Nickel release from hairdressing tools in the United States.

BACKGROUND: Hairdressers have a high prevalence of contact dermatitis, especially to nickel. The presence of nickel in hairdressing tools has been evaluated in the European Union, where the government limits nickel release levels from objects. OBJECTIVES: The aim of this study is to qualitatively investigate nickel release in hairdresser tools in both rural and urban United States, a country without nickel release legislation. METHODS: Hairdressers and individuals with hairdressing tools were invited to participate. Metallic parts of each tool were tested with dimethylglyoxime (DMG), which detects nickel release. Data on tool cost were recorded. RESULTS: A total of 89 tools from 9 salons and 2 over-the-counter sets were tested. Twenty-four (27%) tested positive: trimmers (100%), curling irons (100%), clippers (50%), hair clips (36%), texturizing shears (26%), and trimming shears (4%). Nickel was detected in both salon and over-the-counter tools, and rural and urban salons. Nickel-releasing tools were cheaper than DMG-negative tools of the same type. CONCLUSIONS: Our findings help explain the high prevalence of contact dermatitis among hairdressers, alert clinicians to consider occult occupational nickel when assessing patients with allergic contact dermatitis, reinforces the importance of using barrier protection including gloves when handling hairdressing tools including at home, and augments impetus for more legislation regulating common allergens.

Exploring the Potential and Limitations of Chat Generative Pre-trained Transformer (ChatGPT) in Generating Board-Style Dermatology Questions: A Qualitative Analysis.

This article investigates the limitations of Chat Generative Pre-trained Transformer (ChatGPT), a language model developed by OpenAI, as a study tool in dermatology. The study utilized ChatPDF, an application that integrates PDF files with ChatGPT, to generate American Board of Dermatology Applied Exam (ABD-AE)-style questions from continuing medical education articles from the Journal of the American Board of Dermatology. A qualitative analysis of the questions was conducted by two board-certified dermatologists, assessing accuracy, complexity, and clarity. Out of 40 questions generated, only 16 (40%) were deemed accurate and appropriate for ABD-AE study preparation. The remaining questions exhibited limitations, including low complexity, lack of clarity, and inaccuracies. The findings highlight the challenges faced by ChatGPT in understanding the domain-specific knowledge required in dermatology. Moreover, the model's inability to comprehend the context and generate high-quality distractor options, as well as the absence of image generation capabilities, further hinders its usefulness. The study emphasizes that while ChatGPT may aid in generating simple questions, it cannot replace the expertise of dermatologists and medical educators in developing high-quality, board-style questions that effectively evaluate candidates' knowledge and reasoning abilities.

Comparing Whole Slide Imaging and Light Microscopy to Identify Tumor in en face Frozen Sections.

OBJECTIVE: To assess accuracy of whole slide imaging (WSI) in the interpretation of permanent and frozen sections in surgical pathology and the identification of tumors in cutaneous en face frozen sections. METHODS: Twenty glass slides containing cutaneous en face frozen sections were selected from twenty cases of keratinocyte carcinomas treated with Mohs micrographic surgery. Ten slides contained tumor and ten did not. A blinded dermatologic surgeon used traditional light microscopy (LM) to assess physical slides for tumor presence and type, while noting the confidence (scale 1-10) and time (min) in making the determination. After a seven-day washout period, the surgeon repeated this process using WSI of the same slides, each de-identified and scanned at 20x using the Aperio AT2 (Leica Biosystems). RESULTS: Percent agreement between LM and WSI was 100%, with Cohen's kappa of 1.0. The average time taken to determine tumor presence was significantly greater using WSI than LM. Similarly, the surgeon was significantly more confident using LM than WSI. CONCLUSION: This proof-of-concept study suggests that diagnostic concordance is excellent between LM and WSI in the evaluation of Mohs frozen sections. However, WSI was cumbersome to use, not ergonomic, and required significantly more time.

Guidelines for diagnosis, prevention, and treatment of hand eczema.

BACKGROUND: Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best treatment for their patients. OBJECTIVES: To update the European Society of Contact Dermatitis guideline on the diagnosis, prevention, and treatment on of hand eczema. METHOD: The Guideline Development Group (GDG) was established on behalf of the ESCD. A call for interest was launched via the ESCD website and via the ESCD members' mailing list. Appraisal of the evidence for therapeutic and preventive interventions was applied and a structured method of developing consensus was used and moderated by an external methodologist. The final guideline was approved by the ESCD executive committee and was in external review on the ESCD webpage for 1 month. RESULTS: Consensus was achieved for several statements and management strategies. CONCLUSION: The updated guideline should improve management of hand eczema.

Isothiazolinones Common in Children's Toy Slime.

BACKGROUND: Contact dermatitis to homemade slime has been frequently reported, with isothiazolinones as a likely sensitizer. Little is known on the presence of these preservatives in commercial, store-bought slime products. OBJECTIVES: The aims of the study were to review the literature on "slime dermatitis" and to assess for the presence of isothiazolinones in commercially available slime products and homemade slime components. METHODS: An experimental, colorimetric spot test was used to verify the presence of isothiazolinones in 38 slime products of the 16 best-selling commercial slime kits, 1 finished homemade slime, and 4 common components of homemade slime. High-performance liquid chromatography with UV detection was performed on 8 commercial slime products. RESULTS: According to the spot test, 27 (71%) of the 38 commercial slime products contained isothiazolinones. High-performance liquid chromatography with UV detection analyses indicated, however, that false-positives and false-negatives readily occur: isothiazolinone content was correctly identified in only 4 (50%) of the 8 samples. CONCLUSIONS: This study is the first to demonstrate the presence of isothiazolinones in commercial slime toys. Although the colorimetric spot test may have some utility as a screening assay, it is far from specific and likely not sensitive enough to reliably identify methylisothiazolinone.