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The COVID-19 pandemic catapulted dermatology services into a digital era, with the rapid introduction of teleconsultations. The UK National Health Service operational planning guidance recommends ≥ 25% of consultations are delivered remotely. There is a lack of data regarding the acceptability and effectiveness of paediatric dermatology teleconsultations. We surveyed UK healthcare professionals (HCPs) to explore their experiences of teleconsultations in paediatric dermatology, with a focus on follow-up consultations for paediatric eczema (PE), to inform a future clinical trial. There were 119 responses. Pre-pandemic, 37% provided some form of teleconsultation service, rising to 92% post-pandemic. In total, 41% (n = 49) now carry out > 25% of consultations remotely. We found 55% felt teleconsultations were less effective than face-to-face ones for PE follow-up. Eighty HCPs offered teleconsultations for PE. Among the HPCs who offered teleconsultations for PE, the most effective format for follow-up consultations was felt to be telephone with photographs (52/80, 65%). Our results demonstrate varying opinion on the effectiveness and optimal format of paediatric teleconsultations, supporting the need for further research. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is associated with immunological dysfunction, which may influence cancer development. Previous studies of AD and cancer demonstrate inconsistent results and few of these studies examined children or AD severity and treatment. Objectives To determine malignancy risk among children and adults with AD. Methods We conducted a cohort study using electronic health records data from UK general practices in The Health Improvement Network between 1994 and 2015. Children (< 18 years old) and adults (≥ 18 years old) with AD were matched on age, practice and index date to patients without AD. AD was categorized as mild, moderate or severe using treatments and dermatology referrals as proxies. The primary outcome was any incident malignancy, including in situ malignancy, identified using diagnosis codes and categorized into haematological, skin and solid organ malignancies. Secondary outcomes included specific malignancies: leukaemia, lymphoma, melanoma, nonmelanoma skin cancer (NMSC) and common solid-organ cancers. Results Among 409 431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) and 1 809 029 children without AD who had median follow-up of 5–7 years, the incidence rates of malignancy were 1.9–3.4 and 2.0 per 10 000 person-years (PY), respectively. The adjusted risk of malignancy overall did not differ with respect to AD [hazard ratio (HR) 1.02 (95% confidence interval 0.92–1.12)]. Severe AD was associated with increased lymphoma risk [HR 3.18 (1.41–7.16), excluding cutaneous T-cell lymphoma (CTCL)], and mild AD was associated with increased NMSC risk [1.55 (1.06–2.27)]. Among 625 083 adults with AD (65.7% mild, 31.4% moderate, 2.9% severe) and 2 678 888 adults without AD who had median follow-up of 5 years, incidence rates of malignancy were 97.4–125.3 per 10 000 PY and 103.7 per 10 000 PY, respectively. The adjusted risk of any malignancy did not differ with respect to AD [HR 1.00 (0.99–1.02)]. However, adults with severe AD had a twofold higher risk of non-CTCL lymphoma. AD was also associated with slightly higher skin cancer risk [HR 1.06 (1.04–1.08)] and slightly lower solid cancer risk [0.97 (0.96–0.98)] but results varied by specific cancers and AD severity. Conclusions Epidemiological evidence does not support a strong overall malignancy risk in AD but lymphoma risk may be increased with severe AD. [ABSTRACT FROM AUTHOR]

Immunosuppressive treatments inhibit vaccine-induced immunity against SARS-CoV-2. We evaluated whether a 2-week interruption of methotrexate treatment immediately after the COVID-19 vaccine booster improved antibody responses against the S1 receptor-binding domain (S1-RBD) of the SARS-CoV-2 spike protein compared with uninterrupted treatment in patients with immune-mediated inflammatory diseases. We did an open-label, prospective, two-arm, parallel-group, multicentre, randomised, controlled, superiority trial in 26 hospitals in the UK. We recruited adults from rheumatology and dermatology clinics who had been diagnosed with an immune-mediated inflammatory disease (eg, rheumatoid arthritis, psoriasis with or without arthritis, axial spondyloarthritis, atopic dermatitis, polymyalgia rheumatica, and systemic lupus erythematosus) and who were taking low-dose weekly methotrexate (≤25 mg per week) for at least 3 months. Participants also had to have received two primary vaccine doses from the UK COVID-19 vaccination programme. We randomly assigned the participants (1:1), using a centralised validated computer randomisation program, to suspend methotrexate treatment for 2 weeks immediately after their COVID-19 booster (suspend methotrexate group) or to continue treatment as usual (continue methotrexate group). Participants, investigators, clinical research staff, and data analysts were unmasked, while researchers doing the laboratory analyses were masked to group assignment. The primary outcome was S1-RBD antibody titres 4 weeks after receiving the COVID-19 booster vaccine dose, assessed in the intention-to-treat population. This trial is registered with ISRCT, ISRCTN11442263; following the pre-planned interim analysis, recruitment was stopped early. Between Sept 30, 2021 and March 3, 2022, we recruited 340 participants, of whom 254 were included in the interim analysis and had been randomly assigned to one of the two groups: 127 in the continue methotrexate group and 127 in the suspend methotrexate group. Their mean age was 59·1 years, 155 (61%) were female, 130 (51%) had rheumatoid arthritis, and 86 (34%) had psoriasis with or without arthritis. After 4 weeks, the geometric mean S1-RBD antibody titre was 22 750 U/mL (95% CI 19 314–26 796) in the suspend methotrexate group and 10 798 U/mL (8970–12 997) in the continue methotrexate group, with a geometric mean ratio (GMR) of 2·19 (95% CI 1·57–3·04; p<0·0001; mixed-effects model). The increased antibody response in the suspend methotrexate group was consistent across methotrexate dose, administration route, type of immune-mediated inflammatory disease, age, primary vaccination platform, and history of SARS-CoV-2 infection. There were no intervention-related serious adverse events. A 2-week interruption of methotrexate treatment for people with immune-mediated inflammatory diseases resulted in enhanced boosting of antibody responses after COVID-19 vaccination. This intervention is simple, low-cost, and easy to implement, and could potentially translate to increased vaccine efficacy and duration of protection for susceptible groups. National Institute for Health and Care Research. [ABSTRACT FROM AUTHOR]

