Australasian Journal of Dermatology最新文献

{"title":"An Online Questionnaire Improves Outcomes for Children With Atopic Eczema.","authors":"Danielle Paea, Kate L Francis, David Orchard","doi":"10.1111/ajd.14574","DOIUrl":"https://doi.org/10.1111/ajd.14574","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a condition where management can be complicated as it involves significant education about a variety of triggers and treatment options. Access to specialist care for eczema is often limited in many situations, leading parents of children with AD to seek online support for guidance on effective management strategies.</p><p><strong>Objective: </strong>The intention of the project was to provide an online 'eczema triggers' questionnaire to parents who are waiting for a specialist appointment for their child's eczema. The primary aim was to determine whether using this questionnaire will improve the child's eczema severity as assessed by the SCORing Atopic Dermatitis (SCORAD) clinical tool at the initial appointment. Secondly, to determine if there is a reduced need for a specialist appointment. This can be demonstrated in the form of an increased rate of cancellation in the number of first appointments and/or a decreased need for a review appointment due to improved eczema management and control as a result of completing the online questionnaire.</p><p><strong>Methods: </strong>A randomised controlled study where families waiting for an appointment for their child with AD were allocated to receive access to an online eczema triggers questionnaire before their appointment or to continue with the standard booking process without a pre-appointment questionnaire. The sample size was calculated to be 100 (50 per group), using 90% power to detect a difference of 10 points in the SCORAD.</p><p><strong>Results: </strong>There were 119 families assessed for eligibility. One hundred and eight families were randomised, with 55 (49%) assigned to the intervention group. The mean SCORAD score was lower (indicating better eczema outcome) in the intervention group 21.4 (SD: 14.0), compared to the control group 25.2 (SD: 15.6) (mean difference: -3.8 [95% CI: -9.6 to 2.0], p = 0.195). There were 28% (95% CI: 10 to 46, p = 0.003) fewer appointments booked in the intervention group (46%) compared to the control group (74%) at follow up. Under an 'analysis by treatment administered' approach where the group who completed the triggers questionnaire intervention (n = 30) was compared to the control group and the non-completers (n = 74) the difference in mean SCORAD was more pronounced (-8.4 [95% CI: -14.7 to -2.1, p = 0.010]) between the intervention group (mean score 17.3 SD: 12.5) and non-completers (mean score 25.7, SD: 15.2).</p><p><strong>Conclusion: </strong>The online eczema triggers questionnaire provides positive outcomes in managing a child's AD in the primary care setting, giving access to care and advice whilst waiting for a specialist appointment. The severity of AD upon presentation was found to be less pronounced in individuals who completed the questionnaire, resulting in a reduced need for follow-up appointments. It offers an opportunity to enhance health and well-being outcomes for children and th","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833866","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":"Efficacy and Safety of Phosphodiesterase-4 Inhibitors in Vitiligo: A Systematic Review","authors":"Reya Hanspal,&nbsp;Hibo Rijal,&nbsp;Ilya Mukovozov","doi":"10.1111/ajd.14548","DOIUrl":"10.1111/ajd.14548","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"e378-e381"},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844287","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":"Treatment Recommendations Regarding Superficial BCC Should Not Be Based on the Challenges Encountered in a Select Group of Tumours That Were Referred for Moh's Micrographic Surgery","authors":"Robert Stephens","doi":"10.1111/ajd.14567","DOIUrl":"10.1111/ajd.14567","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"e382-e383"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820448","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":"A Clinical Perspective on Melanoma Overdiagnosis.","authors":"Jennifer Sheerin, Helena Collgros, Alex Chamberlain, Peter Ferguson, Bruna Melhoranse Gouveia, Pascale Guitera, Victoria Mar, David C Whiteman, Tony Caccetta","doi":"10.1111/ajd.14581","DOIUrl":"https://doi.org/10.1111/ajd.14581","url":null,"abstract":"<p><p>Overdiagnosis in melanoma is a nuanced and evolutionary issue. It may appear to be an epidemic from an epidemiological point of view; however, it is important to appreciate all perspectives. We consider overdiagnosis a necessary challenge-which drives clinicians to improve diagnostic accuracy and reduce overtreatment-pathologists to recalibrate histopathological thresholds and reduce overcalling-and researchers to develop markers of biological activity for melanoma. In this article, we present our clinical perspective on the current burden of melanoma overdiagnosis and its future value for progress in the field of melanoma.