Dermatology patients and their doctors

Skincare in Social Media: Analyzing Prominent Themes in Online Dermatologic Discussions

Introduction: As the size and influence of online dermatologic communities have developed significantly in recent years, literature concerning the relationship between social media and dermatology grows more important. One community of interest is r/SkincareAddiction, a forum of over 1.2 million members on Reddit that serves as both a support group and discussion aggregator sourcing information from multiple social media platforms.

Methods: This study reports on the qualitative analysis of 300 highly engaged posts to identify prominent themes in online dermatologic discussions and determine the extent of multiplatform interaction between Reddit and other dermatology-relevant social networks.

Results: Results of an inductive analysis indicate discussions place an emphasis on communicating advice and improving general wellbeing, comprising 71% of measured posts. However, a large portion of this counsel lacks evidence and pseudoscientific recommendations are often accepted as factual. Additionally, 31% of entries were drawn from alternative social media sites.

Conclusion: Assessing the prevalent points of discussion in dermatology-relevant communities can inform clinical practice and reveal alternative methods to advance the delivery of care. As patients increasingly seek health advice and support online, developing digital literacy in common dermatologic trends offers a unique opportunity to improve communication, disseminate evidence-based counsel, and combat misinformation in both clinical and online settings.

Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: results of a qualitative study

Acne, psoriasis and atopic eczema are common diseases and have been consistently associated with adverse psychological sequelae including stigmatization. Being teased on the basis of appearance has been associated with psychiatric morbidity in children and adolescents. The objective of this qualitative study was to explore the experiences of teasing and bullying in patients with acne, psoriasis and eczema, and the role of appearance-related teasing and bullying as mediators of psychological morbidity in these patients. Data collection consisted of 62 in-depth semi-structured interviews with patients with acne, psoriasis or atopic eczema recruited from both specialist dermatology and general practices. Data analysis was cumulative and concurrent throughout the data collection period reflecting a grounded theory approach. Analysis followed the analytic induction method, allowing themes to emerge from the data. Teasing, taunting or bullying was a considerable problem for a significant minority of acne, psoriasis and atopic eczema participants. Themes that emerged were the universally negative nature of the teasing, the use of teasing as an instrument of social exclusion, and as a means of establishing or enforcing power relationships, teasing related to contagion and fear, the emotional and psychological sequelae of teasing and the theme of 'insensate' teasing. For those who had suffered teasing or bullying, this was causally linked in respondents' accounts with psychological sequelae, especially self-consciousness and effects on self-image and self-esteem. Experiences of teasing and bullying were found to have principally occurred during the adolescence of participants and the perpetrators were other adolescents, but there were findings of respondents with psoriasis also having been subjected to ridicule or derogatory remarks by health professionals. Teasing, taunting and bullying may represent an underappreciated source of psychological morbidity in children and adolescents with these common skin diseases.

Impact of psoriasis on quality of life in Kuwait

BACKGROUND

Psoriasis can seriously affect the quality of life (QOL) of patients and has a strong impact on social relations, psychological status and daily activities.

OBJECTIVE

The aim of this study was to describe the impact of different grades of severity in psoriasis on QOL in patients in Kuwait.

PATIENTS/METHODS

We used the Dermatology Quality Of Life scale (DQOLS) developed by Morgan and then validated for use in Kuwait to study a sample of 330 out-patients with psoriasis.

RESULTS

Overall, physical activities were affected in greater than 50% of cases. This figure increased significantly with increased severity of psoriasis. Also, social relationships were disrupted in more than half of the patients but with no significant difference between different grades of severity. All psychological feeling items were affected by psoriasis to variable degrees. However, significant differences related to the severity of psoriasis were detected: feeling embarrassed, feeling short tempered, feeling depressed, and feeling a lack of hope. One third of cases declared their sexual activities were affected by psoriasis.

CONCLUSION

Data provided should improve the physicians' awareness of the importance of patients' QOL and enhance psychological evaluation of the psoriatic patient which will promote his/her positive outcome and compliance with treatment.

Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse

BACKGROUND

The failure of patients to take medicines in a way that leads to clinical benefit is a major challenge. A consensus has emerged that, on average, compliance sufficient to obtain therapeutic objectives occurs about half the time, with noncompliance contributing to therapeutic failure in the other half. These figures refer to simple oral regimens. There has been little work assessing compliance/concordance with complex treatment regimens for atopic eczema. Asthma schools led by specialist nurses have been shown to improve knowledge, use of therapies and clinical outcome.

OBJECTIVES

To determine the effect of education and demonstration of topical therapies by specialist dermatology nurses on therapy utilization and severity of atopic eczema.

METHODS

Fifty-one children with atopic eczema attending a paediatric dermatology clinic were followed for up to 1 year. At each visit the parent's knowledge about atopic eczema and its treatment and therapy utilization was recorded. The severity of the eczema was recorded using the six area, six sign atopic dermatitis severity score (SASSAD) and parental assessment of itch, sleep disturbance and irritability. At the first visit a specialist dermatology nurse explained and demonstrated how to use all of the topical treatments. This education was repeated at subsequent visits depending on the knowledge of the parent.

RESULTS

At baseline less than 5% of parents had received/recalled receiving any explanation of the causes of eczema or demonstration of how to apply topical treatments. The eczema was poorly controlled in all children (mean SASSAD 42.9). Of the children, 24% were not being treated with any emollient cream/ointment; the mean use was 54 g weekly. Of the children, 25% were being inappropriately treated with potent or very potent topical steroids. Following repeated education and demonstration of topical therapies by a specialist dermatology nurse, there was an 89% reduction in the severity of the eczema. The main change in therapy utilization was an 800% increase in the use of emollients (to 426 g weekly of emollient cream/ointment) and no overall increase in the use of topical steroids, accounting for potency and quantity used.

CONCLUSIONS

This study reinforces the importance of specialist dermatology nurses in the management of atopic eczema. It also confirms the opinion of patients, patient support groups, dermatologists and best practice guidelines that the most important intervention in the management of atopic eczema is to spend time to listen and explain its causes and demonstrate how to apply topical therapies.

Can psychotherapy help patients with psoriasis?

Two groups of people with psoriasis attended a short series of meetings conducted by a clinical psychologist. During these sessions the patients were given the opportunity to discuss between themselves problems created by their skin complaint and they were taught specific relaxation techniques for use whenever they felt under stress. Psychological tests showed that the participants were a noticeably anxious group compared to the general population. However, their levels of anxiety were significantly reduced by the end of the study. There was also a modest trend towards physical improvement. No such changes were seen in a matched control group.

A survey of the social and psychological effects of psoriasis

One hundred and four consecutive patients with psoriasis who were being treated in two Dublin dermatology hospital units answered a questionnaire. Social and emotional morbidity was present for many patients despite access to modern treatment facilities. Fifty five percent of patients had never experienced a complete remission from their psoriasis. A large percentage of patients avoided common social activities, for example swimming and sports; 50% felt that psoriasis had inhibited their sexual relationships and 11% of patients said they would avoid having children in case their offspring should develop the condition. Thirty-six per cent felt the hospital doctor spent most of the consultation time writing prescriptions and 59% of patients had never been given an explanatory pamphlet or book about psoriasis. To help patients to come to terms with what is for many a lifelong condition, greater efforts should be made to improve the communication at consultation, and provide more patient education.