1
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Salavastru CM, Cretu S, Dascalu M, Sendrea AM, Suru A, Tiplica GS. Scabies treatment with benzyl benzoate in patients younger than 2 years: A single-centre experience. J Eur Acad Dermatol Venereol 2024. [PMID: 38702971 DOI: 10.1111/jdv.20048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/10/2024] [Indexed: 05/06/2024]
Affiliation(s)
- C M Salavastru
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
| | - S Cretu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - M Dascalu
- Department of Computer Science, National University of Science and Technology POLITEHNICA Bucharest, Bucharest, Romania
| | - A M Sendrea
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - A Suru
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - G S Tiplica
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
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2
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van der Meijden WI, Boffa MJ, Ter Harmsel B, Kirtschig G, Lewis F, Moyal-Barracco M, Tiplica GS, Sherrard J. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol 2022; 36:952-972. [PMID: 35411963 DOI: 10.1111/jdv.18102] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 12/27/2022]
Affiliation(s)
- W I van der Meijden
- Department of Dermatology, Betsi Cadwaladr University Health Board, Bangor, UK
| | - M J Boffa
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - B Ter Harmsel
- Department of Gynaecology, Roosevelt kliniek, Leiden, The Netherlands
| | - G Kirtschig
- Gesundheitszentrum Frauenfeld, Frauenfeld, Switzerland
| | - F Lewis
- St John's Institute of Dermatology, Guy's and St Thomas' Hospital, London, UK
| | - M Moyal-Barracco
- Department of Dermatology, Tarnier-Cochin Hospital, Paris, France
| | - G-S Tiplica
- Dermatology 2, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - J Sherrard
- Department of Sexual Health, Wycombe General Hospital, Bucks, UK
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3
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Tiplica GS. Sexually transmitted infections - 30 years later. J Eur Acad Dermatol Venereol 2021; 35:2285-2286. [PMID: 34647669 DOI: 10.1111/jdv.17667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- G-S Tiplica
- Dermatology II, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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4
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Brüggen MC, Le ST, Walsh S, Toussi A, de Prost N, Ranki A, Didona B, Colin A, Horváth B, Brezinova E, Milpied B, Moss C, Bodemer C, Meyersburg D, Salavastru C, Tiplica GS, Howard E, Bequignon E, Bouwes Bavinck JN, Newman J, Gueudry J, Nägeli M, Zaghbib K, Pallesen K, Bygum A, Joly P, Wolkenstein P, Chua SL, Le Floch R, Shear NH, Chu CY, Hama N, Abe R, Chung WH, Shiohara T, Ardern-Jones M, Romanelli P, Phillips EJ, Stern RS, Cotliar J, Micheletti RG, Brassard A, Schulz JT, Dodiuk-Gad RP, Dominguez AR, Paller AS, Seminario-Vidal L, Mostaghimi A, Noe MH, Worswick S, Tartar D, Sheridan R, Kaffenberger BH, Shinkai K, Maverakis E, French LE, Ingen-Housz-Oro S. Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus. Br J Dermatol 2021; 185:616-626. [PMID: 33657677 DOI: 10.1111/bjd.19893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. OBJECTIVES Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. METHODS Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. RESULTS Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. CONCLUSIONS We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.
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Affiliation(s)
- M-C Brüggen
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Christine Kühne Center for Allergy Research and Education, Davos, Switzerland.,ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France
| | - S T Le
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - S Walsh
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatology, King's College Hospital, London, UK
| | - A Toussi
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - N de Prost
- Intensive Care Unit, AP-HP, Henri Mondor Hospital, Créteil, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France
| | - A Ranki
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Skin and Allergic Diseases, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - B Didona
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,First Dermatology Division, Institute Dermopatico dell'Immacolata (I.D.I.) - IRCCS, Via Monti di Creta 104, Rome, 00167, Italy
| | - A Colin
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - B Horváth
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - E Brezinova
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatovenereology, St Ann's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - B Milpied
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Department of Dermatology, CHU Bordeaux, Bordeaux, France
| | - C Moss
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Birmingham Children's Hospital and University of Birmingham, Birmingham, UK
| | - C Bodemer
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Department of Dermatology, AP-HP, Necker Hospital, Paris, France
| | - D Meyersburg
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - C Salavastru
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - G-S Tiplica
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatology II, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - E Howard
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Birmingham Children's Hospital and University of Birmingham, Birmingham, UK
| | - E Bequignon
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, AP-HP, Henri Mondor Hospital, Créteil, France
| | - J N Bouwes Bavinck
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Newman
- Macmillan Skin Cancer CNS, Normanby Building, Denmark Hill, London, UK
| | - J Gueudry
- Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Ophthalmology Department, Hospital Charles Nicolle, EA7510, UFR Santé, Rouen University, Rouen, France
| | - M Nägeli
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - K Zaghbib
- Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Department of Psychiatry, AP-HP, Henri Mondor-Albert Chenevier Hospitals, Cr, France
| | - K Pallesen
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Department of Dermatology, Aarhus University Hospital, Palle Juul-Jensens, Aarhus, Denmark
| | - A Bygum
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Clinical Institute, University of Southern Denmark, Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - P Joly
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Department of Dermatology, CHU Charles, Nicolle, Rouen, France
| | - P Wolkenstein
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - S-L Chua
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Le Floch
- Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Réanimation Chirurgicale et des Brûlés, PTMC, CHU Nantes, Nantes, France
| | - N H Shear
- Division of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - C-Y Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - N Hama
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - R Abe
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - W-H Chung
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - T Shiohara
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
| | - M Ardern-Jones
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Romanelli
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - E J Phillips
- Department of Medicine & Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - R S Stern
