Quality of life in children with skin disease: A Spanish sample.

INTRODUCTION: The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. MATERIAL AND METHODS: We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). RESULTS: In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DISCUSSION: Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.

Fear of cancer recurrence in patients with non-metastatic melanoma: Spanish validation and disease-related factors.

INTRODUCTION: It is essential for clinicians to understand the phenomenon of fear of cancer recurrence (FCR) in order to understand the psychological impact it has on patients with melanoma. OBJECTIVES: To validate an FCR questionnaire in Spanish for patients with non-metastatic melanoma and to describe the clinical and demographic variables associated with FCR in these patients. METHODS: Patients diagnosed with non-metastatic melanoma were selected. The questionnaire was translated and adapted to Spanish following international guidelines. The internal consistency, construct validity, and temporal stability of the questionnaire were analysed using Cronbach's alpha, confirmatory factor analysis, and test-retest reliability, respectively. Following this, the correlation between FCR scores and the study variables was evaluated. RESULTS: A total of 123 patients were included in the study. The translated and adapted questionnaire showed high reliability (overall Cronbach's alpha 0.834), temporal stability (intraclass correlation coefficient 0.8), and unidimensionality. The mean FCR score was 16.1 ± 6.7. The highest FCR scores were observed in women and young patients (p < 0.01). Patients with a personal history of cancer, facial melanoma, or skin graft reconstruction also obtained a high FCR score (p < 0.05). No differences were found between FCR and other tumour characteristics, such as the Breslow index or the time since diagnosis. CONCLUSIONS: This validated questionnaire is suitable for evaluating FCR. We also identified factors that tend to increase FCR scores, thus allowing clinicians to identify patients at risk and start preventive measures.

Bariatric surgery on social media: A cross-sectional study.

INTRODUCTION: Bariatric Surgery (BS) represents a viable option for the treatment of obesity and its risks. Nevertheless, it is still being underused by the eligible patient population because of the general lack of information, false beliefs, and the stigmatization of obesity. Social media seems to be a solution for overcoming this problem. MATERIALS AND METHODS: The search terms "Bariatric surgery", "Metabolic surgery", "Obesity surgery" and "Weight loss surgery" were employed to analyze the Twitter accounts and Facebook pages dedicated to Bariatric Surgery. The most relevant metadata from each account was collected and analyzed with descriptive statistics. RESULTS: 293 Facebook pages and 122 Twitter accounts were analyzed, being most of them created in the US (42%). No significant differences were found between the mean of followers of both platforms. Medical centers were the biggest creator category with 69.24% of the total number of followers. Although the promotion of medical services accounted for 68.65% of the total number of followers, the promotion of medical products had a significant higher mean of followers. (p = 0.002). CONCLUSION: Doctors and businesses acknowledge the importance of social media for informing patients about BS and promoting their services. Accounts with commercial purposes presented the highest number of followers. The high number of supporters this commercial content has, along with the relative lack of followers in educational and support groups, could lead to undeliberate decisions in detriment of the patients and their well-being.

Development of a Prediction Model for Patients at Risk of Incidental Skin Cancer: A Multicentre Prospective Study.

In the absence of guidelines recommending routine total-body skin examination, patient concern remains the main factor in seeking consultation regarding suspicion of skin cancer. This study explores gaps in patients' understanding of malignant skin lesions, through the factors associated with incidental skin cancer. Included patients had a confirmed histological diagnosis of basal cell carci-noma, squamous cell carcinoma or melanoma. Tumour characteristics, patient demographics and other risk factors related to the development of skin cancer were obtained from each participant. The main measure was incidental skin cancer detection, using both binary logistic regression and Chi-squared Automatic Interaction Detection (CHAID) algorithm. Of the total tumours, 26.6% were detected incidentally. The following variables: male sex, living alone, long-axis diameter, tumour location, symptoms and time of disease evolution were independent predictors of incidental skin cancer. According to the CHAID algorithm, the most significant risk factor for incidental skin cancer was the absence of symptoms at diagnosis.

Factors associated with high Altmetric Attention Score in dermatology research.

BACKGROUND: Alternative metrics are emerging scores to assess the impact of research beyond the academic environment. OBJECTIVE: To analyse whether a correlation exists between manuscript characteristics and alternative citation metrics. MATERIALS AND METHODS: This bibliometric analysis included original articles published in the five journals with the highest impact factors during 2019. We extracted the following characteristics from each record: journal, publication month, title, number of authors, type of institution, type of publication, research topic, number of references, financial support, free/open access status and literature citations. The main measure was the identification of variables of higher social attention (measured by the Altmetric Attention Score ≥25) using binary logistic regression. Model performance was assessed by the change in the area under the curve (AUC). RESULTS: A total of 840 manuscripts were included. The Altmetric scores across all five journals ranged from 0 to 465 (mean 12.51 ± 33.7; median 3). The most prevalent topic was skin cancer, and the study design was clinical science. The scientific journal (P < 0.001), the presence of conflicts of interest (OR 2.2 [95%CI 1.3-3.7]; P = 0.002) and open access status OR 3.2 [95%CI 1.6-6.7]; P = 0.002) were found as independent predictors of high Altmetric scores. CONCLUSIONS: Our study suggests an article´s social recognition may be dependent on some manuscript characteristics, thus providing useful information on the dissemination of dermatology research to the general public.

