Natural language processing of Reddit data to evaluate dermatology patient experiences and therapeutics.

BACKGROUND: There is a lack of research studying patient-generated data on Reddit, one of the world's most popular forums with active users interested in dermatology. Techniques within natural language processing, a field of artificial intelligence, can analyze large amounts of text information and extract insights. OBJECTIVE: To apply natural language processing to Reddit comments about dermatology topics to assess for feasibility and potential for insights and engagement. METHODS: A software pipeline preprocessed Reddit comments from 2005 to 2017 from 7 popular dermatology-related subforums on Reddit, applied latent Dirichlet allocation, and used spectral clustering to establish cohesive themes and the frequency of word representation and grouped terms within these topics. RESULTS: We created a corpus of 176,000 comments and identified trends in patient engagement in spaces such as eczema and acne, among others, with a focus on homeopathic treatments and isotretinoin. LIMITATIONS: Latent Dirichlet allocation is an unsupervised model, meaning there is no ground truth to which the model output can be compared. However, because these forums are anonymous, there seems little incentive for patients to be dishonest. CONCLUSIONS: Reddit data has viability and utility for dermatologic research and engagement with the public, especially for common dermatology topics such as tanning, acne, and psoriasis.

Mesococktails and mesoproducts in aesthetic dermatology.

Mesotherapy is a convenient, safe and relatively painless non-surgical procedure. It has found its way into the aesthetic world and is employed for various indications such as lipolysis, skin rejuvenation, pigmentation and hair loss. The procedure involves delivery of mixture or cocktail of different compounds (plant extracts, nutrients, enzymes, homeopathic agents, pharmaceuticals, vitamins, amino acids and other bioactive substances) into the dermis or subcutaneous layer. A variety of techniques have been employed. The newer no-needle and micro-needle techniques are less invasive. Ingredients of the chosen mesococktail depend on the indication and play a major role in the outcome. Despite its popularity, mesotherapy has a scarcity of large scale studies on its efficacy and safety profile. Nevertheless, the choice of the mesoproduct and technique must be done with great detail to achieve the best desired effect.

Plants and their uses in dermatological recipes of the Receptarium of Burkhard III von Hallwyl from 16th century Switzerland - Data mining a historical text and preliminary in vitro screening.

ETHNOPHARMACOLOGICAL RELEVANCE: Historical texts on materia medica can be an attractive source of ethnopharmacological information. Various research groups have investigated corresponding resources from Europe and the Mediterranean region, pursuing different objectives. Regardless of the method used, the indexing of textual information and its conversion into data sets useful for further investigations represents a significant challenge. AIM OF THE STUDY: First, this study aims to systematically catalogue pharmaco-botanical information in the Receptarium of Burkhard von Hallwyl (RBH) in order to identify candidate plants in a targeted manner. Secondly, the potential of RBH as a resource for pharmacological investigations will be assessed by means of a preliminary in vitro screening. MATERIALS AND METHODS: We developed a relational database for the systematic recording of parameters composing the medical recipes contained in the historical text. Focusing on dermatological recipes, we explored the mentioned plants and their uses by drawing on specific literature. The botanical identities (candidate species) suggested in the literature for the historical plant names were rated based on their plausibility of being the correct attribution. The historical uses were interpreted by consulting medical-historical and modern clinical literature. For the subsequent in vitro screening, we selected candidate species used in recipes directed at the treatment of inflammatory or infectious skin disorders and wounds. Plants were collected in Switzerland and their hydroethanolic crude extracts tested for possible cytotoxic effects and for their potential to modulate the release of IL-6 and TNF in PS-stimulated whole blood and PBMCs. RESULTS: The historical text analysis points up the challenges associated with the assessment of historical plant names. Often two or more plant species are available as candidates for each of the 161 historical plant names counted in the 200 dermatological recipes in RBH. On the other hand, our method enabled to draw conclusions about the diseases underlying the 56 medical applications mentioned in the text. On this basis, 11 candidate species were selected for in vitro screening, four of which were used in RBH in herbal simple recipes and seven in a herbal compound formulation. None of the extracts tested showed a noteworthy effect on cell viability except for the sample of Sanicula europaea L. Extracts were tested at 50 µg/mL in the whole blood assay, where especially Vincetoxicum hirundinaria Medik. or Solanum nigrum L. showed inhibitory or stimulatory activities. In the PBMC assay, the root of Vincetoxicum hirundinaria revealed a distinct inhibitory effect on IL-6 release (IC50 of 3.6 µg/mL). CONCLUSIONS: Using the example of RBH, this study illustrates a possible ethnopharmacological path from unlocking the historical text and its subsequent analysis, through the selection and collection of plant candidates to their in vitro investigation. Fully documenting our approach to the analysis of historical texts, we hope to contribute to the discussion on solutions for the digital indexing of premodern information on the use of plants or other natural products.

