Availability of personal protective equipment among dermatologists in the COVID-19 pandemic: Assessment and risk factors in a web-based, global study.

BACKGROUND: The availability of personal protective equipment (PPE) among dermatologists during the Coronavirus Disease 2019 (COVID-19) pandemic has not been studied. METHODS: We have assessed PPE availability among dermatologists and relevant aspects of hospital service by surveying 733 dermatologists. RESULTS: Considerable percentages of respondents had to purchase their own PPE (40.2%) and were not provided with it at the hospital (37.7%). Only 27% of respondents provided hospital service, and 18.4% were assigned to nondermatologic duty. A substantial percentage (64.4%) indicated the availability of hospital-issued management guidelines (HIMG) for COVID-19 patients. Nearly half of the survey participants (49.1%) responded that the health care system was not equipped for the pandemic. Purchasing one's own PPE was strongly associated with the private practice setting and continent, with the highest rates in Central and South America and in Europe (P < .001). PPE availability at a hospital was associated with 2 continents, with the highest rates in Europe and in North America (P < .001). In logistic regression, the most important factor reducing the odds ratio (OR) for purchasing their own PPE was HIMG for COVID-19 patients (OR, 0.55; 95% confidence interval [CI], 0.32-0.97). Respondents' assessment that the health care system was equipped for COVID-19 was the most powerful increaser of OR for PPE availability (OR, 9.43; 95% CI, 5.37-16.56) followed by >1,000 COVID-19 cases in a participant's country. CONCLUSIONS: Substantial percentages of respondents had to purchase their own PPE and were not provided with it at the hospital. Strategies to increase PPE availability should be implemented by hospitals, industry, and government authorities.

Virtual conferences and e-learning in dermatology during COVID-19 pandemic: Results of a web-based, global survey.

During the pandemic, virtual conferences became the norm. We conducted a cross-sectional global study to assess dermatologists' responses to virtual conference and e-learning program attendance, as well as to discuss the status of such events during the pandemic. This web-based, global survey included 733 dermatologists. Primary outcomes are percentages of responders answering questions. Assessment of the relationship between two categorical variables was performed with the chi-square test. A substantial percentage of responders were willing to attend a virtual meeting (70.6%) or webinar (80.2%), or to conduct a webinar (47.3%). Among participants who provided resident or fellow training before the pandemic, 38% responded that they did not have any teaching systems in place during the pandemic. Virtual conference attendance was significantly associated with video conference attendance before the pandemic, webinar attendance, teledermatology (TD) use during the pandemic, future TD use, having training systems in place for residents or fellows (P < .001 for each), and North American location of participant (P = .001). Webinar attendance was associated with North American location, conducting webinars (P < .001 for each), and future TD use (P = .024). This pandemic has had a profound effect on dermatology conferences and e-learning programs. Attending video conferences and webinars or other online training was associated with TD use and future use, which indicates that these technologies are all here to stay.

Global impact on dermatology practice due to the COVID-19 pandemic.

This contribution focuses on the effects of coronavirus disease 2019 (COVID-19) on dermatology practice. We discuss the impact on practice volume and procedures and on the considerable increase in teledermatology use. We also describe the important roles that dermatologists have played in enhancing infection prevention and on the frontline. During the crisis, dermatologists have faced the challenge of a shortage of resources, such as personal protective equipment, in the health care system. In addition, they have been involved in managing cutaneous manifestations related to COVID-19 and occupational disease caused by personal protective equipment. Dermatologists have made a diligent effort to identify melanoma and to ensure the treatment of high-risk skin cancers. Safety guidelines have been suggested to minimize the potential risks associated with the systemic use of immunosuppressant agents and immunomodulators in patients with severe inflammatory skin disease during the pandemic. Finally, social distancing necessitated that dermatology conferences take place virtually and teaching via e-learning increased.

A new, innovative, and safe treatment in vitiligo: Results of a randomized, double-blinded, parallel-group study.

Vitiligo is a chronic autoimmune disease affecting around 1% of the population worldwide. No existing treatment is giving fully satisfactory results. Further investigations are welcomed for innovative and safe treatments bringing better results. This trial aimed to compare the efficacy and tolerance of various treatment protocols on vitiligo lesions. Four randomized groups of 10 patients with vitiligo covering 8% to 14% of skin surface, except hands and feet were assigned during 8 weeks to (a) UVB microphototherapy 300 to 320 nm (Bioskin-) 1 x week; (b) VITILSI- gel 2 x day; (c) VITILSI- gel 2xday + Bioskin- 1 x week; and (d) placebo 2 x day. Efficacy of the treatment was assessed by planimetry, comparing the photographs of the patients taken at baseline and after 8-week treatment. After completion of the treatment, the increase of the pigment area was 28% in G1 (Bioskin-), 19% in G2 (VITILSI-), 41% in G3 (Bioskin- + VITILSI-) and null in G4. No subject stopped the treatment and no side effect was observed. It was demonstrated that the gel under study was able per se to induce repigmentation in vitiligo lesions and that the results were significantly better when combined with NB-UVB. The protocols used in this trial resulted safe and efficient.

Biorevitalization of the skin with skin boosters: Concepts, variables, and limitations.