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - R G Micheletti
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A Brassard
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J T Schulz
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R P Dodiuk-Gad
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - A R Dominguez
- Department of Dermatology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - L Seminario-Vidal
- Department of Dermatology, University of South Florida, Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, FL, USA
| | - A Mostaghimi
- Department of Dermatology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - M H Noe
- Department of Dermatology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S Worswick
- Keck-USC School of Medicine, Los Angeles, CA, USA
| | - D Tartar
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - R Sheridan
- Burn Surgery Service, Shriners Burns Hospital, Sumner Redstone Burn Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - B H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, Ohio State University, Columbus, OH, USA
| | - K Shinkai
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - E Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - L E French
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
| | - S Ingen-Housz-Oro
- ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN-skin), Paris, France.,Toxic Bullous Dermatoses TOXIBUL Reference Centre, Filière FIMARAD, AP-HP, Henri Mondor Hospital, Créteil, France.,Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France.,Universit, EpiDermE, Créteil, France
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5
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Danescu S, Salavastru C, Tiplica GS, Fritz K. [Treatment of pigmentation disorders in association with systemic diseases]. Hautarzt 2020; 71:932-943. [PMID: 33201325 DOI: 10.1007/s00105-020-04715-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Pigmentation disorders are a frequent skin problem and incorporate a broad spectrum of diseases, caused by an abnormal melanin pigmentation or also non-melanin pigmentation of the skin. Both hypermelanosis and hypomelanosis can be hereditary or acquired. This article summarizes the treatment approaches that are used in the majority of acquired pigmentation disorders of the skin. The following forms of hypermelanosis are addressed: lentiginosis, hyperpigmentation due to endocrine disorders or other systemic diseases, drug-induced hyperpigmentation. Acquired hypomelanoses include postinflammatory hypomelanosis, chemical depigmentation, idiopathic guttate hypomelanosis and punctate leucoderma. With reference to non-melanin pigmentation, the exogenous pigmentation due to chemicals, metals and drug exposure are discussed. The treatment is primarily based on finding the cause of the alterations to the pigment. The affected area, age and ethnic origin are also important factors. The spectrum of therapeutic options is broad: topical agents, chemical peeling, systemic agents, laser and light-based treatment. As some of these treatment procedures can have side effects, the availability of a protocol that contains information on the drug concentration, dose, parameters for laser treatment and the number of sessions is important. For every disorder the specific dermatological treatment is presented even when some pigmentation alterations that occur in association with systemic diseases, are cured by the treatment of the primary disease. Most diseases are exacerbated by exposure to UV light. Therefore, sun protection is recommended and a cosmetic coverage is indicated.
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Affiliation(s)
- Sorina Danescu
- Abteilung für Dermatologie, Universität Iuliu Hatieganu für Medizin und Pharmazie, Cluj, Rumänien
| | - Carmen Salavastru
- Abteilung für pädiatrische Dermatologie, Krankenhaus "Colentina", 19-21 Stefan cel Mare Av., Bukarest, Rumänien.
- Carol-Davila-Universität für Medizin und Pharmazie, Bukarest, Rumänien.
| | - G S Tiplica
- Carol-Davila-Universität für Medizin und Pharmazie, Bukarest, Rumänien
- 2. Klinik für Dermatologie, Krankenhaus "Colentina", Bukarest, Rumänien
| | - K Fritz
- Carol-Davila-Universität für Medizin und Pharmazie, Bukarest, Rumänien
- Hautärzte und Laserzentrum, Landau, Deutschland
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6
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Janier M, Unemo M, Dupin N, Tiplica GS, Potočnik M, Patel R. 2020 European guideline on the management of syphilis. J Eur Acad Dermatol Venereol 2020; 35:574-588. [PMID: 33094521 DOI: 10.1111/jdv.16946] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/04/2020] [Indexed: 12/22/2022]
Abstract
The 2020 edition of the European guideline on the management of syphilis is an update of the 2014 edition. Main modifications and updates include: -The ongoing epidemics of early syphilis in Europe, particularly in men who have sex with men (MSM) -The development of dual treponemal and non-treponemal point-of-care (POC) tests -The progress in non-treponemal test (NTT) automatization -The regular episodic shortage of benzathine penicillin G (BPG) in some European countries -The exclusion of azithromycin as an alternative treatment at any stage of syphilis -The pre-exposure or immediate post-exposure prophylaxis with doxycycline in populations at high risk of acquiring syphilis.
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Affiliation(s)
- M Janier
- STD Clinic, Hôpital Saint-Louis AP-HP and Hôpital Saint-Joseph, Paris, France
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Örebro University Hospital and Örebro University, Örebro, Sweden
| | - N Dupin
- Syphilis National Reference Center, Hôpital Tarnier-Cochin, AP-HP, Paris, France
| | - G S Tiplica
- 2nd Dermatological Clinic, Carol Davila University, Colentina Clinical Hospital, Bucharest, Romania
| | - M Potočnik
- Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - R Patel
- Department of Genitourinary Medicine, the Royal South Hants Hospital, Southampton, UK
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7
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Edwards S, Boffa MJ, Janier M, Calzavara-Pinton P, Rovati C, Salavastru CM, Rongioletti F, Wollenberg A, Butacu AI, Skerlev M, Tiplica GS. 2020 European guideline on the management of genital molluscum contagiosum. J Eur Acad Dermatol Venereol 2020; 35:17-26. [PMID: 32881110 DOI: 10.1111/jdv.16856] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 01/05/2023]
Abstract
Molluscum contagiosum is a benign viral epidermal infection associated with high risk of transmission. The guideline is focused on the sexually transmitted molluscum contagiosum. The diagnosis is clinical with characteristic individual lesions, termed 'mollusca', seen as dome-shaped, smooth-surfaced, pearly, firm, skin-coloured, pink, yellow or white papules, 2 - 5 mm in diameter with central umbilication. Dermoscopy may facilitate diagnosis. Therapeutic options are numerous, including physical treatments (cautery, curettage and cryotherapy), topical chemical treatments (e.g. podophyllotoxin and imiquimod) or waiting for spontaneous resolution in immunocompetent patients. In pregnancy, it is safe to use physical procedures (e.g. cryotherapy). Immunosuppressed patients develop severe and recalcitrant molluscum lesions that may require treatment with cidofovir, imiquimod or interferon. Patients with molluscum contagiosum infection should be offered to be screened for other sexually transmitted infections.
