Patients Attending Dermatology Clinics Research Articles

Cross-sectional burden-of-illness study in atopic dermatitis (MEASURE-AD) in Australia and New Zealand reveals impacts on well-being.

To describe disease burden in individuals with moderate-to-severe atopic dermatitis (AD) in Australia and New Zealand (ANZ) and compare it with other geographic regions. This multicentre, cross-sectional, observational study (MEASURE-AD) recruited consecutive adolescent and adult patients attending dermatology clinics in 28 countries. Data collected included scores of pruritus, disease severity, sleep, pain, disease control, work and quality of life. This study included 112 ANZ participants (Australia n = 72; New Zealand n = 40) from December 2019 to December 2020. Treatments included topicals (85.7% of patients), non-biologic systemic therapy (28.6%), phototherapy (9.8%) and dupilumab (4.5%). Mean Eczema Area and Severity Index (EASI) score was 22.3 (95% CI 19.6-25.0) and Patient-Oriented Eczema Measurement (POEM) score was 18.4 (95% CI 16.8-20.0). Pruritus Numerical Rating Scale (NRS) was 6.0 (95% CI 5.5-6.6) (50% had severe pruritus) and Dermatology Life Quality Index (DLQI) 14.3 (95% CI 12.8-15.8). ADerm-Impact sleep domain score was 15.1 (95% CI 13.2-16.9). ADerm-Symptom Scale worst skin pain domain score was 5.0 (95% CI 4.3-5.6). Work Productivity and Activity Impairment (WPAI) percentages indicated work and productivity impairment. Inadequately controlled AD was self-reported by 41%, with 9.7 flares in the past 6 months. Scores of pruritus, disease severity, sleep, pain, disease control and quality of life in ANZ were often the highest of all the geographic regions studied. ANZ patients with AD have a high disease burden, which extends across multiple facets of daily life. Many are inadequately controlled with existing therapies.

Quality of life and well-being of dermatology patients: Influence of associated anxiety and depression in relation to satisfaction of care

ABSTRACT Background: Many patients attending dermatology clinics have mental health problems which may affect their well-being. Aims: It was intended to study the influence of anxiety and depression on well-being and quality of life (QOL) in relation to satisfaction of dermatological care in an out-patient setting. Materials and Methods: In a cross-sectional study, dermatological patients were assessed for well-being (WHO-5 Well-Being scale), overall QOL, anxiety (General Anxiety Disorder, GAD-7), and depression (Patient health questionnaire, PHQ-9). Satisfaction of care in the dermatology clinic (1: not at all satisfied to 10: very satisfied) and the likelihood of recommending it (1: not at all likely to 10: very likely) were assessed on a 1 to 10 scale. Demographic and clinical variables were also collected. Results: The sample (n = 150) covered a range of dermatological diagnoses including allergy/eczema (53.3%), inflammatory/infective diseases (19.3%), sexually transmitted diseases (10.0%), psycho-somatic diseases (9.3%), and auto-immune diseases (7.3%). A clinically relevant level (moderate degree or above) of depression (12.7%) and anxiety (8.0%) was present in considerable proportions of patients, suggesting that overall 18.7% of patients had anxiety, depression, or both. The satisfaction and recommendation scores were at an appreciable level; however, they did not influence the anxiety and depression scores. Anxiety and depression were negatively correlated with well-being and overall QOL. Conclusion: Anxiety and depression present in a considerable proportion of dermatological patients significantly impaired their well-being and QOL despite high satisfaction and likelihood of recommendation of care in the dermatology clinic. Identifying and supporting psychiatric problems of dermatological patients are needed.

Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals

Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.

Prevalence of scabies in Iraqi patients attending dermatology clinic in Al-Kadhimya hospital

Prevalence of scabies in Iraqi patients attending dermatology clinic in Al-Kadhimya hospital

Non-specialized care of skin disorders: a cross-sectional survey of new patients attending dermatology clinic in a tertiary hospital in Jos, Northcentral Nigeria.

