{"title":"Surgery for the General Dermatologist","authors":"","doi":"10.1111/ajd.14289","DOIUrl":"10.1111/ajd.14289","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"122-124"},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lynita Howie MPhil, Kara Orevillo BSc, Michelle Tu BSc, Alan Schwartz PhD JD, Melanie Funk, Cheryl Talent, Korey Capozza MPH
Atopic dermatitis patients and caregivers experience a high physical, mental and financial burden in Australia. We outline how the current care model impacts disease management and patients' quality of life via a survey of 265 Australian patients and caregivers to capture the experience of managing atopic dermatitis (AD) in Australia. Patients report an unsatisfactory quality of life and a high burden of disease with poor long-term control and low treatment satisfaction. They also reported changing spending and saving patterns to fund medical care. Patient experience improves with more specialised care that incorporates shared decision-making and patient/caregiver training beyond the clinic visit. These results highlight the need for improved general practitioner (GP) education, expedited access to medical specialists, greater patient involvement in treatment choices and more financial assistance to improve the experience of Australian patients and caregivers.
{"title":"The burden of atopic dermatitis in Australia: Medical care, treatment satisfaction, financial impact, long-term control and quality of life","authors":"Lynita Howie MPhil, Kara Orevillo BSc, Michelle Tu BSc, Alan Schwartz PhD JD, Melanie Funk, Cheryl Talent, Korey Capozza MPH","doi":"10.1111/ajd.14299","DOIUrl":"10.1111/ajd.14299","url":null,"abstract":"<p>Atopic dermatitis patients and caregivers experience a high physical, mental and financial burden in Australia. We outline how the current care model impacts disease management and patients' quality of life via a survey of 265 Australian patients and caregivers to capture the experience of managing atopic dermatitis (AD) in Australia. Patients report an unsatisfactory quality of life and a high burden of disease with poor long-term control and low treatment satisfaction. They also reported changing spending and saving patterns to fund medical care. Patient experience improves with more specialised care that incorporates shared decision-making and patient/caregiver training beyond the clinic visit. These results highlight the need for improved general practitioner (GP) education, expedited access to medical specialists, greater patient involvement in treatment choices and more financial assistance to improve the experience of Australian patients and caregivers.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"514-519"},"PeriodicalIF":2.2,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Savoia, Matelda Medri, Ignazio Stanganelli, Silvia Zago, Lucia Domeniconi, Davide Melandri, Mauro Alaibac, Jacopo Tartaglia, Christian Ciolfi, Andrea Sechi
Dermoscopy can be an important help for the diagnosis of skin cancers and inflammatory cutaneous diseases. The list of the dermoscopic features reported in granuloma faciale is wide and includes vascular and non-vascular features. We report here three cases of diffuse flat facial and extrafacial granuloma faciale that exhibited elongated linear vessels simulating branching vessels and diffuse structureless orange areas. The differential diagnosis between flat-type granuloma faciale, basal cell carcinoma and cutaneous sarcoidosis can be extremely difficult, making histology mandatory before any treatment.
{"title":"Elongated linear vessels simulating branching vessels and diffuse structureless orange areas as prominent dermoscopic features of diffuse flat facial and extrafacial granuloma faciale: A case series","authors":"Francesco Savoia, Matelda Medri, Ignazio Stanganelli, Silvia Zago, Lucia Domeniconi, Davide Melandri, Mauro Alaibac, Jacopo Tartaglia, Christian Ciolfi, Andrea Sechi","doi":"10.1111/ajd.14298","DOIUrl":"10.1111/ajd.14298","url":null,"abstract":"<p>Dermoscopy can be an important help for the diagnosis of skin cancers and inflammatory cutaneous diseases. The list of the dermoscopic features reported in granuloma faciale is wide and includes vascular and non-vascular features. We report here three cases of diffuse flat facial and extrafacial granuloma faciale that exhibited elongated linear vessels simulating branching vessels and diffuse structureless orange areas. The differential diagnosis between flat-type granuloma faciale, basal cell carcinoma and cutaneous sarcoidosis can be extremely difficult, making histology mandatory before any treatment.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"467-471"},"PeriodicalIF":2.2,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyun Kyoung Lee MBChB, Harriet Kennedy BHB, MBChB, MPhil, FRACP
Background/Objectives
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.
Methods
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.
Results
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%).
Conclusion
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.
背景/目的：在过去 10 年中，甲基异噻唑啉酮（MI）已成为全球防腐剂相关急性呼吸道感染的致病原因。与欧洲和澳大利亚相比，新西兰对化妆品中的甲基异噻唑啉酮浓度限制有宽松的规定。这项研究的目的是评估MI过敏症在新西兰的发病率，探索MI暴露的来源，并就新西兰有关MI使用的法规提出建议：这项回顾性研究包括2008年至2021年期间在新西兰奥克兰一家三甲医院皮肤科诊所和一家私人皮肤科诊所接受MI贴片测试的患者数据。患者的基线特征和斑贴测试结果均被记录在案。从医疗记录中确定了接触 MI 的来源：在研究期间，对 1044 名患者进行了 1049 次斑贴测试。从 2015 年起，只将 MI 作为一种独立的过敏原进行检测；对 MI 的阳性反应从 2015 年的 5.3% 增加到 2017 年的峰值 11.9%，然后在 2021 年降至 6.4%。最常见的MI接触源是洗发水或护发素（占所有相关反应的27.7%），其次是职业性接触油漆、杀菌剂或胶水（19.1%）：结论：MI 的致敏性和 ACD 似乎都在下降，这可能是由于国际上更严格的浓度限制导致产品配方发生了变化。我们建议新西兰在化妆品中采用较低的 MI 浓度限值，以与澳大利亚和欧洲的限值保持一致。
{"title":"Methylisothiazolinone sensitisation in New Zealand is decreasing","authors":"Hyun Kyoung Lee MBChB, Harriet Kennedy BHB, MBChB, MPhil, FRACP","doi":"10.1111/ajd.14301","DOIUrl":"10.1111/ajd.14301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"423-427"},"PeriodicalIF":2.2,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica McClatchy BBiomed MD, Gayle Ross MBBS (Hons) FACD
We present a case of a 47-year-old male with severe atopic dermatitis and metastatic renal cell carcinoma managed successfully with dupilumab. This case further supports the safety of dupilumab in patients with active malignancy, an area currently with limited data.
