Telemedicine is the use of telecommunications technology to support health care at a distance. Technological advances have progressively increased the ability of clinicians to care for diverse ...patient populations in need of skin expertise. Dermatology relies on visual cues that are easily captured by imaging technologies, making it ideally suited for this care model. Moreover, there is a shortage of medical dermatologists in the United States, where skin disorders account for 1 in 8 primary care visits and specialists tend to congregate in urban areas. Even in regions where dermatologic expertise is readily accessible, teledermatology may serve as an alternative that streamlines health care delivery by triaging chief complaints and reducing unnecessary in-person visits. In addition, many patients in the developing world have no access to dermatologic expertise, rendering it possible for teledermatologists to make a significant contribution to patient health outcomes. Teledermatology also affords educational benefits to primary care providers and dermatologists, and enables patients to play a more active role in the health care process by promoting direct communication with dermatologists.
•The impact of known crocodilian skin pathogens including viral, bacterial, fungal and helminth taxa are reviewed.•Best husbandry practices to minimise these pathogens are discussed.•Husbandry ...improvements, such as heating, have already seen a reduced incidence in many of these pathogens.•Viral pathogens are the largest risk to crocodilian skin quality and require more than improved husbandry practices.
The control of pathogens that target crocodilian skin is essential to the long-term success and sustainability of intensive farming operations worldwide. To understand the impact these pathogens may have on the skin, a brief overview of skin histology is given. A review of the known viral, bacterial, fungal and helminth taxa associated with skin conditions in commercially significant crocodilian species is presented. Best management practices are discussed, with an emphasis on addressing extrinsic factors that influence transmission and pathogenicity. It is argued that, in the past, reduced immune function arising from inadequate thermal regulation was the leading cause of skin disease in captive crocodilians. Consequently, innovations such as temperature control, coupled with the adoption of more stringent hygiene standards, have greatly reduced the prevalence of many infectious skin conditions in intensively farmed populations. However, despite improvements in animal husbandry and disease management, viral pathogens such as West Nile virus, herpesvirus and poxvirus continue to afflict crocodilians in modern captive production systems.
Summary
A pathogenetically relevant link between stress, in terms of psychosocial stress, and disease was first described in the 1970s, when it was proven that viral diseases of mucous membranes ...(such as rhinovirus and Coxsackie virus infections) develop faster and more severe after stress exposure. Since then, there has been an annual increase in the number of publications which investigate this relationship and break it down to the molecular level. Nevertheless, the evidences for the impact of psychosocial stress on chronic inflammatory skin diseases and skin tumors are hardly known. In the present review, we outline current insights into epidemiology, psychoneuroimmunology, and molecular psychosomatics which demonstrate the manifold disease‐relevant interactions between the endocrine, nervous, and immune systems. The focus is on stress‐induced shifts in immune balance in exemplary disorders such as atopic dermatitis, psoriasis, and malignant melanoma. The objective of this article is to convey basic psychosomatic knowledge with respect to etiology, symptomatology, and therapeutic options for chronic skin diseases. Particular attention is directed towards the underlying molecular relationships, both from a somatic to mental as well as a mental to somatic perspective.
The coronavirus disease 2019 (COVID-19) pandemic has affected 18 million people and killed over 690,000 patients. Although this virus primarily causes respiratory symptoms, an increasing number of ...cutaneous manifestations associated with this disease have been reported.
The aim of this review was to collate and categorize the dermatologic findings reported in patients with COVID-19 and identify specific lesions that may facilitate diagnosis and prognostication.
An evidence-based review of the PubMed database was conducted on 14 May, 2020 using the search terms "Covid-19 skin," "Covid-19 rash," "Covid-19 exanthem," and "Covid-19 chilblains." Peer-reviewed publications containing original COVID-19 patient cases and a discussion of the associated cutaneous findings were included in the analysis.