Given the paucity of skin health specialists in Nigeria and the low level of awareness amongst its populace, patients seek for care for skin related disorders from different sources and are given a variety of remedies before accessing specialist care. This study was aimed at describing outlets visited and medication received by patients with skin disorders prior to attending the dermatology outpatient clinic in JUTH. This was a cross sectional study conducted over one year. Information on socio-demography, sources and medication received prior to presentation was obtained and analysed using SPSS 23. The male: female ratio among 166 consenting new patients was 1:1.4. Prior to presentation patients sought care most frequently from Health facilities (68.1%), Patent medicine vendors-PMV (30.7%) and Traditional healers (21.7%). Overall, different steroid preparations were the most commonly used medications (56.6%) across all age groups with fixed combination preparations most frequently used (32.5%). Unconventional substances reportedly used by patients for skin disorders were urine, toothpaste, tomatoes, salt, water in which a life catfish had been kept and fats from a dead dog. Only 21.1% of the patients did not use any medication prior to presentation. There is need to increase capacity in the care of common skin diseases at all levels of the health care system to decrease patronage of unconventional providers. Raising awareness of the general public on the potential dangers of inappropriate treatment of skin diseases and strengthen referral system is imperative to reduce the burden of skin diseases in the country.

Awareness and knowledge of laser hair removal: a cross sectional study from tertiary care dermatology clinics in Oman.

Laser hair removal (LHR), including the use of home-based devices, is becoming very popular in Oman. Despite this, some people still have many misconceptions about this procedure, especially of its long-term complications. This study aimed to assess the awareness and knowledge of LHR among dermatology clinic attendees in Muscat, Oman. A cross sectional survey study was conducted at Al Seeb and Bowshar polyclinics in Muscat, Oman, to attendees between the ages of 18 and 70 years. The Chi-square test was used to assess the association between different categorical variables. Results were considered to be statistically significant if P < 0.05. Of the 500 questionnaires which were distributed, 403 were completed (response rate = 80.6%). The mean (± standard deviation [SD]) age of participants was 32.9 (8.5) years old. In this study, 45.7% (184/403) of participants had used LHR, and of those, 88.6% (163/184) were satisfied with the results. The knowledge percentage among individuals was higher among those who used LHR compared to those who did not use LHR (46% vs. 27%, respectively; P < 0.001). However, there were no significant differences in LHR knowledge percentages based on employment status or monthly income. Female participants and subjects with an educational level of a college degree or above had superior knowledge regarding the safety of LHR use during pregnancy (P < 0.05). This study noted a lack of knowledge, with various misconceptions, about LHR among patients attending dermatology clinics in Oman, especially in individuals who had not used LHR before.

Socio-demographic and clinical characteristics of chronic urticaria among patients attending Dermatology Clinic in a Tertiary Care Hospital

Background: Chronic urticaria (CU) is characterized as the recurrent occurrence of wheals, angioedema, or both on most days of the week, for more than six weeks. Information available on this disease is mainly based on foreign studies. We observed the clinical characteristics of this disease among our population to fill the shortage of information. Materials and Methods: It was a hospital-based, cross-sectional, descriptive study conducted at the Department of Dermatology from July 2022 to March 2023. Patients diagnosed with CU were enrolled in this study after obtaining ethical approval from the Institutional Review Committee (IRC). The calculated sample size was 123. Sociodemographic features and clinical characteristics were recorded after taking consent from the patients. A descriptive analysis was performed and presented in frequency tables. Results: The majority (61%) had chronic spontaneous urticaria (CSU), 13.8% had chronic inducible urticaria (CINDU), and 25.2% had both CSU and CINDU. The mean age of participants was 35.86 ± 13.45 years. Females comprised 72.4% of the patients. A family history of urticaria was found in 16.2% of patients. The mean disease duration was 35.88 ± 60.2 months. Wheals occurred in the evening in 24.3% of cases. Angioedema was reported by 18.6% of the patients. Gastritis was the most common (11.4%) comorbidity. Physical factors precipitated urticaria in 39% of cases. Recurrence of the disease was seen in 17.8%. Prior to visiting the dermatologist, 76.4% had been taking antihistamines and 15% attempting an alternative medicine. Conclusion: Our findings were consistent with those of previous reports. CSU is more than three times more common than CINDU. Females and young adults were more affected by CU. Concomitant CSU and CINDU is also possible. As a chronic condition, it is often difficult to manage, and patients tend to explore alternative options. Key words: Chronic urticaria, Clinical, Demography, Descriptive study

