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consultative dermatology

V Campbell, R Beckett, N Abid, S Hoey
Infantile hepatic hemangiomas (IHH), particularly of the diffuse subtype, can in severe cases be associated with hepatic and cardiac failure, compartment syndrome, and consumptive hypothyroidism. Early recognition and treatment of these pathologies is paramount in order to minimise the risk of longterm sequelae. We report an interesting case of a female infant who presented with systemic compromise, in the absence of large or obvious cutaneous infantile hemangiomas (IH). Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis...
February 28, 2018: Journal of Clinical Research in Pediatric Endocrinology
Mark A Samaan, Polychronis Pavlidis, Sophie Papa, Nick Powell, Peter M Irving
Immune checkpoint inhibitor therapies are a novel group of monoclonal antibodies with proven effectiveness in a wide range of malignancies, including melanoma, renal cell carcinoma, non-small-cell lung cancer, urothelial carcinoma and Hodgkin lymphoma. Their use in a range of other indications, such as gastrointestinal and head and neck cancer, is currently under investigation. The number of agents included in this drug group is increasing, as is their use. Although they have the potential to improve the treatment of advanced malignancies, they are also associated with a substantial risk of immune-related adverse events...
March 7, 2018: Nature Reviews. Gastroenterology & Hepatology
María Fernández, Patricia Guerra, Eloya Martín, Noelia Martínez, Jose Antonio Álvarez-Diz
OBJECTIVE: Dysphoria gender treatment in adolescents is recent. Studies of adolescents treated with analogs are reduced. To ensure the quality of care and safety of the child, follow-up studies are necessary. The aim of the present research was to describe the characteristics of the process of medical and psychological attention in adolescents with the DG in the Gender Identity Treatment Unit of Asturias in the period 2007-2015. METHODS: The sample included 20 minors attended in the Gender Identity Treatment Unit of Asturias in the period 2007-2015...
February 28, 2018: Revista Española de Salud Pública
Marco Alonso Martinez-Guzman, Anabell Alvarado-Navarro, Vidal Delgado-Rizo, Alejandra Garcia-Orozco, Jorge Arturo Mayorga-Rodríguez, Ana Laura Pereira-Suarez, Mary Fafutis-Morris
Leprosy is a chronic disease caused by Mycobacterium leprae that affects the skin and peripheral nerves. It may present as one of two distinct poles: the self-limiting tuberculoid leprosy and the highly infectious lepromatous leprosy (LL) characterized by M. leprae -specific absence of cellular immune response. The pro-inflammatory cytokine macrophage migration inhibitory factor (MIF) enhance the bactericide activities of macrophages after interaction with its receptor, CD74. Importantly, MIF also possesses chemoattractant properties, and it is a key factor in situ for the activation of macrophages and in blood to promote leukocytes migration...
2018: Frontiers in Immunology
Suvarna Samudrala, Sukumar Dandakeri, Ramesh M Bhat
BACKGROUND: 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...
February 26, 2018: International Journal of Dermatology
J Chauvel-Picard, A Pierrefeu, O Harou, P Breton, N Sigaux
INTRODUCTION: Malignant chondroid syringomas, also known as cutaneous malignant mixed tumors, are rare neoplasms that most frequently occur on the torso or extremities of women. Here we present an illustrated case of a facial malignant chondroid syringoma. MATERIALS AND METHODS: A 32-year-old female patient with no notable medical history presented with an approximately 1cm-wide, painless, palpably-mobile subcutaneous nodule, suggestive of a sebaceous cyst, just above the middle third of the right eyebrow...
February 22, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Rachel Giesey, Doria Narively, Valerie Fuller, Eliot Mostow
With the high demand and limited supply of dermatologists, the majority dedicate their time primarily to outpatient practice. A number ofobstacles to inpatient dermatology consults have been described, as well as the essential benefits for some of the sickest patients. Dermatology residency programs partially relieve this need, however with the transition to a single Graduate Medical Education accreditation system and many previously American Osteopathic Association-accredited dermatologyprograms ceasing to train residents after 2020, it is prudent to recruit additional possible consultants...
