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PubMed2004

Learning dermatology.

Students should be involved in curriculum planning and encouraged to formulate their own learning outcomes. Adult learners appreciate opportunities to learn from real or simulated experiences that are applicable to real-life situations. Contact with patients is essential to help students to develop empathy and communication skills and patients with chronic skin conditions such as psoriasis can make an active contribution to the education of students. Students learning dermatology use both pattern- recognition and analytical processes, but pattern recognition develops only with repetition and it is not realistic to expect students to acquire many diagnostic skills. Instead teachers should provide students with a framework that will enable them to analyse skin conditions, to understand the relevance of what is taught and to apply their learning in the future. All medical graduates should be able to describe the skin and record their findings each time they clerk a patient.

Clinical Competence↗
PubMed2004

Assessment in undergraduate dermatology.

Assessment should be considered at an early stage in curriculum planning and must strive for the best balance between validity (testing what is important) and reliability (providing inferences about the student's competence). The primary purpose of summative assessment in clinical medicine is to determine whether the candidate is competent. Dermatologists should use a range of summative assessment techniques that are appropriate for testing the curricular outcomes. These will include tests of application of knowledge and of clinical skills. All students should also receive regular formative assessment to allow them to measure their progress, but this is not used for summative decisions. We review the key issues surrounding assessment and some specific techniques that might be appropriate for testing learning outcomes in undergraduate dermatology, either in the context of a clinical placement or in an integrated assessment involving a number of specialties or systems.

Clinical Competence↗
PubMed2006

Using the Dermatology Index of Disease Severity (DIDS) to assess the responsiveness of dermatitis.

BACKGROUND: The Dermatology Index of Disease Severity (DIDS) is designed as an instrument for staging severity of inflammatory dermatoses. It measures the therapeutic effectiveness and magnitude of clinical improvement in several types of dermatitis, eczema and psoriasis. When used in the Psoriasis Outcomes Study, it was simpler and easier than the Psoriasis Area and Severity Index. The reliability and validity of DIDS have already been established in our previous study. AIM: To test the responsiveness of the DIDS in patients with various types of dermatitis following treatment. METHODS: The DIDS was used to stage patients with dermatitis over time. In total, 142 patients with dermatitis were enrolled into the study. Only 55 patients completed the follow-ups on days 30 or 60, thus the data from these 55 patients only were analysed. The Wilcoxon signed rank test for paired comparisons was used to test for significance of shift in the individual's DIDS staging over the time period. RESULTS: 35 patients were seen on or close to day 30 after the initial visit, of whom 34 patients (76%) had an improvement of at least one stage on DIDS. There were 51 patients seen at or close to day 60, of whom 40 patients (78%) had an improvement of at least one stage on DIDS. The remaining 22-24% of patients did not improve, but neither did they worsen. The joint shift of each individual's DIDS staging from baseline to follow-up was statistically significant (P < 10(-5), two-sided t-test). CONCLUSION: The results of this study support the responsiveness of the DIDS for tracking severity of disease over time in patients with various types of dermatitis.

Acute Disease↗
PubMed1992

Stability of mupirocin ointment (Bactroban) admixed with other proprietary dermatological products.

This study involved the mixing of 1:1 combinations of Bactroban (mupirocin) Ointment 2% with various cream, lotion, ointment, gel, solution and liquid soap formulations with storage at 37 degrees C for 60 days. The mixtures were assayed for mupirocin content at 0, 15, 30, 45 and 60 days using a high-pressure liquid chromatographic (HPLC) assay. At the time of preparation of these admixtures, Bactroban Ointment is chemically and physically compatible with all of the topical dermatological products studied except for Valisone lotion where a physical incompatibility is immediately observed. Admixtures of Hibiclens liquid soap or Lotrimin solution with Bactroban Ointment were stable throughout the entire 60-day study. Combinations of Lotrimin cream, Hytone cream, Valisone ointment or Vytone cream with Bactroban Ointment also retained chemical stability of mupirocin for the entire period even though two layers were observed and mixing was required to restore a physically homogenous mixture. Other Bactroban Ointment admixtures were found to be either chemically stable for mupirocin for periods less than 60 days or physically incompatible mixtures were observed upon storage. No conclusions were drawn from these studies concerning the efficacy or safety of any of these products when used in extemporaneously prepared combinations.

Dermatologic Agents↗
PubMed1985

Epidemiologic approach to community dermatology.

