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Jasly K, Goyal S, Ashwini PK, Kanthraj GR, Chethana SG, Ranugha S. Three-part scoring system (tripartite) for teledermatology versus International Contact Dermatitis Research Group criteria to interpret patch test readings: A comparative, observational study. Indian J Dermatol Venereol Leprol 2024; 90:575-580. [PMID: 38594974 DOI: 10.25259/ijdvl_118_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/10/2023] [Indexed: 04/11/2024]
Abstract
Background The International Contact Dermatitis Research Group (ICDRG) grading is the gold standard and is used to interpret patch test results in allergic contact dermatitis (ACD). The ICDRG readings include a combination of visual and palpation findings. Digital photography limits palpation. An alternative scoring system exists to analyse 2D images and interpret patch test readings in teledermatology (TD). Aim To compare tri-partite scoring system (TPSS) (TD) with ICDRG (face-to-face) and to assess the feasibility of TPSS by TD. Methods In this observational study, two investigators each scored the patch test readings for 78 patients at the 48th h, 96th h and on the 7th day. Results The TPSS has a sensitivity of 100%, specificity of 93.34%, positive predictive value of 91.67% and negative predictive value of 100%. At a confidence interval of 95%, Cohen's kappa (0.90) indicated excellent agreement between both investigators. The concordance between both scoring systems was at 93.2% for agreement and 6.82% for disagreement. Polysensitisation (6 patients with 16 allergens) was detected equally in both methods. Limitation A single centre study. Conclusion The readings obtained by TPSS were in agreement with ICDRG. TPSS can reduce the number of patient visits by 50% and may be used during COVID-19 times and beyond.
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Affiliation(s)
- Kuttiali Jasly
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - Sakshi Goyal
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - P K Ashwini
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - Garehatty Rudrappa Kanthraj
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - S Gurumurthy Chethana
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - Subramaniam Ranugha
- Department of Dermatology, Venereology & Leprosy, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
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Zhou J, Wu Z, Tong Y, Chokkakula S, Shi Y, Jiang H, Liu J, Wang D, Zhang W, Wang C, Zhao T, Yuan K, Li T, Ma L, Yang Q, Wang S, Hong F, Wang H, Li J. Molecular epidemiological characteristics of Mycobacterium leprae in highly endemic areas of China during the COVID-19 epidemic. Front Public Health 2024; 12:1148705. [PMID: 38327578 PMCID: PMC10847240 DOI: 10.3389/fpubh.2024.1148705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
Objectives The present study analyzed the impact of the COVID-19 pandemic on the prevalence and incidence of new leprosy cases, as well as the diversity, distribution, and temporal transmission of Mycobacterium leprae strains at the county level in leprae-endemic provinces in Southwest China. Methods A total of 219 new leprosy cases during two periods, 2018-2019 and 2020-2021, were compared. We genetically characterized 83 clinical isolates of M. leprae in Guizhou using variable number tandem repeats (VNTRs) and single nucleotide polymorphisms (SNPs). The obtained genetic profiles and cluster consequences of M. leprae were compared between the two periods. Results There was an 18.97% decrease in the number of counties and districts reporting cases. Considering the initial months (January-March) of virus emergence, the number of new cases in 2021 increased by 167% compared to 2020. The number of patients with a delay of >12 months before COVID-19 (63.56%) was significantly higher than that during COVID-19 (48.51%). Eighty-one clinical isolates (97.60%) were positive for all 17 VNTR types, whereas two (2.40%) clinical isolates were positive for 16 VNTR types. The (GTA)9, (TA)18, (TTC)21 and (TA)10 loci showed higher polymorphism than the other loci. The VNTR profile of these clinical isolates generated five clusters, among which the counties where the patients were located were adjacent or relatively close to each other. SNP typing revealed that all clinical isolates possessed the single SNP3K. Conclusion COVID-19 may have a negative/imbalanced impact on the prevention and control measures of leprosy, which could be a considerable fact for official health departments. Isolates formed clusters among counties in Guizhou, indicating that the transmission chain remained during the epidemic and was less influenced by COVID-19 preventative policies.
