Dermatological Applications Research Articles

Hydrogels for localized drug delivery: A special emphasis on dermatologic applications.

Skin disease treatment is a complex and time-consuming process due to the complex etiology, numerous side effects of conventional therapies, and difficulties in determining primary causes of the disease. Superficial wounds are often easy to treat. However, treatment of severe wounds caused by burn is challenging for clinicians. Optimum therapeutic benefits are based on the site-specific delivery of medicaments at the right time for a prolonged duration. Systemic toxicity and frequent dosing are the major challenges associated with the use of conventional therapeutics. Hydrogels are material of choice for drug delivery because of their high biocompatibility and ability to hold and release therapeutic agents. The number of hydrogels available for use in cosmetology and dermatology continues to grow during the past 1-2 decades. However, new hydrogel materials with high biocompatibility, antibacterial properties, and the ability to stimulate skin regeneration processes are in high demand. These are three-dimensional networks, which absorb a large amount of biological fluids and water. Hydrogels can be used as a biosensor, carrier systems for cells, drug delivery carriers especially for topical applications and in contact lenses. Hydrogels are highly porous carriers containing about 90% water. Stimuli-responsive hydrogels cause a change in network structure that is completely reversible in nature. The present review describes the applications of hydrogels in pharmaceutical formulations with a special emphasis on the treatment of dermatologic conditions such as acne, psoriasis, and mycosis.

A quantitative technique to analyze and evaluate microstructures of skin hair follicles based on mueller matrix polarimetry

In this study, we propose a quantitative technique to analyze and evaluate microstructures of skin hair follicles based on Mueller Matrix transmission microscopy. We measure the Mueller matrix polar decomposition (MMPD) parameter images to reveal the characteristic linear birefringence distribution induced by hair follicles in mouse skin tissue samples. The results indicate that the Mueller matrix-derived parameters can be used to reveal the location and structural integrity of hair follicles. For accurate hair follicle location identification and quantitative structural evaluations, we use the image segmentation method, sliding window algorithm, and image texture analysis methods together to process the Mueller matrix-derived images. It is demonstrated that the hair follicle regions can be more accurately recognized, and their locations can be precisely identified based on the Mueller matrix-derived texture parameters. Moreover, comparisons between manual size measurement and polarimetric calculation results confirm that the Mueller matrix parameters have good performance for follicle size estimation. The results shown in this study suggest that the technique based on Mueller matrix microscopy can realize automatically hair follicle identification, detection, and quantitative evaluation. It has great potential in skin structure-related studies and clinical dermatological applications.

Platelet-Rich Plasma: Applications in Cosmetic Dermatology

Platelet-rich plasma (PRP) or autologous platelet gel, plasma-rich growth factors, and platelet-concentrated plasma are blood component that is rich in thrombocytes on a small volume of plasma. There were seven primary growth factors that actively secreted by thrombocytes including platelet-derived growth factor, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, fibroblast growth factor, connective tissue growth factor, and insulin-like growth factor-1. PRP application in cosmetic dermatology includes tissue regeneration, wound healing, repairing scar tissue, skin rejuvenation, and being used in alopecia patients. PRP could accelerate soft-tissue formation in the subdermal, activate fibroblast formation and new collagen deposition, and formation of blood vessels and fat cells. PRP is also considered a potential therapy for accelerating hair growth for alopecia.

Confocal microscopy – Working principle and applications in dermatology

Confocal microscopy (CFM) is a novel, non-invasive tool with diagnostic and prognostic value. It has utility in a wide array of dermatological conditions, tele-dermatopathology, and dermatological research. The image contrast is imparted by the differential refractive properties of subcellular structures. Certain stains are also used to accentuate the image contrast. CFM enables the visualization of tissues both in vivo and ex vivo (after excision). Both reflectance (in vivo and ex vivo) and fluorescence modes (ex vivo) of CFM are utilized for imaging. One can view 3D images with a near histological resolution, but with a limited depth of penetration. CFM has reduced the number of biopsies required in the evaluation of skin cancers. However, conventional histopathology remains the gold standard in tumor diagnosis. The in vivo reflectance mode CFM has found applications in dermato-oncology, inflammatory dermatoses, cutaneous infections and infestations, skin aging, and pigmentary disorders. The ex vivo CFM facilitates the immediate perioperative examination of excised tissues. The limited depth of view, photobleaching (in fluorescence mode CFM), high cost, and steep learning curve are the disadvantages. The future of CFM appears promising with the introduction of modified microscopes, the use of specific stains, and the incorporation of artificial intelligence.