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820447","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":"Retrospective Review on Safety and Efficacy of Combination Biologic Therapy for Psoriasis.","authors":"Nicole Kah Mun Yoong, Xin Lin Wong, John Sullivan","doi":"10.1111/ajd.14584","DOIUrl":"https://doi.org/10.1111/ajd.14584","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the use of dual or combination biologic therapy in dermatological patients, particularly in psoriasis or with other coexisting dermatological conditions. However, this may be necessary for a small proportion of patients.</p><p><strong>Methods: </strong>We conducted a retrospective review of 46 patients treated with dual or combination biologic therapy at a single dermatology practice in Sydney, Australia. The patient cohort consisted of 44 patients with psoriasis, 1 patient with hidradenitis suppurativa and 1 patient with a combination of hidradenitis suppurativa and psoriasis.</p><p><strong>Results: </strong>Of 46 patients receiving a combination of biological agents, only 1 experienced an adverse effect that did not require cessation of therapy.</p><p><strong>Conclusion: </strong>The use of combination biologic therapy may be an option for psoriasis patients with recalcitrant disease, in particular for those with concomitant psoriatic arthritis or other dermatological conditions. However, further studies are warranted to evaluate the efficacy, safety and health economics of this treatment approach.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803322","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":"A Case Report of Symmetrical Drug-Related Intertriginous and Flexural Exanthema-Like Eruption Associated With Borrelial Infection.","authors":"Elyana Espinoza, Alex V Nguyen, Tung S Tran, Giang H Nguyen","doi":"10.1111/ajd.14570","DOIUrl":"https://doi.org/10.1111/ajd.14570","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793366","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":"Criteria for Commencing and Continuing Subsidised Janus Kinase Inhibitor Therapy in Australian Alopecia Areata Patients-Results From an Australian Expert Consensus Exercise.","authors":"Meryl Thomas, Madeline Hankins, Emadodin Darchini-Maragheh, Laita Bokhari, Samantha Eisman, Leona Yip, Katherine York, Jane Li, Pooja Sharma, Daranporn Triwongwaranat, Vijaya Chitreddy, Ragini Ghiya, Daniella Kushnir-Grinbaum, John Frewen, Shin Shen Yong, Deepani Rathnayake, William Cranwell, Dmitri Wall, Vanathy Varathan, Kiarash Khosrotehrani, David Orchard, Anthony Moussa, Meghana Paranjape, Rodney Sinclair","doi":"10.1111/ajd.14556","DOIUrl":"https://doi.org/10.1111/ajd.14556","url":null,"abstract":"<p><strong>Background/objectives: </strong>Janus kinase inhibitors (JAKis) have been approved by the Therapeutic Goods Administration for severe alopecia areata (AA) in Australia. However, access is limited as JAKis are not currently subsidised on the Pharmaceutical Benefits Scheme for this indication. This study aimed to establish expert consensus on criteria for initiating and continuing subsidised JAKi therapy for AA.</p><p><strong>Methods: </strong>An eDelphi study was conducted with 26 Australian specialists in hair and scalp disorders, who participated in two online survey rounds. A third round, held as a virtual meeting, facilitated discussion. Consensus was defined as ≥ 75% agreement or disagreement.</p><p><strong>Results: </strong>Twenty-six, twenty-two, and twenty-five experts completed the first, second, and third rounds, respectively. Experts agreed that JAKis were nearly always the best treatment for cases with ≥ 50% scalp hair loss and usually the best treatment for 21%-49% scalp hair loss. The most important additional factors when assessing eligibility for JAKis were refractory disease, rapid progression, psychosocial morbidity, poorly camouflaged hair loss, ophiasis pattern, and impaired quality of life. Treatment failure was defined as < 50% improvement in scalp hair loss after 12 months of therapy. Indicators of remission included achieving SALT 0, regrowth of facial hair, improved DLQI scores, patient satisfaction, negative hair pull test, and reduced psychosocial impairment.