Private Dermatology Clinic Research Articles

Gross and Histopathological Study of Postscabietic Nodules

Background: Nodular postscabietic scabies refer to the persistent intermittent signs of scabies that are seen in active and post-treatment period that might last for months. The spectrum of clinico-morphological ranges that can be observed with sarcoptic nodules is broad, and most of the entity's criteria can be elicited histopathologically and pathologically. The management of such nodules may be a challenge. They are commonly treated through local application of corticosteroids or injection of corticosteroids to nodules but the response to treatment is less than clent and relapses are very frequent. The objective of this study was to illuminate which of these features prevail and which ones fade in scarred sites which undergo postscabietic nodule development. The time span between August 2021 to May 2022 was allowed to collect samples from patients with (1-60) years old and full of scabies burrows who visit teaching hospitals and private dermatology clinics in Kut, Wasit Province, Iraq. Treat groups were split into 30 females, and 20 males; with persistent itchy nodular lesions of scabies demonstrated clinically and histopathologically. Everity grade scabies was evaluated by the number of lesions and rated it as severity of itching. Long-term treatment with topical glucocorticoids for 14 days in every age. Tissue from the blisters of patient was obtained after medication. The specimens were washed, fixed and cut to 4-5 µm and stained with H&E. The staining allowed us to observe the fragments of tissues under light microscope with different magnification power. We have observed excessive males and the prevalence of SCABies were more in a young adult group in comparison with other age groups. It was found that lesions with wiry projections tended to persist for two weeks to 52 weeks and the number of nodules had varied from one to fourteen lesions. Examination of Histopathological slide showing acanthosis in 80, histolymphocytic infiltration in 76, and eosinophilia in 100 of total cases in the whole period. After the scabitic nodule loop, the body experiences a hypersensitivity reaction. From the three hundred cases examined microscopically, most (80%) of them were found to be characterized by acanthotic epidermis and diffuse dense dermal lymphocytic infiltration. Neutrophilic reaction, epithelioid-granulomatous inflammation and eosinophilia have been diagnosed in 76 % sight upon while 100 % of other nodules have shown eosinophilia.

Methylisothiazolinone sensitisation in New Zealand is decreasing.

In the last 10 years methylisothiazolinone (MI) emerged as a global cause of preservative-related ACD. New Zealand has liberal regulations for the MI concentration limit in cosmetic products compared to Europe and Australia. The aim of this study was to evaluate the prevalence of MI sensitisation in New Zealand, explore sources of MI exposure and make recommendations on New Zealand regulations for MI use. This retrospective study included data from patients who underwent patch testing with MI from 2008 to 2021 in a tertiary hospital dermatology clinic and a private dermatology clinic in Auckland, New Zealand. Patient baseline characteristics were recorded along with results of patch testing. Sources of MI exposure were identified from medical records. Over the study period, 1049 patch tests were performed in 1044 patients. MI was only tested as a stand-alone allergen from 2015; positive reactions to MI increased from 5.3% in 2015 to a peak of 11.9% in 2017 and then decreased to 6.4% in 2021. The most common source of MI exposure was shampoo or conditioner (27.7% of all relevant reactions) followed by occupational exposures to paints, biocides or glue (19.1%). Both sensitisation and ACD to MI appear to be decreasing, likely secondary to changes in product compounding due to stricter concentration limits internationally. We recommend New Zealand adopt lower MI concentration limits for cosmetics to match the limits of Australia and Europe.