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Affiliation(s)
- Jiaojiao Zhou
- Key Laboratory of Environmental Pollution and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Ziwei Wu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
| | - Yi Tong
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Santosh Chokkakula
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Chungbuk, Republic of Korea
| | - Ying Shi
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Haiqin Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jie Liu
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - De Wang
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Wenyue Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chen Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | | | | | - Tao Li
- Qiandongnan CDC, Qiandongnan, China
| | - Lu Ma
- Guiyang CDC, Guiyang, China
| | - Qin Yang
- Key Laboratory of Environmental Pollution and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Shizhen Wang
- The Second People’s Hospital of Bijie, Bijie, China
| | - Feng Hong
- Key Laboratory of Environmental Pollution and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Hongsheng Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, National Centre for Leprosy Control, Nanjing, China
- Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Chungbuk, Republic of Korea
| | - Jinlan Li
- Key Laboratory of Environmental Pollution and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
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Roster K, Wang Y, Lipner SR. Retrospective analysis of onychomycosis prescribing patterns using the medicare part D prescribers database 2016-2020. Mycoses 2024; 67:e13660. [PMID: 37840154 DOI: 10.1111/myc.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
Onychomycosis, defined as a fungal nail infection, affects 5.5% of the global population. Our objectives were to analyse prescription trends of onychomycosis medications using the Medicare Part D Prescribers database from 2016 to 2020, stratified by physician specialty. There was a 4% annual increase in the total cost of onychomycosis medications, with a notable decrease of 12.8% in 2020 during the COVID-19 pandemic. Physicians demonstrated a strong consideration for price when selecting treatments, with the least expensive medications (ciclopirox and terbinafine) accounting for nearly 99% of all prescriptions. In contrast, the more costly medications (efinaconazole and tavaborole) were rarely prescribed. In addition, physicians often opted for the less costly generic versions of ciclopirox and itraconazole, prescribing them 99% and 91% of the time, respectively. Notably, physician assistants and nurse practitioners had higher overall increases in prescription rates, at 15%, compared to 1%-6% for other specialties. There are no recent United States onychomycosis guidelines, and our study emphasizes cost considerations when prescribing onychomycosis treatments.
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Affiliation(s)
- Katie Roster
- New York Medical College, New York, New York, USA
| | - Yu Wang
- Department of Dermatology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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Toksöz Yıldırım AN, Zenginkinet T, Okay E, Celik A, Tarcan ZC, Esen MF, Onay T, Turhan Y, Özkan K, Akyurek M. The Impact of COVID-19 Pandemic Restrictions on Musculoskeletal Pathology Services. Cureus 2023; 15:e39493. [PMID: 37362477 PMCID: PMC10290541 DOI: 10.7759/cureus.39493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic has had a negative impact on healthcare in musculoskeletal pathology. There is no standard protocol for pathology services during a pandemic. The study aimed to assess the impact of COVID-19 restrictions on the workload of the musculoskeletal pathology service and the hurdles faced in collaboration with the orthopedic oncology unit in a tertiary reference center in a developing country. MATERIALS AND METHODS The pathology reports from mid-March to mid-June 2019, 2020, and 2021 were retrospectively reviewed. RESULTS Significant differences were found between the pandemic period (2020) and the non-pandemic periods (2019-2021) in benign bone and soft tissue lesions, resection surgeries, and soft tissue tumors, which were more prevalent in the non-pandemic periods. However, there was no significant decrease in biopsy procedures. Conclusion: During the pandemic period, the biopsy procedure appears to be feasible for bone and soft tissue lesions without the need for anesthesia.
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Affiliation(s)
| | - Tulay Zenginkinet
- Pathology, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Erhan Okay
- Orthopaedics, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Aykut Celik
- Orthopaedics, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Zeynep Cagla Tarcan
- Orthopaedics, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Muhammed Fevzi Esen
- Health Information Systems, Institution of Hamidiye Medical Sciences, University of Health Sciences Turkey, Istanbul, TUR
| | - Tolga Onay
- Orthopaedic Surgery and Traumatology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, TUR
| | - Yalçın Turhan
- Orthopaedics and Traumatology, Duzce University Medical Faculty, Duzce, TUR
| | - Korhan Özkan
- Orthopaedics and Traumatology, Medeniyet University Göztepe Training and Reseach Hospital, Istanbul, TUR
| | - Muhlik Akyurek
- Orthopaedics, Maria-Josef-Hospital Greven, Klinik für Orthopadie, Unfall-und Handchirurgie Deutschland, Greven, DEU
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BURLANDO MARTINA, BOLDRIN SAMUELE, SALVI ILARIA, COZZANI EMANUELE, PARODI AURORA. Results of COVID-19 screening in a dermatologic clinic in Northern Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E1-E2. [PMID: 37293464 PMCID: PMC10246614 DOI: 10.15167/2421-4248/jpmh2023.64.1.2544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/07/2023] [Indexed: 06/10/2023]
Affiliation(s)
- MARTINA BURLANDO
- Section of Dermatology, DISSAL, University of Genoa, Ospedale-Policlinico San Martino, IRCCS, Genova, Italy
