Clinical and Experimental Dermatology

Shipman, Alexa R; Matin, Rubeta N

doi: 10.1093/ced/llad212pmid: 37350562

Donoso, Francisca; Peirano, Dominga; Longo, Caterina; Apalla, Zoe; Lallas, Aimilios; Jaimes, Natalia; Navarrete-Dechent, Cristian

doi: 10.1093/ced/llad177pmid: 37155594

Teaching methods in medical education have been changing. More recent teaching modalities have gone beyond the traditional delivery of knowledge, promoting learning motivation, and improving teaching and learning outcomes. ‘Gamification’ and ‘serious games’ are methodologies that use the principles of games to facilitate learning processes and the acquisition of skills and knowledge, thereby improving attitudes towards learning when compared with traditional teaching methods. As dermatology is a visual field, images are a key component of different teaching strategies. Likewise, dermoscopy, a noninvasive diagnostic technique that allows the visualization of structures within the epidermis and upper dermis, also uses images and pattern recognition strategies. A series of Apps using game-based strategy have been created to teach and facilitate dermoscopy learning; however, studies are required to demonstrate their effectiveness. This review summarizes the current evidence of game-based learning strategies in medical education, including dermatology and dermoscopy.

Das, Anupam; Sil, Abheek; Kumar, Piyush; Khan, Ismat

doi: 10.1093/ced/llad150pmid: 37097168

Blue light has garnered attention because of its ability to penetrate more deeply into the skin layers, and induce cellular dysfunction and DNA damage. Photoageing, hyperpigmentation and melasma are some of the cutaneous changes that develop on exposure to blue light. To date, the therapeutic roles of blue light have been evaluated in dermatological conditions like psoriasis, eczema, acne vulgaris, actinic keratosis and cutaneous malignancies, among others. In this review, we have attempted to present an evidence-based compilation of the effects of blue light on the skin.

Palaniappan, Vijayasankar; Murthy, Aravind Baskar; Karthikeyan, Kaliaperumal

doi: 10.1093/ced/llad175pmid: 37151115

Pitted keratolysis is a common bacterial infection encountered in tropical regions. The various facets of this disease are reviewed in this article.

Mintoff, Dillon; Agius, Rachel; Benhadou, Farida; Das, Anupam; Frew, John W; Pace, Nikolai P

doi: 10.1093/ced/llad182pmid: 37171791

Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of the pilosebaceous unit. The typical patient with HS is characterized as someone with obesity, who smokes and who has nodules, abscesses and/or draining tunnels predominantly distributed in intertriginous skin. It has been established that lifestyle and genetic factors are the main pathophysiological drivers of HS. In this critical review, we explore the interrelatedness of meta-inflammation, obesity and HS and discuss if and how this relationship may be manipulated for a therapeutic end.

Pereyra-Rodríguez, José-Juan; Herranz, Pedro; Ruiz-Villaverde, Ricardo; Elosua-González, Marta; Galán-Gutiérrez, Manuel; Figueras-Nart, Ignasi; Miquel, Javier; de la Cueva, Pablo; Serra-Baldrich, Esther; Munera-Campos, Monica; Melé-Ninot, Gemma; Expósito-Serrano, Vicente; Perez, Bibiana;

Ting, Jason S K; Tan, Yu L; Veasuvalingam, Bhavani; Yap, Ashley Y M; Ghui, Shi M; Yong, Jade L  ; Goodson, Michaela

