JMIR dermatology最新文献

Unlabelled: Our team explored the utility of unpaid versions of 3 artificial intelligence chatbots in offering patient-facing responses to questions about 5 common dermatological diagnoses, and highlighted the strengths and limitations of different artificial intelligence chatbots, while demonstrating how chatbots presented the most potential in tandem with dermatologists' diagnosis.

Unlabelled: This observational cost analysis was conducted to assess the efficacy of the Mark Cuban Cost Plus Drug Company (CostPlus) relative to GoodRx and found that CostPlus has significant potential to improve the financial burden of prescription medications within dermatology.

Background: Student-run clinics (SRCs) for dermatology hold potential to significantly advance skin-related health equity, and a comprehensive analysis of these clinics may inform strategies for optimizing program effectiveness.

Objective: We aimed to perform a scoping review of the literature about dermatology SRCs across the United States.

Methods: We conducted systematic literature searches of Ovid MEDLINE, Ovid Embase, and Scopus on March 1, 2023, and June 19, 2024. No date, language, or paper-type restrictions were included in the search strategy. A total of 229 references were uploaded to Covidence for screening by 2 independent reviewers (SK and LL), and 23 full-text documents were assessed for eligibility. After an additional 8 documents were identified through a gray literature search, a total of 31 studies were included in the final analysis. Inclusion criteria were as follows: (1) studies set in an SRC, which was operationally led by medical students and could render condition-relevant treatments to patients, with dermatology care; (2) published in English; (3) within the United States; (4) included characterization of any of the following: logistics, care, patients, or design; and (5) included all study or document types, including gray literature that was not peer reviewed (eg, conference abstracts, preprints, and letters to the editor). Exclusion criteria were (1) papers not published in English and (2) those with duplicated data or that were limited in scope or not generalizable. Data were extracted qualitatively using Microsoft Excel to categorize the studies by several domains, including clinic location, demographics, services offered, and barriers to care.

Results: There are at least 19 dermatology SRCs across the United States. The most common conditions encountered included atopic dermatitis; acne; fungal infections; benign nevi; psoriasis; and neoplasms, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Key facilitators for the clinics included faculty oversight, attending physician participation for biopsy histopathology, and dedicated program coordinators. Major barriers included lack of follow-up, medication nonadherence, and patient no-shows.

Conclusions: Dermatology SRCs serve a diverse patient population, many of whom are underrepresented in traditional dermatology settings. This scoping review provides insights to help build stronger program foundations that better address community dermatologic health needs.

Unlabelled: The Global Burden of Disease (GBD) study aims to characterize the worldwide prevalence and morbidity of major diseases, while PatientsLikeMe (PLM) is an online community providing patient-generated insights into lived experiences; for dermatologic conditions, quantitative comparisons of GBD and PLM data revealed expected demographic differences but also notable correlations, highlighting their potential as complementary data sources elucidating unmet patient needs and priorities.

Unlabelled: Pigmentary disorders have been implicated in causing psychosocial turmoil in patients as they can cause some degree of cosmetic disfigurement. Lichen planus pigmentosus (LPP) presents as ashy, dermatosis-like eruptions on sun-exposed areas, particularly on the head, neck, and earlobes. On the other hand, vitiligo is a chronic disorder that appears as depigmented patches on the skin. A 61-year-old man with Fitzpatrick skin phototype IV presented to us initially with LPP but eventually also developed vitiligo. The patient was treated with low-dose oral isotretinoin for LPP and topical tacrolimus 0.1% ointment for both LPP and vitiligo with a good clinical outcome. One case of segmental vitiligo and zosteriform LPP, affecting a 22-year-old Indian woman, has been previously reported in the English-language literature. An autoimmune etiology that causes melanocytorrhagy may be a plausible hypothesis for the coexistence of these 2 conditions.

Unlabelled: This study investigates the application of ChatGPT, an artificial intelligence tool, in providing information on skin toxicities associated with cancer treatments, highlighting that while ChatGPT can serve as a valuable resource for clinicians, its use for patient education requires careful consideration due to the complex nature of the information provided.

Unlabelled: We found that third-party apps such as Figure 1 were used predominantly by nondermatologist medical personnel for collaboration in medical decision-making related to dermatologic conditions conducted with other health care providers. This finding calls attention to the need for more readily available resources for nondermatologist health care providers encountering patients with skin-related conditions, with the added benefits of trained dermatologists being allies on such medical app platforms, and the platform allowing for recognition of instances when additional consultation or referral to trained dermatologists for more complex cases is appropriate.

Background: Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSIIs) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance.

Objective: This systematic review aims to explore the current literature surrounding dermatologic complications of CGM and CSII as well as the impact on patient outcomes.

Methods: A systematic review of the literature was carried out using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines using 5 online databases. Included articles were those containing primary data relevant to human participants and adverse reactions to CGM and CSII devices in pediatric populations, of which greater than 50% of the sample size were aged 0-21 years. Qualitative analysis was chosen due to the heterogeneity of outcomes.

Results: Following the application of exclusion criteria, 25 studies were analyzed and discussed. An additional 5 studies were identified after the initial search and inclusion. The most common complication covered is contact dermatitis, with 13 identified studies. Further, 7 studies concerned lipodystrophies, 5 covered nonspecific cutaneous changes, 3 covered unique cutaneous findings such as granulomatous reactions and panniculitis, and 2 discussed user acceptability.

Conclusions: The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.

Unlabelled: Through Jimmy Buffett's unfortunate battle with lymphoma originating from Merkel cell carcinoma and subsequent media coverage of his death, public interest in skin cancer, Merkel cell carcinoma, and the health effects of sunlight exposure increased, as evidenced by our results.