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Art of prevention: The importance of dermatologic care when using aromatase inhibitors

Int J Womens Dermatol. 2021 Jul 17;7(5Part B):769-773. doi: 10.1016/j.ijwd.2021.07.002. eCollection 2021 Dec.

ABSTRACT

As of January 2021, there are more than 3.8 million women in the United States with a history of breast cancer. The current standard of care for breast cancer involves surgical resection, radiation therapy, adjuvant endocrine therapy, and/or adjuvant chemotherapy. Aromatase inhibitors (AIs) are the gold standard for endocrine therapy in postmenopausal women. Dermatologic adverse events (dAEs) associated with AIs are rare but have been reported in the literature. Commonly reported dAEs include unspecified rash, pruritus, alopecia, vulvovaginal atrophy, vasculitis, and autoimmune/connective tissue disorders. Appropriate preventative strategies and careful management considerations have the potential to optimize the comprehensive care of patients with cancer and improve quality of life. Furthermore, prevention of dAEs can lead to a reduction in cancer treatment interruptions and discontinuations. Herein, we characterize dAEs of AIs and discuss preventative management to reduce the incidence of AI therapy interruption.

PMID:35028380 | PMC:PMC8714559 | DOI:10.1016/j.ijwd.2021.07.002

Категории: MedLine

Plasma cell vulvitis: A systematic review

Int J Womens Dermatol. 2021 May 4;7(5Part B):756-762. doi: 10.1016/j.ijwd.2021.04.005. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Plasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic.

OBJECTIVE: This study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options.

METHODS: A primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases.

RESULTS: Fifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay.

CONCLUSION: PCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.

PMID:35028377 | PMC:PMC8714578 | DOI:10.1016/j.ijwd.2021.04.005

Категории: MedLine

Hormone therapy and melanoma in women

Int J Womens Dermatol. 2021 Jun 25;7(5Part B):692-696. doi: 10.1016/j.ijwd.2021.06.005. eCollection 2021 Dec.

ABSTRACT

Although primary cutaneous melanoma accounts for approximately 3% of all malignant skin tumors, it has the greatest contribution to skin cancer-related death. Sex-specific differences in melanoma tumor behavior have been described, and melanoma pathogenesis may be hormonally mediated. This review aims to summarize the literature to date regarding the effects of hormone therapy on melanoma in women. Women's exogenous hormone use has changed dramatically over the past few decades. Thus, we focus on studies investigating the associations between oral contraception, fertility treatments, menopausal hormone therapy (MHT), and melanoma. Across hormone therapy types, there does not appear to be a well-established association between exogenous female hormones and melanoma incidence. However, MHT practices and formulations vary significantly across countries. Although MHT does not appear to increase melanoma risk in studies from the United States, conflicting results have been observed in Europe. Unopposed estrogen MHT formulations require further investigation to determine a clear pattern between hormone use and the development of melanoma.

PMID:35028367 | PMC:PMC8714603 | DOI:10.1016/j.ijwd.2021.06.005

Категории: MedLine

Identification of skin signs in human-trafficking survivors

Int J Womens Dermatol. 2021 Oct 2;7(5Part B):677-682. doi: 10.1016/j.ijwd.2021.09.011. eCollection 2021 Dec.

ABSTRACT

Human-trafficking survivors suffer significant physical, mental, and social health consequences, prompting them to seek health care services. Although there is research regarding identification protocols for human-trafficking victims, there is no framework outlining the dermatologic patterns of survivors of human trafficking. We sought to identify the dermatologic signs reported in human-trafficking victims to create a framework for dermatologists and the broader medical community to appropriately screen patients at risk. After screening 577 pertinent records in the PubMed and Google Scholar databases for information about the physical signs of human trafficking in health care, 10 final studies were selected. Significant findings of rashes and brandings, such as tattoos, were more likely in sex-trafficked patients, whereas burns, injuries, and deep cuts were more likely to be found in labor-trafficked patients. This review outlines important identification guidelines that dermatologists and the broader medical community can use to recognize victims and take appropriate action while also raising awareness of human trafficking as an emerging public health issue.