A survey on communicable dermatoses in economically weak villages in India showed wide variations in prevalence rates in similar ecologic setup. A skin diseases, on-spot-treatment, 1-day-camp was organized to treat 1787 subjects in five villages. Two applications of 1% lindane 1 week apart was the only treatment used without attending to hygiene for scabies and pediculosis. Application of 1% gentian violet with four daily doses of sulfamethoxy-pysidazine was administered for pyoderma. The cure rate for scabies and pediculosis was 86%. Epidemiologic determinants of communicable dermatoses are the most important factors in the practice of community dermatology.

Allied Health Personnel↗
PubMed1991

Studies on criteria of the European Academy of Dermatology and Venerology for the classification of cutaneous lupus erythematosus. I. Selection of clinical groups and study factors.

A group of 140 cases of various forms of lupus erythematosus (LE) were examined for 24 variables, including the 11 criteria of the American Rheumatism Association (ARA) for the classification of systemic lupus erythematosus (SLE), and 13 additional criteria suggested by the European Academy of Dermatology and Venerology (EADV) for studies of cutaneous LE with or without systemic involvement. The EADV study factors included skin histopathology and immunopathology, complement and IgG levels, and other laboratory tests, as well as selected clinical findings, most notably the papulosquamous and/or annular lesions that characterize subacute cutaneous LE (SCLE). The patients examined included 50 SLE, 35 SCLE, 30 discoid LE (DLE), 25 disseminated DLE (DDLE), and 17 polymorphous light eruption (PMLE) cases. Preliminary analyses of the data reveal the following: (1) The SCLE cases differed significantly from SLE, DLE, and DDLE in 10 of 11 ARA criteria (all but photosensitivity). (2) The frequencies of positive findings in SCLE also differed significantly for 11 of 13 EADV study factors. (3) While no significant differences appeared in the frequency of photosensitivity between the five study groups, photo-testing revealed significant increases in the frequency of persistence of the photo reactions for 10 days and their Koebnerization in the SCLE cases. (4) The presence of SS-A (Ro)/SS-B (La) antibodies had some predictive value for the appearance of systemic involvement in SCLE, as seen by the increased frequencies of five or more ARA criteria, although highly significant differences from SLE occurred in the absence of renal involvement and lower frequency of ANA and LE band test.(ABSTRACT TRUNCATED AT 250 WORDS)

Dermatology↗
PubMed1992

Dermatology in a war zone: a Persian Gulf experience.

The clinical experience of two US Army dermatologists during the recent Gulf War (Operation Desert Shield/Storm) are presented with comparison with dermatologic experience in previous wars and in civilian practice.

Adult↗
PubMed1992

Senior medical student clinical and research electives in dermatologic surgery.

Five senior medical students enrolled in the 4 week clinical elective in dermatologic surgery and cutaneous oncology (DSCO); two of these students also enrolled in a 4 week research elective in DSCO. During the elective(s) the students made significant improvement in the six areas of clinical diagnosis, histopathologic diagnosis, clinical management, DSCO procedures, research skills, and general information about the subspecialty. Following their elective(s), these students submitted a total of six abstracts, one letter, and seven manuscripts for presentation or publication.

Curriculum↗
PubMed2006

A bibliometric study of dermatology in central Europe 1991-2002.

BACKGROUND: Bibliometric studies have gained interest in recent years, although most analyses are limited to simple use of average citations rates for journals, also known as the "impact factor". Central Europe has a long tradition of dermatological research which has been negatively impacted by general political developments for a long period. This study was undertaken in order to describe the progress made in recent years. METHODS: The study was conducted in two parts: First the annual national output for the period 1991-2002 was identified for each country by MEDLINE searches. In the second part of the study a sample was drawn from the papers identified in the first part and the number of citations for each paper noted. RESULTS: The annual national output showed great variation between countries and from year to year. The mean citation rates were found to vary between 0-5 citations/year, and some underlying publications were 10 years old. Countries with national indexed journals appear to hold a bibliometric advantage over countries without indexed journals. CONCLUSIONS: Throughout the last decade of the 20th century the number of publications has grown with an average of 21.7% per year, and publication rates have only suffered in countries directly involved in war or similar disturbances. The mean citation rates were low, with a varying age of the underlying publications. Some cited publications were however old suggesting a persistent relevance. A national or regional indexed journal appears to confer a bibliometric advantage.

Bibliometrics↗
PubMed2005

Women dermatologists and the Spanish Academy of Dermatology and Venereology (SADV).

