Search

BACKGROUND Social networks have become a means for disseminating information on health-related matters. OBJECTIVE Describe the characteristics and analyze the accuracy of the dermatology content that is most often shared on the most popular social networks. MATERIALS AND METHODS The content most often shared on social networks (Facebook, Pinterest, Twitter, and Reddit) between March 2019 and March 2020 was analyzed using the keywords: acne, alopecia/hair loss, psoriasis, eczema, melanoma, skin cancer, rash, and rosacea. The total number of interactions, skin disease, topic, and origin was collected from each of the records. The content was analyzed and was categorized as precise, confusing, or imprecise based on the scientific evidence available. RESULTS A total of 385 websites were included. About 44.7% of the shared content was rated as imprecise, 20% as confusing, and 35.3% as precise. The records classified as imprecise obtained a higher mean number of interactions (P

Resumen Antecedentes La fototerapia es una opcion terapeutica empleada en dermatitis atopica (DA) y recomendada en multiples guias. Objetivos Evaluar la eficacia de las distintas modalidades de fototerapia y fotoquimioterapia en el tratamiento de pacientes con DA moderada-grave, mediante una revision sistematica. Material y metodos Consideramos los ensayos clinicos aleatorizados (ECA) realizados en pacientes con DA, aceptando cualquier medida de desenlace. Localizamos los articulos mediante una busqueda electronica, utilizando Medline (via Ovid), Embase y Cochrane Central Register of Controlled Trials. Adicionalmente, buscamos los ensayos clinicos registrados en Current Controlled Trials y en la WHO International Clinical Trials Registry Platform. Resultados Incluimos 21 ECA en el analisis cualitativo (961 pacientes). Dos ECA incluyeron ninos y adolescentes (32 pacientes). Las modalidades UVBBE y UVA1 mostraron resultados de eficacia similares en diversas medidas de desenlace. Dos ECA incluyeron la terapia PUVA. No se describieron efectos secundarios graves. En general, el riesgo de sesgos fue elevado y la calidad de las publicaciones baja, en cuanto a comunicacion de la metodologia empleada y los resultados obtenidos. Conclusiones Existe evidencia para el uso de UVBBE y UVA1 en DA moderada-grave. La evidencia para el uso de PUVA en DA es minima, asi como los datos del uso de la fototerapia en la infancia. En futuros estudios seria recomendable estandarizar los criterios de gravedad de la DA y las escalas de valoracion de los pacientes, homogeneizar las tecnicas de irradiacion y establecer un periodo de seguimiento minimo.

Background Phototherapy is a treatment option for atopic dermatitis recommended by several guidelines. Objective To perform a systematic review of the efficacy of different modalities of phototherapy and photochemotherapy in moderate to severe atopic dermatitis. Material and methods We considered all randomized clinical trials (RCTs) performed in patients with atopic dermatitis, and accepted all outcome measures. Articles were identified via an online search of the MEDLINE (via Ovid) and Embase databases and the Cochrane Central Register of Controlled Trials. We also searched for clinical trials registered in Current Controlled Trials and in the World Health Organization's International Clinical Trials Registry Platform. Results Twenty-one RCTs (961 patients) were included in the qualitative analysis. Two of the trials included children and adolescents (32 patients). The efficacy of narrow-band UV-B and UV-A1 phototherapy was similar for the different outcome measures contemplated. Two RCTs assessed the efficacy of psoralen plus UV-A therapy (PUVA). No serious adverse events were described. In general, the publications reviewed were characterized by a high risk of bias and poor reporting of methodology and results. Conclusions There is evidence for the use of narrow-band UV-B and UV-A1 phototherapy in moderate to severe atopic dermatitis. Evidence supporting the use of PUVA in atopic dermatitis is scarce and there is little information on the use of phototherapy in childhood. For the purpose of future studies, it would be advisable to use comparable criteria and scales for the evaluation of disease severity and patients, to standardize radiation methods, and to establish a minimum follow-up time.