Current perspectives of and potential reforms to the dermatology residency application process: A nationwide survey of program directors and applicants.

The COVID-19 pandemic has accelerated discussions about reforms needed in the dermatology residency application process. We sought to evaluate the perspectives of dermatology program directors (PDs) and applicants regarding changes implemented during the 2020-2021 application cycle and measure support for potential reforms. Two online surveys were distributed to PDs and applicants who participated in the 2020-2021 dermatology residency match. Responses were collected from a total of 79 PDs (73.8% response rate, 83.5% complete responses) and 232 applicants (83.6% complete responses). The top 3 reforms supported by PDs were application caps (89.4% in favor), interview caps (86.4% in favor), and token preference signaling (81.8% in favor). The top 3 reforms supported by applicants were coordinated interview invite release (89.7% in favor), national webinars with PDs and/or faculty to discuss the application process (86.6% in favor), and formalized mentorship programs with PDs and/or faculty (78.4% in favor). This study was limited by the inability to capture responses from more dermatology applicants, possibly affecting the generalizability of the results. We identified broad support for multiple proposed reforms to the dermatology residency application process, particularly to improve the efficiency of application review and strengthen communication between programs and applicants.

33648 Assessing health literacy in the homeless and its application in dermatology

Homeless individuals are more likely to experience adverse health effects in comparison to their counterparts with stable housing. Health literacy plays a large role in the health disparities in this population. We present a literature review of health care literacy in the homeless population and evaluated different health literacy programs. In dermatology programs, health literacy is important as skin care is a long-term relationship between the patient and their sun safety practices. To improve health care outcomes, especially within the homeless population, it is important to meet the goals of a health care literacy program while directing the program to the patient population.

Stepping back: Impact of pass-fail Step 1 scoring on dermatology applicants.

The United States Medical Licensing Examination (USMLE) Step 1 recently transitioned to a pass-fail system from their three-digit scoring system. The implications of this change will ultimately influence medical students, residency programs, and, most importantly, patients. This article seeks to address some of the varying ethical and practical effects of this conversion to a pass/fail examination.

Application of Computational Simulation Integrating Inhibition Kinetics for Detecting Tyrosinase Inhibitor: Salsalate Is a New Inhibitor.

Tyrosinase inhibitor developments have been widely attended by investigators for their various applications. A combination of virtual screening of docking simulations and biochemical inhibition kinetics was performed to find a new inhibitor of tyrosinase for the clinical application of an antipigment agent. We conducted docking simulations to detect tyrosinase key binding residues and used the detected binding residues to screen the NCBI PubChem database for probing tyrosinase binding compounds. The serial inhibition kinetics and spectrofluorimetry measurements were performed to validate the inhibitory effect on tyrosinase. We have detected 200 candidates and categorized them into four clusters. Among them, we successfully confirmed salsalate as a new inhibitor of tyrosinase measured by serial enzyme kinetics. Salsalate was detected as a reversible inhibitor of tyrosinase displaying a typical mixedtype inhibition manner (IC50 = 22.19 ± 1.01 mM; Ki = 19.98 ± 2.11 mM). Spectrofluorimetry measurement by integrating with 1-anilinonaphthalene-8-sulfonate showed that salsalate mainly induced a slight regional conformation distortion of the tyrosinase active site accompanied by a slight hydrophobic disruption. Our study suggests that salsalate is a potential anti-pigment drug via inhibition of tyrosinase activity and it might be applicable for dermatologic clinical application. Also, our study enlarges an insight into the salsalate drug application.

35393 Changes in the geographic distribution of dermatology matching during the COVID-19 Cycle: A proxy for the value of away rotations

Dermatology applicants spend an average nearing $2000 per away rotation, and rank among the top specialties in number of away rotations per applicant. These costs add to the financial barriers that disproportionately affect underrepresented minorities. We sought to determine whether the 2020-2021 application cycle, which had suspended away rotations due to COVID-19, impacted the geographic distribution of matches. Data on applicant medical school and residency match for dermatology were collected for the application cycle 2020-2021 and for cycles 2017 to 2019 from published match lists and PGY2-PGY4 lists displayed on residency program websites.