Once again on the Empress Zoe: Women, dermatology, cosmetics, and materia medica (medical matter) in the ancient world.

BACKGROUND: An article published in 2012 in the Journal of Cosmetic Dermatology discussed the historical sources presenting the Byzantine Empress Zoe Porphyrogenita as an expert in cosmetic and pharmacological remedies that could give their users a youthful appearance and a kind of eternal youth. However, it did not take into account a dermatological recipe attributed to Zoe which text transmission has preserved. AIMS: To examine some ingredients of Zoe's recipe from a historical medical point of view and contextualize the text in the tradition of ancient medical matter, physiology of aging, and gender pharmacological skills. METHODS: After contextualizing the recipe from the historical medical point of view, some of its ingredients have been analyzed in relation not only to their use in the most authoritative pharmacological and medical sources of antiquity but also to their symbolic meaning. RESULTS: The analysis of Zoe's dermatological recipe allowed to highlight: The links between cosmetics and medicine in Greek and Roman Antiquity. The reason why ancient sources dealing with medical matter attributed to certain substances and plants the power to save the human body from old age and decay. The consistency between the ingredients of Zoe's recipe and the humoral physiology by genders and by age of Hippocrates. The existence of a female tradition in pharmacological competence. CONCLUSION: Cosmetic dermatology of antiquity is the perfect point in which survival of the myth and rational pharmacology overlap.

Growing role for arnica in cosmetic dermatology: Lose the bruise.

This commentary examines the utility of arnica in cosmetic dermatology. For many years, arnica has been used to reduce the morbidity associated with various procedures, including surgeries and treatments with lasers and other energy-based devices. Arnica is a traditional homeopathic remedy that can reduce post-procedural edema and bruising. Although it has been used clinically by many physicians and is widely and readily available to patients, the available data is limited and often conflicting. We reviewed the relevant information on arnica and offer our own insights into its use in order to shed more light on its periprocedural utility.

Herbal and complementary medicine in dermatology.

This article is a description of how I have integrated Complementary Medicine into the practice of dermatology over the past 2 decades. It emphasizes observing the principles of the system being used, such as the herbal concept of the synergy of the entire plant extract. Examples discussed include the use of flavonoids to protect the liver and capillaries. Herbs and techniques for reducing the inflammatory response, as well as for enhancing immunity, are given. The concept of homeopathy and a few remedies to use in office practice are discussed. Finally, a few methods to complement the treatment of melanoma are presented.

History of self-experimentation in dermatology: should we go first--sometimes?

Because of its availability, the skin has been used over the years for self-experimentation. Many examples can be cited, including the heroic self-experiments of Carrión of Peru with verruga peruana and those of Goldberger with pellagra and Pediculoides ventricosus. My personal self-experimentation began with sensitization to Japanese lacquer. From that starting point I experimented with chemical warfare agents, cortisone versus hydrocortisone, bites of various arthropods, and finally, experiments with lasers. Some dermatologists will continue to do self-experimentation when they acquire infections from their patients. I believe that sometimes, for their patients' benefit, they should go first.

Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India.

