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JAMA Dermatology Jan 2017
Topics: Dermatologists; Dermatology; England; History, 18th Century; History, 19th Century; Humanism; Humans
PubMed: 28114521
DOI: 10.1001/jamadermatol.2016.0100 -
Giornale Italiano Di Dermatologia E... Feb 2020Graft-versus-host disease (GvHD) is a commonly occurring immunological reaction and frequent complication following allogeneic hematopoietic stem cell transplantation.... (Review)
Review
Graft-versus-host disease (GvHD) is a commonly occurring immunological reaction and frequent complication following allogeneic hematopoietic stem cell transplantation. Its highly diverse manifestations including skin involvement as the most common appearance of GvHD, can dramatically influence patient's quality of life, in particular in the chronic stage, in addition to patient's decreased survival outcome. Hence, the role of the dermatologist has become very crucial in an interdisciplinary setting, particularly since appearances of GvHD in the skin can be multifaceted and challenging. Clinical manifestation of the acute GvHD (aGvHD) is limited to erythematous maculopapular rash and oral mucosal lesions while the chronic form manifests in a wider range in a localized area or disseminated including involvement of nail, scalp and genital area. This article aims to provide a comprehensive overview on the variable cutaneous presentations of acute and chronic GvHD for a proper and early diagnosis on the one hand, and to discuss updated therapeutic options for both acute and chronic GvHD on the other hand, to initiate an adequate treatment to obtain the most beneficial clinical outcome.
Topics: Acute Disease; Chronic Disease; Dermatologists; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Physician's Role; Quality of Life; Skin; Skin Diseases
PubMed: 32100975
DOI: 10.23736/S0392-0488.19.06535-0 -
Dermatologic Therapy May 2020Psychiatric symptoms in dermatology practice are increasingly being recognized. The use of psychiatric medications by dermatologist is dealt with caution and uncertainty... (Review)
Review
Psychiatric symptoms in dermatology practice are increasingly being recognized. The use of psychiatric medications by dermatologist is dealt with caution and uncertainty in several psychodermatological conditions. Several skin conditions are associated with anxiety, depression, and obsessive-compulsive symptoms. Some conditions such as delusion of parasitosis require antipsychotic medication treatment. Keeping in mind the importance of psychotropic medications and its use in dermatology, following brief review will familiarize dermatologists about the ease of understanding and prescribing psychotropic medications to help their patients with psychiatric symptoms and increase the compliance in treatment.
Topics: Dermatologists; Dermatology; Humans; Mental Disorders; Psychotropic Drugs; Skin Diseases
PubMed: 32268440
DOI: 10.1111/dth.13385 -
Journal of the American Academy of... Dec 2019Dermatologic diagnosis relies on vision primarily and auditory and verbal input secondarily. Accurate dermatologic diagnosis is predicated on seeing and perceiving a... (Review)
Review
Dermatologic diagnosis relies on vision primarily and auditory and verbal input secondarily. Accurate dermatologic diagnosis is predicated on seeing and perceiving a skin finding, categorizing and naming the finding correctly, and comparing the visual data and data obtained from the totality of the clinical encounter (ie, from other sensory modalities) with one's working mental database of dermatologic diagnoses. The baseline assumption-which is false-is that a dermatologist is an expert at each of the aforementioned steps and transitions sequentially between them seamlessly in an error-free fashion. Each of these steps has inherent challenges, and the transitions between steps can also be problematic. In part 1 of this 2-part report, we describe the pitfalls associated with visual recognition. In part 2, we discuss cognitive heuristics as they relate to the dermatologic diagnostic process and prevention of diagnostic error.
Topics: Biopsy, Needle; Cognition; Dermatologists; Dermatology; Diagnostic Errors; Female; Heuristics; Humans; Immunohistochemistry; Male; Skin Diseases; Visual Perception
PubMed: 30797839
DOI: 10.1016/j.jaad.2018.10.082 -
Der Hautarzt; Zeitschrift Fur... Jul 2019
Topics: Dermatologists; Dermatology; Humans; Melanoma; Physician's Role; Syndrome
PubMed: 31243517
DOI: 10.1007/s00105-019-4442-4 -
Expert Review of Clinical Pharmacology May 2020Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis in 20-30% of patients. PsA presents as a heterogeneous disease involving different... (Review)
Review
INTRODUCTION
Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis in 20-30% of patients. PsA presents as a heterogeneous disease involving different domains and burdened by an important impact on function and quality of life.
AREAS COVERED
Dermatologists play an important role in the early detection of PsA because in most patients PsA develop after cutaneous psoriasis. The ideal goal of treating patients with PsA is to optimize the controls of symptoms, improve quality of life, and prevent structural damage and disability. The choice of treatment in patients with PsA should take into account also the skin signs and symptoms. Treatment options include NSAIDs, synthetic DMARDSs, anti-TNF-α agents, anti-IL-12/IL-23 agents, anti-IL-17 agents, PDE4 inhibitors, JAK inhibitors, and co-stimulatory blockers. A narrative review based on electronic searches on PubMed® database was performed. Original articles assessing either the role of the dermatologist in the management of PsA and the available treatments for PsA were included.