Warts Among Patients Visited Two Private Dermatology Clinics in Aden, Yemen: A Retrospective, Descriptive Study

Background: Cutaneous warts are benign lesions that occur in the mucosa and skin. Objectives: To find out the distribution of cutaneous warts related to sex and age, and to determine the occupation of patients, type of cutaneous warts, site, duration from onset of the disease, complication and treatment. Materials and methods: Two hundred and twelve patients were presented to our clinics in Aden, during the period January 2020 to December 2022 with cutaneous warts. Data including sex, age, occupation, type of warts, site of warts, duration from onset of warts, complications and treatment. Data are presented as mean values with the standard deviation (SD). Results: The study patients were 118 (55.7%) males and 94 (44.3%) females. The age of the study patients ranged between 4 to 65 years. The mean age of the study patients was 27.3 ± 13.7 years. Most of the patients 68 (32.1%) were of age group 21 – 30 years followed by the age group 31 - 40 years with 48 (22.7%) (p = 0.000). Most of occupation of the study patients were laborer (43.4%). Common types of cutaneous warts were predominant (40.6%) (p = 0.000). Face was predominant site in (28.3%) patients. Itching complications found in (25.5%) followed by cosmetic disfigurement (17.9%). Cryotherapy treatments were predominant with (52.8%). Conclusion: Cutaneous warts occurred in younger patients and located on face, upper and lower extremities, sole, genital site, and neck & axilla. Most treatment was cryotherapy. Further studies are needed, to identify the epidemiology of these cutaneous diseases in Aden. Keywords: Cutaneous warts, patients, private clinic, Aden, Yemen.

The Effect of Melasma on the Quality of Life in People with Darker Skin Types Living in Durban, South Africa.

Melasma is a common skin disorder of acquired hyperpigmentation that appears commonly on the face. Although asymptomatic, melasma causes psychosocial and emotional distress. This study aimed to assess melasma's severity on people with darker skin types, evaluate the effects of melasma on the quality of life (QoL), and establish QoL predictors in affected individuals. This was a cross-sectional analytic study that enrolled 150 patients from three private dermatology clinics in Durban, South Africa who were diagnosed with melasma. The severity of melasma alongside QoL were measured using a melasma area and severity index (MASI) score and melasma quality of life scale (MELASQoL), respectively. The associations among factors and QoL were explored using multivariable methods and stepwise regression analysis. p-values less than 0.05 were considered significant. Enrolled patients were predominantly females (95%), of which 76% were of black African ethnicity, 9% were of Indian ethnicity, and 15% had mixed ancestry, with an average age of 47.30 years. Family history revealed that 61% had no prior melasma cases, while 39% had affected relatives, most commonly mothers (41%). The cheeks were the most common site for melasma. MASI score of Masi (β = 0.209, t = 2.628, p < 0.001), the involvement of cheeks (β = -0.268, t = -3.405, p < 0.001), level of education (β = -0.159, t = -2.029, p = 0.044), and being menopausal (β = -0.161, t = -2.027, p = 0.045) were found to be predictors of QoL. A regression model was created to forecast MELASQoL using these four predictors. This equation's significance lies in its ability to enable the remote assessment of MELASQoL based on these four variables. It offers a valuable tool for researchers and medical professionals to quantitatively and objectively evaluate the impact of melasma on an individual's quality of life.

İnfantil Dermatolojik Hastalık ve Tedavilerin Sıklığı: Özel Hastane ve Özel Klinik Analizi

The aim of this study was to determine the prevalence and distribution of dermatologic diseases and treatments in pediatric patients between the ages of 0-2 and the relation between skin diseases and age, gender and application year in private healthcare providers. The study was retrospectively analysed and conducted at dermatology department in a private hospital and private dermatology clinics. A total of 482 patients aged 0-2 years of outpatient admissions from January 1, 2015, to December 1, 2022 were included the study. The most common diseases group were eczemas (53.6%), nevus and benign skin tumors (8.3%), viral diseases (6%), pigmentation disorders (5.7%), and parasitic infections (4%). The dermatitis group was statistically significantly higher in 0-1 age group than 1-2 age. Atopic dermatitis was the most common diagnosis. The viral infections, parasitic infections, nail diseases, and dermatoses due to physical factors were higher in 1-2 age group (p&amp;lt;0.05). Benign skin tumors were commonly observed in girls and 0-1 age group (p&amp;lt;0.05). The topical treatment were usually prescribed to the patients. Systemic treatment was commonly prescribed in 1-2 age (p=0.007) and follow-up decision was usually given to girls than boys (p=0.001). Viral and bacterial infections were observed in higher rates after coronavirus disease 2019 pandemic (p&amp;lt;0.05). New studies in specific pediatric age groups will help to better understand the frequency of dermatological diseases and treatments and also studies conducted at different levels of health care may contribute better to develop health care policies, designing preventive health services and education programmes.