PMID:35028364 | PMC:PMC8714580 | DOI:10.1016/j.ijwd.2021.09.011

Категории: MedLine

Clinical considerations in the management of hidradenitis suppurativa in women

Int J Womens Dermatol. 2021 Oct 29;7(5Part B):664-671. doi: 10.1016/j.ijwd.2021.10.012. eCollection 2021 Dec.

ABSTRACT

Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the skin with a predilection for women. The role of sex hormones, including estrogen and progesterone, is incompletely understood, but alterations in hormone levels may play a role in disease activity for many patients. Specific clinical considerations should be made for women with HS, particularly in the setting of pregnancy, childbirth, breastfeeding, and menopause. Current knowledge gaps regarding HS include the cumulative impact of disease across an individual's lifespan, as well as the mechanistic role of sex hormones in the disease. An improved understanding of the pathophysiologic role of hormones in HS would optimize our ability to use targeted therapies for hormonally driven disease. Psychological and psychosexual support for women with HS is an important facet of any holistic management strategy for the disease. This article integrates up-to-date pathogenic and mechanistic insights with evidence-based clinical management to optimize care for women with HS.

PMID:35028361 | PMC:PMC8714605 | DOI:10.1016/j.ijwd.2021.10.012

Категории: MedLine

Cutaneous mastocytosis in childhood

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Allergol Select. 2022 Jan 5;6:1-10. doi: 10.5414/ALX02304E. eCollection 2022.

ABSTRACT

Mastocytoses are characterized by clonal proliferation of mast cells in various tissues. In childhood, cutaneous mastocytosis (CM) occurs almost exclusively. It is confined to the skin, and has a good prognosis. The most common form is the maculopapular cutaneous mastocytosis (MPCM), formerly called urticaria pigmentosa. A distinction is made between a monomorphic variant of MPCM with multiple small, roundish maculopapular skin lesions and the - more common - polymorphic variant with larger lesions of variable size. One quarter of CM diagnosed in childhood are mastocytomas, which often occur solitary or at multiple sites. The diffuse variant of CM (DCM), which affects 5% of children with CM, should be distinguished from these forms. Systemic mastocytoses (SM) with mast cell infiltrates in the bone marrow or other extracutaneous tissues, such as the gastrointestinal tract, occur predominantly in adults. The diagnosis of CM is usually made clinically: Manifestation in infancy, typical morphology and distribution, pathognomonic Darier sign. Basal serum tryptase is determined if DCM or systemic mastocytosis are to be diagnosed. Children with mastocytosis should be managed in a specialized outpatient clinic. For affected families, detailed information about the clinical picture including prognosis assessment is essential. Mast cell mediated symptoms are controlled by oral non-sedating antihistamines if needed.

PMID:35028497 | PMC:PMC8750954 | DOI:10.5414/ALX02304E

Категории: MedLine

Erratum to "The Dermatological Aspects of hEDS in Women". [International Journal of Women's Dermatology 7/3 (2021) 285- 289]

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jul 31;7(5Part B):869-870. doi: 10.1016/j.ijwd.2021.07.010. eCollection 2021 Dec.

ABSTRACT

[This corrects the article DOI: 10.1016/j.ijwd.2021.01.020.].

PMID:35028407 | PMC:PMC8714565 | DOI:10.1016/j.ijwd.2021.07.010

Категории: MedLine

Seasonal and gender variation in skin disease: A cross-sectional study of 3120 patients at Razi hospital

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Oct 6;7(5Part B):799-802. doi: 10.1016/j.ijwd.2021.09.014. eCollection 2021 Dec.

ABSTRACT

Objective: We aimed to determine the prevalence of different skin diseases and their seasonal variations at the Razi dermatology hospital from 2019 to 2020. Methods: In this cross-sectional study, we obtained data from the medical records of 3120 patients visiting the dermatology clinic of Razi hospital. The prevalence of skin diseases was evaluated using meteorologically defined seasons. We looked for significant equally distributed results during each season. Results: During all seasons, women were referred to our clinic more frequently than men. Some diseases demonstrated significant seasonality with a peak during the winter, including acne, eczema, wart, seborrheic dermatitis, nevus, vitiligo, lentigo, and dermatophytosis. Atopic dermatitis was more frequent during the spring and winter compared with other seasons (p < .05). Actinic keratosis and lichen planus showed a significant seasonal trend with a peak during the summer (p < .05). Infections, including viral, bacterial, and fungal skin diseases, were more frequent during the winter than the summer (p = .001). Conclusion: This study provides an overview of the seasonal distribution of dermatology visits at our referral hospital, which will aid in developing better policies to prevent and manage skin disorders in outpatient visits.

