JMIR dermatology最新文献

Unlabelled: Chronic spontaneous urticaria (CSU) is an autoimmune prompted skin disorder, whose hallmarks include the unpredictable onset of hives and itch. Symptom duration typically exceed 6 weeks, and flares can occur for up to 5 years or longer if untreated, impacting potentially any area of the body. The absence of obvious triggers and the variation in onset frequency often delays formal diagnosis which on average is approximately 2 years from first presentation. Initial standard of care is the use of low through to higher strength antihistamines in the first instance, with eventual escalation to prescription anti-inflammatory agents and potentially biologics once patients are under managed care. The societal impacts of delays in diagnosis are marked, with data suggesting CSU impacts up to 1% of the population, primarily of working age and with twice the prevalence in women. Herein, we advocate for the deployment of smartphone imaging and generative artificial intelligence technology to improve detection and early management of CSU through integrated self-care approaches. Such approaches embodying the tenets of P4 personalized medicine could have sustained impact on the disease through awareness campaigns, reducing the burden on the dermatology community and facilitating earlier access to curative therapeutic interventions.

Unlabelled: This cross-sectional content analysis found that Instagram's hashtag-based reels display consistent dermatologic content regardless of user engagement history, supporting the use of hashtags as an objective and reproducible tool for social media research in dermatology.

Background: Acral persistent papular mucinosis (APPM) is a localized variant of lichen myxedematosus (LM) characterized by asymptomatic, flesh-colored papules primarily distributed on the hands and forearms. This chronic dermatosis, distinct from generalized mucinosis due to its lack of systemic involvement, remains underreported in medical literature.

Objective: In this study, we present two cases of APPM to the limited pool of documented cases in the United States, highlighting its emerging recognition.

Methods: This is a case series of two patients presenting with asymptomatic papular eruptions on the hands and wrists, consistent with the typical presentation of APPM. Diagnostic confirmation via biopsy revealed focal cutaneous mucinosis. Comprehensive laboratory evaluations, including serum and urine protein electrophoresis, showed no evidence of underlying gammopathy in either patient.

Results: Treatment modalities for APPM are limited and often ineffective. Unlike other forms of LM, APPM features are confined to skin lesions, posing primarily as a cosmetic concern with a favorable prognosis. Accurate diagnosis of this localized LM is crucial to differentiate it from the more severe, generalized form, scleromyxedema, which can have organ involvement and may become fatal. Notably, while spontaneous resolution is reported in LM, including discrete papular mucinosis, APPM typically persists without resolution even after extended follow-up.

Conclusions: These cases underscore the importance of recognizing APPM and advocating for broader awareness and exploration of its clinical variability, etiology, and management strategies. With increasing recognition, the understanding of APPM can be enhanced, paving the way for optimized management and improved outcomes for affected individuals.

Unlabelled: A comparison of dermatological cases generated by artificial intelligence (AI) versus those created without AI by medical students revealed that AI-created cases were characterized by detailed case descriptions, analysis of medical history, and clinical examinations, but lacked the depth, clinical relevance, and motivational elements found in non-AI cases, which were shorter, presented clinical dilemmas, and included challenging scenarios that students found more educational and engaging.

Background: Artificial intelligence (AI) and telemedicine have significant potential to transform dermatology care delivery, but patient perspectives on these technologies have not been systematically compared.

Objective: This study aimed to examine patient perspectives on AI and telemedicine in dermatology to inform implementation strategies as these technologies increasingly converge in clinical practice.

Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Embase databases between August 2024 and October 2024. We identified 48 papers addressing patient perspectives on AI and telemedicine in dermatology, with none directly comparing patients' views of both technologies.

Results: Several distinct themes emerged regarding patient perspectives on these technologies: willingness to use, perceived benefits and risks, barriers to implementation, and conditions necessary for successful integration. Findings revealed that patients express hesitancy toward AI-based diagnoses that lack dermatologist involvement, while preferences for teledermatology varied by reason for appointment, age, and previous technology exposure. Patients' motivations for implementing AI are connected to its potential for quicker diagnoses and improved triage efficiency. At the same time, telemedicine addresses logistical challenges such as reduced travel time and improved appointment availability. Both technologies were perceived to improve accessibility and diagnostic efficiency, though patients expressed concerns about AI's limited communication abilities and teledermatology's inability to perform physical examinations. Primary adoption barriers for these modalities included technological limitations and trust concerns, with patients emphasizing the need for dermatologist oversight, transparency, and adequate educational resources for successful integration.

