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Medical dermatology

Oma N Agbai, Parastoo Davari, Jennifer Johnson, April Armstrong, Nasim Fazel
INTRODUCTION: Patient treatment satisfaction and adherence may be affected by the initial understanding of outcomes in the treatment of actinic keratoses with 5-fluorouracil 5% cream (5-FU). Pre-treatment educational videos may optimize this understanding. The objective of this study was to determine whether prospective patient viewing of an educational video delineating treatment effects and expectations improves patient satisfaction and treatment completion rates for the treatment of actinic keratoses with 5-FU...
October 24, 2016: Dermatology and Therapy
P Nicol, P Bernard, P Nguyen, A Durlach, G Perceau
BACKGROUND: Hypertensive leg ulcers (HLU) are a form of necrotic leg ulcer. Their physiopathology is not well known and in these patients, no venous or arterial insufficiency is detected. The primary objective of this study was to evaluate the association between HLU severity and the presence or absence of concomitant vitamin K antagonist (VKA) medication. We furthermore aimed to describe the epidemiology of this entity and the prevalence of thrombophilia factors in this population. PATIENTS AND METHODS: This was a retrospective study in 54 patients hospitalized in the dermatology department of Reims University Hospital between 01/01/2007 and 31/12/2013: 23 patients were included in the "without VKA" group, and 30 were included in the "with VKA" group...
October 19, 2016: Annales de Dermatologie et de Vénéréologie
Monique Vanaman Wilson, Sabrina Guillen Fabi, Ryan Greene
Importance: The pivotal approval trial for a smooth, highly cohesive, viscous, 20-mg/mL hyaluronic acid filler demonstrated sustained aesthetic improvement, with a mean injection volume of 6.65 mL. In daily practice, however, it is not often practical or necessary to use large injection volumes to achieve the desired cosmetic outcome. Objective: To assess the efficacy, longevity, and patient satisfaction associated with correction of age-related midface volume loss using the low volumes of hyaluronic acid filler more commonly used in day-to-day practice...
October 20, 2016: JAMA Facial Plastic Surgery
Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
E Corden, E Higgins, C Smith
A 55-year-old man with severe plaque psoriasis presented with a 2-week history of feeling generally unwell with lethargy and thirst. His symptoms had developed 6 weeks after commencement of the topical vitamin D3 analogue calcitriol. Investigations revealed hypercalcaemia and acute-on-chronic kidney injury, probably directly induced by systemic absorption of vitamin D3 following extensive topical use. Topical calcitriol had been started as a steroid-sparing agent to reduce the patient's liberal potent corticosteroid usage during anti-tumour necrosis factor-alfa therapy...
October 20, 2016: Clinical and Experimental Dermatology
Qiuyu Wang, Chuan Cao, Rui Guo, Xiaoge Li, Lele Lu, Wenping Wang, Shirong Li
OBJECTIVE: To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance...
October 19, 2016: Aesthetic Plastic Surgery
J Augustin, J Austermann, S Erasmi
Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example...
October 18, 2016: Das Gesundheitswesen
Todd P Chang, Sheree M Schrager, Alyssa J Rake, Michael W Chan, Phung K Pham, Grant Christman
Multimedia in assessing clinical decision-making skills (CDMS) has been poorly studied, particularly in comparison to traditional text-based assessments. The literature suggests multimedia is more difficult for trainees. We hypothesize that pediatric residents score lower in diagnostic skill when clinical vignettes use multimedia rather than text for patient findings. A standardized method was developed to write text-based questions from 60 high-resolution, quality multimedia; a series of expert panels selected 40 questions with both a multimedia and text-based counterpart, and two online tests were developed...
October 17, 2016: Advances in Health Sciences Education: Theory and Practice
Morteza Khodaee, George T Edelman, Jack Spittler, Randall Wilber, Brian J Krabak, Daniel Solomon, Scott Riewald, Alicia Kendig, Laura M Borgelt, Mark Riederer, Vladimir Puzovic, Scott Rodeo
Swimming is one of the most popular sports worldwide. Competitive swimming is one of the most watched sports during the Olympic Games. Swimming has unique medical challenges as a result of a variety of environmental and chemical exposures. Musculoskeletal overuse injuries, overtraining, respiratory problems, and dermatologic conditions are among the most common problems swimmers encounter. Although not unique to swimming, overtraining is a serious condition which can have significant negative impact on swimmers' health and performance...
December 2016: Sports Medicine—Open
Ricardo J S Costa, Rhiannon Snipe, Vera Camões-Costa, Volker Scheer, Andrew Murray
BACKGROUND: Debilitating gastrointestinal symptoms (GIS) and dermatological injuries (DI) are common during and after endurance events and have been linked to performance decrements, event withdrawal, and issues requiring medical attention. The study aimed to determine whether GIS and DI affect food and fluid intake, and nutritional and hydration status, of ultramarathon runners during multi-stage (MSUM) and 24-h continuous (24 h) ultramarathons. METHODS: Ad libitum food and fluid intakes of ultramarathon runners (MSUM n = 54; 24 h n = 22) were recorded throughout both events and analysed by dietary analysis software...