PMID:35028385 | PMC:PMC8714557 | DOI:10.1016/j.ijwd.2021.09.014

Категории: MedLine

Analysis of patient preferences on patient-provider interactions through the OpenNotes online portal in dermatology

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Oct 5;7(5Part B):793-798. doi: 10.1016/j.ijwd.2021.10.001. eCollection 2021 Dec.

ABSTRACT

Background: Many medical centers are beginning to use OpenNotes (ON) to empower patients. However, there is a lack of literature reviewing the ON system in dermatology and any differences in attitudes between men and women. If so, it is uncertain what concerns are more important to female patients. Given the complex lexicon of notes in dermatology, the outpatient setting of dermatology practices, and the often-complex nature of treatment regimens, investigation was merited. Objective: This paper aimed to evaluate a survey of dermatologic patients on their attitudes toward the ON system. Methods: From July through October 2015, 333 dermatologic patients at the Beth Israel Deaconess Medical Center completed an anonymous, voluntary, 25-question survey of the ON system while in the waiting room. Approximately 60% of respondents were female and 40% were male. Respondents were older, with 27% age >65 years, 21% between 56 and 65 years, 16% between 46 and 55 years, 17% between 36 and 45 years, 14% between 26 and 35 years, and 4% between 18 and 25 years. Eighty-five percent of respondents were white, and 73% had, at minimum, graduated from college. Results: Patient response to ON was positive, with 93% agreeing ON is a good idea. Of the patients who accessed their own notes (69% of respondents), 99.6% desired continued access. In addition, 85.6% of patients felt ON allowed them to control their own health, and 70% reported increased confidence in their dermatologist. Nineteen percent of respondents thought ON presented a privacy concern. Conclusion: The results showed that female patients strongly desire access to their medical records, but concerns about privacy and security exist. Preliminary analysis by a statistician did not find any statistically significant variations between men and women within the results of the survey. Due to the wide agreement in responses, it is unlikely that there are significant differences in opinion on ON between men and women.

PMID:35028384 | PMC:PMC8714571 | DOI:10.1016/j.ijwd.2021.10.001

Категории: MedLine

Dermatology residency research policies: A 2021 national survey

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 May 24;7(5Part B):787-792. doi: 10.1016/j.ijwd.2021.05.003. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: In this follow-up study to previous work, the authors survey the availability of key measures and resources pertaining to residency research in U.S. Accreditation Council for Graduate Medical Education-accredited dermatology residency programs, including potential policy changes following the COVID-19 pandemic.

OBJECTIVE: The chief objective of this survey was to evaluate and compare dermatology programs' resident research requirements and guidelines.

METHODS: This cross-sectional study employed a 13-item survey administered online in early 2021 to assess the degree to which dermatology residency programs require and support their new physician graduates in scholarly research endeavors.

RESULTS: A total of 32 program directors representing 30 dermatology residency programs (30 of 138 accredited programs contacted [22%]) responded to the survey. Almost all programs described quality improvement project requirements for residents and were able to provide funding for resident conference participation. Most programs also reported resident publication requirements and the availability of research electives. However, the vast majority did not have required research rotations or a formal mentorship program. The COVID-19 pandemic did not have a substantial impact on residency research requirements.

CONCLUSION: Our survey provides objective data about the current dermatology resident research requirements across the United States. These findings may prove valuable to prospective applicants, residency programs, and accrediting agencies in improving, advancing, and structuring dermatology residency guidelines and resources with the aim of encouraging new physician trainees to pursue research.

PMID:35028383 | PMC:PMC8714577 | DOI:10.1016/j.ijwd.2021.05.003

Категории: MedLine

Drivers and sequelae of burnout in U.S. dermatology trainees

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 May 12;7(5Part B):780-786. doi: 10.1016/j.ijwd.2021.05.001. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Burnout is a health care epidemic. Although burnout has been shown to affect dermatologists in multispecialty studies, there are no such studies in dermatology trainees.