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Affiliation(s)
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - M Janier
- STD Clinic, Hôpital Saint-Louis AP-HP and Hôpital Saint-Joseph, Paris, France
| | | | - C Rovati
- Dermatology Department, University of Brescia, Italy
| | - C M Salavastru
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - F Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A Wollenberg
- Dept. of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - A I Butacu
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - M Skerlev
- Zagreb University Hospital and Zagreb University School Of Medicine, Zagreb, Croatia
| | - G S Tiplica
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
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8
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Chernyshov PV, John SM, Tomas-Aragones L, Gonçalo M, Svensson A, Bewley A, Evers AWM, Szepietowski JC, Marron SE, Manolache L, Pustisek N, Suru A, Salavastru CM, Tiplica GS, Salek MS, Finlay AY. Quality of life measurement in occupational skin diseases. Position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Occupational Skin Disease. J Eur Acad Dermatol Venereol 2020; 34:1924-1931. [PMID: 32662100 DOI: 10.1111/jdv.16742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) has started the 'Healthy Skin @ Work' campaign aimed to raise awareness among the public and EU authorities on the frequency and impact of occupational skin diseases (OSDs). The EADV Task Forces (TFs) on Quality of Life and Patient Oriented Outcomes (QoL/PO) and on OSD present their mutual position statement on QoL assessment in OSDs. The EADV TFs recommend the use of the DLQI as a dermatology-specific instrument and SF-36 as a generic instrument in health-related (HR) QoL studies on OSDs. The OSD-specific questionnaire, LIOD, is not recommended for general use in its present form because of its three months recall period. The EADV TFs discourage the use of non-validated and of non-validated modifications of previously validated HRQoL instruments. The EADV TFs wish to encourage research into: the HRQoL impact of OSDs other than occupational contact dermatitis and hand eczema; comparisons between the effects of different treatments and other interventions on HRQoL in OSDs; and into the HRQoL impairment of patients with OSDs from different countries, and with different provoking factors, to predict if the results of successful therapeutic and educational interventions may be generalized across countries and between occupations.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Osnabrueck, Germany
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University, Hospital Miguel Servet, Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, "Carol Davila" University of Medicine and Pharmacy, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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9
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Wittlich M, John SM, Tiplica GS, Sălăvăstru CM, Butacu AI, Modenese A, Paolucci V, D'Hauw G, Gobba F, Sartorelli P, Macan J, Kovačić J, Grandahl K, Moldovan H. Personal solar ultraviolet radiation dosimetry in an occupational setting across Europe. J Eur Acad Dermatol Venereol 2020; 34:1835-1841. [PMID: 32080895 DOI: 10.1111/jdv.16303] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/27/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Work-related solar ultraviolet radiation (UVR) is an important factor in the pathogenesis of non-melanoma skin cancer (NMSC). The World Health Organization, through the International Agency for Research on Cancer, has classified solar UVR as a group 1 carcinogen since 2012. The main problems encountered so far in the study of occupationally induced skin cancer include the lack of accurate occupational UVR dosimetry as well as insufficient distinction between occupational and leisure UVR exposure and underreporting of NMSC. OBJECTIVES The aim of this study was to collect long-term individual UVR measurements in outdoor workers across European countries. METHODS A prospective study was initiated through the European Academy of Dermatology and Venereology, Healthy Skin@Work Campaign, measuring UVR exposure doses at occupational settings of masons from five European countries. Measurements were performed for several consecutive months using the GENESIS-UV measurement system. RESULTS The results identified alarming UVR exposure data. Average daily UVR doses ranged 148.40-680.48 J/m2 in Romania, 342.4-640.8 J/m2 in Italy, 165.5-466.2 J/m2 in Croatia, 41.8-473.8 J/m2 in Denmark and 88.15-400.22 J/m2 in Germany. Results showed an expected latitude dependence with increasing UVR yearly dosage from the north to the south of Europe. CONCLUSIONS This study shows that outdoor workers from EU countries included in this study are exposed to high levels of occupational solar UVR, vastly exceeding the occupational exposure limits for solar UVR exposure, considered to be 1-1.33 SED/day in the period from May to September. This finding may serve as an evidence-based recommendation to authorities on implementing occupational skin cancer prevention strategies.
