Australasian Journal of Dermatology最新文献

{"title":"Dermoscopic features of the normal vermilion in skin of colour.","authors":"Biswanath Behera, Sonika Garg, Vishal Thakur, Shreya K Gowda, Priyanka Sangwan","doi":"10.1111/ajd.14336","DOIUrl":"https://doi.org/10.1111/ajd.14336","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417590","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":"Barriers to the introduction of novel advanced targeted treatments for Australian dermatology patients: Are skin diseases symptomatic of a systemic healthcare problem?","authors":"Patrick David Mahar MBBS (Hons), LLB (Hons), MBA, MDerm, GDLP, PhD, DMedSc, FAICD, FACLM, FACD,&nbsp;Anna Crothers BCom, MHEcon,&nbsp;Peter Foley MBBS, BMedSc, MD, FACD,&nbsp;Joseph Thomas BA (Hons), PhD","doi":"10.1111/ajd.14333","DOIUrl":"10.1111/ajd.14333","url":null,"abstract":"<p>The aim of this article is to provide education to clinicians about certain barriers restricting the use of advanced targeted treatments in Australian health care. For illustrative purposes, the article focuses on dermatological conditions, but the content is relevant to all specialties that treat inflammatory and chronic diseases. Barriers to care discussed result in a lower than necessary standard of care for patients in Australia despite important advancements in medicine.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vismodegib in Gorlin-Goltz syndrome: A systematic review","authors":"Ana Gusmão Palmeiro MD,&nbsp;Mélissa Carvalho MD,&nbsp;Cristina Gonçalves Castro MD,&nbsp;Bernardo Pimentel MD,&nbsp;Goreti Catorze MD","doi":"10.1111/ajd.14326","DOIUrl":"10.1111/ajd.14326","url":null,"abstract":"<p>Treatment with Hedgehog Inhibitors in Gorlin-Goltz syndrome (GGS) yields favourable objective clinical responses, yet secondary resistance and class-related toxicity restrict treatment duration. This study aims to review current data on GGS patients undergoing vismodegib therapy, focusing on treatment duration, clinical outcomes and schedule modifications. A systematic search of the PubMed database was conducted for English articles from 1993 to 2023, identifying 31 papers suitable for inclusion. A total of 351 patients, with a mean age of 52 years, were analysed. The average treatment duration was 9.3 months for patients who discontinued treatment, and 25.1 months for those who continued vismodegib at the time this study was published. Vismodegib achieved a complete response rate of 44%. Treatment interruption predominantly occurred due to side effects (69.1%) and secondary resistance (9.1%). The use of alternative regimens, although not compromising efficacy, may enhance treatment compliance. Further investigations are warranted to ascertain the optimal treatment regimen and timeline for GGS patients. Schedule modifications offer promise in ameliorating side effects and facilitating long-term treatment.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141309929","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 demographic characteristics and risk factors associated with sun protection behaviours in specialist melanoma clinics","authors":"Juliet Smith,&nbsp;David Espinoza,&nbsp;Amelia K. Smit,&nbsp;Bruna Gallo,&nbsp;Andrea L. Smith,&nbsp;Serigne N. Lo,&nbsp;Pascale Guitera,&nbsp;Linda K. Martin,&nbsp;Anne E. Cust","doi":"10.1111/ajd.14314","DOIUrl":"10.1111/ajd.14314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated the association between sun protection behaviours and demographic and melanoma risk characteristics of patients attending Australian melanoma specialist clinics. This may assist in targeting and tailoring melanoma prevention patient education for people at high-risk and specific population subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis of questionnaire data collected from participants attending the dermatology clinics at two major melanoma centres in Sydney, Australia between February 2021 and September 2023. The primary outcome was Sun Protection Habits (SPH) index (a summary score measured as habitual past month use of sunscreen, hats, sunglasses, a shirt with sleeves that covers the shoulders, limiting midday sun exposure and seeking shade, using a Likert scale). The primary analysis considered the SPH index and its component items scored as continuous.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 883 people were analysed. Factors associated with less frequent sun protection behaviours overall included male gender, no personal history of melanoma, lower perceived risk, lower calculated 10-year risk of developing melanoma, and no private health insurance. People aged &gt;61 years reported lower use of sunscreen but higher use of hats and sleeved-shirts compared with people in the younger age group. There was no difference in overall sun protection behaviours according to family history of melanoma, country of birth or by lifetime melanoma risk among people without a personal history of melanoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight the potential for targeting high-risk individuals with less frequent use of sun protection for patient education, public health messaging and ultimately improving sun protection behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teledermatology in Australian public hospital emergency departments: A review","authors":"Danica Xie MD,&nbsp;John Sullivan FACD","doi":"10.1111/ajd.14327","DOIUrl":"10.1111/ajd.14327","url":null,"abstract":"&lt;p&gt;Dermatological complaints account for around one in ten emergency department (ED) presentations.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In Australia, teledermatology in the ED is one strategy to increase access to dermatologic advice, especially in rural and remote communities where barriers such as travel time or lack of dermatology on-call cover, prevent timely communication and dermatological care.