Https://doi.org/10.1093/bjd/ljad213 DearEditor, Direct microscopy is a useful tool in the diagnosis of superficial mycoses. The percentage of respondents (consultant, SpR, respectively) rating their confidence as 1 of 5 or 2 of 5 for diagnosing specific mycoses were as follows: dermatophyte infection (55.1%, 81.5%), candidiasis (65.2%, 77.8%), pityriasis versicolor (66.2%, 76.9%) and I Malassezia i folliculitis (69.1%, 85.2%). [Extracted from the article]

With reduced face-to-face contact and a shift towards remote consultations, it is imperative to prepare dermatology trainees to use teledermatology platforms for their future careers. BT23: The impact of the COVID-19 pandemic and use of teledermatology in specialty training: experience at two UK dermatology training centres We performed a survey at the two UK dermatology training centres of trainees who were working during the pandemic, to evaluate their experience of teledermatology training. [Extracted from the article]

Molluscum contagiosum virus (MCV) is a significant but underreported skin pathogen for children and adults. Seroprevalence studies can help establish burden of disease. Enzyme linked immunosorbent assay (ELISA) based studies have been published for Australian and Japanese populations and the results indicate seroprevalences between 6 and 22 percent in healthy individuals, respectively. To investigate seroprevalence in Europe, we have developed a recombinant ELISA using a truncated MCV virion surface protein MC084 (V123-R230) expressed in E. coli. The ELISA was found to be sensitive and specific, with low inter- and intra-assay variability. Sera from 289 German adults and children aged 0–40 years (median age 21 years) were analysed for antibodies against MC084 by direct binding ELISA. The overall seropositivity rate was found to be 14.8%. The seropositivity rate was low in children below the age of one (4.5%), peaked in children aged 2–10 years (25%), and fell again in older populations (11–40 years; 12.5%). Ten out of 33 healthy UK individuals (30.3%; median age 27 years) had detectable MC084 antibodies. MCV seroconversion was more common in dermatological and autoimmune disorders, than in immunocompromised patients or in patients with multiple sclerosis. Overall MCV seroprevalence is 2.1 fold higher in females than in males in a UK serum collection. German seroprevalences determined in the MC084 ELISA (14.8%) are at least three times higher than incidence of MC in a comparable Swiss population (4.9%). While results are not strictly comparable, this is lower than Australian seroprevalence in a virion based ELISA (n = 357; 23%; 1999), but higher than the seroprevalence reported in a Japanese study using an N-terminal truncation of MC133 (n = 108, 6%; 2000. We report the first large scale serological survey of MC in Europe (n = 393) and the first MCV ELISA based on viral antigen expressed in E. coli. [ABSTRACT FROM AUTHOR]

The article focuses on the need to set up a pediatric dermatology vulval clinic in Great Britain. The specialist clinic aims to improve hospital visits for the children and their parents. However, children present with four symptoms, such as vulval itching, soreness or pain, erosive disease, and abnormal appearance, and diagnosis made in the pediatric vulval clinic.

Examines the incidence of McCune-Albright syndrome, a rare disease in infants in Great Britain. Causes of McCune-Albright syndrome; Basis on the clinical diagnosis of the disease; Symptoms of the disease.

Presents the case of an eleven-year-old Asian male with exophytic pilomatricoma in Great Britain. Characterization of pilomatricomas, benign cutaneous neoplasms; Treatment of the disease; Enlargement of erythematous papule.

