TY - JOUR AU - Brehmer, Alexander AU - Seibold, Constantin AU - Egger, Jan AU - Majjouti, Khalid AU - Tapp-Herrenbrück, Michaela AU - Pinnekamp, Hannah AU - Priester, Vanessa AU - Aleithe, Michael AU - Fischer, Uli AU - Hosters, Bernadette AU - Kleesiek, Jens PY - 2025/5/1 TI - Fine-Grained Classification of Pressure Ulcers and Incontinence-Associated Dermatitis Using Multimodal Deep Learning: Algorithm Development and Validation Study JO - JMIR AI SP - e67356 VL - 4 KW - computer vision KW - image classification KW - wound classification KW - deep learning KW - pressure ulcer KW - incontinence-associated dermatitis KW - multi modal data KW - synthetic image generation N2 - Background: Pressure ulcers (PUs) and incontinence-associated dermatitis (IAD) are prevalent conditions in clinical settings, posing significant challenges due to their similar presentations but differing treatment needs. Accurate differentiation between PUs and IAD is essential for appropriate patient care, yet it remains a burden for nursing staff and wound care experts. Objective: This study aims to develop and introduce a robust multimodal deep learning framework for the classification of PUs and IAD, along with the fine-grained categorization of their respective wound severities, to enhance diagnostic accuracy and support clinical decision-making. Methods: We collected and annotated a dataset of 1555 wound images, achieving consensus among 4 wound experts. Our framework integrates wound images with categorical patient data to improve classification performance. We evaluated 4 models?2 convolutional neural networks and 2 transformer-based architectures?each with approximately 25 million parameters. Various data preprocessing strategies, augmentation techniques, training methods (including multimodal data integration, synthetic data generation, and sampling), and postprocessing approaches (including ensembling and test-time augmentation) were systematically tested to optimize model performance. Results: The transformer-based TinyViT model achieved the highest performance in binary classification of PU and IAD, with an F1-score (harmonic mean of precision and recall) of 93.23%, outperforming wound care experts and nursing staff on the test dataset. In fine-grained classification of wound categories, the TinyViT model also performed best for PU categories with an F1-score of 75.43%, while ConvNeXtV2 showed superior performance in IAD category classification with an F1-score of 53.20%. Incorporating multimodal data improved performance in binary classification but had less impact on fine-grained categorization. Augmentation strategies and training techniques significantly influenced model performance, with ensembling enhancing accuracy across all tasks. Conclusions: Our multimodal deep learning framework effectively differentiates between PUs and IAD, achieving high accuracy and outperforming human wound care experts. By integrating wound images with categorical patient data, the model enhances diagnostic precision, offering a valuable decision-support tool for health care professionals. This advancement has the potential to reduce diagnostic uncertainty, optimize treatment pathways, and alleviate the burden on medical staff, leading to faster interventions and improved patient outcomes. The framework?s strong performance suggests practical applications in clinical settings, such as integration into hospital electronic health record systems or mobile applications for bedside diagnostics. Future work should focus on validating real-world implementation, expanding dataset diversity, and refining fine-grained classification capabilities to further enhance clinical utility. UR - https://ai.jmir.org/2025/1/e67356 UR - http://dx.doi.org/10.2196/67356 ID - info:doi/10.2196/67356 ER - TY - JOUR AU - Liu, Xu AU - Guo, Linghong AU - Jiang, Xian PY - 2025/2/18 TI - Use of Clinical Public Databases in Hidradenitis Suppurativa Research JO - Interact J Med Res SP - e70282 VL - 14 KW - hidradenitis suppurativa KW - clinical public databases KW - disease progression KW - patient data KW - HS UR - https://www.i-jmr.org/2025/1/e70282 UR - http://dx.doi.org/10.2196/70282 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/70282 ER - TY - JOUR AU - Willem, Theresa AU - Wollek, Alessandro AU - Cheslerean-Boghiu, Theodor AU - Kenney, Martha AU - Buyx, Alena PY - 2025/1/28 TI - The Social Construction of Categorical Data: Mixed Methods Approach to Assessing Data Features in Publicly Available Datasets JO - JMIR Med Inform SP - e59452 VL - 13 KW - machine learning KW - categorical data KW - social context dependency KW - mixed methods KW - dermatology KW - dataset analysis N2 - Background: In data-sparse areas such as health care, computer scientists aim to leverage as much available information as possible to increase the accuracy of their machine learning models? outputs. As a standard, categorical data, such as patients? gender, socioeconomic status, or skin color, are used to train models in fusion with other data types, such as medical images and text-based medical information. However, the effects of including categorical data features for model training in such data-scarce areas are underexamined, particularly regarding models intended to serve individuals equitably in a diverse population. Objective: This study aimed to explore categorical data?s effects on machine learning model outputs, rooted the effects in the data collection and dataset publication processes, and proposed a mixed methods approach to examining datasets? data categories before using them for machine learning training. Methods: Against the theoretical background of the social construction of categories, we suggest a mixed methods approach to assess categorical data?s utility for machine learning model training. As an example, we applied our approach to a Brazilian dermatological dataset (Dermatological and Surgical Assistance Program at the Federal University of Espírito Santo [PAD-UFES] 20). We first present an exploratory, quantitative study that assesses the effects when including or excluding each of the unique categorical data features of the PAD-UFES 20 dataset for training a transformer-based model using a data fusion algorithm. We then pair our quantitative analysis with a qualitative examination of the data categories based on interviews with the dataset authors. Results: Our quantitative study suggests scattered effects of including categorical data for machine learning model training across predictive classes. Our qualitative analysis gives insights into how the categorical data were collected and why they were published, explaining some of the quantitative effects that we observed. Our findings highlight the social constructedness of categorical data in publicly available datasets, meaning that the data in a category heavily depend on both how these categories are defined by the dataset creators and the sociomedico context in which the data are collected. This reveals relevant limitations of using publicly available datasets in contexts different from those of the collection of their data. Conclusions: We caution against using data features of publicly available datasets without reflection on the social construction and context dependency of their categorical data features, particularly in data-sparse areas. We conclude that social scientific, context-dependent analysis of available data features using both quantitative and qualitative methods is helpful in judging the utility of categorical data for the population for which a model is intended. UR - https://medinform.jmir.org/2025/1/e59452 UR - http://dx.doi.org/10.2196/59452 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/59452 ER - TY - JOUR AU - Zvulunov, Alex AU - Lenevich, Stepan AU - Migacheva, Natalia PY - 2025/1/22 TI - Mobile Health App as an Auxiliary Tool in Management of Atopic Dermatitis in Children: Randomized Controlled Trial JO - JMIR Dermatol SP - e60479 VL - 8 KW - atopic dermatitis KW - skin KW - disease management KW - children KW - pediatric KW - feasibility KW - mHealth KW - mobile health KW - app KW - eczema KW - Atopic App KW - dermatology N2 - Background: Mobile health apps can boost treatment adherence and support disease management at home. The Atopic App and web-based Atopic School patient education program offer a chance to enhance adherence to atopic dermatitis (AD) management. Objective: We aim to evaluate the feasibility, acceptability, and preliminary efficacy of the Atopic App mobile health intervention in the managing of AD in children. Methods: A randomized controlled study in children with AD divided participants into 3 groups: a control group (no app), an observational group with the app, and an interventional group with investigator supervision. Patients were examined at screening and follow-up visits 1 and 2 at 3-month intervals. Outcome measures included SCORAD (Scoring Atopic Dermatitis) for objective severity and Patient-Oriented Eczema Measure (POEM) for subjective effectiveness. Statistical analysis used paired t tests (2-tailed), the Mann-Whitney U test, and multiple regression. Results: Fifty-eight participants entered this study (38 boys and 20 girls): group 1 (control) comprised 17 patients, while experimental groups 2 and 3 consisted of 20 and 21 patients, respectively. The rates of missed appointments were similar and statistically insignificant across the groups. All groups showed a significant decrease in SCORAD and POEM scores (P<.05). Usage of the app for ?8 days showed a more significant decrease in severity scores compared to those who used it for ?7 days, or did not use it at all. Participants who used the app for ?8 days had a median SCORAD of 6.25 (95% CI 4.6?14.1; IQR 4-16.3) at visit 1, significantly lower than nonusers (17.9, 95% CI 13.9?24.0; IQR 13.9-24; P=.03) and those using it ?7 days (13, 95% CI 9.35?27; IQR 7.2-27; P=.04). Their median POEM of 2 (95% CI 1.0?4.5; IQR 1-5.3) was also significantly lower than those using the app ?7 days (9, 95% CI 2?12; IQR 2-12; P=.04) and lower, though not significantly, than nonusers (7, 95% CI 1?9; IQR 1-9; P=.14). Additionally, using the Atopic App for ?8 days after the screening visit strongly predicted a decrease in both SCORAD and POEM scores (P=.01 and P=.04, respectively). The time since the screening visit significantly predicted increased outcome scores, while prescriptions of topical calcineurin inhibitors, oral antihistamines, and oral antibiotics were weak and insignificant predictors of score changes. Conclusions: Our findings indicate that the Atopic App is helpful tool in managing AD in children, and they underscore the potential of mobile health interventions in the disease management. Trial Registration: ClinicalTrials.gov NCT06412094; https://clinicaltrials.gov/study/NCT06412094 UR - https://derma.jmir.org/2025/1/e60479 UR - http://dx.doi.org/10.2196/60479 ID - info:doi/10.2196/60479 ER - TY - JOUR AU - Bruch, Aimee AU - Weigandt, Wanja AU - Schardt, Yannic AU - Herr, Raphael AU - Benecke, Johannes AU - Schmieder, Astrid PY - 2025/1/21 TI - Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App JO - J Med Internet Res SP - e52159 VL - 27 KW - hand and foot eczema KW - eHealth KW - mHealth KW - teledermatology KW - telemedicine KW - disease management KW - smartphone application KW - mental health KW - eczema KW - clinical outcome KW - quality of life KW - dermatology KW - pain KW - motor skills KW - educational KW - support KW - mobile phone N2 - Background: Hand and foot eczema is a frequent chronic dermatological condition. The persistent itching, pain, and blistering can impair hand and foot function, leading to difficulties in performing tasks requiring fine motor skills. In addition, the impact on the quality of life for affected patients is significant, as the symptoms can be extremely uncomfortable and disruptive to daily activities. By incorporating digital health apps and educational programs into the management of hand and foot eczema, patients may receive ongoing support, optimize their clinical outcomes, and ultimately enhance their overall quality of life. Objective: The purpose of this study was to evaluate the effect of a smartphone app combined with educational training on the clinical outcomes and mental health of patients with chronic hand and foot eczema during a 60-week study period. Methods: Patients in the intervention group participated in an educational program focused on chronic hand and foot eczema at baseline and had in-person visits at weeks 0, 12, 24, 36, and 60, as well as access to our study smartphone app. The app allowed patients to upload pictures of their hands and feet and answer questions about pain severity, itching, mood, and quality of life. A chat function was also available for patients to contact their dermatologist. The control group received only the in-person study visits described above. Results: A total of 87 patients were included in the study and randomized to the intervention (n=43) or control (n=44) groups. In total, 23 patients from the intervention group and 34 patients from the control group completed the study. Throughout the 60-week study period, a significant reduction in Hand Eczema Severity Index (HECSI) was consistently observed in all patients (week 60: linear regression coefficient [Coef]=?1.108; P?.001). A trend toward a greater improvement of the HECSI in the intervention group compared to the control group was noticed (week 60: Coef=0.597; P=.05). Subgroup analysis revealed that patients who used the app with a usage frequency of less than 20% demonstrated a significant reduction in the HECSI from week 0 to week 60 (week 60: Coef=?1.275; P=.04) and a significant reduction in the Dermatology Life Quality Index (week 60: Coef=?1.246; P=.04) compared to the control group. We were able to demonstrate a significant correlation between the HECSI calculated based on pictures uploaded by patients through the app and the HECSI assessed during personal visits (?