The effect of skin conditions on patients' quality of life

Acceptability and feasibility pilot randomised controlled trial of medical skin camouflage for recovery of women prisoners with self-harm scarring (COVER): the study protocol

INTRODUCTION

Self-harm in prison is a major public health concern. Less than 5% of UK prisoners are women, but they carry out more than a fifth of prison self-harm. Scars resulting from self-harm can be traumatising and stigmatising, yet there has been little focus on recovery of women prisoners with self-harm scarring. Medical skin camouflage (MSC) clinics treat individuals with disfiguring skin conditions, with evidence of improved well-being, self-esteem and social interactions. Only one community study has piloted the use of MSC for self-harm scarring.

METHODS AND ANALYSIS

We describe an acceptability and feasibility pilot randomised controlled trial; the first to examine MSC for women prisoners who self-harm. We aim to randomise 20-25 women prisoners to a 6-week MSC intervention and 20-25 to a waitlist control (to receive the MSC after the study period). We aim to train at least 6-10 long-term prisoners with personal experience of self-harm to deliver the intervention. Before and after intervention, we will pilot collection of women-centred outcomes, including quality of life, well-being and self-esteem. We will pilot collection of self-harm incidents during the intervention, resources used to manage/treat self-harm and follow-up of women at 12 weeks from baseline. Data on recruitment, retention and dropout will be recorded. We aim for the acceptability of the intervention to prison staff and women prisoners to be explored in qualitative interviews and focus groups.

ETHICS AND DISSEMINATION

Ethical approval for COVER has been granted by the North East-York Research Ethics Committee (REC) for phases 1 and 2 (reference: 16/NE/0030) and West of Scotland REC 3 for phases 3 and 4 (reference: 16/WS/0155). Informed consent will be the primary consideration; it will be made clear that participation will have no effect on life in prison or eligibility for parole. Due to the nature of the study, disclosures of serious self-harm may need to be reported to prison officials. We aim for findings to be disseminated via events at the study prison, presentations at national/international conferences, journal publications, prison governor meetings and university/National Health Service trust communications.

TRIAL REGISTRATION NUMBER

NCT02638974; Pre-results.

The development of a self-help intervention to build social confidence in people living with visible skin conditions or scars: a think-aloud study

INTRODUCTION

People with a visible difference, such as scarring or a skin condition, can experience anxiety and intrusive reactions from others when in social situations. The use of products to conceal marks on the skin is provided in a number of different hospital services and by charities. However, there are relatively few psychosocial interventions available for these individuals.

OBJECTIVES

To examine the views of skin camouflage users and practitioners on the acceptability, usability and need for a specifically developed cognitive behavioural therapy (CBT) self-help booklet.

METHODS

A think-aloud protocol and descriptive form of thematic analysis were used to ascertain participants' views of this novel psychosocial intervention. Nine participants took part in think-aloud interviews that were analysed using thematic analysis. Six skin camouflage users and three skin camouflage practitioners participated in the study.

RESULTS

Support for the relevance, acceptability and usability of the booklet was found from both participants who used camouflage and those who provided it. However, some participants reported that they would envisage that some people would need additional support so as to be able to use the techniques described within the booklet.

CONCLUSIONS

This study represents an important step towards developing a brief self-help intervention for people with living with visible skin conditions or scars and demonstrates the importance of seeking feedback from experts by experience on theoretically informed psychological interventions for this patient group.

Role of betamethasone valerate 2.250 mg medicated plaster in the treatment of psoriasis and other dermatological pathologies: a review

Treating dermatological pathologies with topical corticosteroids under occlusion is often more effective than nonocclusive therapy, especially in the treatment of psoriasis. Betamethasone valerate medicated plaster provides a controlled and localized method of dosing betamethasone valerate, a well-established corticosteroid with vasoconstrictive, anti-inflammatory, immunosuppressive, and antiproliferative properties. This self-adhesive plaster is approved for the treatment of inflammatory skin disorders that do not respond to treatment with less potent corticosteroids. As a patch, it offers all the clinical benefits of occlusive therapy such as increased penetration of topical agent into the area requiring treatment, enhanced skin hydration, and protection from local trauma or scratching. This translates into improved patient compliance, which is notoriously low in patients with dermatological conditions. This review presents the available clinical data from studies with betamethasone valerate medicated plaster in the treatment of psoriasis and other dermatoses and discusses its place in therapy for dermatological conditions.

Dissatisfaction and acne vulgaris in male adolescents and associated factors

BACKGROUND

Acne vulgaris has high prevalence, disturbing quality of life during adolescence.

OBJECTIVES

To measure dissastifaction and acne in 18-year-old male individuals and its associated factors.

METHODS

A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately.

RESULTS

A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels.

CONCLUSION

This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction.