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1.
Chihiro Imura Azumi Ueyama Yoshikazu Sasaki Masaya Shimizu Yoko Furue Nobuyuki Tai Kenichiro Tsujii Kazufumi Katayama Takayuki Okuno Michitaka Shichijo Kiyoshi Yasui Mina Yamamoto 《Journal of dermatological science》2019,93(3):176-185
Background
Retinoic acid receptor-related orphan receptor gamma t (RORγt) has critical roles in the development, maintenance and function of interleukin (IL)-17-producing cells and is a highly attractive target for the treatment of IL-17-mediated autoimmune disease, particularly psoriasis. On the other hand, RORγt is also critical for controlling apoptosis during thymopoiesis, and genetic RORγt ablation or systematic RORγt inhibition cause progressive thymic aberrations leading to T cell lymphomas.Objective
We investigated whether topical administration of our novel RORγt inhibitor, S18-000003 has therapeutic potential for psoriasis with low risk of thymic aberrations.Methods
We evaluated the effect of topical S18-000003 on psoriasis-like skin inflammation and influence on the thymus in a 12-O-tetradecanoylphorbol-13-acetate-induced K14.Stat3C mouse psoriasis model.Results
S18-000003 markedly inhibited the development of psoriatic skin inflammation via suppression of the IL-17 pathway. In the skin, S18-000003 suppressed all subsets of IL-17-producing cells that we previously identified in this psoriasis model: Th17 cells, Tc17 cells, dermal γδ T cells, TCR? cells that probably included innate lymphoid cells, and CD4?CD8? double-negative αβ T cells. Notably, neither reduction of CD4+CD8+ double-positive thymocytes nor dysregulation of cell cycling was observed in S18-000003-treated mice, even at a high dose.Conclusion
Our topically administered RORγt inhibitor is a potential therapeutic agent for psoriasis with low risk of thymic lymphoma. 相似文献2.
Saki Maeda-Otsuka Ikko Kajihara Yukino Tasaki Saori Yamada-Kanazawa Ryoko Sakamoto Soichiro Sawamura Mamiko Masuzawa Mikio Masuzawa Yasuyuki Amoh Daichi Hoshina Riichiro Abe Yoshihiro Komohara Hironobu Ihn 《Journal of dermatological science》2019,93(2):123-132
Background
Angiosarcoma is a rare malignant tumor with a poor prognosis. It is known that hypoxic condition activates tumor progression in several cancers. Additionally, hypoxic tumor microenvironment accelerates immune escape. However, the presence and significance of hypoxia in angiosarcoma has not been adequately investigated.Objective
To study the role of hypoxia in the progression of angiosarcoma.Methods
The protein level of hypoxia inducible factor-1α (HIF-1α) in angiosarcoma was examined using immunohistochemistry and immunoblotting. To study the effect of hypoxia on tumor progression, cell proliferation, migration, invasion, and tube formation assays were performed in angiosarcoma cells. The influence of tumor cell supernatant in hypoxia from angiosarcoma cells on immune escape and angiogenesis was analysed to investigate the modulatory effect of hypoxia on tumor microenvironment of angiosarcoma. The molecular mechanism related to these results was investigated using immunoblotting and real time RT-PCR.Results
HIF-1α protein was over-expressed in angiosarcoma tissues and cell lines under hypoxic conditions, and there was heterogeneity of oxygen supply in angiosarcoma. Hypoxia enhanced the proliferation, migration, and invasion abilities and inhibited tube formation in angiosarcoma cells. Tumor cell supernatant in hypoxia from angiosarcoma cells activated the monocyte invasion ability, facilitated its differentiation into M2-like macrophages, and suppressed cell-adhesion. These in vitro results were compatible to the pathological findings of angiosarcoma patients.Conclusion
Hypoxia plays a major role in progression of angiosarcoma cells by enhancing cell proliferation, migration, and invasion and by modulating the tumor microenvironment. 相似文献3.