Revisiting the ultimate purpose of pursuing research in dermatology

To the Editor: We applaud Joshi and Lewis 1 Joshi TP, Lewis DJ. Moving towards a holistic dermatology application process: importance of holistic review of applicant research output. J Am Acad Dermatol. Published online August 5, 2022. https://doi.org/10.1016/j.jaad.2022.07.054 Google Scholar for their insightful reply to our article characterizing the indexed publication output of matched dermatology applicants underrepresented in medicine. 2 Zheng DX, Narang J, Schrom KP, et al. Peer-reviewed indexed publication output of matched dermatology residency applicants underrepresented in medicine. J Am Acad Dermatol. Published online June 3, 2022. https://doi.org/10.1016/j.jaad.2022.05.060 Google Scholar In their commentary, 1 Joshi TP, Lewis DJ. Moving towards a holistic dermatology application process: importance of holistic review of applicant research output. J Am Acad Dermatol. Published online August 5, 2022. https://doi.org/10.1016/j.jaad.2022.07.054 Google Scholar the authors discussed an important limitation of our study, that is, our analysis excluded nonindexed publication scholarly works. Here, we address Joshi and Lewis’s 1 Joshi TP, Lewis DJ. Moving towards a holistic dermatology application process: importance of holistic review of applicant research output. J Am Acad Dermatol. Published online August 5, 2022. https://doi.org/10.1016/j.jaad.2022.07.054 Google Scholar critique and provide rationale for our study design in the context of broader trends in the dermatology residency match. Moving toward a holistic dermatology application process: Importance of holistic review of applicant research outputJournal of the American Academy of DermatologyPreviewTo the Editor: We read with great interest the research letter by Zheng et al1 and commend them for characterizing the peer-reviewed indexed publication output of matched dermatology residency applicants underrepresented in medicine (UIM). The authors show that while UIM applicants published fewer papers than their non-UIM counterparts, there was no significant difference in match rates between UIM and non-UIM applicants. Such an observation, as the authors assert, likely reflects the multifactorial nature of the residency review process. Full-Text PDF

Website transparency of dermatology residency programs: a cross-sectional study.

With the onset of the COVID-19 pandemic, the dermatology residency application process rapidly transitioned in a number of dimensions. As in-person activities were canceled and USMLE Step 1 has become pass/fail, there have been several proposed changes to enhance the process, including a push for increased transparency. Given than most dermatology applicants use program websites to learn more about potential residency programs, we conducted a cross-sectional study to quantify how transparent dermatology residency program website were, relative to published guidelines. From February 11, 2022, to February 25, 2022, we examined the available websites of all ACGME-accredited dermatology residencies to determine transparency regarding information dissemination, selection criteria, interview process, program priorities, and program requirements and opportunities. 136 out of 143 dermatology programs (95.1%) were included. Overall, programs were most transparent with program requirements and opportunities (87.25%). This included information on hospital locations, subspecialty clinics, and rotation/call/didactic schedules. Programs were least transparent with sharing their selection and/or exclusion criteria (31.13%) and varied in how much information they shared about the interview process (39.34%), as well as program priorities (64.56%). Opportunities remain for dermatology programs to improve website transparency and aid applicants in this difficult-to-navigate process. These results identify real transparency gaps, with several potential foci for improvement. Our main study limitation is its focus on a single time-period; to ensure that this information remains up to date, ongoing efforts to periodically resurvey content changes is warranted. Our findings provide an overview of programs’ successes and remaining opportunities to follow published transparency guidelines; overall, these findings may guide individual program directors aiming to improve the transparency of their dermatology residency programs and ultimately benefit our future workforce.

Applications of Telemedicine in Dermatology.