</p><p><strong>Conclusions: </strong>This expert consensus provides a framework for determining eligibility for subsidised JAKi therapy in Australian AA patients. Future research, supported by patient registries, should incorporate patient perspectives to further refine these criteria, ensure equitable access to treatment, and assess real-world impact, safety, and effectiveness.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788161","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":"Guidelines for Phototherapy and PUVA Service Delivery in Australia: Minimum Standards and Quality Assurance Framework.","authors":"Stephanie Tan, Kurt GeBauer","doi":"10.1111/ajd.14579","DOIUrl":"https://doi.org/10.1111/ajd.14579","url":null,"abstract":"<p><p>Phototherapy is a well-established treatment modality for various dermatological conditions; however, there is currently no national standard governing its delivery in Australia. These guidelines aim to define minimum standards for the provision of phototherapy and PUVA services, offering a structured framework to support consistency in clinical practice, enhance patient safety, optimise therapeutic outcomes and serve as a national benchmark for high quality phototherapy care. These standards are informed by expert opinion and existing frameworks such as the British Association of Dermatologists' Phototherapy Guidelines.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783362","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":"Topical Steroid Withdrawal: A Perspective of Australian Dermatologists.","authors":"Andrew Awad, Frances Bell, Gayle Ross","doi":"10.1111/ajd.14580","DOIUrl":"https://doi.org/10.1111/ajd.14580","url":null,"abstract":"<p><strong>Background: </strong>Topical steroid withdrawal (TSW) is a rare adverse event from topical corticosteroid use. Recently, there has been increasing interest and discussion in the community regarding TSW; however, there are no diagnostic criteria. Our study aimed to identify Australian dermatologists' perspectives on TSW and provide recommendations for future approaches.</p><p><strong>Methods: </strong>We conducted an online survey distributed by the Australasian College of Dermatologists via email to all dermatology fellows and trainees from September to November 2024. Survey questions were informed by literature on TSW, conference materials, expert input and consultation with the Australasian College of Dermatologists.</p><p><strong>Results: </strong>There were seventy completed survey responses. Most respondents were dermatology fellows, and 60% had a particular interest in atopic dermatitis. Fifty-nine percent of respondents reported that they do not consider TSW a clinical entity. Most respondents (95%) thought the underlying diagnosis was a relapse of atopic dermatitis or periorificial dermatitis (24%). Ninety-seven percent of respondents reported that patients became aware of the term TSW through social media.</p><p><strong>Conclusions: </strong>Our survey identified differing perspectives on TSW among dermatology fellows and trainees; many do not diagnose it, and most patients gain information via social media. This emphasises the importance of developing a unified stance on TSW from medical professionals to prevent the spread of misleading information from non-medical sources.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783363","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":"Modified Reading Man Flap for Scalp Reconstruction: Report of Six Cases.","authors":"Andrés Grau-Echevarría, Daniel Blaya Imbernón, Malena Finello, Elena Pérez Zafrilla, Ángel González García, Alba Nácher Albiach, Laura Giménez Cuenca, Rodrigo Peñuelas Leal, Carolina Labrandero Hoyos, David Muñoz Castro, Jorge Magdaleno Tapial, Pablo Hernández Bel, Esther Díez-Recio","doi":"10.1111/ajd.14578","DOIUrl":"https://doi.org/10.1111/ajd.14578","url":null,"abstract":"<p><p>The Reading man flap remains unexplored in the scalp but may be an excellent reconstructive option. We present six cases of a modified version of the Reading man flap that decreases the risk of ischaemia and achieves good functional and aesthetic results. The steps in designing the modified flap are described. This flap allows for a highly efficient reconstruction by limiting the sacrifice of healthy tissue to a minimum and generating less tension in the closure.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764400","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}