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PubMed2001

Impact factors of dermatological journals for 1991 - 2000.

BACKGROUND: The impact factors of scientific journals are interesting but not unproblematic. It is speculated that the number of journals in which citations can be made correlates with the impact factors in any given speciality. METHODS: Using the Journal Citation Report (JCR) for 1997, a bibliometric analysis was made to assess the correlation between the number of journals available in different fields of clinical medicine and the top impact factor. A detailed study was made of dermatological journals listed in the JCR 1991-2000, to assess the relevance of this general survey. RESULTS: Using the 1997 JCR definitions of speciality journals, a significant linear correlation was found between the number of journals in a given field and the top impact factor of that field (rs = 0.612, p < 0.05). Studying the trend for dermatological journals 1991 to 2000 a similar pattern was found. Significant correlations were also found between total number of journals and mean impact factor (rs = 0.793, p = 0.006), between the total number of journals and the top impact factor (rs = 0.759, p = 0.011) and between the mean and the top impact factor (rs = 0.827, p = 0.003). CONCLUSIONS: The observations suggest that the number of journals available predict the top impact factor. For dermatology journals the top and the mean impact factor are predicted. This is in good agreement with theoretical expectations as more journals make more print-space available for more papers containing citations. It is suggested that new journals in dermatology should be encouraged, as this will most likely increase the impact factor of dermatological journals generally.

Bibliometrics↗
PubMed2006

Pharmionics in dermatology: a review of topical medication adherence.

The objective of this article was to review patient adherence to topical medications and its relationship to health outcomes in dermatologic disease. To this end, MEDLINE searches from January 1966 through June 2006 and EMBASE searches from January 1974 through June 2006 were conducted. Relevant human efficacy studies, including randomized controlled trials, observational studies, and case-control studies, were selected on the basis of the key words 'compliance,' 'adherence,' 'pharmionics,' 'topical,' 'medication,' or 'dermatology.' Studies were included and reviewed on the basis of their experimental design, controls, and statistical analysis. Analysis revealed that suboptimal adherence to topical medications is a common cause of minimal response or lack of response to drugs and is linked with poor dermatologic outcomes in diseases such as psoriasis, atopic dermatitis, and acne. It is concluded that non-adherence to topical medications is as common as non-adherence to oral medications, and its relationship to poor health outcomes is clear. Several barriers to topical medication adherence and predictors of non-adherence are similar to those for oral medications, while other barriers and predictors are unique to topical medications and the nature of dermatologic disease. Further studies of effective interventions to increase adherence are necessary to improve health outcomes in dermatology.

Administration, Cutaneous↗
PubMedDate not supplied

The use of quality benchmarking in assessing web resources for the dermatology virtual branch library of the National electronic Library for Health (NeLH).

BACKGROUND: In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health. They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. OBJECTIVES: This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health. It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. METHODS: Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. RESULTS: Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. CONCLUSIONS: Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for Health service. Furthermore, by promoting the application of agreed quality guidelines and codes of ethics by all health information providers and not just within the National electronic Library for Health, the overall quality of the Web will improve with time and the Web will ultimately become a reliable and integral part of the care space.

Dermatology↗
PubMed2006

Conflicts of interest in dermatology.

Conflicts of interest exist in dermatology when professional judgement concerning a primary interest, such as research validity, may be influenced by a secondary interest, such as financial gain from a for-profit organization. Conflict of interest is a condition and not a behaviour, although there is clear evidence that gifts influence behaviour. Little has been written about conflicts of interest in dermatology. This series of papers raises awareness of the subject by exploring it in greater depth from the perspective of a dermatology researcher, an industry researcher, a dermatology journal editor, a health services researcher and a patient representative. Collectively, they illustrate the many ways in which conflicts can pervade the world of dermatology publications and patient support group activities.

Authorship↗
PubMed1989

The teaching of dermatology to Canadian undergraduates in the mid-1980s.

The Canadian Association of Professors of Dermatology (CAPD) has approved new goals, objectives, and a core curriculum for Canadian undergraduate dermatology teaching. This followed a survey by mailed questionnaire of the 16 Canadian medical schools. The previous core curriculum approved by the Canadian Dermatological Association (CDA) was modified and received additions. This paper draws attention to the prevalence of dermatology problems in clinical practice, shows the reported state of dermatology teaching in 16 Canadian schools in the mid-1980s, and tabulates goals, objectives, and a core curriculum.