OBJECTIVE: We conducted a survey-based study of burnout in U.S. dermatology trainees to identify its drivers and sequelae.

METHODS: All residents enrolled in a U.S. dermatology training program were eligible. The 45-question survey included the Maslach Burnout Inventory, a validated quality of life index, and 31 questions based on known drivers of burnout and new research questions. No identifying data were collected.

RESULTS: A total of 180 residents responded, for a response rate of 14.4%. Notably, an analysis of the cohort showed that our sample was not statistically different from the national complement of trainees based both on proportion of female respondents and mean age (p = .9449 and .2376, respectively). Of the respondents, 59% were female. The average age was 30.6 years. Sixty-nine percent of trainees (124 of 180) met the criteria for burnout. On univariate analysis, age, sex, training year, and relationship status were not associated with burnout. Good work-life balance (p = .032), autonomy in the workplace (p = .0027), intradisciplinary respect (p = .022), and increased work hours (p = .0110) were protective. On multivariate analysis, autonomy in the workplace (odds ratio: 3.580; confidence interval, 1.32-9.71; p = .012) and good work-life balance (odds ratio: 0.262; confidence interval, 0.095-0.722; p = .0097) remained significant.

CONCLUSION: Improving control over working environment, as evidenced by the impact of work-life balance and autonomy, may lessen burnout in trainees. Further studies analyzing regional and program-specific variations will help improve trainee experience.

PMID:35028382 | PMC:PMC8714592 | DOI:10.1016/j.ijwd.2021.05.001

Категории: MedLine

Life after lockdown: Zooming out on perceptions in the post-videoconferencing era

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Aug 27;7(5Part B):774-779. doi: 10.1016/j.ijwd.2021.08.009. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has deeply disrupted daily life across the globe, with profound effects on mental and physical health. After more than a year of isolation and communication via videoconferencing, people are returning to in-person activities.

OBJECTIVE: This study aimed to investigate worsening self-perception, mental health, and anxiety with the return to in-person activities, with a focus on the influence of videoconferencing, social media, and the use of filters.

METHODS: An anonymous survey was distributed online through social media platforms and student network pages.

RESULTS: A total of 7295 participants responded to the survey. Seventy-one precent reported anxiety or stress related to returning to in-person activities, and nearly 64% sought mental health support services. Thirty-percent stated they plan to invest in their appearance as a coping strategy to deal with the anxiety of returning to in-person, and >30% plan to take action in changing their appearance. The most reported dermatologic concerns were skin discoloration (32.36%), wrinkles (24.45%), and acne (14.85%). The prevalence of anxiety and mental health services increased relative to the use of filters in 18- to 24 year-olds.

CONCLUSION: This survey study of >7000 participants across the country elucidates worsening self-perception, anxiety, and mental health as we return to in-person activities in relation to increased videoconferencing, social media usage, and the use of filters. Physicians should be aware of these effects to better serve their patients.

PMID:35028381 | PMC:PMC8714587 | DOI:10.1016/j.ijwd.2021.08.009

Категории: MedLine

Art of prevention: The importance of dermatologic care when using aromatase inhibitors

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jul 17;7(5Part B):769-773. doi: 10.1016/j.ijwd.2021.07.002. eCollection 2021 Dec.

ABSTRACT

As of January 2021, there are more than 3.8 million women in the United States with a history of breast cancer. The current standard of care for breast cancer involves surgical resection, radiation therapy, adjuvant endocrine therapy, and/or adjuvant chemotherapy. Aromatase inhibitors (AIs) are the gold standard for endocrine therapy in postmenopausal women. Dermatologic adverse events (dAEs) associated with AIs are rare but have been reported in the literature. Commonly reported dAEs include unspecified rash, pruritus, alopecia, vulvovaginal atrophy, vasculitis, and autoimmune/connective tissue disorders. Appropriate preventative strategies and careful management considerations have the potential to optimize the comprehensive care of patients with cancer and improve quality of life. Furthermore, prevention of dAEs can lead to a reduction in cancer treatment interruptions and discontinuations. Herein, we characterize dAEs of AIs and discuss preventative management to reduce the incidence of AI therapy interruption.

