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PubMed2004

Dermatological publications in the Gulf Cooperation Council countries. An analysis of 1966-2004 Medline papers.

OBJECTIVE: To investigate the publications in dermatology cited in the Medline from 6 countries of the Gulf Cooperation Council (GCC) from 1966 to 2004. METHODS: Medline was searched with the aid of Internet provider Pubmed using the same strategy at a given time for all countries. RESULTS: At the time of search, the Medline listed biomedical research papers from the GCC countries totaled 12837. Of these, 140 were in Dermatology. The Kingdom of Saudi Arabia followed by Kuwait was by far the most prolific contributor, whereas almost none were noted from Bahrain. The publications were highest during the year 2002 (19) followed by 2003 (13), most of them being in the English language in the International Journal of Dermatology (60 citations) and Pediatric Dermatology (13 citations). CONCLUSION: Though the GCC countries have seen a relatively small period in the history of development of medical research, data show that they are trying to keep pace with the rest of the developed world. What remains to be exploited is their good economy that should be directed to provide better infrastructure and improve the quality of training programs. Professional societies within the region must play an active role in ensuring optimum and judicious use of funds.

Dermatology↗
PubMed2006

Assessment of a blog as a medium for dermatology education.

Our first year experience with the use of a web log as a communication tool for our dermatology interest group at the University of Texas Medical Branch in Galveston (UTMB) is described. We find the UTMB Dermatology Interest Group Blog facilitates educational opportunities and serves as a dermatology resource for medical students, and improves communication. It is an educational innovation that could be adopted by other dermatology departments.

Communication↗
PubMed1985

Dermatologic formulary.

The formulary for dermatologic use in the emergency department must not only encompass drugs that are essential for advanced cardiac and trauma life support, but must have specific drugs that are indicated for common dermatologic conditions that are evaluated in the emergency department. First and foremost is the selection of the appropriate drug for the disease. Other factors, such as the vehicle in which the drug is compounded, become equally important, as this directly affects the delivery of medication to the patient. Although this formulary is by no means complete, it is a reasonable guide for emergency medicine physicians to utilize when comtemplating dermatologic care. It is important when selecting a drug for dermatologic care that the physician be cognizant of the patient--the type, location, and condition of the skin--and of the disease he or she is treating. When these factors are given due consideration, the appropriate drug for the disease will be utilized for the ultimate benefit of the patient.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Current instrumentation in laser dermatology.

Early laser studies noting and assessing tissue reaction to laser energy have led to significant advances in dermatology. In clinical use are the argon, carbon dioxide, and neodymium:yttrium-aluminum-garnet laser systems. Current developments are to miniaturize the systems, shorten pulses, and combine various systems. Current applications include tumor, wart, condylomata acuminata, and port wine mark removal; vascular surgery; for diseases of the skin; and as an adjuvant to other surgical procedures. Laser surgery is, briefly, the use of various laser systems for dermatological surgery, including microsurgery. Laser dermatological medicine is the rapidly developing discipline essentially for diagnosis and for investigative studies in dermatologic photobiology.

Dermatology↗
PubMed1998

[The scientific development in dermatology in Germany in relation to the emigration of Jewish dermatologists during national socialism].

The anti-semitic laws let to the persecution of the Jews in Germany during the time of National Socialism. About 600 Jewish dermatologists had to suffer from the prohibition of their profession. 63% of them left Germany. The emigrants mainly preferred to move out to the U.S. The policy of coordination and elimination of the National Socialists led to the reappointment of dermatological chairs in universities. The National Socialists also forced the change in the boards of dermatological societies and the change of the editorial boards of dermatological journals. All papers of the three leading dermatological journals were analysed for the evaluation of the development of science. The assessment included the number of articles, the origin of the authors and the contents of articles (research, clinics, diagnostic, therapy). From 1933 to 1945 the number of papers per year decreased consequently, especially during the Second World War. During the whole time the number of German authors increased and the number of abroad living authors decreased. There was a very good and interesting international exchange of information in the journal "Archiv für Dermatologie und Syphilis". The activity reduced clearly after the beginning of the Second World War in 1939. The analysis of contents resulted in a reduction of basis science research and an orientation to the clinical research. Papers about therapeutical possibilities were always published. The emigration of Jewish dermatologists led to a continuous reduction of scientific activities and to an extensive international isolation.

Dermatology↗
PubMed1998

Practising dermatology via telemedicine.