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Affiliation(s)
- M Wittlich
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Sankt Augustin, Germany
| | - S M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - G S Tiplica
- 2nd Department of Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C M Sălăvăstru
- Pediatric Dermatology Department, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A I Butacu
- 2nd Department of Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Modenese
- Occupational Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - V Paolucci
- Department of Prevention, Health and Safety Unit, AUSL South-East Tuscany, Grosseto, Italy
| | - G D'Hauw
- Department of Medical Biotechnology, Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - F Gobba
- Occupational Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - P Sartorelli
- Department of Medical Biotechnology, Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - J Macan
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - J Kovačić
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - K Grandahl
- Department of Occupational and Social Medicine, Copenhagen University Hospital, Holbaek, Denmark
| | - H Moldovan
- Department of Occupational Medicine, University of Medicine, Pharmacy, Science & Technology of Targu-Mures, Targu Mures, Romania
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10
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Chernyshov PV, Pustišek N, Gedeon I, Suru A, Tiplica GS, Salavastru CM, Tomas-Aragones L, Marron SE. International pilot tests of the epidermolysis bullosa-specific module of the Infants and Toddlers Dermatology Quality of Life questionnaire. J Eur Acad Dermatol Venereol 2019; 34:e123-e124. [PMID: 31705674 DOI: 10.1111/jdv.16051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - N Pustišek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - I Gedeon
- National Children's Hospital "Okhmatdyt", Kiev, Ukraine
| | - A Suru
- Paediatric Dermatology Discipline, Dermatology Research Unit, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain
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11
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Abstract
Light-based acne treatments may represent a new emerging treatment for acne that does not increase the risk of bacterial resistance and they may be potentially effective with a favorable safety profile. Current data show that photodynamic therapy reduces inflammatory lesions and significantly improves acne. However, there is no consensus on the optimal implementation in the treatment of acne. In addition to topically applied photodynamic therapy, intense pulsed light, pulsed dye lasers, potassium-titanyl-phosphate lasers, infrared diode lasers, broad-spectrum continuous-wave light sources (red light, blue-red light) have been introduced as alternative treatments. Since well-designed studies to evaluate their efficacy versus traditional medical therapies are lacking and standardized regimens have not been agreed upon, procedures including laser, intense pulsed light, and photodynamic therapy should currently not be considered first-line treatment for inflammatory acne.
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Affiliation(s)
- C Salavastru
- Abteilung für Pädiatrische Dermatologie, Colentina-Krankenhaus, 19-21 Stefan cel Mare Av., Bukarest, Rumänien. .,Medizinische und Pharmazeutische Universität Carol Davila, Bukarest, Rumänien.
| | - G S Tiplica
- Medizinische und Pharmazeutische Universität Carol Davila, Bukarest, Rumänien.,Klinik für Dermatologie II, Colentina-Krankenhaus, Bukarest, Rumänien
| | - D E Branisteanu
- Klinik für Dermatologie, Medizinische und Pharmazeutische Universität Grigore T. Popa, Iaşi, Rumänien
| | - K Fritz
- Medizinische und Pharmazeutische Universität Carol Davila, Bukarest, Rumänien.,Hautärzte- und Laserzentrum Landau (Pfalz), Landau, Deutschland
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12
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Chernyshov PV, Sampogna F, Pustišek N, Marinovic B, Manolache L, Suru A, Salavastru CM, Tiplica GS, Stoleriu G, Kakourou T, Alexopoulos A, Nasi L, Szepietowski JC, Trzeciak M, Nowicki RJ, Chubar OV, Chernyshov AV, Pochynok TV. Validation of the dermatology-specific proxy instrument the Infants and Toddlers Dermatology Quality of Life. J Eur Acad Dermatol Venereol 2019; 33:1405-1411. [PMID: 30767284 DOI: 10.1111/jdv.15496] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The first dermatology-specific proxy health-related quality of life (HRQoL) instrument for children 0-4 years old with skin diseases, the Infants and Toddlers Dermatology Quality of Life (InToDermQoL), was recently developed. In order to avoid the problem of cross-cultural inequivalence focus groups work and pilot tests were organized simultaneously in all national centres of the project. The InToDermQoL showed good comprehensibility, clarity and acceptance. OBJECTIVE To validate the InToDermQoL questionnaire during international field tests. METHODS Internal consistency, test-retest reliability, convergent and discriminant validity of the InToDermQoL questionnaire were checked during international field tests. RESULTS Parents of 473 children with skin diseases filled in the national language versions of the InToDermQoL questionnaire. All three age-specific versions of the InToDermQoL questionnaire with 10, 12 and 15 items, respectively, showed high internal consistency (Cronbach's α 0.90-0.93), good test-retest reliability (correlation coefficients > 0.9), significant correlations with the most widely used atopic dermatitis-specific proxy instrument, the Infants Dermatitis Quality of Life Index (correlation coefficients 0.68-0.79). The InToDermQoL versions for children <3 years old well correlated with the atopic dermatis severity measure Scoring of Atopic Dermatitis (correlation coefficients 0.66 and 0.86 for 10 and 12 items versions, respectively). The InToDermQoL questionnaire discriminated well among different diagnoses and disease severity levels. CONCLUSION Our field tests confirmed internal consistency, test-retest reliability, convergent and discriminant validity of the InToDermQoL questionnaire. Development and validation of the InToDermQoL questionnaire make it possible to assess dermatology-specific aspects of HRQoL in youngest children with skin diseases. There are many reasons to assess HRQoL in dermatologic clinical practice, and we hope that our new instrument will be used internationally in paediatric dermatology for research and practical needs.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - N Pustišek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - B Marinovic
- University Department of Dermatology and Venereology, Clinical Hospital Center Zagreb and School of Medicine of University in Zagreb, Zagreb, Croatia
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - A Suru
- Paediatric Dermatology Discipline, Dermatology Research Unit, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C M Salavastru
- Paediatric Dermatology Discipline, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G Stoleriu
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, "St. Spiridon" Hospital, "Dunărea de Jos" University of Galati, Derma Clinique, Iasi, Romania
| | - T Kakourou
- First Pediatric Department of Athens University, Aghia Sophia Children's Hospital, Athens, Greece