=0.885; P<.001), despite the potentially lower image quality of the pictures uploaded through the app. Conclusions: This study provides further evidence that digital health apps can provide valuable support in improving patient clinical outcomes and management, especially as the app-based assessment of hand and feed images appears to be reliable. Trial Registration: Deutsches Register Klinischer Studien DRKS00020963; https://drks.de/search/de/trial/DRKS00020963 UR - https://www.jmir.org/2025/1/e52159 UR - http://dx.doi.org/10.2196/52159 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/52159 ER - TY - JOUR AU - Varghese, Johny Kevin AU - Singh, Som AU - Kamali, Emily AU - Qureshi, Fahad AU - Jamal, Aleena AU - Qureshi, Fawad PY - 2025/1/6 TI - Modern Digital Query Analytics of Patient Education Materials on Acanthosis Nigricans: Systematic Search and Content Analysis JO - JMIR Dermatol SP - e60210 VL - 8 KW - acanthosis nigricans KW - dermatology KW - patient education KW - public health KW - skin KW - readability KW - information resource KW - DISCERN KW - general public KW - reading level KW - information seeking KW - information behavior N2 - Background: Online digital materials are integral to patient education and health care outcomes in dermatology. Acanthosis nigricans (AN) is a common condition, often associated with underlying diseases such as insulin resistance. Patients frequently search the internet for information related to this cutaneous finding. To our knowledge, the quality of online educational materials for AN has not been systematically examined. Objective: The primary objective of this study was to profile the readability and quality of the content of publicly available digital educational materials on AN and identify questions frequently asked by patients. Methods: This study analyzed publicly available internet sources to identify the most frequent questions searched by patients regarding AN using the Google Rankbrain algorithm. Furthermore, available articles on AN were evaluated for quality and reading level using metrics such as the Brief DISCERN score, and readability was determined using three specific scales including the Flesch-Kincaid score, Gunning Fog index, and the Coleman-Liau index, based on literature. Results: Patients most frequently accessed facts on AN from government sources, which comprised 30% (n=15) of the analyzed sources. The available articles did not meet quality standards and were at a reading level not appropriate for the general public. The majority of articles (n=29/50, 58%) had substandard Brief DISCERN scores, failing to meet the criteria for good quality. Conclusions: Clinicians should be aware of the paucity of valuable online educational material on AN and educate their patients accordingly. UR - https://derma.jmir.org/2025/1/e60210 UR - http://dx.doi.org/10.2196/60210 ID - info:doi/10.2196/60210 ER - TY - JOUR AU - Wang, Wei AU - Chen, Xiang AU - Xu, Licong AU - Huang, Kai AU - Zhao, Shuang AU - Wang, Yong PY - 2024/12/27 TI - Artificial Intelligence?Aided Diagnosis System for the Detection and Classification of Private-Part Skin Diseases: Decision Analytical Modeling Study JO - J Med Internet Res SP - e52914 VL - 26 KW - artificial intelligence-aided diagnosis KW - private parts KW - skin disease KW - knowledge graph KW - dermatology KW - classification KW - artificial intelligence KW - AI KW - diagnosis N2 - Background: Private-part skin diseases (PPSDs) can cause a patient?s stigma, which may hinder the early diagnosis of these diseases. Artificial intelligence (AI) is an effective tool to improve the early diagnosis of PPSDs, especially in preventing the deterioration of skin tumors in private parts such as Paget disease. However, to our knowledge, there is currently no research on using AI to identify PPSDs due to the complex backgrounds of the lesion areas and the challenges in data collection. Objective: This study aimed to develop and evaluate an AI-aided diagnosis system for the detection and classification of PPSDs: aiding patients in self-screening and supporting dermatologists? diagnostic enhancement. Methods: In this decision analytical modeling study, a 2-stage AI-aided diagnosis system was developed to classify PPSDs. In the first stage, a multitask detection network was trained to automatically detect and classify skin lesions (type, color, and shape). In the second stage, we proposed a knowledge graph based on dermatology expertise and constructed a decision network to classify seven PPSDs (condyloma acuminatum, Paget disease, eczema, pearly penile papules, genital herpes, syphilis, and Bowen disease). A reader study with 13 dermatologists of different experience levels was conducted. Dermatologists were asked to classify the testing cohort under reading room conditions, first without and then with system support. This AI-aided diagnostic study used the data of 635 patients from two institutes between July 2019 and April 2022. The data of Institute 1 contained 2701 skin lesion samples from 520 patients, which were used for the training of the multitask detection network in the first stage. In addition, the data of Institute 2 consisted of 115 clinical images and the corresponding medical records, which were used for the test of the whole 2-stage AI-aided diagnosis system. Results: On the test data of Institute 2, the proposed system achieved the average precision, recall, and F1-score of 0.81, 0.86, and 0.83, respectively, better than existing advanced algorithms. For the reader performance test, our system improved the average F1-score of the junior, intermediate, and senior dermatologists by 16%, 7%, and 4%, respectively. Conclusions: In this study, we constructed the first skin-lesion?based dataset and developed the first AI-aided diagnosis system for PPSDs. This system provides the final diagnosis result by simulating the diagnostic process of dermatologists. Compared with existing advanced algorithms, this system is more accurate in identifying PPSDs. Overall, our system can not only help patients achieve self-screening and alleviate their stigma but also assist dermatologists in diagnosing PPSDs. UR - https://www.jmir.org/2024/1/e52914 UR - http://dx.doi.org/10.2196/52914 UR - http://www.ncbi.nlm.nih.gov/pubmed/39729353 ID - info:doi/10.2196/52914 ER - TY - JOUR AU - Kamat, Samir AU - Agarwal, Aneesh AU - Lavin, Leore AU - Verma, Hannah AU - Martin, Lily AU - Lipoff, B. Jules PY - 2024/12/13 TI - Dermatology in Student-Run Clinics in the United States: Scoping Review JO - JMIR Dermatol SP - e59368 VL - 7 KW - dermatology KW - dermatologist KW - dermatological KW - volunteerism KW - underserved population KW - medical education KW - student-run clinic KW - scoping review KW - review KW - PRISMA N2 - Background: Student-run clinics (SRCs) for dermatology hold potential to significantly advance skin-related health equity, and a comprehensive analysis of these clinics may inform strategies for optimizing program effectiveness. Objective: We aimed to perform a scoping review of the literature about dermatology SRCs across the United States. Methods: We conducted systematic literature searches of Ovid MEDLINE, Ovid Embase, and Scopus on March 1, 2023, and June 19, 2024. No date, language, or paper-type restrictions were included in the search strategy. A total of 229 references were uploaded to Covidence for screening by 2 independent reviewers (SK and LL), and 23 full-text documents were assessed for eligibility. After an additional 8 documents were identified through a gray literature search, a total of 31 studies were included in the final analysis. Inclusion criteria were as follows: (1) studies set in an SRC, which was operationally led by medical students and could render condition-relevant treatments to patients, with dermatology care; (2) published in English; (3) within the United States; (4) included characterization of any of the following: logistics, care, patients, or design; and (5) included all study or document types, including gray literature that was not peer reviewed (eg, conference abstracts, preprints, and letters to the editor). Exclusion criteria were (1) papers not published in English and (2) those with duplicated data or that were limited in scope or not generalizable. Data were extracted qualitatively using Microsoft Excel to categorize the studies by several domains, including clinic location, demographics, services offered, and barriers to care. Results: There are at least 19 dermatology SRCs across the United States. The most common conditions encountered included atopic dermatitis; acne; fungal infections; benign nevi; psoriasis; and neoplasms, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Key facilitators for the clinics included faculty oversight, attending physician participation for biopsy histopathology, and dedicated program coordinators. Major barriers included lack of follow-up, medication nonadherence, and patient no-shows. Conclusions: Dermatology SRCs serve a diverse patient population, many of whom are underrepresented in traditional dermatology settings. This scoping review provides insights to help build stronger program foundations that better address community dermatologic health needs. UR - https://derma.jmir.org/2024/1/e59368 UR - http://dx.doi.org/10.2196/59368 ID - info:doi/10.2196/59368 ER - TY - JOUR AU - Belizario, Isabel Maria AU - Gatmaitan, Garcia Julius AU - Dayrit, Johannes PY - 2024/11/29 TI - Lichen Planus Pigmentosus and Vitiligo in a 61-Year-Old Filipino Man: Case Report JO - JMIR Dermatol SP - e50401 VL - 7 KW - lichen planus pigmentosus KW - vitiligo KW - autoimmune KW - isotretinoin KW - tacrolimus KW - skin KW - melanin KW - hyperpigmentation KW - LPP UR - https://derma.jmir.org/2024/1/e50401 UR - http://dx.doi.org/10.2196/50401 ID - info:doi/10.2196/50401 ER - TY - JOUR AU - Coican, Alexis AU - Marroquin, A. Nathaniel AU - Carboni, Alexa AU - Holt, Sara AU - Zueger, Morgan PY - 2024/11/13 TI - How Dermatologists Can Aid Nondermatologic Professionals Using the Figure 1 App: Case Analysis JO - JMIR Dermatol SP - e60500 VL - 7 KW - dermatology KW - app KW - nondermatologic professional KW - dermatologist KW - nondermatologist KW - mHealth KW - health professional KW - medical education KW - social media KW - treatment KW - diagnostic UR - https://derma.jmir.org/2024/1/e60500 UR - http://dx.doi.org/10.2196/60500 ID - info:doi/10.2196/60500 ER - TY - JOUR AU - Haight, Macy AU - Jacobs, R. Hayden AU - Boltey, K. Sarah AU - Murray, A. Kelly AU - Hartwell, Micah PY - 2024/10/31 TI - US Public Interest in Merkel Cell Carcinoma Following Jimmy Buffett?s Death and Implications for Continued Health Advocacy: Infodemiology Study of Google Trends JO - JMIR Dermatol SP - e60282 VL - 7 KW - skin cancer KW - merkel cell carcinoma KW - infodemiology KW - cancer KW - carcinoma KW - cell carcinoma KW - sunlight KW - infodemiology study KW - Google Trends KW - temporal analysis KW - United States KW - USA KW - sun UR - https://derma.jmir.org/2024/1/e60282 UR - http://dx.doi.org/10.2196/60282 ID - info:doi/10.2196/60282 ER - TY - JOUR AU - Barlow, Richard AU - Bewley, Anthony AU - Gkini, Angeliki Maria PY - 2024/10/16 TI - AI in Psoriatic Disease: Scoping Review JO - JMIR Dermatol SP - e50451 VL - 7 KW - artificial intelligence KW - machine learning KW - psoriasis KW - psoriatic arthritis KW - psoriatic disease KW - biologics KW - prognostic models KW - mobile phone N2 - Background: Artificial intelligence (AI) has many applications in numerous medical fields, including dermatology. Although the majority of AI studies in dermatology focus on skin cancer, there is growing interest in the applicability of AI models in inflammatory diseases, such as psoriasis. Psoriatic disease is a chronic, inflammatory, immune-mediated systemic condition with multiple comorbidities and a significant impact on patients? quality of life. Advanced treatments, including biologics and small molecules, have transformed the management of psoriatic disease. Nevertheless, there are still considerable unmet needs. Globally, delays in the diagnosis of the disease and its severity are common due to poor access to health care systems. Moreover, despite the abundance of treatments, we are unable to predict which is the right medication for the right patient, especially in resource-limited settings. AI could be an additional tool to address those needs. In this way, we can improve rates of diagnosis, accurately assess severity, and predict outcomes of treatment. Objective: This study aims to provide an up-to-date literature review on the use of AI in psoriatic disease, including diagnostics and clinical management as well as addressing the limitations in applicability. Methods: We searched the databases MEDLINE, PubMed, and Embase using the keywords ?AI AND psoriasis OR psoriatic arthritis OR psoriatic disease,? ?machine learning AND psoriasis OR psoriatic arthritis OR psoriatic disease,? and ?prognostic model AND psoriasis OR psoriatic arthritis OR psoriatic disease? until June 1, 2023. Reference lists of relevant papers were also cross-examined for other papers not detected in the initial search. Results: Our literature search yielded 38 relevant papers. AI has been identified as a key component in digital health technologies. Within this field, there is the potential to apply specific techniques such as machine learning and deep learning to address several aspects of managing psoriatic disease. This includes diagnosis, particularly useful for remote teledermatology via photographs taken by patients as well as monitoring and estimating severity. Similarly, AI can be used to synthesize the vast data sets already in place through patient registries which can help identify appropriate biologic treatments for future cohorts and those individuals most likely to develop complications. Conclusions: There are multiple advantageous uses for AI and digital health technologies in psoriatic disease. With wider implementation of AI, we need to be mindful of potential limitations, such as validation and standardization or generalizability of results in specific populations, such as patients with darker skin phototypes. UR - https://derma.jmir.org/2024/1/e50451 UR - http://dx.doi.org/10.2196/50451 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/50451 ER - TY - JOUR AU - Lim, Subin AU - Kooper-Johnson, Sarah AU - Chau, A. Courtney AU - Chen, Claire AU - Yang, Clarissa Fei-Shiuann AU - Cobos, Gabriela PY - 2024/10/1 TI - Google Search Trends About Systemic Psoriasis Treatment: What Do People Want to Know About Biologics and Janus Kinase Inhibitors? JO - JMIR Dermatol SP - e62948 VL - 7 KW - Google KW - psoriasis vulgaris KW - psoriasis KW - systemic treatment KW - biologics KW - small molecule inhibitors KW - adalimumab KW - apremilast KW - methotrexate KW - health care delivery KW - skin KW - dermatologist KW - medication UR - https://derma.jmir.org/2024/1/e62948 UR - http://dx.doi.org/10.2196/62948 UR - http://www.ncbi.nlm.nih.gov/pubmed/39243516 ID - info:doi/10.2196/62948 ER - TY - JOUR AU - Pulsipher, Kayd AU - Mills, Samantha AU - Harris, Blair AU - Bermudez, Rene AU - Arida, Muammar AU - Crane, Jonathan PY - 2024/8/28 TI - Epithelioid Hemangioendothelioma as a Dangerous, Easy to Miss, and Nearly Impossible to Clinically Diagnose Condition: Case Report JO - JMIR Dermatol SP - e52493 VL - 7 KW - epithelioid hemangioendothelioma KW - EHE KW - vascular tumor KW - tumor KW - vascular KW - blood vessel KW - cutaneous KW - skin KW - lesion KW - histopathology KW - case report KW - metastatic KW - dermatology KW - dermatological KW - diagnose KW - diagnosis KW - rare cancer KW - oncology UR - https://derma.jmir.org/2024/1/e52493 UR - http://dx.doi.org/10.2196/52493 UR - http://www.ncbi.nlm.nih.gov/pubmed/39196615 ID - info:doi/10.2196/52493 ER - TY - JOUR AU - Parmar, Pritika AU - Singal, Amit AU - Szeto, D. Mindy AU - Pathak, N. Gaurav AU - Taranto, Viktoria AU - Truong, M. Thu AU - Rao, Babar AU - Miranda, Andrade Andrea AU - Franco, VA Juan AU - Dellavalle, P. Robert PY - 2024/8/21 TI - From the Cochrane Library: Interventions for Chronic Pruritus of Unknown Origin JO - JMIR Dermatol SP - e53271 VL - 7 KW - Cochrane KW - systematic review KW - randomized controlled trial KW - RCT KW - pruritus KW - chronic pruritus KW - chronic pruritus of unknown origin KW - CPUO KW - serlopitant KW - dupilumab KW - pregabalin UR - https://derma.jmir.org/2024/1/e53271 UR - http://dx.doi.org/10.2196/53271 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/53271 ER - TY - JOUR AU - Woolhiser, Emily AU - Keime, Noah AU - Patel, Arya AU - Weber, Isaac AU - Adelman, Madeline AU - Dellavalle, P. Robert PY - 2024/8/5 TI - Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review JO - JMIR Dermatol SP - e50143 VL - 7 KW - seborrheic dermatitis KW - systematic review KW - diet KW - nutritional supplements KW - alcohol KW - BMI KW - body mass index KW - skin KW - review methods KW - review methodology KW - nutrition KW - nutritional KW - supplement KW - supplements KW - dermatology KW - dermatitis KW - nutrient KW - nutrients KW - micronutrient KW - micronutrients KW - vitamin KW - vitamins KW - mineral KW - minerals KW - obesity KW - obese KW - weight N2 - Background: Pathogenesis of seborrheic dermatitis involves lipid secretion by sebaceous glands, Malassezia colonization, and an inflammatory response with skin barrier disruption. Each of these pathways could be modulated by diet, obesity, and nutritional supplements. Current treatment options provide only temporary control of the condition; thus, it is essential to recognize modifiable lifestyle factors that may play a role in determining disease severity. Objective: This study aimed to summarize published evidence on diet, nutritional supplements, alcohol, obesity, and micronutrients in patients with seborrheic dermatitis and to provide useful insights into areas of further research. Methods: A literature search of Scopus, PubMed, and MEDLINE (Ovid interface) for English language papers published between 1993 and 2023 was conducted on April 16, 2023. Case-control studies, cohort studies, and randomized controlled trials with 5 or more subjects conducted on adult participants (>14 years) were included, case reports, case series, and review papers were excluded due to insufficient level of evidence. Results: A total of 13 studies, 8 case-control, 3 cross-sectional, and 2 randomized controlled trials, involving 13,906 patients were included. Seborrheic dermatitis was correlated with significantly increased copper, manganese, iron, calcium, and magnesium concentrations and significantly lower serum zinc and vitamin D and E concentrations. Adherence to the Western diet was associated with a higher risk for seborrheic dermatitis in female patients and an increased consumption of fruit was associated with a lower risk of seborrheic dermatitis in all patients. The prebiotic Triphala improved patient satisfaction and decreased scalp sebum levels over 8 weeks. Most studies find associations between regular alcohol use and seborrheic dermatitis, but the association between BMI and obesity on seborrheic dermatitis severity and prevalence is mixed. Conclusions: This review sheds light on specific promising areas of research that require further study, including the need for interventional studies evaluating serum zinc, vitamin D, and vitamin E supplementation for seborrheic dermatitis. The negative consequences of a Western diet, alcohol use, obesity, and the benefits of fruit consumption are well known; however, to fully understand their specific relationships to seborrheic dermatitis, further cohort or interventional studies are needed. Trial Registration: PROSPERO CRD42023417768; https://tinyurl.com/bdcta893 UR - https://derma.jmir.org/2024/1/e50143 UR - http://dx.doi.org/10.2196/50143 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/50143 ER - TY - JOUR AU - Bi, Jianing AU - Liu, Li AU - Fan, Zhu AU - Qu, Shengyuan AU - Yang, Jiao AU - Xu, Chenchen AU - Cui, Bingnan PY - 2024/7/31 TI - Efficacy and Mechanism of Acupoint Catgut Embedding in the Treatment of Chronic Spontaneous Urticaria: Protocol for a Randomized Double-Blind Placebo-Controlled Trial JO - JMIR Res Protoc SP - e54376 VL - 13 KW - chronic spontaneous urticaria KW - acupoint catgut embedding KW - functional magnetic resonance imaging KW - randomized controlled trial KW - mechanism of action N2 - Background: Chronic spontaneous urticaria (CSU) is a common chronic inflammatory skin disease that manifests as itching and wheals, seriously affecting quality of life. Clinical observations and previous research trials have shown that acupuncture is safe and effective for the treatment of CSU. However, there are problems, such as a short duration of action and frequent treatment. Compared with traditional acupuncture, acupoint catgut embedding (ACE) has the advantages of a longer effect and higher compliance. Clinical trials are needed to prove its efficacy and mechanism of action. Objective: This trial aims to provide definitive evidence for the treatment of CSU with ACE and explore the mechanism of ACE. Methods: This is a randomized, double-blind, placebo-controlled trial. In this trial, 108 participants aged 18-60 years with a diagnosis of CSU and no history of ACE will be randomly assigned to 2 groups (1:1 ratio) using the Statistical Analysis System: treatment (ACE) and control (sham ACE). The participants and efficacy evaluators will be blinded to the grouping. Both the ACE and sham ACE groups will undergo acupuncture, but the sham ACE group will not receive catgut sutures. Treatment will be performed twice weekly for 8 weeks, with a 1-week run-in period and a 16-week follow-up period. Twenty patients will be randomly selected to undergo functional magnetic resonance imaging before and after the treatment period. The primary outcome will be the urticaria activity score over 7 days (UAS7). We will use R (version 4.0.1; R Project for Statistical Computing) to perform ANOVA and independent samples t tests to compare the differences within and between groups before and after treatment by judging the rejection range based on a significance level of .05. Results: The study protocol has been approved by the Ethics Committee of Guang?anmen Hospital on September 7, 2022, and has been registered on November 30, 2022. Recruitment began on March 1, 2023. A total of 4-6 participants are expected to be recruited each month. The recruitment is planned to be completed on March 1, 2025, and we expect to publish our results by the winter of 2025. As of November 1, 2023, we have enrolled 25 participants with CSU. Conclusions: This randomized, double-blind, placebo-controlled trial aims to provide definitive evidence for the treatment of CSU with ACE and explore the mechanism of ACE. We hypothesize that wheals and itching will show greater improvement in participants receiving active therapy than in those receiving sham treatment. The limitations of this study include its single-center trial design, small sample size, and short treatment duration, which may have certain impacts on the research results. Trial Registration: Chinese Clinical Trial Registry ChiCTR2200066274; https://www.chictr.org.cn/showprojEN.html?proj=179056 International Registered Report Identifier (IRRID): DERR1-10.2196/54376 UR - https://www.researchprotocols.org/2024/1/e54376 UR - http://dx.doi.org/10.2196/54376 UR - http://www.ncbi.nlm.nih.gov/pubmed/39083341 ID - info:doi/10.2196/54376 ER - TY - JOUR AU - Molla, Amr AU - Jannadi, Raed AU - Alayoubi, Hamza AU - Altouri, Haya AU - Balkhair, Maryam AU - Hafez, Dareen PY - 2024/7/12 TI - Assessing the Relationship Between Vitiligo and Major Depressive Disorder Severity: Cross-Sectional Study JO - JMIR Dermatol SP - e60686 VL - 7 KW - vitiligo KW - major depressive disorder (MDD) KW - PHQ-9 KW - Patient Health Questionnaire-9 KW - depression severity KW - Saudi Arabia KW - cross-sectional study N2 - Background: Vitiligo, a common dermatological disorder in Saudi Arabia, is associated with significant psychological impacts. This study explores the relationship between vitiligo and the severity