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Araviiskaia ER, Samtsov AV, Sokolovskiy EV, Bakulev AL, Murashkin NN, Karamova AE. Revisiting the question of assessment by severity and classification of acne. VESTNIK DERMATOLOGII I VENEROLOGII 2023. [DOI: 10.25208/vdv1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The paper presents an analysis of different variants of acne classifications and the assessment of acne severity, carried out by the working group of the RODVK Committee for Classifications in Dermatovenereology. There is a division of acne vulgaris according to age and severity. Assessing the severity of acne is important for choosing the correct prescriptions in daily practice and for the evaluation of treatment outcomes. Most of existing acne grading systems are based either on a global grading of severity or on calculating the number of lesions in a variety of anatomic locations. For clinical practice of dermatovenereologists, as well as for educational and scientific purposes, the working group proposed to supplement the acne classification based on severity grading with counting the number of the lesions, and to take into account localization, rash prevalence and scarring when determining the acne severity.
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Sahin U, Reeve K, Tochtermann G, Kilanowski K, Navarini A, Imhof L, Held U, Hofbauer GFL. HautTief Multidisciplinary Educational Program for Patients with Psoriasis or Atopic Dermatitis: A Randomized Controlled Study. Dermatology 2022; 238:1050-1059. [PMID: 35533665 PMCID: PMC9677846 DOI: 10.1159/000524225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background Improving health-related quality of life (HRQoL), disease severity, and treatment adherence through patient education is an increasingly important, yet relatively new area in dermatology. This randomized controlled trial aims to contribute to this growing area of research by exploring the effects of a 9-week educational program for patients with chronic skin diseases. Objective The aim of the study was to evaluate the effect of a multidisciplinary educational program on HRQoL and disease severity in patients with psoriasis or atopic dermatitis (AD). Methods Sixty-four patients with diagnosed psoriasis or AD were recruited from University Hospital Zurich and randomized (1:1) to the intervention or control group. To assess HRQoL, the following self-reported questionnaires were used: Dermatology Life Quality Index (DLQI), Skindex-29, EuroQol-5D (EQ-5D), RAND 36-Item Short Form Survey (SF-36), and Beck Depression Inventory (BDI) to measure depression symptoms. Psoriasis Area and Severity Index (PASI) and the Eczema Area and Severity Index (EASI) were used to capture disease extent. These scores were assessed at four study visits, which were performed at baseline and 3, 6, and 9 months after the start of the program. Results At month 6, an improvement of at least 25% in BDI was recorded in 15 (68.2%) of 22 patients in the intervention group and 6 (27.3%) of 22 patients in the control group (difference 40.9%, p = 0.016). 53.3% (16 of 30) of patients achieved an improvement in one subdomain of the SF-36 score (role limitations due to emotional problems) at 6-month follow-up, compared with 23.1% (6 of 26) of those not attending the educational program (difference 30.2%; p = 0.042). No significant differences in DLQI, Skindex-29, EQ-5D, PASI, and EASI between both groups at the three time points were found. Conclusion An educational program may improve HRQoL and depression status of patients with psoriasis or AD.
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Affiliation(s)
- Ugur Sahin
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - Kelly Reeve
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland
| | - Giulia Tochtermann
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - Kamilla Kilanowski
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - Alexander Navarini
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - Laurence Imhof
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - Ulrike Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland
| | - Günther F L Hofbauer
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
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The Unmet Needs in Atopic Dermatitis Control in Latin America: A Multidisciplinary Expert Perspective. Dermatol Ther (Heidelb) 2021; 11:1521-1540. [PMID: 34449071 PMCID: PMC8395384 DOI: 10.1007/s13555-021-00595-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction Adoption of control tools for atopic dermatitis (AD) in Latin America (LA) is currently very limited. Clinical assessment tools represent a practical method to measure the impact of treatment on disease activity and on the quality of life of patients. However, the use of these tools in the LA clinical practice setting is limited. Methods A selected panel of Latin American experts in fields related to atopic dermatitis were provided with a series of relevant questions to address prior to the multi-day conference. Within this conference, each narrative was discussed and edited by the entire group, through numerous drafts and rounds of discussion, until a consensus was achieved. Results The panel proposes specific and realistic recommendations for implementing control tools for AD care in LA. In creating these recommendations, the authors strove to address all barriers to the widespread use of these tools. Conclusion This article includes a narrative analysis of barriers to AD control in LA and provides necessary recommendations to integrate and increase the use of validated AD control assessment tools throughout the region.
