Pub Date : 2022-10-17DOI: 10.1097/jdn.0000000000000712
Mitzy Placencia, Eugene Wong
GANGRENE and eyanosis of an extremity, due to thrombophlebitis with massive venous occlusions, is an uncommon condition and is often confused with primary arterial oeclusive disease. With massive venous occlusion and the associated arterial venospasm the blood flow may be so impeded to an extremity that cyanosis and eventually gangrene may occur. The recognition of this is important, since this gangrene is usually superficial or limited to the digits. Conservative treatment of this type of gangrene is indicated in contrast to the more radical treatment advocated for gangrene due to primary arterial insufficiency. This disease has been called "phlegmasia cerulea dolens," "blue phlebitis of Gregoire," "acute massive venous occlusion of the extremities," "pseudoembolic phlebitis, " and " gangrene of venous origin. " That gangrene of an extremity can be of venous origin was first recognized by Fabricius Hiddanus in 1593.1 Excellent review articles on phlegmasia cerulea dolens have been published by Haimovici2 auid DeBakey,3 making a detailed review of the literature unnecessary. Of the 102 cases in the literature in which information is available, 69 occurred in the left lower extremity, 27 in the right lower extremity, four in the left upper extremity, and two in the right upper extremity. The high incidence in the left lower extremity is probably because the right common iliac artery crosses over the left common iliac veini shortly after the bifurcation of the abdominal aorta. Spontaneous involvement of the upper extremity is rare, and it has been reported in only five previous cases. It is the purpose of this paper to report two cases, one with involvement of the upper extremity.
{"title":"Phlegmasia Cerulea Dolens","authors":"Mitzy Placencia, Eugene Wong","doi":"10.1097/jdn.0000000000000712","DOIUrl":"https://doi.org/10.1097/jdn.0000000000000712","url":null,"abstract":"GANGRENE and eyanosis of an extremity, due to thrombophlebitis with massive venous occlusions, is an uncommon condition and is often confused with primary arterial oeclusive disease. With massive venous occlusion and the associated arterial venospasm the blood flow may be so impeded to an extremity that cyanosis and eventually gangrene may occur. The recognition of this is important, since this gangrene is usually superficial or limited to the digits. Conservative treatment of this type of gangrene is indicated in contrast to the more radical treatment advocated for gangrene due to primary arterial insufficiency. This disease has been called \"phlegmasia cerulea dolens,\" \"blue phlebitis of Gregoire,\" \"acute massive venous occlusion of the extremities,\" \"pseudoembolic phlebitis, \" and \" gangrene of venous origin. \" That gangrene of an extremity can be of venous origin was first recognized by Fabricius Hiddanus in 1593.1 Excellent review articles on phlegmasia cerulea dolens have been published by Haimovici2 auid DeBakey,3 making a detailed review of the literature unnecessary. Of the 102 cases in the literature in which information is available, 69 occurred in the left lower extremity, 27 in the right lower extremity, four in the left upper extremity, and two in the right upper extremity. The high incidence in the left lower extremity is probably because the right common iliac artery crosses over the left common iliac veini shortly after the bifurcation of the abdominal aorta. Spontaneous involvement of the upper extremity is rare, and it has been reported in only five previous cases. It is the purpose of this paper to report two cases, one with involvement of the upper extremity.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82255975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-13DOI: 10.1097/JDN.0000000000000710
K. Boozer, Kelly L. Rossler, Jaclyn L. Saitta
ABSTRACT Primary care nurse practitioners (NPs) are positioned to improve patient outcomes and reduce the global burden of skin cancers including cutaneous melanoma (CM). Improving skin cancer and CM educational opportunities, especially at the graduate student level, is a necessary step to overcome practice barriers and improve patient care. The purpose of this quality improvement project was to evaluate the effectiveness of an online graduate educational training program to improve knowledge, confidence, and practice intent. An exploratory, descriptive design guided this project with a nonprobability, convenience sample of NP graduate students. This project served as the first phase of a long-term research initiative focused on integrating CM education within an NP curriculum.