This is the largest study of laboratory-diagnosed onychomycosis in England for children younger than 17 years. The most common (91.5%) cultured organism in this population was Trichophyton rubrum. Candida species were isolated only from fingernails, and the majority were from children younger than 5 years. Continued analysis of fungal pathogens is vital to identify changing trends. [ABSTRACT FROM AUTHOR]

The article offers dermatological news and notices in Great Britain in 2013. The 93rd annual meeting of the British Association of Dermatologists (BAD) will be held at the ACC Liverpool from July 9-11. The Hans Schaefer Young Researchers Grant 2013 will be given to Hair and Skin Research Foundation. International Society of Pediatric Dermatology announces the 12th World Congress of Pediatric Dermatology which will be held in Madrid, Spain from September 25-27.

The article offers information on topics related to dermatology in Great Britain in 2012-2013. A British Skin Foundation (BSF) Small Grant is already available for those whishing to carry out British research on skin disease. The 12th World Congress of Pediatric Dermatology will be held in Madrid, Spain on September 25-27, 2013. Moreover, application for BSF Large Grant such as the BSF Fellowship is already available.

In the current financial climate where resources in the National Health Service are becoming increasingly limited, it is essential that the role of the pediatric dermatology nurse specialist remains appreciated and supported. Our pediatric dermatology nurse specialist was first employed in September 2002 having had 6 years experience nursing children with a wide variety of dermatologic conditions prior to her employment. She achieved her pediatric community nursing degree in 2003 undertaking the nurse prescribing extended formulary course in 2006, her training history representative of many nurse specialists. We present the results of an audit highlighting how the employment of our pediatric dermatology nurse specialist has led to a decrease in hospital admissions as well as providing a significant positive impact on waiting lists. [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'An Adult Case of Purpura Fulminans Associated With Factor V Leiden Mutation,' by G.K. Patel, A. Morris, A. Rashid and A. Anstey presented at the annual meeting of the British Society of Dermatopathology in Great Britain.

Presents an abstract of the research paper 'Measurement of the Impact of Atopic Dermatitis on Infant's and Their Family's Lives,' by M.S. Lewis-Jones, A.Y. Finlay and P.J.D. Dykes presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Non-Bullous Ichthyosiform Erythroderma Due to Transglutaminase Deficiency: A Case Report,' by D. Ramlogan and C. Moss presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Reports on developments in dermatology in Great Britain as of August 1988. Availability of a Dermatology Fellowship by the British Association of Dermatology; Announcement of a symposium by the European Society for Dermatological Research and the International Society of Dermatopathology; Conduction of the annual meeting of the British Society for Paediatric Dermatology.

Provides updates on dermatology in Great Britain. Venue for the annual meeting of the European Society for Dermatological Research; Alteration to the scheduled symposium on pediatric dermatology; Establishment of the European Academy of Dermatology and Venereology.

Presents an abstract of the research paper 'Frictional Dermatitis of Children,' by M. Al-Aboosi, F. Al-Momani, D.J. Todd and K. Al-Shibly presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Monoterpenoides and Tetralin as Pediculocides,' by A.M.R. Downs, K.A. Stafford and G.C. Coles presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Juvenile Colloid Milium,' by M.M.U. Chowdhury, S. Blackford and S. Williams presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Topical Steroid Phobia in Dermatology Outpatients With Atopic Eczema,' by C.R. Charman, A. Morris and H.C. Williams presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Mapping of Primary Congenital Lymphoedema (Milroy's Disease) to the 5q35.3 Region,' by J.L. Rosbotham, A.L. Evans, G.H. Brice, V. Sotirova, P. S. Mortimer, J. Beninson, K.G. Burnand, T.O. Nunan, A.H. Child and M. Sarfarazi presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Haploinsufficiency of Desmoplakin Causes a Striate Subtype of Palmoplantar Keratoderma,' by D.K.B. Armstrong, K.E. Mckenna, P.E. Purkis, K.J. Green, R.A.J. Eady I.M. Leigh and A.E. Hughes presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Presents an abstract of the research paper 'Unusual Pigmented Lesions in Children,' by C.S. Jury, P.M. Chenry, R. Lever and M. Fallowfield presented at the annual meeting of the British Society for Paediatric Dermatology in Great Britain.

Reports on developments related to dermatology in Great Britain as of October 1983. Distinction given to Renwick Vickers, winner of the Archibald Gray Medal for services to British Dermatology; Subjects that will be discussed in a course on pediatric dermatology on April 24-28, 1984 in France; Lectures and discussions that will be featured at the Fifth World Congress of Tropical Dermatology on October 16-20, 1984 in Mexico City, Mexico.

Reports developments related to dermatology in Great Britain as of October 1996. Prize announcement for dermatologists and photoimmunologists at the International Award for Photoimmunology; 8th International Congress of Pediatric Dermatology; Introductory Course on the Biology of the Skin.