Keloids are disfiguring benign scars that develop due to an exaggerated response to cutaneous wound healing, growing beyond the boundaries of the cutaneous insult into normal, previously uninvolved skin. The association of keloids with other underlying health conditions has been postulated, but not well characterized.
Objective: This study aims to identify whether there is any association of keloids with underlying health conditions in African-American women.
Methods: This study was done via the use of the National Inpatient Sample, a subset of the Healthcare Cost and Utilization Project. African-American women with keloids who had undergone cesarean sections were compared with a control group of African-American women with no history of keloids who had undergone cesarean sections.
Results: A total of 301 African-American inpatient encounters with patients with keloids were compared with 37,144 encounters in the control group. The keloid patients had an increased association with peritoneal adhesions compared with the control group.
Limitations: results are limited to one race and restricted age range; also, unable to differentiate keloids from hypetrophic scarring with ICD-10 codes.
Conclusion: These findings suggest that keloids and peritoneal adhesions may have similar inflammatory processes.
Epidermolysis bullosa (EB) represents a group of rare genetic skin fragility disorders characterized by (muco) cutaneous blistering upon minimal mechanical trauma. Ninety percent of EB patients experience podiatric symptoms which may affect physical functioning and emotional well-being. To date, an EB-specific podiatric assessment has not been outlined to guide clinicians in the assessment of EB podiatric involvement. This review describes the podiatric involvement of patients with EB and assesses the relevance of validated foot and ankle patient-reported outcome measures (PROMs) in measuring podiatric severity among EB patients. A literature review was conducted to identify systematic reviews and clinical studies investigating foot health and podiatric manifestations using validated foot health PROMs across foot and ankle conditions. Limited studies have documented the significance of podiatric involvement among EB patients. Existing EB-specific PROMs are not region-specific for assessing podiatric involvement. Among the foot and ankle PROMs, the Foot Health Status Questionnaire, Foot Function Index, and Manchester Oxford Foot Questionnaire were identified as potentially appropriate for assessing podiatric severity among EB patients, each with its strengths and limitations in assessment. However, they have not been widely validated for assessing dermatology-related diseases. An evaluation of the relevance of each identified PROM to EB podiatric assessment would enable future development of an appropriate EB-specific podiatric assessment tool that would guide management.
Minority patients are more likely to require dose adjustments for chemotherapy, with cultural barriers and access to medical care cited as contributory factors.
Objective: We sought to pilot an educational intervention, in the form of a pamphlet, to evaluate the effectiveness of this tool in teaching skin of color (SoC) patients about potential dermatologic toxicities of chemotherapy that are relevant to their skin type.
Methods: At a chemotherapy infusion center, SoC patients (n = 26) who were receiving chemotherapy for breast cancer voluntarily consented to read an educational pamphlet and complete a series of survey questions before and after this educational intervention.
Results: Most participants identified as female (96%), African American/Black (81%), and non-Hispanic (85%); all respondents had obtained at least a high school degree. Survey responses revealed a significant increase in knowledge about the potential dermatologic effects of cancer treatment after this intervention. Notably, 100% of participants either agreed or strongly agreed that they would like to see other doctors use this educational tool as a form of patient education, that they would recommend this pamphlet to other patients who are starting cancer treatment, and that the pamphlet was easy to understand.
Limitations: Limitations of this study include small sample size and single-institution recruitment, which may limit generalizability. Furthermore, this study only included patients who are proficient in English.
Conclusion: This study pilots an effective educational tool that addresses dermatologic toxicities of chemotherapy that are relevant to SoC patients. Further multi-institutional studies with larger sample sizes and translation to other languages can overcome the limitations of this pilot study.