Telemedicine is a technological tool that enhances well-being all around the globe. Practicing medicine or performing a clinical examination from a distance was a mere thought until this decade's pandemic hit the world. Telemedicine is practicing medicine sitting on one side of a globe and diagnosing and treating a different individual from the opposite part of the world. There is a long way to go for medical practitioners to execute an entire clinical examination analogous to an accurate clinical examination. Telemedicine is a supplement to a patient's total care, not a replacement for in-person doctor visits. Family doctors can easily access specialists using telemedicine, which enables them to monitor their patients closely. Numerous telemedicine systems, including store and forward, real-time and remote, or self-monitoring, are used worldwide for education, healthcare delivery and control, sickness screening, and disaster management. Even if telemedicine cannot solve every issue, it can significantly lessen the strain on the healthcare system. Nevertheless, investigations performed via telemedicine have started incorporating various medical instruments called telemedicine peripherals, including electronic stethoscopes, teleophthalmoscopes, and video-otoscopes. The prevailing disease around the globe of coronavirus has remarkably debilitated the medical infrastructure in providing diagnosis, treatment, monitoring, and follow-ups. As a result, there is a significant change in the way of practicing medicine and managing patients. Telemedicine provides timely patient care and reduces the risk of exposure to various communicable diseases offered to medical practitioners. The development of imaging technologies has significantly impacted dermatology, a specialty that relies on visual signals. Reviewing dermatology's existing situation and potential digital future, in brief, is the goal of this study. This study provides brief information on telemedicine, its application and scope in dermatology, and how it can alter the healthcare system.

Dermatologic facial applications of Morpheus8 fractional radiofrequency microneedling.

Dermatologic patients are expressing increasing interest in minimally invasive procedures to address a wide range of common concerns from skin laxity to acne and scarring. Fractional radiofrequency (RF) microneedling offers an effective method for addressing a variety of dermatologic conditions with reduced downtime compared with historically more invasive procedural approaches. This article aims to describe the technology utilized in fractional RF microneedling (Morpheus8, InMode Aesthetics) and its studied applications in dermatology for treatment of the face.

Differences in Underrepresented in Medicine Applicant Backgrounds and Outcomes in the 2020-2021 Dermatology Residency Match.

Dermatology is one of the least diverse medical specialties. Although there have been studies addressing barriers faced by underrepresented in medicine (UIM) applicants to dermatology, there is little information about how UIM applicants approach and fare in the dermatology residency match process. This study aimed to assess differences between UIM and non-UIM applicants in the dermatology match process. A survey was administered to 2020-2021 dermatology applicants (N=232) to evaluate applicant characteristics, approaches, and outcomes in the match process. Survey responses were analyzed to determine if differences between variables were statistically significant. An additional survey was administered to dermatology residency program directors to evaluate their approach to the 2020-2021 application process. Our findings are important in identifying interventions to improve equity in the dermatology application process and to improve diversity in the dermatology workforce.

Emojis and Emoticons in Health Care and Dermatology Communication: Narrative Review.

Emoticons and emojis have become staple additions to modern-day communication. These graphical icons are now embedded in daily society through the various forms of popular social media and through users' personal electronic conversations. With ever-increasing use and inclusivity, exploration of the possible health care and dermatology applications of these tools is imperative. The goal of this narrative review was to provide and evaluate an up-to-date literature survey examining the utility of emoticons and emojis in medicine. Special attention was paid to their existing and potential uses in the field of dermatology, especially during the COVID-19 pandemic. A PubMed search of peer-reviewed publications was performed in mid-2021 to collect articles with emoticon or emoji keywords in combination with other health care-relevant or dermatology-relevant keywords. Screening of publications and described studies was performed by the authors with education and research experience in health care, dermatology, social media, and electronic communication trends. Selected articles were grouped based on common subjects for qualitative analysis and presentation for in-depth discussion. From this extensive search, researchers were able to identify a wide variety of publications detailing the use of emoticons and emojis in general health care, pediatric health care, public health, and dermatology. Key subject areas that emerged from the investigation included the ability of emoticons and emojis to improve communication within pediatric health care, enhance mood and psychological assessment or mental health screening in adults, develop interventions to improve patient medication adherence, complement novel means of public health and COVID-19 surveillance, and bolster dermatology-specific applications. This review illuminated the repurposing of emojis and emoticons for a myriad of advantageous functions in health care and public health, with applications studied in many populations and situations. Dermatology-specific uses were relatively sparse in the literature, highlighting potential opportunities for growth in future studies and practices. The importance of diversity and inclusivity has extended to emojis, with the recent introduction of skin color customization and new emojis better representing the comprehensive spectrum of users' experiences. A continuously evolving and technology-driven population creates a unique niche for emoticons and emojis to ease worldwide communication and understanding, transcending the barriers of age, language, and background. We encourage future studies and innovations to better understand and expand their utility.