Actinic keratoses are cutaneous lesions that appear as the result of the proliferation of atypical keratinocytes. These lesions are considered pre-malignant and they can progress to squamous cell carcinoma. Ingenol mebutate has been approved as an effective treatment for AK on the face and trunk. We studied the local skin reactions to this therapy. Data about local skin reactions were collected in a series of 5 patients with photographic documentation, a visual analog scale, and a ranking of satisfaction of the patient. Moderate to severe reactions were reported in most of patients, but only one stopped treatment early. The short duration of treatment contributes to high adherence to the therapy.

Introduction and objectives Systematic reviews —the most comprehensive type of literature review—should be taken into account before a clinical trial or a narrative review on a topic is undertaken. The objective of this study was to describe the use of systematic reviews in clinical trials and narrative reviews in dermatology. Material and methods This was a descriptive cross-sectional study. We selected randomized clinical trials and narrative reviews from the dermatological clinical research journals identified as most important (according to impact factor) and from Actas Dermosifiliograficas , and studied the bibliographies to ascertain whether the authors made reference to existing systematic reviews and Cochrane reviews. Results Of the 72 clinical trials for which a systematic review was available, 24 (33.3%) cited at least 1 review; reference was made to relevant Cochrane reviews in 15.6% of cases and to non-Cochrane reviews in 32%. In the case of the 24 narrative reviews for which a review was available, 10 (41.7%) cited at least 1 review; Cochrane reviews were cited in 20% and non-Cochrane reviews in 35.3%.In the case of Actas Dermosifiliograficas , very few clinical trials were found and the findings for narrative review articles were similar to those observed for the other journals. Conclusions Systematic reviews are not often taken into account by the authors of clinical trials and narrative reviews and this may lead to redundant studies and publications. Authors appear to use Cochrane reviews even less than non-Cochrane reviews and are therefore ignoring one of the main sources of available evidence.

Resumen Introduccion y objetivos Las revisiones sistematicas son la forma de revision mas exhaustiva y deberian ser consideradas antes de realizar un ensayo clinico o revision sobre un tema. El objetivo de este estudio es describir la utilizacion de revisiones sistematicas en los ensayos clinicos y revisiones narrativas publicadas en dermatologia. Material y metodos Se diseno un estudio descriptivo transversal. Se seleccionaron ensayos clinicos aleatorizados y revisiones narrativas de las revistas mas relevantes (por factor de impacto) de investigacion clinica de dermatologia y de Actas Dermosifiliograficas y se evaluo si hacian referencia a revisiones sistematicas y Cochrane (en caso de existir) en la bibliografia. Resultados En el grupo de ensayos clinicos se hacia referencia a alguna de las revisiones sistematicas existentes en el 33,3% de los articulos (15,6% de las revisiones Cochrane que existian y 32,2% de las no Cochrane sobre el tema). En el grupo de revisiones narrativas alguna de las revisiones sistematicas existentes eran referenciadas en el 41,7% de los trabajos (20% Cochrane y 35,3% no Cochrane). En Actas Dermosifiliograficas existian muy pocos ensayos clinicos publicados; las revisiones narrativas reproducian lo que se observaba en el resto de revistas. Conclusiones Las revisiones sistematicas son poco tenidas en cuenta en la realizacion de ensayos clinicos y revisiones narrativas, lo que puede llevar a estudios y publicaciones redundantes. Ademas las revisiones Cochrane parecen ser incluso menos empleadas, obviando asi los autores una de las principales fuentes de evidencia existentes.

Background To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. Objective We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. Methods This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. Results In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). Limitations The retrospective design is a limitation. Conclusions Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.

