Hospital Dermatology Research Articles

Clinico-etiological Study of Nail Disorders at a Tertiary Care Center in Maharashtra, India

Background: Nail abnormalities comprise a significant proportion of dermatological disorders. Nail is a window that provides vital clues for any underlying, dermatological, and systemic diseases. Any cutaneous assessment is incomplete without examining nails despite which it is a fairly neglected appendage. Objectives: This study was carried out to document the clinical pattern, determine the etiology, and identify risk factors for various nail changes. Methods: This cross-sectional observational study was conducted on 200 consecutive patients presenting with nail changes to the outpatient department of dermatology and venereal diseases of a tertiary care hospital. The patients were enrolled after obtaining informed consent. A case record form was designed for every patient, including demographic data, nail characteristics, associated dermatological and systemic disease, and investigation details. Results: The mean age of the patients was 37.98 ± 16.79 years with a male preponderance. Occupation (housewife and manual laborer) was observed to be a significant risk factor (P < 0.001) for onychomycosis. The chief complaint related to nails was cosmetic in 49.5% of the cases. Etiology-wise nail changes secondary to dermatological diseases (44%) were the most common, followed by infections (36%); however, among dermatological diseases, psoriasis (42.2%) followed by lichen planus (16.6%) predominated. Although nail pitting was noticed in various conditions, there was a significant association between nail pitting and psoriasis (P < 0.001). Onychomycosis showed a significant association (P < 0.001) with nail discoloration and onycholysis. Distal lateral subungual onychomycosis (61.4%) was the most frequently observed pattern; nevertheless, the most common causative agent was dermatophyte Trichophyton rubrum (58.26%). A nail biopsy was performed on 15 cases, with conclusive findings in 12 patients. Conclusions: Nails should be considered an integral part of the complete dermatological evaluation. The meticulous examination of nails facilitates the early diagnosis of hitherto undetected cutaneous/systemic disease. The nail unit deserves greater attention for better understanding and utilization as a diagnostic tool.

Addictions in patients with atopic dermatitis: a cross‐sectional pilot study in Germany

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide and displays many atopic, but also non-atopic comorbidities. Among the latter, mental health disorders such as depression have been extensively studied. However, data on addictions are still rare. The aim of this study was to assess the prevalence of different kinds of addictions in adult AD patients using a single-centre approach. This non-interventional cross-sectional study was performed from 03/2020 to 05/2020 at the Department of Dermatology of a large German university hospital. Participants with a diagnosis of AD confirmed by a dermatologist answered questions about disease severity (patient-oriented eczema measure, POEM), quality of life (Dermatology Life Quality Index, DLQI) and smoking habits. They were screened for problematic alcohol consumption, drug abuse, internet addiction and pathological gambling using internationally established and validated questionnaires. 157 patients (56.1% female; mean age of 49.9 ± 20.4) with an average POEM of 13.7 ± 7.5 and DLQI of 6.1 ± 5.4 were evaluated. 14.1% were identified as regular smokers, 12.1% screened positive for alcohol dependency, 6.4% for drug use disorders, 4.5% for Internet addiction and 3.2% for pathological gambling. Co-occurrences of different addictions were observed, and a positive correlation was noted between DLQI scores and smoking. In summary, this study hints at elevated positive screening rates for problematic alcohol consumption, drug use disorders, Internet addiction and problem gambling compared with the general population. Screening routinely for addictions may improve patient-centred health care of AD patients.

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

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.

Structures and performance characteristics of dermatology hospitals in Germany. Current status and long-term development.

The objective of the study was to characterize the performance of German dermatology hospitals. A structured survey questionnaire was sent out to all dermatology hospitals in October 2019 as part of a cross-sectional analysis based on health care research. Of the 115 hospitals, 95 (82.6%) responded, including 34 (35.8%) university hospitals (UC) and 61 (64.2%) non-university hospitals (NUC), of which 78% were urban (43% UC, 57% NUC) and 22% rural (10% UC, 90% NUC). The dermatology departments comprised an average of 45 inpatient and 11 day-care beds (UC: 52/13, NUC: 40/9). An average of 2,302 inpatients were cared for in 2018 (UC: 2,874, NUC: 1,983), and the case mix index was 0.76 (UC: 0.74, NUC: 0.77, overall range: 0.40-0.96). Mean length of stay was 5.5 days for UC, relevantly lower than 2013 (5.9 days) and 2011 (7.1 days) data, and also significantly lower for NUC at 5.9 (2018) versus 5.1 days (2013). German dermatology hospitals continue to have a high volume of inpatient care, with a comparison of the last six years again showing a compression with shorter length of stay and higher occupancy density. Dermatological hospitals represent an essential pillar of dermatological care.