AIM: An interactive telemedicine service has been established between Taumarunui Hospital and the Department of Dermatology at Waikato Hospital. The first one hundred dermatological consultations were reviewed to see if the consultations were satisfactory for medical staff and patients. METHODS: A proprietary video conferencing system communicating via the Integrated Systems Digital Network was used to conduct dermatological consultations. Data were collected regarding waiting time, diagnosis and follow-up arrangements. Each patient was asked to complete a questionnaire after the consultation. RESULTS: Of these consultations, 83 were newly referred patients and the rest were follow-ups. The median waiting time for a new patient was 63 days. A variety of skin lesions (in 40 patients), inflammatory eruptions (31) and infections (13) were diagnosed and managed. Sixteen patients had to be seen at the base hospital for surgical treatment (7), face-to-face diagnosis (3), patch testing (3), a second opinion (2), or for personal reasons (1). The others were followed up locally. Savings in time and cost to patients were noted particularly. CONCLUSION: Only about 20% of consultations with new patients resulted in a further face-to-face appointment. The majority of patients found the telelink acceptable. The data supported the continuation and possible expansion of the dermatology telemedicine service. However, improved image quality is desirable.

Dermatology↗
PubMed1995

Essential mixed cryoglobulinemia. A comparative study of dermatologic manifestations in patients infected or noninfected with hepatitis C virus.

BACKGROUND AND DESIGN: An association between essential mixed cryoglobulinemia and hepatitis C virus (HCV) infection has been reported. Dermatologic manifestations are a classic presenting complaint in essential mixed cryoglobulinemia. The aim of this study was to compare the frequency and the nature of dermatologic manifestations in essential mixed cryoglobulinemia according to the presence of anti-HCV antibodies. Sixty-two consecutive patients with essential mixed cryoglobulinemia were tested for anti-HCV antibodies. Dermatologic manifestations were systematically assessed. RESULTS: Anti-HCV antibodies were detected in 35 patients. Palpable purpura corresponding histologically to leukocytoclastic vasculitis was the more frequently observed dermatologic manifestation and occurred mainly in HCV-antibody-positive patients. The patients with purpura had significantly higher serum cryoglobulin levels than patients without purpura. CONCLUSIONS: The frequency of palpable purpura is higher in HCV-antibody-positive patients and is related to the serum cryoglobulin levels.

Cryoglobulinemia↗
PubMed1992

Dermatologic adverse drug reactions in a family medicine setting.

To determine the prevalence of dermatologic adverse drug reactions in a family medicine outpatient practice setting, identify associated drug classes, and describe associated patient demographics and risk factors, we reviewed the charts of 557 patients in a university-based family medicine center who were diagnosed with a dermatologic condition. The study population included all patients diagnosed during a 1-year period. Thirty-five patients (6.3%) were identified as having dermatologic adverse drug reactions, of which the two most common types were exanthematous eruptions (n = 18 [51.4%]) and generalized erythroderma (n = 6 [17.1%]), with antibiotic use accounting for the majority (n = 21 [60.0%]) of reactions. Patient characteristics most commonly associated with a dermatologic adverse drug reaction were race (African-American), gender (female), and age (70 years and older). These data should provide insight into the types of cutaneous drug reactions commonly seen in community practice. Educational programs in all health-care disciplines, particularly medicine, pharmacy, and public health, that incorporate pharmacoepidemiologic strategies into their curricula are necessary to improve the overall process of monitoring and reporting of adverse drug reactions.

Academic Medical Centers↗
PubMed1994

Adverse dermatologic reactions from antiarrhythmic drug therapy.

Undesirable cutaneous reactions to drugs may occur early or late in the course of treatment. The ingestion of drugs may also aggravate existing dermatologic conditions. The adverse dermatologic reactions from antiarrhythmic drug therapy are reviewed. The exact incidence of dermatologic side effects from cardiovascular drugs has been difficult to estimate because of sporadic reporting. In this review, the cutaneous side effects are discussed according to drug class and the type of dermatologic reaction.

Anti-Arrhythmia Agents↗
PubMed2005

Off-label dermatologic uses of anti-TNF-a therapies.

BACKGROUND: Tumor necrosis factor-alpha (TNF-a) is a proinflammatory cytokine that plays an immunomodulatory role in a variety of systemic and dermatologic diseases. Currently, three anti-TNF-a drugs are available in North America- infliximab (approved in the U.S. for the treatment of rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, ulcerative colitis, and psoriatic arthritis), etanercept (approved in the U.S. for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis), and adalimumab (approved for the treatment of rheumatoid arthritis and psoriatic arthritis). OBJECTIVE: To review the current literature supporting alternative (and currently off-label) dermatologic uses of TNF-a antagonists. METHODS: A MEDLINE search (1966-March 2005) was conducted using the keywords "infliximab," "etanercept," "adalimumab," "TNF inhibitors," and "off-label" to identify published reports of off-label dermatologic uses of TNF-a inhibitors. RESULTS: Anti-TNF-a therapies have been reported in the following dermatologic diseases: sarcoidosis, hidradenitis suppuritiva, cicatricial pemphigoid, Behçet's disease, pyoderma gangrenosum, multicentric reticulohistiocytosis, apthous stomatitis, Sneddon-Wilkinson disease, SAPHO syndrome, pityriasis rubra pilaris, eosinophilic fasciitis, panniculitis, Crohn's disease, necrobiosis lipoidica diabeticorum, dermatomyositis, and scleroderma. The vast majority of these reports are in the form of individual case reports and small case series. Only two published randomized controlled trials involving the off-label use of a TNF inhibitor were found. CONCLUSIONS: A growing number of published reports suggest that anti-TNF-a therapies may be effective in the treatment of numerous inflammatory skin diseases outside their currently approved indications.