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Lugović-Mihić L, Meštrović-Štefekov J, Cvitanović H, Bulat V, Duvančić T, Pondeljak N, Tolušić-Levak M, Lazić-Mosler E, Novak-Bilić G. The COVID-19 Pandemic and Recent Earthquake in Zagreb Together Significantly Increased the Disease Severity of Patients with Atopic Dermatitis. Dermatology 2023; 239:91-98. [PMID: 36049473 PMCID: PMC9892999 DOI: 10.1159/000525901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/OBJECTIVE Stress may affect patients with atopic dermatitis (AD). The aim of this study was to examine the impact of the COVID-19 pandemic and the earthquake in Zagreb, Croatia (March 2020), on AD patients and their disease severity, symptoms/itch, and perceived stress. METHODS Our observational cross-sectional study included three groups of AD patients diagnosed by a physician: group 1 (n = 50), who experienced both the pandemic (quarantine) and the earthquake; group 2 (n = 50), who experienced only the pandemic; and group 3 (n = 50), the comparison group, who experienced neither disaster (patients examined 2018-2019). Groups 1 and 2 were examined May-June 2020, immediately after the national lockdown/quarantine. Disease severity (SCORAD), data from the Perceived Stress Scale (PSS), and information on patients' confirmed allergies were recorded for all groups, while groups 1 and 2 additionally completed a questionnaire concerning their disease, hand hygiene, and experience during the pandemic and/or earthquake. RESULTS The patients exposed to both disasters reported more pronounced AD worsening (p < 0.001; r = 0.388) and more frequent itching (p < 0.001; r = 0.350) than those exposed to the pandemic only. Notably, we found certain differences by gender: during the pandemic, women significantly more frequently washed their hands (81% of women washed "very frequently," while 52% of men washed "quite often") and had significantly higher PSS levels than men (p < 0.05). Concerning allergies, present or absent, during the pandemic, there was no significant difference in SCORAD between groups 1 and 2, neither when analyzed separately for indoor nor for outdoor allergens. The most commonly reported psychological disturbances during the pandemic were concern (46%), anger (18%), anxiety (16%), depression (9%), and increased alcohol, cigarette, and opioid agent use (6%). CONCLUSION The COVID-19 pandemic together with the earthquake significantly increased disease severity and influenced AD worsening, itching, and psychological disturbances. This indicates that stressful events meaningfully affect the course of AD.
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Affiliation(s)
- Liborija Lugović-Mihić
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia,School of Dental Medicine, University of Zagreb, Zagreb, Croatia,*Liborija Lugović-Mihić,
| | | | - Hrvoje Cvitanović
- Department of Dermatovenerology, Karlovac General Hospital, Karlovac, Croatia
| | - Vedrana Bulat
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Tomislav Duvančić
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Nives Pondeljak
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Maja Tolušić-Levak
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Elvira Lazić-Mosler
- Department of Dermatology and Venereology, General Hospital “Dr. Ivo Pedišić”, Sisak, Croatia
| | - Gaby Novak-Bilić
- Unit of Dermatology and Venereology, General Hospital Zabok, Bračak-Zabok, Croatia,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
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Lugović-Mihić L, Bulat V, Pondeljak N. Trends in dermatological practice in work with patients with skin diseases during the COVID-19 pandemic: our experience and observations. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2022. [DOI: 10.15570/actaapa.2022.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Shourick JP, Laurent CSM, Mion G, Skayem CL, Hamann PMG. Impact of SARS-CoV-2 pandemic on dermatology residents: A nationwide French study. Indian J Dermatol Venereol Leprol 2021; 88:478-482. [PMID: 34672472 DOI: 10.25259/ijdvl_1016_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has changed the practice of all health-care professionals. Determining the impact could prevent repercussions in future crisis. OBJECTIVES The objectives of the study were to assess the impact of the COVID-19 pandemic on dermatology residents' professional practice, working conditions, academic training and mental health. METHODS An online questionnaire was sent to all French dermatology residents. We compared the activity of residents working in areas heavily impacted by COVID-19 to others. Logistic multivariate regressions were done, using as outcome variables the negative impact of the COVID crisis on residents' possibility to practice dermatology during the crisis, supervision, academic training and working more than 50 h/week. The last part of the questionnaire was the burnout questionnaire of Maslach. RESULTS A total of 246 residents filled the questionnaire. Residents working in highly impacted COVID areas (odds ratio, OR 0.34 confidence interval, CI [0.18, 0.61], P ≤ 0.001), first-year postgraduate (PGY-1) residents (OR 0.46 CI [0.23, 0.91], P = 0.023) and those in private practice (OR 0.10 CI [0.01, 0.57], P = 0.032) were significantly less able to maintain dermatology activities. Worse supervision was significantly more frequent with non-PGY-1 residents (OR 3.24 CI [1.65, 6.65], P < 0.001). One hundred and eighty one residents claimed the pandemic to have a negative effect on their dermatology curriculum with no difference according to their regions' affection by COVID-19. This was mostly attributed to the cancelation of courses and congresses. PGY-1 residents (OR 2.09 CI [1.09, 4.04], P = 0.029) and residents in highly affected areas (OR 1.79 CI [1.01, 3.18], P = 0.049) were more at risk of working above the maximal legal working time. None of the residents was free of burnout symptoms. CONCLUSION Dermatology residents have been highly affected by COVID-19. It might be important to have a more integrated healthcare system to fight times of crisis with the least repercussions on residents.