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Czajkowska J, Badura P, Korzekwa S, Płatkowska-Szczerek A. Deep learning approach to skin layers segmentation in inflammatory dermatoses. ULTRASONICS 2021; 114:106412. [PMID: 33784575 DOI: 10.1016/j.ultras.2021.106412] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Monitoring skin layers with medical imaging is critical to diagnosing and treating patients with chronic inflammatory skin diseases. The high-frequency ultrasound (HFUS) makes it possible to monitor skin condition in different dermatoses. Accurate and reliable segmentation of skin layers in patients with atopic dermatitis or psoriasis enables the assessment of the treatment effect by the layer thickness measurements. The epidermis and the subepidermal low echogenic band (SLEB) are the most important for further diagnosis since their appearance is an indicator of different skin problems. In medical practice, the analysis, including segmentation, is usually performed manually by the physician with all drawbacks of such an approach, e.g., extensive time consumption and lack of repeatability. Recently, HFUS becomes common in dermatological practice, yet it is barely supported by the development of automated analysis tools. To meet the need for skin layer segmentation and measurement, we developed an automated segmentation method of both epidermis and SLEB layers. It consists of a fuzzy c-means clustering-based preprocessing step followed by a U-shaped convolutional neural network. The network employs batch normalization layers adjusting and scaling the activation to make the segmentation more robust. The obtained segmentation results are verified and compared to the current state-of-the-art methods addressing the skin layer segmentation. The obtained Dice coefficient equal to 0.87 and 0.83 for the epidermis and SLEB, respectively, proves the developed framework's efficiency, outperforming the other approaches.
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Affiliation(s)
- Joanna Czajkowska
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800 Zabrze, Poland.
| | - Pawel Badura
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800 Zabrze, Poland
| | - Szymon Korzekwa
- Department of Temporomandibular Disorders, Division of Prosthodontics, Poznan University of Medical Sciences, Poland
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Luger T, Dirschka T, Eyerich K, Gollnick H, Gupta G, Lambert J, Micali G, Ochsendorf F, Ständer S, Traidl-Hoffmann C. Developments and challenges in dermatology: an update from the Interactive Derma Academy (IDeA) 2019. J Eur Acad Dermatol Venereol 2021; 34 Suppl 7:3-18. [PMID: 33315305 DOI: 10.1111/jdv.17009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 01/09/2023]
Abstract
The 2019 Interactive Derma Academy (IDeA) meeting was held in Lisbon, Portugal, 10-12 May, bringing together leading dermatology experts from across Europe, the Middle East and Asia. Over three days, the latest developments and challenges in relation to the pathophysiology, diagnosis, evaluation and management of dermatological conditions were presented, with a particular focus on acne, atopic dermatitis (AD) and actinic keratosis (AK). Interesting clinical case studies relating to these key topics were discussed with attendees to establish current evidence-based best practices. Presentations reviewed current treatments, potential therapeutic approaches and key considerations in the management of acne, AK and AD, and discussed the importance of the microbiome in these conditions, as well as the provision of patient education/support. It was highlighted that active treatment is not always required for AK, depending on patient preferences and clinical circumstances. In addition to presentations, two interactive workshops on the diagnosis and treatment of sexually transmitted infections/diseases (STIs/STDs) presenting to the dermatology clinic, and current and future dermocosmetics were conducted. The potential for misdiagnosis of STIs/STDs was discussed, with dermoscopy and/or reflectance confocal microscopy suggested as useful diagnostic techniques. In addition, botulinum toxin was introduced as a potential dermocosmetic, and the possibility of microbiome alteration in the treatment of dermatological conditions emphasized. Furthermore, several challenges in dermatology, including the use of lasers, the complexity of atopic dermatitis, wound care, use of biosimilars and application of non-invasive techniques in skin cancer diagnosis were reviewed. In this supplement, we provide an overview of the presentations and discussions from the fourth successful IDeA meeting, summarizing the key insights shared by dermatologists from across the globe.