PMID:35028380 | PMC:PMC8714559 | DOI:10.1016/j.ijwd.2021.07.002

Категории: MedLine

Plasma cell vulvitis: A systematic review

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 May 4;7(5Part B):756-762. doi: 10.1016/j.ijwd.2021.04.005. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Plasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic.

OBJECTIVE: This study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options.

METHODS: A primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases.

RESULTS: Fifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay.

CONCLUSION: PCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.

PMID:35028377 | PMC:PMC8714578 | DOI:10.1016/j.ijwd.2021.04.005

Категории: MedLine

Malar reshaping technique using bidirectional barb thread suspension procedure for 3-dimensional aging in Asian faces

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Aug 8;7(5Part B):747-755. doi: 10.1016/j.ijwd.2021.08.004. eCollection 2021 Dec.

ABSTRACT

Background: Aging is a natural process that causes skin texture changes, facial volume loss, and altered 3-dimensional topography of the underlying tissues. Objective: The aim of this study is to assess the malar reshaping strategy in Asian patients using bidirectional suspension-barbed threads. Methods: A prospective interventional study was conducted on Asian patients presenting with mild-to-moderate facial aging who were treated with the Definisse double-needle thread in the Hong Kong Special Administrative Region. The primary endpoint was assessed using the Global Aesthetic Improvement Scale and scoring the benefit of anterior projection using a questionnaire. Patient safety was the secondary endpoint measured. Results: Twenty Asian patients (4 men [20%] and 16 women [80%]; age <45 to ≥45 years) were included in the study. The patients experienced marked improvement (score 2) in their appearance, except for the follow-up after 1 month. One month after the procedure, patients scored 1 for optimal cosmetic improvement in their looks. The nasolabial fold disappeared in all patients (n = 20 [100%]) and the face looked slimmer. Nine patients (45%) reported that the focus seemed centralized. Four patients (20%) reported prominence of the nose and chin. Redness, swelling, and bruising were the most common adverse events experienced by 75% of patients (n = 15), followed by pain (n = 6; 30%). All adverse events resolved within 4 weeks after their incidence. Because 80% of our patients were women, these positive cosmetic outcomes may be of interest across the aging female population. Conclusion: Overall, 3-dimensional facial rejuvenation with the Definisse thread seems to be an effective, safe, and minimally invasive office-based procedure to achieve immediate and long-term effects. These absorbable barbed sutures used in the malar reshaping technique can result in satisfactory esthetic enhancement of 3-dimensional aging, including sagginess, jowling, central facial heaviness, and tissue descent in female and male Asian patients.

PMID:35028376 | PMC:PMC8714604 | DOI:10.1016/j.ijwd.2021.08.004

Категории: MedLine

Quality of life in lupus erythematosus female patients with cutaneous lesions in Antananarivo, Madagascar

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jul 31;7(5Part B):743-746. doi: 10.1016/j.ijwd.2021.07.013. eCollection 2021 Dec.

ABSTRACT

Background: Lupus erythematosus (LE) is a chronic autoimmune disease that affects more women than men. The quality of life (QoL) of patients with lupus erythematosus and skin manifestations is impaired, but little is known about Malagasy patients. Objective: This study aimed to assess the impact of cutaneous lesions on the QoL of patients who present with LE. Methods: A transversal study, during 3 months, was conducted in patients who presented with LE and cutaneous lesions at the University Hospital Antananarivo. QoL was assessed using the Dermatology Life Quality Index (DLQI) scales. Results: The impact of cutaneous lesions on the QoL was assessed in 37 patients with LE, of whom 34 were women. The mean age of patients was 37.32 years. The mean DLQI was 5.43 ± 4.67 (range, 0-21). Of the patients, 2.7% had a very important effect (DLQI >21), 18.9% reported a great effect of skin symptoms of LE in their QoL (DLQI: 11-20), 18.9% had a moderate effect (DLQI: 6-10), 40.4% had a small effect (DLQI: 2-5), and 18.9% had no effect of cutaneous lesions on their QoL. Daily activities, symptoms, and feelings were the most altered dimensions. The alteration in patients' QOL was influenced by high monthly income, severe medical history, and localization of the cutaneous lesions on the face and neckline. No correlation was found between sex and QoL. Conclusion: This study shows that significant impairment of QoL was found in patients with LE and cutaneous manifestations, which affected their sense of well-being.