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;\u0000 &lt;/p&gt;&lt;p&gt;Diagnostic accuracy with in-person dermatology for asynchronous store-and-forward (SAF) teledermatology and real-time (RT) videoconferencing systems is 71–98%, while mobile phones as a platform for hybrid teledermatology reveal potential value in the early diagnosis of skin cancer.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt;\u0000 &lt;/p&gt;&lt;p&gt;However, there is currently limited teledermatology implemented in the emergency department, despite having already been successfully trialled.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; We reviewed the literature to identify the current benefits and limitations of teledermatology use in the hospital ED and highlight how this technology is best considered complementary to in-person dermatology.&lt;/p&gt;&lt;p&gt;Our literature search returned four eligible studies (&lt;i&gt;n&lt;/i&gt; = 660 patients) which were all based in the Australian healthcare system (Table 1).&lt;/p&gt;&lt;p&gt;The most common diagnoses were dermatitis/eczema, infection, and drug eruption (Table 2). Three of four studies conducted store-and-forward technology&lt;span&gt;&lt;sup&gt;2, 3, 7&lt;/sup&gt;&lt;/span&gt; while one study analysed RT teledermatology.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The response rate within 3 h for dermatology advice ranged from 56% to 94%.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The benefits and limitations of teledermatology in the ED have been summarised below.&lt;span&gt;&lt;sup&gt;2, 3, 5, 7&lt;/sup&gt;&lt;/span&gt;\u0000 &lt;/p&gt;&lt;p&gt;This review reveals the value of ED teledermatology, with 50% of referrals being converted to non-urgent outpatient review, reducing the need for costly hospital admissions.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In France, an RT teledermatology study of four ED's (&lt;i&gt;n&lt;/i&gt; = 111) revealed that ED physicians recommended admission more frequently (8.2% vs. 7.2%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), while dermatologists chose to discharge patients more often (46.8% vs. 39.1%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;\u0000 &lt;/p&gt;&lt;p&gt;Muir and colleagues&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; reported up to 98% diagnostic concordance using SAF technology in ED. Furthermore, the management concordance between the teledermatologists and in-person dermatologists were complete agreement in 96% of cases (&lt;i&gt;n&lt;/i&gt; = 48).&lt;/p&gt;&lt;p&gt;More than 80% of images in this review were sent with adequate resolution. Computer workstations on wheels (WOW) are mobile nodes of a hospital's electronic medical record and with high-definition cameras, WOW's could be a solution to managing dermatological conditions in contexts where specialists are scarce.&lt;/p&gt;&lt;p&gt;While many SAF studies used an internal teledermatology email to receive teledermatolo","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of case–control studies of cytokines in blister fluid and skin tissue of patients with Stevens Johnson syndrome and toxic epidermal necrolysis","authors":"Thomas Jonathan Stewart BBioMedSci, MBBS, MMed, MS, FRACGP, FACD,&nbsp;Joshua Farrell BA, MBBS, MMed,&nbsp;John Walter Frew MBBS, MMed, MS, PhD, FACD","doi":"10.1111/ajd.14329","DOIUrl":"10.1111/ajd.14329","url":null,"abstract":"<p>Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions characterised by keratinocyte apoptosis, necroptosis and epidermal detachment. Several cytokines and cytotoxic proteins have been shown to be elevated in the blood and skin of SJS/TEN sufferers and biologics such as intravenous immune globulin and tumour necrosis factor (TNF)-alpha inhibitors have demonstrated good therapeutic potential. The exact pathogenic model of SJS/TEN however remains elusive. This systematic review aimed to evaluate the case–control studies of cytokines and cytotoxic proteins in the blister fluid and skin of adults with Stevens Johnson syndrome and/or toxic epidermal necrolysis. This review was registered with INPLASY and conducted in accordance with the PRISMA reporting guidelines. Potential bias was assessed using the NIH criteria. Eleven articles describing results from 96 cases and 170 controls were included. Fas, Fas ligand, Interleukin (IL)-8 and B-cell lymphoma (Bcl)-2 were elevated in SJS/TEN blister fluid and skin tissue, compared with healthy controls. IL-2, IL-6, TNF-alpha, tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon-gamma and matrix metalloproteinase-2 were elevated in SJS/TEN blister fluid compared with fluid sampled from lesional controls. Granulysin, IL-33, TGF-beta-1 and IL-13 were elevated in SJS/TEN skin tissue compared with lesional lichen planus tissue, as was IL-13, IFN-gamma, IL-2 and IL-5, when compared with erythema multiforme tissue. A wide array of cytokines and cytotoxic proteins are present at higher concentrations in the blister fluid and skin tissue of SJS/TEN patients compared with healthy and lesional controls. Our findings suggest that these proteins may be pathogenic, as well as possibly markers for diagnosis, disease severity and course. They may also prove to be useful therapeutic targets. More research is needed.