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Affiliation(s)
- T Luger
- Department of Dermatology, University of Münster, Münster, Germany
| | - T Dirschka
- Centroderm Clinic, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Unit of Dermatology, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - H Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
| | - G Gupta
- University Department of Dermatology, Edinburgh, UK
| | - J Lambert
- Department of Dermatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Ochsendorf
- Department of Dermatology, Frankfurt University Hospital, Frankfurt/Main, Germany
| | - S Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
| | - C Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany
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Goldin D. Concepts in Psychodermatology: An Overview for Primary Care Providers. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wollenberg A, Christen‐Zäch S, Taieb A, Paul C, Thyssen J, Bruin‐Weller M, Vestergaard C, Seneschal J, Werfel T, Cork M, Kunz B, Fölster‐Holst R, Trzeciak M, Darsow U, Szalai Z, Deleuran M, Kobyletzki L, Barbarot S, Heratizadeh A, Gieler U, Hijnen D, Weidinger S, De Raeve L, Svensson Å, Simon D, Stalder J, Ring J. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol 2020; 34:2717-2744. [DOI: 10.1111/jdv.16892] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023]
Affiliation(s)
- A. Wollenberg
- Department of Dermatology and Allergy Ludwig‐Maximilian‐University Munich Germany
| | - S. Christen‐Zäch
- Pediatric Dermatology Unit Departments of Dermatology and Pediatrics Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
| | - A. Taieb
- University of Bordeaux Bordeaux France
| | - C. Paul
- Department of Dermatology and Allergy Toulouse University and CHU Toulouse France
| | - J.P. Thyssen
- Department of Dermatology and Allergy Herlev‐Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - M. Bruin‐Weller
- National Expertise Center for Atopic Dermatitis Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands
| | - C. Vestergaard
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - J. Seneschal
- Department of Dermatology National Reference Center for Rare Skin Diseases Bordeaux University Hospitals Bordeaux France
| | - T. Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - M.J. Cork
- Sheffield Dermatology Research IICDUniversity of Sheffield UK
| | - B. Kunz
- Dermatologikum Hamburg Hamburg Germany
| | - R. Fölster‐Holst
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - M. Trzeciak
- Department of Dermatology, Venereology and Allergology Medical University of Gdansk Gdansk Poland
| | - U. Darsow
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- ZAUM – Center of Allergy & Environment Munich Germany
| | - Z. Szalai
- Department of Dermatology Heim Pál National Children’s Institute Budapest Hungary
| | - M. Deleuran
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Kobyletzki
- School of Medical Sciences Lund University Malmö Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - S. Barbarot
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRA, F‐44000 Nantes Université Nantes France
| | - A. Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - U. Gieler
- Department of Dermatology University of Gießen and Marburg GmbH Gießen Germany
| | - D.J. Hijnen
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - S. Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - L. De Raeve
- Department of Dermatology Universitair Ziekenhuis Brussel (UZB)Free University of Brussels (VUB) Brussels Belgium
| | - Å. Svensson
- Department of Dermatology Skane University Hospital Malmö Sweden
| | - D. Simon
- Department of Dermatology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - J.F. Stalder
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRAE, F‐44000 Nantes Université Nantes France
| | - J. Ring
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- Christiane‐Kühne Center for Allergy Research and Education (CK‐Care) Davos Switzerland
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A machine learning‐based, decision support, mobile phone application for diagnosis of common dermatological diseases. J Eur Acad Dermatol Venereol 2020; 35:536-545. [DOI: 10.1111/jdv.16967] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/22/2020] [Accepted: 08/05/2020] [Indexed: 01/09/2023]
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The content and conduct of GP consultations for dermatology problems: a cross-sectional study. Br J Gen Pract 2020; 70:e723-e730. [PMID: 32895240 PMCID: PMC7480176 DOI: 10.3399/bjgp20x712577] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/02/2020] [Indexed: 01/16/2023] Open
Abstract
Background Skin complaints are common in primary care, and poor outcomes in long-term conditions are often due to low adherence to treatment. Shared decision making and self-management support may help, yet there is little understanding of patient involvement or the support provided by GPs. Aim To describe the content of primary care consultations for skin problems, including shared decision making practice, delivery of self-management advice, and follow-up. Design and setting Cross-sectional study of video-recorded UK adult GP consultations and linked data. Method A coding tool was developed and applied to all consultations with skin problems. Shared decision making was assessed using the observer OPTION5 scale. Results A total of 45/318 consultations (14.2%) related to one or more skin problems, which were discussed alongside other problems in 71.1% (32/45) of consultations. Of the 100 different problems discussed in these consultations, 51 were dermatological. The mean amount of time spent on skin problems in the consultations was 4 minutes 16 seconds. Medication was recommended for 66.7% (34/51) of skin problems, with low shared decision making (mean OPTION5 score = 10.7). Self-management advice (verbal only) was given for 47.1% (24/51) of skin problems. Most skin problems (84.3%; 43/51) were not referred to secondary care; 32.6% (14/43) of the skin problems not referred were seen again in primary care within 12 weeks, of which 35.7% (5/14) follow-up appointments were not planned. Conclusion In this study, skin problems were usually presented alongside other complaints and resulted in a medication recommendation. Shared decision making was uncommon and self-management advice not consistently given, with re-attendance for the same problem common. GPs’ training should reflect how frequently skin problems are seen and seek to improve patient involvement in decision making and support self-management.