doi: 10.1093/ced/llad149pmid: 37097177

BackgroundTo date, to our knowledge, there has not been a study on dermatological teaching in the preclinical years (usually the first 2 years of medical school), where the majority of learning takes place in the form of lectures and seminars. Near-peer teaching (NPT) involves students who are at least one academic year more senior imparting knowledge to junior students. The principles behind scaffolding are having a more experienced teacher to guide learning, breaking down learning into smaller tasks and helping to build interest in learning.ObjectivesTo investigate the feasibility and effectiveness of NPT in scaffolding dermatological learning among preclinical-year medical students.MethodsNear-peer teachers who are content experts in dermatology taught alongside conventional teaching with lecturers. We employed five quiz questions before and after the case launch lecture, where students were first exposed to dermatology. We also invited students to provide feedback using a questionnaire on NPT in dermatology at the end of the case 8 teaching week.ResultsIn total, 74 students participated in the pre- and post-lecture quiz questions, and 47 completed feedback. There was overwhelmingly positive feedback towards NPT, and various learning theories can help explain the success of this project.ConclusionsPreclinical students enjoy dermatological teaching with the involvement of suitable near-peers. With the professional barrier removed, students can better relate to near-peers (and vice versa). Helping students understand the relevance of dermatology in the clinical setting at an early stage and adopting learning tools such as mnemonics, summary tables, comparison tables and mapping teaching with the learning curriculum clearly helped students learn about dermatology.

Brookes, Tenzin Sung-rab; Barlow, Richard; Mohandas, Padma; Bewley, Anthony

doi: 10.1093/ced/llad161pmid: 37119282

BackgroundTopical steroid withdrawal (TSW) is a newly described disease characterized by erythema and burning following discontinuation of prolonged use of mid- to high-potency topical corticosteroids. No consensus diagnostic criterion exists. TSW is frequently interpreted as flaring of the underlying disorder or contact allergy to topical treatment.ObjectivesTo better characterize TSW symptomatology, detail our experience with management and assess the proportion of patients who pursue nonconventional management.MethodsA retrospective review of case notes collected from our multidisciplinary service between January 2019 and June 2021 was carried out to identify patients presenting with TSW.ResultsNineteen cases of TSW were identified, 15 in females and 4 in males. The majority were < 35 years old. Eighteen had atopic dermatitis. The most frequently reported features were redness, skin pain (typically ‘burning’), skin sensitivity, excessive skin flaking, insomnia and severe itching. There was a high burden of anxiety and depression, with three patients expressing suicidal thoughts. Nonconventional treatments were pursued by approximately half the cohort, some of whom sought private consultation with international dermatologists. Improvements were noted in the context of open psychodermatology consultations with an earlier introduction of conventional management options.ConclusionsMany patients report dismissal by dermatology healthcare professionals, often driving them to seek help from unregulated online sources, heightening the burden of mental, social and physical morbidity. Dermatology healthcare professionals need to be aware of TSW and offer support with shared decision-making when considering treatments.

Chan, Jonathan; MacNeill, Stephanie J; Stuart, Beth; Lo, Y T Eunice; Roberts, Amanda ; Mitchell, Dann; Ridd, Matthew J

doi: 10.1093/ced/llad147pmid: 37130096

This cohort study of 519 children with eczema, examined the effect of short-term temperature changes on eczema symptoms. The seasonal variation in symptom scores was observed, suggesting worsening with colder weather in winter and improvements with warmer weather in summer. We provide evidence to show temperature changes may play a role, specifically that hot weather is protective against flares. Switching emollients in different weather states to try and prevent a flare is unlikely to be helpful.

Wada, Shogo; Ogata, Dai; Nakano, Eiji; Namikawa, Kenjiro; Yamazaki, Naoya

doi: 10.1093/ced/llad172pmid: 37162010

Unresectable extramammary Paget disease (EMPD) has a poor prognosis but no consensus has been reached regarding the optimal choice of chemotherapy owing to lack of data. This single-centre retrospective study, with 32 patients diagnosed with unresectable EMPD, evaluated the efficacy of three regimens: docetaxel monotherapy; combination therapy with 5-fluorouracil, epirubicin, carboplatin, vincristine and mitomycin C; and tegafur monotherapy. Each regimen showed limited efficacy for the treatment of unresectable EMPD, so further investigations with larger cohorts are necessary.