Physical activity and mental health among patients with atopic dermatitis or chronic spontaneous urticaria: A cross‐sectional study

AbstractBackgroundPhysical and mental health are cogently enhanced through exercise. Atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) are two common inflammatory skin diseases greatly impacting lives of affected patients. Yet, little is known about physical activity and its implications among patients with these diseases.ObjectivesTo investigate physical exercise among patients with AD and CSU, exacerbation of the diseases through exercise, and associations with mental health, life quality measures, and disease severity.MethodsWe performed a cross‐sectional questionnaire study in Denmark on adult AD and CSU patients from two university hospitals and two private dermatology clinics. Included patient‐reported outcome measures (PROMs) were Physical Activity Scale 2 (PAS 2), Dermatology Life Quality Index (DLQI), 9‐item Patient Health Questionnaire (PHQ‐9), 7‐item Generalised Anxiety Disorder (GAD‐7), Insomnia Severity Index (ISI), Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH), Urticaria Control Test (UCT), Urticaria Activity Score over 7 days (UAS7), and Patient‐Oriented Eczema Measure (POEM). AD severity was measured with Eczema Area and Severity Index (EASI). Data were non‐normally distributed and analysed with non‐parametric statistics. REDCap and Stata for Macintosh (Apple Inc., USA) were used for management and analysis of data.ResultsIn the AD cohort, any amount of exercise was associated with less symptoms of depression (p &lt; 0.001), anxiety (p = 0.043), and insomnia (p &lt; 0.001). Exacerbation of AD through exercise did not affect PROMs. Exercising CSU patients did not differ concerning any PROMs. Concurrent cholinergic urticaria (CholU) was associated with more symptoms of depression (p = 0.006) and anxiety (p = 0.035) and daily activity impairment (p = 0.015).ConclusionsExercise was associated with improved life quality measures among AD patients but not among CSU patients. Exacerbation of skin disease through exercise did not affect AD patients but was associated with impairment of mental health among CSU patients.

Griscelli Syndrome in Skin of Color: A Trichoscopic Perspective.

Griscelli syndrome (GS) is a very rare autosomal recessive disorder, belongs to group of "silvery hair syndromes" which includes Chediak-Higashi syndrome (CHS) and Elejalde syndrome. Hair light microscopy helps in the differentiation of GS and CHS, as both manifest with clinical features. Trichoscopy is useful in the diagnosis of many hair shaft disorders. Here, authors describe the trichoscopic features of GS in skin of color. This was an observational study conducted in a private dermatology clinic and in a tertiary care hospital. A total of 5 cases of suspected GS were referred by pediatrician. Consent was obtained. The demographic data in terms of age, gender, consanguinity, and clinical history was documented. Trichoscopic examination was performed with FotoFinder videodermoscope with 20× magnification, the clinical images were captured with Medicam 1000. Trichoscopy showed large and irregular pigment clumps in 4 cases. One case demonstrated hypopigmentation of hair without pigment clumps [Figure 3a]. Trichoscopy showed large and irregular pigment clumps in 4 cases. One case demonstrated hypopigmentation of hair without pigment clumps. Trichoscopy shows characteristic features GS. It is a useful method when facility for light or polarized microscope is unavailable.