of major depressive disorder (MDD), highlighting the broader implications on mental health among affected individuals. Objective: We aim to assess the prevalence and predictors of depression among adult patients with vitiligo, and to examine the relationship between MDD severity and vitiligo. Methods: Using a cross-sectional design, the research used the vitiligo area severity index and the Patient Health Questionnaire-9 to measure the extent of vitiligo and depression severity, respectively. This study involved 340 diagnosed patients with vitiligo from various health care settings. Logistic and ordinal regression analysis were applied to evaluate the impact of sociodemographic variables and vitiligo types on MDD severity. Results: The prevalence of MDD was 58.8% (200/340) of participants. Depression severity varied notably: 18.2% (62/340) of patients experienced mild depression, 17.9% (61/340) moderate, 11.8% (40/340) moderately severe, and 10.9% (37/340) severe depression. Female patients had higher odds of severe depression than male patients (adjusted odds ratio [aOR] 3.14, 95% CI 1.93-5.1; P<.001). Age was inversely related to depression severity, with patients aged older than 60 years showing significantly lower odds (aOR 0.1, 95% CI 0.03-0.39; P<.001). Lower income was associated with higher depression severity (aOR 10.2, 95% CI 3.25-31.8; P<.001). Vitiligo types also influenced depression severity; vulgaris (aOR 5.3, 95% CI 2.6-10.9; P<.001) and acrofacial vitiligo (aOR 2.8, 95% CI 1.5-5.1; P<.001) were significantly associated with higher depression levels compared to focal vitiligo. Conclusions: The findings suggest that vitiligo contributes to an increased risk of severe depression, highlighting the need for integrated dermatological and psychological treatment approaches to address both the physical and mental health aspects of the disease. UR - https://derma.jmir.org/2024/1/e60686 UR - http://dx.doi.org/10.2196/60686 UR - http://www.ncbi.nlm.nih.gov/pubmed/38888950 ID - info:doi/10.2196/60686 ER - TY - JOUR AU - Lambert, Raphaella AU - Choo, Zi-Yi AU - Gradwohl, Kelsey AU - Schroedl, Liesl AU - Ruiz De Luzuriaga, Arlene PY - 2024/5/16 TI - Assessing the Application of Large Language Models in Generating Dermatologic Patient Education Materials According to Reading Level: Qualitative Study JO - JMIR Dermatol SP - e55898 VL - 7 KW - artificial intelligence KW - large language models KW - large language model KW - LLM KW - LLMs KW - machine learning KW - natural language processing KW - deep learning KW - ChatGPT KW - health literacy KW - health knowledge KW - health information KW - patient education KW - dermatology KW - dermatologist KW - dermatologists KW - derm KW - dermatology resident KW - dermatology residents KW - dermatologic patient education material KW - dermatologic patient education materials KW - patient education material KW - patient education materials KW - education material KW - education materials N2 - Background: Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels. Objective: This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees. Methods: The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to ?Create a patient education handout about [condition] at a [FKRL]? to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees. Results: The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%). Conclusions: GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the seventh-grade FKRL for rare conditions. LLM-produced PEMs may reliably meet seventh-grade FKRLs for select common and rare dermatologic conditions and are easy to read, understandable for patients, and mostly accurate. LLMs may play a role in enhancing health literacy and disseminating accessible, understandable PEMs in dermatology. UR - https://derma.jmir.org/2024/1/e55898 UR - http://dx.doi.org/10.2196/55898 UR - http://www.ncbi.nlm.nih.gov/pubmed/38754096 ID - info:doi/10.2196/55898 ER - TY - JOUR AU - Cano, Mireia AU - Ruiz-Postigo, A. José AU - Macharia, Paul AU - Ampem Amoako, Yaw AU - Odame Phillips, Richard AU - Kinyeru, Esther AU - Carrion, Carme PY - 2024/4/30 TI - Evaluating the World Health Organization?s SkinNTDs App as a Training Tool for Skin Neglected Tropical Diseases in Ghana and Kenya: Cross-Sectional Study JO - J Med Internet Res SP - e51628 VL - 26 KW - SkinNTDs app KW - mHealth KW - mobile health KW - neglected tropical diseases KW - NTDs KW - skin neglected tropical diseases KW - low- and middle-income countries KW - tropical disease KW - app KW - training tool KW - digital health KW - intervention KW - decision support tool KW - mobile phone N2 - Background: Neglected tropical diseases (NTDs) affect over 1.5 billion people worldwide, primarily impoverished populations in low- and middle-income countries. Skin NTDs, a significant subgroup, manifest primarily as skin lesions and require extensive diagnosis and treatment resources, including trained personnel and financial backing. The World Health Organization has introduced the SkinNTDs app, a mobile health tool designed to train and be used as a decision support tool for frontline health care workers. As most digital health guidelines prioritize the thorough evaluation of mobile health interventions, it is essential to conduct a rigorous and validated assessment of this app. Objective: This study aims to assess the usability and user experience of World Health Organization SkinNTDs app (version 3) as a capacity-building tool and decision-support tool for frontline health care workers. Methods: A cross-sectional study was conducted in Ghana and Kenya. Frontline health care workers dealing with skin NTDs were recruited through snowball sampling. They used the SkinNTDs app for at least 5 days before completing a web-based survey containing demographic variables and the user version of the Mobile Application Rating Scale (uMARS), a validated scale for assessing health apps. A smaller group of participants took part in semistructured interviews and one focus group. Quantitative data were analyzed using SPSS with a 95% CI and P?.05 for statistical significance and qualitative data using ATLAS.ti to identify attributes, cluster themes, and code various dimensions that were explored. Results: Overall, 60 participants participated in the quantitative phase and 17 in the qualitative phase. The SkinNTDs app scored highly on the uMARS questionnaire, with an app quality mean score of 4.02 (SD 0.47) of 5, a subjective quality score of 3.82 (SD 0.61) of 5, and a perceived impact of 4.47 (SD 0.56) of 5. There was no significant association between the app quality mean score and any of the categorical variables examined, according to Pearson correlation analysis; app quality mean score vs age (P=.37), sex (P=.70), type of health worker (P=.35), country (P=.94), work context (P=.17), frequency of dealing with skin NTDs (P=.09), and dermatology experience (P=.63). Qualitative results echoed the quantitative outcomes, highlighting the ease of use, the offline functionality, and the potential utility for frontline health care workers in remote and resource-constrained settings. Areas for improvement were identified, such as enhancing the signs and symptoms section. Conclusions: The SkinNTDs app demonstrates notable usability and user-friendliness. The results indicate that the app could play a crucial role in improving capacity building of frontline health care workers dealing with skin NTDs. It could be improved in the future by including new features such as epidemiological context and direct contact with experts. The possibility of using the app as a diagnostic tool should be considered. International Registered Report Identifier (IRRID): RR2-10.2196/39393 UR - https://www.jmir.org/2024/1/e51628 UR - http://dx.doi.org/10.2196/51628 UR - http://www.ncbi.nlm.nih.gov/pubmed/38687587 ID - info:doi/10.2196/51628 ER - TY - JOUR AU - Weber, Isaac AU - Zagona-Prizio, Caterina AU - Sivesind, E. Torunn AU - Adelman, Madeline AU - Szeto, D. Mindy AU - Liu, Ying AU - Sillau, H. Stefan AU - Bainbridge, Jacquelyn AU - Klawitter, Jost AU - Sempio, Cristina AU - Dunnick, A. Cory AU - Leehey, A. Maureen AU - Dellavalle, P. Robert PY - 2024/3/11 TI - Oral Cannabidiol for Seborrheic Dermatitis in Patients With Parkinson Disease: Randomized Clinical Trial JO - JMIR Dermatol SP - e49965 VL - 7 KW - cannabidiol KW - cannabis KW - CBD treatment KW - CBD KW - image KW - photograph KW - photographs KW - imaging KW - sebum KW - clinical trials KW - seborrheic dermatitis KW - Parkinson disease KW - clinical trial KW - RCT KW - randomized KW - controlled trial KW - drug response KW - SEDASI KW - drug KW - Parkinson KW - dermatitis KW - skin KW - dermatology KW - treatment KW - outcome KW - chi-square N2 - Background: Seborrheic dermatitis (SD) affects 18.6%-59% of persons with Parkinson disease (PD), and recent studies provide evidence that oral cannabidiol (CBD) therapy could reduce sebum production in addition to improving motor and psychiatric symptoms in PD. Therefore, oral CBD could be useful for improving symptoms of both commonly co-occurring conditions. Objective: This study investigates whether oral CBD therapy is associated with a decrease in SD severity in PD. Methods: Facial photographs were collected as a component of a randomized (1:1 CBD vs placebo), parallel, double-blind, placebo-controlled trial assessing the efficacy of a short-term 2.5 mg per kg per day oral sesame solution CBD-rich cannabis extract (formulated to 100 mg/mL CBD and 3.3 mg/mL THC) for reducing motor symptoms in PD. Participants took 1.25 mg per kg per day each morning for 4 ±1 days and then twice daily for 10 ±4 days. Reviewers analyzed the photographs independently and provided a severity ranking based on the Seborrheic Dermatitis Area and Severity Index (SEDASI) scale. Baseline demographic and disease characteristics, as well as posttreatment SEDASI averages and the presence of SD, were analyzed with 2-tailed t tests and Pearson ?2 tests. SEDASI was analyzed with longitudinal regression, and SD was analyzed with generalized estimating equations. Results: A total of 27 participants received a placebo and 26 received CBD for 16 days. SD severity was low in both groups at baseline, and there was no treatment effect. The risk ratio for patients receiving CBD, post versus pre, was 0.69 (95% CI 0.41-1.18; P=.15), compared to 1.20 (95% CI 0.88-1.65; P=.26) for the patients receiving the placebo. The within-group pre-post change was not statistically significant for either group, but they differed from each other (P=.07) because there was an estimated improvement for the CBD group and an estimated worsening for the placebo group. Conclusions: This study does not provide solid evidence that oral CBD therapy reduces the presence of SD among patients with PD. While this study was sufficiently powered to detect the primary outcome (efficacy of CBD on PD motor symptoms), it was underpowered for the secondary outcomes of detecting changes in the presence and severity of SD. Multiple mechanisms exist through which CBD can exert beneficial effects on SD pathogenesis. Larger studies, including participants with increased disease severity and longer treatment periods, may better elucidate treatment effects and are needed to determine CBD?s true efficacy for affecting SD severity. Trial Registration: ClinicalTrials.gov NCT03582137; https://clinicaltrials.gov/ct2/show/NCT03582137 UR - https://derma.jmir.org/2024/1/e49965 UR - http://dx.doi.org/10.2196/49965 UR - http://www.ncbi.nlm.nih.gov/pubmed/38466972 ID - info:doi/10.2196/49965 ER - TY - JOUR AU - Wang, Andrew AU - Fulton, Rachel AU - Hwang, Sy AU - Margolis, J. David AU - Mowery, Danielle PY - 2024/1/26 TI - Patient Phenotyping for Atopic Dermatitis With Transformers and Machine Learning: Algorithm Development and Validation Study JO - JMIR Form Res SP - e52200 VL - 8 KW - atopic dermatitis KW - classification KW - classifier KW - dermatitis KW - dermatology KW - EHR KW - electronic health record KW - health records KW - health KW - informatics KW - machine learning KW - natural language processing KW - NLP KW - patient phenotyping KW - phenotype KW - skin KW - transformer KW - transformers N2 - Background: Atopic dermatitis (AD) is a chronic skin condition that millions of people around the world live with each day. Performing research into identifying the causes and treatment for this disease has great potential to provide benefits for these individuals. However, AD clinical trial recruitment is not a trivial task due to the variance in diagnostic precision and phenotypic definitions leveraged by different clinicians, as well as the time spent finding, recruiting, and enrolling patients by clinicians to become study