Background: References have been made in the literature to the funding of clinical trials by the pharmaceutical industry. Other types of funding, however, have been less well studied. Objective: To describe the sources of funding for research by Spanish dermatology departments published in 2008. Material and methods: A bibliometric study was performed of the research articles published by Spanish, French, and British dermatology departments and by Spanish rheumatology departments in 2008 according to MEDLINE records. Results: Articles published by Spanish dermatology departments received funding in 36.4% of cases. This percentage is lower than that found for the other groups studied and remained low for all different types of funding. Statistically significant relationships were found between a higher percentage of funding and a higher level of evidence, as well as between a higher level of funding by the pharmaceutical industry and the publication of research into quality of life and pharmacological treatment. Inadequate declaration of funding was observed in 57.1% of articles from Spanish dermatology departments and the role of the sponsor was not declared in any article. Similar findings were obtained for the other groups studied. Conclusions: The proportion of research articles published by Spanish dermatology departments that receive external funding is low, and this is associated with a lower level of scientific evidence. In order to obtain more external funding, we must improve our competitiveness. © 2010 Elsevier Espana, S.L. and AEDV. All rights reserved.

Resumen Introduccion Existen referencias en la literatura acerca de la financiacion de los ensayos clinicos por la industria farmaceutica. Otros tipos de financiacion han sido menos evaluados. Objetivos Describir la presencia de financiacion y su tipo en la investigacion realizada por los Servicios de Dermatologia espanoles en el ano 2008. Material y metodos Estudio bibliometrico de los articulos de investigacion publicados por Servicios de Dermatologia espanoles, franceses y britanicos y Servicios de Reumatologia espanoles en el ano 2008, indexados en Medline. Resultados El porcentaje de financiacion de los articulos de investigacion publicados por Servicios de Dermatologia espanoles fue del 36,4%, siendo este porcentaje menor en comparacion con los restantes grupos estudiados, y manteniendose bajo para los distintos tipos de financiacion. Existen relaciones significativas entre un mayor porcentaje de financiacion y un mayor nivel de evidencia, asi como entre un mayor porcentaje de financiacion por la industria y los temas de calidad de vida y de tratamiento farmacologico. En un 57,1% de los articulos de investigacion dermatologica espanola no se declara la financiacion de modo adecuado y en ninguno se indico el papel del financiador. Estos ultimos hallazgos fueron similares para los restantes grupos estudiados. Conclusion El porcentaje de financiacion externa en los articulos de investigacion publicados por Servicios de Dermatologia espanoles es bajo, y se relaciona con menor nivel de evidencia cientifica que los restantes grupos estudiados. Se propone la necesidad de aumentar nuestra competitividad para obtener mayor financiacion externa.

Dystrophic epidermolysis bullosa (DEB) is a rare disease that represents a heavy burden for both the patient and the health care system. There are currently no data on the prevalence of DEB in Spain.To determine the prevalence of DEB in Spain.We used data from 3 incomplete population-based sources (hospital dermatology departments, diagnostic laboratories performing antigenic mapping, genetic testing or both, and the Spanish Association of Epidermolysis Bullosa Patients [DEBRA]) and combined them using the 3-source capture-recapture methodology.We identified 152 living DEB patients. The estimated prevalence of DEB was 6.0 cases per million (95% CI, 4.2-11.8) in adults and 15.3 (95% CI, 10.4-40.8) in children under 18 years of age. The data indicated that 77% of the patients were not being followed up in specialized centers of reference; 65% had not had a genetic diagnosis, and 76% were not members of DEBRA.The prevalence of DEB in Spain is 6.0 patients per million (95% CI, 4.2-11.8), a figure higher than previous estimates in many areas, but similar to those found in other southern Europe countries. The north-south difference may represent real geographic differences in prevalence, but it might be due to the fact that most of the data come from registries with a lower than expected catchment. Many patients are not being followed up in centers of reference, do not have genetic diagnosis, and are not members of patients' associations, suggesting that there is room for considerable improvement in their care.