Adalimumab↗
PubMed1994

Impact of non-CTCL dermatologic diagnoses and adjuvant therapies on cutaneous T-cell lymphoma patients treated with total skin electron beam radiation therapy.

PURPOSE: To evaluate the impact of pre-cutaneous T-cell lymphoma dermatologic diagnoses and adjuvant therapies on the relapse-free and overall survivals of patients treated with total skin electron beam therapy. METHODS AND MATERIALS: Between 1974 and 1990, 164 patients were evaluated by members of Yale University School of Medicine departments of Dermatology and Therapeutic Radiology and treated with total skin electron beam therapy to a total dose of 3600 cGy. Patients who achieved a clinical complete response were offered doxorubicin/cyclophosphamide chemotherapy, extracorporeal photopheresis, or no systemic adjuvant therapy. The effects of TNM stage, antecedent non-T-cell lymphoma dermatologic diagnoses, and systemic adjuvant therapies were analyzed for their impact on relapse-free and overall survival. RESULTS: In this cohort of patients, an antecedent dermatologic diagnosis of follicular mucinosis or lymphomatoid papulosis was significantly associated with a shorter relapse-free survival for T1 and T2 patients, while antecedent "non-specific" dermatitides were associated with a somewhat better relapse-free survival. When the impact of systemic adjuvant therapies was analyzed, neither systemic doxorubicin/cyclophosphamide chemotherapy nor systemic extracorporeal photopheresis were found to delay cutaneous relapse. CONCLUSION: Our results suggest that antecedent follicular mucinosis and lymphomatoid papulosis may be associated with short relapse-free survival in T1 and T2 patients treated with total skin electron beam therapy. They also imply that neither adjuvant chemotherapy nor extracorporeal photopheresis delay cutaneous relapse after total skin electron beam therapy.

Adult↗
PubMed2005

Psychiatric evaluation of the dermatology patient.

Over one third of dermatologic disorders have significant psychiatric comorbidity. The impact of the skin disorder on quality of life, the role of psychosocial stressors, and use of substances should be assessed. Major depressive disorder is the most frequently encountered psychiatric disorder in dermatology and is often associated with suicide risk. Other psychiatric syndromes comorbid with dermatologic disorders include obsessive-compulsive disorder, social phobia, posttraumatic stress disorder associated with dissociation and conversion symptoms, body image pathologies, delusional disorder, and a wide range of personality disorders. This article reviews psychiatric guidelines that may be used to assess psychopathology in the dermatology patient.

Humans↗
PubMed2006

Dermatologic manifestations of the immune reconstitution inflammatory syndrome.

The immune reconstitution inflammatory syndrome (IRIS) represents a diverse range of immunopathologic reactions resulting in clinical deterioration that may occur as immune function is partially restored in HIV-infected patients receiving highly active antiretroviral therapy. Approximately half of IRIS events are dermatologic, and dermatologic IRIS is described in relation to a wide range of conditions, the commonest being herpes zoster and herpes simplex. Most cases of IRIS result in mild and moderate symptoms, but non-dermatologic manifestations related to IRIS have resulted in death. This article covers certain general issues related to IRIS and then focuses on the spectrum of dermatologic manifestations.

Antiretroviral Therapy, Highly Active↗
PubMed2006

Prevalence of psychotropic medication use among cosmetic and medical dermatology patients: a comparative study.

BACKGROUND: Little is known about the psychologic status of cosmetically oriented dermatology patients. OBJECTIVE: We sought to determine the prevalence of psychotropic medication use among such patients to offer insight into the rates of psychopathology in this group. METHODS: We conducted a retrospective chart review of patients seeking consultation at a cosmetic dermatology practice, recorded patients' use of psychotropic medicines, and compared this with data from a control group of medical dermatology patients. RESULTS: Both groups reported rates of psychotropic medication use above those expected in the general population. There was no statistically significant difference in the prevalence of psychotropic drug use between cosmetic (18%) and medical (17%) dermatology patients. LIMITATIONS: There is not a one-to-one correspondence between psychotropic medication use and the presence of psychopathology. Data are based on patient health histories and, thus, may be subject to underreporting. CONCLUSIONS: There is a relatively high rate of psychotropic drug use among all patients seeking care from dermatologists, but this does not appear to be more common among patients interested in undergoing cosmetic procedures.