PMID:35028375 | PMC:PMC8714573 | DOI:10.1016/j.ijwd.2021.07.013

Категории: MedLine

Motivations and characteristics of patients seeking minimally invasive cosmetic procedures in two Iranian dermatology centers: A cross-sectional study

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jul 18;7(5Part B):737-742. doi: 10.1016/j.ijwd.2021.07.001. eCollection 2021 Dec.

ABSTRACT

Background: Few studies have evaluated patients' motivations for seeking minimally invasive cosmetic procedures. Objective: This study aimed to assess the demographic characteristics and motivation of patients who seek minimally invasive cosmetic procedures in two academic referral dermatology centers. Methods: The study included adult patients seeking minimally invasive facial cosmetic procedures at two academic dermatology centers in Tehran, Iran, between January 2019 and June 2019. Results: The majority of patients were married, employed women with a mean age of 39.6 ± 10.74 years. The most common region of the face they expected to change was the eyes (56%). Patients who requested fillers desired their cheeks to improve significantly more than patients who requested toxin injections (20.5% vs. 3%; p = .005). Patients had mostly heard about the procedures from friends (40.4%). Approximately one third of patients had experienced a major life event during the preceding year (loss of a family member [50%], marriage [26.9%]). A minority of patients had ever visited a psychiatrist (13.9%), and 15.3% had a history of using psychiatric drugs. The procedure type requested by men was significantly different from that requested by women (88.2% vs. 60.8 % for Botox; 11.8% vs. 34.9% for fillers, and 0% vs. 4.3 % for fat injections; p = .044). The most common motivating factor for patients was gaining rejuvenation (39.2%). The most common preventive factors for patients to undergo the procedures earlier were financial issues (41.7%). Conclusion: Patients seeking minimally invasive cosmetic procedures were married, educated, employed women in their 30s desiring rejuvenation and commonly were not influenced by external factors, such as relationships or the media.

PMID:35028374 | PMC:PMC8714556 | DOI:10.1016/j.ijwd.2021.07.001

Категории: MedLine

Assessing the quality of life in the families of patients with epidermolysis bullosa: The mothers as main caregivers

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Aug 26;7(5Part B):721-726. doi: 10.1016/j.ijwd.2021.08.007. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Epidermolysis bullosa (EB) is an uncommon group of inherited disorders characterized by skin blistering after friction or mechanical trauma. EB affects patients and their families physically, socially, and emotionally.

OBJECTIVE: This study aimed to assess the family quality of life of these patients using the Family Dermatology Life Quality Index (FDLQI) questionnaire.

METHODS: In this cross-sectional study, we enrolled caregivers of patients with EB registered at the Molecular Dermatology Research Center, affiliated with Shiraz University of Medical Sciences, up to 2020. Participants filled out a demographic data collection form and the FDLQI questionnaire. The data were analyzed using SPSS software, version 22.

RESULTS: Overall, 80 participants, consisting of 65 mothers (81.2%) and 15 fathers (18.7%) as primary caregivers, were enrolled in this study. The average FDLQI score was 19.88 ± 4.71. The FDLQI scores of caregivers of patients with EB simplex was significantly lower than scores observed in those with other types of EB (p < .001). There was a significant positive association between the number of patients with EB in the family and FDLQI score (p = .049). FDLQI scores were lower in caregiving mothers who had a higher education (p < .001) and those who were employed (p < .001).

CONCLUSION: Family quality of life is affected in patients with EB. Families with lower socioeconomic status and unemployed caregivers require special attention. More studies are needed to determine the parameters involved in the quality of life of patients with EB and their families.

