1
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Young B, Jansen R, Kirk J, Dellavalle R. 5-Fluorouracil toxicosis in our pets: A review and recommendations. J Am Acad Dermatol 2024; 90:1051-1052. [PMID: 38224913 DOI: 10.1016/j.jaad.2023.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Brandon Young
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Rachel Jansen
- Northwest Georgia Veterinary Emergency Center, Rome, Georgia
| | - Jessica Kirk
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado
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2
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Sivesind TE, Oganesyan A, Bosma G, Hochheimer C, Schilling LM, Dellavalle R. Prescribing Patterns of Dupilumab for Atopic Dermatitis in Adults: Retrospective, Observational Cohort Study. JMIR Dermatol 2023; 6:e41194. [PMID: 37647114 PMCID: PMC10500357 DOI: 10.2196/41194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 06/28/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a common inflammatory disease caused by a type 2 T helper cell-mediated immune response to environmental antigens. Approximately 1 in 5 patients with AD presents with moderate to severe disease, and treatments approved by the Food and Drug Administration include emollients, topical glucocorticoids, and calcineurin inhibitors. Dupilumab, a fully human monoclonal antibody, improves AD via inhibition of interleukin-4 and interleukin-13. OBJECTIVE Our aim was to characterize the prescribing patterns of dupilumab for AD in adults at a large university-affiliated health system. METHODS A retrospective, observational cohort study was conducted using electronic data from the Observational Health Data Sciences and Informatics database, assessing data from the University of Colorado Medical Campus and its affiliates. The outcome measured was the prevalence of dupilumab prescribed for adults with AD (n=6421), between March 28, 2013, and March 28, 2021. We assessed whether the characteristics of patients who received dupilumab were different from those who did not. Each patient characteristic was assessed using a univariate logistic regression with the binary outcome of receiving or not receiving dupilumab. RESULTS We found a population prevalence of 5.6% (6421/114,476) for AD. In our cohort, Black patients with AD were more than twice as likely to have received dupilumab compared to White patients (odds ratio 2.352, 95% CI 1.58-3.39). Patients with a diagnosis of atopic neurodermatitis were approximately twice as likely to have received dupilumab compared to those with other diagnostic variants of AD (odds ratio 1.87, 95% CI 1.01-3.22). CONCLUSIONS Our results demonstrate that both patient racial characteristics and specific AD diagnoses were associated with variations in dupilumab prescription patterns.
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Affiliation(s)
- Torunn E Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Ani Oganesyan
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Grace Bosma
- Center for Innovative Design and Analysis, The Colorado School of Public Health, University of Colorado School of Medicine, Aurora, CO, United States
| | - Camille Hochheimer
- Center for Innovative Design and Analysis, The Colorado School of Public Health, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lisa M Schilling
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Dellavalle
- The Colorado School of Public Health, University of Colorado School of Medicine, Aurora, CO, United States
- Dermatology Service, Eastern Colorado Health Care System, US Department of Veterans Affairs, Denver, CO, United States
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3
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Nigro NN, Chandnani N, Doshi A, Fritsch A, Marroquin NA, Zueger M, Sivesind TE, Dellavalle R, Dunnick C. Distinguishing Gender Identity From Biological Sex in Dermatologic Health Care: Methods, Harms, and Paths Forward. JMIR Dermatol 2023; 6:e47118. [PMID: 37632974 PMCID: PMC10394595 DOI: 10.2196/47118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/28/2023] [Accepted: 06/20/2023] [Indexed: 08/28/2023] Open
Abstract
Accurate assessment of gender identity and biological sex in dermatology research is crucial since their conflation or poor demarcation undermines patient respect and study accuracy. Clearer guidance is needed for health care researchers, particularly in light of the notable disparities in skin disease rates, skincare practices, literature representation, and the persistent underrepresentation of transgender and nonbinary patients.
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Affiliation(s)
- Noah N Nigro
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Neal Chandnani
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Athena Doshi
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Alexa Fritsch
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | | | - Morgan Zueger
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Medical Center, Eastern Colorado Health Care System, Aurora, CO, United States
- Dermatology Service, US Department of Veterans Affairs, Aurora, CO, United States
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States
| | - Cory Dunnick
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
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4
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Burnette C, Smithy W, Strock D, Sivesind TE, Dellavalle R. The Importance of Gender-Neutral Terminology in Risk Evaluation and Mitigation Strategy Programs: A Call to Action. JMIR Dermatol 2023; 6:e45329. [PMID: 37632908 PMCID: PMC10335131 DOI: 10.2196/45329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/07/2023] [Accepted: 06/06/2023] [Indexed: 08/28/2023] Open
Abstract
The use of risk evaluation and mitigation strategy (REMS) programs is frequently required for prescriptions with potentially teratogenic effects, especially in the field of dermatology. Among these REMS programs, the most well-known example is isotretinoin, an oral retinoid that uses the iPLEDGE system. iPLEDGE has strict regulations and a lengthy approval process, and until recently, patients were grouped into 3 categories: male, female, or female of reproductive potential. This strict grouping has posed problems in the medical community, especially for gender-diverse individuals where their perceived gender conflates with their assigned grouping causing patient-specific distress. The distinction between gender-a multifactorial perception of identity-and biological sex is addressed under new iPLEDGE guidelines. Dermatologists now register patients under one of 2 categories: patients who can become pregnant and those who cannot become pregnant. This change simultaneously improves the accessibility to isotretinoin among gender-diverse individuals, while limiting prescription barriers. Despite initial success being limited due to lengthy system conversions, a registration process based on reproductive potential ultimately enhances iPLEDGE's goal to prevent potential birth defects. We propose that other REMS programs follow the standard set by the iPLEDGE system, including those for the medications thalidomide, acitretin, and mycophenolate mofetil, all of which currently have a similar taxonomy to that of the old iPLEDGE system. Implementing the standardization of gender-neutral terminology can maximize enrollment and minimize distress. Current and ongoing refinement of iPLEDGE and other REMS is needed to build protocols solely around the prevention of birth defects without regard to sex or gender.
