Journal of Cutaneous Medicine and Surgery最新文献

{"title":"The Dermatologist is Out? Assessment of Dermatologists in Ontario Accepting Ontario Health Insurance Plan (OHIP) Referrals for Hair Loss Evaluation.","authors":"Victoria Young, Renée A Beach","doi":"10.1177/12034754251324941","DOIUrl":"10.1177/12034754251324941","url":null,"abstract":"<p><strong>Background: </strong>The Ontario Health Insurance Plan (OHIP) insures appointments for the assessment and diagnosis of hair loss, or alopecia. Although anecdotal, discussion suggests that, increasingly, dermatologists decline to see referrals of this nature. There has been a lack of objective surveillance to determine the proportion of dermatologists in practice who accept referrals for this concern.</p><p><strong>Objectives: </strong>This study investigated the proportion of dermatologists in Ontario accepting OHIP referrals for hair loss. Secondary objectives included wait times, consultation fees for non-OHIP visits, and factors affecting referral acceptance or rejection.</p><p><strong>Methods: </strong>A cross-sectional telephone survey was conducted, in which 284 dermatologists' offices listed by the College of Physicians and Surgeons of Ontario (CPSO) were contacted. The study investigated the acceptance of OHIP referrals for hair loss, wait times, additional referral requirements, and private consultation fees. Descriptive statistics were employed to summarize data.</p><p><strong>Results: </strong>Of the 284 offices contacted, 38.38% (109/284) accepted OHIP referrals for hair loss, 48.59% (138/284) did not, and 13.03% (37/284) were unavailable for contact. The average wait time for offices that accepted referrals was 4.51 ± 4.07 months. Non-OHIP consultation fees ranged from $135 to $299 CAD. Some offices limited acceptance to specific conditions such as alopecia areata and male androgenetic alopecia.</p><p><strong>Conclusion: </strong>A total of 48.59% of dermatologists in Ontario do not accept OHIP referrals for hair loss, while the status of 13.03% remains unknown. This reality raises concerns about accessibility to care. Further research is needed to investigate factors influencing referral acceptance.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251324941"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Mycosis Fungoides and Sézary Syndrome With Oral Systemic Therapies.","authors":"Jonathan D Greenzaid, Sach Thakker, Ainsley J Ruley, Justin M Eichinger, Lindsay C Strowd","doi":"10.1177/12034754251322881","DOIUrl":"10.1177/12034754251322881","url":null,"abstract":"<p><p>Mycosis fungoides (MF) and Sézary syndrome (SS) are subtypes of cutaneous T-cell lymphoma with numerous topical and systemic therapies. Early-stage MF can be managed with topical corticosteroids, mechlorethamine, and phototherapy. However, patients are often non-responsive to topical therapies, thus requiring systemic therapies. There are few studies summarizing oral (PO) therapies for MF and SS. We aim to discuss the efficacy and safety of FDA-approved, off-label, and investigational oral therapies for MF and SS. FDA-approved oral therapies include bexarotene and vorinostat, both of which are effective in patients who are recalcitrant to prior topical therapies. Off-label oral therapies include methotrexate, acitretin, and chlorambucil. Methotrexate improves MF lesions in both early-stage and late-stage MF and is effective in erythrodermic MF. A combination of acitretin with phototherapy may lead to better response rates compared to acitretin monotherapy. Chlorambucil is mainly used to treat erythrodermic MF. Investigational oral therapies for MF include tenalisib, duvelisib, cerdulatinib, lenalidomide, bortezomib, and azacytidine, and direct comparison studies between these investigational agents and FDA-approved therapies should be undertaken to better understand their role in the management of MF and SS.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251322881"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Calcium Supplementation be Abandoned in Patients With Calcinosis Cutis?","authors":"Rose He, Mohammed Osman, Agnieszka Owczarczyk-Saczonek, Robert Gniadecki","doi":"10.1177/12034754251320640","DOIUrl":"https://doi.org/10.1177/12034754251320640","url":null,"abstract":"<p><p>Calcinosis cutis, characterized by the pathological deposition of insoluble calcium salts in the skin, is associated with several disease entities, particularly autoimmune conditions such as scleroderma and dermatomyositis. Lesions of calcinosis are often painful, prone to ulceration, and significantly impair quality of life. Despite the clinical impact, no effective treatments have been established to date, making prevention of this condition a critical priority. In this narrative review, we explore the evidence suggesting that calcium supplementation may contribute to skin calcification. Calcium supplements have been demonstrated to transiently elevate plasma calcium levels, potentially promoting dystrophic tissue calcification-a process that may be exacerbated in a context of magnesium and vitamin K2 deficiencies. Furthermore, calcium supplementation has been associated with an increased risk of adverse cardiovascular events; this concern is particularly relevant in patients with autoimmune diseases who already face elevated cardiovascular comorbidity. Notably, there is no robust evidence supporting the efficacy of calcium supplementation in preventing osteoporosis. Instead, sufficient dietary intake of calcium and protein, along with the supplementation of micronutrients critical for calcium homeostasis (magnesium, zinc, vitamin D₃, and vitamin K₂), should be considered as alternatives to calcium supplementation.