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1.
Dermatol Clin ; 39(4): 587-597, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556248

RESUMO

The impact of the COVID-19 pandemic on dermatology practice cannot be overstated. At its peak, the pandemic resulted in the temporary closure of ambulatory sites as resources were reallocated towards pandemic response efforts. Many outpatient clinics have since reopened and are beginning to experience a semblance of pre-pandemic routine, albeit with restrictions in place. We provide an overview of how COVID-19 has affected dermatology practice globally beginning with the rise of teledermatology. A summary of expert recommendations that shape the "new normal" in various domains of dermatology practice, namely, dermatology consultation, procedural dermatology, and phototherapy, is also provided.


Assuntos
Instituições de Assistência Ambulatorial/tendências , Dermatologia/normas , Atenção Primária à Saúde/tendências , Dermatopatias/terapia , Telemedicina/tendências , COVID-19/epidemiologia , Dermatologia/tendências , Acesso aos Serviços de Saúde/tendências , Humanos , Visita a Consultório Médico/tendências , Dermatopatias/epidemiologia
2.
Dermatol Clin ; 39(4): 599-608, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556249

RESUMO

The accelerated implementation and use of teledermatology during the coronavirus disease 2019 pandemic has met with successes and challenges. This review explores how telemedicine was used in dermatology before the pandemic, the regulatory adaptions made in response to the pandemic, and the effectiveness of the rapid implementation of teledermatology during the coronavirus disease 2019 pandemic, and, finally, how teledermatology has expanded in response to the pandemic. This review examines lessons learned and how teledermatology's reliance on digital technologies might paradoxically exacerbate health care disparities, and finally, considers the future outlook.


Assuntos
COVID-19/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Dermatopatias/diagnóstico , Dermatopatias/terapia , Telemedicina/estatística & dados numéricos , Dermatologia/organização & administração , Humanos , Consulta Remota/estatística & dados numéricos , Índice de Gravidade de Doença
3.
Dermatol Clin ; 39(4): 609-618, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556250

RESUMO

COVID-19 has created challenges across medicine, including in medical education, with deeply rooted impacts in the dermatology residency experience. Its effects are both acute and chronic, including: shifts to virtual education and conferences, skewed clinical experiences, negatively impacted wellness, and uncertainty in the future. As educators and mentors, it is important to recognize and address these issues so that we may remain transparent, adaptable, and engaged as we continue to build a better tomorrow for our resident trainees.


Assuntos
COVID-19/epidemiologia , Dermatologia/educação , Bolsas de Estudo/tendências , Internato e Residência/tendências , Administração dos Cuidados ao Paciente/tendências , Dermatopatias/terapia , Atitude do Pessoal de Saúde , Humanos , Percepção Social
4.
Dermatol Clin ; 39(4): 619-625, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556251

RESUMO

In this article, we discuss the impact of the COVID-19 pandemic on various areas of global health dermatology, including patient care, neglected tropical diseases, education, and collaborations. Information was collected from literature review and informal interviews with more than 20 dermatologists from around the world. Many of the setbacks and hardships experienced by the global health community in the last year highlight long-standing global interdependencies and systems that perpetuate ethnic, economic, and social inequalities on local and global scales. The pandemic has brought discussions on global health colonialism and domestic health inequality to the forefront.


Assuntos
COVID-19/epidemiologia , Dermatologia/tendências , Saúde Global , Disparidades nos Níveis de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Humanos , Dermatopatias/terapia , Problemas Sociais , Fatores Socioeconômicos
5.
Dermatol Clin ; 39(4): 639-651, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34556253

RESUMO

Coronavirus disease 2019 (COVID-19) brought the world to its knees. As each nation grappled with launching an effective response while simultaneously minimizing repercussions on health care systems, economies, and societies, the medical and scientific landscape shifted forever. In particular, COVID-19 has challenged and transformed the field of dermatology and the way we practice. In this article, dermatologists from 11 countries share insights gained from local experience. These global perspectives will help provide a better framework for delivering quality dermatologic care and understanding how the field has evolved during this medical crisis.