Hsiao-Chi Lai Chang-Shen Lin Ching-Shuang Wu Cheng-Che E. Lan 《Journal of dermatological science》2019,93(2):116-122
Background
Ultraviolet B (UVB) is commonly used for treating dermatologic conditions. Recently, high irradiance UVB (HIUVB) has been suggested to be more effective for treating skin conditions as compared to its low irradiance (LI) counterpart. The biological impact of UVB radiation emitted at different irradiance on cutaneous immunity remains obscure.Objective
This study aimed to explore the impacts of UVB radiation administered at equivalent fluence (mJ/cm2) but different irradiance (mW/cm2) on cutaneous immune response.Methods
Cultured bone marrow derived dendritic cell (BMDC) were treated with equivalent fluence of UVB radiation with HIUVB or LIUVB. The phenotypic and functional alterations of BMDCs were documented. Animal models were used to validate the in vitro results in vivo and explore the mechanisms involved.Results
After equivalent fluence of UVB radiation, the HIUVB treated BMDC showed significantly lower MHCII and CD86 expressions, reduced capacity to stimulate T cell proliferation, and enhanced activation of aryl hydrocarbon receptor (AhR)-activated genes as compared to control while their LIUVB treated counterpart showed no significant change. Using animal model, the HIUVB induced significantly higher immune suppressive effect in mice as compared to their LIUVB counterpart after equivalent fluence of UVB treatment. The superior immune suppressive effect of HIUVB over LIUVB radiation was not observed when similar experiments were performed using AhR-deficient mice.Conclusion
We propose irradiance played an important role modulating UVB-induced cutaneous immune suppression. Future works on UVB phototherapy, both clinical and research, should incorporate this important parameter into consideration. 相似文献4.
Chanat Kumtornrut Takeshi Yamauchi Saaya Koike Setsuya Aiba Kenshi Yamasaki 《Journal of dermatological science》2019,93(3):150-158
Background
The main pathogenesis of acne vulgaris is increase in sebum production and abnormal keratinization of the hair infundibulum. The androgens are involved in acne pathogenesis by modulating sebaceous glands to enhance sebum production. However, the molecular mechanisms of abnormal keratinization of the hair infundibulum are not fully elucidated.Objective
We hypothesized that the androgens affect the dermal fibroblasts, another androgen receptor-positive cells in the skin, resulting in abnormal keratinization through keratinocyte-fibroblast interaction.Methods
We investigated effects of androgens and estrogens on growth factors expressions by RT-PCR and western blot analysis in human fibroblast (hFB), human keratinocyte (hKC), and fibroblast-keratinocyte co-culture. In vivo, we examined the growth factor expression in acne lesions compared to normal hair follicles by laser-assisted confocal microscope.Results
In vitro, androgens but not estrogens significantly increased amphiregulin (AREG), epiregulin (EREG), fibroblast growth factor (FGF) 10, and insulin-like growth factor binding protein (IGFBP) 5 mRNA and protein expressions in human fibroblasts but not in keratinocytes. In vivo, AREG, EREG, FGF10, and IGFBP5 were more abundant in acne lesion compared to normal facial skin. FGF10 suppressed cytokeratin 1 and cytokeratin 10 expression in hKC, which was along with the decreased ratio of cytokeratin 10 against cytokeratin 14 in acne lesions compared to normal facial skin. Also, DHT suppressed cytokeratin 1 and cytokeratin 10, in fibroblast-keratinocyte co-culture similarly to the effect of FGF10 to hKC.Conclusion
These observations suggested that androgens enhance growth factors production from dermal fibroblasts, and growth factors from fibroblasts alter keratinocyte differentiation in acne lesion. 相似文献5.
