The role of hydroxychloroquine in the treatment of lichen planopilaris: A retrospective case series and review.

A variety of systemic agents are used to treat lichen planopilaris (LPP) with a limited evidence base. The aim of our study was to retrospectively review the response rate to and tolerability of hydroxychloroquine in a cohort of patients with LPP in an effort to add to the evidence base for its use. Twenty-three patients with a clinical and histopathological diagnosis of LPP who had been treated with hydroxychloroquine for their disease in a single center were identified. A retrospective review of these patients' medical records was performed and physician rated response was documented. Complete response was observed in 61% of our patients, and a further 9% of patients demonstrated partial response. Thirteen percent of patients withdrew from treatment because of suspected adverse effects. Our sample size was small, and data was collected retrospectively. We found hydroxychloroquine to be a reasonable therapeutic choice in LPP.

A dermatology outpatient waiting list initiative.

Skin disease is the most common reason for people to present to their general practitioner (GP) with a new episode of disease. In April 2010 there were estimated 23,000 patients on dermatology outpatient waiting lists in Ireland, including almost 11,000 patients waiting over 6 months. We analysed the data of 200 dermatology outpatient visits scheduled under an initiative to target patients waiting more than 120 days for a new dermatology outpatient appointment. There were 171 (85.5%) patients seen, 29 (14.5%) patients did not attend the appointment. The data from 161 patients seen under the initiative was included in the analysis. Skin lesions accounted for 81 (50%) referrals, of these 71 (44%) patients had benign skin lesions and 10 (6%) patients were considered to have suspicious skin lesions. There was no case of malignant melanoma. After the initial consultation, 66% (106) of the patients were discharged to their primary care physician.

Practical considerations in the performance of physical examinations on women with disabilities.

There are over 28 million women with disabilities in the United States (1). This includes women with mobility and self-care limitations of varying degrees. Many of these women have difficulty obtaining comprehensive, accessible, and dignified physical examinations. Additionally, patients and clinicians are often misinformed about issues pertaining to healthcare needs of women with disabilities (2). This article outlines strategies to overcome physical barriers and gaps in knowledge, and proposes creative solutions for common problems encountered during the performance of the basic physical examination of a woman who has disabilities. It discusses the reality of sexually transmitted disease, promotes awareness of abuse in the population of women with disabilities, and offers guidelines physicians can follow in assisting their patients in resolving this abuse.

Sexual functioning among women with physical disabilities.

OBJECTIVE: Three a priori hypotheses were tested: (1) There are significant differences in sociosexual behaviors of women with physical disabilities compared with women without disabilities; (2) the sexual functioning of women with disabilities is significantly related to age at onset of disability; (3) psychological factors explain more of the variance in the sexual functioning of women with physical disabilities than do disability, social and environmental factors. DESIGN: Case-comparison study using written survey. SETTING: General community. PARTICIPANTS: The questionnaire was mailed to 1,150 women with physical disabilities who were recruited as volunteers or through independent living centers. Each woman gave a second copy of the questionnaire to an able-bodied female friend, which comprised the comparison group. The response rate was 45%, with 475 cases and 425 comparisons eligible to participate. The most common disability type was spinal cord injury (24%), followed by polio (18%), muscular dystrophy (11%), cerebral palsy (11%), multiple sclerosis (10%), joint disorders (7%), and skeletal abnormalities (5%). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Sexual-functioning, consisting of four factors: (1) sexual desire, (2) sexual activity, (3) sexual response, (4) sexual satisfaction. RESULTS: Highly significant differences were found in level of sexual activity (p = .000001), response (p = .000009), and satisfaction (p=.000001) between women with and without disabilities. No significant differences were found between groups on sexual desire. Severity of disability was not significantly related to level of sexual activity. CONCLUSIONS: Psychological and social factors exert a strong impact on the sexual functioning of women with physical disabilities. Further investigations is needed of the effect of social environment on development of self-esteem and sexual self-image, and how these influences affect levels of sexual functioning in women with physical disabilities.