Assuntos
COVID-19/epidemiologia , Tomada de Decisão Clínica/métodos , Dermatologia/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Dermatopatias/terapia , Centros Médicos Acadêmicos , COVID-19/prevenção & controle , Humanos , Comunicação Interdisciplinar
6.
Cutis ; 108(1): E15-E21, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34397366

RESUMO

Identifying safe, effective, and affordable evidence-based dermatologic treatments for older adults can be challenging because of age-related changes. Few studies have examined the effectiveness of phototherapy in older adults. Our retrospective study of patients 65 years and older who were treated with narrowband UVB(NB-UVB) phototherapy aimed to (1) identify the most common dermatologic conditions treated with phototherapy in older adults, (2) examine the effectiveness and safety of phototherapy in older adults, and (3) compare the outcomes to 2 similar studies in the United Kingdom and Turkey.


Assuntos
Dermatopatias , Terapia Ultravioleta , Idoso , Humanos , Fototerapia , Estudos Retrospectivos , Dermatopatias/terapia , Resultado do Tratamento , Turquia
7.
Int J Mol Sci ; 22(15)2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34360634

RESUMO

Autophagy is an attractive process to researchers who are seeking novel potential treatments for various diseases. Autophagy plays a critical role in degrading damaged cellular organelles, supporting normal cell development, and maintaining cellular homeostasis. Because of the various effects of autophagy, recent human genome research has focused on evaluating the relationship between autophagy and a wide variety of diseases, such as autoimmune diseases, cancers, and inflammatory diseases. The skin is the largest organ in the body and provides the first line of defense against environmental hazards, including UV damage, chemical toxins, injuries, oxidative stress, and microorganisms. Autophagy takes part in endogenous defense mechanisms by controlling skin homeostasis. In this manner, regulating autophagy might contribute to the treatment of skin barrier dysfunctions. Various studies are ongoing to elucidate the association between autophagy and skin-related diseases in order to find potential therapeutic approaches. However, little evidence has been gathered about the relationship between autophagy and the skin. In this review, we highlight the previous findings of autophagy and skin barrier disorders and suggest potential therapeutic strategies. The recent research regarding autophagy in acne and skin aging is also discussed.


Assuntos
Autofagia , Dermatopatias/etiologia , Humanos , Terapia de Alvo Molecular , Permeabilidade , Pele/metabolismo , Dermatopatias/metabolismo , Dermatopatias/terapia
8.
J Med Virol ; 93(10): 5756-5767, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34241899

RESUMO

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.


Assuntos
COVID-19/complicações , Dermatopatias/etiologia , COVID-19/tratamento farmacológico , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/etiologia , Dermatite Ocupacional/patologia , Dermatite Ocupacional/terapia , Diagnóstico Diferencial , Erupção por Droga/diagnóstico , Erupção por Droga/etiologia , Erupção por Droga/patologia , Erupção por Droga/terapia , Humanos , Equipamento de Proteção Individual/efeitos adversos , SARS-CoV-2 , Dermatopatias/diagnóstico , Dermatopatias/patologia , Dermatopatias/terapia
9.
Int J Mol Sci ; 22(13)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34209467

RESUMO

DRESS/DiHS is a complex and potentially fatal drug reaction. Little is known about risk factors and elements that can help to identify patients with a severe reaction early. The aim of the study was to investigate those factors favoring the disease and its severity by analyzing the clinical conditions and therapies preceding the reaction. We conducted a retrospective analysis on patients admitted to our center between 2010 and 2020 who were discharged with a diagnosis of DRESS. We used the RegiSCAR diagnostic criteria. We defined the severity of DRESS using the criteria of Mizukawa et al. We included 25 patients (15 females) with a median age of 66 years. Skin involvement, eosinophilia, and liver injury were the most important aspects. Allopurinol was found to be the most involved drug. Reaction severity was significantly associated with the number of daily medications (p=0.0067) and an age of at least 68 years (p=0.013). In addition, 75% of severe cases had at least three comorbidities in history, and most of the severe cases were female. In our study the advanced age, the high number of comorbidities and home therapies, and the inflammatory state were found to be predisposing elements to the development of the disease and its severity.


