The British journal of dermatology
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Randomized Controlled Trial
A randomized controlled trial in children with eczema: nurse practitioner vs. dermatologist.
Background We hypothesized that a nurse practitioner would improve the quality of life of a child with eczema more than a dermatologist because of a structured intervention and more consultation time. Objectives To compare the level of care by nurse practitioners with that by dermatologists in children with eczema. Methods New referrals aged < or = 16 years with a diagnosis of eczema were recruited. ⋯ Significantly higher satisfaction levels were observed at 4, 8 and 12 months in the nurse practitioner group. Conclusions The level of care provided by a nurse practitioner in terms of the improvement in the eczema severity and the quality of life outcomes was comparable with that provided by a dermatologist. In addition, the parents were more satisfied with the care that was provided by a nurse practitioner.
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Studies have shown the benign to malignant ratio of excised pigmented skin lesions is suboptimal in primary care. ⋯ In a primary care setting the combination of dermoscopy and short-term SDDI reduces the excision or referral of benign pigmented lesions by more than half while nearly doubling the sensitivity for the diagnosis of melanoma.
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Little is known about brain mechanisms supporting the experience of chronic puritus in disease states. ⋯ Our results demonstrate that ASL fMRI is a promising technique to assess brain activity in chronic itch. Brain activity of acute itch in AD seems to differ from that in healthy subjects. Moreover, the activity in cortical areas involved in affect and emotion correlated to measures of disease severity.
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Photodermatoses are skin disorders induced or exacerbated by light. They can be broadly classified into four groups: (i) immunologically mediated photodermatoses (idioapathic); (ii) drug- and chemical-induced photosensitivity; (iii) defective DNA repair disorders; and (iv) photoaggravated dermatoses. The exact pathomechanism of those diverse skin reactions to light radiation remains unclear. ⋯ The management of photodermatoses starts with clinical recognition of characteristic lesions localized predominantly in light exposed skin. Detailed history-taking, phototesting and photopatch testing are required to establish a correct diagnosis, especially if patients present in disease-free intervals. Classification and short description of distinctive clinical features of most common photodermatoses, several practical aspects of evaluation and management of the patient with photosensitivity will be outlined.