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Cowdell F, Ahmed T, Layfield C. Knowledge mobilisation: a UK co-creation study to devise strategies to amend lay and practitioner atopic eczema mindlines to improve consultation experiences and self-management practices in primary care. BMJ Open 2020; 10:e036520. [PMID: 32988943 PMCID: PMC7523205 DOI: 10.1136/bmjopen-2019-036520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/17/2020] [Accepted: 08/19/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To devise strategies to amend lay and practitioner atopic eczema mindlines 'collectively reinforced, internalised tacit guidelines', to improve consultation experiences and self-management practices in primary care. DESIGN Co-creation workshops informed by the Co:Create Coproduction Matrix. SETTING Conference centre in central England and via remote communication. PARTICIPANTS Lay people with, and parents of children with, atopic eczema, practitioners, a researcher and a facilitator (n=22). RESULTS Eczema mindline amendment needs to address people and parents of children with the condition, practitioners and wider society in parallel. For lay people trust and 'realness' of amendment activity was vital and practitioners wanted practical, locally relevant, hints and tips, tailored, 'no faff' approaches. To improve consultation experiences and self-management practices, five key, consistent, evidence-based messages need to be instilled into eczema mindlines: (1) eczema is more than just dry skin, (2) eczema does not just go away, (3) moisturisers are for every day, (4) steroid creams are okay when you need them and (5) you know your child's eczema best. CONCLUSION This co-creation study provides original insights into what eczema knowledge should be mobilised, who needs to have this knowledge, how this should be achieved to amend existing mindlines to improve consultation experiences and self-management practices in primary care.The remaining challenge is to refine, implement and evaluate the effectiveness of strategies developed to instil the five core messages and erase outdated or inaccurate information.
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Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Taheeya Ahmed
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Carron Layfield
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Chishti MA, Mohi-Ud-Din E, Zakki SA, Aslam MR, Siddiqui S, Ahmad S, Hayee A. Antibacterial and Toxicity Evaluation of Eastern Medicine Formulation Eczegone for the Management of Eczema. Dose Response 2020; 18:1559325820956798. [PMID: 32952485 PMCID: PMC7485166 DOI: 10.1177/1559325820956798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/15/2022] Open
Abstract
The present study was conducted to evaluate the antibacterial activity, in vitro and in vivo cytotoxicity, cell viability and safety of Eastern Medicine coded medicinal formulation Eczegone comprising extracts of Azadirachta indica (Azin), Fumaria indica (Fuin), Sphaeranthus indicus (Spin) and Lawsonia inermis (Lain). This work also evaluated antibacterial activity of Eczegone formulation having above mentioned plants ethanolic extracts against different bacteria’s by disk diffusion method. In vitro toxicity of Eczegone formulation was investigated by using human skin keratinocytes HaCaT cell line, crystal violet stained cells, and methyl tetrazolium cytotoxicity (MTT) assay. In vivo acute oral and dermal cytotoxicity was determined by using Swiss albino mice and albino rabbits, respectively. The Eczegone formulation showed antibacterial activity against 3 gram negative bacteria including Escherichia coli, Klebsiella pneumonia, Proteus vulgaris and a gram positive Staphylococcus aureus. We didn’t observe any toxic effect of Eczegone formulation on the skin keratinocytes. Furthermore, the Ezcegone formulation was non-irritant according to draize score (OECD TG404, 2002). After rigorous safety evaluation by in vitro and in vivo acute oral and dermal toxicity analysis, we concluded that Eczegone formualtion possessses antibacterial effects and is safe, non-toxic, non-irritant, and the drug would be subjected for further biochemical and clinical studies.
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Affiliation(s)
- Muhammad Amjad Chishti
- Department of Basic Clinical Sciences, Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan
| | - Ejaz Mohi-Ud-Din
- Department of Surgery and Allied Sciences, Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan
| | | | - Muhammad Rahil Aslam
- University College of Conventional Medicine, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Pakistan
| | - Sheraz Siddiqui
- Department of Community Medicine and Behavioural Sciences, Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan
| | - Saeed Ahmad
- University College of Agriculture, University of Sargodha, Pakistan
| | - Abdul Hayee
- University College of Conventional Medicine, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Pakistan
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Hudson MP, Thompson AR, Emerson LM. Compassion-focused self-help for psychological distress associated with skin conditions: a randomized feasibility trial. Psychol Health 2019; 35:1095-1114. [DOI: 10.1080/08870446.2019.1707829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Mark P. Hudson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
| | - Andrew R. Thompson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
| | - Lisa-Marie Emerson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
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Peralta C, Hamid P, Batool H, Al Achkar Z, Maximus P. Psoriasis and Metabolic Syndrome: Comorbidities and Environmental and Therapeutic Implications. Cureus 2019; 11:e6369. [PMID: 31938651 PMCID: PMC6957052 DOI: 10.7759/cureus.6369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Psoriasis (PS) is an incessant, fiery skin sickness characterized by erythematous plaques with thick silvery scales, white or red patches of the skin, which encompasses several immunological, biomolecular, genetic, and environmental factors that may lead to further development of metabolic syndrome (MS) and vice versa. Metabolic syndrome is composed of multiple components (high blood pressure, abdominal obesity, glucose intolerance, and dyslipidemia) of risk factors that arise primarily from insulin resistance, mostly mediated by inflammatory cytokines, such as tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) together with leptin and adiponectin, which are molecules also found in PS. The incidence, severity, and poor prognosis of the psoriatic diseases could be influenced by cardiometabolic diseases, which are controllable or preventable with intense lifestyle modification such as diet, exercise, and weight control. We performed a far-reaching writing search of different databases as part of this review; 47 investigations were regarded as important based on our search. Fasting, proper weight management, and special diet modifications seemed to have a positive impact on the management of PS. This review agrees with previous literature that nutritionists and specialists of preventive medicine should play a central role in the evaluation and management of psoriatic patients. We recommended that the management of this disease should focus on the environmental factors first instead of the genetic and immunologic pathways.