Self‐reported stigmatisation among patients with atopic dermatitis (AD) or chronic spontaneous urticaria (CSU): A cross‐sectional study

AbstractBackgroundAtopic dermatitis (AD) and chronic spontaneous urticaria (CSU) are two prevalent, visible and itching skin diseases associated with decreased quality of life (QoL), sleep disturbance, depression and anxiety. However, little is known about stigmatisation among patients suffering from these diseases.ObjectivesTo examine whether patients with AD or CSU experience stigmatisation and if disease severity or psychosocial variables associate with experienced stigmatisation.MethodsA cross‐sectional survey was performed among adult AD and CSU patients from two highly specialised university hospitals and two private dermatology clinics. External stigmatisation was examined using the 6‐item Stigmatisation Scale (6SS). AD severity was assessed by dermatologists using the Eczema Area and Severity Index (EASI) score. Patient‐reported outcome measures (PROMs) included: Patient‐Oriented Eczema Measure, Urticaria Activity Score over 7 days (UAS7), Urticaria Control Test, Dermatology Life Quality Index, 9‐item Patient Health Questionnaire, 7‐item Generalised Anxiety Disorder, Insomnia Severity Index and Work Productivity and Activity Impairment Questionnaire: General Health. Nonparametric statistics were used due to nonnormal distribution of data. Data were managed in REDCap and analysed with Stata for macOS.ResultsMean EASI score was 7.6 (±10.7) and the mean UAS7 score was 15.6 (±12.0), for patients with AD and CSU, respectively. External stigmatisation was reported by 78.6% of AD patients and 57.3% of CSU patients. Mean 6SS score was 2.9 (±2.8) among AD patients and 1.9 (±2.8) among CSU patients, and stigmatisation levels differed significantly (p &lt; 0.001). In both AD and CSU patients, stigmatisation correlated weakly to moderately with sleep disturbance (rs = 0.48 and rs = 0.30) and symptoms of depression (rs = 0.50 and rs = 0.38) and anxiety (rs = 0.46 and rs = 0.36), but not with disease severity as measured by EASI and UAS7.ConclusionBoth AD and CSU patients report external stigmatisation, which correlated with psychological parameters but not with disease severity. Further studies on stigmatisation are needed and should include a standardised scale embracing both external and internal facets of stigmatisation.

Quality of life in patients with scabies in Erbil, Iraq

Background and objective: Scabies, known as the seven-year itch, is a contagious skin infestation by the mite Sarcoptes scabiei that causes a pruritic skin eruption. Scabies is endemic in most of the communities of the developing world. This study aimed to assess the quality of life of scabies patients, taking into consideration the demographic profile and clinical presentation of patients in Erbil. Methods: In this cross-sectional study, 107 scabies patients attending a private dermatology clinic were recruited. Dermatology Quality of Life Index questionnaire was used for data collection. Results: More than half (51.4%) of the patients were less than 30 years of age, including 58.9% males, 70.1% of them were married, and 67.3% were living in the urban area. More than 84% of the study sample’s quality of life was very large and extremely large affected. The overall mean of the quality of life scores was 14.95±4.5 with no significant association between the overall quality of life scores to disease severity and certain sociodemographic characteristics of the patients. The mean scores of the two domains of embarrassment and shopping were significantly associated with the male gender (P = 0.003 and 0.021, respectively). However, 40.2%, 35.5%, and 29% of the patients reported that the disease affected very much on their shopping, clothing, and working activities, respectively. Conclusion: The disease had caused a significant effect on patients' lives, with no significant association between the severity of the disease and overall quality of life scores. The disease in its mild, moderate, and severe forms adversely affected patient lives. The commonest quality of life scores were those in the range of 11-20. Keywords: Quality of life; Scabies; Erbil; Iraq.

Allergic contact dermatitis in healthcare workers.