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Affiliation(s)
- Colin Burnette
- Nova Southeastern University College of Osteopathic Medicine, Davie, FL, United States
| | - William Smithy
- Nova Southeastern University College of Osteopathic Medicine, Davie, FL, United States
| | - Daniel Strock
- Eastern Virginia Medical School, Norfolk, VA, United States
| | - Torunn E Sivesind
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Dellavalle
- University of Colorado School of Medicine, Aurora, CO, United States
- US Department of Veterans Affairs, University of Colorado, Aurora, CO, United States
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5
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Minion S, Kiene J, Dellavalle R. Dermatology Journals' Editorial Boards Require Improved Gender Equity: JMIR Dermatology's Future Directions. JMIR Dermatol 2023; 6:e43256. [PMID: 37632917 PMCID: PMC10335117 DOI: 10.2196/43256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/07/2023] [Accepted: 04/25/2023] [Indexed: 08/28/2023] Open
Abstract
Gender disparities exist across all facets of academic medicine including within the editorial boards of dermatology journals. Only 22% of these editorial boards comprised women, even though 51% of full-time, faculty dermatologists are female. When inviting academic dermatologists to our editorial board at JMIR Dermatology, we invited 50% women to represent the gender distribution of academic dermatologists; however, we have not sufficiently reached gender equity among accepted editorial board members. We will continue to strive toward the goal of gender equity on our editorial board and invite other dermatology journals to do the same.
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Affiliation(s)
- Sarah Minion
- Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Julianne Kiene
- Georgetown University School of Medicine, Washington, DC, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
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6
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Oganesyan A, Sivesind TE, Dellavalle R. From the Cochrane Library: Interventions for Cutaneous Molluscum Contagiosum. JMIR Dermatol 2023; 6:e41514. [PMID: 37632925 PMCID: PMC10335125 DOI: 10.2196/41514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 08/28/2023] Open
Affiliation(s)
- Ani Oganesyan
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Department of Dermatology, Rocky Mountain Regional Veterans Affairs Medical Center, Eastern Colorado Health Care System, Aurora, CO, United States
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7
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Burnette C, Sivesind TE, Dellavalle R. From the Cochrane Library: Optical Coherence Tomography for Diagnosing Skin Cancer in Adults. JMIR Dermatol 2023; 6:e41355. [PMID: 37632933 PMCID: PMC10335143 DOI: 10.2196/41355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Affiliation(s)
- Colin Burnette
- Nova Southeastern University College of Osteopathic Medicine, Davie, FL, United States
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Rocky Mountain Reginal Veterans Affairs Medical Center, Aurora, CO, United States
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8
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Kiene J, Minion S, Rodriguez R, Dellavalle R. Diversity, Equity, and Inclusion of Dermatology Journals and Their Editorial Board Members. JMIR Dermatol 2023; 6:e44217. [PMID: 37632920 PMCID: PMC10335123 DOI: 10.2196/44217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
Dermatology as a whole suffers from minority underrepresentation. We conducted a search of the top 60 dermatology journals for mention of their approach to increasing diversity, equity, and inclusion (DEI) within their publication through editorial board members or peer-review processes. Of those 60, only 5 had DEI statements or editorial board members dedicated to increasing DEI. There are publications with checklists and frameworks for increasing DEI within the literature. We propose that more journals implement these resources within their peer-review process to increase diversity within their publication.
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Affiliation(s)
- Julianne Kiene
- School of Medicine, Georgetown University, Washington, DC, United States
| | - Sarah Minion
- College of Medicine, The University of Iowa Carver, Iowa City, IA, United States
| | - Ramiro Rodriguez
- Department of Dermatology, School of Medicine, University of Colorado, Denver, CO, United States
| | - Robert Dellavalle
- Department of Dermatology, School of Medicine, University of Colorado, Denver, CO, United States
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9
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Quinn A, Pulsipher K, Szeto M, Presley C, Marroquin N, Dellavalle R. Monkeypox Vaccination and Cutaneous Considerations for the Dermatologist. J Drugs Dermatol 2023; 22:105-106. [PMID: 36607751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Monkeypox has infected over 18,000 individuals in the United States since the first reported case on May 17, 2022.1 Monkeypox is a variola poxvirus that is related to smallpox, but monkeypox symptoms (fever, painful vesicular or pustular rash, and lymphadenopathy) are milder and fatalities are rare.
