Дерматология, косметология, облысение

[Наталья П.]

полный текст pdf
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Health Technol Assess. 2006 Nov;10(43):1-58.

Telemedicine in dermatology: a randomised controlled trial.

Bowns IR, Collins K, Walters SJ, McDonagh AJ.

School of Health and Related Research (ScHARR), University of Sheffield, UK.

OBJECTIVES: To compare the clinical equivalence, patient and clinician opinion of store-and-forward (SF) teledermatology with conventional face-to-face consultation in setting a management plan for new, adult outpatient referrals. To assess the equivalence of digital photography and dermoscopy with conventional face-to-face consultation in the management of suspected cases of malignant melanoma or squamous cell carcinoma.
DESIGN: For the SF teledermatology aspect of the study, a prospective randomised controlled trial was carried out.
SETTING: Eight general practices and a hospital dermatology department in Sheffield, England.
PARTICIPANTS: For the SF teledermatology part of the study, adults (aged 16 years and over) requiring a new (not seen by a hospital dermatologist within the past year) consultant opinion. For the digital photography element of the study, adults (aged 16 years and over) requiring a consultant opinion due to suspicion of malignant melanoma or squamous cell carcinoma.
INTERVENTIONS: Patients in the telemedicine intervention group were referred to the consultant, and managed as far as possible using one or more digital still images and a structured, electronic referral and reply. The control group was managed by conventional hospital outpatient consultation. Patients referred to the 2-week wait clinic were invited to have a series of digital photographs, with and without dermoscopy, immediately before their face-to-face consultation. A second consultant viewed these and outlined a diagnosis and management plan which was compared with the actual management. Both were compared with the definitive diagnosis (either the final clinical or histological diagnosis, where undertaken).
MAIN OUTCOME MEASURE: The concordance between the consultant who had managed the case and an independent consultant who gave a second face-to-face opinion.
RESULTS: A total of 208 patients were recruited. There was also a greater loss of control cases (26%) than intervention cases (17%). A statistically significant difference in ages between the two groups completing the study (mean age of intervention group 43.6 years, control group 49.7 years, p = 0.039) indicates that this may have introduced a bias between the two groups. A further possible source of bias is the delay (mean difference of 54 days, p = 0.0001) between the SF opinion and the second opinion in the SF group, whereas control patients usually received their second opinion on the same day as their outpatient appointment. In 55% (51/92) of telemedicine cases and 78% (57/73) of control cases, the diagnosis concurred, with the second opinion. In 55% (51/92) of telemedicine cases and 84% (61/73) of control cases, the management plan concurred with the second opinion. Of the 92 telemedicine cases, 53 were judged also to require a face-to-face consultation, mainly to establish a diagnosis and treatment plan. With the digital photography for suspected skin cancer aspect of the study, it was found that an unexpectedly high proportion (33%, 85/256) of referrals proved to have a malignancy or a severely dysplastic lesion, with almost 22% having a malignant melanoma or squamous cell carcinoma, possibly reflecting the rise in incidence of skin cancers reported elsewhere. When both standard and dermoscopic images were employed, diagnostic concordance was modest (68%). The approach was highly sensitive (98%, 95% CI: 92 to 99%), at the expense of specificity (43%, 95% CI: 36 to 51%). Overall, 30% of cases would not have needed to be seen face-to-face, though two squamous cell carcinomas would have been missed (a number-needed-to-harm of 153). If the highest level of clinician confidence had been applied, no cancers would have been missed, but only 20% of patients would have avoided an outpatient appointment.
CONCLUSIONS: In view of the difficulties in recruitment and the potential biases introduced by selective loss of patients and the delay in obtaining a valid second opinion in the study group, no valid conclusions can be drawn regarding the clinical performance of this model of SF telemedicine. With regard to digital photography in suspected skin cancer, it is unlikely that this approach can dramatically reduce the need for conventional clinical consultations, whilst still maintaining clinical safety. Additional research on the assessment of diagnostic and management agreement between clinicians would be valuable in this and other fields of research.

[dr.Agapov]

Diagnostic Atlas of HSV Infection

Атлас дифференциальной диагностики генитального герпеса,атипичных форм и локализаций герпеса (20 оригинальных слайдов)

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[dr.Agapov]

Симпатичный online атлас по дерматологии с оригинальными фото

Gary M. White & Neil H. Cox

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[Наталья П.]

Arch Dermatol Res. 2007 May 12; [Epub ahead of print] Related Articles, LinkOut


German evidence-based guidelines for the treatment of Psoriasis vulgaris (short version).

Nast A, Kopp I, Augustin M, Banditt KB, Boehncke WH, Follmann M, Friedrich M, Huber M, Kahl C, Klaus J, Koza J, Kreiselmaier I, Mohr J, Mrowietz U, Ockenfels HM, Orzechowski HD, Prinz J, Reich K, Rosenbach T, Rosumeck S, Schlaeger M, Schmid-Ott G, Sebastian M, Streit V, Weberschock T, Rzany B.

