Dermatology Bulletin: Healthcare Library of Northern Ireland

Rhinoplasty is considered a very challenging surgery since minimal changes of this central area of the face may significantly impact a person's appearance and self-awareness. This is even more challenging in thick-skinned patients because results are less predictable, and changes to the osseocartilaginous framework (OCF) may not be sufficiently visible due to the blanket effect of the thick skin. Furthermore, pre-existing skin conditions may exacerbate following surgery. Therefore, managing patients with extremely thick skin or patients who suffer from pre-existing dermatological conditions such as rosacea or acne requires a synergy of surgeons and dermatologists to achieve optimal results...

Atopic dermatitis (AD) is a chronic disease related to skin disorders that affect individuals in their childhood and can persist or start in adulthood. Patients affected by this disease commonly show skin lesions on the body surface (mainly on the upper and lower limbs) and allergic rhinitis or asthma crises. Looking at the disease from a molecular perspective, the major cytokines involved in inflammatory skin diseases, not only AD, include IL-4, IL-17, IFN-γ and IL-10. Although they can produce these cytokines and infiltrate the affected epithelia in patients with AD, γδ T cells are still almost unexplored...

Climate change, fueled by increasing concentrations of greenhouse gases, is associated with rising temperatures, extreme weather events, increased aeroallergen production, and air pollution. Our understanding that many inflammatory cutaneous diseases carry important mental health comorbidities is expanding. Simultaneously, the detrimental impacts of climate change on human health are now widely recognized as a global public health crisis. Importantly, these climate-associated phenomena exacerbate the environmental triggers of atopic dermatitis (AD) and are also associated with amplification of comorbid mental health conditions in AD including depression, anxiety, trauma-related disorders, and psychotic spectrum disorders...

BACKGROUND: Epidermolysis bullosa (EB) is an inherited genodermatosis that results in mucocutaneous fragility. There is a lack of data on the impact of this disease on parents. There are no studies on the impact on siblings and few on healthcare professionals in dealing with this devastating disease. METHODS: A scoping review was performed using the Arksey and O'Malley and PRISMA-ScR framework. Twenty-seven articles were reviewed, and a data-charting sheet was formulated...

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Informed consent is a legal and ethical obligation of healthcare providers, and there are several steps that must be followed for informed consent to be obtained. Numerous challenges exist to obtaining informed consent including gaps in health literacy, language barriers, impaired decision-making capacity, and inadequacy of informed consent forms. Dermatologists must understand the importance and process for obtaining informed consent to protect patients as well as avoid litigation. This narrative review provides an overview of the process of obtaining informed consent, insight into the top challenges that clinicians may face with suggested recommendations, and a brief review of litigation from improper consent among dermatologists...

The 2022 mpox outbreak has rapidly emerged onto the global medical scene while the world continues to grapple with the COVID-19 pandemic. Unlike COVID-19, however, most patients with mpox present with skin findings, the evolving clinical presentation of which may be mistaken for other common skin diseases, particularly sexually transmitted infections. This Special Communication provides an overview of the evolution of mpox skin findings from its initial description in humans in 1970 to the present-day multinational outbreak...

Psoriasis is one of the most frequent skin diseases. The cause of psoriasis is not fully expained as there are many factors (infectious, traumatic, hormonal, and chemical) that may play a role in the manifestation of its symptoms. One of the factors that may contribute to the appearance of psoriatic lesions may be the lesions in the oral cavity. The occurrence of lesions in the oral cavity is defined as rare, what can be explained by their nonspecific clinical image, and also by the possibility of being overlooked...

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer, accounting for 20% of all skin cancers. The risk of the disease continues to rise annually with an estimated 50-200% increase in incidence within the last three decades. Although cSCC is one of the most common skin cancers, reported having 1 million cases per year in the United States, there is inconsistency with its reported metastatic rate. Research exploring cSCC metastasis found an overall rate of 1.2-5% but this range varies, and some dermatologists are finding cSCC's ability to spread more worrisome...

IMPORTANCE: Adherence, both in research trials and in clinical practice, is crucial to the success of interventions. There is limited guidance on strategies to increase adherence and the measurement and reporting of adherence in trials of melanoma self-management practices. OBJECTIVE: This scoping review aimed to describe (1) strategies to improve adherence to self-management practices in randomized clinical trials of people at high risk of melanoma and (2) measurement and reporting of adherence data in these trials...

IMPORTANCE: Various surgical approaches for hidradenitis suppurativa (HS) have been described in the literature, but the nomenclature is inconsistent. Excisions have been described as wide, local, radical, and regional with variable descriptions of margins. Deroofing procedures have been described with various approaches though descriptions of the approach are generally more uniform. No international consensus has been formed to globally standardize terminology for HS surgical procedures...

Despite reaching historical lows in the early 2000s, cases of both primary and secondary syphilis and congenital syphilis have increased dramatically in the U.S. over the last decade. In the U.S., the current syphilis epidemic is disproportionately impacting communities that have been historically underserved in medicine. These include men who have sex with men, especially those infected with HIV; people of color; and reproductive-age women with poor access to prenatal care. With syphilis now being more commonly diagnosed in non-STI than STI clinics in all genders, and since primary and secondary syphilis and congenital syphilis present with characteristic mucocutaneous manifestations, dermatologists are in a position to help reduce the advance of this preventable epidemic, by actively considering this diagnosis and incorporating syphilis screening into their practice...

Tranexamic acid is a plasmin inhibitor that is used off-label for the treatment of melasma. The use of tranexamic acid has expanded in the field of dermatology based on its anti-inflammatory and anti-melanin-producing properties, which include the treatment of rosacea, urticaria, and post-inflammatory hyperpigmentation. Tranexamic acid may have more uses in dermatology that require future studies. It should be used with caution during the COVID-19 pandemic given its procoagulant nature.

CONTEXT: The most reported viral co-infections in leprosy are human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV), hepatitis B virus (HBV), hepatitis C virus (HCV), and SARS-CoV-2. In co-infections, the burden of an agent can be increased or decreased by the presence of others. To address this issue, we need to fully understand their prevalence, risk factors, immunology, clinical manifestations, and treatment. The purpose of this scoping review is to describe the clinical and epidemiological characteristics of the most reported viral co-infections in leprosy to inform clinicians and guide future research...

IMPORTANCE: Antibiotics are an important risk for Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), which are the most severe types of drug hypersensitivity reaction with a mortality rate up to 50%. To our knowledge, no global systematic review has described antibiotic-associated SJS/TEN. OBJECTIVE: To evaluate the prevalence of antibiotics associated with SJS/TEN worldwide. DATA SOURCES: The MEDLINE and Embase databases were searched for experimental and observational studies that described SJS/TEN risks since database inception to February 22, 2022...