Clinico-Epidemiological Profile of Allergic Contact Dermatitis and Its Correlation With Patch Testing in a Tertiary Care Center in Eastern India.

Allergic contact dermatitis (ACD) is one of the most commonskin disorders seen among patients attending dermatology clinics in India. Patch testing is the gold standard for diagnosing ACD. The clinical-epidemiological pattern of ACD and the allergen-causing it may be different in different geographic locations. Finding the profile of allergens commonly causing ACD in a particular region will help to formulate prevention strategies for the development of ACD. The primary aim of the study was to find out the clinical-epidemiological distribution of allergic contact dermatitis and to identify the common allergens causing it by patch testing in this region of India. A total of 111 cases of ACD were included in the study. Clinico epidemiological profiles of all patients were documented. The patch testing was performed in the outpatient department using the antigens of the Indian Standard Series kit (Systopic Laboratories Pvt. Ltd., New Delhi, India). Patches were removed after 48 hours (two days) of application. The first reading was taken 15 to 20 minutes after the removal of patches on day two.A second reading was taken on day four (96 hours of application) to confirm the presence of an allergic reaction. Results: The patch test was found to be positive in 69% of cases. It was observed that male persons from lower socioeconomic status were getting ACD on most accounts. Potassium dichromate (PDC) was found to be the most commonallergen (30.43%) followed by parthenium (26.08%), para-phenylenediamine (PPD) (21.73%), nickel sulfate (18.84%), chlorocresol (15.94%), black rubber (14.49%), cobalt sulfate (13.04%), and wool alcohols (7.24%) respectively. Our study showed potassium dichromate is the commonest allergen causing ACD in this part of the country. The importance of patch testing lies mainly in educating the patient regarding the avoidance of exposure to particular allergens to avoid the development of new ACD as well as an exaggeration of pre-existing ACD.

Frequency of skin diseases in Egyptian population during coronavirus disease 2019 pandemic

Background Coronavirus disease 2019 (COVID-19) pandemic has resulted in remarkable changes in the profiles of diseases including dermatologic conditions. Aim To investigate the patterns of skin diseases in Egypt during the COVID-19 pandemic. Patients and methods In this cross-sectional study, we reviewed the data of patients who visited dermatology clinics between August 2020 and January 2021 and compared them with the data from the same clinics in the previous year. Results The total number of patients who attended the dermatology clinics between August 2020 and January 2021 was 803 as compared with 1611 patients in the corresponding period of the previous year (49.84% reduction). During the COVID-19 pandemic, there was a significant increase in the frequency of allergic contact dermatitis, irritant contact dermatitis, pityriasis rosea, alopecia areata, erythema multiforme, vasculitis, herpes zoster, and chicken pox (P&lt;0.05). On the contrary, some dermatological conditions such as urticaria and nonscarring hair loss had significantly decreased frequencies during the COVID-19 pandemic (P&lt;0.05). Several skin diseases had unchanged frequencies during the COVID-19 pandemic. These included skin infections (other than viral infections), bullous disorders, some eczematous skin diseases, papulosquamous disorders, and disorders of skin pigmentation. Conclusion This study indicates a significant reduction in the total number of patients attending dermatology clinics in Egypt during the COVID-19 pandemic. The frequency of some skin diseases increased significantly, whereas other skin diseases decreased significantly or remained unchanged during the pandemic. Periodic evaluation of the epidemiologic characteristics of skin diseases is required at different stages of evolution of the COVID-19 pandemic.