Natsuko Noguchi Tomonori Hirose Tomoko Suzuki Masami Kagaya Kazuhiro Chida Shigeo Ohno Motomu Manabe Shin-Ichi Osada 《Journal of dermatological science》2019,93(2):101-108
Background
The epidermis possesses regenerative properties that become apparent only after wounding. Atypical protein kinase C (aPKC) isoforms aPKCζ and aPKCλ form a ternary complex with Par3 and Par6, and play crucial roles in establishing and maintaining epithelial cell polarity. The epidermal loss of aPKCλ?results in progressive depletion of hair follicle stem cells. However, it is unclear whether aPKCs have equivalent activities in epidermal regeneration.Objectives
To clarify functional differences between aPKCζ and aPKCλ in cutaneous wound healing.Methods
We compared cutaneous wound healing processes in vivo using mutant mice with genetic deletion of each aPKC isoform. We also analyzed functional differences between aPKCζ and aPKCλ in cell proliferation, directional cell migration, and formation of microtubules in vitro using primary keratinocytes established from each mutant mouse.Results
Wound healing was significantly retarded in epidermis-specific aPKCλ knockout mice. In aPKCλ-deleted keratinocytes, the correct orientation of cell protrusions toward the wound was disrupted through the destabilization of Par6β. The elongation of stabilized β-tubulin was also deteriorated in aPKCλ-deleted keratinocytes, leading to defects in cell spreading. Conversely, wound healing and directional cell migration in aPKCζ-deleted mice were comparable to those in their control littermates.Conclusions
aPKCs are not functionally equivalent; aPKCλ, but not aPKCζ, plays a primary role in cutaneous wound healing. 相似文献6.
Hideyuki Masuda Makoto Kimura Akiko Nishioka Hiroshi Kato Akimichi Morita 《Journal of dermatological science》2019,93(2):109-115
Background
Photosensitizers used for photodynamic therapy (PDT) to treat dermatologic disease are metabolized into mainly protoporphyrin IX (PpIX), which has five absorption wavelength peaks: 410?nm, 510?nm, 545?nm, 580?nm, and 630?nm. Although only red light around 635?nm and blue light around 400?nm are used as light sources for PDT, the efficiency of PDT might be improved by using multiple wavelengths, including those that correspond to the other absorption peaks of PpIX. Furthermore, because the target disease often occurs on the face, a flexible-type light-source unit that can be fitted to the lesion without unnecessarily exposing the mucous membranes, e.g., the eyes, nostrils, and mouth, is preferred.Objective
We investigated the efficacy of a flexible light-emitting diode (LED) unit that emits multiple wavelengths to improve PDT effects.Methods
HaCaT cells were incubated with 5-ALA and subsequently irradiated with either a single wavelength or sequentially with two wavelengths. Cell viability and reactive oxygen species were analyzed. Nude mice were implanted with COLO679 cells by subcutaneous injection into the flank. 5-ALA was subcutaneously injected into the tumor. The tumor was irradiated with 50?J/cm2 (day 0) and assessed daily until day 21.Results
The synergistic PDT effects of dual-wavelength irradiation and reactive oxygen species production were highest with the 405-nm and 505-nm wavelength combination. This dual wavelength combination was also the most effective in vivo.Conclusion
We could therefore conclude that dual-wavelength PDT is an efficient strategy for improving the therapeutic effects of PDT. Using a flexible LED unit is expected to achieve more uniform irradiation of uneven areas. 相似文献7.
8.
Ligia Aranibar Duran Jonathan Stevens González Carlos Palma Ducommun Solange Zapata Manque Javiera Pizarro Olave 《Piel》2017,32(10):604-609
Introduction
Tinea capitis (TC) is a dermatophytosis that affects the hair and scalp. The epidemiology of TC depends on the different geographical areas and is variable over time. Direct microscopic examination and fungal culture are essential to confirm the diagnostic suspicion and to identify the germ involved.Objectives
To determine the frequency of TC, to identify the etiological agents and to analyze the epidemiological aspects, in patients with suspected TC from Santiago Norte during the period 2009-2015.Materials and methods
A total of 505 patients with suspected TC were evaluated in the Dermatology Laboratory, Hospital Clinico Universidad de Chile. Direct microscopic examination was performed with KOH 30% and fungal culture of scalp lesions. Identification of the fungi was mainly morpho-physiological.Results
The diagnosis of TC was confirmed in 155 cases (30.7%). Male gender predominated (57.4%). The average age was 5 years. 85.2% of the cases occurred in the preschool and school population. The most frequent isolated agent was Microsporum canis in 89.8%, followed by Trichophyton tonsurans in 7.1%. It was confirmed that 81.8% of the cases of Trichophyton tonsurans had foreign ancestry, mainly of Haiti and Peru.Conclusions
This study evidenced the occurrence of Trichophyton tonsurans as a cause of TC, which could be explained by the increase in the immigrant population and the anthropophilic characteristics of the dermatophyte. 相似文献9.