The literature search identified 115 records, of which 34 publications describing 996 patients with dermatologic conditions were included. Case reports (n = 15), case series (n = 13), and observational prospective studies (n = 4) were the most common publication types. Acral lesions resembling pseudo-chilblains were the most frequent lesion identified (40.4% of cases), appearing in young adults (mean age, 23.2 years) after the onset of extracutaneous COVID-19 symptoms (55/100 patients). Erythematous maculopapular rashes affected 21.3% of patients, most frequently impacting middle-aged adults (mean age, 53.2 years) and occurring at the same time as non-cutaneous symptoms (110/187 patients). Vesicular rashes affected 13.0% of patients, appearing in middle-aged adults (mean age, 48.3 years) after the onset of other symptoms (52/84 patients). Urticarial rashes affected 10.9% of patients, appearing in adults (mean age, 38.3 years) and occurring at the same time as non-cutaneous symptoms (46/78 patients). Vascular rashes resembling livedo or purpura were uncommon (4% of cases), appearing in elderly patients (mean age, 77.5 years) and occurring at the same time as non-cutaneous COVID-19 symptoms (18/29 patients). Erythema multiforme-like eruptions, although infrequent (3.7% of cases), affected mostly children (mean age, 12.2 years).
Vesicular rashes may suggest an initial diagnosis of COVID-19, acral lesions may be most appropriate for epidemiological uses, and vascular rashes may be a useful prognostic marker for severe disease. As a potential correlate to disease severity, prognosis, or infectibility, it is critical that all healthcare professionals be well versed in these increasingly common cutaneous manifestations of COVID-19.
The Koebner phenomenon Sagi, Lior, MD; Trau, Henri, MD
Clinics in dermatology,
03/2011, Letnik:
29, Številka:
2
Journal Article
Recenzirano
Abstract The Koebner phenomenon is one of the most well-known entities in dermatology. It was first described by Heinrich Koebner in 1876 as the formation of psoriatic lesions in uninvolved skin of ...psoriatic patients after cutaneous trauma. This isomorphic phenomenon is now known to involve numerous diseases, among them vitiligo, lichen planus, and Darier disease. The pathogenesis of the Koebner phenomenon is still obscure but may involve cytokines, stress proteins, adhesion molecules, and autoantigens. This contribution reviews the clinical manifestations of Koebner phenomenon, its provocative factors, suggested pathogenesis mechanisms, and the various skin conditions that exhibit this unique response.
The high volume of information produced in the age of omics was and still is an important step to understanding several pathological processes, providing the enlightenment of complex molecular ...networks and the identification of molecular targets associated with many diseases. Despite these remarkable scientific advances, the majority of the results are disconnected and divergent, making their use limited. Skin diseases with alterations in the Notch signaling pathway were extensively studied during the omics era. In the GWAS Catalog, considering only studies on genomics association (GWAS), several works were deposited, some of which with divergent results. In addition, there are thousands of scientific articles available about these skin diseases. In our study, we focused our attention on skin diseases characterized by the impairment of Notch signaling, this pathway being of pivotal importance in the context of epithelial disorders. We considered the pathologies of five human skin diseases, Hidradenitis Suppurativa, Dowling Degos Disease, Adams-Oliver Syndrome, Psoriasis, and Atopic Dermatitis, in which the molecular alterations in the Notch signaling pathway have been reported. To this end, we started developing a new multiomics platform, PlatOMICs, to integrate and re-analyze omics information, searching for the molecular interactions involved in the pathogenesis of skin diseases with alterations in the Notch signaling pathway.
Detecting dangerous illnesses connected to the skin organ, particularly malignancy, requires the identification of pigmented skin lesions. Image detection techniques and computer classification ...capabilities can boost skin cancer detection accuracy. The dataset used for this research work is based on the HAM10000 dataset which consists of 10015 images. The proposed work has chosen a subset of the dataset and performed augmentation. A model with data augmentation tends to learn more distinguishing characteristics and features rather than a model without data augmentation. Involving data augmentation can improve the accuracy of the model. But that model cannot give significant results with the testing data until it is robust. The k-fold cross-validation technique makes the model robust which has been implemented in the proposed work. We have analyzed the classification accuracy of the Machine Learning algorithms and Convolutional Neural Network models. We have concluded that Convolutional Neural Network provides better accuracy compared to other machine learning algorithms implemented in the proposed work. In the proposed system, as the highest, we obtained an accuracy of 95.18% with the CNN model. The proposed work helps early identification of seven classes of skin disease and can be validated and treated appropriately by medical practitioners.
Objective:
To establish a multidisciplinary management model based on Delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients.
...Methods:
On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The Delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients.
Results:
Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years; Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall’s harmony coefficients were 0.193 and 0.250, with statistically significant differences (p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients.
Conclusion:
Cancer patients based on Delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.
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