Two cases of proximal subungual onychomycosis caused by Trichophyton rubrum in HIV negative patients during treatment with TNF-α inhibitors combined with methotrexate.

Proximal subungual onychomycosis (PSO) is a rare subtype of onychomycosis with a clinical presentation characterized by proximal leukonychia in the lunular area of the nail. PSO is associated with immunosuppression and regarded a sign of Human Immunodeficiency Virus (HIV) infection when caused by Trichophyton (T.) rubrum. We present two cases of PSO caused by T. rubrumdeveloped during treatment with TNF-α inhibitors combined with methotrexate (MTX). </p

Communicating with patients through pictograms and pictures – a scoping review

Background Communication between patients and healthcare workers (HCWs) may on occasion be challenged by disparities in cultural background, age and educational level. Written educational material is commonly used to reduce the risk of miscommunication. However, literacy among patients may also differ and it is, therefore, speculated that the use of pictograms may improve patients’ understanding and adherence. Objective To evaluate the scientific literature and investigate the effect and practical utility of pictograms in medical settings with focus on dermatological patients. Materials and methods Pubmed, EMBASE, and Cochrane Library were searched July 2021 for studies regarding use of pictograms in medical settings and dermatology. Results The use of pictograms in dermatology is not well characterized, but studies in other fields of medicine report a positive effect of using pictograms in communication. Pictograms have a significant positive effect when presented alongside verbal or written explanations. Conclusions The quality of the development process is important to ensure the utility of any pictogram. Involving the target population in the design and validation of the pictograms may be critical. In the validation process, testing of transparency and translucency may benefit from international recommendations