Background The ichthyoses comprise a group of inherited disorders of keratinization. Because of the need for lifelong treatment, it is important that therapies are beneficial, safe, and well tolerated. Objectives We sought to review the evidence on existing treatments for the congenital ichthyoses, excluding ichthyosis vulgaris. Method We undertook a systematic review using the methodology of the Cochrane Collaboration. Articles published in MEDLINE, EMBASE, and CENTRAL and registered clinical trials were screened. Randomized controlled trials involving patients with the inherited ichthyoses, either syndromic or nonsyndromic but excluding ichthyosis vulgaris, were considered. Results Six trials met the inclusion criteria. Topical treatments including 5% urea, 20% propylene glycol alone or in combination with 5% lactic acid, calcipotriol ointment, and liarozole 5% cream showed therapeutic benefit. Oral liarozole, a retinoic acid metabolism blocking agent, showed no advantage over oral acitretin. Limitations Most studies were performed on a small sample of patients and lacked methodological and reporting quality. The small number of trials and the nearly constant positive results make publication bias likely. The absence of standardization of outcome measures precluded the comparison of studies. Conclusions Topical treatments including emollients, calcipotriol ointment, and liarozole cream seem to have therapeutic benefit and a good safety profile, although the use of topical calcipotriol is limited by a maximum weekly dose of 100 g. The advantage of oral liarozole over acitretin is uncertain. Multicenter trials comparing oral and topical interventions and evaluation of long-term outcomes are needed.

[Background]: Previous reports on the prevalence of autosomal recessive congenital ichthyosis (ARCI) were based on single source data, such as lists of members in a patient association. These sources are likely to be incomplete. [Objectives]: We sought to describe the prevalence of ARCI. [Methods]: We obtained data from 3 incomplete sources (dermatology departments, a genetic testing laboratory, and the Spanish ichthyosis association) and combined them using the capture-recapture method. [Results]: We identified 144 living patients with ARCI. Of these, 62.5% had classic lamellar ichthyosis and 30.6% had congenital ichthyosiform erythroderma. The age distribution included fewer elderly patients than expected. The prevalence of ARCI in patients younger than 10 years, the best estimate as less subject to bias, was 16.2 cases per million inhabitants (95% confidence interval 13.3-23.0). According to the capture-recapture model, 71% of the patients were not being followed up in reference units, 92% did not have a genetic diagnosis, and 78% were not members of the ichthyosis association. [Limitations]: The prevalence of ARCI in Spain and findings related to the Spanish health care system might not be generalizable to other countries. [Conclusions]: The prevalence of ARCI is higher than previously reported. Many patients are not being followed up in reference units, do not have a genetic diagnosis, and are not members of a patient association, indicating room for improvement in their care. Data suggesting a reduced number of older patients might imply a shorter life expectancy and this requires further study.

Introduction Clinical research is the form of research nearest to clinical practice. Material and methods For the years 1992, 1996, 2000, 2004, and 2008, we identified all indexed articles published by Spanish dermatologists and calculated the percentages corresponding to clinical research according to a previously validated definition; we then calculated the proportion of clinical research articles offering higher levels of evidence. For 2008, we compared these percentages to those of French and British dermatologists and Spanish rheumatologists. We also compared these groups’ rates of productivity in 2008 in relation to articles providing higher levels of evidence. Results In 2008, 36% of Spanish dermatologists’ publications reported clinical research; 7% were studies offering higher levels of evidence. The proportions did not change significantly over the period studied. Clinical research publications accounted for 35% and 43% of the articles by French and British dermatologists in 2008 and 54% of articles by Spanish rheumatologists in that year. The proportion of publications reporting clinical research was significantly higher for Spanish rheumatologists than for Spanish dermatologists. The proportions of publications offering higher levels of evidence were significantly different in 2008 only for the comparison between Spanish dermatologists and rheumatologists. Other differences were not statistically significant. In the comparison of rates of productivity in clinical research offering higher levels of evidence, British dermatologists were significantly more productive than Spanish dermatologists. Discussion Differences were observed in relation to specialty (Spanish dermatologists vs rheumatologists) and nationality (Spanish vs British dermatologists). Conclusions The reasons for the differences identified need to be studied in order to improve this situation.

Chronic ulcerated skin lesions and skin biopsies should be considered as wounds prone to tetanus