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Affiliation(s)
- Cesar Peralta
- Internal Medicine, California Institute of Behavioral Neuroscience and Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Humera Batool
- Internal Medicine, California Institute of Behavorial Neurosciences and Psychology, Fairfield, USA
| | - Zeina Al Achkar
- Internal Medicine, California Institute of Behavioral Neuroscience and Pshycology, Fairfield, USA
| | - Pierre Maximus
- Internal Medicine, California Institute of Behavioral Neuroscience and Psychology, Fairfield, USA
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Dressler C, Lambert J, Grine L, Galdas P, Paul C, Zidane M, Nast A. Therapeutische Patientenschulungsprogramme und Unterstützung beim Selbstmanagement für Patienten mit Psoriasis – eine systematische Übersicht. J Dtsch Dermatol Ges 2019; 17:685-697. [DOI: 10.1111/ddg.13840_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Corinna Dressler
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Jo Lambert
- Department of DermatologyGhent University Hospital Ghent Belgium
| | - Lynda Grine
- Department of DermatologyGhent University Hospital Ghent Belgium
| | - Paul Galdas
- Department of Health SciencesFaculty of ScienceUniversity of York York United Kingdom
| | - Carle Paul
- Department of DermatologyCHU and Paul Sabatier University Toulouse France
| | - Miriam Zidane
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Alexander Nast
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Saito-Abe M, Futamura M, Yamamoto-Hanada K, Yang L, Suzuki K, Ohya Y. Topical corticosteroid phobia among caretakers of children with atopic dermatitis: A cross-sectional study using TOPICOP in Japan. Pediatr Dermatol 2019; 36:311-316. [PMID: 30882946 DOI: 10.1111/pde.13784] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND/OBJECTIVES The TOPICOP scale is an easy-to-use scale for assessing topical corticosteroid (TCS) phobia in atopic dermatitis (AD) patients and their caretakers. TCS phobia is a common problem among AD patients and their caretakers. The aim of this study was to examine the relationship between TCS phobia in caretakers of children with AD and the characteristics of patients using the TOPICOP scale. METHODS Caretakers of AD patients who visited the allergy clinic at the National Center for Child Health and Development in Tokyo between February 2014 and May 2014 were recruited. Caretakers of patients in follow-up had already attended an education session on treatment at the institution. All participants completed an anonymous questionnaire on the characteristics of the respondents and patients using the Patient-Oriented Eczema Measure (POEM) and the Japanese version of TOPICOP. RESULTS In total, 243 participants (88.9% female) completed the survey. The average TOPICOP score was 40.3 and the median POEM score was 4. The TOPICOP score was significantly higher for patients younger than 12 months old with moderate to very severe AD (POEM ≥ 8) whose caretaker had not attended an educational session (P < 0.01, respectively). There was no significant difference in the family history of AD, age, or gender of the respondents. In multivariable analysis, preattendance at an education session was the only significant factor accounting for a higher TOPICOP score (P < 0.001). CONCLUSIONS Regardless of their background, caretakers of AD patients can be affected from TCS phobia. Attending an educational session might ease their anxiety.
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Affiliation(s)
- Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Masaki Futamura
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | - Limin Yang
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kohta Suzuki
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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16
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Dressler C, Lambert J, Grine L, Galdas P, Paul C, Zidane M, Nast A. Therapeutic patient education and self‐management support for patients with psoriasis – a systematic review. J Dtsch Dermatol Ges 2019; 17:685-695. [DOI: 10.1111/ddg.13840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/20/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Corinna Dressler
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin BerlinCorporate member of Freie Universität BerlinHumboldt‐Universität zu Berlinand Berlin Institute of Health Berlin Germany
| | - Jo Lambert
- Department of DermatologyGhent University Hospital Ghent Belgium
| | - Lynda Grine
- Department of DermatologyGhent University Hospital Ghent Belgium
| | - Paul Galdas
- Department of Health SciencesFaculty of ScienceUniversity of York York United Kingdom
| | - Carle Paul
- Department of DermatologyCHU and Paul Sabatier University Toulouse France
| | - Miriam Zidane
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin BerlinCorporate member of Freie Universität BerlinHumboldt‐Universität zu Berlinand Berlin Institute of Health Berlin Germany
| | - Alexander Nast
- Division of Evidence‐Based MedicineDepartment of DermatologyCharité – Universitätsmedizin BerlinCorporate member of Freie Universität BerlinHumboldt‐Universität zu Berlinand Berlin Institute of Health Berlin Germany
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17
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Solomon I, Ilie MA, Draghici C, Voiculescu VM, Căruntu C, Boda D, Zurac S. The impact of lifestyle factors on evolution of atopic dermatitis: An alternative approach. Exp Ther Med 2018; 17:1078-1084. [PMID: 30679977 PMCID: PMC6327646 DOI: 10.3892/etm.2018.6980] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/26/2018] [Indexed: 01/19/2023] Open
Abstract
Atopic dermatitis (AD) is a multifactorial chronic inflammatory disease with an incompletely understood etiopathogenesis. With a significant impact on the quality of life of patients, AD has attracted the interest of many research studies aiming to investigate the complex cellular and molecular mechanisms and to identify new therapeutic pathways. Various studies have focused on psycho-immunology, emphasizing the involvement of stress, defined as a general response of the body to external or internal challenges to the AD pathology. Factors like lifestyle and leisure activities may change the behavior of immune cells in AD with a strong impact on the evolution of the disease. Moreover, the poor adherence of AD patient to standard treatment approach has led to the necessity to combine different therapies in the field of complementary and alternative medicine. Although there are still not enough data to conclude that adjuvant therapies are effective in a conventional sense, there are already promising results suggesting that alternative therapeutic strategies could be a main subject of further research.