{"title":"Effectiveness of Cutaneous Melanoma Education on Knowledge, Confidence, and Practice Intent Among Graduate Nursing Students","authors":"K. Boozer, Kelly L. Rossler, Jaclyn L. Saitta","doi":"10.1097/JDN.0000000000000710","DOIUrl":"https://doi.org/10.1097/JDN.0000000000000710","url":null,"abstract":"ABSTRACT Primary care nurse practitioners (NPs) are positioned to improve patient outcomes and reduce the global burden of skin cancers including cutaneous melanoma (CM). Improving skin cancer and CM educational opportunities, especially at the graduate student level, is a necessary step to overcome practice barriers and improve patient care. The purpose of this quality improvement project was to evaluate the effectiveness of an online graduate educational training program to improve knowledge, confidence, and practice intent. An exploratory, descriptive design guided this project with a nonprobability, convenience sample of NP graduate students. This project served as the first phase of a long-term research initiative focused on integrating CM education within an NP curriculum.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79717315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-13DOI: 10.1097/JDN.0000000000000708
Taylor Rager, E. Lake
ABSTRACT Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. Although mycosis fungoides affects patients of all skin tones, mycosis fungoides has a higher incidence in patients with skin of color. Patients with skin of color who are diagnosed with mycosis fungoides have worse outcomes and poor prognosis compared with patients with lighter skin tones. Mycosis fungoides is difficult to diagnose in patients with skin of color as rare subtypes or clinical presentations are commonly seen in these populations. Increased awareness of the presentation of mycosis fungoides in skin of color and early detection could address the higher rates of morbidity and mortality in these populations.
{"title":"Mycosis Fungoides in Skin of Color","authors":"Taylor Rager, E. Lake","doi":"10.1097/JDN.0000000000000708","DOIUrl":"https://doi.org/10.1097/JDN.0000000000000708","url":null,"abstract":"ABSTRACT Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. Although mycosis fungoides affects patients of all skin tones, mycosis fungoides has a higher incidence in patients with skin of color. Patients with skin of color who are diagnosed with mycosis fungoides have worse outcomes and poor prognosis compared with patients with lighter skin tones. Mycosis fungoides is difficult to diagnose in patients with skin of color as rare subtypes or clinical presentations are commonly seen in these populations. Increased awareness of the presentation of mycosis fungoides in skin of color and early detection could address the higher rates of morbidity and mortality in these populations.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87295152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1097/jdn.0000000000000701
Maggie Holmes, Daim Tabba, Chelsea S. Mockbee, R. Brodell, V. Nahar
{"title":"Allergic Contact Dermatitis After Prior Burn Injury","authors":"Maggie Holmes, Daim Tabba, Chelsea S. Mockbee, R. Brodell, V. Nahar","doi":"10.1097/jdn.0000000000000701","DOIUrl":"https://doi.org/10.1097/jdn.0000000000000701","url":null,"abstract":"","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74218782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1097/JDN.0000000000000695
Melissa A. Nickles, Kathie Velez, Jessica Maloh, A. Shakhbazova, M. Singh, R. Sivamani
BACKGROUND Increased intestinal permeability, known as leaky gut syndrome, occurs when the intestinal lining of the gastrointestinal tract has been damaged. The influx of unwanted material in the bloodstream can induce an immune response releasing proinflammatory cytokines that have been thought to be correlated with dermatologic conditions. OBJECTIVE We aimed to evaluate the role of leaky gut in dermatological conditions. Methods PubMed and Embase were systematically searched through September 2020 for clinical studies that measured intestinal permeability in participants with a dermatological condition. RESULTS We identified 20 studies including participants with dermatitis herpetiformis, atopic dermatitis/eczema, systemic sclerosis, psoriasis, bullous pemphigoid, and pemphigus vulgaris/foliaceus. Atopic dermatitis was the most well studied. Studies utilized a range of measures of intestinal permeability, including sugar excretion tests and serum markers. For all disorders reviewed, except bullous pemphigoid and pemphigus vulgaris/foliaceus, there was evidence of increased intestinal permeability in the disease state compared with controls. LIMITATIONS The range of methodology across clinical studies makes it difficult to draw conclusions across results. In addition, studies tended to be small, and only one study included an intervention to target leaky gut syndrome. CONCLUSIONS We have found preliminary evidence of a relationship between leaky gut and certain dermatological conditions.