| | - A Alexopoulos
- First Pediatric Department of Athens University, Aghia Sophia Children's Hospital, Athens, Greece
| | - L Nasi
- First Pediatric Department of Athens University, Aghia Sophia Children's Hospital, Athens, Greece
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - M Trzeciak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - R J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - O V Chubar
- Kiev City Clinical Dermatovenereologic Hospital, Kiev, Ukraine
| | - A V Chernyshov
- Department of Cellular Radiobiology, State Institution "National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine", Kiev, Ukraine
| | - T V Pochynok
- Department of Pediatrics Number 1, National Medical University, Kiev, Ukraine
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13
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Chernyshov PV, Suru A, Gedeon I, Derevyanko LA, Tiplica GS, Salavastru CM. Epidermolysis bullosa-specific module of the Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire. J Eur Acad Dermatol Venereol 2018; 33:612-617. [PMID: 30422350 DOI: 10.1111/jdv.15337] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Epidermolysis bullosa (EB) may have severe impact on different aspects of patients' life. Until now there was no EB-specific quality of life (QoL) instrument for young children. OBJECTIVE To create EB-specific proxy module of the Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire. METHODS Focus groups with parents of children with EB were organized. Parents of EB children were interviewed by the project staff with regard to their perception of QoL issues of the skin disease of their children. RESULTS Focus groups with parents of EB children in Ukraine and Romania were organized. Parents represented eight boys and 12 girls from 3 months to 4 years old with different EB types and disease severity. Based on the analysis of focus groups' results, two EB specific items that were not mentioned by parents of children with other skin diseases and therefore were not included to the dermatology-specific InToDermQoL questionnaire were developed: 'problems with defecation' and 'problems with shoes'. These problems were mentioned by 55% of all parents and 11.76% of parents that represented EB children older than 1 year, respectively. CONCLUSION We want to invite other centres and EB related organizations to join our project starting from the pilot test. There are many different reasons why QoL measurement is important in dermatology clinical practice and our goal is practical use of the instrument in children with EB.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Suru
- Paediatric Dermatology Discipline, Dermatology Research Unit, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - I Gedeon
- National Children's Hospital "Okhmatdyt", Kiev, Ukraine
| | | | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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14
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Moldovan HR, Voidazan ST, John SM, Weinert P, Moldovan G, Vlasiu MA, Szasz ZA, Tiplica GS, Szasz S, Marin AC, Salavastru CM. The Eastern European experience on occupational skin diseases. Make underreporting an issue? J Eur Acad Dermatol Venereol 2018; 31 Suppl 4:5-11. [PMID: 28656727 DOI: 10.1111/jdv.14315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND While legislation in most of the Eastern European countries is nowadays widely harmonized with the legal safety and health provisions of Western countries, there is still a sustained resistance to the notification of occupational skin diseases (OSD). OBJECTIVE The aim of the study was to identify the main barriers in notification and recognition of OSD in 22 Eastern European countries. METHODS An online survey was administered to key persons in the field of occupational safety and health in 22 Eastern European countries. Multiple variables of the notification system were studied, including clinical, organizational and educational issues. RESULTS The main causes of underreporting OSD are ineffective enforcement of occupational safety and health legislation, contractual relationship employer-employee, long duration of the notifying process, restrictions of the notification systems in terms of who is entitled to notify an OSD, ineffective regulations in regards to the pre-employment and periodical medical examination, ineffective compensation schemes, restraints and hesitations, mainly from the doctors, inappropriate mentalities - fear of losing the jobs, fining of the employers by the authorities, stigmatization of the workers with OSD, additional costs for employers, stakeholders' lack of interest in notifying, lack of guidelines and protocols and lack of preventive programmes. CONCLUSIONS The most valuable method for a proper recognition of OSD is to increase the awareness of physicians involved in the management of OSD (occupational physicians, GPs, dermatologists), as well as employers and workers. There is an urgent need to improve national legislation, to develop and promote adequate preventive programmes, emphasizing ethical, legal, economical and psychological aspects in order to achieve an increased recognition and a real reporting of OSD, and to enforce an international action plan for Eastern Europe in order to improve the notification of OSD.
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Affiliation(s)
- H R Moldovan
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - S T Voidazan
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - S M John
- Department of Dermatology and Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Osnabrueck, Germany
| | - P Weinert
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Osnabrueck, Germany
| | - G Moldovan
- Mediconsult Medical Centre, Tirgu-Mures, Romania
| | - M A Vlasiu
- Mures County Clinical Hospital, Tirgu-Mures, Romania
| | - Z A Szasz
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - G S Tiplica
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - S Szasz
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - A C Marin
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - C M Salavastru
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
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15
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Abstract
With a clear increase in the incidence and a continuously earlier onset, the main risk factors for the development of basal cell carcinoma are still exposure to sunlight, fair skin, immunosuppression, carcinogens such as arsenic, chronic irritations and certain genodermatoses. Treatment options for localized resectionable basal cell carcinoma include micrographically controlled surgery, simple excision, curettage, laser ablation, cryosurgery, imiquimod, 5‑fluorouracil, photodynamic treatment and radiotherapy. Non-surgical treatment options are more suited for cases in which surgical procedures lead to disfigurement or functional impairments or for patients with a high surgical risk. Laser treatment, ablative and non-ablative as monotherapy or in combination can represent a meaningful treatment option in selected cases. In recent years there has been an increase in knowledge about the indications and effects of laser treatment of basal cell carcinoma; nevertheless, further studies with a high level of evidence are necessary.