January 15, 2018: Dermatology Online Journal
Lauren N Ko, Daniela Kroshinsky
BACKGROUND: 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. METHODS: 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. RESULTS: Thirty participants completed the survey (yield 93...
February 22, 2018: International Journal of Dermatology
A K Nandi, M Shahidullah, K A Islam, N Islam, M Shafiquzzaman, M K Khan, R K Karmoker, S Fardous, D Afroz
Microscopic examination of skin and mucous membrane is an established investigation in diagnosis and follow up of many dermatological conditions frequently encountered during practice. Histopathological examination is performed with biopsied specimen from skin and or mucous membrane where required. However neither do all skin biopsies produce neither a conclusive diagnosis nor the dermatologists routinely perform this procedure to every patient they consult. This cross sectional descriptive study conducted by reviewing the records of all biopsied cases studied for histopathology in Mymensingh Medical College, Mymensingh and Shaheed Mansur Ali Medical College, Dhaka, Bangladesh from January 2012 to December 2016...
January 2018: Mymensingh Medical Journal: MMJ
Christian Greis, Christine Meier Zürcher, Vahid Djamei, Andreas Moser, Stephan Lautenschlager, Alexander A Navarini
BACKGROUND: Digital health services are rapidly gaining acceptance in healthcare systems. Dermatology as an image-centric specialty is particularly well suited for telemedical services. However, dermatology patients' demands of electronic services remain largely unexplored. METHODS: This study investigated patients' views in primary, secondary, and tertiary referral centers. In August 2017, 841 questionnaires were filled in by dermatology patients. RESULTS: 76...
March 14, 2018: Journal of Dermatological Treatment
David G Li, Fan Di Xia, Hasan Khosravi, Anna K Dewan, Daniel J Pallin, Christopher W Baugh, Karl Laskowski, Cara Joyce, Arash Mostaghimi
Importance: Many inflammatory skin dermatoses mimic cellulitis (pseudocellulitis) and are treated with antibiotics and/or hospitalization, leading to unnecessary patient morbidity and substantial health care spending. Objective: To evaluate the impact of early dermatology consultation on clinical and economic outcomes associated with misdiagnosed cellulitis. Design, Setting, and Participants: This prospective cohort study enrolled patients with presumed diagnosis of cellulitis in the emergency department, in the emergency department observation unit, or within 24 hours of admission to an inpatient unit of a large urban teaching hospital between February and September 2017...
February 16, 2018: JAMA Dermatology
Lauren N Ko, Anna C Garza-Mayers, Jessica St John, Lauren Strazzula, Priyanka Vedak, Radhika Shah, Allison S Dobry, Sowmya R Rao, Leslie W Milne, Blair Alden Parry, Daniela Kroshinsky
Importance: Each year, cellulitis leads to 650 000 hospital admissions and is estimated to cost $3.7 billion in the United States. Previous literature has demonstrated a high misdiagnosis rate for cellulitis, which results in unnecessary antibiotic use and health care cost. Objective: To determine whether dermatologic consultation decreases duration of hospital stay or intravenous antibiotic treatment duration in patients with cellulitis. Design, Setting, and Participants: This randomized clinical trial was conducted in a large urban tertiary care hospital between October 2012 and January 2017, with 1-month follow-up duration...
February 16, 2018: JAMA Dermatology
Bevin Bhoyrul, Samantha Keegan, Avad Mughal
BACKGROUND: An initial study of patch testing practices across Wales, United Kingdom, showed wide variation in practice against a standardized set of guidelines and best practice recommendations. OBJECTIVES: To evaluate (i) current patch testing practice on a national level in the United Kingdom and Republic of Ireland (ROI), (ii) compliance with the current published guidelines, and (iii) the proportion of the catchment population tested by patch testing centres...