Assuntos
Síndrome de Hipersensibilidade a Medicamentos , Eosinofilia , Índice de Gravidade de Doença , Dermatopatias , Idoso , Comorbidade , Síndrome de Hipersensibilidade a Medicamentos/epidemiologia , Síndrome de Hipersensibilidade a Medicamentos/terapia , Eosinofilia/epidemiologia , Eosinofilia/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Dermatopatias/epidemiologia , Dermatopatias/terapia
11.
Health Expect ; 24(5): 1582-1592, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34190397

RESUMO

BACKGROUND: The COVID-19 pandemic has accelerated the adoption of telemedicine, including teledermatology. Monitoring skin lesions using teledermatology may become increasingly important for several skin diseases, including low-risk skin cancers. The purpose of this study was to describe the key factors that could serve as barriers or facilitators to skin disease monitoring using mobile health technology (mHealth) in older adults. METHODS: Older adult dermatology patients 65 years or older and their caregivers who have seen a dermatologist in the last 18 months were interviewed and surveyed between December 2019 and July 2020. The purpose of these interviews was to better understand attitudes, beliefs and behaviours that could serve as barriers and facilitators to the use of mHealth and active surveillance to monitor low-risk skin cancers. RESULTS: A total of 33 interviews leading to 6022 unique excerpts yielded 8 factors, or themes, that could serve as barriers, facilitators or both to mHealth and active surveillance. We propose an integrated conceptual framework that highlights the interaction of these themes at both the patient and provider level, including care environment, support systems and personal values. DISCUSSION AND CONCLUSIONS: These preliminary findings reveal factors influencing patient acceptance of active surveillance in dermatology, such as changes to the patient-provider interaction and alignment with personal values. These factors were also found to influence adoption of mHealth interventions. Given such overlap, it is essential to address barriers and facilitators from both domains when designing a new dermatology active surveillance approach with novel mHealth technology. PATIENT OR PUBLIC CONTRIBUTION: The patients included in this study were participants during the data collection process. Members of the Stanford Healthcare and Denver Tech Dermatology health-care teams aided in the recruitment phase of the data collection process.


Assuntos
COVID-19 , Dermatopatias , Telemedicina , Idoso , Atenção à Saúde , Humanos , Pandemias , SARS-CoV-2 , Dermatopatias/diagnóstico , Dermatopatias/terapia , Conduta Expectante
12.
Biochimie ; 188: 35-44, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34097985

RESUMO

Skin is the most vulnerable organ of the human body since it is the first line of defense, covering the entire external body surface. Additionally, skin has a critical role in thermoregulation, sensation, immunological surveillance, and biochemical processes such as Vitamin D3 production by ultraviolet irradiation. The ability of the skin layers and resident cells to maintain skin physiology, such as hydration, regulation of keratinocytes proliferation and differentiation and wound healing, is supported by key proteins such as aquaporins (AQPs) that facilitate the movements of water and small neutral solutes across membranes. Various AQP isoforms have been detected in different skin-resident cells where they perform specific roles, and their dysregulation has been associated with several skin pathologies. This review summarizes the current knowledge of AQPs involvement in skin physiology and pathology, highlighting their potential as druggable targets for the treatment of skin disorders.