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Affiliation(s)
- C Salavastru
- Abteilung für paediatrische Dermatologie, Colentina Clinical Hospital, 19-21 Stefan cel Mare Av., Bukarest, Rumänien. .,"Carol Davila" Universität für Medizin und Pharmazie, Bukarest, Rumänien.
| | - G S Tiplica
- "Carol Davila" Universität für Medizin und Pharmazie, Bukarest, Rumänien.,2. Dermatologische Klinik, Colentina Clinical Hospital, Bukarest, Rumänien
| | - K Fritz
- "Carol Davila" Universität für Medizin und Pharmazie, Bukarest, Rumänien.,Hautärzte und Laserzentrum, Landau (Pfalz), Deutschland
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16
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Salavastru CM, Chosidow O, Janier M, Tiplica GS. European guideline for the management of pediculosis pubis. J Eur Acad Dermatol Venereol 2017; 31:1425-1428. [PMID: 28714128 DOI: 10.1111/jdv.14420] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/06/2017] [Indexed: 01/11/2023]
Abstract
Pediculosis pubis is caused by Phthirus pubis. The disease can be sexually transmitted. Patients main complain is of itch in the pubic area. The parasite can be spotted with the naked eye and blue macules can be observed in the pubic area. First line therapy consists of permethrin or pyrethrins with piperonyl butoxide. Second line therapy contains phenothrin, malathion and oral ivermectin. Partner management needs a look-back period of time of 3 months. Pubic lice incidence is increased in populations groups living in crowded spaces with scarce sanitary conditions as in time of war or disaster.
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Affiliation(s)
- C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - O Chosidow
- Department of Dermatology, Hôpital Henri Mondor AP-HP, Créteil, France
| | - M Janier
- STD Clinic, Dermatology Department, Hôpital Saint-Joseph, Paris, France
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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17
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Abstract
Scabies is caused by Sarcoptes scabiei var. hominis. The disease can be sexually transmitted. Patients' main complaint is nocturnal itch. Disseminated, excoriated, erythematous papules are usually seen on the anterior trunk and limbs. Crusted scabies occurs in immunocompromised hosts and may be associated with reduced or absent pruritus. Recommended treatments are permethrin 5% cream, oral ivermectin and benzyl benzoate 25% lotion. Alternative treatments are malathion 0.5% aqueous lotion, ivermectin 1% lotion and sulphur 6-33% cream, ointment or lotion. Crusted scabies therapy requires a topical scabicide and oral ivermectin. Mass treatment of large populations with endemic disease can be performed with a single dose of ivermectin (200 micrograms/kg of bodyweight). Partner management needs a look-back period of 2 months. Screening for other STI is recommended. Patients and close contacts should avoid sexual contact until completion of treatment and should strictly observe personal hygiene rules when living in crowded spaces. Written information should be provided to suspected cases.
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Affiliation(s)
- C M Salavastru
- Department of Dermato-Pediatry, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - O Chosidow
- Department of Dermatology, Hôpital Henri Mondor AP-HP, Créteil, France
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - M Janier
- STD Clinic, Hôpital Saint-Louis AP-HP, and Head of Dermatology Department, Hôpital Saint-Joseph, Paris, France
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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18
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van der Meijden WI, Boffa MJ, Ter Harmsel WA, Kirtschig G, Lewis FM, Moyal-Barracco M, Tiplica GS, Sherrard J. 2016 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol 2017; 31:925-941. [PMID: 28164373 DOI: 10.1111/jdv.14096] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 12/14/2016] [Indexed: 12/21/2022]
Abstract
Vulval conditions may present to a variety of clinicians, such as dermatologists, gynaecologists and general practitioners. Women with these conditions are best managed by a multidisciplinary approach, which includes clear referral pathways between disciplines or access to a specialist multidisciplinary vulval service. Informed consent is a prerequisite for all examinations, investigations and treatments. Consent is particularly important for intimate examinations of the anogenital area, and a chaperone should be offered in all cases. All efforts should be made to maintain a patient's dignity. Depending on symptoms and risk factors, screening for sexually transmitted infections (STI) should be considered. If the patient presents with vulval itch, particularly if also complaining of increased vaginal discharge, vulvaginal candidiasis should be excluded. Sexual dysfunction should be considered in all patients with vulval complaints, either as the cause of the symptoms or secondary to symptoms, and assessed if appropriate. This guideline covers several aspects, such as diagnosis and treatment, of the more common vulval conditions (relatively) often encountered at vulval clinics, i.e. vulval dermatitis (eczema), psoriasis, lichen simplex chronicus, lichen sclerosus, lichen planus, vulvodynia and vulval intraepithelial neoplasia (VIN).
