RESUMEN
Platelet-rich concentrates (PRCs), derived from a patient's blood, are being used in various fields of medicine, including dermatology, for an increasing number of indications. Although considered a generally safe procedure for dermatologic indications, there have been reports in the last several years linking this treatment to cases of blood-borne infections including HIV and hepatitis.1 Patient safety should always be the primary focus for physicians and other health care professionals, and systems-based protocols should exist within care settings to minimize errors. Herein, we review our protocol to decrease the risk of complications related to transmission of blood-borne infections and other medical errors related to PRCs. J Drugs Dermatol. 2024;23(9)790-791. doi:10.36849/JDD.8166.
Asunto(s)
Errores Médicos , Plasma Rico en Plaquetas , Humanos , Errores Médicos/prevención & control , Seguridad del Paciente , Patógenos Transmitidos por la Sangre , Protocolos Clínicos , Dermatología/métodos , Dermatología/normas , Enfermedades de la Piel/terapiaAsunto(s)
Dermatología , Infecciones por VIH , Derivación y Consulta , Enfermedades de la Piel , Humanos , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/terapia , Infecciones por VIH/diagnóstico , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Dermatología/métodos , Dermatología/normas , Femenino , Masculino , Persona de Mediana Edad , Adulto , Pacientes Internos , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/complicacionesAsunto(s)
Dermatólogos , Pacientes Internos , Calidad de la Atención de Salud , Humanos , Estudios Transversales , Calidad de la Atención de Salud/normas , Dermatólogos/estadística & datos numéricos , Dermatología/normas , Encuestas y Cuestionarios/estadística & datos numéricos , Femenino , Masculino , Atención al Paciente/normas , Atención al Paciente/métodosRESUMEN
This S2k guideline on venous leg ulcers was created on the initiative and under the leadership of the German Society of Phlebology and Lymphology (DGPL). The guideline group also consisted of representatives from the German Society for Phlebology and Lymphology, German Dermatological Society, German Society for General Medicine, German Society for Angiology, German Society for Vascular Surgery and Vascular Medicine, German Society for Surgery, German Society for Dermatosurgery, German Society for Wound Healing and Wound Treatment, Professional Association of Phlebologists and Lymphologists and Initiative Chronische Wunden. The aim of this guideline is to combine the different approaches and levels of knowledge of the respective professional groups on the basis of consensus, so that a basic concept for the best possible treatment of patients with venous leg ulcers can be provided. A total of 70 specific recommendations were formulated and agreed upon, divided into the subject areas of diagnostics, therapy, prevention of recurrences, and everyday challenges. The guideline thus reflects the current state of scientific knowledge and is intended to be widely used as the best available document for the treatment of patients with venous leg ulcers in everyday clinical practice.
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Úlcera Varicosa , Humanos , Úlcera Varicosa/terapia , Úlcera Varicosa/diagnóstico , Alemania , Sociedades Médicas , Dermatología/normasRESUMEN
BACKGROUND/OBJECTIVES: Lichen sclerosus (LS) is a chronic condition that warrants close follow-up due to the risk of scarring. The optimal long-term management of pediatric vulvar and perianal lichen sclerosus (PVPLS) is unknown. This study aimed to identify diagnostic, treatment, and maintenance regimens among pediatric dermatologists and pediatric/adolescent gynecologists, as well as assess provider confidence and desire for guidance on long-term PVPLS management. METHODS: A cross-sectional 35-question survey was administered through the Pediatric Dermatology Research Alliance (PeDRA) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG) between 7/13/2021 and 8/30/2021 to ascertain PVPLS diagnostic and management regimens. RESULTS: Most responders were attending-level pediatric/adolescent gynecologists (46%) and pediatric dermatologists (41%). Although 85% of participants felt completely or very confident in diagnosing PVPLS, the majority (86%) desired further management guidelines. While the initial treatment was similar among providers, maintenance regimens and follow-up varied considerably, with only 42% recommending lifelong monitoring despite potential persistence into adulthood. CONCLUSIONS: While initial treatment was similar among practitioners, there was variation by specialty in subsequent management and a lack of uniformity in long-term follow-up. Additional studies are needed to clarify the optimal management of PVPLS and to provide evidence-based guidelines regarding long-term follow-up. J Drugs Dermatol. 2024;23(6):450-455. doi:10.36849/JDD.8084.