Inpatient care for skin diseases in Germany: multi-source analysis on the current and future health care needs.

In Germany, skin diseases are mainly treated in the 115 dermatological hospitals. Health care and health economic analysis of dermatological inpatient care and prediction of future care needs based on primary and secondary data. Outpatient and inpatient care for dermatologic treatment indications is predominantly provided by dermatology specialists. Inpatient treatment was provided for 833,491 cases in 2018, corresponding to 4.21% of all inpatient cases (19,808,687). Most common treatment cases were: epithelial skin cancer (total 87,386, of which dermatology clinics 52,608), followed by melanoma (23,917/17,774), psoriasis (19,291/13,352), erysipelas (73,337/11,260), other dermatitis (12,671/10,842), atopic dermatitis (AD) (11,421/9,734), and herpes zoster (26,249/9,652). With an average length of stay of 5.69 days, dermatology hospitals were in the bottom third. The proportion of inpatient indications cared for in dermatology hospitals was highest for prurigo (95.2%), pemphigus (94.9%), parapsoriasis (94.6%), pemphigoid (90.3%), eczema other than AD (85.6%), and AD (85.2%). While the total number of inpatient treatment cases in Germany has increased by an average of 17.5% between 2000 and 2018, this is the case for 26.6% of skin diseases and over 150% for individual ones. The projection of current to future inpatient care suggests a continued high demand for inpatient care by dermatology hospitals. Inpatient dermatological care will continue to be an indispensable component of qualified, socially necessary care in Germany.

Status quo and perspectives of dermatology hospitals in Germany: spectra of health care and staff situation.

Inpatient care in Germany has been subject to change since the introduction of the DRG-based payment system. There have been no publications on important differentiating factors such as the spectrum of care and the staffing situation in dermatology. Health care analysis of 115 dermatology hospitals in October 2019 using a structured survey questionnaire. On average, the spectrum of care included 31.0% general dermatology, 33.6% surgical dermatology, 15.6% oncology, and 10.1% allergology. The clinics had an average of 14 full-time positions and 3 part-time positions (university clinics: 23/5, non-university clinics: 9/2). The mean nationwide proportion of women in the physician teams showed the following distribution: postgraduate physicians 73.3%, senior physicians 53.0%, directors 20.0%. The applicant situation of senior physicians and specialists was assessed as predominantly poor, that of residents as predominantly good. Worse applicant situations were present in non-university hospitals and in rural areas. The satisfaction of the medical directors with the current conditions of inpatient care showed a variable assessment independent of university hospital and non-university hospital status. However, the threat to inpatient care was predominantly assessed as low (71.6%). The overall situation of inpatient dermatological care can be classified as predominantly good. In addition, the majority of dermatology clinics provide a wide range of care with regard to the variety of indications. The general conditions, which in some cases are rated as inadequate, require further measures.

Study of Comparison of Serum CXCL10 in Vitiligenous Patients before and after NB-UVB