Allergic contact dermatitis is a common occupational skin disease among healthcare workers (HCWs). This study describes causes of allergic contact dermatitis in New Zealand HCWs. All HCWs undergoing patch testing between July 2008 and January 2020 at a public hospital patch test clinic and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre- and post-patch test diagnoses. Out of 837 patients tested, 67 were HCWs. The mean age of HCWs was 41 years (SD 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). Thirty-eight (57%) had at least one positive reaction on patch testing, including 19 (28%) with a positive result of current relevance. There were 16 relevant reactions to rubber accelerators, 11 to fragrances, 10 to preservatives and 6 to corticosteroids. The most frequent relevant allergens were methylisothiazolinone/methylchloroisothiazolinone (4%), hydroxyisohexyl 3-cyclohexene carboxaldehyde (4%) and methylisothiazolinone (4%). The most common allergens in HCWs were rubber chemicals, fragrances, preservatives and topical corticosteroids. Important allergens for patch testing HCWs are outlined, in particular, those with hand dermatitis should be tested to a rubber series.

28522 The impact of the SARS-CoV-2 pandemic on phototherapy utilization

Phototherapy is a mainstay of treatment for several dermatologic conditions. Patients often require multiple treatments per week for several weeks to months to achieve treatment efficacy. The SARS-CoV-2 global pandemic caused many dermatology clinics to close completely or significantly reduce patient volumes, which may have limited patient access to this beneficial treatment. This retrospective study examines the pandemic’s impact on phototherapy treatment rates and reimbursement at one major tertiary care center and five locations of a private dermatology clinic in Southeast Michigan.

Rhinophyma in women: a case series.

Rosacea has an overall female predominance; however, rhinophyma, a feature attributed to advanced rosacea, is exceedingly rare in females. The impact of this condition on quality of life can be profound. Multiple treatment modalities have been described. However fully ablative carbon dioxide (CO2) laser for moderate-severe rhinophyma has been shown to be most effective with good cosmetic outcome and high patient satisfaction. We describe a series of 7 female patients presenting with rhinophyma to a tertiary NHS laser centre and a private dermatology clinic. A retrospective case review of rhinophyma management was performed, assessing presentation, treatments and outcomes. The mean age at presentation was 47 years (27-62 years). Three patients developed rhinophyma before the age of 30 years. One patient had severe, 2 patients had moderate and 4 patients had minor rhinophyma. Four patients underwent fractional CO2 laser treatment with a good cosmetic outcome. Two further patients developed scarring following fully ablative CO2 laser. Long-term low-dose oral isotretinoin was used in 3 patients following laser treatment, to prevent relapse. One patient solely received isotretinoin with a good outcome. In our experience, females suffering with rhinophyma presented for treatment at an early age and stage of severity. Fractional or fully ablative CO2 laser alone or in combination with oral isotretinoin is a very effective treatment modality.

Role of Alpha Trypticase Enzyme, Total IgE, Specific IgE &amp; IgG4 In Patients with Food Allergy

Background: Foodallergy is an abnormal adverse immune response to exposure and consumption of a variety of food containing allergens in individuals inherited atopic gene. Different types of food materials are imposed on food hypersensitivity like egg, milk, dairy products, nuts, and other foodstuffs. Different tests are used to diagnose and follow up food allergies like total IgE, Specific IgE and Skin test. Objectives: This study aimed to investigate the importance of IgG4 and Alpha Typticase parameters besides total and specific IgE in diagnosis food allergy cases in patients. Patients &Methods: The study was conducted during the period from October 2019 to January 2020 at Ramadi Teaching Hospital and Microbiology Department, College of Medicine, University of Anbar. Seventy-five (75) Patients form both sexes, adults and children were showing signs and symptoms consistent with food allergy were attending Allergy Section at Ramadi Teaching Hospital and Private Allergy and Dermatology Clinics at Ramadi city, each patient was examined and followed by a senior physician. serum from each was investigated for total IgE, Specific IgE, IgG4, and serum Trypticase contents. Fifty normal individuals resembling the patient's group were considered as the Control group and the same investigations were done for them. Data were analyzed using SPSS system. Results: Adult patients above 30 years old were showing the highest ratio of food allergy (52.0%) while the lowest ratio (16%) was found among children with predominance in females (54.7%) Higher values of IgE were found among patients (38.7%) with mean value more than 200IU/ml. Serum IgG4 was elevated in those with food allergy with increased total IgE in the patient group. Higher Tryptase enzyme means values (17.21 ng / ml) were found in patients sera than control individuals (9.4 ng / ml) with no effect of gender. Eight (8, 38%) of sera were showing positive specific IgE in children while eighteen (18, 71%) of adult sera were positive for specific IgE . Child patients were showing positive results for Milk, Egg white, Cacao, Nuts, and Wheat, while adults were found positive for pepper, Barely, Tomato, Citrus, and Broad beans. Conclusion: Food allergy represents a common health problem at any age group and mostly in adult and child females. Total serum IgE, IgG4, and Serum tryptase were elevated in these patients affected with a variety of food allergens. So They are good parameters for food allergy.