EXPERT OPINION
Among different treatments, some drugs show more efficacy in joint signs and symptoms, and poor response on the skin and vice versa. The perspective of the dermatologist in a multidisciplinary setting may provide a helpful tool in the management of patients with PsA.
Topics: Animals; Antirheumatic Agents; Arthritis, Psoriatic; Dermatologic Agents; Dermatologists; Humans; Physician's Role; Psoriasis; Quality of Life
PubMed: 32320308
DOI: 10.1080/17512433.2020.1759415 -
Journal of the American Academy of... May 2020Inpatient dermatology has been shown to improve patient outcomes at a reduced cost. Few hospitals have dermatologists available. Teledermatology may allow...
BACKGROUND
Inpatient dermatology has been shown to improve patient outcomes at a reduced cost. Few hospitals have dermatologists available. Teledermatology may allow dermatologists to assess hospitalized patients remotely.
OBJECTIVE
To examine the diagnostic concordance between a hospitalist, dermatologist, and teledermatologist using store-and-forward teledermatology.
METHODS
For 100 consecutive patients requiring inpatient dermatology consultation, a survey was conducted by all 3 raters to convey diagnostic impressions and therapeutic recommendations. Complete and partial agreements were assessed using the Cohen kappa statistic.
RESULTS
Inpatient dermatology consultation often resulted in a change in diagnosis (50.9%) and a change in systemic therapy (41.5%). Likewise, virtual teledermatology consultation would have resulted in a change in diagnosis (54.7%) and a change in systemic therapy (47.2%) at similar rates. Comparing the dermatologist and teledermatologists, diagnostic complete and partial agreement were 52.8% and 84.9%, respectively. Systemic therapy agreement was 77.4%. Teledermatologists recommended biopsy more often (68.5% vs 43.5%).
LIMITATIONS
Small sample size, tertiary academic medical center, single rater for inpatient teledermatology with specific inpatient niche.
CONCLUSION
Teledermatologists performed comparably to an in-person dermatologist for the diagnosis and management of hospitalized patients with skin conditions. Teledermatology may be a suitable alternative for delivery of inpatient care if no dermatologist is available.
Topics: Academic Medical Centers; Biopsy; Dermatologists; Dermatology; Hospitalists; Hospitalization; Humans; Remote Consultation; Skin; Skin Diseases; Tertiary Care Centers
PubMed: 31972258
DOI: 10.1016/j.jaad.2020.01.030 -
JAMA Dermatology Mar 2022This research letter explores how frequently dermatologists separate from their medical practices and the characteristics associated with practice separation.
This research letter explores how frequently dermatologists separate from their medical practices and the characteristics associated with practice separation.
Topics: Dermatologists; Dermatology; Humans; Workforce
PubMed: 35138354
DOI: 10.1001/jamadermatol.2021.5862 -
Archives of Dermatological Research Nov 2023
Topics: Humans; Dermatologists; Artificial Intelligence
PubMed: 37971538
DOI: 10.1007/s00403-023-02762-8 -
The Journal of Dermatological Treatment Mar 2022Physician-patient gender concordance has been linked to more effective patient communication and preventative care screening in the primary care setting. We sought to...
OBJECTIVES
Physician-patient gender concordance has been linked to more effective patient communication and preventative care screening in the primary care setting. We sought to characterize physician-patient gender concordance among dermatologists based on dermatologist practice setting and characteristics as well as compare these rates to those in other physician specialties.
MATERIALS AND METHODS
Retrospective, cross-sectional review of the 2017 Medicare Physician and Other Supplier Public Use File.
RESULTS
In the Medicare population, the mean gender concordance rates among male (52.7) and female (59.9) dermatologists were greater than the overall prevalence of male (46.7) and female (53.3) dermatology beneficiaries ( < .0001). Female concordance rates were higher among dermatologists with an increased frequency of beneficiary visits (62.0 vs. 54.0, < .0001), while gender concordance rates for male dermatologists were higher than those for all other assessed specialties (52.7 vs. 38.3-46.0, all < .0001).
CONCLUSIONS
Male and female dermatologists experienced high degrees of physician-beneficiary gender concordance across various practice settings in the Medicare population, especially when compared to other specialties. Reasons for the observed gender concordance and potential implications for dermatologic care merit further investigation.
Topics: Aged; Cross-Sectional Studies; Dermatologists; Dermatology; Female; Humans; Male; Medicare; Retrospective Studies; United States
PubMed: 32643459
DOI: 10.1080/09546634.2020.1793894