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10
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Ahmad A, Alhanshali L, Jefferson IS, Dellavalle R. Cochrane Skin Group's Global Social Media Reach: Content Analysis of Facebook, Instagram, and Twitter Posts. JMIR Dermatol 2022; 5:e40905. [PMID: 37632904 PMCID: PMC10334931 DOI: 10.2196/40905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/23/2022] [Accepted: 11/15/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Researchers in all medical specialties increasingly use social media to educate the public, share new publications with peers, and diversify their audiences. OBJECTIVE Given Cochrane Skin Group's expanded use of social media in the past years, we aimed to characterize Cochrane Skin Group's international social media audience and identify themes that result in increased content engagement. METHODS Cochrane Skin Group's Facebook, Instagram, and Twitter analytics data were extracted for follower demographics and the most viewed posts within a 3-year span (June 2019 to June 2022). RESULTS Overall, Cochrane Skin Group had the highest number of followers on Facebook (n=1037). The number of Instagram and Twitter followers reached 214 and 352, respectively. The greatest numbers of Facebook followers were from Brazil, Egypt, and India, with 271, 299, and 463 followers, respectively. Facebook's most viewed post about Cochrane Skin Group's annual meeting received 1041 views. The top post on Instagram, which introduced Cochrane Skin Group's social media editors, received 2522 views. CONCLUSIONS Each of the social media platforms used by Cochrane Skin Group reached varying audiences all over the world. Across social media platforms, posts regarding Cochrane Skin Group meetings, members, and professional opportunities received the most views. Overall, Cochrane Skin Group's multiplatform social media approach will continue to grow an international audience, connecting people interested in skin disease.
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Affiliation(s)
- Areebah Ahmad
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States
| | - Lina Alhanshali
- SUNY Downstate Health Sciences University, College of Medicine, Brooklyn, NY, United States
| | - Itisha S Jefferson
- Loyola University Stritch School of Medicine, Maywood, IL, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
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11
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Sivesind T, D'Angelo J, Khazova T, Hassan S, Kamara M, Wallace E, Dunnick C, Dellavalle R. Participation in Clinical Trials Among Academic Dermatologists Affiliated With Veterans Affairs Hospitals: Survey Study. JMIR Dermatol 2022; 5:e35379. [PMID: 36187494 PMCID: PMC9511003 DOI: 10.2196/35379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Clinical trials have led to the development of new and effective therapies for many dermatologic conditions. To our knowledge, there is no published study that has quantified and described the degree of involvement in clinical trials among academic dermatologists and their university affiliates. Objective The purpose of this study was to characterize the involvement of academic dermatology departments in clinical trials research. Methods An online survey was sent to 211 Veterans Affairs (VA)–employed dermatologists. It comprised 20 questions related to the number of clinical trials, support staff dedicated to clinical research, skin diseases studied, and the effect of the COVID-19 pandemic on conducting clinical research. Three rounds of survey invitations were sent over a 3-month period (March to May 2021). Data from all survey responses were reviewed for quantitative and descriptive analyses of the key outcome measures. Results A total of 48 dermatologists completed the survey and provided their university affiliations and details of involvement in clinical trials research. Over half of participants (n=25, 58.1%) with a university affiliate reported that their affiliated dermatology department had a dedicated clinical trials unit. Basal cell carcinoma was the most frequently studied skin condition (n=9, 18.8%), followed by atopic dermatitis and psoriasis (n=4, 8.3% each); 66.7% of participants reported no current clinical trials participation. Of those conducting clinical trials, 87% (n=18) noted that COVID-19 was a barrier to conducting trials, with 52.2% (n=11) citing disrupted or decreased trials due to the pandemic. Conclusions Although many dermatologists with university affiliations reported having a dedicated clinical trials unit at their institution, a majority of those surveyed reported not taking part in any active trials. Overall, the diseases investigated in academic clinical trials appear to follow national trends, though some of the top dermatological diseases are underrepresented in clinical trials research. A key limitation of our study was the low response rate (~23%) and that the survey responses from the sample of VA-based dermatologists may not be generalizable to all academic dermatology departments in the United States. The effect of the COVID-19 pandemic appeared to play a significant role in disrupting active trials.