Kimiko Nakajima Sayo Kataoka Kenji Sato Mikiro Takaishi Mayuko Yamamoto Hideki Nakajima Shigetoshi Sano 《Journal of dermatological science》2019,93(2):82-91
Background
Psoriasis is an inflammatory disease associated with aberrant crosstalk between the epidermis and immune system. However, the role of Langerhans cells (LCs) in psoriasis remains controversial.Objectives
To elucidate whether LCs are functionally involved in the development of psoriasis using a mouse model.Methods
Two lines of transgenic mice were used and crossed. They included K5.Stat3C, the psoriasis-model mouse and langerin DTR knock-in (KI) mouse. We performed immunofluorescence staining for LCs in psoriatic lesion of human and model mice. Flow cytometric analyses were performed to compare between dendritic cells (DCs) and LCs in the epidermis and skin-draining lymph nodes (sDLNs). To assess cytokine/chemokine expression in the skin lesion or primary cultured keratinocytes, we performed RT-PCR, microarray analysis or intracellular staining on the flow cytometer.Results
LCs were activated in psoriatic lesion of patients with psoriasis and K5.Stat3C mice. Compared with non-transgenic mice, K5.Stat3C mice constitutively showed an increased number of LCs in the sDLNs before psoriasis-like lesion developed. Stat3C transgenic keratinocytes expressed an elevated level of IL-1α. Psoriasis-like lesion in K5.Stat3C mice were attenuated in the absence of LCs, indicating that LCs were essential to the development of psoriasis-like lesion. Furthermore, we also recognized that epidermal LCs in psoriatic lesion of not only K5.Stat3C mice but also psoriasis patients produced IL-23.Conclusions
Our study suggests that Stat3 activation in keratinocytes may impact on LC activation in situ via IL-1α stimulation, at least in part, and that their presence may be essential for the pathogenesis of psoriasis through producing IL-23. 相似文献10.
Lula María Nieto Benito Ángel Manuel Rosell Díaz Ana Mateos Mayo Carmen Rodríguez Sáinz Ricardo María Suárez Fernández Ofelia Baniandrés Rodríguez 《Piel》2019,34(5):266-271
Introduction
Palmoplantar pustulosis (PPP) is characterised by the presence of sterile association with other diseases differ among published studies. IL36RN gene mutation has recently been identified in patients with mainly generalised pustular forms, but also in some patients with PPP. The objective of this study is to describe clinical and epidemiological characteristics, the incidence of inflammatory diseases in PPP, and to study the frequency of IL36RN gene mutations.Methods
An observational, retrospective, longitudinal study is presented, which includes all patients attended in our centre between 2009 and 2017 with a PPP diagnosis if only they were controlled by photography.Results
41 patients were included (90% women; average age of 55, 8). 94% were smokers or ex-smokers, 24% had a history of plaque psoriasis, 39% ungueal psoriasis and 27% a positive familiar background. On analysing IMIDs (immune mediated inflammatory disorders) incidence in PPP patients, 7% had inflammatory bowel disease, 10% psoriatic arthritis, and 22% other types of arthritis. No IL36RN gene mutations were found in any of the 11 patients in whom a genetic study was performed.Conclusions
Patients with PPP are mostly women who smoke, in the fifth decade of life, with an incidence of IMIDs higher than expected, as well as with a high prevalence of personal and family history of psoriasis. 相似文献11.
