Current management of herpes zoster: The European view

The overall incidence of herpes zoster in Europe is approximately 3 per 1000 people per year and more than 10 per 1000 people per year in those aged >80 years. Post herpetic neuralgia (PHN) is a common debilitating complication of herpes zoster, particularly in patients aged >50 years, in persons with severe pain or rash at presentation, and in those with significant prodromal symptoms. Antiviral drugs can effectively control acute symptoms and, if used early enough in the course of the illness, can help prevent the development of PHN and other complications. However, despite this, many patients do not receive such treatment. The economic impact of zoster and PHN is largely underestimated in Europe. Furthermore, there is considerable variation throughout Europe in the management of herpes zoster. Use of antiviral therapy including the newer potent antiviral agents such as brivudin, which requires less frequent administration than acyclovir, is improving patient outcomes in some European countries. However, in many countries, patient awareness of herpes zoster and, as a result, overall antiviral use is low. Guidelines recommending the use of antiviral agents, particularly in patients at risk of developing PHN, are available but are not widely used. More needs to be done to educate the general public and increase awareness among primary healthcare providers of the benefits of timely and appropriate pharmacological therapy in patients with herpes zoster. © 2005 Adis Data Information BV. All rights reserved

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of nonmelanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection

Gender differences in self-assessed health-related quality of life in children with atopic dermatitis

Background: Atopic dermatitis has a significant impact on quality of life of children and families. Objective: It is important to assess gender differences in health-related quality of life in children with atopic dermatitis in order to effectively use health-related quality of life results. Methods: Children 5- to 16-years of age with atopic dermatitis from Italy, Singapore, Czech Republic, and Ukraine were divided into two groups (boys and girls). Each child in the group of boys was matched to a corresponding child in the group of girls from the same country whose age and scoring atopic dermatitis value were almost identical. Self-assessed health-related quality of life was measured by the Children's Dermatology Life Quality Index. Results: The difference in overall Children's Dermatology Life Quality Index between boys and girls was not significant (P=0.33). Girls with atopic dermatitis assessed Children's Dermatology Life Quality Index item on embarrassment significantly higher (0.78±0.93 for boys and 1.14±0.93 for girls, p<0.05). Lowest scored items were the same and overall Children's Dermatology Life Quality Index results significantly correlated with scoring atopic dermatitis values in both groups. Two separate Children's Dermatology Life Quality Index items in boys and five items in girls significantly correlated with atopic dermatitis severity. The Children's Dermatology Life Quality Index item on affected sleep significantly correlated with the age of boys (r=0.38, P=0.02) and another Children's Dermatology Life Quality Index item on school work/holiday with the age of girls (r=0.59, p<0.01). Conclusion: Despite that the authors did not find differences in overall health-related quality of life results, girls were more embarrassed, self-conscious, upset, and sad because of atopic dermatitis. The authors' results may influence the educational part of consultations of children with atopic dermatitis

An international multicenter study on quality of life and family quality of life in children with atopic dermatitis

10.4103/0378-6323.104669Indian Journal of Dermatology, Venereology and Leprology79152-5

Euromelanoma: A dermatology-led European campaign against nonmelanoma skin cancer and cutaneous melanoma. Past, present and future

Summary Euromelanoma is a dermatologist-led skin cancer prevention programme conducting an annual screening and public education campaign in over 20 European countries. Within its 10-year history, Euromelanoma has screened over 260 000 individuals across Europe, detecting a significant number of cutaneous melanomas and nonmelanoma skin cancers, identifying high-risk individuals for further surveillance and promoting awareness on the suspicious features of melanoma and the hazardous effects of ultraviolet exposure. In this review article, we summarize the history of the Euromelanoma campaign, present its organizational structure and discuss the results of the campaign in individual countries and on a European scale. Euromelanoma has had a significant impact on melanoma prevention and early diagnosis in participating countries and, despite many challenges, has positively influenced public health attitudes towards regular mole examination and the implementation of preventive measures against skin cancer. © 2012 The Authors

Euromelanoma: a dermatology-led European campaign against nonmelanoma skin cancer and cutaneous melanoma. Past, present and future

Euromelanoma is a dermatologist-led skin cancer prevention programme conducting an annual screening and public education campaign in over 20 European countries. Within its 10-year history, Euromelanoma has screened over 260,000 individuals across Europe, detecting a significant number of cutaneous melanomas and nonmelanoma skin cancers, identifying high-risk individuals for further surveillance and promoting awareness on the suspicious features of melanoma and the hazardous effects of ultraviolet exposure. In this review article, we summarize the history of the Euromelanoma campaign, present its organizational structure and discuss the results of the campaign in individual countries and on a European scale. Euromelanoma has had a significant impact on melanoma prevention and early diagnosis in participating countries and, despite many challenges, has positively influenced public health attitudes towards regular mole examination and the implementation of preventive measures against skin cancer

The Euromelanoma skin cancer prevention campaign in Europe: Characteristics and results of 2009 and 2010

Background Euromelanoma is a skin cancer education and prevention campaign that started in 1999 in Belgium as &apos;Melanoma day&apos;. Since 2000, it is active in a large and growing number of European countries under the name Euromelanoma. Objective To evaluate results of Euromelanoma in 2009 and 2010 in 20 countries, describing characteristics of screenees, rates of clinically suspicious lesions for skin cancer and detection rates of melanomas. Methods Euromelanoma questionnaires were used by 20 countries providing their data in a standardized database (Belgium, Croatia, Cyprus, Czech Republic, FYRO Macedonia, Germany, Greece, Hungary, Italy, Lithuania, Luxembourg, Malta, Moldavia, Portugal, Serbia, Slovenia, Spain, Sweden, Switzerland and Ukraine). Results In total, 59 858 subjects were screened in 20 countries. Most screenees were female (64%), median ages were 43 (female) and 46 (male) and 33% had phototype I or II. The suspicion rates ranged from 1.1% to 19.4% for melanoma (average 2.8%), from 0.0% to 10.7% for basal cell carcinoma (average 3.1%) and from 0.0% to 1.8% for squamous cell carcinoma (average 0.4%). The overall positive predictive value of countries where (estimation of) positive predictive value could be determined was 13.0%, melanoma detection rates varied from 0.1% to 1.9%. Dermoscopy was used in 78% of examinations with clinically suspected melanoma; full body skin examination was performed in 72% of the screenees. Conclusion Although the population screened during Euromelanoma was relatively young, high rates of clinically suspected melanoma were found. The efficacy of Euromelanoma could be improved by targeting high-risk populations and by better use of dermoscopy and full body skin examination. © 2011 European Academy of Dermatology and Venereology