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Affiliation(s)
| | | | - Georges Mion
- Faculty of Medicine, University of Paris, Paris, France
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Mintoff D, Chatterjee M, Podder I, Shipman A, Das A. Clinical Dermatology and COVID-19 Pandemic: Narrative Review. Indian J Dermatol 2021; 66:246-255. [PMID: 34446947 PMCID: PMC8375546 DOI: 10.4103/ijd.ijd_463_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic has radical repercussions on every aspect of medical science, including dermatology. The magnitude of the impact on clinical dermatology cannot be overemphasized. Dermatologists have been forced to modify and reconsider the way they consult patients. Teledermatology has come up in a big way, with most of the clinicians resorting to technology and software-based consultations. Management of different dermatological conditions like papulosquamous disorders, vesiculobullous disorders, malignancies, etc., needs to be modified as per the different recommendations proposed by expert panels. This review is an attempt to highlight the impact of this destructive pandemic on various aspects of clinical dermatology.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | - Indrashis Podder
- Department of College of Medicine and Sagore Dutta Hospital, India
| | - Alexa Shipman
- Department of Portsmouth Hospitals University NHS Trust, UK
| | - Anupam Das
- Department of KPC Medical College and Hospital, Kolkata, West Bengal, India
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Abstract
Purpose of Review The use of teledermatology has been evolving slowly for the delivery of health care to remote and underserved populations. Improving technology and the recent COVID-19 pandemic have hastened its use internationally. Recent Findings Some barriers to the use of teledermatology have fallen considerably in the last year. Summary Teledermatology use has increased significantly in recent years in both government-sponsored and private health care systems and individual practices. There are no recognized international practice guidelines and variable use within countries. Many barriers remain to increasing the use of teledermatology.
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Das A, Sil A, Chakrabarti A. An Observational Survey to Appraise the Influence of COVID-19 Pandemic on Dermatology Training Programs in India: Residents' Standpoint. Indian Dermatol Online J 2021; 12:423-428. [PMID: 34211909 PMCID: PMC8202489 DOI: 10.4103/idoj.idoj_657_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/22/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Given the all-encompassing foothold of COVID-19, it is plausible that the pandemic would have a long-lasting impact on medical training programs, including dermatology. We conducted a survey amongst the residents of dermatology (across India) to assess the impact of COVID-19 pandemic on their teaching and education programs. Materials and Methods: An online semi-structured English questionnaire was prepared on the Google-forms platform and the link was circulated among the residents. The questionnaire comprised of five sections (demographic details, impact on clinical training, procedural training, academic curriculum, and research activities). Appropriate statistical tests were carried out to analyze the data obtained. Results: Three-hundred and seventy-eight responses were taken into consideration. A majority of the respondents (63.5%) were engaged in both COVID-19-related duties and departmental work (out-patient and in-patient duty). Around two-thirds of the trainees (65.1%) claimed a reduction in patient footfall (greater than 50% compared to pre-COVID times). Sixty-nine percent reported a decline of more than 50% in in-patient admission; 47.6% felt that the discontinuity in patient care had severely affected their residency training; 50.8% highlighted that no procedures were being performed in their department; 54.5% opined that academic activities were relatively unhampered as regular seminars were being conducted through online web-based applications; and 65.1% of the trainees were not able to devote any time to their thesis-related work. Conclusion: Since the after-effects of this pandemic will last long, it is advisable that residents and faculties adapt themselves to web-based learning programs in the academic curriculum so that the training of the future consultants does not get jeopardized. Our survey, being the first of its kind in dermatology, will throw some light on the perspective of residents and the way forward to combat the untoward consequences on their training programs.
