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Background: Current health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure. Few interventions exist to support health behaviors beyond U.V. exposure. We adapted Harvest for Health, a home-based mentored gardening intervention for cancer survivors, for implementation in Arizona as a community-based intervention. Methods: Stakeholder-informed adaptations for Harvest for Health Together Arizona (H4H2-AZ) included updating intervention materials to be relevant to the arid desert environment, emphasizing the importance of sun safety in cancer survivorship, and shifting from a home-based to a community-based delivery model. Participants will be enrolled in cohorts aligned with growing seasons (e.g., spring, monsoon, fall) and matched to an individual 30 ft2 community garden plot for two growing seasons (6 months). Original intervention components retained are: 1) Master Gardeners deliver the intervention providing one-to-one mentorship and 2) gardening materials and supplies provided. This pilot six-month single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer as primary outcomes. Secondary outcomes are to explore the effects on cancer preventive health behaviors and health-related quality of life. Discussion: This pilot single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer. If successful, the intervention could be widely implemented throughout existing Master Gardener programs and community garden networks for survivors of other cancers. Trial registration: ClinicalTrials.gov identifier: NCT05648604. Trial registered on December 13, 2022.
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Verruca vulgaris is a common cutaneous manifestation of Human Papillomavirus (HPV) infection that presents as hyperkeratotic, cauliflower-like papules with central black petechiae. These lesions may be resistant to conventional therapies, posing a therapeutic challenge and prolong significant morbidity for the patient. This case report demonstrates an immediate and robust response of recalcitrant warts to intralesional bleomycin injection paired with cryotherapy. J Drugs Dermatol. 2022;21(2):195-196. doi:10.36849/JDD.6424.
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Bleomicina , Verrugas , Crioterapia , Humanos , Injeções Intralesionais , Verrugas/tratamento farmacológicoRESUMO
Generalised eruptive histiocytosis is a rare proliferative disease that typically presents with indolent cutaneous eruptions. We describe the case of a 73-year-old man presenting with diffuse, asymptomatic crops of pink to dusky red papules preceded by general malaise, myalgias, fluctuating fever, chills, and weight loss. Histological evaluation revealed a non-Langerhans cell histiocytic dermal infiltrate with spindle cell features and chronic inflammation, reactive for CD68 and negative for both S100 and CD1a. Malignancy screening was negative. This report aims to highlight a unique presentation of generalised eruptive histiocytosis, emphasise histological findings, and discuss considerations for malignancy screening.
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Exantema , Histiocitose de Células de Langerhans , Histiocitose , Idoso , Exantema/etiologia , Histiocitose/diagnóstico , Humanos , Masculino , Doenças RarasRESUMO
BACKGROUND AND PURPOSE: Skin cancer, the most commonly diagnosed cancer in the United States, is a serious health care concern. Early skin cancer detection improves prognosis; most common early detection approach is a comprehensive clinical skin examination (CSE). A CSE consists of skin cancer risk assessment, head-to-toe skin examination, and skin lesion assessment. Nurse practitioners (NPs) currently lack adequate training and confidence to conduct CSE. The goal of this systematic review was to learn more about published interventions targeting CSE training for primary care NPs and/or other primary care providers. The findings were categorized based on the established procedures for intervention development. METHODS: The databases PubMed, Google Scholar, CINAHL, and Web of Science were searched. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 10 articles were selected for data extraction. CONCLUSIONS: There is a paucity of articles that report rigorously developed interventions aimed at educating primary care NPs to conduct CSE. Existing CSE interventions were not tested for efficacy or effectiveness, and the implementation methods were weak or not reported. A synthesis of the review findings revealed inadequately reported sample characteristics, vague intervention goals, unspecified frequency or duration of interventions, and lack of standardized intervention protocols. IMPLICATIONS FOR PRACTICE: This review builds a foundation for more rigorously developed interventions to improve CSE and provides guidance for NPs to select education on CSE and other clinical foci. Future research will guide the development and evaluate the effectiveness of CSE education, which ultimately could improve skin cancer prognosis interventions and lack of standardized intervention protocols.
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Pessoal de Saúde/educação , Exame Físico/métodos , Atenção Primária à Saúde/métodos , Neoplasias Cutâneas/diagnóstico , Detecção Precoce de Câncer/métodos , Educação Continuada/métodos , Educação Continuada/tendências , Humanos , Atenção Primária à Saúde/tendênciasRESUMO
BACKGROUND AND PURPOSE: Skin cancer is the most common malignancy in the United States; early detection reduces the public health burden. This systematic review updates the state of advanced practice nurses' skin cancer knowledge and attitudes, performance of and barriers to clinical skin examination (CSE), recognition of skin lesions, and related training activities. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided a search of eight literature databases that yielded 12 studies from 2010 to 2016. The United States Preventive Services Task Force's Levels of Certainty guided evidence assessment. CONCLUSIONS: The studies mainly targeted or included nurse practitioners. Collectively, participants had variable, suboptimal skin cancer knowledge, even after an intervention. A slight majority performed CSE during annual visits but agreed that CSE was important and within their scope of practice. Major CSE barriers were lack of time, training, and confidence. Participants who received training were more proficient in identifying suspicious versus benign lesions. Few skin cancer detection training opportunities for nurses exist. IMPLICATIONS: The level of certainty of the evidence for skin cancer detection by advanced practice nurses and their impact on the skin cancer problem remain low. These nurses would benefit from accessible and efficacious CSE and lesion training.
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Competência Clínica/normas , Detecção Precoce de Câncer/normas , Neoplasias Cutâneas/diagnóstico , Adulto , Prática Avançada de Enfermagem/métodos , Prática Avançada de Enfermagem/normas , Detecção Precoce de Câncer/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/prevenção & controle , Estados UnidosRESUMO
PURPOSE: To conduct a pilot survey to assess acceptance of mobile teledermoscopy (MTD) by primary care nurse practitioners (NPs) working in Arizona. DATA SOURCES: Sixty-two participants recruited from NP and academic listservs in Arizona completed an online survey prefaced by a MTD definition, device photographs, and a practice case, followed by 33 items measuring Teledermatology Technology Acceptance Model (TeleTAM) constructs. CONCLUSIONS: Participants were highly interested in using MTD to assess skin lesions. They perceived MTD utility to greatly improve diagnosis and positively impact their practice. Most participants had never used MTD, but had high mean scores for MTD attitude and moderate scores for MTD perceived ease of use, perceived use, and facilitators of MTD. They had moderate scores for intention to use MTD. The construct facilitators (organizational infrastructure) were most strongly associated with intention to use MTD. Cronbach alphas were 0.70 or higher for all subscales except compatibility and habit. IMPLICATIONS FOR PRACTICE: Moderate acceptance of MTD may reflect NPs' knowledge of the technology, self-confidence for using it, or MTD financial constraints. Future research will address these factors to foster use of MTD by NPs, thereby improving patients' access to early skin lesion assessment and diagnosis.