The Skin Cancer Index: quality-of-life outcomes of treatments for nonmelanoma skin cancer

Introduction: Non-melanoma skin cancers (NMSCs) are the most common malignancies in humans. When treating NMSC, quality-of-life (QOL) is an important consideration. The purpose of this study was to measure and compare QOL outcomes of two common therapies for NMSC: Mohs micrographic surgery and excision, using a disease-specific QOL instrument, the Skin Cancer Index (SCI).Methods: The University of Miami Institutional Review Board approved this retrospective chart review of patients diagnosed with NMSC from 2016 through 2019 at a private dermatology clinic (Deerfield Beach, FL, USA). Disease-specific QOL before and after surgery was measured with the SCI.Results: Pre- and post-surgery surveys were completed by 208 patients undergoing Mohs surgery and 30 patients undergoing excisional surgery. All patients were similar in age, gender, and race, and most patients undergoing either procedure had a history of additional prior skin cancers. For the Mohs cohort, the total SCI scores and each of the subscales were significantly higher post-surgery when compared with the baseline scores. In contrast, in the excision cohort, the social subscale was significantly lower post-surgery when compared with the baseline scores.Conclusion: There is limited data in the literature describing the specific effects of Mohs or excision for NMSC on QOL using a disease-specific QOL instrument. Our data supports increased QOL at 2-week follow up for patients with NMSC treated with Mohs, but no improvement in QOL was noted for patients treated with excision. This data is limited by the fact there were far more patients that underwent Mohs as opposed to excision, which gave the Mohs cohort greater statistical power when analyzing the difference in SCI.

High naevus count and MC1R red hair alleles contribute synergistically to increased melanoma risk.

A high total body naevus count is the highest risk factor for melanoma; the phenotype of red hair colour, freckling and pale skin that burns easily, produced by MC1R R alleles, also predisposes to melanoma. To determine whether the known melanoma risk factors of high naevus count and red hair or MC1R R alleles act synergistically to increase melanoma risk. The Brisbane Naevus Morphology Study involved 1267 participants from volunteers presenting at a melanoma unit, dermatology outpatient clinic, private dermatology clinics, the Brisbane Longitudinal Twin Study and the QSkin Study. We examined pigmentation characteristics, total body naevus ≥ 5 mm count, and MC1R, ASIP and CDKN2A genotype in participants with and without a personal history of melanoma, living in Queensland, Australia, which is an area of high ultraviolet radiation. Cases were older than controls (median 57 vs. 33 years). Compared with individuals with dark brown hair and zero to four naevi, individuals with red hair and ≥ 20 naevi had a melanoma odds ratio of 10·0 (95% confidence interval 4·2-24·3). Individuals with MC1R R/R genotype and ≥ 20 naevi (≥ 5 mm diameter) had a melanoma odds ratio of 25·1 (95% confidence interval 8·4-82·7) compared with wild-type (WT)/WT individuals with zero to four naevi. The highest risk group is Australian men with the MC1R R/R genotype and ≥ 20 moles, who have an absolute risk of melanoma to age 75 years of 23·3%, compared with 0·8% for men with the WT/WT genotype and zero to four naevi. Patients who live in areas of high ultraviolet radiation, and have many large naevi and the red hair colour phenotype, particularly those with the MC1R R/R genotype, have a high risk of melanoma above the threshold recommended for screening in other cancers. Therefore, they should undergo intensive physician-led surveillance. What's already known about this topic? A high number of acquired melanocytic naevi, the red hair phenotype and MC1R R alleles all independently increase melanoma risk. Women with atypical naevi have an increasing melanoma risk gradient from darker hair to lighter hair. Women with many naevi have an increasing melanoma risk gradient from those with no elements of the red hair phenotype, to those with freckles but not red hair, to those with red hair. What does this study add? In Queensland, Australia, people with ≥ 20 naevi (≥ 5 mm diameter) and MC1R R/R genotype have a 25-fold increased melanoma risk, relative to people with zero to four naevi and the MC1R WT/WT genotype. In Queensland, individuals with ≥ 20 naevi and the MC1R R/R genotype have an absolute melanoma risk to age 75years of 23·3% for men and 19·3% for women. This effect is independent of CDKN2A genotype. Further research is required to determine the effect of areas of lower ultraviolet radiation, as this study took place in the Queensland, Australia, which is an area of high ultraviolet radiation. MC1R R/r genotype is associated with increased total body naevus count but this is not the case for R/R. What is the translational message? Patients with many large naevi and the red hair colour phenotype, particularly those with an MC1R R/R genotype, have an unusually high risk of melanoma. In a high ultraviolet environment, this risk exceeds the threshold recommended for screening in other cancers, and such individuals should undergo intensive, regular, physician-led surveillance. Patients with many large naevi but with non-red colour hair may benefit further from clinical MC1R genotyping.