December 2016: Sports Medicine—Open
L Lazzeri, R Colucci, A Cammi, F Dragoni, S Moretti
Background. There are limited epidemiological studies evaluating the effect of age at onset on disease features in vitiligo. Objectives. To identify factors associated with adult onset vitiligo in comparison with childhood onset vitiligo. Patients and Methods. We retrospectively collected medical records of 191 patients. Such records included clinical examination, personal and familial medical history, laboratory evaluations, concomitant vitiligo treatment and drug assumption. Results. 123 patients with a disease onset after the age of 40 (adult onset vitiligo) were compared with 68 patients who developed vitiligo before the age of 12 (childhood onset vitiligo)...
2016: BioMed Research International
Marco Rimoldi, Oliviero Rossi, Nadia Rota
OBJECTIVE: To assess the clinical status of chronic spontaneous urticaria (CSU) and understand treatment approaches in Italy through specialists who treat CSU (dermatologists and allergy specialists) and CSU patients' experience. DESIGN: Multicentre survey. SETTING: Online structured questionnaires (one for physicians and one for patients). PARTICIPANTS: Physicians and patients with CSU in Italy. INTERVENTIONS: None...
October 14, 2016: BMJ Open
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
Anna Kurayev, Alice B Gottlieb
OBJECTIVE: To describe a case in which a patient developed Candida esophagitis (CE) after treatment of atopic dermatitis (AD) with mycophenolate mofetil (MMF) for 22 months. CASE SUMMARY: A 59-year-old Caucasian female with long-standing history of AD successfully treated with MMF presented to the dermatology clinic for follow-up appointment with 3 months' history of projectile vomiting, choking, and trouble swallowing. Patient underwent esophagogastroduodenoscopy (EGD) that demonstrated whitish plaques in esophagus consistent with CE, which was confirmed by biopsy and cytology...
October 1, 2016: Journal of Drugs in Dermatology: JDD
Alan G Wade, Gordon M Crawford, David Young, Joyce Leman, Neil Pumford
BACKGROUND: Scottish Intercollegiate Guidelines Network and National Institute of Health and Care Excellence guidelines stress the importance of assessing patients with psoriasis for psoriatic arthritis, comorbidities associated with severe disease and quality of life (QoL). The purpose of the study was to evaluate the primary care management of psoriasis in relation to disease severity and QoL from a patient's perspective. METHODS: A cross-sectional survey of adults (≥18 years) with psoriasis managed in primary care was conducted in Scotland over 1-year (2012-2013)...
October 14, 2016: BMC Family Practice
Bruce J Thomas, Garry W K Ho, Timothy J Yu, Michelle I Henne
Providing care to football players often involves recognizing and treating nonorthopedic conditions. We report on common ophthalmologic, dental, and dermatologic conditions seen by the football team physician.
September 2016: American Journal of Orthopedics
Vidhi V Shah, Marshall B Kapp, Stephen E Wolverton
Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs...
October 12, 2016: American Journal of Clinical Dermatology
A M C Coneo, A R Thompson, A Lavda
BACKGROUND: Individuals with visible skin conditions often experience stigmatisation and discrimination. This may trigger maladaptive responses such as feelings of anger and hostility with negative consequences to social interactions and relationships. OBJECTIVES: The present study aimed to identify psychosocial factors contributing to aggression levels in dermatology patients. METHODS: Data was obtained from ninety-one participants recruited from out-patient clinics in the north of England, UK...
October 11, 2016: British Journal of Dermatology
M J van Geel, M E Otero, E M G J de Jong, P C M van de Kerkhof, M M B Seyger
BACKGROUND: The Simplified Psoriasis Index (SPI) is a three-domain assessment measure for psoriasis, including separate indicators of current severity (SPI-s), psychosocial impact (SPI-p), and past history and interventions (SPI-i). There are two complementary versions available designed for completion by a health professional (proSPI) or by patient self-assessment (saSPI). The validity and reliability of proSPI versus saSPI have already been demonstrated in adults. To date, validated severity measures for pediatric psoriasis do not exist...
October 8, 2016: British Journal of Dermatology
Lalit Kumar Gupta, Abhay Mani Martin, Nidheesh Agarwal, Paschal D'Souza, Sudip Das, Rajesh Kumar, Sushil Pande, Nilay Kanti Das, Muthuvel Kumaresan, Piyush Kumar, Anubhav Garg, Saurabh Singh
BACKGROUND: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor-α inhibitors. AIM: The ideal therapy of Stevens-Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments...
November 2016: Indian Journal of Dermatology, Venereology and Leprology
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