{"title":"Dupilumab for atopic dermatitis in metastatic cancer","authors":"Jessica McClatchy BBiomed MD, Gayle Ross MBBS (Hons) FACD","doi":"10.1111/ajd.14296","DOIUrl":"10.1111/ajd.14296","url":null,"abstract":"<p>We present a case of a 47-year-old male with severe atopic dermatitis and metastatic renal cell carcinoma managed successfully with dupilumab. This case further supports the safety of dupilumab in patients with active malignancy, an area currently with limited data.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"472-475"},"PeriodicalIF":2.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140837381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral retinoids are teratogenic, and pregnancy avoidance is an important part of retinoid prescribing. Australia does not have a standardised pregnancy prevention programme for women using oral retinoids, and the contraception strategies for women who use oral retinoids are not well understood.
The objectives were to determine trends in the use of prescription retinoids among Australian reproductive-aged women and whether women dispensed oral retinoids used contraception concomitantly.
Methods
This was a population-based study using Australian Pharmaceutical Benefits (PBS) dispensing claims for a random 10% sample of 15-44-year-old Australian women, 2013 - 2021. We described rates and annual trends in dispensing claims for PBS-listed retinoids and contraceptives. We also estimated concomitant oral retinoid and contraceptive use on the day of each retinoid dispensing and determined if there was a period of contraceptive treatment that overlapped. Estimates were then extrapolated to the national level.
Results
There were 1,545,800 retinoid dispensings to reproductive-aged women; 57.1% were oral retinoids. The rate of retinoid dispensing to reproductive-aged women increased annually, from 28 dispensings per 1000 population in 2013 to 41 per 1000 in 2021. The rate of oral retinoid dispensing doubled over the study period, from 14 dispensings per 1000 population in 2013 to 28 per 1000 in 2021, while topical retinoid dispensing did not change. Only 25% of oral retinoid dispensings had evidence of concomitant contraceptive use in 2021.
Conclusions
Rates of oral retinoid dispensing have doubled among reproductive-aged women over the past decade. A large percentage of oral retinoid use does not appear to have concomitant contraception use, posing a risk of teratogenic effects in pregnancies.
{"title":"Prescription retinoid and contraception use in women in Australia: A population-based study","authors":"Laura Gerhardy BBNSc, MBBS, GCertBiostat, FRANZCOG, CMFM, DDU, Natasha Nassar PhD MPH BEc, Melisa Litchfield BAppSc, MPH(Hons), Debra Kennedy MBBS, FRACP, MBioth, HGSA (Clin Genetics), Annika Smith MBBS (HONS1) MPHTM FRACP FACD, Malcolm B. Gillies BSc(Hons) PhD MBiostat, Sallie-Anne Pearson PhD, Helga Zoega BA, MA, PhD, Antonia Shand FRANZCOG,M.Med (Clin Epi)","doi":"10.1111/ajd.14294","DOIUrl":"10.1111/ajd.14294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Obectives</h3>\u0000 \u0000 <p>Oral retinoids are teratogenic, and pregnancy avoidance is an important part of retinoid prescribing. Australia does not have a standardised pregnancy prevention programme for women using oral retinoids, and the contraception strategies for women who use oral retinoids are not well understood.</p>\u0000 \u0000 <p>The objectives were to determine trends in the use of prescription retinoids among Australian reproductive-aged women and whether women dispensed oral retinoids used contraception concomitantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a population-based study using Australian Pharmaceutical Benefits (PBS) dispensing claims for a random 10% sample of 15-44-year-old Australian women, 2013 - 2021. We described rates and annual trends in dispensing claims for PBS-listed retinoids and contraceptives. We also estimated concomitant oral retinoid and contraceptive use on the day of each retinoid dispensing and determined if there was a period of contraceptive treatment that overlapped. Estimates were then extrapolated to the national level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 1,545,800 retinoid dispensings to reproductive-aged women; 57.1% were oral retinoids. The rate of retinoid dispensing to reproductive-aged women increased annually, from 28 dispensings per 1000 population in 2013 to 41 per 1000 in 2021. The rate of oral retinoid dispensing doubled over the study period, from 14 dispensings per 1000 population in 2013 to 28 per 1000 in 2021, while topical retinoid dispensing did not change. Only 25% of oral retinoid dispensings had evidence of concomitant contraceptive use in 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rates of oral retinoid dispensing have doubled among reproductive-aged women over the past decade. A large percentage of oral retinoid use does not appear to have concomitant contraception use, posing a risk of teratogenic effects in pregnancies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"428-436"},"PeriodicalIF":2.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140837386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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