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Affiliation(s)
- Iulia Solomon
- Department of Dermatology and Allergology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Mihaela Adriana Ilie
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Biochemistry, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Carmen Draghici
- Department of Dermatology and Allergology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Vlad Mihai Voiculescu
- Department of Dermatology and Allergology, Elias Emergency University Hospital, 011461 Bucharest, Romania.,Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Căruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Sabina Zurac
- Department of Pathology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
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18
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Cowdell F. Knowledge mobilisation: an ethnographic study of the influence of lay mindlines on eczema self-management in primary care in the UK. BMJ Open 2018; 8:e021498. [PMID: 30158225 PMCID: PMC6119411 DOI: 10.1136/bmjopen-2018-021498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To investigate the way in which mindlines, 'collectively reinforced, internalised tacit guidelines', are constructed among lay people with eczema in primary care. DESIGN Ethnographic study. SETTING Observation in one general practice in the UK and interviews across central England. PARTICIPANTS In observation, patients in the participating general practice regardless of presenting complaint and in interviews, people with eczema or parents of children with eczema (n=16). RESULTS Observation of over 250 hours and interview data were combined and analysed using an ethnographic approach through the lenses of mindlines and self-management. Four themes were identified: doctor knows best; not worth bothering the doctor; I need to manage this myself; and how I know what to do. Themes were set within the context of four broad typologies of lay people's approach to self-management: content to self-manage; content to accept practitioner management; self-managing by default; and those referred to secondary care. CONCLUSIONS This study is the first to examine how lay eczema mindlines are developed and to recognise typologies of people with different need for, and receptiveness to, information. Lay eczema mindlines are constructed in many ways. The outstanding challenge is to find strategies to revise or modify these mindlines by adding reliable and useful knowledge and by erasing outdated or inaccurate information.
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Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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19
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Diamantopoulos A, Wright E, Vlahopoulou K, Cornic L, Schoof N, Maher TM. The Burden of Illness of Idiopathic Pulmonary Fibrosis: A Comprehensive Evidence Review. PHARMACOECONOMICS 2018; 36:779-807. [PMID: 29492843 PMCID: PMC5999165 DOI: 10.1007/s40273-018-0631-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a debilitating condition with significant morbidity and poor survival. Since 2010, there has been increased activity in the development of treatments that aim to delay progression of the disease. OBJECTIVE Our study involves a comprehensive review of the literature for evidence on health-related quality of life (HRQoL), healthcare resource use (HCRU) and costs, and an assessment of the burden of illness of the condition. METHODS We carried out a systematic literature review (SLR) to identify economic evaluations and HRQoL studies. We searched EMBASE, MEDLINE and MEDLINE In Process for relevant studies from database origins to April 2017. Alongside the presentation of the study characteristics and the available evidence, we carried out a qualitative comparison using reference population estimates for HRQoL and national health expenditure for costs. RESULTS Our search identified a total of 3241 records. After removing duplicates and not relevant articles, we analysed 124 publications referring to 88 studies published between 2000 and 2017. Sixty studies were HRQoL and 28 were studies on costs or HCRU. We observed an exponential growth of publications in the last 3-5 years, with the majority of the studies conducted in Europe and North America. Among the HRQoL studies, and despite regional differences, there was some agreement between estimates on the absolute and relative level of HRQoL for patients with IPF compared with the general population. Regarding costs, after adjustments for the cost years and currency, the suggested annual per capita cost of patients with IPF in North America was estimated around US$20,000, 2.5-3.5 times higher than the national healthcare expenditure. Additionally, studies that analysed patients with IPF alongside a matched control cohort suggested a significant increase in resource use and cost. CONCLUSION The reviewed evidence indicates that IPF has considerable impact on HRQoL, relative to the general population levels. Furthermore, in studies of cost and resource use, most estimates of the burden were consistent in suggesting an excess cost for patients with IPF compared with a control cohort or the national health expenditure. This confirms IPF as a growing threat for public health worldwide, with considerable impact to the patients and healthcare providers.