Abstract Background Vitiligo is a common, asymptomatic, acquired depigmentation disorder, clinically characterized by milky white sharply demarcated, macules and patches that are scattered symmetrically or asymmetrically over the body causing severe cosmetic distress and social stigma. It can be classified as nonsegmental, segmental, mixed, or unclassified. In vitiligo, melanocytes are targeted by multiple aggressions leading to marked reduction and destruction of pigment cells, including autoimmune process, altered cellular environment, defective melanocytes migration, stress, and genetic factors. Objective To evaluate the serum CXCL10 level in patients with more than one year stability, compare them with healthy controls and compare the serum and tissue level before and after treatment with NB-UVB. Patients and Methods The present prospective controlled study included 20 patients with stable vitiligo (according to the VIDA activity score age of patients ranged from 18 to 54 years old were divided into 10 males and 10 females, and were recruited from the outpatient clinic of dermatology of Ain Shams University Hospital in the period from october 2018 to march 2019, twenty healthy persons were used as controls. All the patients were subjected to a full history taking, general and local clinical examination laboratory tests, and graded via VIDA score as below, digital photography were taken before and after NB-UVB. Results A Total of 20 patients were enrolled in the study, completed the study till the end of follow up of 24 visits during 12 weeks, their ages ranged from 18 to 54years old with a mean of 32.88 ± 10.42 years. Patients were divided into 10 males (50%) and 10 females (50%). Only one patient (5%) had a past medical history of diabetes mellitus and five patients (25%) had similar vitiligo affection in their families. As regard the mean difference of serum CXCL10 in comparison to tissue levels after the treatment there was no statistically significant differences indicating that serum is good indicator for measurement of expression of CXCR3 expression with less invasive procedure and tissue CXCL10 is not necessary to be measured Conclusion Cxcl10 is a useful marker for vitiligo and its severity Serum CXCL10 is equally significant to tissue CXCL10, so serum CXCL10 can replase invasive tissue CXCL10 Some drugs can be directed against CXCL10 or its receptor CXCR3 and may be a useful tool to control vitiligo in the future.

The Level of Expressed Emotion (LEE) Scale (Short Version): The Turkish Validity and Reliability Study in Patients Admitting to Dermatology Clinic

Purpose: The purpose of the present study was to determine the Turkish validity and reliability of the LEE Scale (short version) in patients admitted to the Dermatology Clinic, and to ensure its use in patient evaluations for dermatology and other branches. Material and Methods: The LEE Scale (short version) had 38 items, and was developed originally in English. The scale was translated into Turkish by following the proper translation steps. The Turkish scale that was created was applied to the patients. A total of 510 people, 279 of whom were women (54.7%), and 231 men (45.3%), applying to Sivas Cumhuriyet University Hospital Dermatology Clinic were included in the study. The internal structure consistency and test-retest reliability were measured for reliability analyses. The Cronbach’s Alpha Coefficient was estimated for internal consistency. The scale was applied to 50 patients twice, at baseline and two weeks later for test-retest reliability, which was also statistically evaluated with the Pearson Correlation Test. The Exploratory Factor Analysis was performed to evaluate the construct validity of the scale. The significance level was taken as p<0.05. Results: The ages of the patients included in the study ranged between 18 and 72, and the mean age was 28.2±9.6. The Cronbach-Alpha Coefficient was found to be 0.915 in the internal structure consistency measurement. The correlation coefficient was calculated as r=0.868 in test-retest reliability. The total LEE scale (short version) score was a mean ± SD of 59.6 ± 14.2. Conclusion: It was concluded in the present study that the LEE Scale (short version) is a measurement tool that can be used in a reliable and valid manner for the evaluation of emotional expressions of individuals who have dermatological diseases.

Evaluation of Serum Level of Claudin‐ 3 and Its Association with Disease Severity in Patients with Psoriasis in Iraqi patients

Background Psoriasis is a prevalent inflammatory skin disease. Psoriasis is a complex illness in which environmental variables acting on individuals with unique genetic predisposition causing immunological dysregulation. Claudins are transmembrane proteins that help to generate tight junctions by binding to the actin cytoskeleton. Claudin 3 in the blood is thought to be a good indicator of intestinal permeability. Objective: The aim of this study was to detect of the alteration of claudin-3 in psoriasis patient and find the correlation between severity and concentration of the claudin-3. Patients and methods: forty psoriatic patients (25males and 15 females) and thirty normal healthy controls (19 men and 11 females) who were age and sex matched to the cases group were included in this study. They were chosen at random from Al Fallujah hospital Dermatology Department outpatient clinic. Result: When compared to the control group, the psoriasis group had substantially greater levels of claudin-3 (mean=2.18 ± 0.16 versus 1.27 ± 0.03; p0.0001). Furthermore, the amount of claudin-3 rose progressively as the severity grade increased (001). There were no significant correlations between claudin-3 levels and gender, dietary status, or family history in the psoriasis group (p&gt;0.05 for each). Conclusion: Claudin-3 levels were considerably greater in psoriasis patients than in healthy controls. PASI levels were shown to be linked to claudin-3 levels.