BASIS: The Spanish Academy of Dermatology and Venereology (SADV) consists of a large majority of Spanish dermatologists. Their track record and history can be considered as parallel to that of female dermatologists. The aim of this study is to determine the role of women in the SADV throughout its history, both in terms of their involvement and their positions of responsibility. MATERIALS AND METHODS: To obtain data, we consulted the SADV archives from the year of its foundation until 2001. We also consulted other Spanish medical societies, receiving responses from three of them. RESULTS: Until 1964, no woman had ever become a member of the SADV. Since then, the percentage began to increase slowly (5.5% in 1975). Over the last decade, their involvement has increased rapidly, reaching 41.34% in 2001. During this time, only 11 women have held positions on the Board of Directors, and in all cases in nonpresidential positions. The percentage of women in paediatrics, ophthalmology and pathologic anatomy is similar. CONCLUSIONS: During this time, the number of female dermatologists in the SADV has gradually increased. This increase is, nonetheless, not uniform, with the greatest growth being seen during the last decade. Women in positions of responsibility have been scarce and, to date, there has been no female national president. These results coincide with statistics revealed in other areas of the medical society.

Academies and Institutes↗
PubMedDate not supplied

A practical approach to preparing children for dermatologic surgery.

This paper presents a series of stratagems designed to minimize the potential psychological problems of children who require dermatological surgery. After discussing the "normal" critical periods of childhood, the selective approaches to children at different ages are presented. General and specific suggestions are made for pre- and postoperative management for both office and hospital surgical procedures.

Child↗
PubMed1978

Suturing techniques for Dermatologic Surgery.

Various suture techniques that are commonly used in dermatologic surgery are discussed and illustrated. They are applicable to operations as simple as closure of elliptical excisions and as complex as cosmetic surgery.

Dermatologic Surgical Procedures↗
PubMed1980

Nitrous oxide-oxygen analgesia in dermatologic surgery.

Nitrous oxide-oxygen analgesia is a safe and effective means of abating pain and anxiety. It is applicable to a wide range of patients and procedures, has minimal side effects, and minimizes need for additional sedation. Determination of its ultimate usefulness and practicality in dermatologic surgery requires controlled clinical trials.

Analgesia↗
PubMed1980

Analgesia induced by nitrous oxide and oxygen as an adjunct to local anesthesia in dermatologic surgery. Results of clinical trials.

Clinical trials were carried out to determine if analgesia induced by nitrous oxide and oxygen could be useful as an adjunct to local anesthesia in dermatologic surgery. Patients readily accepted the procedure. The analgesia obtained reduced anxiety and pain, and no important adverse side effects were encountered. Overall, the agents and method are effective and have advantages over more commonly used agents and methods used as adjuncts to local anesthesia.

Adolescent↗
PubMed1984

Coping with the complexities of informed consent in dermatologic surgery.

Few medico-legal issues have generated as much controversy as informed consent--the right of patients to be fully informed about the risks, complications, and alternatives to a medical treatment or surgical procedure before deciding whether or not to submit to it. This paper discusses the complexities inherent in the legal doctrine of informed consent and their implications for dermatologic surgery. Particular emphasis is placed on the legal requirements for informed consent, as well as the problems associated with informing patients and their potential solutions.

Comprehension↗
PubMed1985

Lasers in dermatology--1985.

Since the introduction of medical lasers in 1960, the skin has been a major site for applied laser research and therapy. Argon and carbon dioxide lasers have been the most widely used in clinical practice, and many diseases that were impossible or difficult to manage are now being effectively treated with these. Exciting developments today involve other systems, including tunable dye, ruby, neodymium-YAG, and low-energy lasers. Photodynamic therapy for cancer may provide a selective method of destroying clinically inapparent malignant cells. Lasers now seem to have become an integral part of the dermatologic surgeon's armamentarium.

Argon↗
PubMed1988

The use of a combination skin hook and tissue forceps: a new instrument for dermatologic surgery ("Frankel-Adson forceps").

The dermatologic surgeon frequently uses both skin hook and tissue forceps to accomplish atraumatic wound closure. Since this requires the surgeon to change instruments frequently during the course of the procedure, a combination skin hook and tissue forceps has been developed to make possible the simultaneous use of these two instruments. In addition, using a new technique that combines the two capabilities of this instrument, the surgeon can further reduce the risk of tissue trauma during surgery. The instrument and this technique are described.

Dermatologic Surgical Procedures↗
PubMed1988

Wound infection rate in dermatologic surgery.

Most dermatologic surgery is performed in clinical settings and not in the rigorous sterile environment of a hospital operating room. This prospective study measures the wound infection rate over a 2 1/2 year period for cutaneous surgery performed in a clinical environment. This percent infection rate compares very favorably with that of formal operating room settings.

Dermatologic Surgical Procedures↗