Subject(s)
COVID-19 , Antibodies, Monoclonal, Humanized , Humans , Incidence , Prognosis , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
GENERAL PURPOSE: To present the results of a scoping review exploring chronic wound care telemedicine before and during the pandemic, including the characteristics of the models implemented. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Identify the characteristics of the studies the authors examined for their scoping review of chronic wound care telemedicine.2. Choose the electronic methods commonly used for wound care telemedicine in the studies the authors examined.3. Recognize the implications for the patients who participated in chronic wound care telemedicine in the studies the authors examined. ABSTRACT: OBJECTIVETo explore different chronic wound telemedicine models and identify current research on this topic.METHODSThe authors searched the MEDLINE and EMBASE databases on August 10, 2021 and identified 58 articles included in the analysis.RESULTSIncluded studies were published between 1999 and 2021, with more than half of the studies published between 2015 to 2019 (25.9%, n = 15/58) and 2020 to 2021 (25.9%, n = 15/58). There were 57 models identified, of which 87.7% (n = 50/57) used a blended model of care. Image assessment was the most common element in blended care (66.0%, n = 33/50), followed by video consultation (46.0%, n = 23/50), text (44.0%, n = 22/50), and telephone consultation (22.0%, n = 11/50). Purely virtual care was used in 12.3% (n = 7/57) of models, 85.7% (n = 6/7) of which were implemented during the COVID-19 pandemic. Most studies conducted a quantitative analysis (62.1%, n = 36/58); 20.7% (n = 12/58) conducted a qualitative analysis, and 17.2% (n = 10/58) conducted both. The most frequently assessed results were wound outcomes (53.4%, n = 31/58) and patient opinions (25.9%, n = 15/58).CONCLUSIONSChronic wound care-related telemedicine has common elements: image assessment, video and telephone consultation, and text-based information that can be combined in a variety of ways with unique implementation barriers. Blended care models are more common than purely virtual alternatives. Heterogeneity among outcomes and reporting methods make the results difficult to synthesize.
Subject(s)
COVID-19 , Telemedicine , Humans , Pandemics , Referral and Consultation , SARS-CoV-2 , TelephoneSubject(s)
Anti-Allergic Agents , Asthma , COVID-19 , Chronic Urticaria , Urticaria , Anti-Allergic Agents/therapeutic use , Asthma/complications , Asthma/drug therapy , Asthma/epidemiology , Chronic Disease , Chronic Urticaria/drug therapy , Chronic Urticaria/epidemiology , Humans , Incidence , Omalizumab/therapeutic use , Retrospective Studies , Treatment Outcome , Urticaria/drug therapy , Urticaria/epidemiologyABSTRACT
GENERAL PURPOSE: To familiarize wound care practitioners with the differential diagnoses of chilblains-like lesions that could be associated with the complications of COVID-19. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Identify the population most often affected by COVID toes.2. Select the assessments that help differentiate the various conditions that cause chilblains-like lesions.3. Choose appropriate treatment options for the various conditions that cause chilblains-like lesions.
This review article focuses on the pathogenesis, clinical features, and diagnostic testing of the common pathologies that can manifest as chilblains-like lesions. These differentials include "COVID toes," Raynaud phenomenon, acrocyanosis, critical limb ischemia, thromboangiitis obliterans, chilblains associated with lupus erythematosus, and idiopathic chilblains. The authors present a helpful mnemonic, ARCTIC, to assist clinicians in recognition and diagnosis.
Subject(s)
COVID-19/diagnosis , Chilblains/diagnosis , Skin Diseases/diagnosis , COVID-19/complications , Chilblains/pathology , Chilblains/virology , Diagnosis, Differential , Fingers/pathology , Humans , Skin Diseases/pathology , Skin Diseases/virology , Symptom Assessment , Toes/pathologyABSTRACT
GENERAL PURPOSE: Forthcoming. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: Forthcoming. ABSTRACT: This review article focuses on the pathogenesis, clinical features, and diagnostic testing of the common pathologies that can manifest as chilblains-like lesions. These differentials include COVID toes, Raynaud phenomenon, acrocyanosis, critical limb ischemia, thromboangiitis obliterans, chilblains associated with lupus erythematosus, and idiopathic chilblains. The authors present a helpful mnemonic, ARCTIC, to assist clinicians in recognition and diagnosis.
Subject(s)
Betacoronavirus/immunology , Biological Products/adverse effects , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Psoriasis/immunology , Withholding Treatment , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , Canada/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Susceptibility/immunology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Psoriasis/complications , Psoriasis/drug therapy , Retrospective Studies , Risk Factors , SARS-CoV-2Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Dermatology/education , Education, Distance/methods , Internship and Residency/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Asymptomatic Infections , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Dermatologists/education , Dermatology/standards , Education, Distance/standards , Humans , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Internship and Residency/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Self-Directed Learning as TopicABSTRACT
BACKGROUND: While evidence suggests that hydroxychloroquine (HCQ) may decrease the viral load in patients with a COVID-19 infection, a number of case reports indicate adverse dermatologic effects of this potential treatment. OBJECTIVE: To conduct a systematic review of previously reported cases of psoriasis onset, exacerbation, or relapse after HCQ treatment. METHODS: Embase and MEDLINE were comprehensively searched for original studies examining adverse effects of HCQ treatment related to psoriasis. Participant demographics and details of HCQ administration and psoriasis diagnosis were extracted from 15 articles representing 18 patients. RESULTS: Women accounted for a significantly larger number of cases of psoriasis compared with men and unreported sex (14 [77.8%] vs 2 [11.1%] vs 2 [11.1%], respectively). In addition, 50% (n = 9) of the patients did not have a history of psoriasis before taking HCQ. Of the 18 patients, 9 (50.0%) experienced de novo psoriasis, 5 (27.8%) experienced exacerbation of psoriatic symptoms, and 4 (22.2%) had a relapse of psoriasis after HCQ administration. CONCLUSION: HCQ treatment may result in induction, exacerbation, or relapse of psoriasis. Monitoring for adverse effects of HCQ treatment is necessary, and clinical trials are essential in characterizing the safety profile of HCQ use in patients with a COVID-19 infection.