Association between the severity of chronic spontaneous urticaria and sleep-disordered breathing

BackgroundChronic spontaneous urticaria (CSU) is a common mast cell-driven disease, presenting with wheals, angioedema, or both. Sleep-disordered breathing (SDB) is also a common condition and contributes to various diseases by causing chronic inflammation. Recent studies have suggested an association between CSU and SDB. MethodsTo determine the association between the severity of SDB and that of CSU, we studied consecutive patients with CSU who visited the Sagamihara National Hospital allergy department or dermatology department between April 1 and October 31, 2018. The severity of CSU and SDB was evaluated based on the urticaria activity score 7 (UAS7) and peripheral arterial tone apnea-hypopnea index (pAHI) derived from out-of-center sleep testing (OCST) findings, respectively; their correlation was examined. ResultsOf the 37 patients studied, 19 had symptom-free-to-mild CSU (UAS7 ≤15) and 18 had moderate-to-severe CSU (UAS7 ≥16). The pAHI in the latter group was significantly higher than that in the former group (18 vs. 4.2, p = 0.001). In multivariate logistic analysis, moderate-to-severe SDB (pAHI ≥15) was significantly associated with moderate-to-severe CSU even after adjusting for the BMI (adjusted odds ratio 22 [95% confidence interval, 1.7–285]). ConclusionsThe severity of SDB is correlated with that of CSU independently of the BMI. Physicians should consider comorbid SDB when treating patients with CSU.

Managing respiratory complications in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

In the recently published guidelines by the Society of Dermatology Hospitalists on the management of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), a brief section was included on airway management. These recommendations provide an easy reference on how to manage respiratory complications of the disease. Understanding the evidence that underlies these recommendations would offer physicians greater clarity on the considerations behind every decision and treatment offered. We present a review of the literature on respiratory manifestations associated with SJS and TEN. In addition, we aim to address specific concerns regarding the respiratory management of these patients. These include issues such as the indications and optimal timing of intubation, tracheostomy, role of flexible nasoendoscopy, bronchoscopy, ventilation strategies, and management of chronic respiratory complications.

IDENTIFICATION OF MALASSEZIA SPECIES AND ITS ASSOCIATION WITH CLINICAL MANIFESTATIONS OF ATOPIC DERMATITIS

Introduction: Atopic dermatitis is a chronic, recurrent inflammatory skin disease that is characterized by an eczematous reaction. Few studies have investigated fungi in the pathogenesis of atopic dermatitis, however, there are different about distribution of Malassezia species. Objectives: To indentificate of Malassezia species and its asociation with clinical manifestations in Vietnamese atopic dermatitis patient. Methods: 178 patients who were diagnosed with atopic dermatitis and had a postitive direct examination of Malassezia at the National hospital of dermatology and venereology between July 2019 and June 2020. Specimens were taken with cellotape, then stained in 20% of potassium hydroxit combined with ParkerTM blue black ink. All patient who had postive test were cultured on SDA and mDixon. For fungal samples, we selected pure colonies with morphological characteristics of yeast as follows about 1cm in diameter, round, cream or milky in color, smooth and glossy to detect the species. Results: From the samples of atopic dermatitis patients, we cultured and idenfified 41 cases. 5 species were found, in which M. globosa was the most common species, accounting for 39%, followed by M. restricta (19.5%), M. dermatis (17.1%), M. furfur (17.1%) and M. sympodialis (2.4%). Conclusion: On the skin lesions of Vietnamese patients with atopic dermatitis, M. globosa was the most common species with 39.0%.

