The rise in subscription skin care services

Subscription skin care services are a rising niche of direct-to-consumer telehealth models. The explosion of such services may be a reflection of the increasing demand by patients to have accessible, affordable dermatological care. These models come with both benefits and risks to patients. A thorough understanding of how subscription skin care services work may benefit dermatologists in addressing patients' questions regarding alternative care options

Contact dermatitis: one for the books

Allergic contact dermatitis (ACD) is a frequent problem, often caused from repeated exposure to an object or substance related to the patient's routine activities. We present a case of a well-demarcated, erythematous, scaly plaque on a finger caused from reading with an e-book device. Although metal from mobile devices can cause ACD, mobile device cases may cause irritation or contain additives that can also cause contact dermatitis. Similar presentations of contact dermatitis may become more common as technology use increases

Diet and psoriasis

Background: Patients with psoriasis have a growing interest in managing their disease through diet.Objective: This review paper aims to analyze dietary interventions for psoriasis and their outcome.Methods: Terms "psoriasis AND diet" were used to search PubMed database and 63 articles describing dietary changes influencing psoriasis were selected.Results: Low calorie diet (LCD) improves Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in conjunction with topical or systemic therapy, although LCD was unsuccessful in maintaining disease remission when patients discontinued concomitant cyclosporine or methotrexate therapy. A fish oil diet improved baseline PASI of 7.7 to 5.3 at three months and 2.6 at 6 months compared to control (PASI: 8.9, 7.8, and 7.8, respectively). A randomized, double-blind, placebo-controlled study investigating selenium supplementation in psoriasis provided no PASI improvement. Zinc supplementation with concomitant betamethasone valerate 0.0025% ointment in a randomized, double-blind, placebo-controlled study provided a mean PASI of 11.2 in the intervention group and 8.0 in the control group with no significant difference between both arms. Gluten free diet and vitamin D supplementation were also efficacious dietary changes although results were mixed.Conclusions: Dietary changes alone do not cause a large effect in psoriasis but may become an important adjunct to current first line treatments

Cutis marmorata telangiectasia congenita with painful ulcerations

Cutis marmorata telangiectatica congenita (CMTC) is a rare, congenital, vascular disorder that may sometimes be associated with ulcerations of the involved skin. We present a case of CMTC, asymptomatic since birth, that began developing painful ulcerations during adolescence. Although laser therapy may benefit the superficial aspect of this vascular anomaly, the presence of deeper involvement in lesions with ulcerations may not respond favorably to laser therapy and the best approach needs to be further evaluated

Diet and psoriasis

Background: Patients with psoriasis have a growing interest in managing their disease through diet.Objective: This review paper aims to analyze dietary interventions for psoriasis and their outcome.Methods: Terms "psoriasis AND diet" were used to search PubMed database and 63 articles describing dietary changes influencing psoriasis were selected.Results: Low calorie diet (LCD) improves Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in conjunction with topical or systemic therapy, although LCD was unsuccessful in maintaining disease remission when patients discontinued concomitant cyclosporine or methotrexate therapy. A fish oil diet improved baseline PASI of 7.7 to 5.3 at three months and 2.6 at 6 months compared to control (PASI: 8.9, 7.8, and 7.8, respectively). A randomized, double-blind, placebo-controlled study investigating selenium supplementation in psoriasis provided no PASI improvement. Zinc supplementation with concomitant betamethasone valerate 0.0025% ointment in a randomized, double-blind, placebo-controlled study provided a mean PASI of 11.2 in the intervention group and 8.0 in the control group with no significant difference between both arms. Gluten free diet and vitamin D supplementation were also efficacious dietary changes although results were mixed.Conclusions: Dietary changes alone do not cause a large effect in psoriasis but may become an important adjunct to current first line treatments

The effect of the COVID-19 pandemic on perceptions of teledermatology

There is limited information of the effect of the COVID-19 pandemic on the general population's perceptions towards teledermatology. This study aims to assess the pandemic's impact on people's willingness to use teledermatology as well as to investigate influencing factors. We recruited 544 participants through Amazon Mechanical Turk (MTurk) and surveyed them using REDCap. Participants' willingness to use teledermatology before, during, and after the COVID-19 pandemic was measured via a 5-point Likert scale. The survey also included questions regarding factors influencing participants' attitudes towards teledermatology and their sociodemographic characteristics. Of the 185 participants who reported unwillingness to use teledermatology prior to the COVID-19 pandemic, 79.2% and 66.5% became either neutral or willing to use teledermatology during and after the pandemic, respectively. Less than half of prior satisfactory telemedicine users reported willingness to use teledermatology before the pandemic; willingness to use teledermatology increased to 80.1% and 63.8% during and after the COVID-19 pandemic, respectively. The top reason for lack of interest in teledermatology was concern for security and privacy (24.4%). Although a useful tool, teledermatology has been met with reluctance by the public. However, the unique circumstances of the COVID-19 pandemic have improved the public's perceptions and readiness to use teledermatology

The rise in subscription skin care services

Subscription skin care services are a rising niche of direct-to-consumer telehealth models. The explosion of such services may be a reflection of the increasing demand by patients to have accessible, affordable dermatological care. These models come with both benefits and risks to patients. A thorough understanding of how subscription skin care services work may benefit dermatologists in addressing patients' questions regarding alternative care options

Treatment of keratosis pilaris and its variants: a systematic review

Introduction Keratosis pilaris (KP) is a common, benign skin condition of follicular hyperkeratosis. Although KP is asymptomatic, the cosmetic appearance of KP can lead to psychosocial distress among patients. New emerging treatments are increasingly being utilized. Yet, there is little to no summative data on the treatments of KP and its subtypes. Objective To summarize existing literature on treatments for KP and its subtypes. Methods A comprehensive search was performed using Pubmed/MEDLINE, Embase and Web of Science databases. The search identified 1150 non-duplicated articles, and 47 articles were included in the review. The primary outcomes measured were KP treatment type and the degree of improvement following therapy. Findings Our findings demonstrate that the most supported form of treatment for KP is laser therapy, particularly the QS:Nd YAG laser. Topical treatments – including Mineral Oil-Hydrophil Petrolat, tacrolimus, azelaic acid, and salicylic acid – are also effective at least for improving the appearance of KP. Conclusion While the measured treatment outcomes varied among studies, laser therapy appears to be the most effective form of treatment. Use of topicals also improved KP lesions

Digital future of dermatology

Evolution of technology in the past several decades has undeniably transformed the practice of medicine. Dermatology, a field relying on visual cues, has been particularly impacted by advancement in imaging technologies. The purpose of this study was to review the current status as well as digital future of dermatology. The PubMed database was searched for articles pertaining to digital dermatology using search terms digital dermatology, teledermatology, and dermatopathology education. Digital dermatology has found a role in almost every aspect of dermatology: research, dermatology education and training, and clinical practice including disease prevention, diagnosis, treatment, and patient follow-up. Smartphone applications such VisualDx, MyDermPath, YouDermoscopy serve as diagnostic aid tools and can also help increase the user's knowledge of dermatology. Tools such as multispectral digital skin lesion analysis (MSDSLA) improve diagnostic accuracy and lead to fewer unnecessary biopsies. Teledermatology increases patient satisfaction, as they are able to experience shorter waits times and decreased costs. Underserved communities and those in rural settings are more likely to have a dermatologic evaluation by a specialist via teledermatology. Addressing important topics such as legal framework and updating reimbursement policies will allow for a smoother incorporation of digital dermatology into clinical practice and likely benefit patient care