Arturo César Argote Ruiz Óscar Mora Hernández Lilian Torres-Tobar Marcela Gómez Garzón Carlos Reverend Catherine Alba Ayala Joanna Cajamarca Rueda Alejandra Toquica Díaz 《Piel》2019,34(4):204-211
Background
Acne is one of the most common reasons for consultation in dermatology. It affects the most adolescents and brings psychosocial consequences that alter their quality of life. Among the pathophysiological aspects is the colonization by Cutibacterium acnes (C. acnes) of which currently have been described 6 phylotypes (IA1, IA2, IB, IC, II, and III) related to their inflammatory potential.Objective
To identify the phylotypes of C. acnes in the lesions of patients with acne who consulted the Dermatology Department at Hospital San José, Bogotá, Colombia.Methods and materials
A 90 samples of acne patients pustules were collected. The bacterium was identified in culture by anaerobic conditions. The isolates where subjected to antibiotic sensitivity tests and subsequently processed and analysed using Microflex? LT MALDI-TOF.Result
57.78% of the isolates corresponded to the genera Propionibacterium and Cutibacterium; of these, 65.38% were C. acnes, typified by mass spectrometry. The phylotypes found were of type IA1, IA2, IB, and II in 5.88%, 85.29%, 2.94%, and 5.88%, respectively.Conclusions
The phylotype IA2 was the most frequently identified, a result that differs from data reported in non-Latin American studies in which the IA1 is the predominant, this relevant finding opens new questions about the behavior of C. acne in different populations. It also reports the global antibiotic resistance to the phylotypes to the four antibiotics most commonly used in clinical practice, finding greater resistance to erythromycin, followed by clindamycin, and in a lesser proportion to doxycycline and tetracycline. 相似文献12.
Yu-Jing Zhang Yang Han Yu-Zhe Sun Hang-Hang Jiang Min Liu Rui-Qun Qi Xing-Hua Gao 《Journal of dermatological science》2019,93(3):168-175
Background
Malassezia is one of the commensal microorganisms colonized on human skin and has been shown to be related to several inflammatory cutaneous disorders. Previous studies indicated that Malassezia. sympodialis (M. sympodialis) can produce extracellular vesicles, however, the immunoregulatory function of Malassezia extracellular vesicles on keratinocytes has not been studied.Objective
To investigate the extracellular vesicular production capability of Malassezia. furfur (M. furfur) and examine their immunoregulatory effects both in vitro and in vivo.Methods
Extracellular vesicles derived from M. furfur were isolated by sequential ultracentrifugation procedure. Their structure and diameter were determined by negative stain TEM and NTA, respectively. Confocal microscopy was used to visualize the internalization of these nanoparticles into HaCaT cells and mice epidermal keratinocytes. The expressions of inflammatory cytokines were screened using PCR Array assay and validated in vitro by qPCR and ELISA assays. In vivo cytokine production was measured by the IHC method. The role of NF-κB in such process was evaluated in HaCaT cells by western blot assay.Results
Our results showed that M. furfur produced ovoid-shaped nanoparticles, which could be then internalized into HaCaT cells, as well as mice epidermal keratinocytes. IL-6 expression was significantly enhanced in response to extracellular vesicular stimulation both in vitro and in vivo, in which process the activation of NF-κB was involved.Conclusion
M. furfur has the ability to release extracellular vesicles, which can be internalized into keratinocytes and promote the production of IL-6 with the involvement of NF-κB dependent pathway. Such findings reveal some important new insights into Malassezia pathogenesis and therapy. 相似文献13.
José Luis Gatica Montserrat Arceu Leoncio Muñoz Miguel Espinoza Ivo Sazunic Juan Honeyman Rodrigo De La Parra Solange Zapata 《Piel》2017,32(3):126-131
Background
Onychomycosis is a prevalent disease in the general population. There are currently 2 methods recommended for its clinical and laboratory diagnosis, direct microscopy (with potassium hydroxide KOH) and mycology culture. However, both test have notable deficiencies that call into question its clinical efficacy. Direct microscopy has a low sensitivity and is operator dependent, while the mycology culture is very sensitive and requires an incubation period of 35 days. Consequently, numerous techniques have been employed to overcome the diagnostic difficulties in onychomycosis. These include the histological study of the nail plate with PAS staining. This has shown good diagnostic indices, with reports of positivity of 33 to 92%, with a mean of 48%.Objective
To determine and compare the sensitivity and negative predictive value of three diagnostic methods for onychomycosis: Direct mycological with potassium hydroxide, mycological culture, and biopsy of nail plate with PAS staining in patients with clinical suspicion of onychomycosis in residents of the Juan Fernández Archipelago.Materials and methods
A cross-sectional study was conducted with a sample size of 55 patients living in the Juan Fernandez Archipelago. Specimens of nail tissue were taken for the direct mycological study, mycological culture, and histological study with PAS staining. Calculation and comparison of sensitivity and NPV for the three diagnostic methods was performed.Results
A total of 39 (70.9%) patients showed positive in at least one of the three practiced methods used, which was considered positive for onychomycosis (gold standard). By comparing each test in isolation, the best sensitivity was direct microscopy with 83%, followed by PAS (80.9%), and finally culture (46.8%). The highest sensitivity (97.9%) was detected in the combination of direct microscopy with potassium hydroxide and with histology PAS staining. The negative predictive value was 50% for direct microscopy, 47.1% for PAS, and 24.2% for the culture.Conclusions
The high sensitivity demonstrated and high negative predictive value shown in the histopathological PAS technique can be considered a simple and rapid alternative method for the diagnosis of onychomycosis. 相似文献14.