Medical management of Stevens-Johnson syndrome/toxic epidermal necrolysis among North American dermatologists

Medical management of Stevens-Johnson syndrome/toxic epidermal necrolysis among North American dermatologists

2019年中国医学科学院皮肤病医院门诊病种分析

2019年中国医学科学院皮肤病医院门诊病种分析

Evaluation of glycolic acid and trichloroacetic acid peels in the treatment of melasma

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Melasma is a chronic acquired hypermelanosis of the skin mainly affecting women. The etiopathogenesis of melasma is not fully understood but multiple factors like genetic influences, sunlight exposure, pregnancy, estrogen ingestion and family history are implicated. The present study was aimed to evaluate the therapeutic, efficacy of glycolic acid (GA) and trichloroacetic acid (TCA) superficial chemical peels in melasma patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Fifty patients with clinically diagnosed melasma of either sex attending the outpatient clinic of department of dermatology of Mamata medical college and hospital, Khammam during the period of April 2007 to March 2008 constituted the subject material.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Distribution of melasma patients by duration of lesions showed the duration varied from 6 months to 6 years in both the groups, the difference in the duration of disease in two groups was statistically non-significant. Whereas site involvement showed malar region (96%) was the most commonly affected site followed by forehead (80%) and chin (20%). Study also showed sunlight was the main precipitating factor and the most frequent Fitzpatrick skin phototype was type V. The majority of cases in both the groups pigmentation was homogenous. In both the groups, at the end of three peels, it was observed that maximum cases had moderate improvement. Burning sensation was significantly high in group B compared to group A, erythema was seen in more in group B.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study proposes to combine both their modalities of chemical peels for better results TCA peels are used initially to get prompt response and then followed by GA peels to further reduce the pigmentation and maintain the effect.&lt;/p&gt;

Demographic profile of patients treated for melasma with glycolic acid and trichloroacetic acid: an institutional experience

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Melasma is an acquired disorder of hyperpigmentation characterised by forehead, cheeks, around eyelids and chin mostly in the sun-exposed areas of the skin. The etiology for melasma is not clear, various factors like genetic or hormonal influences the cause. The aim was to understand the demographical distribution and epidemiological pattern of pigmentation in melasma patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 50 patients were participated in the present study at department of dermatology of Mamata medical college and hospital, Khammam over a period of one year.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age of patients with melasma was 33.84±5.76 years, with the youngest and oldest being 20 and 40 years with female preponderance, with a male to female ratio of 1:9. The maximum number of patients educated up to middle school level (38%) followed by primary school. The maximum number of individuals participated in the present study were housewife’s and out of 50 individuals 92% patients in the present series were married whereas family history of melasma was noted only 16% of the melasma patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The present observations demonstrates that the melasma is a female predominant, affecting young adults, etiological observations like sunlight, married, pregnancy, indoor, family history followed by cosmetics plays an important role in the melasma.&lt;/p&gt;

Clinical background of patients with psoriasiform skin lesions due to tumor necrosis factor antagonist administration at a single center.

Paradoxical reaction (PR) occurs when a drug elicits a reaction contrary to what was expected. To clarify the clinical features and genetic background of individuals susceptible to PR, we analyzed the clinical course of patients in whom psoriatic eruptions worsened or newly developed during tumor necrosis factor (TNF) antagonist administration and the role of focal infections and genetic variations. Of 125 patients who received TNF antagonist therapy for psoriasis, acrodermatitis continua of Hallopeau (ACH), generalized pustular psoriasis (GPP), or palmoplantar pustular psoriasis (PPP), eight patients with PR were surveyed at our hospital Dermatology Department between 2010 and 2021. A survey was also done on six patients who received TNF antagonist therapy for Crohn's disease, rheumatoid arthritis, ankylosing spondylitis, and hidradenitis suppurativa and were referred to our department due to PR. Additionally, Sanger sequencing analysis was performed for all exons and flanking introns of IL36RN (interleukin 36 receptor antagonist), CARD14 (caspase recruitment domain-containing protein 14), and AP1S3 (adaptor-related protein complex 1 subunit sigma 3). The clinical assessment of the 14 patients demonstrated an average age at PR onset of 48.4years, a male:female ratio of 5:9, and a mean administration period until onset of 9.2months. The clinical types of PR were plaque psoriasis, PPP, GPP, pustulosis, acne, ACH, hair loss, and exacerbation of arthralgia. Histopathology revealed psoriasiform dermatitis in three patients. One patient continued TNF antagonist therapy. All of the patients with psoriasis and GPP had dental infections, suggesting that focal infection may be a risk factor of the development of PR following TNF antagonist therapy. Gene analysis demonstrated CARD14 gene variants associated with RA, CD, AS, or PPP in four patients. In addition, all of the patients with ACH and PPP experienced PR, suggesting that these diseases may predispose patients to PR to TNF antagonist therapy.