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Affiliation(s)
| | | | | | | | - Nils Schoof
- Boehringer Ingelheim GmbH, Ingelheim, Germany
| | - Toby M Maher
- NIHR Biomedical Research Unit Royal Brompton Hospital, London, UK
- Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
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20
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Foulkes AC, Ferguson F, Grindlay DJC, Williams HC, Griffiths CEM, Warren RB. What's new in psoriasis treatment? An analysis of systematic reviews published in 2015. Clin Exp Dermatol 2018; 43:759-765. [PMID: 29806111 DOI: 10.1111/ced.13601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/16/2022]
Abstract
This review provides a summary of key findings from 27 systematic reviews of 51 articles first published or indexed during 2015, focusing on the treatment of psoriasis and on precision medicine in psoriasis. The evidence supports weight-loss interventions by dieting and exercise for improvement in disease severity in overweight and obese patients with psoriasis. No significant increased risk of serious infections was reported for the biologic therapies adalimumab, etanercept and ustekinumab compared with appropriate comparators. Evidence could not provide reliable estimates of rare adverse events, emphasizing the need for large prospective registries. Polymorphisms in the tumour necrosis factor (TNF)-α gene may confer improved responses to TNF inhibitor (TNFI) therapy, but the studies to date lack power to detect a true association. From the limited available evidence, multidisciplinary management is both more effective and more satisfactory for patients with psoriasis and psoriatic arthritis than conventional consultations. This summary of reviews provides a succinct guide for clinicians and patients wishing to remain up to date with high-quality evidence for the treatment of psoriasis.
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Affiliation(s)
- A C Foulkes
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - F Ferguson
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - D J C Grindlay
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - C E M Griffiths
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - R B Warren
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
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21
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Lloyd-Lavery A, Rogers NK, Davies E, Grindlay DJC, Thomas KS. What's new in atopic eczema? An analysis of systematic reviews published in 2015. Part 2: prevention and treatment. Clin Exp Dermatol 2018; 43:653-658. [DOI: 10.1111/ced.13554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/20/2022]
Affiliation(s)
- A. Lloyd-Lavery
- Department of Dermatology; Churchill Hospital; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - N. K. Rogers
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus; Lenton Lane Nottingham UK
| | - E. Davies
- Department of Dermatology; The Royal Liverpool and Broadgreen University Hospitals; Thomas Drive Liverpool UK
| | - D. J. C. Grindlay
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus; Lenton Lane Nottingham UK
| | - K. S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus; Lenton Lane Nottingham UK
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22
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Identifying training and informational components to develop a psoriasis self- management application. Med J Islam Repub Iran 2017; 31:67. [PMID: 29445696 PMCID: PMC5804427 DOI: 10.14196/mjiri.31.67] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Indexed: 01/19/2023] Open
Abstract
Background: Psoriasis is a complex disease with lifelong emotional and social consequences for affected patients. It also reduces
the patients’ quality of life and requires a long-term management. Therefore, in addition to appropriate treatment of the disease, selfmanagement
strategies to improve patient health and quality of life are essential. On the other hand, smartphone-based applications
alter the way people interact with health care and public health systems. This study aimed at identifying training and informational
components to develop a psoriasis self- management application.
Methods: This descriptive-analytic study was conducted on 100 patients with psoriasis and 26 dermatologists who were selected
randomly, using Morgan table. The data were collected using a researcher- made questionnaire, which included demographic and clinical
information, lifestyle training and management, and application capabilities in psoriasis self-management. A group of experts and
a test-retest method were used to confirm the validity and reliability of the questionnaire, respectively.
Results: The mean scores for demographic and clinical information, lifestyle training and management, and application capabilities
in self-management were 80.55%, 85.7%, and 88.8% from the patients’ perspective, and 83.7%, 71%, and 75% from the specialists’
viewpoint, respectively.