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251320640"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Dermoscopy for Distinguishing Early Melanomas and Intermediate Melanocytic Lesions From Low-Grade Dysplastic Nevi.","authors":"Ceylan Avcı, Meltem Kaşıkçı, Banu Lebe, Sevgi Akarsu, Turna İlknur","doi":"10.1177/12034754251325508","DOIUrl":"https://doi.org/10.1177/12034754251325508","url":null,"abstract":"<p><strong>Background: </strong>Early melanomas, dysplastic melanocytic nevi, and melanocytic tumours of uncertain malignant potential (MELTUMPs) reveal similar clinic and dermoscopic findings leading to underdiagnosis of malign lesions or unnecessary excision of benign ones. High-grade dysplastic nevi and MELTUMPs in the intermediate category should be recognized and completely excised.</p><p><strong>Objectives: </strong>We evaluated the diagnostic performance of pattern analysis, ABCD rule, colour, architecture, symmetry, and homogeneity algorithm, melanoma-specific structures and asymmetry of dermoscopic features in distinguishing early melanomas, high-grade dysplastic nevi, and MELTUMPs from low-grade dysplastic nevi.</p><p><strong>Methods: </strong>We retrospectively assessed dermoscopic images blindly to the histopathological diagnoses in a university hospital.</p><p><strong>Results: </strong>One hundred forty histopathologically confirmed melanocytic lesions were included (93 low-grade dysplastic nevi, 26 thin melanomas, 17 high-grade dysplastic nevi, and 4 MELTUMPs). All dermoscopic methods had poor diagnostic performance in early melanomas and intermediate melanocytic lesions. In the multivariate analyses of dermoscopic findings, the atypical pigment network (OR: 3.58, 95% CI: 1.31-9.72), asymmetry of globules (OR: 3.17, 95% CI: 1.37-7.35), streaks (OR: 6.16, 95% CI: 1.95-19.48) and homogenous structureless areas (OR: 5.92, 95% CI: 2.36-14.92) were the significant predictive factors for melanomas and intermediate melanocytic lesions. Positive predictive values of melanoma-specific structures were shiny white structures (100%), scar-like depigmentation (85.7%), blue-white veil (72.7%), atypical blotch (72.2%), and negative pigment network (71.4%).</p><p><strong>Conclusions: </strong>Shiny white structures, atypical network, asymmetry of globules, streaks, and homogeneous structureless areas were the most significant dermoscopic findings in discriminating early melanomas and intermediate melanocytic lesions from low-grade dysplastic nevi.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251325508"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Eczema Education Pictorial Study (PEEPS): A Pilot Investigation.","authors":"Bethany F Wilken, Sonja Molin, Thomas Herzinger, Robert Bobotsis, Anne K Ellis, Yuka Asai","doi":"10.1177/12034754251320645","DOIUrl":"10.1177/12034754251320645","url":null,"abstract":"<p><strong>Background: </strong>For optimal control of atopic dermatitis (AD), patient education is essential to complement traditional therapy. Patient education has proven to benefit AD outcomes, but previous methods of delivery are costly and time-consuming.</p><p><strong>Objective: </strong>To assess the effectiveness of a one-page pictorial education tool at improving AD quality of life (QoL) and disease severity.</p><p><strong>Methods: </strong>Patients with AD and caregivers (if patient <18 years) received education with a pictorial education tool. QoL and disease severity were measured at baseline and in follow-up 2 to 6 months after education.</p><p><strong>Results: </strong>Forty-seven patients and caregivers from speciality clinics in dermatology and allergy received education. At follow-up, there were significant decreases in QoL scores and median disease severity scores.</p><p><strong>Conclusions: </strong>A pictorial education tool for AD is associated with significant benefits for patients and caregivers after 2 to 6 months. This tool may be valuable for health care providers who are in need of an effective and efficient method of AD education; however, further studies are needed to address identified knowledge gaps and expand to other sites and non-specialist clinics.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251320645"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Here Comes the Sun! A Study on Sun Exposure and Associated Risks in the Canadian Population.","authors":"Thierry Passeron, Henry Lim, Jean Krutmann, Brigitte Dreno, Sonya Abdulla, Patricia Ting, Monica Li, Nadir Chemani, Delphine Kerob, Caroline Le Floch, Nour R Dayeh","doi":"10.1177/12034754251322778","DOIUrl":"https://doi.org/10.1177/12034754251322778","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the awareness of and attitudes toward various aspects of sun-exposure risks and protection methods among Canadians.</p><p><strong>Methods: </strong>An online survey conducted from September 28 to October 18, 2021, included 17,001 participants aged 18 years and above from 17 countries across 5 continents; the data presented are those of the Canadian population (n = 1,000). The survey focused on demographics, sun-exposure habits, comprehension of risks, and knowledge of photoprotection. The results were analyzed using descriptive statistics to identify prevalent trends and discrepancies in sun-protective behaviours among Canadians.</p><p><strong>Results: </strong>The majority of Canadian respondents (93%) acknowledged the health risks associated with sun exposure. While 81% of Canadians reported using some form of sun protection, only 10% systematically implemented all recommended protective measures, highlighting a gap in knowledge translation. Misconceptions regarding the safety of tanned skin and the effectiveness of sunscreens were widespread, particularly in younger demographics and in individuals with darker skin. Knowledge and preventive behaviours were markedly better among individuals who regularly consult dermatologists.