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Biomedical subjects

Glen H Crawford

Publications and source records attributed to Glen H Crawford.

At least 19 recordsLinked to original sources

Allergic contact dermatitis in children.

PURPOSE OF REVIEW: The following paper reviews the recent literature pertaining to allergic contact dermatitis in the pediatric population. RECENT FINDINGS: Allergic contact dermatitis may affect as many as 20% of the pediatric population. Recent studies implicate the following chemicals as the most common causes: nickel, topical antibiotics, preservative chemicals, fragrances and rubber accelerators. Several less common, but emerging, allergens have also been reported recently, including para-phenylenediamine in henna tattoos, cocamidopropyl betaine in 'no tears' shampoos and cleansers, and disperse dyes in clothing materials. Allergic contact dermatitis occurs less frequently in the first few months of life and increases in prevalence with increasing age. In the adolescent age group, females have significantly higher rates of allergic contact dermatitis on the face. This is likely explained by increased exposures to nickel in piercings and to preservative and fragrance chemicals in cosmetic products. SUMMARY: The documented rates of allergic contact dermatitis in children are on the rise. This increased prevalence may be due to increased chemical exposures in this age group, better recognition by pediatricians and perhaps more widespread use of epicutaneous patch testing. This review outlines the basic pathophysiology, epidemiology and clinical manifestations of allergic contact dermatitis in children.

Adolescent↗

Patients' attitudes toward resident participation in dermatology outpatient clinics.

The attitudes of patients toward resident participation in a university-based dermatology outpatient clinic were evaluated. Of 206 patients asked to participate, 191 patients completed the self-administered questionnaire (92.7%). The overwhelming majority of patients (99.5%) were satisfied (81.8% "very satisfied" and 17.7% "satisfied") with the resident's participation in their care. Many more patients expressed a willingness to allow residents to take histories (93.6%), perform physical examinations (87.2%), and counsel on preventive measures (74.5%), than to allow surgical excisions of skin cancers (19.7%), perform skin biopsies (43.6%), or prescribe medications (44.7%). Of respondents to the questionnaire, 83.2% self-reported an understanding of the difference between "resident" and "attending" physicians. However, only 31.3% (95% confidence interval 24.5-38.1) were able to broadly categorize the amount of training completed by dermatology residents. Dermatology resident participation in outpatient clinics is essential to quality dermatologic education. Consistent with the results of prior studies in other medical disciplines, our study demonstrated an overwhelming patient satisfaction with the participation of dermatology residents in their care.

Clinical Competence↗

Use of aromatherapy products and increased risk of hand dermatitis in massage therapists.

OBJECTIVES: To determine the 12-month prevalence of hand dermatitis among massage therapists, to investigate a potential association between hand dermatitis and the use of aromatherapy products, and to study potential associations with other known risk factors for hand dermatitis. DESIGN: Mailed survey. SETTING: Philadelphia, Pa. PARTICIPANTS: Members of a national massage therapy organization who live in the greater Philadelphia region. MAIN OUTCOME MEASURES: Self-reported and symptom-based prevalences of hand dermatitis. RESULTS: The number of respondents was 350 (57%). The 12-month prevalence of hand dermatitis in subjects was 15% by self-reported criteria and 23% by a symptom-based method. In multivariate analysis, statistically significant independent risk factors for self-reported hand dermatitis included use of aromatherapy products in massage oils, lotions, or creams (odds ratio, 3.27; 95% confidence interval, 1.53-7.02; P =.002) and history of atopic dermatitis (odds ratio, 8.06; 95% confidence interval, 3.39-19.17; P<.001). CONCLUSIONS: The prevalence of hand dermatitis in massage therapists is high. Significant independent risk factors include use of aromatherapy products in massage oils, creams, or lotions and history of atopic dermatitis.

Adult↗

Statistical reviewing policies in dermatology journals: results of a questionnaire survey of editors.

BACKGROUND: Problems with statistical methods and reporting have been noted in articles published in dermatology journals. Conclusions presented in published reports may be misleading if based on inappropriate or misinterpreted statistical analysis. OBJECTIVE: We sought to assess dermatology journal editors' policies and perceptions regarding statistical review of submitted manuscripts. DESIGN: We mailed and e-mailed a questionnaire survey. PARTICIPANTS: A total of 43 dermatology journal editors, representing 35 dermatology journals from the United States and abroad, participated in this study. RESULTS: In all, 32 editors (74.4%), representing 30 journals (85.7%), returned questionnaires. A total of 24 editors (75%) reported having requested statistical reviews on less than 5% of published manuscripts containing original quantitative analysis (ie, excluding reviews and case reports), whereas 3 editors (9.4%) reported having requested statistical reviews on more than 75% of such manuscripts. Most editors reported requesting statistical reviews on a case-by-case basis either after initial favorable review by subject-matter (nonstatistical) reviewers (12 editors; 37.5%) or at the same time that subject-matter review was requested (6 editors; 18.8%). A total of 4 editors (12.5%) reported requesting statistical review for all manuscripts at the same time they are sent for subject-matter review. Another 10 editors (31.3%) said their journals had no general policy on statistical reviewing, and statistical review is almost never needed. For 15 editors (46.9%), ideal statistical reviewing policy was identical to their current policy, whereas 13 (40.6%) favored a more rigorous and 3 (9.4%) a less rigorous policy. CONCLUSIONS: Dermatology journals infrequently perform statistical reviews of submitted manuscripts. Dermatology journal editors' statistical review policies range from no general policy to (most frequently) requesting reviews on a case-by-case basis to reviewing all submitted manuscripts. Many editors favor more rigorous statistical reviewing policies for their journals. Increased use of statistical reviewing may increase the reliability of conclusions published in dermatology journals.

Dermatology↗

Rosacea: I. Etiology, pathogenesis, and subtype classification.

Rosacea is one of the most common conditions dermatologists treat. Rosacea is most often characterized by transient or persistent central facial erythema, visible blood vessels, and often papules and pustules. Based on patterns of physical findings, rosacea can be classified into 4 broad subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. The cause of rosacea remains somewhat of a mystery. Several hypotheses have been documented in the literature and include potential roles for vascular abnormalities, dermal matrix degeneration, environmental factors, and microorganisms such as Demodex folliculorum and Helicobacter pylori. This article reviews the current literature on rosacea with emphasis placed on the new classification system and the main pathogenic theories. Learning objective At the conclusion of this learning activity, participants should be acquainted with rosacea's defining characteristics, the new subtype classification system, and the main theories on pathogenesis.

Adrenal Cortex Hormones↗

Rosacea: II. Therapy.

Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtypes of rosacea include erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea, and ocular rosacea. These phenotypic expressions are probably caused by divergent pathogenic factors and consequently respond to different therapeutic regimens. A subtype-directed approach to therapy is discussed in part II of this review. We provide an overview of the available topical, oral, laser, and light therapies in the context of these cutaneous subtypes, review the evidence that supports their use, and outline their therapeutic approach. Suggestions for future areas of study also are provided. Learning objective At the completion of this learning activity, participants should be familiar with the subtype-directed approach to therapy for rosacea including available topical, oral, laser, and light therapies.

Anti-Infective Agents↗

Tea tree oil: cutaneous effects of the extracted oil of Melaleuca alternifolia.

The use of botanical extracts for their perceived therapeutic benefits has gained increased popularity in this country and abroad. In particular, tea tree oil (the extracted oil of Melaleuca alternifolia) has gained widespread use for its purported antimicrobial and therapeutic effects. In parallel with this increased use is an expanding series of reported adverse effects, including allergic contact dermatitis, systemic contact dermatitis, linear immunoglobulin A disease, erythema multiforme-like id reactions, and systemic hypersensitivity reactions. We present a review of tea tree oil with regard to its history, chemistry, purported medicinal uses, and possible adverse cutaneous effects.

Allergens↗

Effect of wax epilation before hair removal with a long-pulsed alexandrite laser: a pilot study.

BACKGROUND: Recent reports indicate that laser hair removal is most effective on anagen hairs. However, no published trials have examined laser epilation after hair cycle synchronization. OBJECTIVE: To evaluate the potential for enhanced laser hair removal after the induction of telogen hairs into anagen by wax epilation. METHODS: We identified four 2.5-cm square areas with equivalent hair length and density on the backs of 13 dark-haired white men. To induce typically telogen hairs into anagen, two areas on each patient were wax epilated. Two weeks later, one waxed area and one unwaxed area were treated with a long-pulsed alexandrite laser. One month after laser treatment, a subjective comparison was made based on hair density, length, and thickness. RESULTS: In 12 of 13 patients, lasered areas that had been pretreated with wax epilation were clearer of hair as compared with areas that had been pretreated by shaving (P=0.0034). No significant difference was noted between waxed and unwaxed control areas that had not been laser treated (P=1.0). CONCLUSION: Wax epilation 2 weeks before laser hair removal improves cosmetic outcomes at 1 month. This effect may be secondary to the recruitment and heightened sensitivity of early anagen hairs.

Adult↗

Poison ivy.

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Toxicodendron↗