ABSTRACT
Background: Emoticons and emojis have become staple additions to modern-day communication. These graphical icons are now embedded in daily society through the various forms of popular social media and through users' personal electronic conversations. With ever-increasing use and inclusivity, exploration of the possible health care and dermatology applications of these tools is imperative. Objective: The goal of this narrative review was to provide and evaluate an up-to-date literature survey examining the utility of emoticons and emojis in medicine. Special attention was paid to their existing and potential uses in the field of dermatology, especially during the COVID-19 pandemic. Methods: A PubMed search of peer-reviewed publications was performed in mid-2021 to collect articles with emoticon or emoji keywords in combination with other health care-relevant or dermatology-relevant keywords. Screening of publications and described studies was performed by the authors with education and research experience in health care, dermatology, social media, and electronic communication trends. Selected articles were grouped based on common subjects for qualitative analysis and presentation for in-depth discussion. Results: From this extensive search, researchers were able to identify a wide variety of publications detailing the use of emoticons and emojis in general health care, pediatric health care, public health, and dermatology. Key subject areas that emerged from the investigation included the ability of emoticons and emojis to improve communication within pediatric health care, enhance mood and psychological assessment or mental health screening in adults, develop interventions to improve patient medication adherence, complement novel means of public health and COVID-19 surveillance, and bolster dermatology-specific applications. Conclusions: This review illuminated the repurposing of emojis and emoticons for a myriad of advantageous functions in health care and public health, with applications studied in many populations and situations. Dermatology-specific uses were relatively sparse in the literature, highlighting potential opportunities for growth in future studies and practices. The importance of diversity and inclusivity has extended to emojis, with the recent introduction of skin color customization and new emojis better representing the comprehensive spectrum of users' experiences. A continuously evolving and technology-driven population creates a unique niche for emoticons and emojis to ease worldwide communication and understanding, transcending the barriers of age, language, and background. We encourage future studies and innovations to better understand and expand their utility.
ABSTRACT
Without a global standard for neonatal or infant skin care, and with few emollient studies performed in term infants, Kelleher et al’s Cochrane review [2] provides a much-needed assessment of the evidence for emollients and other interventions to prevent eczema, as well as their effects on the development of food allergy. Outcomes Comparison Relative risk (RR) or hazard ratio (HR) (CI) Number of studies and participants in the pooled analysis Quality of evidence Development of eczema by 1-2 years Skin care interventions vs standard carea RR=1.03 (CI 0.81-1.31) 7 trials, 3075 participants Moderate Time needed to develop eczema Skin care interventions vs standard care HR=0.86 (CI 0.65-1.14) 9 trials, 3349 participants Moderate Development of skin infections Skin care interventions vs standard care RR=1.34 (CI 1.02-1.77) 6 trialsb, 2728 participants Moderate IgEc-mediated food allergies at 1-2 years Skin care interventions vs standard care RR=2.53 (CI 0.99-6.47) 1 trial, 996 participants Very low Sensitization to food allergens at 1-2 years Skin care interventions vs standard care RR=0.86 (CI 0.28-2.69) 2 trials, 1055 participants Very low aStandard care is defined as no skin care or care as usual. bWhile 2 out of the 6 studies in the pooled analysis slightly favored skin care interventions (not statistically significant), the pooled data suggested an increased risk of skin infection with emollients. There are currently a number of ongoing clinical trials assessing skin care interventions for the prevention of atopic dermatitis and food allergy;one trial recently concluded there is no evidence that the use of daily emollients reduces the risk of eczema by the age of 2 years in high-risk patients (patients with first-degree relatives with a history of eczema, asthma, or allergic rhinitis) [3].
ABSTRACT
BACKGROUND: The innate immune system is recognized as an essential aspect of COVID-19 pathogenesis. Toll-like receptors (TLRs) are important in inducing antiviral response, triggering downstream production of interferons (IFNs). Certain loss-of-function variants in TLR7 are associated with increased COVID-19 disease severity, and imiquimod (ImiQ) is known to have immunomodulating effects as an agonist of TLR7. Given that topical imiquimod (topImiQ) is indicated for various dermatologic conditions, it is necessary for dermatologists to understand the interplay between innate immunity mechanisms and the potential role of ImiQ in COVID-19, with a particular focus on TLR7. SUMMARY: Our objective was to survey recent peer-reviewed scientific literature in the PubMed database, examine relevant evidence, and elucidate the relationships between IFNs, TLR7, the innate immune system, and topImiQ in the context of COVID-19. Despite limited studies on this topic, current evidence supports the critical role of TLRs in mounting a strong immune response against COVID-19. Of particular interest to dermatologists, topImiQ can result in systemic upregulation of the immune system via activation of TLR7. Key Message: Given the role of TLR7 in the systemic activation of the immune system, ImiQ, as a ligand of the TLR7 receptor, may have potential therapeutic benefit as a topical immunomodulatory treatment for COVID-19.