{"title":"Leaky Gut and Dermatological Conditions","authors":"Melissa A. Nickles, Kathie Velez, Jessica Maloh, A. Shakhbazova, M. Singh, R. Sivamani","doi":"10.1097/JDN.0000000000000695","DOIUrl":"https://doi.org/10.1097/JDN.0000000000000695","url":null,"abstract":"BACKGROUND Increased intestinal permeability, known as leaky gut syndrome, occurs when the intestinal lining of the gastrointestinal tract has been damaged. The influx of unwanted material in the bloodstream can induce an immune response releasing proinflammatory cytokines that have been thought to be correlated with dermatologic conditions. OBJECTIVE We aimed to evaluate the role of leaky gut in dermatological conditions. Methods PubMed and Embase were systematically searched through September 2020 for clinical studies that measured intestinal permeability in participants with a dermatological condition. RESULTS We identified 20 studies including participants with dermatitis herpetiformis, atopic dermatitis/eczema, systemic sclerosis, psoriasis, bullous pemphigoid, and pemphigus vulgaris/foliaceus. Atopic dermatitis was the most well studied. Studies utilized a range of measures of intestinal permeability, including sugar excretion tests and serum markers. For all disorders reviewed, except bullous pemphigoid and pemphigus vulgaris/foliaceus, there was evidence of increased intestinal permeability in the disease state compared with controls. LIMITATIONS The range of methodology across clinical studies makes it difficult to draw conclusions across results. In addition, studies tended to be small, and only one study included an intervention to target leaky gut syndrome. CONCLUSIONS We have found preliminary evidence of a relationship between leaky gut and certain dermatological conditions.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72526448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1097/JDN.0000000000000703
S. R. Caro
OBJECTIVE The purpose of this search was to review the literature on the subject of alopecia areata. METHODS This literary review utilized the library databases of Cumulative Index of Nursing and Allied Health Literature and PubMed as well as the medical research platform Ovid, exploring topics associated with the subject matter of alopecia areata examining issues associated with the autoimmune disorder including diagnosis, treatment, and the patient experience. This investigation examines the diagnosis and progression of the autoimmune disease including relevant and recent literature reflecting research outcomes from the specialties of dermatology, psychology, genetics, and nursing. RESULTS In summary, the outcome of the literature exploration reflects research from the specialties of dermatology, psychology, and medicine, revealing numerous difficulties patients diagnosed with alopecia areata experience. CONCLUSION The nursing profession pursues research to promote best practice and improve patient outcomes; however, nursing research falls short on the topic of alopecia areata. This autoimmune disorder causes a significant psychological impact on people living with the disease; therefore, individuals diagnosed with the condition experience the unique phenomenon of living without hair. The literature review indicates the need for further investigation of the essence of living with the daily reality of cyclic patterns of hair loss and the resulting health-illness transition from one stable state of health to another state of health.
