INTRODUCTION: The COVID-19 pandemic has changed care provision models, with a rapid increase in the adoption of telemedicine to reduce in-person visits. Although there are many benefits to teledermatology, there are also factors that hinder its widespread adoption. We aimed to examine patients' perceptions of teledermatology to identify the barriers to its adoption. METHODS: A prospective study was conducted from 15 June to 14 August 2020. Patients were invited to complete a questionnaire in an outpatient dermatology clinic via direct approach by clinical staff or posters posted at the door of consultation rooms. RESULTS: Out of 2,276 clinic attendances, 997 survey responses (43.8%) were collected over a 3-month period. When asked if they would change their subsequent visit to teledermatology, 294 (29.5%) patients were keen, 166 (16.6%) were unsure and 537 (53.9%) declined. Significant factors for declining teledermatology were lack of prior exposure to videoconferencing ( P < 0.01) and lower educational level ( P = 0.019). Patients also raised concerns regarding the ability of teledermatology to address medical concerns (32.1%) and indicated a preference for face-to-face consultation (29.7%). CONCLUSION Factors that influence patients' decision to adopt teledermatology, such as concerns about its ability to address medical issues, lack of IT literacy or experience in teleconferencing, are modifiable. Targeted strategies such as careful patient selection, a dedicated teleconsultation workflow, and the use of a novel 'teledermatology patient journey' (including a clinic walkthrough at the first visit) and an intuitive audio-enabled user interface, may improve patient perceptions and adoption of teleconsultation service.
Humans ; COVID-19/epidemiology* ; Dermatology/methods* ; Telemedicine ; Male ; Female ; Prospective Studies ; Middle Aged ; Adult ; Surveys and Questionnaires ; SARS-CoV-2 ; Aged ; Perception ; Young Adult ; Pandemics ; Skin Diseases/diagnosis* ; Videoconferencing

Allergy and Immunology ; Ambulatory Care ; Autoimmune Diseases/therapy* ; COVID-19 ; Communicable Disease Control ; Connective Tissue Diseases/therapy* ; Delivery of Health Care/methods* ; Dermatology ; Humans ; Immunosuppressive Agents/therapeutic use* ; Patient Selection ; SARS-CoV-2 ; Singapore ; Skin Diseases, Vesiculobullous/therapy* ; Telemedicine/methods* ; Tertiary Care Centers ; Vasculitis/therapy*

INTRODUCTION: Cigarette smoking is a leading cause of morbidity and mortality, and has a deleterious effect on dermatological conditions, such as skin cancers, hidradenitis suppurativa and psoriasis. The study aimed to evaluate the efficacy of a pharmacist-led smoking cessation clinic in reducing cigarette smoking at a tertiary referral dermatology centre. We described the impact of this clinic to provide guidance on how such a model could be further improved and implemented more widely. METHODS: In this single-centre, retrospective study, 74 currently smoking patients who received counselling at a structured smoking cessation clinic between January 2010 and March 2013 were identified. Information on baseline demographic characteristics and detailed past medical history, including smoking history, was collected. Follow-up was conducted at two weeks and three months. RESULTS: At the first follow-up at two weeks, which was attended by 57 patients, 9 (15.8%) had stopped smoking and 26 (45.6%) showed reduction in the number of cigarette sticks smoked per day, with an average reduction of 4.1 cigarette sticks per day. However, a few patients also reported no change or increased number of cigarette sticks smoked per day following counselling. CONCLUSION A structured pharmacist-led smoking cessation clinic is effective and can be made a part of the holistic management of dermatological conditions.
Adolescent ; Adult ; Dermatology ; organization & administration ; Female ; Hidradenitis Suppurativa ; complications ; Humans ; Male ; Middle Aged ; Program Development ; Psoriasis ; complications ; Retrospective Studies ; Skin Neoplasms ; complications ; Smoking Cessation ; methods ; Tobacco Use Disorder ; therapy ; Treatment Outcome ; Young Adult

Dermatofibrosarcoma protuberans (DFSP) is a slow growing low-grade cutaneous sarcoma. Local recurrence after excision is common due to the poorly defined periphery that renders histological control of surgical margin difficult, Mohs micrographic surgery is the optimal method for treatment. A 41 years old male patient, who had a previous history of DFSP, came to our dermatology clinic for evaluation of an asymptomatic firm flesh-colored nodule on the forehead. Total excision biopsy was done and the mass was histologically proved as DFSP. Wide excision with reconstruction was performed and showed no sign of recurrence till 18-month follow up. Local recurrence is known to be common for DFSP but a new visible lesion distant from the initial site may be confused as a de novo lesion or a benign neoplasm especially in scalp area, and thus interrupt early detection of DFSP. Herein, we report a case of recurrent DFSP of scalp which recurred distant from the original lesion.
Biopsy ; Dermatofibrosarcoma* ; Dermatology ; Follow-Up Studies ; Forehead ; Humans ; Male ; Methods ; Mohs Surgery ; Recurrence ; Sarcoma ; Scalp*

