shown that a living area with immigration,tropical weather conditions and poverty may lead to this common infection.