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Dermatólogos , Ginecología , Pautas de la Práctica en Medicina , Humanos , Femenino , Estudios Transversales , Dermatólogos/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Pautas de la Práctica en Medicina/normas , Niño , Ginecología/estadística & datos numéricos , Ginecología/normas , Adolescente , Encuestas y Cuestionarios/estadística & datos numéricos , Masculino , Liquen Escleroso Vulvar/diagnóstico , Liquen Escleroso Vulvar/terapia , Liquen Escleroso Vulvar/tratamiento farmacológico , Dermatología/métodos , Dermatología/normas , Dermatología/estadística & datos numéricos , Liquen Escleroso y Atrófico/diagnóstico , Liquen Escleroso y Atrófico/terapia , Guías de Práctica Clínica como Asunto , GinecólogosAsunto(s)
Acné Vulgar , Fármacos Dermatológicos , Dermatología , Isotretinoína , Proveedores de Redes de Seguridad , Humanos , Isotretinoína/efectos adversos , Isotretinoína/uso terapéutico , Isotretinoína/administración & dosificación , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Fármacos Dermatológicos/efectos adversos , Acné Vulgar/tratamiento farmacológico , Dermatología/normas , Femenino , Masculino , Pautas de la Práctica en Medicina/normas , Pautas de la Práctica en Medicina/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Prescripciones de Medicamentos/normas , AdolescenteRESUMEN
SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by atopic dermatitis. The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This ï¬rst part of the guideline includes general information on its scope and purpose, the health questions covered, target users and a methods section. It also provides guidance on which patients should be treated with systemic therapies, as well as recommendations and detailed information on each systemic drug. The systemic treatment options discussed in the guideline comprise conventional immunosuppressive drugs (azathioprine, ciclosporin, glucocorticosteroids, methotrexate and mycophenolate mofetil), biologics (dupilumab, lebrikizumab, nemolizumab, omalizumab and tralokinumab) and janus kinase inhibitors (abrocitinib, baricitinib and upadacitinib). Part two of the guideline will address avoidance of provocation factors, dietary interventions, immunotherapy, complementary medicine, educational interventions, occupational and psychodermatological aspects, patient perspective and considerations for pediatric, adolescent, pregnant and breastfeeding patients.
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Dermatitis Atópica , Humanos , Dermatitis Atópica/tratamiento farmacológico , Italia , Fármacos Dermatológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Dermatología/normasRESUMEN
SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by atopic dermatitis. The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This second part of the guideline includes recommendations and detailed information on basic therapy with emollients and moisturizers, topical anti-inï¬ammatory treatment, antimicrobial and antipruritic treatment and UV phototherapy. Furthermore, this part of the guideline covers techniques for avoiding provocation factors, as well as dietary interventions, immunotherapy, complementary medicine and educational interventions for patients with atopic eczema and deals with occupational and psychodermatological aspects of the disease. It also contains guidance on treatment for pediatric and adolescent patients and pregnant or breastfeeding women, as well as considerations for patients who want to have a child. A chapter on the patient perspective is also provided. The ï¬rst part of the guideline, published separately, contains recommendations and guidance on systemic treatment with conventional immunosuppressive drugs, biologics and janus kinase (JAK) inhibitors, as well as information on the scope and purpose of the guideline, and a section on guideline methodology.
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Dermatitis Atópica , Humanos , Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/terapia , Italia , Femenino , Embarazo , Niño , Adulto , Masculino , Emolientes/uso terapéutico , Complicaciones del Embarazo/terapia , Complicaciones del Embarazo/tratamiento farmacológico , Dermatología/normasRESUMEN
The evidence- and consensus-based guideline on atopic eczema, published in JEADV on 18 August 2022 (part 1) and 3 September 2022 (part 2) was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. To reflect the most recent evidence on novel systemic medications, an update was published in October 2022. According to the purpose of the Italian Society of Dermatology and STD (SIDEMAST), the Italian Association of Hospital Dermatologists (ADOI) and the Italian Society of Allergological and Environmental Dermatology (SIDAPA) to adapt the EuroGuiDerm guideline on the treatment of atopic eczema into the Italian Healthcare setting, the original update has been supplemented by inserting notes, well highlighted by the original text, to emphasize the laws, rules, procedures and suggestions of the Italian Ministry of Health and regional Health authorities.