M. Ribera S. Ros B. Madrid R. Ruiz-Villaverde F. Rebollo S. Gómez E. Loza G. Carretero 《Actas dermo-sifiliográficas》2019,110(2):102-114
Objective
To establish recommendations to determine, identify, and manage the psychological and emotional needs of patients with chronic inflammatory skin diseases in clinical practice.Methods
A guided discussion was held at meeting of a nominal group of expert dermatologists and psychologists on the psychological and emotional needs of patients with chronic inflammatory skin diseases, how to manage these cases, and which referral criteria to employ. Based on the results of the discussion, and with the aid of a patient focus group and a review of the literature, a master document was drawn up with recommendations for discussion. A Delphi survey was circulated among a larger group of dermatologists and psychologists to assess the level of agreement with the recommendations.Results
Ten recommendations were established and can be summarized as follows: explore the psychological sphere of the patients with open questions at the time of diagnosis and during the course of the disease; provide patients with clear explanations that address their concerns and inform them of the existence of patient associations; investigate symptoms of anxiety and depression and, if confirmed by means of a Hospital Anxiety and Depression score (HADS) of 11 or greater, consider referral to a mental-health specialist; and, during visits, create a climate of trust, empathize with patients, agree goals and treatment options with them, and motivate them to adhere to those treatments.Conclusions
These recommendations may help health care professionals address psychological and emotional aspects of their patients in daily clinical practice. 相似文献15.
Derivación de pacientes en consulta de dermatología y de teledermatología en España. Estudio DIADERM
G. González-López M.Á. Descalzo-Gallego S. Arias-Santiago A. Molina-Leyva Y. Gilaberte P. Fernández-Crehuet H. Husein-El Ahmed A. Viera-Ramírez P. Fernández-Peñas R. Taberner I. García-Doval A. Buendía-Eisman 《Actas dermo-sifiliográficas》2019,110(2):146-152
16.
Ying Liu Linli Xue Hang Gao Lucheng Chang Xiuju Yu Zhiwei Zhu Xiaoyan He Jianjun Geng Yanjun Dong Hongquan Li Liping Zhang Haidong Wang 《Journal of dermatological science》2019,93(3):159-167
Background
Pigmentation is controlled by complex mechanisms. Evidence suggests that miRNAs can regulate pigmentation. However, the mechanism has not been fully elucidated. Objective In this study, we revealed a novel mechanism that regulates pigmentation involving exosomes, miRNAs and the crosstalk between keratinocytes and melanocytes.Methods
The expression and localization of exosome specific marker TSG101 in keratinocytes and melanocytes; Changes of melanin content in melanocytes after co-culture of exosome and melanocytes; Expression changes of target gene TYR and its related genes and inhibitory effect of miR-330-5p on pigmentation were studied by using various molecular biological techniques.Results
In this experiment, we used miR-330-5p in keratinocytes to verify the effect of keratinocyte derived exosome on melanocyte pigmentation. First, we found that keratinocytes secrete exosomes carrying miR-330-5p; moreover, greater miR-330-5p expression was found in exosomes derived from keratinocytes that overexpressed miR-330-5p. Second, we found that exosomes derived from keratinocytes with overexpression of miR-330-5p caused a significant increase in miR-330-5p in melanocytes. Finally, exosomes derived from keratinocytes that overexpressed miR-330-5p induced a significant decrease in the production of melanin and expression of TYR in melanocytes. Meanwhile, we overexpressed miR-330-5p in melanocytes, which also proved the inhibitory effect of miR-330-5p on pigmentation.Conclusion
These findings suggest that keratinocytes crosstalk with melanocytes in the epidermal melanin unit via exosomal miRNAs. These studies reveal an important role of exosomes in melanocyte pigmentation, which opens a new pathway of melanogenesis. 相似文献17.
