Australasian Journal of Dermatology最新文献

Teledermatology improves access to care, but its reliability for scoring skin diseases compared with face-to-face assessments remains underexplored. We undertook a systematic review of studies comparing teledermatology and in-person assessments using validated scoring tools. Following PRISMA guidelines, we searched MEDLINE and Embase for English-language studies up to 16 December 2024. Eligible studies reported agreement metrics between photographic and in-person evaluations. Two reviewers independently screened and extracted data. Meta-analysis was performed for EASI and PASI using a random-effects model. Risk of bias was assessed with QUADAS-2. No funding was received. This project was registered on PROSPERO [CRD420251026970]. Sixteen studies involving 927 participants were included: six on atopic dermatitis, five on plaque psoriasis, three on patch testing, and two on acne. Reported reliability metrics included the intraclass correlation coefficient (ICC) and kappa values. These ranged from moderate to excellent. Reliability was influenced by assessor experience, image quality, and disease severity. Nine studies were at risk of bias due to unclear methodology. Pooled ICCs demonstrated excellent reliability for atopic dermatitis (0.90) and good reliability for psoriasis (0.87). These findings suggest that teledermatology appears as reliable as in-person review for atopic dermatitis and psoriasis, supporting its role in clinical practice. Standardisation of image capture and further research across a broader range of dermatological conditions is required.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, severe mucocutaneous diseases associated with high rates of mortality. While the acute complications of SJS and TEN are well documented, it is being increasingly recognised that survivors may develop psychological sequelae that can be associated with significant morbidity. This systematic review and meta-analysis aimed to critically evaluate observational studies of psychiatric complications and quality of life in adults with SJS and TEN. This review was registered with INPLASY and conducted in accordance with the PRISMA reporting guidelines. Potential bias was assessed using the NIH criteria. Ten articles describing results from 1123 cases and 2687 controls were included. The overall quality of the studies was suboptimal, and the level of heterogeneity was very high (I² = 96%). Meta-analysis of eight studies with fifteen study groups (n = 2120) showed a prevalence of psychiatric complications of 24.9% in SJS and TEN patients. SJS and TEN survivors appear to suffer a high burden of psychological complications, including post-traumatic stress disorder, depression, anxiety, as well as quality of life impairment. This population would likely benefit from early multidisciplinary input and long-term follow-up; however, additional larger controlled studies are needed.

We describe four cases of iron extravasation injuries presenting to a dermatology clinic, where compression applied post-infusion appeared to reduce or prevent cutaneous siderosis. In each case, distinct patterns of hyperpigmentation were observed, with areas of compression from bandages or dressings showing reduced staining. Iron extravasation, a complication of intravenous iron therapy, can cause permanent cosmetic damage and distress. Current treatment options for reversing staining are limited, costly and require multiple sessions. This case series suggests that compression may be a simple, safe and effective measure to minimise cutaneous siderosis and improve patient outcomes.