Correlation between serum brain-derived neurotrophic factor level and depression severity in alopecia areata patients

Background: Alopecia areata (AA) is a type of non-scarring hair loss affecting anagen stage hair follicles with a multifactorial autoimmune pathogenesis and an unknown etiology. It affects about 2-3% of new patients attending Dermatology Clinics, presenting a wide range of clinical heterogeneity. Objectives: To investigate the correlation between serum BDNF level and depression severity in alopecia areata patients. Methods: The present study had been carried out on 50patients suffering from Alopecia Areata. A written informed consent was obtained from all subjects and approval of the Ethics committee will be sought. Results: Obtained data were presented as mean ± SD, ranges, numbers and percentages as appropriate. Nominal variables were analyzed using Chi-squared (χ2) test. Continuous variables were analyzed using unpaired Student’s t-test or Univariate two-group repeated measures “mixed-design” analysis of variance (ANOVA) with post hoc Dunnett’s test as appropriate. Nominal and non-normally distributed variables were analyzed using Mann-Whitney U test. Statistical calculations were performed using Microsoft® Office Excel 2016 and SPSS (Version 20, 2011). P value &lt; 0.05 was considered statistically significant. Conclusion: This analytical cross-sectional study revealed that the lower serum BDNF level, the higher the severity of depression and Alopecia Areata will be.

Clinical audit on knowledge, practice and common mistakes in drug usage among psoriasis patients attending Dermatology Clinic at National Hospital Kandy

Psoriasis is a chronic disease with several relapses which respond poorly in certain situations. Patients’ compliance and knowledge is poor regarding disease and treatment methods. Identification and correction of the defects in patient education and monitoring is very important in management of a disease like psoriasis.&#x0D; We have studied the knowledge, practice and common mistakes in drug usage among 30 with psoriasis patients which showed a few mistakes which may have been prevented with prior planning. Patient information leaflet for psoriasis patients have been prepared to improve adherence and compliance of patients to the available treatment modalities. This will reduce unwanted side effects and complication related to the drug usage. Monitoring charts will facilitate clinicians’ ability to detect complications and drug side effects early.

Significance of Diet in Acne Vulgaris patients attending Dermatology clinic at Dow University of Health Sciences, Karachi

BACKGROUND &amp; OBJECTIVE: The pathology of acne is vaguely understood to date, current epidemiologic evidence in Eastern populations indicates that consumption of chocolate, milk intake, fatty products, and glycemic load may be involved. Previously little research has been conducted highlighting the possible relationship between diet and acne among patients in Pakistan. The objective of this study was to identify the association of acne vulgaris and dietary intake patterns.&#x0D; METHODOLOGY: An observational study enrolled 246 participants, both genders, 16 to 40 years of age, diagnosed with Acne Vulgaris recruited from a tertiary-care hospital out-patient clinic in Karachi. The structured questionnaire consisted of various methods for assessing nutritional parameters. Statistical analysis was carried out using SPSS, the association of Acne was tested with dietary habits using Pearson-Chi Square test. Food items with a p-value less than 0.05 in the Chi Square test were considered in Binary logistic regression for estimating the risk for Acne with a 95% confidence interval (C.I.).&#x0D; RESULTS: Fifty-two percent of participants were found with mild acne, use of yogurt, ice cream butter, margarine, French fries, chocolate, bakery chips, white bread, vegetable, fruits, cake dates, and pickles give a significant association with severity of acne using Fisher's Exact test p&lt;0.05. Logistic regression showed that butter gave more risk for acne with an odds ratio of 1.11 and 95% C.I. (1.0, 9.2). &#x0D; CONCLUSION: It can be stated that dairy products, high glycemic index, and fatty foods are associated with acne aggravation in our population. As patients are always concerned about dietary advice, suggesting that they reduce these products would help them maintain their skin.