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Affiliation(s)
- Torunn Sivesind
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Josephine D'Angelo
- Department of Dermatology University of Rochester Rochester, NY United States
| | - Tatyana Khazova
- College of Osteopathic Medicine Rocky Vista University Parker, CO United States
| | - Shahzeb Hassan
- Feinberg School of Medicine Northwestern University Chicago, IL United States
| | - Michael Kamara
- School of Medicine University of Missouri Columbia, MO United States
| | - Elizabeth Wallace
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Cory Dunnick
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
| | - Robert Dellavalle
- Department of Dermatology University of Colorado Anschutz Medical Center Aurora, CO United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center US Department of Veterans Affairs Eastern Colorado Health Care System Aurora, CO United States
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12
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Laughter MR, Anderson JB, Sinkevich D, Anderson JD, Yang RA, Box N, Caraveo Y, Lim G, Dellavalle R, Sadeghpour M. 31243 Age requirements for regarding indoor UV tanning in Colorado. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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13
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Jueng J, Bhupalam V, Su A, Dupuis L, Infante C, Shaikh S, Dellavalle R, Brooks I, Burton V, Solomon J. Title: Using Artificial Intelligence to Analyze Publicly Available Social Media Posts to Understand Patient Perspectives Towards Specific Treatments of Alopecia Areata. JAAD Int 2022; 9:102-104. [PMID: 36237847 PMCID: PMC9552096 DOI: 10.1016/j.jdin.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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14
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Cooper B, Pulsipher K, Presley C, Dellavalle R. 393 An analysis of dermatology resident population’s medical trainings and degrees. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Cooper B, Pulsipher K, Presley C, Dellavalle R. 355 Responding to a call of action: An analysis of ethnic diversity within dermatology residency programs. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Chandani B, Jueng J, Dellavalle R, Brooks I, Burton O, Shaikh S, Bhupalam V, Solomon J. LB1031 Using social media to elucidate the patient experience with common acne treatments. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Zagona-Prizio C, Sivesind T, Szeto M, Wallace E, Sillau S, Liu Y, Leehey M, Dunnick C, Dellavalle R. LB948 Oral cannabidiol treatment of seborrheic dermatitis in patients with Parkinson’s disease. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Jueng J, Bhupalam V, Su A, Infante C, Dupuis L, Shaikh S, Dellavalle R, Brooks I, Burton O, Solomon J. 366 Comparing patient perspectives towards treatment for alopecia areata before and during COVID-19 using social media data mining. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Hatch J, Albrecht J, Presley C, Anderson J, Hamp A, Anderson J, Rundle C, Laughter M, Dellavalle R. 370 An analysis of androgenetic alopecia treatment content on Instagram and TikTok. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Oganesyan A, Sivesind T, Dellavalle R. From the Cochrane Library: Interventions for Cellulitis and Erysipelas. JMIR Dermatol 2022; 5:e37888. [PMID: 37632897 PMCID: PMC10334911 DOI: 10.2196/37888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ani Oganesyan
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Torunn Sivesind
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Dellavalle
- University of Colorado School of Medicine, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
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21
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Sivesind TE, Szeto MD, Anderson J, Maghfour J, Matheny M, Le QNM, Kamara M, Dellavalle R. Pharmaceutical Payments to Authors of Dermatology Guidelines After Publication. JMIR Dermatol 2022; 5:e37749. [PMID: 37632871 PMCID: PMC10334891 DOI: 10.2196/37749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Mindy D Szeto
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jarett Anderson
- Arizona College of Osteopathic Medicine, Glendale, AZ, United States
| | - Jalal Maghfour
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, United States
| | - Maya Matheny
- Santa Clara University, Santa Clara, CA, United States
| | | | - Michael Kamara
- University of Missouri School of Medicine, Columbia, MO, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
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22
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Sivesind T, Viola J, Zhang L, Dellavalle R, Chi CC. From the Cochrane Library: Interventions for the Prevention of Herpes Simplex Labialis (Cold Sores on the Lips). JMIR Dermatol 2022; 5:e38322. [PMID: 37632876 PMCID: PMC10334877 DOI: 10.2196/38322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Torunn Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jennifer Viola
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
| | - Linda Zhang
- Ochsner Clinical School, School of Medicine, University of Queensland, New Orleans, LA, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
| | - Ching-Chi Chi
- Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Maghfour J, Sivesind T, Piguet V, Dellavalle R, Ingram JR. From the Cochrane Library: Interventions for Hidradenitis Suppurativa. JMIR Dermatol 2022; 5:e29966. [PMID: 37632870 DOI: 10.2196/29966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/05/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jalal Maghfour
- Photomedicine and Photobiology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, United States
| | - Torunn Sivesind
- Dermatology Department, University of Colorado, Aurora, CO, United States
| | | | - Robert Dellavalle
- Dermatology Department, University of Colorado, Aurora, CO, United States
| | - John R Ingram
- Dermatology Department, Glamorgan House, University Hospital of Wales, Cardiff, United Kingdom
- Division of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
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Bonnell LN, Obi N, Miller K, Hu S, Dellavalle R, Cockburn M. Intent to Change Sun-Protective Behaviors Among Hispanic People After a UV Photoaging Intervention: Cohort Study. JMIR Dermatol 2022. [DOI: 10.2196/33339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Mortality rates from melanoma are higher among Hispanic populations than non-Hispanic White (NHW) populations. Interventions to improve sun safety are needed. The Reveal Imager is a camera that uses standard cross-polarized flash photography to record surface and subsurface skin conditions.
Objective
This study aims to determine the intervention’s effectiveness in increasing awareness of sun damage and exposure reduction between Hispanic and NHW populations.
Methods
A cohort of 322 participants, aged ≥18 years, were recruited from community events in 2018. Baseline information was collected on demographics, sun exposure, and perception of risk factors. A facial image was then captured using the Reveal Imager. The results were explained and counseling on sun safety was given, followed by filling out an immediate postimage survey. Chi-square tests, analysis of variance, Wilcoxon signed-rank test, McNemar tests, and multivariable logistic regression were used.