BACKGROUND: Globally, governments have recognized the growing popularity of Complementary and Alternative Medicines and the possibility of their combined use with biomedicine. Decisions within the Government of India have led to a conducive environment for conducting clinical studies, to achieve integration of more than one system of medicine, so that their combined benefits can be brought to bear on chronic, difficult-to-treat conditions. AIM: To develop integrative dermatology treatment protocols for patients with long-standing skin diseases who have received treatment from many centers. MATERIALS AND METHODS: A team of doctors from modern dermatology, Ayurveda, yoga therapy, and homeopathy studied recruited patients to develop mutual orientation on each therapeutic system and a working knowledge of approach to their clinical diagnosis. Six-hundred thirty-eight patients affected by lower limb lymphedema requiring skin care as a major part of treatment were treated integrating modern dermatology and Ayurveda. Three-hundred eighty-one vitiligo patients were examined and treated to understand the clinical presentations and treatment options in Ayurveda. RESULTS: A two-step cluster analysis performed by SPSS Version 16 showed average volume reductions of 13.3% and 23% on day 14, 19.7% and 31.1% on day 45, and 23.4% and 39.7% on day 90 of treatment in small and large lymphedematous limbs. Inflammatory episodes before the onset on this treatment was reported by 79.5% of our lymphedema patients, and 9.4% reported this at the end of three months after our treatment. Among vitiligo patients, we found that 39.6% of patients had kapha, 39.8% pitta, 10.8% had vatha and 0.52% has tridoshaja presentation. There are over 100 treatment options available in Ayurveda to treat vitiligo. DISCUSSION: Each system of medicine recognizes the same disease albeit with minor difference in description. Skin care procedures like washing and emollients restore the barrier function and skin health. We have converged Ayurvedic skin care with that of dermatology with an aim of achieving patient management that is better than that achievable by a single system alone. Overload of the lymphatic system due to loss of epidermal barrier function and consequent inflammation from bacteria and soil irritants is responsive to selected Ayurvedic herbal preparations. CONCLUSION: It is evident that integration at the therapeutic level is possible, although the pathological basis is interpreted differently. Irrespective of background understanding of the given disease, a mutually oriented multisystem therapeutic team was able to effectively use medicines from more than one system of medicine and to develop guidelines for their prescription and a patient care algorithm.

Effect of alternative medicinal systems and general practice.

Alternative medicinal systems like Ayurveda and homeopathy are respected and legitimate sciences. The former was born in India. Colleges abound in this country churning out tens of thousands of graduates of these fields. It is ironic that a large number of them pratice allopathic general practice instead of, or along with, their field of specialisation despite laws prohibiting them to do so. Their gross lack of knowledge of dermatology wreaks a havoc. Even GPs contribute to this confusion for the same reason. Pharmacists contribute to unauthorised sale of dermatologic drugs and promote unsupervised treatment flouting the law. The result is neglected and vitiated dermatoses, unwanted adverse drug reactions and resource depletion for the patient. The practising dermatologist in India is unfortunately the one who bears the brunt of the above confusion. However these situations are also contributory to the enviable clinical skills that Indian dermatologists are so well known for.

Perfil dos usuários do ambulatório de dermatologia antroposófica - HU/CAS- UFJF, Juiz de Fora - MG / The patient´s profile of the anthroposophic dermatology service - HU/CAS - UFJF, Juiz de Fora - MG

Este trabalho busca demonstrar o perfil do usuário da Medicina Antroposófica (MA) no Ambulatório de Dermatologia do Hospital Universitário ? Centro de Atenção à Saúde da Universidade Federal de Juiz de Fora (HU/CAS-UFJF), assim como avaliar sua aceitação pela comunidade.O ambulatório surgiu dentro de uma visão mais abrangente da Medicina, em conformidade com a Organização Mundial de Saúde, que vem estimulando o uso da Medicina Tradicional e Complementar/Alternativa nos Sistemas de Saúde de forma integrada às técnicas modernas da medicina ocidental; e visa difundir a prática Médica Antroposófica em Juiz de Fora demonstrando sua eficácia e qualidade.Para tal feito, foi realizado um estudo retrospectivo, quali-quantitativo, através da coleta de dados, a partir de prontuários de 2008 e 2009 do HU/CAS-UFJF, seguida da análise das informações.O resultado demonstrou que a MA foi eficaz em mais de 75% dos tratamentos propostos, com média de cura/melhora completa em 40% dos casos analisados. Discute-se então, sobre os resultados encontrados e percebe-se que têm semelhanças com os da literatura em relação à frequência das doenças dermatológicas. As conclusões são positivas e contribuem para a legitimidade da Medicina Antroposófica.