participants. Thus, there is a need for automatic and effective patient phenotyping for cohort recruitment. Objective: This study aims to present an approach for identifying patients whose electronic health records suggest that they may have AD. Methods: We created a vectorized representation of each patient and trained various supervised machine learning methods to classify when a patient has AD. Each patient is represented by a vector of either probabilities or binary values, where each value indicates whether they meet a different criteria for AD diagnosis. Results: The most accurate AD classifier performed with a class-balanced accuracy of 0.8036, a precision of 0.8400, and a recall of 0.7500 when using XGBoost (Extreme Gradient Boosting). Conclusions: Creating an automated approach for identifying patient cohorts has the potential to accelerate, standardize, and automate the process of patient recruitment for AD studies; therefore, reducing clinician burden and informing the discovery of better treatment options for AD. UR - https://formative.jmir.org/2024/1/e52200 UR - http://dx.doi.org/10.2196/52200 UR - http://www.ncbi.nlm.nih.gov/pubmed/38277207 ID - info:doi/10.2196/52200 ER - TY - JOUR AU - Huang, S. Ryan AU - Patil, S. Nikhil AU - Khan, Yasser PY - 2023/11/28 TI - Periorbital Necrotizing Fasciitis: Case Presentation JO - Interact J Med Res SP - e52507 VL - 12 KW - periorbital necrotizing fasciitis KW - Streptococcus pyogenes A KW - skin infection KW - soft tissue infection KW - dermatology infection KW - skin reaction KW - periorbital KW - necrotizing fasciitis KW - necrotizing KW - necrosis KW - case report KW - case reports KW - fasciitis KW - fatal KW - life-threatening KW - fascia KW - soft tissue KW - infection KW - pathology KW - pathophysiology KW - eye KW - orbital KW - orbit KW - muscle KW - bacteria KW - bacterial KW - Streptococcus KW - inflammation KW - tissue KW - tissues UR - https://www.i-jmr.org/2023/1/e52507 UR - http://dx.doi.org/10.2196/52507 UR - http://www.ncbi.nlm.nih.gov/pubmed/37971729 ID - info:doi/10.2196/52507 ER - TY - JOUR AU - Fang, Heping AU - Chen, Lin AU - Li, Juan AU - Ren, Luo AU - Yin, Yu AU - Chen, Danleng AU - Yin, Huaying AU - Liu, Enmei AU - Hu, Yan AU - Luo, Xiaoyan PY - 2023/7/19 TI - A Web-Based Instrument for Infantile Atopic Dermatitis Identification (Electronic Version of the Modified Child Eczema Questionnaire): Development and Implementation JO - J Med Internet Res SP - e44614 VL - 25 KW - atopic dermatitis KW - identification KW - infant KW - web-based questionnaire KW - public health N2 - Background: Atopic dermatitis (AD) is a chronic inflammatory cutaneous disease that affects 30.48% of young children; thus, there is a need for epidemiological studies in community settings. Web-based questionnaires (WBQs) are more convenient, time-saving, and efficient than traditional surveys, but the reliability of identifying AD through WBQs and whether AD can be identified without the attendance of doctors, especially in community or similar settings, remains unknown. Objective: This study aimed to develop and validate a web-based instrument for infantile AD identification (electronic version of the modified Child Eczema Questionnaire [eCEQ]) and to clarify the possibility of conducting WBQs to identify infantile AD without the attendance of doctors in a community-representative population. Methods: This study was divided into 2 phases. Phase 1 investigated 205 children younger than 2 years to develop and validate the eCEQ by comparison with the diagnoses of dermatologists. Phase 2 recruited 1375 children younger than 2 years to implement the eCEQ and verify the obtained prevalence by comparison with the previously published prevalence. Results: In phase 1, a total of 195 questionnaires were analyzed from children with a median age of 8.8 (IQR 4.5-15.0) months. The identification values of the eCEQ according to the appropriate rules were acceptable (logic rule: sensitivity 89.2%, specificity 91.5%, positive predictive value 97.1%, and negative predictive value 72.9%; statistic rule: sensitivity 90.5%, specificity 89.4%, positive predictive value 96.4%, and negative predictive value 75%). In phase 2, a total of 837 questionnaires were analyzed from children with a median age of 8.4 (IQR 5.2-14.6) months. The prevalence of infantile AD obtained by the eCEQ (logic rule) was 31.9% (267/837), which was close to the published prevalence (30.48%). Based on the results of phase 2, only 20.2% (54/267) of the participants identified by the eCEQ had previously received a diagnosis from doctors. Additionally, among the participants who were not diagnosed by doctors but were identified by the eCEQ, only 6.1% (13/213) were actually aware of the possible presence of AD. Conclusions: Infantile AD can be identified without the attendance of doctors by using the eCEQ, which can be easily applied to community-based epidemiological studies and provide acceptable identification reliability. In addition, the eCEQ can also be applied to the field of public health to improve the health awareness of the general population. UR - https://www.jmir.org/2023/1/e44614 UR - http://dx.doi.org/10.2196/44614 UR - http://www.ncbi.nlm.nih.gov/pubmed/37467020 ID - info:doi/10.2196/44614 ER - TY - JOUR AU - Haugsten, Rygvold Elisabeth AU - Vestergaard, Tine AU - Trettin, Bettina PY - 2023/6/23 TI - Experiences Regarding Use and Implementation of Artificial Intelligence?Supported Follow-Up of Atypical Moles at a Dermatological Outpatient Clinic: Qualitative Study JO - JMIR Dermatol SP - e44913 VL - 6 KW - artificial intelligence KW - AI KW - computer-assisted diagnosis KW - CAD KW - dermatology KW - diagnostic tool KW - FotoFinder KW - implementation KW - interview KW - melanoma KW - Moleanalyzer Pro KW - total body dermoscopy KW - TBD N2 - Background: Artificial intelligence (AI) is increasingly used in numerous medical fields. In dermatology, AI can be used in the form of computer-assisted diagnosis (CAD) systems when assessing and diagnosing skin lesions suspicious of melanoma, a potentially lethal skin cancer with rising incidence all over the world. In particular, CAD may be a valuable tool in the follow-up of patients with high risk of developing melanoma, such as patients with multiple atypical moles. One such CAD system, ATBM Master (FotoFinder), can execute total body dermoscopy (TBD). This process comprises automatically photographing a patient´s entire body and then neatly displaying moles on a computer screen, grouped according to their clinical relevance. Proprietary FotoFinder algorithms underlie this organized presentation of moles. In addition, ATBM Master?s optional convoluted neural network (CNN)-based Moleanalyzer Pro software can be used to further assess moles and estimate their probability of malignancy. Objective: Few qualitative studies have been conducted on the implementation of AI-supported procedures in dermatology. Therefore, the purpose of this study was to investigate how health care providers experience the use and implementation of a CAD system like ATBM Master, in particular its TBD module. In this way, the study aimed to elucidate potential barriers to the application of such new technology. Methods: We conducted a thematic analysis based on 2 focus group interviews with 14 doctors and nurses regularly working in an outpatient pigmented lesions clinic. Results: Surprisingly, the study revealed that only 3 participants had actual experience using the TBD module. Even so, all participants were able to provide many notions and anticipations about its use, resulting in 3 major themes emerging from the interviews. First, several organizational matters were revealed to be a barrier to consistent use of the ATBM Master?s TBD module, namely lack of guidance, time pressure, and insufficient training. Second, the study found that the perceived benefits of TBD were the ability to objectively detect and monitor subtle lesion changes and unbiasedness of the procedure. Imprecise identification of moles, inability to photograph certain areas, and substandard technical aspects were the perceived weaknesses. Lastly, the study found that clinicians were open to use AI-powered technology and that the TBD module was considered a supplementary tool to aid the medical staff, rather than a replacement of the clinician. Conclusions: Demonstrated by how few of the participants had actual experience with the TBD module, this study showed that implementation of new technology does not occur automatically. It highlights the importance of having a strategy for implementation to ensure the optimized application of CAD tools. The study identified areas that could be improved when implementing AI-powered technology, as well as providing insight on how medical staff anticipated and experienced the use of a CAD device in dermatology. UR - https://derma.jmir.org/2023/1/e44913 UR - http://dx.doi.org/10.2196/44913 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632937 ID - info:doi/10.2196/44913 ER - TY - JOUR AU - Goodwin, Glenn AU - Ryckeley, Christian AU - Fox, Davide AU - Ashley, Michael AU - Dubensky, Laurence AU - Danckers, Mauricio AU - Slesinger, Todd PY - 2023/3/8 TI - Acute Spontaneous Colonic Perforation in a Case of Newly Confirmed Scleroderma: Case Report JO - Interact J Med Res SP - e43295 VL - 12 KW - scleroderma KW - systemic sclerosis KW - spontaneous bowel perforation KW - CREST syndrome KW - calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasis KW - multisystem connective tissue disorder KW - sclerosis KW - skin KW - dermatology KW - internal medicine KW - autoimmune KW - perforation KW - gastroenterology KW - esophagus KW - esophageal KW - connective tissue KW - emergency KW - gastrointestinal KW - case report UR - https://www.i-jmr.org/2023/1/e43295 UR - http://dx.doi.org/10.2196/43295 UR - http://www.ncbi.nlm.nih.gov/pubmed/36862558 ID - info:doi/10.2196/43295 ER - TY - JOUR AU - Long, Valencia AU - Chandran, Suyien Nisha PY - 2022/5/17 TI - A Glance at the Practice of Pediatric Teledermatology Pre- and Post?COVID-19: Narrative Review JO - JMIR Dermatol SP - e34228 VL - 5 IS - 2 KW - teledermatology KW - telehealth KW - telemedicine KW - pediatric teledermatology KW - COVID-19 KW - pandemic KW - dermatology KW - pediatric KW - children N2 - Background: The COVID-19 pandemic has accelerated the use of pediatric teledermatology, with centers showing increased uptake of teledermatology. Pediatric patients possess unique characteristics that pose different challenges with teledermatology compared to adults, in turn affecting the feasibility and uptake of pediatric teledermatology in the community. Objective: This narrative review summarizes the evolution of pediatric teledermatology from pre?COVID-19 pandemic times to the post?COVID-19 period. Methods: A search of MEDLINE, PubMed, and Embase was performed for original articles written in English and published from December 1, 2019, to April 1, 2022. Results: A total of 22 publications were included. Conclusions: Teledermatology will continue to play an increasing role in the management of skin diseases. A mindset shift in the types of conditions deemed suitable for pediatric teledermatology is needed. UR - https://derma.jmir.org/2022/2/e34228 UR - http://dx.doi.org/10.2196/34228 UR - http://www.ncbi.nlm.nih.gov/pubmed/35610984 ID - info:doi/10.2196/34228 ER - TY - JOUR AU - Kokoska, E. Ryan AU - Szeto, D. Mindy AU - Sivesind, E. Torunn AU - Dellavalle, P. Robert AU - Wormald, R. Justin C. PY - 2022/5/4 TI - From the Cochrane Library: Hydrosurgical Debridement Versus Conventional Surgical Debridement for Acute Partial-Thickness Burns JO - JMIR Dermatol SP - e37030 VL - 5 IS - 2 KW - Cochrane KW - systematic review KW - randomized controlled trial KW - hydrosurgery KW - hydrosurgical debridement KW - debridement KW - burns KW - wound healing UR - https://derma.jmir.org/2022/2/e37030 UR - http://dx.doi.org/10.2196/37030 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632860 ID - info:doi/10.2196/37030 ER - TY - JOUR AU - Bailey, Michel Adrian Joseph AU - Li, Oi-Yee Heidi AU - Kirchhof, G. Mark PY - 2022/5/2 TI - Novel Kappa-Opioid Receptor Agonist for the Treatment of Cholestatic Pruritus: Systematic Review JO - JMIR Dermatol SP - e30737 VL - 5 IS - 2 KW - opioid KW - pruritus KW - cholestasis KW - dermatology KW - chronic pruritis KW - kappa-opioid receptor KW - opioid receptor UR - https://derma.jmir.org/2022/2/e30737 UR - http://dx.doi.org/10.2196/30737 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632854 ID - info:doi/10.2196/30737 ER - TY - JOUR AU - Han, Joseph AU - Kamat, Samir AU - Agarwal, Aneesh AU - O'Hagan, Ross AU - Tukel, Connor AU - Owji, Shayan AU - Ghalili, Sabrina AU - Luu, Yen AU - Dautriche Svidzinski, Cula AU - Abittan, J. Brian AU - Ungar, Jonathan AU - Gulati, Nicholas PY - 2022/4/27 TI - Correlation Between Interest in COVID-19 Hair Loss and COVID-19 Surges: Analysis of Google Trends JO - JMIR Dermatol SP - e37271 VL - 5 IS - 2 KW - COVID-19 KW - SARS-CoV-2 virus KW - pandemic KW - hair loss KW - telogen effluvium KW - Google Trends KW - omicron KW - omicron variant KW - delta variant KW - public interest KW - stress KW - dermatology KW - public perception KW - social media KW - online health KW - digital dermatology UR - https://derma.jmir.org/2022/2/e37271 UR - http://dx.doi.org/10.2196/37271 UR - http://www.ncbi.nlm.nih.gov/pubmed/35505684 ID - info:doi/10.2196/37271 ER - TY - JOUR AU - Mark, Erica AU - Sridharan, Mira AU - Florenzo, Brian AU - Schenck, L. Olivia AU - Noland, B. Mary-Margaret AU - Barbieri, S. John AU - Lipoff, B. Jules PY - 2022/4/22 TI - Crowdsourcing Medical Costs in Dermatology: Cross-sectional Study Analyzing Dermatologic GoFundMe Campaigns JO - JMIR Dermatol SP - e34111 VL - 5 IS - 2 KW - crowdfunding KW - crowdsourcing KW - fundraising KW - GoFundMe KW - social media KW - medical expenses KW - financial burden KW - health equity N2 - Background: Crowdfunding for medical costs is becoming increasingly popular. Few previous studies have described the fundraising characteristics and qualities associated with success. Objective: This study aimed to characterize and investigate the qualities associated with successful dermatological fundraisers. Methods: This cross-sectional study of dermatological GoFundMe campaigns collected data, including demographic variables, thematic variables using an inductive qualitative method, and quantitative information. Linear regression examined the qualities associated with success, which are defined based on funds raised when controlling for campaign goals. Logistic regression was used to examine qualities associated with extremely successful campaigns, defined as those raising >1.5 times the IQR. Statistical significance was set at P<.05. Results: A total of 2008 publicly available campaigns at the time of data collection were evaluated. Nonmodifiable factors associated with greater success included male gender, age 20-40 years, and White race. Modifiable factors associated with success included more updates posted to the campaign page, non?self-identity of the campaign creator, mention of a chronic condition, and smiling in campaign profile photographs. Conclusions: Understanding the modifiable factors of medical crowdfunding may inform future campaigns, and nonmodifiable factors may have policy implications for improving health care equity and financing. Crowdfunding for medical disease treatment may have potential implications for medical privacy and exacerbation of existing health care disparities. This study was limited to publicly available GoFundMe campaigns. Potential limitations for this study include intercoder variability, misclassification bias because of the data abstraction process, and prioritization of campaigns based on the proprietary GoFundMe algorithm. UR - https://derma.jmir.org/2022/2/e34111 UR - http://dx.doi.org/10.2196/34111 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632862 ID - info:doi/10.2196/34111 ER - TY - JOUR AU - Ranpariya, K. Varun AU - Fathy, Ramie AU - Chu, Brian AU - Wang, Sonia AU - Lipoff, B. Jules PY - 2022/3/30 TI - Patterns of Promotional Content by Dermatology Influencers on TikTok JO - JMIR Dermatol SP - e34935 VL - 5 IS - 1 KW - social media KW - TikTok KW - Instagram KW - promotion KW - conflicts of interest KW - influencer KW - dermatology KW - dermatologist UR - https://derma.jmir.org/2022/1/e34935 UR - http://dx.doi.org/10.2196/34935 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632857 ID - info:doi/10.2196/34935 ER - TY - JOUR AU - Lu, Di Justin AU - Gotesman, D. Ryan AU - Varghese, Shawn AU - Fleming, Patrick AU - Lynde, W. Charles PY - 2022/3/30 TI - Treatments for Primary Delusional Infestation: Systematic Review JO - JMIR Dermatol SP - e34323 VL - 5 IS - 1 KW - delusional infestation KW - Morgellons disease KW - treatment KW - delusional parasitosis KW - atypical KW - typical KW - antipsychotic KW - SSRI KW - delusion KW - rare disorder KW - systematic review KW - pharmacology KW - pharmacological KW - psychiatric KW - dermatology KW - dermatologist KW - drug N2 - Background: Delusional infestation, also known as Ekbom syndrome, is a rare delusional disorder characterized by the fixed belief that one is infested with parasites, worms, insects, or other organisms. Although delusional infestation is a psychiatric condition, patients often consult dermatologists with skin findings, and it is currently unclear what treatments are recommended for this disorder. Objective: We aimed to systematically review and describe the treatment and management of patients presenting with primary delusional infestation. Methods: A systematic search was conducted using Ovid on MEDLINE, Embase, PsycINFO, and the Cochrane Register of Clinical Trials. Relevant data, including treatment, dosage, response, adherence, and side effects, were extracted and analyzed. Results: A total of 15 case series were included, comprising 280 patients (mean age 53.3 years, 65.4% female) with delusional infestation. Overall, aripiprazole had the highest complete remission rate at 79% (11/14), although this was limited to 14 patients. Among drug classes, selective serotonin reuptake inhibitors were the most effective with a 79% (11/14) complete remission rate and 43% (9/21) partial remission rate in patients with comorbid depression, anxiety, or trichotillomania. First-generation antipsychotics and second-generation antipsychotics had similar complete remission rates (56/103, 54.4% vs 56/117, 47.9%, respectively) and partial remission rates (36/103, 35% vs 41/117, 35%, respectively). Conclusions: Due to the rarity of delusional infestation, we only found 15 case series. However, we found that first-generation antipsychotics appear to be similar in effectiveness to second-generation antipsychotics for the treatment of primary delusional infestation. Larger studies and randomized controlled trials are needed to evaluate the efficacy of pharmacological therapy for delusional infestation. Trial Registration: PROSPERO CRD42020198161; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=198161 UR - https://derma.jmir.org/2022/1/e34323 UR - http://dx.doi.org/10.2196/34323 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632851 ID - info:doi/10.2196/34323 ER - TY - JOUR AU - Clare, M. Isabelle AU - Gamage, Nisali AU - Alvares, A. Gail AU - Black, J. Lucinda AU - Francis, Jacinta AU - Jaimangal, Mohinder AU - Lucas, M. Robyn AU - Strickland, Mark AU - White, James AU - Nguyen, Rebecca AU - Gorman, Shelley PY - 2022/3/16 TI - The Effects of Using the Sun Safe App on Sun Health Knowledge and Behaviors of Young Teenagers: Results of Pilot Intervention Studies JO - JMIR Dermatol SP - e35137 VL - 5 IS - 1 KW - app development KW - co-design KW - knowledge gain KW - sun exposure KW - sun protection KW - sun behaviors KW - teenagers KW - UV Index KW - vitamin D KW - young adolescents KW - mobile phone N2 - Background: A balanced approach toward sun exposure and protection is needed by young people. Excessive sun exposure increases their risk for skin cancers such as melanoma, whereas some exposure is necessary for vitamin D and healthy bones. We have developed a new iOS smartphone app?Sun Safe?through a co-design process, which aims to support healthy and balanced decision-making by young teenagers (aged 12-13 years). Objective: The aim of this study was to test the capacity of Sun Safe to improve sun health knowledge and behaviors of young teenagers in 3 pilot intervention studies completed in 2020. Methods: Young teenagers (aged 12-13 years; N=57) were recruited through the web or through a local school via an open-access website and given access to Sun Safe (29/57, 51%) or a placebo (SunDial) app (28/57, 49%). Participants completed sun health questionnaires and knowledge quizzes before and after the 6-week intervention (either on the web or in class) and rated the quality of the app they used via a survey. Results: Of the 57 participants, 51 (89%) participants (26, 51% for placebo arm and 25, 49% for the Sun Safe arm) completed these studies, with most (>50%) reporting that they used a smartphone to access their designated app either ?once a fortnight? or ?once/twice in total.? Improved sun health knowledge?particularly about the UV Index?was observed in participants who were given access to Sun Safe compared with those who used the placebo (?6.2 [percentage correct] difference in predicted means, 95% CI ?12.4 to ?0.03; P=.049; 2-way ANOVA). Unexpectedly, there were significantly more sunburn events in the Sun Safe group (relative risk 1.7, 95% CI 1.1-1.8; P=.02; Fisher exact test), although no differences in time spent outdoors or sun-protective behaviors were reported. COVID-19 pandemic?related community-wide shutdowns during April 2020 (when schools were closed) reduced the time spent outdoors by >100 minutes per day (?105 minutes per day difference in predicted means, 95% CI ?150 to ?59 minutes per day; P=.002; paired 2-tailed Student t test). Sun Safe was well-rated by participants, particularly for information (mean 4.2, SD 0.6 out of 5). Conclusions: Access to the Sun Safe app increased sun health knowledge among young teenagers in these pilot intervention studies. Further investigations with larger sample sizes are required to confirm these observations and further test the effects of Sun Safe on sun-protective behaviors. UR - https://derma.jmir.org/2022/1/e35137 UR - http://dx.doi.org/10.2196/35137 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632872 ID - info:doi/10.2196/35137 ER - TY - JOUR AU - Xia, Joyce AU - Melian, Christina AU - Guo, William AU - Usmani, Hunya AU - Clark, Richard AU - Lozeau, Daniel PY - 2022/3/16 TI - Vitiligo and Metabolic Syndrome: Systematic Review and Meta-Analysis JO - JMIR Dermatol SP - e34772 VL - 5 IS - 1 KW - vitiligo KW - leukoderma KW - metabolic syndrome X KW - dysmetabolic syndrome X KW - insulin resistance syndrome X KW - syndrome X N2 - Background: Metabolic syndrome (MetS) has been associated with various skin conditions including vitiligo. However, the association between these 2 conditions has yet to be determined by quantitative meta-analysis. Objective: The aim of this paper was to determine the association between vitiligo and metabolic syndrome via systematic review and meta-analysis. Methods: A systematic literature search of Pubmed, Embase, Cochrane, and Web of Science was performed for all published literature prior to August 16, 2020. Case control and prospective cross-sectional studies analyzing the association between vitiligo and MetS were included in this review. The primary outcome measures include the type of vitiligo, diagnostic criteria for MetS, components of MetS (waist circumference, blood pressure, triglycerides, fasting glycemic index, and high-density lipoprotein cholesterol), low-density lipoprotein cholesterol levels, and BMI. A meta-analysis was performed to evaluate the prevalence and association of MetS in patients with vitiligo. Results: A total of 6 studies (n=734 participants) meeting eligibility criteria were included for systematic review and meta-analysis. The pooled prevalence of MetS in patients with vitiligo was (0.296, 95% CI 0.206, 0.386; P<.001). Patients with vitiligo were no more likely to develop MetS compared to control patients (odds ratio 1.66, 95% CI 0.83, 3.33; P=.01). A leave-one-out sensitivity analysis showed a significant association between MetS and vitiligo (P<.001). Significant elevations in fasting glycemic index (mean difference 5.35, 95% CI 2.77, 7.93; P<.001) and diastolic blood pressure (mean difference 1.97, 95% CI 0.02, 3.92; P=.05) were observed in patients with vitiligo compared to control patients. Conclusions: The association between vitiligo and metabolic syndrome carries important clinical implications. Dermatologists and other multidisciplinary team members should remain vigilant when treating this patient population in order to prevent serious cardiovascular complications that may arise as a result of metabolic disease. UR - https://derma.jmir.org/2022/1/e34772 UR - http://dx.doi.org/10.2196/34772 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632859 ID - info:doi/10.2196/34772 ER - TY - JOUR AU - Hughes, Olivia AU - Hunter, Rachael PY - 2022/3/15 TI - The Importance of Exploring the Role of Anger in People With Psoriasis JO - JMIR Dermatol SP - e33920 VL - 5 IS - 1 KW - psoriasis KW - skin conditions