Results
At follow-up, 125 of 141 (89%) Hispanic participants reported that viewing the UV photoaged image influenced intent-to-change sun protection behaviors, compared to 88 of 121 (73%) NHW participants (odds ratio 2.9, 95% CI 1.5-5.6). Of 141 Hispanic participants, 96 (68%) reported that they intended to increase sunscreen use, compared to only 41 of 121 (34%) NHW participants (P<.001).
Conclusions
We demonstrated an application of Reveal Imager for education and risk assessment. The Reveal Imager was especially helpful in motivating intention to change sun exposure among Hispanic populations.
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Damiani G, Bragazzi NL, Karimkhani Aksut C, Wu D, Alicandro G, McGonagle D, Guo C, Dellavalle R, Grada A, Wong P, La Vecchia C, Tam LS, Cooper KD, Naghavi M. The Global, Regional, and National Burden of Psoriasis: Results and Insights From the Global Burden of Disease 2019 Study. Front Med (Lausanne) 2022; 8:743180. [PMID: 34977058 PMCID: PMC8716585 DOI: 10.3389/fmed.2021.743180] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Psoriasis is a common, chronic, inflammatory, debilitating, systemic disease with a great impact on healthcare systems worldwide. As targeted therapies have transformed the therapeutic landscape, updated estimates of the Global Burden of Disease (GBD) imposed by psoriasis are necessary in order to evaluate the effects of past health care policies and to orient and inform new national and international healthcare strategies. Methods: Data were extracted from the GBD 2019 study, which collates a systematic review of relevant scientific literature, national surveys, claims data, and primary care sources on the prevalence of psoriasis. Prevalence data were combined with disability weight (DW) to yield years lived with disability (YLDs). Measures of burden at global, regional, and national levels were generated for incidence, prevalence, and YLDs, due to psoriatic disease. All measures were reported as absolute numbers, percentages, and crude and age-adjusted rates per 100,000 persons. In addition, psoriasis burden was assessed by socio-demographic index (SDI). Findings: According to the GBD 2019 methodology, there were 4,622,594 (95% uncertainty interval or UI 4,458,904-4,780,771) incident cases of psoriasis worldwide in 2019. The age-standardized incidence rate in 2019 was 57.8 (95% UI 55.8-59.7) per 100,000 people. With respect to 1990, this corresponded to a decrease of 20.0% (95% UI -20.2 to -19.8). By sex, the age-standardized incidence rate was similar between men [57.8 (95% UI 55.8-59.8) per 100,000 people] and women [(57.8 (95% UI 55.8-59.7) per 100,000 people]. With respect to 1990, this corresponded to a decrease by 19.5% (95% UI -19.8 to -19.2) and by 20.4% (95% UI -20.7 to -20.2) for men and women, respectively. The age-standardized incidence rate per 100,000 persons was found to vary widely across geographic locations. Regionally, high-income countries and territories had the highest age-standardized incidence rate of psoriasis [112.6 (95% UI 108.9-116.1)], followed by high-middle SDI countries [69.4 (95% UI 67.1-71.9)], while low SDI countries reported the lowest rate [38.1 (95% UI 36.8-39.5)]. Similar trends were detected for prevalence and YLDs. Conclusion: In general, psoriasis burden is greatest in the age group of 60-69 years, with a relatively similar burden among men and women. The burden is disproportionately greater in high-income and high SDI index countries of North America and Europe. With advances in psoriasis therapeutics, objective evaluation of psoriasis disease burden is critical to track the progress at the population level.
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Affiliation(s)
- Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States.,Clinical Dermatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | | | | | - Dongze Wu
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Dennis McGonagle
- National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, United Kingdom
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Robert Dellavalle
- Department of Dermatology, University of Anschutz Medical Campus, Aurora, CO, United States
| | - Ayman Grada
- Department of Dermatology, Boston University School of Medicine, Boston, MA, United States
| | - Priscilla Wong
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Lai-Shan Tam
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Kevin D Cooper
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
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Oganesyan A, Sivesind T, Dellavalle R. From the Cochrane Library: Topical Treatments for Cutaneous Warts. JMIR Dermatol 2021; 4:e33900. [PMID: 37632858 PMCID: PMC10334969 DOI: 10.2196/33900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ani Oganesyan
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Torunn Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
- Department of Dermatology, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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Oganesyan A, Sivesind T, Dellavalle R. From the Cochrane Library: Interventions for Impetigo. JMIR Dermatol 2021. [DOI: 10.2196/33433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pulsipher KJ, Concilla A, Presley CL, Laughter MR, Anderson J, Chea E, Lim K, Rundle CW, Szeto MD, Dellavalle R. An Analysis of Skin of Color Content on TikTok (Preprint). JMIR Dermatology 2021. [DOI: 10.2196/33340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Su A, Jueng J, Dupuis L, Brooks I, Sinha R, Maner B, Dellavalle R, Burton V, Solomon JA. Artificial intelligence (AI) comparison of social media-based patient-reported outcomes of PD-1, BRAF, and CTLA-4 inhibitors for melanoma treatment. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21572 Background: Due to side effects and adverse psychosocial factors, there can often be a disconnect between clinical impression and the patient perspective of treatment. Melanoma patients frequently use social media to discuss their disease sentiments and outcomes, providing a window into patient insight, otherwise not readily attainable. We analyzed publicly available full text posts on multiple social media platforms concerning melanoma treatments PD-1 inhibitors (pembrolizumab/Keytruda, nivolumab), BRAF inhibitors (dabrafenib, vemurafenib), and CTLA-4 inhibitor (ipilimumab/Yervoy) associated with Patient Global Impression of Change (PGIC) terms to compare and identify patient burden. Methods: Millions (12,599,313) of publicly available online social media text data were extracted and run through Brandwatch Artificial Intelligence-powered database and machine learning algorithm to categorize treatment-specific posts with PGIC terms associated with sentiment. Results: Out of 52,962 posts related to a select list of melanoma treatments, we identified Keytruda (6,080), nivolumab (1,614), dabrafenib (529), vemurafenib (329), and ipilimumab (1715) posts. The top ten types of posts by volume for each treatment were predominantly positive for PGIC terms (improving, well, progress) while being associated with negative emotions (fear and sadness). Patient-perceived better treatments were associated with decrease fear. PD-1 inhibitor Keytruda displayed markedly less fear (56.9%) with a very high positive PGIC (92.3%) in comparison with PD-1 inhibitor nivolumab with decreased positive PGIC (78.0%) and increased fear (81.6%). Likewise, this patten was discovered for the BRAF inhibitors and CTLA-4 inhibitor, albeit less distinct: dabrafenib (positive PGIC 86.4%, fear 71.9%), vemurafenib (positive PGIC 78.0%, 81.6%), ipilimumab (positive PGIC 75.0%, fear 79.3%). Conclusions: Our initial results indicate that despite patients reporting good outcomes from melanoma treatment, they remain fearful. Nonetheless, a trend is identified between patient-perceived better treatment and decreased patient fear. This analysis can help bridge the gap of understanding patient perspective and provides an indication for translation into more effective clinical and pharmaceutical response.
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Affiliation(s)
- Ashley Su
- University of Central Florida College of Medicine, Orlando, FL
| | - Jeremy Jueng
- University of Central Florida College of Medicine, Orlando, FL
| | - Léonie Dupuis
- University of Central Florida College of Medicine, Orlando, FL
| | - Ian Brooks
- University of Illinois, Center for Health Informatics, Urbana, IL
| | - Ritika Sinha
- University of Illinois, Center for Health Informatics, Urbana, IL
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Laughter M, Yemc M, Presley C, Pulsipher K, Szeto M, Zangara T, Rundle C, Maymone M, Dellavalle R. 372 Gender representation in academic dermatology: A necessary shift to the current paradigm. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Presley C, Pulsipher K, Rietcheck H, Szeto M, Laughter M, Dellavalle R. 370 TikTok: An emerging social media platform for dermatologist influencers. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jueng J, Su A, Maner B, Meisenheimer J, Dupuis L, Dellavalle R, Brooks I, Shaikh S, Burton V, Solomon J. 427 Discerning patient perspectives towards specific treatments of alopecia areata using artificial intelligence. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Engel T, Nguyen A, Fergus J, Dellavalle R, Maverakis E, Sivamani R. 260 Sun protection attitudes and behaviors among minority groups in a low socioeconomic community. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sivesind T, Presley C, Szeto M, Afrin A, Lada S, Laughter M, Maymone M, Dellavalle R. 351 Most influential authors in dermatology: Standardized citation indicators from updated databases. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sivesind T, Runion T, Branda M, Schilling L, Dellavalle R. 352 Dermatology research with the Observational Health Data Sciences and Informatics (OHDSI) network. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Presley C, Szeto M, Pulsipher K, Swink S, Militello M, Ward K, Laughter M, Dellavalle R. 371 Scarcity of the LGBTQ community in dermatology literature. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Smires S, Afach S, Mazaud C, Phan C, Garcia Doval I, Boyle R, Dellavalle R, Williams HC, Grindlay D, Sbidian E, Le Cleach L. Quality and Reporting Completeness of Systematic Reviews and Meta-Analyses in Dermatology. J Invest Dermatol 2021; 141:64-71. [DOI: 10.1016/j.jid.2020.05.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
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Maghfour J, Rietcheck H, Rundle C, Runion T, Jafri Z, Dercon S, Lio P, Fernandez J, Fujita M, Dellavalle R, Yardley H. An Observational Study of the Application of a Topical Cannabinoid Gel on Sensitive Dry Skin. J Drugs Dermatol 2020; 19:1204-1208. [DOI: 10.36849/jdd.2020.5464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
BACKGROUND Eczema is a common and chronic, relapsing, inflammatory skin disorder. It seriously impacts quality of life and economic outcomes, especially for those with moderate to severe eczema. Various treatments allow sustained control of the disease; however, their relative benefit remains unclear due to the limited number of trials directly comparing treatments. OBJECTIVES To assess the comparative efficacy and safety of different types of systemic immunosuppressive treatments for moderate to severe eczema using NMA and to generate rankings of available systemic immunosuppressive treatments for eczema according to their efficacy and safety. SEARCH METHODS We searched the following databases up to August 2019: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, and Embase. SELECTION CRITERIA All randomised controlled trials (RCTs) of systemic immunosuppressive agents for moderate to severe atopic eczema when compared against