Blue Light and Skin Health.

Although blue light has been present in our lives for decades, this type of visible light has recently become a topic of significant interest as we shift to a greater percentage of our time spent in front of light-emitting devices. Especially during the Covid pandemic, as many companies pivoted from in-person meetings to discussions conducted via video conference, the impact of consistent visible light exposure from artificial sources became more relevant than ever in our daily lives. As dermatologists and skin health experts, we often get asked by patients if the light emitted from computers, smart phones, and overhead light has a significant impact on our skin. As leaders in skin knowledge, it is important to have a thorough and evidence-based understanding of the role that visible light, and blue light in particular, plays in skin health and certain dermatoses. In this article, we provide a comprehensive review of blue light and how it impacts our skin. We discuss the role of blue light in skin pigmentation and skin damage. Additionally, we discuss measures that can be taken to protect our skin from blue light. Understanding the role of blue light in our daily lives, and the role of sunscreens and antioxidants in visible light protection, is important information that we can impart to our patients. J Drugs Dermatol. 2022;21(9):962-966. doi:10.36849/JDD.6374.

Self-reported quality of life following stroke: a systematic review of instruments with a focus on their psychometric properties.

PURPOSE: To evaluate the psychometric properties of common health-related quality-of-life instruments used post stroke and provide recommendations for research and clinical use with this diagnostic group. METHODS: A systematic review of the psychometric properties of the five most commonly used quality-of-life measurement tools (EQ-5D, SF-36, SF-6D, AQoL, SS-QOL) was conducted. Electronic searches were performed in MEDLINE, CINAHL, and EMBASE on November 27th 2019. Two authors screened papers against the inclusion criteria and where consensus was not reached, a third author was consulted. Included papers were appraised using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist and findings synthesized to make recommendations. RESULTS: A total of n = 50,908 papers were screened and n = 45 papers reporting on 40 separate evaluations of psychometric properties met inclusion criteria (EQ-5D = 19, SF-36 = 16, SF-6D = 4, AQoL = 2, SS-QOL = 4). Studies reported varied psychometric quality of instruments, and results show that psychometric properties of quality-of-life instruments for the stroke population have not been well established. The strongest evidence was identified for the use of the EQ-5D as a quality-of-life assessment for adult stroke survivors. CONCLUSIONS: This systematic evaluation of the psychometric properties of self-reported quality-of-life instruments used with adults after stroke suggests that validity across tools should not be assumed. Clinicians and researchers alike may use findings to help identify the most valid and reliable measurement instrument for understanding the impact of stroke on patient-reported quality of life.

Initiating growth hormone therapy for children and adolescents.

It is common for children and adolescents on growth hormone (GH) treatment to miss one or more injections per week, thereby compromising their linear growth outcome. Among factors likely to affect treatment concordance are patient education and support in the selection of the most appropriate GH injection device. The authors discovered inconsistencies in the process of starting patients on GH therapy throughout the UK, and found that there were no clinical recommendations to support health professionals starting patients on treatment. This article describes the issues involved and the development of practical recommendations for use when starting paediatric patients on long-term GH therapy.

Mohs micrographic surgery: How ACMS fellowship directors practice.

BACKGROUND: Mohs micrographic surgery (MMS) is widely employed in the removal of skin cancer. As this technique becomes more widely employed, it is useful to establish the patterns of care provided by American College of Mohs Surgery (ACMS)-approved fellowship directors. OBJECTIVE: To compile and analyze data collected annually by the ACMS to determine practice patterns and trends in MMS as performed by ACMS-approved fellowship directors. MATERIALS AND METHODS: A retrospective study of case logs from 50 fellowship directors obtained from the ACMS detailing case volume, type of cancer treated, location, lesion size, wound size, number of stages, referral percentage, and type of repairs performed. RESULTS: Annual case volume per surgeon has increased linearly. The incidence of squamous cell carcinoma treated using MMS is rising steadily. The size of lesions treated using MMS has decreased slightly over several decades, as has the number of stages of MMS taken per lesion. The majority of MMS performed by fellowship directors is for skin cancer on the face. Dermatologic surgeons perform most of their own reconstructions. Academic and private fellowship practice patterns are nearly identical. CONCLUSIONS: ACMS-approved fellowship directors use MMS mainly for facial skin cancers, and they perform most of their own reconstructions. Practice patterns for most fellowship directors are similar. Private fellowships and academic fellowships are similar in scope and practice.

Guidelines for laser hair removal.

Requests for removal of unwanted body hair are common in dermatologic and surgical practices. Technology continues to improve the achievement of a more permanent reduction through the use of lasers. Despite the increased use of lasers, to date, few guidelines exist in terms of how to approach laser hair removal. Specifically, one must understand the mechanism of hair growth and how lasers work to target the hair follicle. There is significant variation among practitioners in pre-and post-laser recommendations to patients as well as intervals between treatment sessions. We performed a thorough review of the literature in order to determine evidence for the ideal interval between treatment sessions and the ideal number of sessions. We also sought to establish, based on published reports, the recommendations for shaving, plucking, waxing or other hair removal methods prior to laser hair removal and the guidelines for sun exposure before and after laser treatments. Finally, we searched the literature to find out whether there are areas that should not be treated with laser hair removal. The evidence and recommendations in this article aim to help guide practitioners in their approach to laser hair removal.

Ammonium removal using a vertically moving biofilm system.

Ammonium-nitrogen (NH4-N) removal using a vertically moving biofilm system was investigated at a temperature of 11 degrees C. The biofilms in this process were grown on biofilm modules, consisting of high surface area plastic media, which were vertically and repeatedly moved up into the air and down into the wastewater. The maximum NH4-N removal efficiency was up to 98.8% and the areal NH4-N removal rates, based on the surface area of the biofilm modules, were within the range of 0.68-1.94 g NH4-N m(-)2 day(-1). The kinetics of ammonium removal occurring after carbonaceous oxidation was completed can be simulated by using a zero-order empirical model. The ammonium removal rate was found to be proportional to the square root of the mass of biofilms on the modules. Monitoring DO concentrations in the bulk fluid showed that the vertically moving biofilm system possessed good aeration efficiency.