</p><p><strong>Conclusions: </strong>This study highlights general awareness of sun-protective behaviours but a lack of universal and comprehensive implementation among Canadians. Given the knowledge gaps in younger demographics and darker skin phototypes, targeted educational initiatives are essential to correct prevalent misconceptions about sun exposure and tanned skin. Dermatologists and other health care professionals can play a pivotal role in education and primary prevention strategies for skin cancer and other sun-related comorbidities.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251322778"},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Incidence of Prurigo Nodularis: A Systematic Review of Population-Based Studies.","authors":"Ryan S Q Geng, Siddhartha Sood, Martin Heung, Khalad Maliyar, Muskaan Sachdeva, Abrahim Abduelmula, Asfandyar Mufti, Jensen Yeung","doi":"10.1177/12034754251325467","DOIUrl":"https://doi.org/10.1177/12034754251325467","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251325467"},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Treatment Outcomes of Reported Cases of Non-Cutaneous Melanomas: A Systematic Review.","authors":"Edgar Akuffo-Addo, Sinthiha Krishnan, Ennie Olajide, Eunice Aluko, Lea Saroufim, Ezekiel Garuba, Nana Efia Acquah, Katya Peri, Angel Osei, Robin Olaonipekun, Ebenezer Oladogba, Ilya Mukovozov","doi":"10.1177/12034754251324943","DOIUrl":"https://doi.org/10.1177/12034754251324943","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251324943"},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Pediatric Chronic Hand Eczema: A Systematic Review with Focus on Causes and Management.","authors":"Katie C Y Yeung, Joshua Lowe, Jessica S S Ho, Sonja Molin","doi":"10.1177/12034754251322883","DOIUrl":"https://doi.org/10.1177/12034754251322883","url":null,"abstract":"<p><p>Chronic hand eczema (CHE) is commonly seen in adults and often in the context of occupational exposures. Recently, there has been a growing number of cases reported among children. We conducted a systematic review using the PRISMA framework to identify cases of pediatric CHE. Search terms included \"eczema,\" \"dermatitis,\" \"pompholyx,\" \"dyshidrosis,\" \"contact allergy,\" and \"pulpitis.\" Case reports of patients aged <18 years old without an alternate/confounding diagnosis were included. 62 cases were included with a mean age of 10.9 years. In the patients with reported data, 61% (28/46) had a history of atopy and 38% (14/37) reported lesions were present for >1 year. The most common cause was allergic-contact dermatitis (71%) with the bilateral hands affected (87%). A total of 35 unique triggers were identified, with the top 5 being homemade slime (n = 28), store-bought slime (n = 8), outdoor plants (n = 4), UV-curing methacrylate nail polish (n = 4), and sporting gloves (n = 4). Patch testing was performed in 87% (54/62) of patients, of which 96% (52/54) tested positive to 1+ allergens. Positive reactions to methylchloroisothiazolinone and/or methylisothiazolinone (MCI/MI) were among the most common. In 53% (33/62) of patients, removal of the trigger resulted in resolution. Patterns of CHE triggers in pediatric patients differ from adults, and workup should include a detailed history of leisure-time and school activities. MCI/MI was the most common culprit, and trends involving children making slime has led to an increase in prolonged/repeated exposure. Awareness of potential causes ensures early identification, patch testing, prompt removal of trigger, and appropriate management.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251322883"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitiligo: A Review of Pathogenesis and Treatments, Including New Therapies on the Horizon.","authors":"Catalina Retamal, Dan Hartmann, Fernando Valenzuela","doi":"10.1177/12034754251320637","DOIUrl":"https://doi.org/10.1177/12034754251320637","url":null,"abstract":"<p><p>Vitiligo is an acquired depigmentation skin disease caused by the immune-mediated death of melanocytes. It is the most common cause of depigmentation with an estimated worldwide prevalence of 1% but has shown insufficient response to current therapies. The latest research in vitiligo pathogenesis has translated into finding new molecular targets [type I interferon and Janus kinase signal transducers and transcription activators (JAK STAT) pathways], with new therapies generating promising results, such as JAK inhibitors. Other therapeutic strategies include phototherapy, surgical treatment, and complementary options such as micropigmentation, microneedling, and lasers. This review aimed to discuss the mechanisms involved in the development of the disease and the new therapeutic options that have become available, as well as the evidence on complementary therapies. For this purpose, a review of the evidence was conducted using the PubMed database. Based on this review, it was concluded that the progress in understanding the pathophysiology of vitiligo has allowed for the consideration of new molecular targets, with JAK inhibitors showing particular promise in both systemic and topical applications. Nonetheless, further investigation is required to assess the safety of JAK inhibitors and to determine the optimal regimen and dosage for administering these drugs. Complementary treatments should be considered on a case-by-case basis.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"12034754251320637"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}