placebo or any other eligible eczema treatment. DATA COLLECTION AND ANALYSIS We synthesised data using pair-wise analysis and NMA to compare treatments and rank them according to their effectiveness. Effectiveness was assessed primarily by determining the proportion of participants who achieved at least 75% improvement in the Eczema Area and Severity Index (EASI75) and improvement in the Patient-Oriented Eczema Measure (POEM). Safety was evaluated primarily by considering the proportion of participants with serious adverse events (SAEs) and infection. We deemed short-term follow-up as ≤ 16 weeks and long-term follow-up as > 16 weeks. We assessed the certainty of the body of evidence from the NMA for these primary outcomes using six domains of CiNEMA grading. MAIN RESULTS We included a total of 74 studies, with 8177 randomised participants. Approximately 55% of participants were male, with average age of 32 years (range 2 to 84 years), although age and gender were unreported for 419 and 902 participants, respectively. Most of the included trials were placebo controlled (65%), 34% were head-to-head studies (15% assessed the effects of different doses of the same drug), and 1% were multi-armed studies with both an active comparator and a placebo. All trials included participants with moderate to severe eczema, but 62% of studies did not separate data by severity; 38% of studies assessed only severe eczema. The total duration of included trials ranged from 2 weeks to 60 months, whereas treatment duration varied from a single dose (CIM331, KPL-716) to 60 months (methotrexate (MTX)). Seventy studies were available for quantitative synthesis; this review assessed 29 immunosuppressive agents from three classes of interventions. These included (1) conventional treatments, with ciclosporin assessed most commonly; (2) small molecule treatments, including phosphodiesterase (PDE)-4 inhibitors, tyrosine kinase inhibitors, and Janus kinase (JAK) inhibitors; and (3) biological treatments, including anti-CD31 receptors, anti-interleukin (IL)-22, anti-IL-31, anti-IL-13, anti-IL-12/23p40, anti-OX40, anti-TSLP, anti-CRTH2, and anti-immunoglobulin E (IgE) monoclonal antibodies, but most commonly dupilumab. Most trials (73) assessed outcomes at a short-term duration ranging from 2 to 16 weeks, whereas 33 trials assessed long-term outcomes, with duration ranging from 5 to 60 months. All participants were from a hospital setting. Fifty-two studies declared a source of funding, and of these, pharmaceutical companies funded 88%. We rated 37 studies as high risk; 21, unclear risk, and 16, low risk of bias, with studies most commonly at high risk of attrition bias. Network meta-analysis suggests that dupilumab ranks first for effectiveness when compared with other biological treatments. Dupilumab is more effective than placebo in achieving EASI75 (risk ratio (RR) 3.04, 95% confidence interval (CI) 2.51 to 3.69) and improvement in POEM score (mean difference 7.30, 95% CI 6.61 to 8.00) at short-term follow-up (high-certainty evidence). Very low-certainty evidence means we are uncertain of the effects of dupilumab when compared with placebo, in terms of the proportion of participants who achieve EASI75 (RR 2.59, 95% CI 1.87 to 3.60) at longer-term follow-up. Low-certainty evidence indicates that tralokinumab may be more effective than placebo in achieving short-term EASI75 (RR 2.54, 95% CI 1.21 to 5.34), but there was no evidence for tralokinumab to allow us to assess short-term follow-up of POEM or long-term follow-up of EASI75. We are uncertain of the effect of ustekinumab compared with placebo in achieving EASI75 (long-term follow-up: RR 1.17, 95% CI 0.40 to 3.45; short-term follow-up: RR 0.91, 95% CI 0.28 to 2.97; both very low certainty). We found no evidence on ustekinumab for the POEM outcome. We are uncertain whether other immunosuppressive agents that targeted our key outcomes influence the achievement of short-term EASI75 compared with placebo due to low- or very low-certainty evidence. Dupilumab and ustekinumab were the only immunosuppressive agents evaluated for longer-term EASI75. Dupilumab was the only agent evaluated for improvement in POEM during short-term follow-up. Low- to moderate-certainty evidence indicates a lower proportion of participants with SAEs after treatment with QAW039 and dupilumab compared to placebo during short-term follow-up, but low- to very low-certainty evidence suggests no difference in SAEs during short-term follow-up of other immunosuppressive agents compared to placebo. Evidence for effects of immunosuppressive agents on risk of any infection during short-term follow-up and SAEs during long-term follow-up compared with placebo was of low or very low certainty but did not indicate a difference. We did not identify differences in other adverse events (AEs), but dupilumab is associated with specific AEs, including eye inflammation and eosinophilia. AUTHORS' CONCLUSIONS Our findings indicate that dupilumab is the most effective biological treatment for eczema. Compared to placebo, dupilumab reduces eczema signs and symptoms in the short term for people with moderate to severe atopic eczema. Short-term safety outcomes from clinical trials did not reveal new safety concerns with dupilumab. Overall, evidence for the efficacy of most other immunosuppressive treatments for moderate to severe atopic eczema is of low or very low certainty. Given the lack of data comparing conventional with newer biological treatments for the primary outcomes, there remains high uncertainty for ranking the efficacy and safety of conventional treatments such as ciclosporin and biological treatments such as dupilumab. Most studies were placebo-controlled and assessed only short-term efficacy of immunosuppressive agents. Further adequately powered head-to-head RCTs should evaluate comparative long-term efficacy and safety of available treatments for moderate to severe eczema.