Canada↗
PubMedDate not supplied

A multi-agent architecture for teaching dermatology.

This work proposes the integration of computer-aided instruction systems in the curricula of medical education, and describes an intelligent tutoring system used for teaching Dermatology. The Dermatology Tutor uses a self-organized society of autonomous software agents which have different capabilities or roles. The society contains tutor, medical and information agents which participate in the tutoring process and collaborate through deliberation in order to achieve a tutoring task. The agents are built according to a BDI architecture, which implements the mental attitudes of beliefs (B), desires (D) and intentions (I). Each medical agent is a specialist in a medical field, while a tutoring agent, which implements a widely accepted dermatology teaching process, coordinates the overall operation of the system. Depending on the subject that is to be taught during any session, the tutoring agent forms teams of medical agents, which in turn use search agents to retrieve information. Although the presented multi-agent architecture is dedicated to teaching dermatology (since the tutor agent is specialized in Dermatology), it can be extended to other domains also with the incorporation of other tutor agents.

Computer Systems↗
PubMed2003

How common is obsessive-compulsive disorder in a dermatology outpatient clinic?

BACKGROUND: This study was prompted by reports suggesting a high prevalence of unrecognized obsessive-compulsive disorder (OCD) in the dermatology clinic. METHOD: 92 consecutive dermatology referrals were screened for DSM-IV OCD using the Mini-International Neuropsychiatric Inverview (MINI), the Yale-Brown Obsessive Compulsive Scale (YBOCS), and the 5-item screening questionnaire from the International Council on OCD. Illness severity was rated on the YBOCS, and symptom profiles and dermatologic diagnoses were established for screen-positive cases. RESULTS: 18 patients (20%) qualified for a DSM-IV diagnosis of OCD, of whom 17 were previously undiagnosed. The range and type of OCD symptoms covered the normal clinical spectrum. Most patients had more than 1 symptom, and among obsessions (including somatic obsessions), checking, washing, and symmetry were common. The mean total YBOCS score was 16/40 (SD = 7.2), indicating moderate OCD, and 40% of the positive cases scored 16 or higher. Dermatologic diagnoses were various and did not seem to bear a direct relationship with the OCD. CONCLUSION: These results suggest that there is a high prevalence of clinically relevant OCD in the dermatology clinic. This is an area that merits attention with regard to better recognition and treatment for OCD sufferers.

Adolescent↗
PubMed1998

An international dermatological image atlas on the WWW: practical use for undergraduate and continuing medical education, patient education and epidemiological research.

We describe the development of an image database DOIA (Dermatological OnlIne Atlas) and present several spin-off projects using images of the atlas, e.g. student education using the atlas including results of an questionnaire evaluating computer-literacy, prerequisites and interests of students for using computers and the World-Wide-Web (WWW), a patient information system and an experiment to collect epidemiological data from patients with dermatological diseases via WWW. The database, available on the WWW at http:@www.derma.med.uni-erlangen.de, contains about 3,000 clinical images covering more than 540 dermatological diagnoses. It is designed for worldwide use; international submissions are encouraged. One aim of the project is to compile an international reference for dermatological images, containing images of high educational quality and also covering conditions on different skin types and rare diagnoses which are not commonly illustrated in ordinary textbooks. All images were originally mapped to the Erlanger Diagnosis Code, which is a proprietary modified ICD-9 key, later also to the UMLS (Unified Medical Language System). In addition, images are described with keys for the location, physical attributes of the location and clinical and histopathological features of the lesion. In order to facilitate the integration of the atlas into other web-based medical resources and to allow easy access to additional information, the Erlanger Diagnosis Code was mapped to the CUIs (unique concept identifiers) of the UMLS Metathesaurus. One purpose of the UMLS is to allow conversion of terms from one controlled medical vocabulary to another, thus, mapping of our diagnosis code to the UMLS CUIs allows simultaneous search for a given diagnosis in a number of other databases and also access to our image database from other databases. Mapping was successful for 619 out of 1383 dermatological diagnosis terms. For images with these diagnoses we are able to provide a hyperlink to other databases available on the Internet, such as MEDLINE, PDQ and OMIM, with automatic retrieval using the preferred vocabulary of the respective database. By grouping all diagnoses into sets with similar morphologies we further integrated a differential diagnosis mode. In order to educate patients via the Internet, a separate patient information system has been developed, using images of the electronic atlas. As an experiment to explore the feasibility of the Internet to gather epidemiological data from patients, users are asked to complete an electronic questionnaire covering signs for atopy. We conclude that an online image atlas has multiple educational, clinical and research applications.