February 14, 2018: Contact Dermatitis
A Kargl, B Kosse, S Uhrlaß, D Koch, C Krüger, K Eckert, P Nenoff
Patient 1: After contact to a central European hedgehog (Erinaceus europaeus), a 50-year-old female with atopy developed erythrosquamous tinea manus on the thumb and thenar eminence of the right hand. The patient had previously been scalded by hot steam at the affected site. The zoophilic dermatophyte Trichophyton erinacei could be cultured from the hedgehog as well as from scrapings from the woman's skin. Antifungal treatment of the hedgehog was initiated using 2 weekly cycles of itraconazole solution (0...
February 12, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
E Audureau, F Roux, D Lons Danic, M Bagot, A Cantagrel, E Dernis, N Gouyette, P Hilliquin, D Jullien, F Lioté, T Passeron, M A Richard, P Claudepierre
BACKGROUND: Dermatologists are recommended to ask psoriasis patients about musculoskeletal complaints to allow early detection and treatment of psoriatic arthritis (PsA). Screening tools have been developed to help identifying patients warranting further rheumatologic assessment, but evidence suggests room for improvement in their diagnostic value and ease of use for outpatient practice. OBJECTIVE: To develop and internally validate a brief tool for dermatologists to screen patients to refer to a rheumatologist for PsA diagnosis...
February 11, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
J Brütting, M Bergmann, C Weber, C Berking, W Tilgen, D Schadendorf, F Meier
BACKGROUND: Besides medical consultations, various sources of information and support are available for melanoma patients (MP) in Germany from commercial and non-commercial providers; however, little is known about how they are perceived and accepted by MPs. MATERIAL AND METHODS: Between July and October 2016 a total of 529 melanoma patients were surveyed at 27 accredited German skin cancer centers by means of a standardized questionnaire. Their awareness and satisfaction with 12 given sources of information and counseling services (print, online and by telephone) were surveyed...
February 2, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Muhammad Anees, Ghazala Butt, Shaista Gull, Asif Nazeer, Ijaz Hussain, Muhammad Ibrahim
OBJECTIVE: To determine skin changes in patients of End Stage Renal Disease (ESRD) on maintenance hemodialysis (MHD) and factors affecting these changes. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: Nephrology Department, Mayo Hospital, Lahore in collaboration with Dermatology Department, King Edward Medical University, Lahore, from October 2015 to January 2016. METHODOLOGY: Two hundred patients who were undergoing MHD for more than three months were included in the study...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Brigitte Dréno, Vincenzo Bettoli, Elena Araviiskaia, Miguel Sanchez Viera, Anne Bouloc
BACKGROUND: Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome. AIM: to assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome. METHODS: two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review...
January 29, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Wei Zhang, Zhaohua Deng, Ziying Hong, Richard Evans, Jingdong Ma, Hui Zhang
BACKGROUND: With the rise in popularity of Web 2.0 technologies, the sharing of patient experiences about physicians on online forums and medical websites has become a common practice. However, negative comments posted by patients are considered to be more influential by other patients and physicians than those that are satisfactory. OBJECTIVE: The aim of this study was to analyze negative comments posted online about physicians and to identify possible solutions to improve patient satisfaction, as well as their relationship with physicians...
January 25, 2018: Journal of Medical Internet Research
L R Khoury, T Møller, C Zachariae, L Skov
BACKGROUND: Treatment and care of moderate to severe psoriasis requires lifelong consultations with a dermatologist with close monitoring of systemic treatment. OBJECTIVES: To investigate the effect of patient-initiated care consultations (PICC) for patients with psoriasis in a dermatology outpatient clinic. METHODS: A prospective randomised controlled trial with patients in well-controlled systemic treatment randomised to either 1) the PICC group, where they participated in one annual consultation with a dermatologist but were able to initiate consultations when needed; or 2) routine care, where they participated in a consultation every 12-16 weeks...
January 24, 2018: British Journal of Dermatology
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