Smartphone app to screen individuals with scabies symptoms.

INTRODUCTION: Patients with scabies are often misdiagnosed before being attended by a dermatologist. The aim of this study was to use a smartphone app to screen individuals from the general population with scabies symptoms. METHODS: Subjects who suspected that they had scabies were recruited online and downloaded a app tailored for this study. A questionnaire on symptoms was completed and photos of the skin were uploaded from within the app. Two physicians, a board-certified dermatologist and a resident dermatologist, evaluated the requests by categorising the scabies risk of each case, and categorisation triggered an auto-generated response describing the level of scabies and letting the participant know whether to contact a general practitioner or not. RESULTS: Within 15 days of advertisement, 228 requests were sent (71% women); mean age 24 years (standard deviation: ± 10.0). Itch was experienced by 90% (n = 208) and rash by 76% (n = 174). The rash was distributed bilaterally in 79% (n = 138). The areas of rash localisation were: arms (63%), hands (56%), legs (55%), abdomen (52%), inner thigh (45%), chest (26%), genitals (24%), head and neck (17%) and axilla (16%). 5% of all cases evaluated by either the senior or junior physician were evaluated as having a high risk of scabies. CONCLUSION: In a very short time, the app received a high number of requests from individuals worrying about scabies; 5% of the incoming requests were categorised as carrying a high risk of having scabies. Mobile apps are a helpful tool to screen for scabies in primary care settings. FUNDING: Omhu A/S. TRIAL REGISTRATION: Not relevant.

Investigating the efficacy and safety of calcipotriol/betamethasone dipropionate foam and laser microporation for psoriatic nail disease-A hybrid trial using a smartphone application, optical coherence tomography, and patient-reported outcome measures.

There is a lack of efficacious topical treatments for patients suffering from psoriatic nail disease (PND). We investigated the efficacy of Calcipotriol-Betamethasone Dipropionate (Cal/BD) foam with and without ablative fractional laser (AFL) in patients with PND. A total of 144 nails from 11 patients were treated in a 24-week long, open-label, randomized, intra-patient controlled proof-of-concept hybrid trial. In addition to daily Cal/BD foam application, half of each patient's psoriatic nails were randomized to receive optical coherence tomography (OCT)-guided AFL treatment at baseline, 6-, and 12-week follow-ups. In-clinic assessment (N-NAIL), patient-reported outcomes (PROMs), and drug consumption were supplemented by remote evaluation of 15 subclinical OCT features, smartphone app-based safety monitoring, and photo-based assessment (NAPSI). After 24 weeks of Cal/BD foam treatment, patients achieved a significant improvement (p < 0.001) in both clinical (N-NAIL -76%, NAPSI -68%) and subclinical (OCT -43%) PND severity as well as a 71% reduction in PROMs. AFL-assisted Cal/BD treatment led to higher clinical (N-NAIL -85%, NAPSI -78%) and OCT-assessed (-46%) reduction of PND signs than Cal/BD alone (N-NAIL -66%, NAPSI -58%, OCT -37%), but did not reach statistical significance. Smartphone app images documented adverse events and mild local skin reactions, particularly erythema (75%), laser-induced swelling (28%), and crusting (27%). This hybrid trial demonstrated a reduction in clinical NAPSI and N-NAIL scores, subclinical OCT features, and PROMs, suggesting that Cal/BD foam is a safe and efficacious treatment for PND. Larger trials are warranted to prove the clinical benefit of AFL pretreatment as a Cal/BD delivery enhancer.