Computer-Assisted Instruction↗
PubMed1994

[The establishment of the first journals of dermatology and venereology in the nineteenth century].

Medical periodicals specialized in dermatology and sexually transmitted diseases were first published during the second half of the nineteenth century. Their goal was to promote the diffusion of medical knowledge, among specialists (clinical research), as well as towards general practitioners (medical education). Until now, medical journals are the major tool for the diffusion of news and progress in medicine. We briefly describe the first of these dermatological journals: Syphilidologie, founded in 1838 in Leipzig by Friedrich Jacob Behrend; Annales des maladies de la peau et de la syphilis, the first truly dermatological journal, published in Paris from August 1843 to 1852 by Alphée Cazenave; Giornale italiano delle malattie veneree e delle malattie della pelle, founded in 1866 in Milan by Giovanni Battista Soresina; Journal of cutaneous medicine and diseases of the skin, created in London in 1867 by Erasmus Wilson, and which lasted only four years; Annales de dermatologie et de syphiligraphie, founded in Paris in 1868 by Adrien Doyon, which are still published now; Archiv für Dermatologie und Syphilis, published in Prague in 1869 by Heindrich Auspitz and Filipp Josef Pick; The American Journal of Syphilography and Dermatology, the first non-European dermatological periodical, created in 1870 in New York by Morris H. Henry.

Dermatology↗
PubMed2004

Assessment of knowledge and skills in early diagnosis of leprosy and attitudes towards leprosy amongst doctors working in dermatological services, Shandong Province, People's Republic of China.

After the leprosy control programme in Shandong Province, China, had declared elimination in 1994, it was no longer cost effective to rely on rapid surveys, population surveys and contact tracing for case detection, and since then most new cases have been diagnosed by the dermatological services. The dermatological services will continue to play an important role in diagnosis of the few incident leprosy cases scattered in wide geographic areas and in a population of 90 million. In order to better understand the knowledge and skills in early diagnosis of leprosy among doctors working in dermatological services around the province, doctors attending the dermatological annual meeting and a dermatological training workshop were assessed on their knowledge and skills in early diagnosis of leprosy and their attitude towards leprosy with a semi-structured questionnaire. The results showed that continuous training was needed for dermatologists from both general hospitals and the leprosy control programme. In particular, the training methods for the skills in nerve examination including palpation of peripheral nerves and nerve function assessment should be improved.

Adult↗
PubMed2006

Dermatology postgraduate training in Canada: CanMEDS competencies.

Medical residency education and the development of formalized training objectives in Canada have evolved continuously, especially with the introduction of the Canadian Medical Education Directions for Specialists (CanMEDS) competencies by the Royal College of Physicians and Surgeons of Canada (RCPSC) in 1996. In order to evaluate the effectiveness of implementation of CanMEDS competencies in Canadian postgraduate dermatology training programs from the residents' perspective, a comprehensive national survey of all Canadian core dermatology residents was conducted in June 2004. One hundred percent of core (PGY3-5) dermatology residents across the country (n = 48) completed the survey. Forty eight percent of residents were familiar with the CanMEDS competencies. Within the CanMEDS framework, the competencies were felt to be taught adequately by the following proportion of residents: medical expert (78 %), professional (66 %), communicator (52 %), collaborator (48 %), health advocate (48 %), scholar (48 %), and manager (28 %), with notable differences based on the year of training. This is the first national Canadian survey examining dermatology postgraduate education from the residents' perspective with a focus on CanMEDS competencies. While the RCPSC CanMEDS project implementation is presently in the faculty development phase, further work must be accomplished to enhance awareness of CanMEDS competencies and to incorporate these into dermatology residency programs across the country. Particular targeting of the roles perceived to be poorly taught is needed.