Assuntos
Aquaporinas/fisiologia , Dermatopatias/fisiopatologia , Dermatopatias/terapia , Pele/metabolismo , Animais , Aquaporinas/efeitos dos fármacos , Glicerol/metabolismo , Humanos , Terapia de Alvo Molecular , Isoformas de Proteínas/efeitos dos fármacos , Isoformas de Proteínas/fisiologia , Água/metabolismo
14.
Cutis ; 107(4): E37-E39, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34096860

RESUMO

The COVID-19 pandemic resulted in profound changes to most facets of medical practice. The field of dermatology has adapted by rapidly incorporating teledermatology as a means of evaluating, treating, and staying connected with our patients. Broader dermatology access, convenience to patients, and value to payers are benefits to this rapidly evolving practice model and suggest that teledermatology will be a part of day-to-day practice even as the worst of the pandemic is behind us. This interview provides one recent dermatology resident graduate's experiences incorporating teledermatology into his practice model and provides advice for future residents on preparing to do the same.


Assuntos
COVID-19/prevenção & controle , Consulta Remota/métodos , Dermatopatias/terapia , Telemedicina/métodos , COVID-19/epidemiologia , Dermatologia/normas , Humanos
15.
Chem Commun (Camb) ; 57(53): 6507-6510, 2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34105530

RESUMO

We applied a new in silico approach for using protease-substrate motifs to design a kallikrein 7 (KLK7)-specific phosphonate activity-based probe (ABP) to quantify the active KLK7 in situ. Epidermal application of the ABP-inhibitor on Spink5-/-Klk5-/- mice, a Netherton syndrome model, reversed disease hallmarks, providing preclinical proof-of-concept for using ABPs as theranostics.


Assuntos
Simulação por Computador , Calicreínas/metabolismo , Sondas Moleculares/metabolismo , Dermatopatias/diagnóstico , Dermatopatias/terapia , Dermatopatias/metabolismo
16.
Acta Derm Venereol ; 101(9): adv00540, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34043017

RESUMO

Most teledermatology studies focus on patients' satisfaction; fewer focus on the experiences of healthcare professionals. This qualitative study explored healthcare professionals' perceptions of teledermatology used for linking public primary care clinics with the specialist dermatology centre in Singapore. Semi-structured in-depth interviews were conducted with 25 family physicians and dermatologists. Six themes were identified: satisfaction with the service; perceived patient benefits; rationale for introducing teledermatology; educational impact; challenges of virtual consultations; and desirable service refinements for the future. Family physicians and dermatologists were positive about the service, but highlighted a need to streamline referral processes and improve the quality of transmitted images. Reduced need for referral to the specialist centre could be achieved by expanding the polyclinic's pharmacopoeia and treatment modalities. This study highlights the benefits of telemedicine for patient, professionals, and healthcare organizations, and these are reassuring given the widespread and rapid introduction of telemedicine through necessity during the COVID-19 pandemic.


Assuntos
COVID-19 , Dermatologia , Dermatopatias , Humanos , Pandemias , Médicos de Família , Atenção Primária à Saúde , SARS-CoV-2 , Singapura/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/terapia , Especialização
17.
Biochem Biophys Res Commun ; 561: 113-119, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34022711

RESUMO

microRNAs have been shown to be associated with the development of skin fibrosis. Therefore, miRNA modulators play an important role in the management of cutaneous fibrotic diseases and are worthy of investigation. However, a major obstacle of miRNAs therapy is to deliver miRNAs to target cell types, tissues or organs. The study reported here investigated the effects of miR-16-5p delivery by keratinocytes-derived exosomes on skin fibrosis in the bleomycin (BLM)-treated mice. In results, miR-16-5p-overexpressing keratinocytes-derived exosomes significantly suppressed the enhancing effects of TGF-ß1 on proliferation, migration and COL1A1 expression of fibroblasts. Moreover, we found that miR-16-5p-overexpressing keratinocytes-derived exosomes inhibited the endogenous Smad3 expression. In vivo, subcutaneously injected of miR-16-5p-overexpressing keratinocytes-derived exosomes significantly enhanced miR-16-5p expression in the skin compared with the control group, while suppressing BLM-induced skin fibrosis with reduced dermal thickening and lower COL1A1 expression. In conclusion, our results suggest that the localized delivery of miR-16-5p by keratinocytes-derived exosomes may have potential for efficient clinical treatment of skin fibrosis.