This paper seeks to demonstrate the patients’ profile of the Anthroposophical Medicine (AM) in the Dermatology Clinic of the Hospital Undergraduate / Secondary Service Center, Federal University of Juiz de Fora - MG (HU / CAS-UFJF) as well as evaluate its acceptance by the community. This Clinic of AM emerged within a more comprehensive vision of medicine in accordance with the World Health Organization which has encouraged the use of Traditional Medicine and Complementary / Alternative Systems in an integrated manner with the modern Western medicine techniques, and aims to spread the Anthroposophical Medicine experience in Juiz de Fora and demonstrate its effectiveness and quality. For this, it was performed a retrospective study and quali-quantitative data collection made in the period of June- December 2009 from medical files of the HU/ CAS - UFJF, followed by analysis of the collected data. The findings were that the AM was effective in more than 75% of the proposed treatments, with healing / improvement average of 100% in 40% of cases. It is argued then about the results and perceives that has similarities with the literature in relation to frequency. The conclusions are positive and contribute to the legitimacy of Medicine Antroposófica.

[Regulative therapy: treatment with nonspecific stimulants in dermatology in traditional and modern perspectives]. / Regulationstherapie: Behandlung mit unspezifischen Reizen in der Dermatologie aus traditioneller und moderner Sicht.

Stimulation or regulation therapies are old therapeutic procedures based on models reaching back to traditional medical faculties in ancient times and in the Middle Ages. Among this heterogeneous group are acupuncture, purgative procedures (especially the Aschner methods), autohemotherapy, fasting therapy, homeopathy, microbiological and physical therapies. The basic principle underlying all of these procedures is that stimulants applied in proper doses to the organism elicit counterregulation. The counterregulation stimulates 'self-healing processes' within the organism. The efficacy of stimulation therapies was originally deduced mostly from traditional explanatory models which have lost their relevance for modern medicine. However, it has been found in applications in dermatology that many of these stimulation therapies can lead to clinical improvement in selected indications and that modern explanatory models can be found for these effects. This presentation reports on exemplary applications of stimulation therapies in dermatology. Traditional and modern concepts of action are compared.

Evidence-based veterinary dermatology: a systematic review of the pharmacotherapy of canine atopic dermatitis.

The efficacy of pharmacological interventions used to treat canine atopic dermatitis, excluding fatty acid supplementation and allergen-specific immunotherapy, was evaluated based on the systematic review of prospective clinical trials published between 1980 and 2002. Studies were compared with regard to design characteristics (randomization generation and concealment, masking, intention-to-treat analyses and quality of enrolment of study subjects), benefit (improvement in skin lesions or pruritus scores) and harm (type, severity and frequency of adverse drug events) of the various interventions. Meta-analysis of pooled results was not possible because of heterogeneity of the drugs evaluated. Forty trials enrolling 1607 dogs were identified. There is good evidence for recommending the use of oral glucocorticoids and cyclosporin for the treatment of canine atopic dermatitis, and fair evidence for using topical triamcinolone spray, topical tacrolimus lotion, oral pentoxifylline or oral misoprostol. Insufficient evidence is available for or against recommending the prescription of oral first- and second-generation type-1 histamine receptor antagonists, tricyclic antidepressants, cyproheptadine, aspirin, Chinese herbal therapy, an homeopathic complex remedy, ascorbic acid, AHR-13268, papaverine, immune-modulating antibiotics or tranilast and topical pramoxine or capsaicin. Finally, there is fair evidence against recommending the use of oral arofylline, leukotriene synthesis inhibitors and cysteinyl leukotriene receptor antagonists.

Interacciones medicamentosas de utilidad en dermatología / Drug interactions in dermatology

Numerosos factores pueden producir interacciones entre dos o más medicamentos cuando se administran simultáneamente. El presente artículo enumera los principales mecanismos causales y hace un listado de las principales drogas de uso dermatológico común, especificando sus principales interacciones

Síndrome de Sweet (Dermatosis Neutrofílica Febril Aguda) / Sweet’s syndrome (acute febrile neutrophilic dermatosis)

El síndrome de Sweet es una enfermedad dermatológica recurrente poco común, que se caracteriza por presentar placas inflamatorias dolorosas en las extremidades, cara o cuello asociadas a malestar general, fiebre, artralgias y leucocitosis periférica.

Dermatologie humaine et veterinaire: comparaison pratique / Human and veterinary dermatology: a practical comparaison

Bien que nous connaissions tres mal la dermatologie humaine, il est des similitudes que nous developperons, mais egalement des differences, pratiques plus encore que theoriques, que la clinique quotidienne nous amene a souligner en premier lieu.(AU)

Puntos en dermatología / Spots in dermatology

Los autores hacen una síntesis de un aspecto poco referido en la bibliografía mundial, como son los puntos en dermatología, y destacan su valor en la semiotecnica cutánea