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Affiliation(s)
- Ratree Sawangjit
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Piyameth Dilokthornsakul
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Antonia Lloyd-Lavery
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | | | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
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Rundle C, Fortugno A, Chosidow O, Naldi L, Hay R, Dellavalle R. 519 Evaluating world health organization essential medicines list for dermatologic disease. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hu S, Laughter M, Dellavalle R. 481 Reliability of self-reported data on social media vs. National Residency Match Program Charting Outcomes for dermatology applicants. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maymone M, Laughter M, Jones J, Anand P, Dellavalle R, Hugh J, Dunnick C. 551 Mid-level providers and the dermatology literature: A bibliometric analysis of trends 1973-2018. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Grada A, Aksut C, Dellavalle R, Naghavi M. 486 The global burden of acne vulgaris: Results from the GBD study 2017. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Barber C, Dellavalle R, Coolman T, Ranpariya V. 461 Emojis in dermatology: Changing the faces in medicine. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Su A, Dupuis L, Jueng J, Kunadia A, Brooks I, Sinha R, Siddiqui F, Maner B, Harding T, Burton V, Dellavalle R, Seyffert J, Solomon JA. Use of artificial intelligence for analyzing emotion vs patient global impression of change of melanoma treatments. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24177 Background: The link between melanoma patients’ emotions and their impressions of treatments response are poorly understood. With the rise of social media, patients use online platforms to communicate their concerns related to melanoma treatments. In this study, we utilize real-world data collected from social media with search terms focused on treatment-specific Patients’ Global Impression of Change (PGIC) compared with their emotions. We aim to identify and focus melanoma patient perspective trends to improve patient-centered care. Methods: Social media data mining of search terms were extracted from millions of publicly available interactions on Twitter and other online platforms from May/2008 to January/2020 using Crimson Hexagon (database of real-time social media posts). Results: For chemotherapy posts, the top three emotions by volume were negative alongside negative PGIC “worse” (Worse/Sadness 700, Worse/Fear 596, Worse/Disgust 403, and “decline” (Decline/Sadness 262, Decline/Fear 186, Decline/Disgust 57). Interestingly, Sadness, Fear, and Disgust were as prevalent alongside positive PGIC “well” and “cured” (Well/Sadness 3577, Well/Fear 2545, and Well/Disgust 1770; Cured/Sadness 518, Cured/Disgust 275, and Cured/Fear 167). For Keytruda treatment posts, emotions in negative PGIC “worse” were (Worse/Fear 117, Worse/Anger 68, Worse/Sadness 6). In positive PGIC “well”, results were (Well/Fear 880, Well/Sadness 366, Well/Anger 186). Further analysis will compare these emotional sentiments with a spectrum of PGIC terms and specific types of melanoma treatments. Conclusions: To our knowledge, this is the first investigation of online patient melanoma treatments associated with PGIC terms. The findings indicate a trend of negative emotions even when patients have reported wellness or being cured by treatment. While treatments may be effective, patients are not necessarily satisfied. Correlating changes in emotions with perceived changes in disease severity can provide insight into patient perspectives, which has implications in translating clinical response and a need for continued emotional support in patients with treatment response.
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Affiliation(s)
| | - Léonie Dupuis
- University of Central Florida College of Medicine, Orlando, FL
| | - Jeremy Jueng
- University of Central Florida College of Medicine, Orlando, FL
| | - Anuj Kunadia
- University of Central Florida College of Medicine, Orlando, FL
| | - Ian Brooks
- University of Illinois, School of Information Sciences, Champaign, IL
| | - Ritika Sinha
- University of Illinois, School of Information Sciences, Champaign, IL
| | | | | | - Tanner Harding
- University of Central Florida College of Medicine, Orlando, FL
| | | | | | - Jennifer Seyffert
- Kansas City University of Medicine and Biosciences- Advanced Dermatology and Cosmetic Surgery, Department of Dermatology, Orlando, FL
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Altman E, Dellavalle R, Grant-Kels J, Elston DM. New ways to learn: Enhanced social media and JAAD virtual journal club 1 year later. J Am Acad Dermatol 2020; 82:31. [DOI: 10.1016/j.jaad.2019.07.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 11/28/2022]
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Smires S, Afach S, Mazaud C, Phan C, Garcia Doval I, Boyle R, Dellavalle R, Williams H, Grindlay D, Sbidian E, Le Cleach L. Méthodologie et description des revues systématiques et méta-analyses en dermatologie. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gonzalez C, Walkosz B, Dellavalle R. LB1130 Latino tattoo artists providing sun safety counseling to young Latino adults via aftercare instructions and social media: A semi-structured interview study. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Karimkhani Aksut C, Schilling L, Dellavalle R. 249 Characterization of international oral antibiotic use for acne. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tang H, Little C, Aalborg J, Asdigian N, Terzian T, Dellavalle R, Barón A, Mokrohisky S, Morelli J, Crane L, Box N. 864 Genetics of pigmentation changes in a pediatric population. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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