Effect of vitamin D supplementation on patients with acne vulgaris: An intervention study

Background: Acne is a common chronic inflammatory disease of the skin. Vitamin-D is fat soluble vitamin with immunomodulatory function, its deficiency has been noticed in various skin diseases. Objectives: assess frequency of serum vitamin-D deficiency among acne vulgaris patients and the effect of vitamin-D supplementation on acne grading. Method: the study was conducted on two phases, phase I was a cross-sectional study included measuring serum vitamin D level for 80 acne patients attending dermatology clinic at Menoufia University Hospital. Phase II was case control study where studied acne patients with vitamin-D deficiency (66 patients) were randomly divided into two groups; one group (33 patients) were treated with free Oral vitamin-D 2000IU/ tablet for 2 months in addition to regular acne treatment. The other group (33 patients) received traditional treatment for acne without vitamin-D supplementation and both groups were followed up clinically for two months. Results: frequency of vitamin-D deficiency among studied patients was 82.5%, there was statistically significant relationship between vitamin-D deficiency and severity of acne. Vitamin-D deficiency is significantly prevalent among female patients (98.4%). There was significant improvement in acne grading after vitamin-D supplementation Conclusion and recommendation: There’s significant relation between vitamin-D deficiency and severity of acne vulgaris and vitamin -D has a good role in management of acne. So. It is recommended to evaluate the serum level of vitamin D in acne patients and provide vitamin D supplementation to vitamin D deficient patients beside topical treatments for acne.

Antibiotic resistant Cutibacterium acnes among acne patients in Jordan: a cross sectional study

BackgroundAntibiotics have been used for decades against Cutibacterium acnes (previously known as Propionibacterium acnes; C. acnes). Alarmingly, antibiotic resistance to this bacterium has become a worldwide problem in recent years. No studies are available on the antibiotic susceptibility patterns of C. acnes among Jordanian acne patients and how that is influenced by antibiotic use.This study aims to assess antibiotic resistance patterns of C. acnes clinical isolates and neighboring Gram-positive normal flora of the skin obtained from acne patients attending dermatology clinics in Amman –Jordan appraising the role of antibiotic consumption.MethodsThis is a cross-sectional study of acne patients presenting to selected dermatology outpatient clinics over a 6-month study period. Swabs obtained from inflamed lesions were cultured aerobically and anaerobically. Isolates were identified and screened for antibiotic susceptibility. In addition, all patients were asked to fill in a questionnaire that included questions about the history of antibiotic treatment.ResultsC. acnes was isolated from lesions of 100 patients out of 115 participants included in this study. 73% of the isolates were resistant to erythromycin and 59% to clindamycin 37% to doxycycline, 36% to tetracycline, 31% to trimethoprim / sulfamethoxazole, 15% to levofloxacin, and 3% to minocycline. Multi drug resistance (MDR) in C. acnes isolates as well as Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis) with a similar pattern of resistance were detected from the same patient in most cases. A pattern of higher resistance towards variable antibiotic was observed in patients previously treated with antibiotics for acne management.ConclusionsThe findings of this study demonstrate the distribution of antibiotic resistance of C. acnes towards used antibiotics and emphasizes the influence of antibiotic consumption on development of antibiotic resistance. The similar pattern of resistance between skin bacteria tested in this study highlights the genetic transfer of resistance between skin commensals including S. aureus and S. epidermidis hence promoting its circulation in the community.

Sociodemography and Clinical Features of Psoriasis in Patients Attending Dermatology Clinic in Al Diwaniyah Teaching Hospital

Sociodemography and Clinical Features of Psoriasis in Patients Attending Dermatology Clinic in Al Diwaniyah Teaching Hospital

Skin disorders among elderly patients: clinicodemographic characteristics of 808 Egyptian patients

Background Geriatric health care has increased rapidly worldwide. The frequency of skin diseases is rising among elderly patients. Objectives This study aimed to evaluate demographic features and pattern and frequency of skin disorders among elderly patients attending dermatology clinics. Patients and methods This was a cross-sectional clinical hospital-based study that included all patients aged more than or equal to 60 years old who attended the Outpatient Clinics of Dermatology, Sohag University, Upper Egypt. All the patients were subjected to a detailed medical history and complete general and dermatological examination. Results This study included 808 elderly patients, with a mean age of 70.21±7.51 years. A total of 434 (53.7%) patients were females and 374 (46.3%) were males. Among the patients, 264 (32.7%) were living in urban areas. Overall, 188 (23.3%) patients were smokers. Among patients, 268 (33.1%) had low education levels and 450 (53.2%) patients had a previous history of manual work. The most common comorbidities were diabetes mellitus, seen in 270 (33.41%) patients, and hypertension, seen in 64 (7.92%) patients. Of 808 elderly patients, 188 (23.7%) had infectious skin diseases, 162 (20%) had allergic and eczematous diseases, 98 (12.1%) had senile pruritus, 78 (9.7) had xerosis, 48 (5.9%) had papulosquamous diseases, 32 (4%) had cutaneous tumors, 30 (3.7%) had vesiculobullous diseases, 28 (3.5%) had pigmentary skin diseases, and 18 (2.3%) had vascular disorders. Conclusion Skin diseases are common among elderly patients. Infectious skin diseases, allergic and eczematous diseases, senile pruritus, and xerosis are the most common skin diseases among elderly patients.

Assessment of knowledge and attitude towards sun exposure and photoprotection measures among Indian patients attending dermatology clinic

Background: Many skin diseases are known to be either initiated or aggravated by excessive ultraviolet (UV) exposure. High cumulative levels of UV radiation may lead to tanning, burning, photoaging, photoallergic and phototoxic reactions, immunosuppression, and even skin cancers. Many international studies have found that the level of knowledge, attitudes, and practices of the general public toward sun exposure and sun protection measures is good in the Western countries, especially in countries with high incidence of skin cancers compared to Asian countries and Middle East. In India, the incidence of skin cancer is not very high, but UV exposure has definitely increased in the past few decades. Little is known about the knowledge and attitude of Indians toward sun exposure and sun protection due to the paucity of research in this arena. Aims and Objectives: This study was aimed at exploring the knowledge and attitudes of Indians toward sun exposure and sun protection measures. Materials and Methods: A cross-sectional survey was conducted using a predesigned questionnaire related to the knowledge, behavior, and attitudes toward sun exposure and sun protection of the participants visiting a dermatology outpatient clinic for various dermatological problems. Results: total of 324 patients were studied. Participants were divided into five age groups of equal number of male and female participants. Mean age was 37.7 ± 13.15. Overall awareness and knowledge was poor and only 14% were using regular sunscreen. Females had better knowledge and attitude toward sun exposure and protection. The most commonly used sun protection measure was avoiding sun during peak hours of the day. Conclusion: The level of knowledge regarding sun exposure hazards was very low among the study population, and sun prevention behaviors were also very poor. Regular use of sunscreen was practiced only by a small fraction of our population. Knowledge of sun exposure and photoprotection was better in urban, young participants, female gender, and also positively associated with higher education and socioeconomic status. Participants from urban background, females, and middle-aged participants had better attitude toward photoprotection.