27971 Single institution experience with a dermatology hospitalist service

The dermatology hospitalist model was first defined by the Society of Dermatology Hospitalists in 2009; however, scant evidence exists to demonstrate its institutional benefit. Dartmouth-Hitchcock Medical Center established a formal dermatology consult service in early 2019, for which we named a director, ensured faculty continuity, and enacted earlier rounding times to communicate with primary teams. Here, we examine the value of an inpatient dermatology consult service at our institution. Both utilization and value of the service were determined for the year 2019 through analysis of the number of consults, consulting team, provisional diagnosis of primary team, final diagnosis of the dermatology service, performance of inpatient biopsy, and scheduled follow-up for hospitalized patients.

Integrated care pathways and the hub-and-spoke model for the management of non-melanoma skin cancer: A proposal of the Italian Association of Hospital Dermatologists (ADOI).

The term non-melanoma skin cancer (NMSC) refers to skin cancer different from melanoma, and it is usually restricted to basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and their pre-cancerous lesions, e.g., actinic keratosis. These conditions represent the most frequent tumors in Caucasians and are characterized by an increasing incidence worldwide and a high socio-economic impact. The term Integrated Care Pathway (ICP) refers to “a complex intervention for the mutual decision making and organization of care processes for a well-defined group of patients during a well-defined period”. The purpose of this paper is to present a proposal from the Italian Association of Hospital Dermatologists (ADOI) for an ICP organization of care of NMSC, considering the hub-and-spoke model in the different geographical areas.This proposal is based on the most recent literature and on documents from the Italian Association of Medical Oncology (AIOM), the European consensus-based interdisciplinary guidelines from the European Association of Dermato- Oncology (EADO), and the National Comprehensive Cancer Network (NCCN).We initially discuss the NMSC outpatient clinic, the role of the multidisciplinary working groups, and the hub-and-spoke model regarding this topic. Then, we define the ICP processes specific for BCC and SCC.The ICP for NMSC is an innovative strategy to guarantee the highest possible quality of health care while the hub-andspoke model is crucial for the organization of different health care structures. Considering the importance on this topic, it is essential to create a valid ICP together with an efficient organization within the different geographical areas.

Effect of Educational Program on Health Consequences of Patients with Leprosy

Context: Leprosy remains a leading cause of peripheral neuropathy and disability globally despite the extensive efforts to reduce the disease burden. It is associated with social stigma, and the patients sometimes suffer social discrimination because it often leads to visible physical deformities.&#x0D; Aim: The present study aimed to evaluate the effect of educational program on the health consequences of patients with leprosy.&#x0D; Methods: The study was conducted at outpatient clinics in Dermatology Hospital affiliated to the Ministry of Health and population. A quasi-experimental (pre/post-test) design was used on a purposive sample of 72 leprosy patients. Four tools were used to collect the data for this study: A structured interviewing questionnaire, a patients' reported practices checklist, an attitude assessment scale for patients with leprosy, and health consequences assessment questionnaire for patients with leprosy. &#x0D; Results: The current study reveals a significant improvement in the patients’ knowledge, reported practice, and attitude toward leprosy. A significant improvement in health consequences (problems and needs) after education compared with the preintervention level. An association between the total knowledge, practice, and attitude after health education was significant (p&lt;0.001). An association between the mean and standard deviation of knowledge, practice, and attitude before and after the health education program was significant (p&lt;0.001).&#x0D; Conclusion: Educational program had a remarkable effect on improving patients' knowledge, practice level, patient attitude, and health consequences (problems and needs) of leprosy. The study recommended applying educational programs for patients with leprosy in different health care settings focusing on prevention from disabilities.