The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran.

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine ( P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

Calcinosis Cutis and Calciphylaxis.

Calcinosis cutis (CC) is defined as the deposition of calcium salts in the skin. The condition is divided into 5 types: calciphylaxis and dystrophic, metastatic, idiopathic, and iatrogenic CC. Dystrophic CC is the most common form and usually occurs in association with autoimmune diseases. CC can be treated surgically or with the use of drugs such as diltiazem, bisphosphonates, warfarin, ceftriaxone, probenecid, minocycline, or aluminum hydroxide. Calciphylaxis is defined as calcification of the media of small- and medium-sized blood vessels in the dermis and subcutaneous tissue. Clinically, calciphylaxis causes livedo racemosa, which progresses to retiform purpura and skin necrosis. First-line treatment is with sodium thiosulfate. We present a review of the calcifying disorders of the skin, focusing on their diagnosis and treatment.

[History of method of classification of dermatosis of modern and contemporary China].

The classification of individual things marks the depth of one's recognition on the general character of things. The method for the classification of dermatosis reflects the developmental level of dermatology from one aspect. Since modern time, there appeared a condition of the coexistence of multiple knowledge of medical systems, including traditional Chinese, western, amalgamation of traditional Chinese and western, and integration of Chinese and western. In the external medical system in TCM, skin diseases were always categorized under external medicine without detailed descriptions on any concrete specific skin disease, instead, only the morphological injury of skin were classified. The works of amalgamation of traditional Chinese and western medicine roughly classified dermatosis basically on the basis of the characteristics of morphological damage of skin, thus lifted out of the infancy of TCM dermatology; while in the works of integrating Chinese and western medicine, the disease terminology of western medicine and its method of classification were directly applied, and the traditional Chinese disease titles and classification methods were discarded. Thus, the descriptions under each disease with western medical terms eventually established a model for the diagnosis and treatment of skin diseases based on the integration of differentiating disease names by western medicine and differentiating syndromes by TCM, hence opening a new approach of developing TCM dermatology by modern scientific methods, a major feature of Chinese dermatology.

[Referrals to dermatology: proportion of banal disorders]. / Demanda derivada a Dermatología: peso de la patología banal.

BACKGROUND AND OBJECTIVE: Skin diseases account for a large number of consultations in primary care. The objective of this study was to determine the characteristics and cost of referrals from primary care to a dermatology clinic. MATERIAL AND METHODS: Descriptive cross-sectional study of referrals from a primary care health center to a dermatology clinic. The dermatology clinic was situated in the same health center and was attended by a dermatologist from Complejo Hospitalario Universitario in Albacete, Spain. The study was performed on 10 days selected at random between April 21, 2009, and June 26, 2009. The data gathered included age, sex, use of cryotherapy, and diagnostic group. Patients were divided into 4 diagnostic groups: A) benign degenerative disease or trivial disorders whose treatment may not merit involvement of the national health service, B) diseases resolved with a single dermatology consultation at the health center, C) diseases requiring evaluation in hospital-based dermatology outpatients, and D) diseases referred for surgical treatment. RESULTS: Data were gathered on 257 patients with a mean age was 41.18 years and there was a slight female predominance. The majority of patients were in diagnostic group B (53.7%), followed by groups A (19.1%), C (19.1%), and D (8.2%). The total estimated cost of these 257 visits was €29 750.32, of which €5672.24 was for trivial disorders. CONCLUSIONS: The current high prevalence of trivial disorders in the caseload of dermatology clinics by trivial disorders makes it necessary to control referrals from primary care more strictly.

Assessment of skin integrity in the elderly 1.

Intrinsic changes to the skin are a normal part of the ageing process. Careful assessment of the skin for any abnormalities should be included in any patients' holistic assessment. It is essential that all health care professionals have a fundamental knowledge of the structure and function of the skin in order to be able to assess any changes to normal skin; identify existing skin problems and potential risk factors. Only by carrying out a detailed and systematic examination, we can implement effective strategies of management. This is the first of two papers. This paper will describe the structure and functions of the skin and explore skin assessment. The second paper will describe some of the more common skin conditions seen in ageing skin and their management.

Nongenital warts: classification and treatment options.

Common, plantar and flat warts are the primary classes of nongenital warts. Although spontaneous remission does occur, all warts should be treated to avoid spreading. Common warts often develop in the periungual region of the fingers. This type of wart generally can be removed with cryotherapy, topical application of salicylic acid or occlusive taping. Plantar warts are found over pressure points of the heel or metatarsal heads. They are also treated with cryotherapy or salicylic acid. Flat warts are commonly seen on the dorsum of the hands or on the face. These warts are best treated with topical retinoids. Immunotherapies are being developed.

Historical outline of attempts to classify skin diseases.

Over the years physicians have attempted to classify skin diseases. Plenck and Willan were the first to outline clearly the basic components of skin diseases and to devise classifications based on living gross pathologic features. With the development of molecular biology, etiologic classification--a system unrelated to that of clinical appearance--was begun. Most current textbooks present combinations of these two systems and those based on location or on other concepts.