A study on incidence of various allergens involved in allergic contact dermatitis by patch testing among 150 patients in a tertiary care hospital in South India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Allergic contact dermatitis is common dermatoses seen among patients attending dermatology clinics. Allergic contact dermatitis is due to delayed type of hypersensitivity reaction. The diagnosis of allergic contact dermatitis is made by patch testing. A positive reaction to a patch test commonly proves the cause of dermatitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective study was conducted&lt;strong&gt; &lt;/strong&gt;to estimate the incidence of various allergens among 150 patch test positive patients with allergic contact dermatitis who had attended the dermatology OPD in Rajiv Gandhi Government General Hospital, Chennai, between October 2014 and September 2016. All the details regarding history, examination findings, investigations and patch test results were collected from case records, the data were tabulated and analysed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Allergic contact dermatitis to cement was the commonest (44.7%), followed by nickel (10%) and plant antigens (9.3%). The commonest allergen to be tested positive was Potassium dichromate (82 cases), followed nickel (15 cases) and formaldehyde (8 cases). Most of the patients were in the age category between 41 and 50 years (47 cases– 31.33%). Male to female ratio was 2.41:1. 14 were atopic individuals (9.33%) by Hanifin and Rajka's criteria. Allergic contact dermatitis in 103 cases of our study were of occupational in origin (67%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Avoidance of allergen and proper preventive measures in workplace and day to day activities will lead to significant decrease in the morbidity of the disease and improvement in quality of life in patients with allergic contact dermatitis. &lt;/p&gt;

Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance.

Although syphilis rates have been relatively high in Italy for more than 15 years, no data on the molecular types of Treponema pallidum subspecies pallidum circulating in this country are yet available. Likewise, no data on how widespread is resistance to macrolide or tetracycline antibiotics in these strains exist. Such data would, however, promote comprehensive studies on the molecular epidemiology of syphilis infections in Italy and inform future interventions aiming at syphilis control in this and other European countries. Swabs from oral, genital, cutaneous, or anal lesions were obtained from 60 syphilis patients attending dermatology clinics in Milan, Turin, Genoa, and Bologna. Molecular typing of T. pallidum DNA was performed to provide a snapshot of the genetic diversity of strains circulating in Northern Italy. Samples were also screened for mutations conferring resistance to macrolides and tetracyclines. T. pallidum DNA was detected in 88.3% (53/60) of the specimens analyzed. Complete and partial T. pallidum typing data were obtained for 77.3% (41/53) and 15.0% (8/53) of samples, respectively, whereas 4 samples could not be typed despite T. pallidum DNA being detected. The highest strain type heterogeneity was seen in samples from Bologna and Milan, followed by Genoa. Minimal diversity was detected in samples from Turin, despite the highest number of typeable samples collected there. Resistance to macrolides was detected in 94.3% (50/53) of the strains, but no known mutations associated with tetracycline resistance were found. Genetic diversity among T. pallidum strains circulating in Northern Italy varies significantly among geographical areas regardless of physical distance. Resistance to macrolides is widespread.

Prevalence and predictors of depressive symptoms among attendees of a tertiary care dermatology clinic in Muscat, Oman.

Various studies have suggested that depression is more prevalent among patients with skin disorders than in the general population. Most of the studies addressing this subject involve Euro-American populations. The present study aimed to estimate the prevalence of depressive symptoms among patients with dermatological disorders and, then, to decipher the clinical-demographic factors associated with depressive symptoms. A cross-sectional analytical study was conducted among a random sample of patients attending a dermatology clinic in Muscat. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to find the adjusted and unadjusted odds ratios (ORs). A total of 260 patients participated in this study, with a response rate of 81%. The prevalence of depression symptoms was 24%. According to regression analysis, family history of depression, comorbid medical disorders, and treatment with topicals or isotretinoin were significant predictors of depression (OR=9.41, 95% confidence interval [CI]: 2.27-39.05, P=0.002; OR=2.0, 95% CI: 1.2-3.21, P=0.05; OR=2.28, 95% CI: 1.09-4.76, P=0.028; and OR=2.78; 95% CI: 1.08-7.19, P=0.035, respectively). This study indicates that depressive symptoms are common among patients with dermatological disorders in Oman, particularly in those with a family history of depression and medical comorbidities, and those who use a specific dermatological medication. Screening for depression in patients attending dermatology clinics is essential in order to detect and promptly treat patients suffering from depression.