Division of Evidence Based Medicine (dEBM), Klinik fur Dermatologie, Venerologie, Allergologie, Charite-Universitatsmedizin Berlin, Schumannstrasse 20/21, 10117, Berlin, Germany, [Ссылки доступны только зарегистрированным пользователям ].

Psoriasis vulgaris is a common and chronic inflammatory skin disease which has the potential to significantly reduce the quality of life in severely affected patients\. The incidence of psoriasis in Western industrialized countries ranges from 1.5 to 2%\. Despite the large variety of treatment options available, patient surveys have revealed insufficient satisfaction with the efficacy of available treatments and a high rate of medication non-compliance\. To optimize the treatment of psoriasis in Germany, the Deutsche Dermatologische Gesellschaft and the Berufsverband Deutscher Dermatologen (BVDD) have initiated a project to develop evidence-based guidelines for the management of psoriasis\. The guidelines focus on induction therapy in cases of mild, moderate, and severe plaque-type psoriasis in adults\. The short version of the guidelines reported here consist of a series of therapeutic recommendations that are based on a systematic literature search and subsequent discussion with experts in the field; they have been approved by a team of dermatology experts\. In addition to the therapeutic recommendations provided in this short version, the full version of the guidelines includes information on contraindications, adverse events, drug interactions, practicality, and costs as well as detailed information on how best to apply the treatments described (for full version, please see Nast et al., JDDG, Suppl 2:S1-S126, 2006; or [Ссылки доступны только зарегистрированным пользователям ] ).

PMID: 17497162 [PubMed - as supplied by publisher]

[Наталья П.]

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Summaries and commentary of dermatology medical journal articles covering topics such as dermatitis, melanoma, and hemangioma.

[Наталья П.]

[Ссылки доступны только зарегистрированным пользователям ]

Guidelines Updated for Screening for Chlamydia Infection

Release Date: June 21, 2007; Valid for credit through June 21, 2008

Нужна регистрация (бесплатная)

[Наталья П.]

DermQuest is a resource center that provides content addressing the needs
of practicing dermatologists in the areas of:

a.. Diagnosis and treatment
b.. Patient care and support
c.. Research developments and other news
d.. Opinion leader insights and commentary
e.. Practice support

DermQuest is an exclusive community for practicing dermatologists. The site
includes news, publications, edcational materials, links, conferences, PubMed search. Free registration required

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[Dr.Anisimova]

Shimizu's Textbook of Dermatology

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[Dr.Anisimova]

Evidence Based Dermatology
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[Ссылки доступны только зарегистрированным пользователям ]

Cochrane Skin Group
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[Ссылки доступны только зарегистрированным пользователям ]
Published Systematic Reviews
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Published Protocols
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Skin Disorders Specialist Library
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[Dr.Anisimova]

Evidence Based Dermatology
автор/ы : Williams Hywel, Bigby Michael, Diepgen Thomas, Herxheimer Andrew, Naldi Luigi, Rzany Berthold
год : 2003
страниц : 738
издательство : Bmj Publishing Group; Bk&CD-Rom edition
ISBN: 0727914421

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Dermatology books
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[Dr.Anisimova]

Обзор научно-медицинских статей(работает служба рассылок);
Бесплатный сайт, новости по специальностям
"The MDLinx Proposition
MDLinx connects healthcare professionals and patients to tomorrow’s medical knowledge and provides the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and research solutions."
По дерматологии и не только:
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На русском:
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[Dr.Anisimova]

После регистрации на сайте dermquest.com доступны следующие видео-интервью по самым актульным проблемам дерматологии:

Jean-Paul ORTONNE, MD, France - Vitiligo
Interview of Jean Paul ORTONNE, MD, made on Sept 18th during 2008 Paris EADV
Christopher GRIFFITHS, MD, UK - Indication and differential use of anti-TNF agents
Eggert STOCKFLETH, MD, Germany - Actinic Keratosis
Eggert STOCKFLETH, MD, Germany - Basal Cell Carcinoma
Frank POWELL, MD, Ireland - Rosacea and seborrheic dermatitis
Harald GOLLNICK, MD, Germany - Acne: maintenance therapy
Ines VERNER, MD, Israël - Age and ageing
Jean-Paul ORTONNE, MD, France - Melasma
Lasse BRAATHEN, MD, Switzerland - Guidelines for PDT
Odile ENJOLRAS, MD, France - Haemangiomas and vascular malformation
Pierre ANDRE, MD, France - Botulinic Toxin
Mauro PICARDO, MD, Italy - Vitiligo
Mauro PICARDO, MD, Italy - Melasma
Brigitte DRENO, MD, France - Laser, light and PDT in acne
Jean-Jacques GROB, MD, France - Melanoma
Robert BARAN, MD, France - Nail Disorders
Wolfram STERRY, MD, Germany - Psoriasis: new treatments in the light of pathogenesis

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[Dr.Anisimova]

Ссылки на разделы по дерматологии в известных общемедицинских журналах:
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[Dr.Anisimova]

Mycology
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[Dr.Anisimova]

О чень хороший ресурс(блог) по дерматоскопии, спасибо Валерию Валерьевичу:
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