Introduction
Medical photography is a noninvasive technique used for diagnostic, monitoring, and educational purposes. It is important to understand the patient's attitude to all or part of their body being photographed. The objective of this study was to analyze the attitudes of patients towards medical photography at a district hospital in Tarragona, Spain.Methodology
This exploratory study used a questionnaire to evaluate attitudes to medical photography among outpatients at Pius Hospital de Valls. The questionnaire explored the patients’ beliefs about the usefulness of medical photography, the circumstances in which they would agree to be photographed and by whom, as well as their prior experience of medical photography. They were also asked whether they would authorize the use of photography and, if not, to explain their motives.Results
The questionnaire was completed by 134 patients. The results showed that patients had a clearly positive attitude to being photographed for medical purposes (94.8%), treatment follow-up (88.1%), and consultation of their case with other physicians (86.6%). Acceptance was 88.8% if the lesion was malignant and 85.1% if it was extensive. For facial lesions, only 78.4% were willing to be photographed and in the case of genitals the percentage fell to 70.2%. Most patients (95.5%) would agree to being photographed by their doctor. The rate of acceptance was 66.4% in the case of a nurse, 64.9% for another doctor, and 21.6% for a professional photographer.Conclusions
Our study revealed that patients have a positive attitude to being photographed for medical purposes, particularly when they have a malignant lesion, when the photograph is taken by their specialist, and when they cannot be identified. 相似文献18.
Background
The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned.Objectives
To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration.Design
Judgement Analysis.Setting
UK community and primary care nursing services.Participants
18 community non-specialist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses.Methods
Using judgement analysis methods, 18 community non-specialist nurses and 18 community tissue viability specialist nurses made diagnoses and treatment judgements about compression therapy for 110 clinical scenarios and indicated their confidence for each judgement. An expert panel made consensus judgements for the same scenarios and these judgements were used as a standard against which to compare the participants. Confidence analysis was used to assess the nurses' confidence about their diagnostic judgements and treatment choices.Results
Despite being very experienced, both non-specialist nurses' and specialist tissue viability nurses' levels of confidence were not well calibrated with their levels of accuracy.Conclusion
The results of this study are important as errors resulting from both over and under-confidence at the diagnostic phase of management may influence treatment choices, and thus increase the chances of treatment error. 相似文献19.
Anke Scheel-Sailer Angela Frotzler Gabi Mueller Simon Annaheim René Michel Rossi Siegfried Derler 《Journal of tissue viability》2017,26(2):89-94
Aim of the study
To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.Study design
An experimental controlled study with a convenience sample.Setting
A Swiss acute care and rehabilitation clinic specializing in SCIs.Materials and methods
We determined hydration, redness, elasticity and perfusion of the unloaded skin in the sacral region of 6 SCI/PU patients (affected and healthy skin), 20 SCI/PA patients and 10 able-bodied controls. These measures were made by two trained examiners after the patients were lying in the supine position.Results
The affected skin of SCI/PU patients showed elevated redness: median 595.5 arbitrary units (AU) (quartiles 440.4; 631.6) and perfusion: 263.0 AU (104.1; 659.4), both significantly increased compared to the healthy skin in SCI/PA patients and CON (p < 0.001). Similarly, healthy skin of SCI/PA patients showed elevated redness (p = 0.016) and perfusion (p < 0.001) compared to CON. On the other hand, differences in redness and perfusion between the affected and unaffected skin in SCI/PU patients were not significant. The results for skin hydration and skin elasticity were similar in all groups.Conclusions
Skin perfusion and redness were significantly increased in grade 1 PUs and for healthy skin in both SCI/PA patients and CON participants; thus, these are important in understanding the pathophysiology of PUs and skin in SCI. 相似文献20.
Naomi Fearns Stephen Heller-Murphy Joanna Kelly Jenny Harbour 《Journal of tissue viability》2017,26(4):254-259