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients","authors":"William Cranwell MBBS(Hons), BMedSc(Hons), MPH&TM, FACD,&nbsp;Nekma Meah MBChB, MRCP (UK), MRCP(Derm), FACD,&nbsp;Dmitri Wall MRCP(Derm),&nbsp;Bevin Bhoyrul MBBS, MRCP (UK), FACD,&nbsp;Bokhari Laita MPhil, MMed,&nbsp;Rodney D. Sinclair MBBS, MD, FACD","doi":"10.1111/ajd.14325","DOIUrl":"10.1111/ajd.14325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase-signal transducer and activator of transcription (JAK–STAT) pathway is implicated in the pathogenesis of AA and Janus Kinase inhibitor (JAKi) medications are promising emerging treatments for AA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We evaluated the safety and effectiveness of tofacitinib in a real-world setting over 18 months of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of all patients with scalp AA commenced on tofacitinib between 1 November 2016 and 31 May 2019. The primary endpoint was the percent change in Severity of Alopecia Tool (SALT) score at 18 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and two patients were included. After 18 months of treatment, 55.9%, 42.6% and 29.2% achieved 50%, 75% and 90% reductions in their SALT scores respectively. Increased duration of AA was a negative predictor of hair regrowth. Males and patients with baseline SALT ≥90 were slower to respond to treatment in the first 12 months. One hundred and twenty-four patients and 168 patients received concomitant systemic corticosteroids or low-dose oral minoxidil during tofacitinib therapy respectively. There were no serious adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tofacitinib was a safe and effective treatment for patients with moderate-to-severe AA. Further randomised controlled studies are needed to establish the optimal treatment regimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236865","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":"Tildrakizumab use for recalcitrant pityriasis rubra pilaris","authors":"Zachary Holmes MBBChBAO, MSc, MRCP,&nbsp;Michelle S. Goh MBBS, FACD,&nbsp;Peter Foley MD, FACD,&nbsp;Benjamin S. Daniel MBBS, MMed, FACD","doi":"10.1111/ajd.14307","DOIUrl":"10.1111/ajd.14307","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173720","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":"Dermatoscopy of pigmentary changes in systemic sclerosis","authors":"Sushama Sushama MD,&nbsp;Shivani Bansal MD, DNB, MNAMS,&nbsp;Kavita Poonia MD, DNB, MNAMS","doi":"10.1111/ajd.14328","DOIUrl":"10.1111/ajd.14328","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173715","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":"Identifying dermatological emergencies in patients with skin of colour: Insights from Australian emergency medicine practitioners","authors":"N. Punchihewa MD,&nbsp;P. Pouryahya MD, FACEM, GC ClinEpi, CCPU, M Traumatology, MPH,&nbsp;M. Rodrigues MBBS (Hons), FACD","doi":"10.1111/ajd.14324","DOIUrl":"10.1111/ajd.14324","url":null,"abstract":"&lt;p&gt;Many dermatological conditions can be managed in an outpatient setting; however, some are life-threatening emergencies requiring prompt diagnosis and management. Textbook images of dermatological conditions primarily showcase manifestations on light skin, leading to a significant underrepresentation of patients with skin of colour (SOC).&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Previous research has revealed that common skin conditions may possess distinct variations in patients with SOC&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; yet this remains largely unexplored within the realm of dermatological emergencies. Given doctors in the emergency department are likely to encounter such presentations before dermatologist consultation, providing comprehensive education in this domain is crucial. The objective of this study is to evaluate and address the knowledge gaps and preferences for further education initiatives among emergency medicine practitioners in diagnosing dermatological emergencies in patients with SOC, with the overarching goal of enhancing patient care across diverse populations.&lt;/p&gt;&lt;p&gt;An online survey and quiz were distributed among emergency medicine practitioners in Victoria, Australia from February to October 2023. The survey gathered information regarding participant demographics, confidence in diagnosing dermatological emergencies in individuals with SOC and attitudes towards current training formats. The quiz comprised clinical images of dermatological emergencies in four separate patients with SOC, accompanied by multiple-choice questions. A total of 76 doctors participated in the survey, including 17 junior doctors (22%), 18 registrars (24%) and 41 consultants (54%).&lt;/p&gt;&lt;p&gt;Our quiz findings indicate variations in response accuracy across different questions, highlighting existing uncertainty among emergency medicine practitioners in diagnosing dermatological emergencies specific to SOC. Question 1 showed an image of lower limb cellulitis in an adult with Fitzpatrick skin type (FST) 6 for which 36% of respondents selected the correct answer. Background pigmentation masking erythema in darker skin tones may have contributed to the low amount of correct responses.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Question 2 showed an image of eczema herpeticum in a child with FST 3 for which 78% of respondents selected the correct answer. The appearance of monomorphic vesicles and punched-out erosions in this condition is less influenced by alterations in the background skin pigmentation, potentially contributing to the observed high rate of accurate responses.&lt;/p&gt;&lt;p&gt;Question 3 showed an image of psoriatic erythroderma in an adult with FST 6 for which 45% of respondents selected the correct answer. Psoriatic plaques in SOC have a violaceous hue compared with salmon-pink plaques observed in light skin&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; which may have caused difficulty identifying the correct answer. Question 4 showed an image of toxic epidermal necrolysis (TEN) in an adult with FST 5 for wh","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}