"Fake news" in dermatology. Results from an observational, cross-sectional study.

BACKGROUND: Social networks have become a means for disseminating information on health-related matters. OBJECTIVE: Describe the characteristics and analyze the accuracy of the dermatology content that is most often shared on the most popular social networks. MATERIALS AND METHODS: The content most often shared on social networks (Facebook, Pinterest, Twitter, and Reddit) between March 2019 and March 2020 was analyzed using the keywords: acne, alopecia/hair loss, psoriasis, eczema, melanoma, skin cancer, rash, and rosacea. The total number of interactions, skin disease, topic, and origin was collected from each of the records. The content was analyzed and was categorized as precise, confusing, or imprecise based on the scientific evidence available. RESULTS: A total of 385 websites were included. About 44.7% of the shared content was rated as imprecise, 20% as confusing, and 35.3% as precise. The records classified as imprecise obtained a higher mean number of interactions (P < 0.05). No differences were found in terms of the level of certainty and the dermatosis studied, whereas they did exist in relation to their topic and origin (P < 0.001). Of the contents classified as imprecise, the most frequent topic and origin were "alternative medicines" and "individual opinions, articles not affiliated with health institutions, nor peer reviewed," respectively. CONCLUSIONS: The majority of the contents often shared on social networks are below acceptable quality standards. Strategies are needed to discredit imprecise information and promote the dissemination of evidence-based dermatology information.

Assessment of sun-related behaviour, knowledge and attitudes among nursing students.

BACKGROUND: As future healthcare professionals, nursing students will play an important role in social training and promoting healthy behaviours including protection against sunlight. However, few studies to date have focused on their knowledge and attitudes regarding sun-related behaviour. OBJECTIVE: To evaluate the level of knowledge, attitudes and practices about sun protection and skin cancer among nursing students. METHODS: This cross-sectional study included 200 all year nursing students from University of Vigo, located in the Vigo, Ourense and Pontevedra campus. Participants completed a validated, self-reported questionnaire with 38 questions regarding their demographic characteristics, sun-related behaviour, knowledge and attitudes. RESULTS: Approximately 87% of students reported experiencing sunburn last summer and 57% stated that they had sunbathed more than 15 days. Participants showed low level of sun protection behaviours, with the exception of using sunscreen (86%) and wearing sunglasses (72.5%). Knowledge about skin cancer and sun protection was considered high (rate of correct responses 87.7%, 6.14 out of 7). Moreover, positive tanning attitudes were high in the sample overall. Nursing students awarded a high value to tanned skin and showed misconceptions about sun exposure. CONCLUSION: Although most of the students were aware of the side effects of sun exposure, their behaviours and attitudes were unsatisfactory. A high level of knowledge may not be predictive of positive practices and adequate attitudes, even among future healthcare professionals. Further guidance and educational campaigns are utmost important, particularly in a group that will be directly involved in prevention and early diagnosis of skin cancer.

Multiple Pilomatricomas: A Retrospective Study and Literature Review.

Pilomatricoma is usually a single lesion. However, some patients present with more than one, a fact that has been reported in association with several systemic diseases. The aim of this analysis is to determine the prevalence of multiple pilomatricomas (MP) in our institution as well as to describe their clinical features and associated comorbidities. This is a retrospective analysis reviewing patients with a histological diagnosis of pilomatricoma registered in the database of the Pathology Department of our institution, from January 2005 to March 2017. One hundred ninety-five patients with histological criteria for pilomatricoma were registered. Fourteen (0.7%) of those patients suffered from MP. Among them, the most relevant findings were: 9 (64%) patients were women and 5 (36%) were men. The median age at diagnosis was 16 years. Seven (50%) had 2 pilomatricomas and 7 (50%) had more than 2. Two (14%) suffered from Steinert myotonic dystrophy (SMD). Regarding family background, 3 of them had relatives with pilomatricomas, one of them with pancreatic cancer, and another one with SMD. A total of 36 pilomatricomas were excised from those 14 patients with the following characteristics: The mean lesion size was 12 mm. The majority of the lesions (53%) were located on the head and neck. There was no recurrence or malignant transformation in any patient. Articles reporting on MP are scarce. We communicate 2 new familial MP without associated comorbidities. We would like to highlight that 2 of our patients with MP also developed SMD, an association previously reported. Thus, a thorough physical examination and inquiring about family history are of utmost importance for an early diagnosis of possible associated diseases.

Genotype-phenotype correlation in type 1 neurofibromatosis: pMet992del mutation and milder disease.

A few genotype-phenotype correlations have been described in type 1 neurofibromatosis. One deletion, p.Met992del, seems to be responsible for a mild form of the condition, in which there is absence of externally visible neurofibromas. We report a mother and a son with this mutation.

Plantar Reconstruction Using a Dermal Substitute: Description of 2 Cases.

Acral lentiginous melanoma is the most common subtype among melanomas on the foot. Reconstruction of a wide surgical defect once it is excised may result in a challenge that requires replacing the lost tissue with another tissue having similarly unique physical characteristics. Although reconstructive options such as skin grafts and either local or distant flaps offer adequate coverage, they often are subject of contraction, muscle atrophy, and contour abnormalities. Dermal substitutes provide support and structure and recreates the dermal layer to ensure a durable reconstruction. We report 2 cases of plantar melanoma in which adequate reconstruction was achieved using a dermal substitute.