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Dermatitis Atópica , Humanos , Dermatitis Atópica/tratamiento farmacológico , Italia , Dermatología/normasRESUMEN
The American Academy of Dermatology first published a series of guidelines for diagnosing and managing atopic dermatitis in 2014. Twelve clinicians were selected to review, grade, and offer clinical insight on available data regarding the clinical features, symptomology, pathophysiology, education, treatment, and emerging clinical studies on atopic dermatitis (AD). Based on these findings, the AAD released a guideline to streamline information on atopic dermatitis for physicians, recommending using clinical evidence to diagnose and first treating with nonpharmacologic therapies to restore the natural skin barrier. Topical pharmacologic therapies were recommended for improving pruritus and inflammation and newer systemic agents for clinically relevant moderate-to-severe cases. Evidence-based practices were emphasized in comparison to those that lacked therapeutic data. To highlight the emerging evidence and pharmacologic breakthroughs in atopic dermatitis, the AAD produced an updated set of guidelines educating physicians on new agents and their role in treatment. This chapter reviews the AAD guidelines as a tool for managing atopic dermatitis and staying up to date on disease advancements.
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Dermatitis Atópica , Dermatología , Humanos , Dermatitis Atópica/terapia , Dermatitis Atópica/diagnóstico , Fármacos Dermatológicos/uso terapéutico , Dermatología/normas , Dermatología/métodos , Medicina Basada en la Evidencia/normas , Guías de Práctica Clínica como Asunto , Estados UnidosRESUMEN
BACKGROUND: Large language model (LLM)-powered chatbots such as ChatGPT have numerous applications. However, their effectiveness in dermatopathology has not been formally evaluated. Dermatopathological cases often require immunohistochemical workup. Here, we evaluate the performance of a chatbot in providing diagnostically useful information on immunohistochemistry relating to dermatological diseases. METHODS: We queried a commonly used chatbot for the immunophenotypes of 51 cutaneous diseases, including a diverse variety of epidermal, adnexal, hematolymphoid, and soft tissue entities. We requested it to provide references for each diagnosis. All tests were repeated, compiled, quantified, and then compared with established literature standards. RESULTS: Clustering analysis demonstrated that recommendations correlated with tumor type, suggesting chatbots can supply appropriate panels. However, a significant portion of recommendations were factually incorrect (13.9%). Citations were rarely clinically useful (24.5%). Many were confabulated (27.2%). Prompt responses for cutaneous adnexal lesions tended to be less accurate while literature references were less useful. Reference retrieval performance was associated with the number of PubMed entries per entity. CONCLUSIONS: This foundational study suggests that LLM-powered chatbots may be useful for generating immunohistochemical panels for dermatologic diagnoses. However, specific performance capabilities and biases must be considered. In addition, extreme caution is advised regarding the tendencies to fabricate material. Future models intentionally fine-tuned to augment diagnostic medicine may prove to be valuable.
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Inmunohistoquímica , Enfermedades de la Piel , Humanos , Inmunohistoquímica/métodos , Inmunohistoquímica/normas , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/patología , Dermatología/métodos , Dermatología/normasRESUMEN
Background The International Contact Dermatitis Research Group (ICDRG) grading is the gold standard and is used to interpret patch test results in allergic contact dermatitis (ACD). The ICDRG readings include a combination of visual and palpation findings. Digital photography limits palpation. An alternative scoring system exists to analyse 2D images and interpret patch test readings in teledermatology (TD). Aim To compare tri-partite scoring system (TPSS) (TD) with ICDRG (face-to-face) and to assess the feasibility of TPSS by TD. Methods In this observational study, two investigators each scored the patch test readings for 78 patients at the 48th h, 96th h and on the 7th day. Results The TPSS has a sensitivity of 100%, specificity of 93.34%, positive predictive value of 91.67% and negative predictive value of 100%. At a confidence interval of 95%, Cohen's kappa (0.90) indicated excellent agreement between both investigators. The concordance between both scoring systems was at 93.2% for agreement and 6.82% for disagreement. Polysensitisation (6 patients with 16 allergens) was detected equally in both methods. Limitation A single centre study. Conclusion The readings obtained by TPSS were in agreement with ICDRG. TPSS can reduce the number of patient visits by 50% and may be used during COVID-19 times and beyond.