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Affiliation(s)
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - W A Ter Harmsel
- Department of Gynaecology, Roosevelt kliniek, Leiden, The Netherlands
| | - G Kirtschig
- University Hospital of Tübingen, Tübingen, Germany
| | - F M Lewis
- St John's Institute of Dermatology, Guy's and St Thomas' Hospital, London and Frimley Health NHS Trust, London, UK
| | - M Moyal-Barracco
- Department of Dermatology, Tarnier-Cochin Hospital, Paris, France
| | - G S Tiplica
- Dermatology 2, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - J Sherrard
- Department of Sexual Health, Churchill Hospital, Oxford, UK
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19
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Salavastru CM, Ulrich C, Cretu S, Moldovan HR, Tiplica GS. The experience of a tertiary referral centre in Romania on basal cell carcinomas in outdoor workers: why to assess? J Eur Acad Dermatol Venereol 2016; 30 Suppl 3:12-6. [PMID: 26995017 DOI: 10.1111/jdv.13604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Published epidemiological literature indicates that outdoor workers are at significantly increased risk for developing basal cell carcinomas. OBJECTIVES The main objective is to identify basal cell carcinoma features in patients with prolonged occupational exposure to UV radiation and compare them to basal cell carcinoma in patients with no occupational exposure to UV radiation. METHODS Data regarding age, gender, living area, occupation, number of lesions, involved anatomic site and histologic subtype of tumor were collected from the charts of 321 patients diagnosed with basal cell carcinoma in our department between 01.01.2013-31.12.2014. We divided the patient population in which the occupation was accurately identified in two study groups: occupations with UV exposure (OW), and non-UV exposed occupations (IW) and we compared the clinical and histologic features of the lesions in the two groups. RESULTS The most affected area in both groups was the facial "mask area". The cheek was second most affected area in exposed group whereas the scalp area was the second most affected in the non-exposed group. The nodular pattern is the most numerous in both groups (30 lesions in OW group and 15 lesions in the IW group with a mean number of lesions of 1.57±0.90 and 1.27±0.46, respectively) with the mixed type being the second most frequent type for both groups. However, for the OW group the mixed type with an aggressive component was the second most frequent one, while in the non-exposed group, the mixed type with non-aggressive components was the second most frequent, the difference being statistically significant. A multinomial logistic regression analysis was conducted to predict the presence of histopathologically aggressive lesions using gender, age, exposure and anatomical site out of which UV exposure and 3 main anatomical sites (mask zone, cheek and torso) were selected in the final analysis. The probability of the model chi-square (9.430), p = .05, supports a relationship between the dependent variable and the independent variables. CONCLUSION Our data suggest that in Romania patients diagnosed with basal cell carcinoma, occupationally exposed to UV radiation, develop more frequently lesions on the "mask area" of the face; furthermore, prediction of the histo-pathologically aggressive lesions may be supported by the presence of occupational UV exposure and anatomical site (mask zone, cheek and torso) involved.Also, these patients may be at a higher risk to develop more aggressive histologic subtype BCCs. Although limited by a number of factors, especially the small number of subjects, these data suggest the necessity of conducting both retrospective and prospective studies on clinical and histological types of BCCs evolving in patients working outdoor along with identifying additional risk factors.
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Affiliation(s)
- C M Salavastru
- Dermato-oncology Research Unit, Colentina Clinical Hospital, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - C Ulrich
- Hauttumor Centrum der Charité, Berlin, Germany
| | - S Cretu
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - H R Moldovan
- Occupational Medicine Department, University of Medicine and Pharmacy Tirgu-Mures, Tirgu-Mures, Romania
| | - G S Tiplica
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
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Tiplica GS, Radcliffe K, Evans C, Gomberg M, Nandwani R, Rafila A, Nedelcu L, Salavastru C. 2015 European guidelines for the management of partners of persons with sexually transmitted infections. J Eur Acad Dermatol Venereol 2015; 29:1251-7. [PMID: 25951082 DOI: 10.1111/jdv.13181] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 04/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Partner management is the process of identifying the contacts of a person infected by a sexually transmitted infection (STI) and referral to a health care provider for appropriate management. It represents a public health activity. METHODS This guideline is produced by the IUSTI European Guideline Editorial Board and EDF Guideline Committee. RESULTS It provides recommendations concerning the infections that require partner management, the lookback periods for this STI and the main steps to follow for partner management (offering support to patients, notifying partners, identification of contacts). Partner management is voluntary and needs to be performed with respect to human rights, social, cultural and religious behaviours. CONCLUSIONS In European countries, there are different approaches to the partner management; some common type of actions can enhance the fight against STI.
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Affiliation(s)
- G-S Tiplica
- Department of Dermatology 2, Carol Davila University of Medicine and Pharmacy, Colentina Hospital Bucharest, Bucharest, Romania
| | - K Radcliffe
- Department Sexual Health Birmingham, University Hospitals Birmingham, Birmingham, UK
| | - C Evans
- Chelsea and Westminster NHS Foundation Trust, Charing Cross Hospital London, London, UK
| | - M Gomberg
- Central Institute of Skin and Venereal Diseases, Laboratory of Viral Urogenital Infections, Moskow, Russian Federation
| | - R Nandwani
- NHS, Greater Glasgow & Clyde Glasgow, Glasgow, UK
| | - A Rafila
- Carol Davila University of Medicine and Pharmacy, Matei Bals National Infectious Diseases Institute, Bucharest, Romania
| | - L Nedelcu
- Department of Dermatology 2, Carol Davila University of Medicine and Pharmacy, Colentina Hospital Bucharest, Bucharest, Romania
| | - C Salavastru
- Department of Dermatology 2, Carol Davila University of Medicine and Pharmacy, Colentina Hospital Bucharest, Bucharest, Romania
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Boralevi F, Saint Aroman M, Delarue A, Raudsepp H, Kaszuba A, Bylaite M, Tiplica GS. Long-term emollient therapy improves xerosis in children with atopic dermatitis. J Eur Acad Dermatol Venereol 2013; 28:1456-62. [PMID: 24267728 DOI: 10.1111/jdv.12314] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 10/11/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hydration with topical emollients forms the backbone of treatment for mild atopic dermatitis (AD), but few randomized controlled trials have assessed their efficacy in young children. OBJECTIVES Assess the efficacy and tolerability of long-term emollient therapy in the treatment of moderate to severe xerosis in young children with AD. METHODS This was a phase III, multicentre, double-blind, randomized, vehicle-controlled trial. Children (n = 251) aged 2-6 years with AD-associated xerosis were randomized 1 : 1 to a 28-day treatment with an emollient combining glycerol and paraffin or its vehicle. Non-responders at the end of the double-blind period were treated open label with emollient until day 84. Responders stopped treatment until reassessment on day 56. Those who relapsed after stopping treatment were treated open label with emollient until day 84. RESULTS During the double-blind period, xerosis score (XS) of the scoring atopic dermatitis (SCORAD) index, objective SCORAD and visual analogue score decreased and skin hydration increased more in the emollient group than in the vehicle group (P < 0.001 for all measures). More patients were responders with emollient than with vehicle (66.1% vs. 45.6%, P < 0.001). During the open-label period, stopping emollient treatment led to relapse but improvement returned if treatment was restarted with emollient. Regular use of the emollient also yielded improvement in children who did not initially respond. Adverse events were similar in the two groups, and no treatment-related severe adverse events were reported. CONCLUSIONS Long-term therapy with emollient is effective and well tolerated for the treatment of xerosis in children with atopic dermatitis.