Canada↗
PubMed1985

National survey of undergraduate dermatologic medical education.

A survey of dermatology department or section chairmen was conducted to investigate the extent of undergraduate dermatologic training in US medical schools. The median number of required hours of dermatologic training was 14, which represents 0.24% of the overall medical school curriculum time. Required dermatologic training time varied greatly among schools, but most such training occurred in the fourth year of school. Students in 53% of the schools that responded to the survey were not involved in either clinical or basic dermatologic investigative activities.

Curriculum↗
PubMed2005

Antibiotic prophylaxis in dermatologic surgery: updated guidelines.

BACKGROUND: Antibiotic prophylaxis in dermatologic surgery is poorly understood, and data on its use are lacking. Prophylaxis is indicated for the prevention of endocarditis and prosthesis infection, as well as surgical site infection. OBJECTIVE: We review essential considerations for the use of antibiotic prophylaxis in dermatologic surgery and provide clear guidelines for practical implementation. METHODS: Guidelines were developed after review of the literature and consultation with infectious disease specialists and subspecialists in the areas of cardiac, orthopedic, and neurosurgical infectious disease at Mayo Clinic. RESULTS: Three factors affect the decision to use prophylactic antibiotics in dermatologic surgery: (1) the underlying indication for prophylaxis (patient risk stratification), (2) the condition of the skin, and (3) the specific procedure planned. Thorough preoperative evaluation and surgical planning are critical in identifying and optimizing patient and environmental risk factors that may increase the risk of infection. Appropriate antibiotic selections with site-specific consideration and appropriate timing of antibiotic administration are key factors in providing effective prophylaxis. CONCLUSIONS: Low rates of infection associated with dermatologic surgical procedures warrant selective use of antibiotic prophylaxis. The proposed guidelines reflect current standards of practice.

Antibiotic Prophylaxis↗
PubMed1998

Prevalence of human herpesvirus 8 infection measured by antibodies to a latent nuclear antigen in patients with various dermatologic diseases.

BACKGROUND: Human herpesvirus 8 (HHV-8) has been detected in all epidemiological forms of Kaposi sarcoma (KS). The role of HHV-8 in dermatologic diseases other than KS is controversial. Some studies based on polymerase chain reaction findings suggest an association between HHV-8 and epithelial tumors of the skin, lymphoproliferative disorders, or pemphigus. OBJECTIVE: To assess the prevalence of antibodies against a latent nuclear antigen of HHV-8 in patients with various dermatologic diseases. DESIGN: An indirect immunofluorescence assay was used to search for HHV-8 antibodies. SETTING: Ambulatory or hospitalized patients from a university hospital associated with a research laboratory. PATIENTS: Eighty-three patients with various non-KS dermatologic diseases and 16 patients with KS who were seronegative for the human immunodeficiency virus. Controls were 100 healthy subjects living in the same area. RESULTS: Antibodies to HHV-8 were found in 100% (16/16) of the patients with KS and 3.6% (3/83) of the patients with non-KS dermatologic diseases: 1 patient with pemphigus vulgaris, 1 with discoid lupus erythematosus, and 1 with bullous pemphigoid. The prevalence of antibodies to HHV-8 in controls was 2% (2/100) and was not significantly different than the prevalence in patients with dermatologic diseases other than KS (P =.28). CONCLUSIONS: Our serologic study confirms the higher prevalence of HHV-8 antibodies in patients with KS and demonstrates that contrary to other human herpesviruses, HHV-8 is not a ubiquitous virus in France. We could not determine any causal association between HHV-8 and pemphigus or lymphoproliferative disorders of the skin.

Adult↗
PubMed2007

Short-term thallium intoxication: dermatological findings correlated with thallium concentration.