PMID:35028371 | PMC:PMC8714583 | DOI:10.1016/j.ijwd.2021.08.007

Категории: MedLine

Management of common scabies and postscabetic itch in adults: Lessons learned from a single-center retrospective cohort study

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Sep 12;7(5Part B):716-720. doi: 10.1016/j.ijwd.2021.09.001. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Common scabies can be difficult to diagnose and treat. There are limited data on the clinical characteristics of patients who may benefit from combined topical permethrin plus oral ivermectin. Postscabetic itch is common, but there is scant data describing its prognosis and management.

OBJECTIVE: This study describes the clinical characteristics and evaluates treatment outcomes of participants with common scabies treated with combined topical permethrin plus oral ivermectin and describes the prognosis and management of postscabetic itch.

METHODS: We conducted a single-center retrospective cohort study of participants with common scabies treated with combined topical permethrin plus oral ivermectin therapy and topical permethrin only. Participants previously treated with permethrin and/or ivermectin were excluded. The primary outcome was clinical outcome at follow-up, categorized as cure, worsening, or no change. Secondary outcomes included time from treatment initiation to cure, duration of follow-up after cure, recurrence rate, frequency of postscabetic itch, and duration of postscabetic itch.

RESULTS: Of 55 participants treated with combined topical permethrin plus oral ivermectin, 49 (89%) achieved cure, 5 (9%) had no change, and 1 (2%) had worsening disease. Of 48 participants treated with topical permethrin only, 46 (96%) achieved cure, 2 (4%) had no change, and 0 (0%) had worsening disease. Thirty-five participants (34%) experienced postscabetic itch for 52.5 days (interquartile range, 28-135). More participants in the older (mean: 55 years; standard deviation: 21 years; p = .002) combined treatment group experienced postscabetic itch than in the younger (mean: 42 years; standard deviation: 19 years) permethrin-only treatment group (42% vs. 25%; p = .072).

CONCLUSION: These findings support the use of combined topical permethrin plus oral ivermectin therapy in treating common scabies, highlight that postscabetic itch can persist for longer than previously reported, and reveal a potential relationship between older age and postscabetic itch.

PMID:35028370 | PMC:PMC8714596 | DOI:10.1016/j.ijwd.2021.09.001

Категории: MedLine

Drug survival of systemic immunosuppressive treatments for atopic dermatitis in a long-term pediatric cohort

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jul 22;7(5Part B):708-715. doi: 10.1016/j.ijwd.2021.07.005. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: : Systemic immunosuppressive treatments are central in the treatment of severe atopic dermatitis (AD). Yet, comparative data are sparse on the performance of such immunosuppressive treatments in pediatric cohorts with severe AD.

OBJECTIVE: : This study aimed to examine the drug survival of systemic immunosuppressive treatments in a cohort of children with severe AD.

METHODS: : A retrospective pediatric cohort was identified using diagnosis and treatment codes registered in medical charts. In total, 135 cases were identified; of these, 36 were excluded. All information was obtained through examination of clinical records. Drug survival was analyzed with Kaplan-Meier plots, and a log-rank test was used to test for differences in drug survival.

RESULTS: : First-line treatment was primarily methotrexate (MTX; n = 63) and azathioprine (AZA; n = 32). For MTX, the drug survival rates were 69%, 50%, and 18% after 1, 2, and 4 years, respectively, with a median drug survival time of 1.58 years. For AZA, these rates were 63%, 53%, and 21%, respectively, with a median drug survival time of 1.14 years. There was no significant difference in drug survival between the treatments. The main reason for discontinuation was adverse effects (MTX: 25%; AZA: 41%). Despite this, a majority of patients experienced a good effect at the moment of discontinuation or data-lock (MTX: 60%; AZA: 53%), and treatment effect assessed as improvement in sleep quality was highly significant (p = .001). Second-line treatments included MTX (n = 12), AZA (n = 7), and cyclosporine (n = 5). These showed a median drug survival time of 1.8, 0.2, and 0.885 years, respectively.

CONCLUSION: : MTX and AZA were the dominant first-line treatments prescribed and were safe and equally valuable treatment options for severe childhood AD with similar drug survival outcomes. MTX was the most used second-line treatment.

PMID:35028369 | PMC:PMC8714597 | DOI:10.1016/j.ijwd.2021.07.005

Категории: MedLine
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