Phenotypic and genotypic analysis of amelanotic and hypomelanotic melanoma patients.

Amelanotic/hypomelanotic melanoma is associated with poorer outcomes due to a more advanced disease stage at diagnosis. To determine phenotypic risks and genotypic associations with amelanotic/hypomelanotic melanoma to develop a clinical and genetic profile that could assist in identifying high-risk individuals. The Brisbane Naevus Morphology Study conducted from 2009 to 2016 has recruited a core of 1254 participants. Participants were drawn from a combination of volunteers from dermatology outpatient clinics, private dermatology clinics, the Brisbane Longitudinal Twin Study and QSkin study. Case participants had a personal history of melanoma and control participants no personal history of melanoma. We specifically examined seven known candidate pigmentation and melanoma genes and pigmentary phenotypic characteristics in participants with amelanotic/hypomelanotic melanoma compared to pigmented melanomas. This assayed single nucleotide polymorphisms in MC1R, TYR, HERC/OCA2, IRF4, MTAP, PLA2G6 and MITF. Forty-seven participants had at least one amelanotic/hypomelanotic melanoma, and 389 had pigmented melanomas, with amelanotic/hypomelanotic melanoma patients significantly older than pigmented melanoma participants (63.3±13.0 vs. 54.6±15.3years; P<0.001). Amelanotic/hypomelanotic melanoma patients were more likely than pigmented melanoma patients to have red hair (34% vs. 15%; P=0.01), severe hand freckling (13% vs. 5%; P=0.01) and propensity to sunburn (63% vs. 44%; P=0.01). MC1R R/R genotype was much more frequent in our amelanotic/hypomelanotic melanoma population (31.1% vs. 11%; P<0.001; OR 26.4 vs. 5.9; control 1.0). Amelanotic/hypomelanotic melanoma was associated with TYR rs1126809*A/A [OR (CI 95%) 2.7 (1.1-6.8) vs. 1.2 (0.8-1.9)] and PLA2G6 rs11570734*A/A [OR (CI 95%) 3.7 (1.0-13.6) vs. 1.3 (0.9-2.0)]. The MTAP melanoma risk SNP genotype, associated with darker pigmentation, (rs4636294*A/A) was less common in amelanotic/hypomelanotic melanoma patients [OR (CI 95%) 0.8 (0.3-2.1) vs. 2.0 (1.3-3.1)]. Knowledge of phenotypic and genotypic associations of amelanotic/hypomelanotic melanoma can help predict risks and associations of this difficult to diagnose melanoma, which may ultimately assist clinical management and patient skin self-examination.