The Antibacterial Action of Safranin and Gentian Violet.

BackgroundThe increasing resistance of many bacterial pathogens against antibiotic measures urgently requires new or repurposing therapeutic strategies. Gentian violet is a triarylmethane dye used as a histological stain and for Gram’s method of classifying bacteria. It also exerts an antimicrobial effect against certain pathogens, especially dermatological infections. Safranin is the most popular counterstain used in medical laboratories due to its low cost and safe laboratory usage. However, few studies have been conducted on the antimicrobial activity of safranin.ObjectiveWith the growing prevalence of multidrug-resistant bacteria, this study aimed to evaluate the antibacterial efficacy of gentian violet and safranin against multidrug-resistant Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa).MethodsAll tested bacteria were multidrug-resistant (MDR) bacteria isolated from skin infections (abscesses and wounds). Using gentian violet and safranin, antibacterial effects were studied using the well-diffusion method against 20 samples of clinically isolated bacteria, 10 diagnosed as S. aureus, and 10 as P. aeruginosa. Bacteria were diagnosed using the VITEK 2 automated system (bioMérieux, Marcy-l’Étoile, France). Iodine served as the control agent, since both Gram-positive and Gram-negative bacteria are sensitive to it.ResultsGentian violet dye has been shown to be 100% sensitive to both Gram-positive and Gram-negative bacterial isolates. Although safranin also had high sensitivity (100%) to S. aureus isolates, its sensitivity to P. aeruginosa was only 20%. Staphylococcus aureus was more resistant to iodine (40% sensitivity) compared to P. aeruginosa, which was 100% sensitive to iodine.ConclusionsGentian violet and safranin are low-cost and better tolerated topical agents that have potential for use in dermatological applications. Gentian violet had good antibacterial activity against both Gram-positive and Gram-negative bacteria, making it useful for treating bacterial skin pathogens such as S. aureus and P. aeruginosa especially for MDR bacteria. While safranin has good efficacy against Gram-positive bacteria (S. aureus), its effect against Gram-negative bacteria (e.g. P. aeruginosa) is poor.

689 A comparison of scholarly productivity among matched dermatology applicants by underrepresented in medicine status

Introduction: Research output is an important metric for evaluating dermatology residency applicants. Although dermatology is among the least racially/ethnically diverse specialties, efforts have been made to increase representation among trainees underrepresented in medicine(UIM). Yet, UIM students often face barriers to pursuing research relative to their non-UIM peers. We evaluated the association of UIM status with scholarly productivity among matched dermatology applicants. Methods: We analyzed a cohort of allopathic medical students matching into dermatology residency in the years 2009, 2011, 2016, and 2018.

Perspectives of using electrospun nanofibers for dermatological application.

Perspectives of using electrospun nanofibers for dermatological application.

Innovatív in vivo képalkotó módszerek a bőrgyógyászatban

As a result of advances in the development of medical imaging, the toolbox of dermatological imaging in the XXI. century expanded considerably. In addition to the histological examination that is currently the gold standard in diagnostics, a number of noninvasive imaging methods have emerged in recent decades that have become part of the clinical and preclinical practice. The characteristics of many dermatological diseases have been described in vivo studies with commercially available devices. The authors summarize the principles of terahertz imaging, photoacoustic imaging, reflectance and autofluorescence imaging, near-infrared spectroscopy, and nonlinear microscopy, as well as the in vivo dermatological results and clinical applications of these modalities.

Post-Residency Training Instead of Medical Student Research Fellowships Will Improve Dermatology Patient Care and Excellence.

Research fellowships among prospective dermatology residency applicants are becoming increasingly popular. These fellowships provide opportunities for mentorship, publications, and clinical experience, but unpaid positions impose a significant financial burden. We advocate for a more holistic analysis of dermatology applicants, with less emphasis on publication quantity, and propose allocating funds for post-residency fellowships in underserved areas of dermatology.