Adult↗
PubMed2006

[Photodynamic therapy in dermatology].

Photodynamic therapy (PDT) is a therapeutic modality based on the photooxidation of biological materials induced by a photosensitizer, which selectively locates itself in certain tumorous cells or tissues, so that when illuminated by a light of the right length and at a sufficient dose, these cells are destroyed. In dermatology, PDT with topical 5-aminolevulinic acid or 5-methyl aminolevulinate is very effective in the treatment of actinic keratoses, basal cell carcinomas and Bowen's disease. In addition, very promising results have been obtained in inflammatory pathologies like morphea or sarcoidosis, infections like warts, and cosmetic processes such as photoaging, among others. This article reviews the most significant aspects of PDT in dermatology. First of all, we will review the basic fundamentals of photodynamic treatment. Next, we will outline its clinical applications in dermatology, both in oncological applications and all those dermatological processes in which PDT may play a role in their management. We will also discuss its promising cosmetic application in the treatment of photoaging. We will complete the review with photodiagnosis and the different non-invasive ways to monitor the effectiveness of PDT.

Aminolevulinic Acid↗
PubMed1992

The role of psychological factors in dermatologic conditions.

Knowledge about the psychiatric factors affecting dermatologic illness is far from conclusive. Studies in the past decade have strengthened concepts regarding associated psychological factors. Many dermatologic conditions are now considered in the context of genetic predisposition, personality, and biopsychosocial factors. Several psychotropic medications have been observed to affect dermatologic conditions. This article reviews the research and clinical reports of the past decade that address nosologic and diagnostic aspects of psychological factors affecting dermatologic conditions. This article is a result of the efforts of a work group to propose revisions to the DSM-III-R diagnostic category of psychological factors affecting physical condition and supports the need for a systematic, nosologic schema that would potentially increase our knowledge and improve our understanding of this important psychosomatic domain.

Humans↗
PubMed2006

[Palliative care management of patients in a dermatology department].

BACKGROUND: The number of patients referred to French University dermatology departments for skin cancers has increased continuously for many years. The aim of this study was to assess the management and number of patients who died in our dermatology department over a 10-year period. PATIENTS AND METHODS: All cases of patients who died in our dermatology department from 1992 to 2002 were retrospectively assessed. Demographic data, past history, main diagnosis, duration of hospitalisation and main treatment given were recorded. RESULTS: The number of patients who died increased from 9 per year at the beginning of the study period to 25 per year at the end of this study. The mean age of patients remained unchanged at 66.5 years old. Forty-nine percent of patients in this study had metastatic melanoma, with no significant modification during the study period. Morphine-based drugs were used (mainly orally) in 41 percent of patients at the beginning of the study and in 56 percent (mainly via subcutaneous infusions) at the end of the study. Forty-five percent of patients were managed in close collaboration with the palliative care unit. CONCLUSION: This study showed a three-fold increase in the number of patients referred for end-of-life care in a dermatology department during a 10-year period. Most of these patients had disseminated malignant melanoma. Major changes in patient management occurred during this period.

Age Distribution↗
PubMed1983

The development of retinoids in experimental and clinical oncology and dermatology.

The retinoids are a class of compounds consisting of vitamin A and its natural and synthetic analogues. Vitamin A has a marked influence on the differentiation of epithelial tissues, such as skin and mucous membranes. Vitamin A deficiency leads to hyperkeratosis of the skin and squamous metaplasia of mucous membranes, histologic features common to various dermatologic and precancerous diseases. The beneficial effect of vitamin A in these diseases was, however, unsatisfactory. Therefore, a retinoid program was set up in order to find new synthetic retinoids with the highest possible therapeutic activity and the least possible side effects. It was discovered that the chemically induced skin papilloma of the mouse responded to retinoids with a marked regression. This therapeutic activity in combination with the determination of a therapeutic index (relation between therapeutic action and hypervitaminosis A syndrome) served as criteria in choosing retinoids for clinical trials in dermatologic and oncologic diseases. Until now three particular compounds have achieved remarkable usefulness in dermatology: 13-cis-retinoic acid (isotretinoin; Accutane) in the treatment of cystic acne, the aromatic retinoid etretinate in the therapy of severe forms of psoriasis, and an arotinoid. Much less spectacular success has been achieved with these compounds in the prevention and therapy of premalignant and malignant diseases. It is hoped that newer retinoids with a still better therapeutic index or a more selective therapeutic activity will further enrich our therapeutic armamentarium in the fields of dermatology, oncology, and other disciplines of medicine.

9,10-Dimethyl-1,2-benzanthracene↗