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Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Abheek Sil
- Department of Dermatology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Aditi Chakrabarti
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
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Abstract
The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.
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Affiliation(s)
- Maryam Daneshpazhooh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - HamidReza Mahmoudi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
When the COVID-19 pandemic struck the United States in early 2020, few healthcare workers were prepared for what lay ahead. Dermatology nurses, medical assistants, and nurse practitioners experienced rapid changes in the way they conducted their daily practice. This article discusses many of those changes and explores the challenges these healthcare workers faced and continue to face. Almost every aspect of how dermatologic care was delivered prepandemic was affected. Some dermatology nurses, medical assistants, and nurse practitioners were redeployed to COVID-19 testing tents and inpatient hospital units or were asked to perform tasks to help support other healthcare workers. This article explores how clinical practice, dermatology staff, patient care, and education were affected. These changes forced dermatology healthcare workers to be brave, accept risks, and ultimately grow from these experiences.
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Hafi B, Uvais NA, Jafferany M, Muhammed RT, Afra TP, Ameerali AM. Management of a case of pemphigus foliaceus in a paraplegic man with palliative dermatology principles during COVID-19 pandemic. Dermatol Ther 2020; 34:e14564. [PMID: 33216403 PMCID: PMC7744916 DOI: 10.1111/dth.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/10/2020] [Accepted: 11/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Bishurul Hafi
- IQRAA International Hospital and Research Centre, Kozhikkode, Kerala, India
| | - N A Uvais
- IQRAA International Hospital and Research Centre, Kozhikkode, Kerala, India
| | - Mohammad Jafferany
- Department of Psychodermatology, Psychiatry and Behavioral Sciences, Central Michigan University of Medicine, Mount Pleasant, Michigan, USA
| | - Razmi T Muhammed
- IQRAA International Hospital and Research Centre, Kozhikkode, Kerala, India
| | - T P Afra
- IQRAA International Hospital and Research Centre, Kozhikkode, Kerala, India
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Bhargava S, Sarkar R. Impact of COVID-19 Pandemic on Dermatology Practice in India. Indian Dermatol Online J 2020; 11:712-719. [PMID: 33235835 PMCID: PMC7678512 DOI: 10.4103/idoj.idoj_240_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/02/2020] [Accepted: 07/22/2020] [Indexed: 11/22/2022] Open
Abstract
Background: COVID-19 pandemic has disrupted healthcare systems throughout the globe. It has affected dermatology practice to a great extent. Since most of the consultations (except emergencies) in dermatology are deferred as a precautionary measure, dermatologists have taken the route of virtual appointments in order to continue treating patients in the present lockdown state. However, the concept of telemedicine is quite new for doctors as well as for patients in India. Material and Methods: An online questionnaire was circulated among Indian dermatologists which included participant demographics, changes in their practice and teaching during COVID-19, use of virtual or e-health technologies, and attitudes/opinions on their experiences. We also wanted to understand doctor perspectives on their own roles, wellness, and hospital responses to the pandemic. Results: A total of 260 responses from qualified dermatologists of different parts of India were received between 1st and 8th April 2020 and were analyzed. Two-thirds of the respondents were within 10 years of starting practice. Virtual consultations have increased by almost three-fold during the pandemic, which is a major change noticed in the practice when we compare before and during the pandemic. Earlier the focus of teledermatology (TD) was mainly for follow-up care (85%), whereas during the pandemic, both new and follow-up patients were provided virtual consultations. The number of patients coming to them for a consultation has drastically reduced. Only 2% of the responders are still performing minor procedures with proper care. Almost two-thirds do not have systems in place to train their residents and fellows due to the disruptions caused by the pandemic. The rest of them have started to take the virtual route of teaching through webinars, virtual rounds, and providing access to online journals to continue their teaching. Only 18.6% of dermatologists at work were provided with personal protective equipment. TD has opened new doors to virtual consultation and it was evident that 54.4% of doctors are willing to continue it in the future even after the pandemic is over. Conclusion: TD platforms hold great promise to improve access to high-quality dermatologic care in the future. Results from this survey of Indian dermatologists suggest that TD is the future of dermatology as it will be accessed by patients in remote areas and it is a cost-effective move for the patients.
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Affiliation(s)
- Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Rashmi Sarkar
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
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