{"title":"Alopecia Areata","authors":"S. R. Caro","doi":"10.1097/JDN.0000000000000703","DOIUrl":"https://doi.org/10.1097/JDN.0000000000000703","url":null,"abstract":"OBJECTIVE The purpose of this search was to review the literature on the subject of alopecia areata. METHODS This literary review utilized the library databases of Cumulative Index of Nursing and Allied Health Literature and PubMed as well as the medical research platform Ovid, exploring topics associated with the subject matter of alopecia areata examining issues associated with the autoimmune disorder including diagnosis, treatment, and the patient experience. This investigation examines the diagnosis and progression of the autoimmune disease including relevant and recent literature reflecting research outcomes from the specialties of dermatology, psychology, genetics, and nursing. RESULTS In summary, the outcome of the literature exploration reflects research from the specialties of dermatology, psychology, and medicine, revealing numerous difficulties patients diagnosed with alopecia areata experience. CONCLUSION The nursing profession pursues research to promote best practice and improve patient outcomes; however, nursing research falls short on the topic of alopecia areata. This autoimmune disorder causes a significant psychological impact on people living with the disease; therefore, individuals diagnosed with the condition experience the unique phenomenon of living without hair. The literature review indicates the need for further investigation of the essence of living with the daily reality of cyclic patterns of hair loss and the resulting health-illness transition from one stable state of health to another state of health.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73410343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1097/jdn.0000000000000706
{"title":"Alopecia Areata: Exploring the Literature","authors":"","doi":"10.1097/jdn.0000000000000706","DOIUrl":"https://doi.org/10.1097/jdn.0000000000000706","url":null,"abstract":"","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77525949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1097/jdn.0000000000000705
Angela L. Borger
{"title":"Nostalgia and Passions","authors":"Angela L. Borger","doi":"10.1097/jdn.0000000000000705","DOIUrl":"https://doi.org/10.1097/jdn.0000000000000705","url":null,"abstract":"","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82095647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-05DOI: 10.1097/JDN.0000000000000702
S. W. Matthews, Stephanie Binick, K. Sherman, Andy J Chien
BACKGROUND Narrowband ultraviolet phototherapy is a safe and effective treatment option for chronic skin conditions. The requirements of clinic-based phototherapy can be burdensome, with home-based phototherapy as a reasonable alternative. OBJECTIVE This study aimed to analyze the effects of a nurse-led home phototherapy program and describe the clinical resources required. METHODS A pragmatic multicenter prospective observational cohort study was conducted from 2019 to 2021. Eighteen participants were enrolled in the program and followed for 9 months. Outcome measures included clearance rates, erythema incidence, Dermatology Life Quality Index, the burden of treatment scores, dermatologic medication usage, and clinic contacts. RESULTS Fourteen of the 18 patients (77.8%) reported high skin clearance. Mild erythema was common, moderate erythema was rare, and two episodes of severe erythema were recorded overall. Dermatology Life Quality Index and burden of treatment impact were minimal. Adjunct topical medications decreased by half. Nurses successfully reached participants up to the 3-month time point, with completed contacts decreasing over time. Unplanned contacts included phone calls and emails. CONCLUSION Dermatology nurses possess the skills needed to lead safe and effective home phototherapy programs. Although this pragmatic study was small, results are optimistic for the future of nurse-led home phototherapy.
{"title":"A Pragmatic Study on Nurse-Led Home Phototherapy","authors":"S. W. Matthews, Stephanie Binick, K. Sherman, Andy J Chien","doi":"10.1097/JDN.0000000000000702","DOIUrl":"https://doi.org/10.1097/JDN.0000000000000702","url":null,"abstract":"BACKGROUND Narrowband ultraviolet phototherapy is a safe and effective treatment option for chronic skin conditions. The requirements of clinic-based phototherapy can be burdensome, with home-based phototherapy as a reasonable alternative. OBJECTIVE This study aimed to analyze the effects of a nurse-led home phototherapy program and describe the clinical resources required. METHODS A pragmatic multicenter prospective observational cohort study was conducted from 2019 to 2021. Eighteen participants were enrolled in the program and followed for 9 months. Outcome measures included clearance rates, erythema incidence, Dermatology Life Quality Index, the burden of treatment scores, dermatologic medication usage, and clinic contacts. RESULTS Fourteen of the 18 patients (77.8%) reported high skin clearance. Mild erythema was common, moderate erythema was rare, and two episodes of severe erythema were recorded overall. Dermatology Life Quality Index and burden of treatment impact were minimal. Adjunct topical medications decreased by half. Nurses successfully reached participants up to the 3-month time point, with completed contacts decreasing over time. Unplanned contacts included phone calls and emails. CONCLUSION Dermatology nurses possess the skills needed to lead safe and effective home phototherapy programs. Although this pragmatic study was small, results are optimistic for the future of nurse-led home phototherapy.","PeriodicalId":17315,"journal":{"name":"Journal of the Dermatology Nurses' Association","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81844150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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