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Affiliation(s)
- F Boralevi
- Pediatric Dermatology Unit, CHU Bordeaux, University Hospital of Bordeaux, Hôpital Pellegrin-Enfants, Bordeaux, France; CIC 0005, Centre d'investigation clinique, Bordeaux, France
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Abstract
Oral alitretinoin (9-cis retinoic acid) is an endogenous retinoid related to vitamin A. Studies have shown that oral alitretinoin is effective and well-tolerated in the treatment of severe chronic hand eczema, so that it is approved for this indication. This review summarizes new studies and clinical experience on the off-label use of alitretinoin.
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Affiliation(s)
- K Fritz
- Haut und Laser Centrum - Landau, Reduitstr. 13, 76829, Landau, Deutschland,
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Tiplica GS, Olteanu R, Chiriac A, Sălăvăstru CM. Skin cancer screening campaigns in a Bucharest dermatology clinic. J Eur Acad Dermatol Venereol 2013; 28:388-9. [PMID: 23676085 DOI: 10.1111/jdv.12190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 04/25/2013] [Indexed: 11/29/2022]
Affiliation(s)
- G-S Tiplica
- 2nd Clinic of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
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Salavastru CM, Nedelcu LE, Tiplica GS. Management of leg ulcers in patients with chronic venous insufficiency: the experience of a Dermatology Clinic in Bucharest, Romania. Dermatol Ther 2013; 25:304-13. [PMID: 22950557 DOI: 10.1111/j.1529-8019.2012.01513.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Venous ulcers are the most severe skin manifestation of chronic venous insufficiency. Treatment is complex and it is performed according to the stage of the disease. It includes changes of lifestyle, compressive therapy, phlebotropic medication, topical therapy of the ulcer, antibiotic therapy (topical and systemic), sclerotherapy, and surgical treatment. Patients with venous leg ulcers that attend the Second Dermatology Clinic of Colentina Clinical Hospital, are treated both as inpatients and as outpatients. They benefit from topical treatment and bandaging performed by specialized medical personnel in separate treatment room with strictly monitored conditions of asepsis and antisepsis. A follow-up study of these patients was made from January 1, 2009 to December 31, 2011. The average age of patients was 65.9 years (± 14.2), most of them being in the eight decade of life (31.9%). In almost half of the cases (44.2%), the patients spent more than 1 week in the hospital. Bacteriological investigations from the ulcers were performed in 55.1% of patients and the most frequent infectious agents were found to be Staphylococcus aureus (26.3%) and Enterobacter spp. (17.2%). Treatment of leg ulcer patients proves to be a long and complex one, a systematic and organized approach being needed in order to obtain healing of the wound.
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Affiliation(s)
- C M Salavastru
- 2nd Clinic of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
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Tiplica GS, Salavastru CM. Mometasone furoate 0.1% and salicylic acid 5% vs. mometasone furoate 0.1% as sequential local therapy in psoriasis vulgaris. J Eur Acad Dermatol Venereol 2009; 23:905-12. [DOI: 10.1111/j.1468-3083.2009.03214.x] [Citation(s) in RCA: 15] [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] [Indexed: 11/26/2022]
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Sălăvăstru C, Ruşinoiu A, Pârvu A, Constantin M, Panduru M, Popa GL, Tiplica GS. Epidemiological surveillance of syphilis patients in Colentina Hospital (Bucharest, Romania). Roum Arch Microbiol Immunol 2007; 66:80-84. [PMID: 18928067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Syphilis remains a global health problem with an estimated 12 million people infected each year. In Romania a decrease in the syphilis prevalence can be observed. From 2002 (12,702 cases) and 2003 (9,698 cases) until 2006 (5,657 syphilis cases) the reduction can be explained through the intensified efforts of the Ministry of Pubic Health to fight STI. The decrease is probably not related to an improvement of the general health status and not a consequence of some epidemiological prevention and control measures but probably was done by the reorientation of the patients to the general practitioners and to the private practice medical offices and to the lack of reporting of the cases. In Colentina Hospital a similar abrupt decrease of new cases was registered from 2004 (259 cases) to 2006 (110 cases). General problems related to syphilis cases recorded at Colentina Hospital included the patient presentation for consultation in the advanced stages of the disease, the socio-economic and educational factors, proxenetism and the sexual aggression of minors. There is a need in strengthening of the public health component in the control and surveillance of HIV/AIDS and STI. This may need changes in the legal framework to improve reporting and to target vulnerable groups in prevention activities. Laboratory capacity needs to be increased in order to be able to properly diagnose STI and improve the control and patient management. The reporting needs to be improved and simplified as for reporting protocol, reporting forms, case definitions to be taken into account in the renewed STI surveillance.
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