BACKGROUND: Delivery of pathology reports to the patient is a key step in the biopsy pathway, which is important for patient safety in dermatology. Automated systems for facilitating such medical process began in 2010 in our hospital, sending short message service to scheduled patients. OBJECTIVE: The purpose of this study was to evaluate the delivery of pathology reports to patients and investigate factors that influence this process and annual trends. METHODS: We retrospectively reviewed the medical records of all outpatients (n=2,452) who underwent skin biopsy at our department of dermatology in 2009 and 2014. In each year group, we analyzed the proportion of revisiting patients in terms of year, sex, age, season, biopsy method and diagnosis. RESULTS: In 2009, a smaller proportion of patients (205; 91.5%) who had undergone shave or excisional biopsy than of those who had undergone punch biopsy returned (781; 98.0%; p<0.001). This trend was not significant in 2014. Whereas there was no significant difference of return visit ratio between men and women in 2009, a higher proportion of women (754; 98.0%) than men (633; 95.6%) re-visited after skin biopsy to confirm their diagnosis in 2014 (p=0.008). Three patients with either a malignant tumor or suspected malignant lesion that required complete excision did not return to our clinic. CONCLUSION: Pathology report delivery rates were fairly satisfactory, regardless of year, age, season, and diagnosis. Sex and biopsy method influenced the return visit ratio. More organized follow-up protocols are required to strengthen patient safety and prevent critical patient drop-out.
Biopsy ; Dermatology ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Methods ; Outpatients ; Pathology* ; Patient Safety ; Retrospective Studies ; Seasons ; Secondary Care Centers* ; Skin ; Text Messaging

Cryotherapy is one of the most widely used procedures in the field of dermatology. Since the development of cryotherapy with the use of liquid nitrogen beginning in the 19(th) century, its use has gradually increased for various dermatologic conditions, including benign conditions, premalignant lesions, and malignancies. Because the therapeutic effects of cryotherapy are diverse, it must be applied specifically for each indication, requiring a thorough understanding of the basic principles and mechanisms of cryotherapy. In addition, both acute and chronic complications can develop, which may possibly leave permanent scars and tissue damage, thus, careful manipulation is required. In conclusion, cryotherapy is a frequently used treatment method but should be performed precisely by well-trained specialists.
Cicatrix ; Cryotherapy* ; Dermatology* ; Methods ; Nitrogen ; Specialization ; Therapeutic Uses

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

Atopic eczema is a commonly encountered chronic skin condition in primary care. In this article, we share a holistic, structured approach, which is grounded on the chronic and atopic nature of the condition - planned reviews, patient empowerment, a written action plan for chronic and fare management, and trigger avoidance. Common pitfalls in management are insufficient emphases on scheduled reviews and patient empowerment, as well as neglect in the care of the loss of the epidermal barrier during acute flares.
Chronic Disease ; Dermatitis, Atopic ; diagnosis ; physiopathology ; therapy ; Dermatology ; methods ; Education, Medical, Continuing ; Humans ; Inflammation ; Primary Health Care ; methods ; Skin ; pathology

BACKGROUND: Tinea manus is a common superficial dermatophyte infection that is usually coexistent with tinea pedis. Trichophytom rubrum is the most commonly isolated agent in tinea manus. Despite this condition, there have been only a few reports on the clinical and mycological features of tinea manus. OBJECTIVE: This study aims to evaluate the variables related with tinea manus and to determine the correlation with other superficial dermatophyte infection. METHODS: Clinical and mycological features of 54 cases with tinea manus from the department of dermatology in Daegu Catholic University Hospital and the Catholic Skin Clinic from January 2011 to December 2012 were evaluated retrospectively. RESULTS: The male to female ratio was 2:1. The age distribution ranged from 14 to 81 years old. The affected site was the palm in 31 cases (57.4%), the dorsum in 13 cases (24.1%), and both palm and sole in 10 cases (18.5%). Tinea manus was accompanied with other superficial dermatophyte infections, such as tinea pedis, tinea unguium, and tinea corporis in 42 cases (77.8%) and not in 12 cases (22.2%). Fungal culture result was positive in 8 cases of tinea manus only group and in 26 cases of tinea manus with other dermatophyte infection group. The most commonly isolated agent was Trichophyton rubrum in both groups. CONCLUSION: The patients with only tinea manus tend to predilect the dorsum of hand and were relatively more caused by other fungus than Trichophyton ruburum when compared with the patients with other dermatophytosis.
Age Distribution ; Arthrodermataceae ; Daegu ; Dermatology ; Female ; Fungi ; Hand ; Humans ; Male ; Methods ; Onychomycosis ; Retrospective Studies ; Skin ; Tinea Pedis ; Tinea* ; Trichophyton

Dermatology ; education ; methods ; trends ; Hospitals ; Humans ; Medicine ; Singapore ; Skin Diseases ; therapy