KW - psychodermatology KW - stigma KW - chronic illness KW - dermatology KW - mental health KW - quality of life UR - https://derma.jmir.org/2022/1/e33920 UR - http://dx.doi.org/10.2196/33920 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632869 ID - info:doi/10.2196/33920 ER - TY - JOUR AU - Maghfour, Jalal AU - Sivesind, Torunn AU - Piguet, Vincent AU - Dellavalle, Robert AU - Ingram, R. John PY - 2022/3/11 TI - From the Cochrane Library: Interventions for Hidradenitis Suppurativa JO - JMIR Dermatol SP - e29966 VL - 5 IS - 1 KW - hidradenitis suppurativa KW - quality of life KW - outcome measures KW - heterogenetity in HS research KW - dermatology KW - comorbidities KW - treatment interventions KW - review UR - https://derma.jmir.org/2022/1/e29966 UR - http://dx.doi.org/10.2196/29966 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632870 ID - info:doi/10.2196/29966 ER - TY - JOUR AU - Grine, Lynda AU - Hilhorst, Niels AU - Michels, Nathalie AU - Abbeddou, Souheila AU - De Henauw, Stefaan AU - Lambert, Jo PY - 2022/2/23 TI - The Effects of Modified Intermittent Fasting in Psoriasis (MANGO): Protocol for a Two-Arm Pilot Randomized Controlled Open Cross-over Study JO - JMIR Res Protoc SP - e26405 VL - 11 IS - 2 KW - psoriasis KW - leaky gut KW - gut-skin axis KW - dietary intervention KW - intermittent fasting N2 - Background: Psoriasis is a complex disease associated with multiple comorbidities, including metabolic syndrome and leaky gut syndrome. Dietary lifestyle interventions have been reported to affect the disease in terms of lesional severity. It remains unclear how diets affect these comorbidities and the general health in psoriasis patients. Modified intermittent fasting (MIF) on 2 nonconsecutive days has shown beneficial effects on metabolic parameters. A significant advantage of MIF over the currently investigated dietary changes is its feasibility. Objective: Here, we aim to study the effects of MIF on skin, gut, and metabolic health in psoriasis patients. Methods: A 2-arm pilot randomized controlled open cross-over study will be performed in 24 patients with psoriasis. Patients will be randomized 1:1 to either start with 12 weeks of MIF and go on a subsequent regular diet for another 12 weeks or start with 12 weeks of regular diet and do subsequent MIF for 12 weeks. The following parameters will be assessed: demographics, disease phenotype, medical and familial history, psoriasis severity, dermatology-specific and general quality of life, nutritional and physical habits, mental and intestinal health, intestinal and cutaneous integrity, inflammatory and metabolic markers, and satisfaction. Results: A total of 24 participants have been enrolled in the study. The final visit is foreseen for June 2021. Conclusions: The aim is to uncover the effects of MIF on psoriasis severity and gut health integrity through clinical and molecular investigation. More precisely, we want to map the evolution of the different markers, such as psoriasis severity, permeability, and inflammation, in response to MIF as compared to a regular diet,. Understanding how dietary lifestyles can affect epithelial lineages, such as the skin and gut, will greatly improve our understanding of the development of psoriasis and may offer a nonpharmacological venue for treatments. Trial Registration: ClinicalTrials.gov NCT04418791; https://clinicaltrials.gov/ct2/show/NCT04418791 International Registered Report Identifier (IRRID): DERR1-10.2196/26405 UR - https://www.researchprotocols.org/2022/2/e26405 UR - http://dx.doi.org/10.2196/26405 UR - http://www.ncbi.nlm.nih.gov/pubmed/35195533 ID - info:doi/10.2196/26405 ER - TY - JOUR AU - Lam, Megan AU - Lu, Di Justin AU - Elhadad, Levi AU - Sibbald, Cathryn AU - Alhusayen, Raed PY - 2022/2/8 TI - Common Dermatologic Disorders in Down Syndrome: Systematic Review JO - JMIR Dermatol SP - e33391 VL - 5 IS - 1 KW - autoimmune KW - comorbidities KW - trisomy 21 KW - inflammatory KW - Down syndrome KW - dermatology KW - hidradenitis suppurativa KW - systematic review N2 - Background: Down syndrome (DS) has been associated with cardiovascular, gastrointestinal, and immune-related abnormalities. Several dermatologic conditions, including hidradenitis suppurativa, have also been found to be associated with DS. Objective: The objective of this study was to characterize the prevalence, presentation, and unique features of dermatologic disorders associated with DS. Methods: Electronic searches of EMBASE (via Ovid), MEDLINE (via Ovid), and Web of Science databases were conducted on December 14, 2020. Observational studies including case reports of patients with DS presenting with concomitant primary dermatologic disorder were included. Results: This systematic review captured 40 observational studies and 99 case reports, including 10 observational studies that examined the prevalence of common skin disorders in patients with DS. The most common dermatologic conditions reported includes atopic dermatitis (8 studies, n=180; 19.7% mean prevalence), hidradenitis suppurativa (15, n=478; 3.2%), ichthyosis (4, n=16; 4.7%), lichen nitidus (6, n=6; 1.1%), psoriasis (21, n=65; 4.8%), alopecia areata (27, n=253; 7.4%), vitiligo (8, n=40; 4.4%), onychomycosis (3, n=198; 24.7%), calcinosis cutis (14, n=15), connective tissue nevi (6, n=6), dermatofibroma (3, n=3), melanoma (3, n=3), syringomas (14, n=182; 21.2%), and elastosis perforans serpiginosa (19, n=24; 0.5%). Conclusions: Our results indicate an increased prevalence of common cutaneous disorders in patients with DS, particularly infectious, inflammatory, autoimmune, and connective tissue conditions. Current guidelines for the screening, general management, and use of systemic immunomodulatory agents in this patient population are lacking. Patients with DS would benefit from screening for dermatologic disorders not otherwise regularly performed for earlier diagnosis and treatment. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021226295; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=226295 UR - https://derma.jmir.org/2022/1/e33391 UR - http://dx.doi.org/10.2196/33391 ID - info:doi/10.2196/33391 ER - TY - JOUR AU - Voillot, Paméla AU - Riche, Brigitte AU - Portafax, Michel AU - Foulquié, Pierre AU - Gedik, Anaïs AU - Barbarot, Sébastien AU - Misery, Laurent AU - Héas, Stéphane AU - Mebarki, Adel AU - Texier, Nathalie AU - Schück, Stéphane PY - 2022/1/28 TI - Social Media Platforms Listening Study on Atopic Dermatitis: Quantitative and Qualitative Findings JO - J Med Internet Res SP - e31140 VL - 24 IS - 1 KW - atopic dermatitis KW - Atopic Dermatitis Control Tool KW - health-related quality of life KW - social media use KW - real world KW - dermatology KW - skin disease KW - social media KW - online health information KW - online health KW - health care N2 - Background: Atopic dermatitis (AD) is a chronic, pruritic, inflammatory disease that occurs most frequently in children but also affects many adults. Social media have become key tools for finding and disseminating medical information. Objective: The aims of this study were to identify the main themes of discussion, the difficulties encountered by patients with respect to AD, the impact of the pathology on quality of life (QoL; physical, psychological, social, or financial), and to study the perception of patients regarding their treatment. Methods: A retrospective study was carried out by collecting social media posts in French language written by internet users mentioning their experience with AD, their QoL, and their treatments. Messages related to AD discomfort posted between July 1, 2010, and October 23, 2020, were extracted from French-speaking publicly available online forums. Automatic and manual extractions were implemented to create a general corpus and 2 subcorpuses depending on the level of control of the disease. Results: A total of 33,115 messages associated with AD were included in the analysis corpus after extraction and cleaning. These messages were posted by 15,857 separate web users, most of them being women younger than 40 years. Tips to manage AD and everyday hygiene/treatments were among the most discussed topics for controlled AD subcorpus, while baby-related topics and therapeutic failure were among the most discussed topics for insufficiently controlled AD subcorpus. QoL was discussed in both subcorpuses with a higher proportion in the controlled AD subcorpus. Treatments and their perception were also discussed by web users. Conclusions: More than just emotional or peer support, patients with AD turn to online forums to discuss their health. Our findings show the need for an intersection between social media and health care and the importance of developing new approaches such as the Atopic Dermatitis Control Tool, which is a patient-related disease severity assessment tool focused on patients with AD. UR - https://www.jmir.org/2022/1/e31140 UR - http://dx.doi.org/10.2196/31140 UR - http://www.ncbi.nlm.nih.gov/pubmed/35089160 ID - info:doi/10.2196/31140 ER - TY - JOUR AU - Shakshouk, Hadir AU - Hua, Camille AU - Adler, L. Brandon AU - Ortega-Loayza, G. Alex PY - 2022/1/21 TI - From the Cochrane Library: Interventions for Necrotizing Soft Tissue Infections in Adults JO - JMIR Dermatol SP - e34578 VL - 5 IS - 1 KW - necrotizing soft tissue infections KW - therapy KW - intervention KW - systematic review KW - infections KW - management KW - evidence-based medicine KW - dermatology KW - skin infection UR - https://derma.jmir.org/2022/1/e34578 UR - http://dx.doi.org/10.2196/34578 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632849 ID - info:doi/10.2196/34578 ER - TY - JOUR AU - Hill, K. Mary AU - Laughter, R. Melissa AU - Harmange, I. Cecile AU - Dellavalle, P. Robert AU - Rundle, W. Chandler AU - Dunnick, A. Cory PY - 2021/12/16 TI - The Contact Dermatitis Quality of Life Index (CDQL): Survey Development and Content Validity Assessment JO - JMIR Dermatol SP - e30620 VL - 4 IS - 2 KW - contact dermatitis KW - allergic contact dermatitis KW - irritant contact dermatitis KW - quality of life KW - outcomes instruments KW - health outcomes N2 - Background: There is limited measurement and reporting of quality of life (QoL) outcomes for patients with contact dermatitis (CD). Objective: The purpose of this study is to develop a standardized Contact Dermatitis Quality of Life index (CDQL) for adult patients. Methods: A list of 81 topics was compiled from a review of QoL measures used previously in CD research. A total of 2 rounds of web-based Delphi surveys were sent to physicians who registered to attend the 2018 American Contact Dermatitis Society meeting, asking that they rank the relevance of topics for measuring QoL in CD using a 4-point scale. Items met consensus for inclusion if at least 78% of respondents ranked them as relevant or very relevant, and their median score was ?3.25. Results: Of the 210 physicians contacted, 34 physicians completed the initial survey and 17 completed the follow-up survey. A total of 22 topics met consensus for inclusion in the CDQL, addressing symptoms, emotions, functions of daily living, social and physical functions, work/school functions, and treatment. Conclusions: This study was limited by the following factors: few open-ended questions in the initial survey, a lack of direct patient feedback, and long survey length, which likely contributed to lower survey participation. The CDQL is a comprehensive, CD-specific QoL measure developed on the basis of expert consensus via a modified Delphi process to be used by physicians and other health care professionals who care for adult patients with contact dermatitis. UR - https://derma.jmir.org/2021/2/e30620 UR - http://dx.doi.org/10.2196/30620 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632827 ID - info:doi/10.2196/30620 ER - TY - JOUR AU - Abdulkarim, S. Louay AU - Motley, J. Richard PY - 2021/12/15 TI - First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand? JO - JMIR Cancer SP - e29912 VL - 7 IS - 4 KW - advanced cutaneous melanoma KW - first-line treatments KW - immunotherapy KW - targeted therapy KW - combinational therapy KW - dermatologic adverse events KW - cutaneous side effects UR - https://cancer.jmir.org/2021/4/e29912 UR - http://dx.doi.org/10.2196/29912 UR - http://www.ncbi.nlm.nih.gov/pubmed/34914610 ID - info:doi/10.2196/29912 ER - TY - JOUR AU - Oganesyan, Ani AU - Sivesind, Torunn AU - Dellavalle, Robert PY - 2021/12/14 TI - From the Cochrane Library: Topical Treatments for Cutaneous Warts JO - JMIR Dermatol SP - e33900 VL - 4 IS - 2 KW - cutaneous wart KW - plantar wart KW - topical treatment KW - papillomavirus infections KW - evidence-based medicine KW - wart KW - treatment KW - disease management KW - dermatology UR - https://derma.jmir.org/2021/2/e33900 UR - http://dx.doi.org/10.2196/33900 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632858 ID - info:doi/10.2196/33900 ER - TY - JOUR AU - Oganesyan, Ani AU - Sivesind, Torunn AU - Dellavalle, Robert PY - 2021/12/3 TI - From the Cochrane Library: Interventions for Impetigo JO - JMIR Dermatol SP - e33433 VL - 4 IS - 2 KW - impetigo KW - pustular lesions KW - Staphylococcus aureus KW - Streptococcus pyogenes KW - dermatology KW - skin infection UR - https://derma.jmir.org/2021/2/e33433 UR - http://dx.doi.org/10.2196/33433 ID - info:doi/10.2196/33433 ER - TY - JOUR AU - Dunaway, Spencer AU - Aggarwal, Pushkar AU - Shaughnessy, Cristin AU - Neltner, Scott PY - 2021/11/1 TI - Surgical Surprise: Cutaneous Metastasis Presenting for Mohs Micrographic Surgery Without a Prior Diagnostic Biopsy JO - JMIR Dermatol SP - e33241 VL - 4 IS - 2 KW - cutaneous metastasis KW - Mohs surgery KW - biopsy KW - micrographic surgery KW - dermatology KW - dermatologist KW - skin cancer KW - melanoma UR - https://derma.jmir.org/2021/2/e33241 UR - http://dx.doi.org/10.2196/33241 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632877 ID - info:doi/10.2196/33241 ER - TY - JOUR AU - Hamp, Austin AU - Anderson, D. Jarett AU - Sivesind, E. Torunn AU - Szeto, D. Mindy AU - Cury-Martins, Jade PY - 2021/10/28 TI - From the Cochrane Library: Topical Tacrolimus for Atopic Dermatitis JO - JMIR Dermatol SP - e31838 VL - 4 IS - 2 KW - atopic dermatitis KW - eczema KW - calcineurin inhibitor KW - tacrolimus KW - lymphoma KW - dermatology KW - dermatitis UR - https://derma.jmir.org/2021/2/e31838 UR - http://dx.doi.org/10.2196/31838 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632863 ID - info:doi/10.2196/31838 ER - TY - JOUR AU - Huang, Kai AU - Jiang, Zixi AU - Li, Yixin AU - Wu, Zhe AU - Wu, Xian AU - Zhu, Wu AU - Chen, Mingliang AU - Zhang, Yu AU - Zuo, Ke AU - Li, Yi AU - Yu, Nianzhou AU - Liu, Siliang AU - Huang, Xing AU - Su, Juan AU - Yin, Mingzhu AU - Qian, Buyue AU - Wang, Xianggui AU - Chen, Xiang AU - Zhao, Shuang PY - 2021/9/21 TI - The Classification of Six Common Skin Diseases Based on Xiangya-Derm: Development of a Chinese Database for Artificial Intelligence JO - J Med Internet Res SP - e26025 VL - 23 IS - 9 KW - artificial intelligence KW - skin disease KW - convolutional neural network KW - medical image processing KW - automatic auxiliary diagnoses KW - dermatology KW - skin KW - classification KW - China N2 - Background: Skin and subcutaneous disease is the fourth-leading cause of the nonfatal disease burden worldwide and constitutes one of the most common burdens in primary care. However, there is a severe lack of dermatologists, particularly in rural Chinese areas. Furthermore, although artificial intelligence (AI) tools can assist in diagnosing skin disorders from images, the database for the Chinese population is limited. Objective: This study aims to establish a database for AI based on the Chinese population and presents an initial study on six common skin diseases. Methods: Each image was captured with either a digital camera or a smartphone, verified by at least three experienced dermatologists and corresponding pathology information, and finally added to the Xiangya-Derm database. Based on this database, we conducted AI-assisted classification research on six common skin diseases and then proposed a network called Xy-SkinNet. Xy-SkinNet applies a two-step strategy to identify skin diseases. First, given an input image, we segmented the regions of the skin lesion. Second, we introduced an information fusion block to combine the output of all segmented regions. We compared the performance with 31 dermatologists of varied experiences. Results: Xiangya-Derm, as a new database that consists of over 150,000 clinical images of 571 different skin diseases in the Chinese population, is the largest and most diverse dermatological data set of the Chinese population. The AI-based six-category classification achieved a top 3 accuracy of 84.77%, which exceeded the average accuracy of dermatologists (78.15%). Conclusions: Xiangya-Derm, the largest database for the Chinese population, was created. The classification of six common skin conditions was conducted based on Xiangya-Derm to lay a foundation for product research. UR - https://www.jmir.org/2021/9/e26025 UR - http://dx.doi.org/10.2196/26025 UR - http://www.ncbi.nlm.nih.gov/pubmed/34546174 ID - info:doi/10.2196/26025 ER - TY - JOUR AU - Funkhouser, H. Colton AU - Funkhouser, E. Martha AU - Wolverton, E. Jay AU - Maurer, Toby PY - 2021/9/8 TI - Teledermatology Consults in a County Hospital Setting: Retrospective Analysis JO - JMIR Dermatol SP - e30530 VL - 4 IS - 2 KW - dermatology KW - teledermatology KW - telemedicine KW - referrals KW - primary care KW - keratosis KW - digital health KW - skin cancer KW - dermatitis UR - https://derma.jmir.org/2021/2/e30530 UR - http://dx.doi.org/10.2196/30530 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632816 ID - info:doi/10.2196/30530 ER - TY - JOUR AU - Anderson, Jarett AU - Sivesind, Torunn PY - 2021/9/2 TI - From the Cochrane Library: Skin Care Interventions in Infants for Preventing Eczema and Food Allergy JO - JMIR Dermatol SP - e30197 VL - 4 IS - 2 KW - eczema KW - atopic dermatitis KW - skin care KW - emollients KW - pediatrics KW - food allergy KW - allergy KW - dermatology UR - https://derma.jmir.org/2021/2/e30197 UR - http://dx.doi.org/10.2196/30197 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632815 ID - info:doi/10.2196/30197 ER - TY - JOUR AU - Garcia-Souto, Fernando AU - Pereyra-Rodriguez, Juan Jose PY - 2021/6/8 TI - Psoriasis Google Trends JO - JMIR Dermatol SP - e21709 VL - 4 IS - 1 KW - Google Trends KW - psoriasis KW - treatment UR - https://derma.jmir.org/2021/1/e21709 UR - http://dx.doi.org/10.2196/21709 UR - http://www.ncbi.nlm.nih.gov/pubmed/37625163 ID - info:doi/10.2196/21709 ER - TY - JOUR AU - Ali, Zarqa AU - Joergensen, Melbardis Kristina AU - Andersen, Daniel Anders AU - Chiriac, Andrei AU - Bjerre-Christensen, Theis AU - Manole, Ionela AU - Dutei, Ana-Maria AU - Deaconescu, Irina AU - Suru, Alina AU - Serban, Adina AU - Isberg, Pall Ari AU - Dahiya, Priyanka AU - Thomsen, Francis Simon AU - Zibert, Robert John PY - 2021/5/25 TI - Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation JO - JMIR Form Res SP - e24766 VL - 5 IS - 5 KW - atopic dermatitis KW - eczema KW - remote assessment KW - photo KW - photographs KW - EASI KW - SCORAD KW - severity KW - assessment KW - agreement N2 - Background: Digital imaging of dermatological patients is a novel approach to remote assessment and has recently become more relevant since telehealth and remote decentralized clinical trials are gaining ground. Objective: We aimed to investigate whether photographs taken by a smartphone are of adequate quality to allow severity assessments to be made and to explore the usefulness of an established atopic dermatitis severity assessment instrument on photograph evaluation. Methods: During scheduled visits in a previously published study, the investigating doctor evaluated the severity of atopic dermatitis using the Scoring AD (SCORAD) index and took photographs of the most representative lesions (target lesions) with both a smartphone and a digital single-lens reflex camera (DSLR). The photographs were then assessed by 5 dermatologists using the intensity items of the SCORAD (iSCORAD), which consists of erythema, oedema/papulation, excoriations, lichenification, oozing/crusts, and dryness (scale 0-3, maximum score 18). The mean iSCORAD of the photographs was calculated and compared with in-person assessments using Pearson correlation and Bland-Altman plots. Intraclass correlation coefficients were used for interrater reliability. Results: A total of 942 photographs from 95 patients were assessed. The iSCORAD based on smartphone photographs correlated strongly with the evaluations performed in person (iSCORAD: r=0.78, P<.001; objective SCORAD: r=0.81, P<.001; and total SCORAD: r=0.78, P<.001). For iSCORAD specifically, a Bland-Altman plot showed a difference in mean score of 1.31 for in-person and remote iSCORAD. In addition, the interrater agreement between the 5 rating dermatologists was 0.93 (95% CI 0.911-0.939). A total of 170 lesions were photographed, and the difference in mean scores was 1.32, 1.13, and 1.43 between in-person and remote evaluations based on photographs taken by a DSLR camera, a smartphone without flash, and a smartphone with flash, respectively. Conclusions: In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera. Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low. UR - https://formative.jmir.org/2021/5/e24766 UR - http://dx.doi.org/10.2196/24766 UR - http://www.ncbi.nlm.nih.gov/pubmed/34032580 ID - info:doi/10.2196/24766 ER - TY - JOUR AU - Costigan, Jennifer AU - Feldman, S. Sue AU - Lemak, Mark PY - 2020/5/12 TI - Assessment of Patient Satisfaction With Dermatology Clinics According to Clinic Type: Mixed Methods Study JO - JMIR Dermatol SP - e17171 VL - 3 IS - 1 KW - Consumer Assessment of Healthcare Providers and Systems survey scores KW - patient satisfaction KW - dermatology KW - private dermatology clinic KW - rapid access dermatology clinic KW - wait time KW - patient resource stewardship KW - communication N2 - Background: Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center?s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors. Objective: This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics). Methods: This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital?s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores. Results: The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center. Conclusions: This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic. UR - http://derma.jmir.org/2020/1/e17171/ UR - http://dx.doi.org/10.2196/17171 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/17171 ER - TY - JOUR AU - Mleeh, Talal Nouf AU - Alzahrani, Abdulwahed Nujood AU - Hariri, Osama Jehad AU - Mortada, Hisham Hatan AU - Algethami, Ridha Mohammed PY - 2019/12/19 TI - Dermatologists? Adherence to the Latest Recommendations for Screening of Hydroxychloroquine Retinopathy in Saudi Arabia: Cross-Sectional Study JO - Interact J Med Res SP - e15218 VL - 8 IS - 4 KW - Saudi Arabia KW - dermatologist KW - adherence KW - hydroxychloroquine KW - retinopathy N2 - Background: Hydroxychloroquine (HCQ) has been used to manage many inflammatory skin conditions. Nevertheless, retinopathy continues to be its most significant adverse effect. The American Academy of Ophthalmology (AAO) recommends baseline ophthalmologic screening in the first year of HCQ treatment. However, a recent study found an inadequate awareness of the recommendations. Furthermore, limited data are available regarding the implementation of the recommendations among dermatologists. Objective: The aim of this study was to assess dermatologists? adherence to recommendations pertaining to their current practice regarding HCQ toxicity detection. Methods: A self-administrated questionnaire was distributed between February 2 and May 4, 2018, among members of the Saudi Society of Dermatology. The questionnaire comprised demographic-related questions and questions pertaining to each physician?s routine practice about the follow-up of HCQ-treated patients. Results: A total of 76 dermatologists completed the questionnaire. We achieved a response rate of 62.54%. More than half (43/76, 56%) of the dermatologists were male. Furthermore, more than half (41/76, 53%) of them reported treating 1 to 3 patients with HCQ during the last year. Furthermore, two-thirds (47/76, 61%) of them reported screening patients before initiating HCQ treatment. Regarding follow-up recommendations, 59% (45/76) of dermatologists reported yearly after starting treatment for no-risk patients, whereas 94% (72/76) reported ?yearly within 5 years of treatment? for at-risk patients. Data were considered significant at P<.05. All analyses were performed using SPSS, version 20 (IBM). Conclusions: Dermatologists in Saudi Arabia are not well informed about some aspects of the latest recommendations regarding screening for HCQ toxicity in terms of tests, follow-up timing, cessation of the drug, and causative agents. Therefore, we recommend conducting more studies in Saudi Arabia to determine the adherence of more physicians to the AAO recommendations. Furthermore, patient education regarding HCQ toxicity and increased patient awareness are recommended for effective and safe HCQ use. UR - http://www.i-jmr.org/2019/4/e15218/ UR - http://dx.doi.org/10.2196/15218 UR - http://www.ncbi.nlm.nih.gov/pubmed/31855186 ID - info:doi/10.2196/15218 ER -