BACKGROUND: The dermatological features and skin biopsy findings of short-term thallium intoxication have been described. However, the correlation between the dermatological findings and the thallium concentration, the prognosis of peripheral neuropathy, and a cutaneous nerve biopsy study are lacking. OBSERVATIONS: Two patients initially developed perioral numbness, erythematous facial rashes, and polyneuropathy after ingesting thallium-containing water. Severe diffuse alopecia was noted, and a skin biopsy specimen revealed parakeratosis and vacuolar degeneration of the basal layer. Examinations of the hair mount demonstrated a tapered appearance of the anagen root. A serial cutaneous nerve biopsy study showed a loss of epidermal nerves 7 weeks and even 1 year after the thallium intoxication. A toxicology survey disclosed a high concentration of thallium (about 3124 mg/L) in the water. The clinical dermatological features subsided completely, but polyneuropathy with severe painful feet persisted. The blood and daily urinary thallium concentrations decreased slowly in the following 3-month period. CONCLUSIONS: The clinical dermatological features subsided completely, but painful polyneuropathy persisted. The series cutaneous nerve biopsy specimens showed persistent damage to the sensory nerve endings. The disappearance of the dermatological features and the appearance of Mees lines correlated with the decrease of blood and urinary thallium concentrations.

Alopecia↗
PubMed2005

Dermatologic manifestations of the antiphospholipid syndrome: two hundred consecutive cases.

OBJECTIVE: To describe dermatologic manifestations of the antiphospholipid syndrome (APS) and to investigate possible correlations between livedo reticularis and other APS manifestations. METHODS: We conducted a single-center study of 200 consecutive patients with primary or systemic lupus erythematosus-related APS. To qualify for the study, patients had to fulfill clinical and laboratory criteria from the most recent international consensus statement on classification of definite APS. Dermatologic manifestations were systematically evaluated by a dermatologist. Only dermatologic lesions that may be related to APS were included in the analyses. Correlations between livedo reticularis and other APS manifestations were determined using Fisher's 2-tailed, chi-square, and nonparametric Mann-Whitney tests. RESULTS: Dermatologic manifestations were noted in 49% of the patients and were the presenting manifestations in 30.5%. Livedo reticularis was the most frequent manifestation, observed in 25.5% of the patients. Livedo reticularis was shown to be significantly associated with cerebral or ocular ischemic arterial events (odds ratio [OR] 10.8, 95% confidence interval [95% CI] 5.2-22.5), seizures (OR 6.5, 95% CI 2.6-16), all arterial events (OR 6, 95% CI 2.9-12.6), heart valve abnormalities detected on echocardiography (OR 7.3, 95% CI 3.6-14.7), and arterial systemic hypertension (>/=160/90 mm Hg) (OR 2.9, 95% CI 1.5-5.7). Conversely, it was observed with decreased frequency in patients with only venous thrombosis (OR 0.2, 95% CI 0.1-0.5). CONCLUSION: The dermatologic manifestations of APS are frequently the presenting feature of the syndrome, and livedo reticularis is significantly associated with the arterial subset of APS.

Adolescent↗
PubMed1998

[Assessment of the quality of life of patients in dermatology].

A judgement on the patient's quality of life cannot be based solely on the information about the clinical severity of a disease. Very often there is no correlation between these parameters. It is necessary to assess the quality of life by a health status questionnaire since non-life threatening diseases common in dermatology influence the quality of life very much. The most frequently used questionnaires are the SF-36 and the Nottingham Health Profile. However, these forms do not evaluate all dermatologic patients adequately. Therefore specific tools such as the DLQI (Dermatology Life Quality Index) and Skindex have been established for dermatology. Further disease-specific questionnaires have been created to measure time related changes in dermatological patients.

Activities of Daily Living↗
PubMed2002

Use of eye movement desensitization and reprocessing (EMDR) in the treatment of dermatologic disorders.

BACKGROUND: The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations. OBJECTIVE: We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder. METHODS: Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3-6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6-12 months after the end of EMDR therapy. RESULTS: All 4 patients experienced a marked improvement in their symptoms after 3-6 sessions of EMDR, within a period of </= 3 months, and maintained improvement during followup periods of 6-12 months. CONCLUSION: Our preliminary findings suggest that EMDR may be beneficial in the treatment of a wide range of stress-mediated dermatologic symptoms.

Adult↗