Conclusions: The complementary strengths of AI and teledermatology suggest they could mitigate each other's limitations when integrated-AI potentially enhancing teledermatology's diagnostic accuracy, while teledermatology addresses AI's lack of human connection. By thoroughly examining these perspectives, this review may serve as a guide for the patient-centered integration of technology in the future landscape of accessible dermatologic care.

Background: Xylazine has been associated with skin wounds. The rising prevalence of xylazine and its debated role in wound causation have sparked concerns among public health professionals, medical experts, and people who use drugs.

Objective: This study used a qualitative evaluation of Reddit posts to understand the experiences of people who use drugs concerning xylazine-associated wounds.

Methods: This study explored xylazine discussions on Reddit. Data were collected from 930+ drug-related subreddits via the PRAW Python application programming interface, and natural language processing methods were employed to identify posts that mentioned xylazine and wound-related keywords. Retrieved posts were manually coded for thematic analysis, and a term frequency-inverse document frequency analysis was performed per theme to obtain additional insights.

Results: The manual classification of 286 posts revealed predominant themes related to the pathophysiology of xylazine, wound locations on the body, and management strategies. The 3 most frequent xylazine wound-related themes were "Mechanisms of xylazine-associated wounds" (84 posts, 29.4%), "Geographic region" (67, 23.4%), and "Location of wounds on the body" (56, 19.6%). The analysis showed xylazine's presence in the discussions among Reddit's drug-using communities, with a notable focus on wound management and geographic trends. The term frequency-inverse document frequency analysis revealed prominent lexical markers within each theme.

Conclusions: The findings suggest that social media platforms such as Reddit can serve as valuable resources for understanding emerging health issues such as xylazine-associated wounds. The study's findings highlight patterns of use, the characteristics of wounds on people who use drugs, and discussions about wound management. This study adds to a growing body of literature using social media to understand the consequences of emerging drugs on human health.

Unlabelled: We reviewed 30 of the top-viewed Instagram videos using the hashtags #retinoid and #retinol to assess reliability using the DISCERN instrument. Dermatologists produced more accurate content than laypeople, though important details such as treatment risks were often omitted. Our findings highlight the need for health professionals to balance accessibility with accuracy to provide trustworthy dermatologic information on social media.

Unlabelled: Dermal fillers have gained increasing popularity for their ability to enhance facial symmetry, restore volume, and improve skin texture. However, their use in patients with cancer undergoing active chemotherapy and radiation therapy poses unique challenges, as these treatments can alter both the safety profile and efficacy of filler procedures. Chemotherapy can interfere with normal wound healing and immune responses, warranting a more cautious and individualized approach when considering dermal fillers in this population. Although rare, dermal fillers have been associated with adverse outcomes in a limited number of diseases, including cellulitis, autoimmune/inflammatory syndrome induced by adjuvants, and a possible predisposition to malignancy. Other effects include localized inflammatory, systemic hypersensitivity, and delayed granulomatous formation, and these could be more severe in patients undergoing antineoplastic therapy. Furthermore, chemotherapy is often paired with adjuvant radiation therapy in cancer treatment, making it important to note the potential changes radiation can have on the skin. More research is needed to examine the direct interactions of chemotherapy and radiation on various filler materials injected within the skin, and how these can alter one's risk of adverse effects. The lack of research on this topic further emphasizes that clinicians should thoroughly educate patients receiving chemotherapy and adjuvant radiation treatment about the heightened potential risks associated with dermal filler injections and treatment regimens should be planned accordingly to minimize any adverse events.

Unlabelled: This research letter evaluates the quality and readability of hidradenitis suppurativa (HS) websites found on Google and Bing with the DISCERN instrument and Flesch-Kincaid Readability metrics. Comprehensive and reliable articles can lead to increased knowledge about HS and further enhance physician-patient relationships and shared decision-making. This study's aim was to identify reliable resources to help bridge knowledge gaps and support informed discussions on management and treatment options.