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1.
Dermatol Online J ; 26(8)2020 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-32941716

RESUMEN

We present a rare case of dermatomyositis associated with nivolumab therapy for melanoma. Nivolumab is an immune checkpoint inhibitor that blocks the programmed death-1 (PD1) receptor and has a number of associated immunotherapy related adverse events. Although most are T-cell mediated, some are antibody mediated mimics of classical autoimmune diseases. We review the characteristics of other cases of anti-PD1 associated dermatomyositis and the recent literature to better understand how to classify and treat this challenging immunotherapy related adverse event.


Asunto(s)
Dermatomiositis/inducido químicamente , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Nivolumab/efectos adversos , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Adulto , Antineoplásicos Inmunológicos/efectos adversos , Antineoplásicos Inmunológicos/uso terapéutico , Dermatomiositis/patología , Humanos , Masculino , Melanoma/tratamiento farmacológico , Nivolumab/uso terapéutico
2.
Dermatol Online J ; 26(12)2020 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-33423417

RESUMEN

Burnout is increasingly common in the medical field. In dermatology, burnout is attributed to high patient volume and excessive time spent on electronic medical record system activities. The shortage of the dermatology workforce in academic medicine is well-known. Studies have yet to examine the relationship between well-being during dermatology residency and the pursuit of academia. OBJECTIVE: To assess the well-being of dermatology residents in the United States, identify barriers/enablers to well-being, and determine the implications of these measures. METHODS: A cross-sectional survey was distributed to program coordinators of 136 accredited dermatology programs with instructions to forward to their current dermatology residents. Residents provided self-reported ratings on validated scales measuring burnout, depression, anxiety, fatigue, and quality of life. Descriptive statistics and correlations were examined. RESULTS: Residents with higher levels of burnout reported they were significantly less likely to pursue academia, full-time work, clinical research, and fellowships after residency. The results showed opposite effects for residents with higher qualities of life. CONCLUSIONS: This study showed that resident well-being can have a significant impact on residents' future career plans, including pursuing academic dermatology, clinical research, and fellowship. Addressing burnout in the field of dermatology offers an opportunity to increase the academic dermatology workforce.


Asunto(s)
Agotamiento Profesional , Selección de Profesión , Dermatología/educación , Internado y Residencia , Estudios Transversales , Humanos , Calidad de Vida , Encuestas y Cuestionarios , Estados Unidos
4.
Dermatol Online J ; 25(1)2019 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-30710895

RESUMEN

The possible presentations of cytomegalovirus (CMV) are vast not only in its systemic manifestations, but also in the various cutaneous lesions that may result. Cutaneous cytomegalovirus is rarely reported in the literature because the clinical and pathologic features can be difficult to identify. Its identification, however, is vital as cutaneous human CMV infection can signal systemic disease and an unfavorable prognosis. The objective of this study is to aid in recognition, diagnosis, and treatment of CMV according to dermatological evidence. A complete literature search was performed within PubMed, resulting in the inclusion of 58 patient cases. The most common dermatologic manifestation was perianal or oral ulcers, but the locations and types of lesions noted throughout the review were numerous. Treatment is often simple, yet incorrect diagnoses along with concurrent illnesses can often complicate management. It is imperative for CMV to be detected early in its course to prevent mortality, especially in the immunocompromised. Dermatological presentations are often the first sign of this deadly virus' activity and it is essential that these diagnoses are made more efficient and accurate.


Asunto(s)
Infecciones por Citomegalovirus/diagnóstico , Enfermedades Cutáneas Virales/diagnóstico , Antivirales/uso terapéutico , Infecciones por Citomegalovirus/tratamiento farmacológico , Infecciones por Citomegalovirus/inmunología , Infecciones por Citomegalovirus/patología , Infecciones por VIH/inmunología , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Trasplante de Órganos , Enfermedades Cutáneas Virales/tratamiento farmacológico , Enfermedades Cutáneas Virales/inmunología , Enfermedades Cutáneas Virales/patología
5.
Clin Dermatol ; 37(5): 561-579, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31896410

RESUMEN

White diseases are a heterogenous group characterized by hypopigmentation or depigmentation. Skin and eye color are determined by the number and size of melanosomes present. Melanin is produced by melanosomes in the melanocytes present within the epidermis of the skin, uvea, and retinal pigmented epithelium (RPE). Conditions altering the number of melanocytes or concentration of melanin result in a lack of pigmentation, appearing as "white diseases" ranging from the well-known albinism and vitiligo to more esoteric white hand syndrome and Degos disease.


Asunto(s)
Hipopigmentación/diagnóstico , Hipopigmentación/etiología , Albinismo/diagnóstico , Albinismo/etiología , Albinismo/terapia , Color , Cosméticos/efectos adversos , Diagnóstico Diferencial , Humanos , Hipopigmentación/patología , Hipopigmentación/terapia , Inflamación/complicaciones , Liquen Escleroso y Atrófico/diagnóstico , Liquen Escleroso y Atrófico/etiología , Liquen Escleroso y Atrófico/patología , Liquen Escleroso y Atrófico/terapia , Papulosis Atrófica Maligna/diagnóstico , Papulosis Atrófica Maligna/etiología , Papulosis Atrófica Maligna/patología , Membrana Mucosa , Enfermedades de la Uña/etiología , Nevo con Halo/diagnóstico , Nevo con Halo/etiología , Nevo con Halo/patología , Pitiriasis Liquenoide/diagnóstico , Pitiriasis Liquenoide/etiología , Pitiriasis Liquenoide/terapia , Pronóstico , Preparaciones para Aclaramiento de la Piel/efectos adversos , Tiña Versicolor/diagnóstico , Tiña Versicolor/tratamiento farmacológico , Tiña Versicolor/etiología , Vibración/efectos adversos , Vitíligo/diagnóstico , Vitíligo/etiología , Vitíligo/terapia , Síndrome de Waardenburg/diagnóstico , Síndrome de Waardenburg/etiología
6.
JMIR Med Educ ; 4(1): e3, 2018 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-29434018

RESUMEN

BACKGROUND: Online medical education has relevance to public health literacy and physician efficacy, yet it requires a certain standard of reliability. While the internet has the potential to be a viable medical education tool, the viewer must be able to discern which information is reliable. OBJECTIVE: Our aim was to perform a literature review to determine and compare the various methods used when analyzing YouTube videos for patient education efficacy, information accuracy, and quality. METHODS: In November 2016, a comprehensive search within PubMed and Embase resulted in 37 included studies. RESULTS: The review revealed that each video evaluation study first established search terms, exclusion criteria, and methods to analyze the videos in a consistent manner. The majority of the evaluators devised a scoring system, but variations were innumerable within each study's methods. CONCLUSIONS: In comparing the 37 studies, we found that overall, common steps were taken to evaluate the content. However, a concrete set of methods did not exist. This is notable since many patients turn to the internet for medical information yet lack the tools to evaluate the advice being given. There was, however, a common aim of discovering what health-related content the public is accessing, and how credible that material is.

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