Aging leads to diminished capacity in the functionality of all the skin layers, which in turn leads to a structurally weak and esthetically unappealing skin which is dull, dehydrated, and inelastic. Skin boosters can be defined as biological materials or bio-actives that help or encourage the skin to increase or improve its function. Boosters have been used in treating skin structural changes associated with aging as well as other factors such as corticosteroid-induced skin atrophy. Restoring the loss in skin nourishment and vital components is the concept involved in biorevitalization of the skin. The authors aim to present an update and a short review of skin boosters in this commentary.

Female pattern hair loss: A comprehensive review.

Female pattern hair loss is a common form of hair loss in women that increases in incidence with age. The etiology is unknown with numerous factors identified that influence its onset. Female pattern hair loss may be viewed as a marker for an increased risk of cardiovascular and metabolic disease. New treatments include microneedling, low-level laser therapy, and autologous fat transfer. This article focuses on the pathophysiology, diagnosis, systemic associations, and current treatments for female pattern hair loss, which is the most common cause of alopecia in women.

Scabies: A comprehensive review and current perspectives.

Human scabies is a contagious skin infestation caused by the parasitic mite Sarcoptes scabiei var. hominis. It is a common skin disease worldwide that occurs not only in the underprivileged sections of society but also in developed countries. In 2009, World Health Organization (WHO) recognized scabies as "neglected tropical disease (NTD)" or NTD thus emphasizing the need for community awareness and proper treatment strategies. This review attempts to summarize the varied clinical presentation of the disease and describes the advances in diagnosis and management including the ongoing search for novel agents to overcome the problems associated with conventional treatments. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till February 2020 and reference lists of respective articles. Only articles published in English language were included.

Therapeutic implications of personality disorders in dermatology.

There is a significant psychiatric comorbidity that exists in multiple dermatological conditions, stemming from the patient''s own psychological make up. This article reviews personality disorders and their types, which influence the course and prognosis of several psychodermatological disorders. Self-inflicted skin lesions, for example, are usually associated with obsessive-compulsive behavior, but they also share connections to Narcissistic and Borderline personality disorders. Body dysmorphic disorder is another psychodermatological condition seen in dermatology, aesthetic, and cosmetic surgery clinics, which is influenced by patient's personality type. In general, there is a significantly high proportion of personality disorders seen in aesthetic and cosmetic surgery. The management of patients with personality disorders is challenging, but joint liaison between psychiatry and dermatology has proven helpful and can provide patients with the best care for their psychological needs and dermatologic care.

Treatment of skin picking disorder: Interdisciplinary role of dermatologist and psychiatrist.

Skin picking disorder (excoriation disorder) is a common psychodermatological disorder characterized by irresistible urges to pick skin on dominant hand accessible parts of the body. There is no specific recommended treatment available. Various pharmacological agents particularly selective serotonin reuptake inhibitors and glutamatergic agents have been tried with variable success. Habit reversal therapy has been commonly employed in the treatment and has some evidence-based success. This review focuses on the interdisciplinary team approach consisting of a liaison with psychiatry, in the management of this disorder. The specific roles of dermatologist and psychiatrist are discussed in detail.

Psychological aspects of aesthetic and cosmetic surgery: Clinical and therapeutic implications.

Recently there is a surge in cosmetic and aesthetic surgery procedures. Several patient seeking various cosmetics procedures present to aesthetic surgery clinics and demanding procedures which are out of proportion. Several of these patients have under-recognized or untreated psychiatric disorders. Proper screening and evaluation of these patients could save money and resources. This brief review focuses on current trends, clinical and psychological assessment and expectations on the part of patients and recommendations regarding management of these patients.

Advanced fractional radiofrequency for the rejuvenation of face, neck, and décolleté.

Recently great attention has been paid to the rejuvenation of the face, neck, and décolleté of women with advanced radial fractional radiofrequency. We aimed to clinically evaluate the results obtained with this treatment method. We treated 10 women aged 42 to 62, suffering from skin aging. After carrying out the hydration and sebometry skin tests in each patient, collecting the medical history and taking photographs of the face and décolleté in the standard projections, a questionnaire was submitted to each patient. Finally, we have submitted the patients to one session of application of radiofrequency energy, by an Italian device named "Thuzzle" (GMV, Rome, Italy). The obtained results show a high effectiveness in improving the texture and tone of skin, decreasing micro wrinkles and spot reduction. Advanced radial fractional radiofrequency treatment method shows promising results. Further studies are required to confirm the findings.

Therapeutic and etiologic considerations related to blood group and triggers in psoriasis-A retrospective study.

The aim of this study was to investigate the relationship between the ABO blood, groups and triggers, including food, of psoriasis. A total of 683 psoriasis patients were included in the retrospective study and divided into groups based on their blood group (ABO). Patients were asked to complete a series questions related to the effect of certain foods and other triggers on their psoriasis symptoms. A significant difference between blood groups and the effect of different triggers on the initiation and exacerbation of psoriasis was noted. Furthermore, similarities in response were found between blood groups sharing the same alleles, such as A and AB, or B and AB. Results from this study suggest a link between blood group type and triggering factors of psoriasis. The data show that different blood groups are significantly more likely to have different initiating and exacerbating triggers for psoriasis.