Assuntos
Bleomicina/toxicidade , Exossomos , Fibroblastos/metabolismo , Queratinócitos/metabolismo , MicroRNAs/administração & dosagem , Dermatopatias/terapia , Animais , Antibióticos Antineoplásicos/toxicidade , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Modelos Animais de Doenças , Feminino , Fibrose , Humanos , Camundongos , Camundongos Endogâmicos BALB C , MicroRNAs/biossíntese , MicroRNAs/genética , Dermatopatias/induzido quimicamente , Dermatopatias/genética , Dermatopatias/patologia , Fator de Crescimento Transformador beta1/metabolismo
18.
J Dtsch Dermatol Ges ; 19(5): 720-741, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33938626

RESUMO

Occupational dermatoses are among the most common occupational diseases, with BK 5101 accounting for the largest proportion. Historically, the latter was also the most frequently reported group of occupational diseases within the working age population. More than 80,000 suspected cases of occupational diseases were notified in 2019, of which 19,883 related to BK 5101. In Germany, work-related hand eczema accounts for 90 % of all BK 5101 diseases, and consists mainly of contact eczema. Especially young people working in the hairdressing sector, health care, metal, food or construction industries belong to the high-risk group. Diagnosis, therapy and prevention of BK 5101 play an important role, since advanced skin diseases are usually accompanied by a poor prognosis and long periods of inability to work, which can have considerable socio-economic consequences. On January 1st , 2021, with the "Seventh Act amending the Fourth Book of the German Social Code (SGB) and other Laws", an amendment to the Occupational Diseases Law came into force, with which the obligation to cease work was abolished, thereby fulfilling a decades-long requirement for recognition of BK 5101. As of this year, only the "severe or repeated recurrences" of a skin disease remain as a criterion for the occurrence of an insured event, which will likely result in an increased number of notifications and acknowledged cases of occupational skin diseases.


Assuntos
Dermatite de Contato , Dermatite Ocupacional , Eczema , Dermatoses da Mão , Doenças Profissionais , Dermatopatias , Adolescente , Dermatite Ocupacional/diagnóstico , Alemanha , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/terapia
20.
Indian J Dermatol Venereol Leprol ; 87(5): 603-610, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969653

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is implicated in the ongoing pandemic across the globe since December 2019. It was first notified by China from Wuhan on 31 December 2020 and transmission to healthcare workers was first reported on 20 January 2020. Human-to-human transmission is mainly by droplet infection. At present no effective vaccine is available. Our speciality needs to collectively address the urgent issue of risk of transmission in dermatology practice. A case series of Coronavirus Disease 2019 (COVID-19) from Wuhan described that 41.3% of their patients may have acquired the infection from the hospital. Of all the infected health care workers, 77.5% worked in general wards and departments. These data highlight the significant risk of nosocomial transmission of COVID-19 and also the higher risk in general wards and departments compared to the emergency room or intensive care unit. Dermatology patients are generally seen in clinics and in outpatient departments in hospitals. Patients wait together in the waiting area, intermingle and then are seen by the physician in their chamber. This can cause transmission of the pathogen among patients and from patient to physician. Social distancing, hand hygiene and the use of personal protective equipment are important for preventing the spread of infection and dermatology practices also have to incorporate these aspects. Telemedicine is becoming an important tool for the management of dermatology patients in these times. At-risk patients in dermatology also need to be given priority care. Protocols for the use of immunosuppressants and biologics in dermatology during the pandemic are being developed.


Assuntos
COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Dermatologia/organização & administração , Dermatopatias/terapia , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Produtos Biológicos/uso terapêutico , COVID-19/transmissão , Infecção Hospitalar/transmissão , Humanos , Imunossupressores/uso terapêutico , Índia , Fatores de Risco , SARS-CoV-2 , Dermatopatias/complicações , Dermatopatias/diagnóstico , Telemedicina/legislação & jurisprudência , Vacinação , Salas de Espera
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