A Prospective Study on the Characteristics of Sensitive Skin Syndrome in Chinese Patients Attending a Private Clinic-Based Setting in Hong Kong

A clinic based prospective study was carried out during the period of 1st May 2018 to 30 April 2019 in a private clinic located in the Centre of Kowloon district; Hong Kong. The objectives were to study the proportion of clinically diagnosed SSS patients attending the private clinic setting, demographic and clinical characteristics. The study suggested that SSS was a common disease encountered in the private dermatology clinic with a female gender predominance over the face region and at the age group of age 20 to 30. Our study also suggested that SSS patients could be identified by a validated ten item Sensitive Scale–10 questionnaire with a cut-off score of above 20. This is in accordance with that reported in the documented literature. A cut off value of patients scored above 20 in the questionnaire without concomitant skin disease at the same time can be diagnosed to have probable SSS. The score may be effectively used as a monitoring tool of the progress of SSS after management including counseling explanation, education and treatment.

Acne in South African black adults: A retrospective study in the private sector.

Acne vulgaris is the most common skin disorder affecting teenagers and young adults, and is becoming increasingly common in middle-aged women. It affects all skin types and ethnic groups, but dark-skinned individuals are burdened by post-inflammatory hyperpigmentation (PIH) as a sequela. PIH causes distress in acne patients even after the inflammatory lesions have resolved. To describe the characteristics of acne in black South African adults in the private health sector in Durban, KwaZulu-Natal Province. A retrospective study of records of patients attending two large private dermatology clinics in central Durban, mainly catering for black patients, was performed. Data were collected for the period January - December 2014. Records with acne as a diagnosis were retrieved and analysed with regard to age, demographics, type and severity of acne, therapy, HIV status and outcomes. Of a total of ~3 000 charts available for the 12-month period, 242 had acne as a diagnosis and were retrieved and analysed. Of these patients, 204 (84.3%) were female and the remainder were male. The mean age was 28.5 years (under-18s were excluded from the study). Inflammatory acne was the most frequently encountered form (58.6%). Fifteen patients (6.2%) were on topical treatment only, and 226 (93.4%) were on topical plus systemic treatment. PIH was the most common sequela (81.0% of patients). The majority of the patients were young females with inflammatory acne, and PIH was the most common sequela. Early and vigorous treatment of acne may minimise its complications, including those seen mainly in black patients.

Quality of Life in Children with Atopic Dermatitis

Background : Atopic dermatitis (AD) is the most common chronic skin disease in children which caused significant morbidity and impaired quality of life (QoL). The main goal of AD therapy is to prevent flare -ups, prolong remission and increase QoL. Therefore, the study aimed to discover QoL in children with AD. Methods : The study was conducted at Pasundan Public Health Centre, Al Islam General Hospital and Kimia Farma Private Dermatology Clinic, from September to November 2015. This descriptive study used consecutive sampling with 24 outpatients who were admitted to the health facility and diagnosed as AD. A questionnaire on Infant Dermatitis Quality of Life for infants aged 0–4 years, and Children Dermatology Life Quality Index for children aged 5–16 years was used in this study to measure QoL. Results : Out of 24 patients, 9 patients aged 0–4 years had mean score of 4.44±4.36, and 15 patients aged 5–16 years had mean score of 5.80±3.95. Mean SCORAD Objective in patients aged 0–4 and 5–16 was 15.61±7.75 and 17.44±11. Conclusions : The QoL in children with AD vary among patients. Most of the patients have mild-moderate impairment in QoL.

The diagnostic challenge of pemphigus foliaceus: A retrospective review of 142,240 new patient visits to a private dermatology clinic

The diagnostic challenge of pemphigus foliaceus: A retrospective review of 142,240 new patient visits to a private dermatology clinic