Conclusion: Determining self-management components by patients as persons who are suffering from the disease and physicians as
specialists in the field will be helpful in efficient psoriasis self-management. It is more likely that self-reliant patients, who are aware
of the benefits and risks of their disease management application, will follow their treatment plan and pursue the management of their
disease more seriously
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23
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Ridd MJ, King AJL, Le Roux E, Waldecker A, Huntley AL. Systematic review of self-management interventions for people with eczema. Br J Dermatol 2017; 177:719-734. [PMID: 28432696 PMCID: PMC5637890 DOI: 10.1111/bjd.15601] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 01/25/2023]
Abstract
Eczema is a common long‐term condition, but inadequate support and information can lead to poor adherence and treatment failure. We have reviewed the international literature of interventions designed to promote self‐management in adults and children with eczema. MEDLINE, MEDLINE in process, Embase, CINAHL and the Global Resource for EczemA Trials database were searched from their inception to August 2016, for randomized controlled trials. Two authors independently applied eligibility criteria, assessed risk of bias for all included studies and extracted data. Twenty studies (3028 participants) conducted in 11 different countries were included. The majority (n = 18) were based in secondary care and most (n = 16) targeted children with eczema. Reporting of studies, including descriptions of the interventions and the outcomes themselves, was generally poor. Thirteen studies were face‐to‐face educational interventions, five were delivered online and two were studies of written action plans. Follow‐up in most studies (n = 12) was short term (up to 12 weeks). Only six trials specified a single primary outcome. There was limited evidence of effectiveness. Only three studies collected and reported outcomes related to cost and just one study undertook any formal cost‐effectiveness analysis. In summary, we have identified a general absence of well‐conducted and well‐reported randomized controlled trials with a strong theoretical basis. Therefore, there is still uncertainty about how best to support self‐management of eczema in a clinically effective and cost‐effective way. Recommendations on design and conduct of future trials are presented. What's already known about this topic? Eczema requires a high degree of self‐management by patients. Adherence to eczema treatments, and hence control of symptoms, can be poor. There is uncertainty about how best to support self‐management in a clinically effective and cost‐effective way.
What does this study add?A wide range of interventions designed to promote self‐management have been evaluated in 20 studies across 11 different countries. Reporting of the design and conduct of these studies is generally poor, and explicit theory describing how interventions are expected to improve care is uncommon. What works best for people with eczema and whether it is cost‐effective is unknown. Recommendations for future trials are made.
Linked Comment: Arents. Br J Dermatol 2017; 177:613–614 Plain language summary available online
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Affiliation(s)
- M J Ridd
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
| | - A J L King
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
| | - E Le Roux
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
| | - A Waldecker
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
| | - A L Huntley
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
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24
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López-Estebaranz J, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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25
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López-Estebaranz JL, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:120-131. [PMID: 27816123 DOI: 10.1016/j.ad.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 01/24/2023] Open
Abstract
Acne is a chronic inflammatory disease whose psychosocial effects can greatly impair quality of life. Various scales are used to classify the severity of acne, and several treatment algorithms are currently applied: no consensus on a common scale or treatment guidelines has been reached. A group of Spanish experts therefore met to identify a scale the majority could accept as the most appropriate for classifying severity and treating accordingly. The group chose the following classifications: comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne, moderate nodular acne, and nodular-cystic acne (or acne tending to leave scars). Consensus was reached on first- and second-choice treatments for each type and on maintenance treatment. The experts also issued specific recommendations on antibiotic use (starting with mild or moderate papulopustular acne), always in combination with retinoids and/or benzoyl peroxide. The use of isotretinoin (starting at severe papulopustular or moderate nodular acne) was also covered.
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Affiliation(s)
| | | | - B Dréno
- Hospital Universitario de Nantes, Nantes, Francia
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26
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Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174:1228-41. [PMID: 26833102 DOI: 10.1111/bjd.14435] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 01/10/2023]
Abstract
Patient and carer education has been proposed as a way of improving health-related quality of life (HRQoL) among people with chronic inflammatory skin conditions. This systematic review aimed to assess the effects of education that specifically addresses HRQoL among people with chronic inflammatory skin conditions. We searched 12 literature databases and other sources (up to July 2014). Seven randomized controlled trials (RCTs) met the review inclusion criteria. Data from these RCTs were extracted and critically appraised. Two RCTs showed that for psoriasis in adults, group-based and text message education (as adjuncts to usual care) resulted in better HRQoL and disease severity outcomes than comparators, respectively. One RCT found that group-based education for children with eczema (atopic dermatitis) and their parents resulted in greater improvements in parents' HRQoL and in the children's disease severity than no education at 12 months. The remaining RCTs evaluated an educational session for psoriasis, a website for carers of children with eczema, information on skincare and make-up use given to women with acne, and an itch-coping programme for a range of conditions, all as adjuncts to usual care. None of these RCTs found statistically significant effects on HRQoL or disease severity compared with usual care. Common features of the effective interventions were long delivery (over 6 weeks to 3 months) and delivery by a multidisciplinary team. Overall, the evidence base is currently limited and generally has an unclear risk of bias. There is a need for more large RCTs evaluating piloted and theory-based interventions.
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Affiliation(s)
- K Pickett
- Southampton Health Technology Assessments Centre, Faculty of Medicine, University of Southampton, Southampton, SO16 7NS, U.K
| | - G Frampton
- Southampton Health Technology Assessments Centre, Faculty of Medicine, University of Southampton, Southampton, SO16 7NS, U.K
| | - E Loveman
- Southampton Health Technology Assessments Centre, Faculty of Medicine, University of Southampton, Southampton, SO16 7NS, U.K.,Effective Evidence LLP, Chandlers Ford, Hampshire, U.K
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