METHODS: This is a 5-year retrospective audit on patients who underwent phototherapy between 2011 and 2015.
RESULTS: There were 892 patients, M:F=1.08:1, aged from 4- 88 years, with a median age of 38.8 years who underwent phototherapy. Majority (58.9%) had skin phototype IV, followed by type III (37.7%) and type II (0.7%). There were 697(78.1%) who underwent NBUVB, 136 (15.2%) had topical PUVA, 22(2.5%) had oral PUVA, 12(1.4%) had UVA1 and 23(2.6%) had NBUVB with topical or oral PUVA/UVA1 at different time periods. The indications were psoriasis (46.6%), vitiligo (26.7%), atopic eczema (9.8%), pityriasis lichenoides chronica (5.3%), mycosis fungoides (3.9%), lichen planus (2.5%), nodular prurigo (2.2%), scleroderma (1.2%), alopecia areata (0.7%) and others. The median number of session received were 27 (range 1-252) for NBUVB, 30 (range 1-330) for topical PUVA, 30 (range 3-190) for oral PUVA and 24.5 (range 2-161) for UVA1. The acute adverse effects experienced by patients were erythema (18%), pruritus (16.3%), warmth (3.3%), blister formation (3.1%), cutaneous pain (2.4%), and xerosis (0.8%), skin swelling (0.7%) and phototoxicity (0.2%).
CONCLUSION: Narrow-band UVB was the most frequently prescribed phototherapy modality in our center. The most common indication for phototherapy in our setting was psoriasis. Acute adverse events occurred in a third of patients, although these side effects were mild.
OBJECTIVES: To develop a novel in vitro skin glycation model as a screening tool for topical formulations with antiglycation properties and to further characterize, at the molecular level, the glycation stress-driven skin ageing mechanism.
METHODS: The glycation model was developed using human reconstituted full-thickness skin; the presence of N(ε) -(carboxymethyl) lysine (CML) was used as evidence of the degree of glycation. Topical application of emulsion containing a well-known antiglycation compound (aminoguanidine) was used to verify the sensitivity and robustness of the model. Cytokine immunoassay, quantitative real-time polymerase chain reaction and histological analysis were further implemented to characterize the molecular mechanisms of skin ageing in the skin glycation model.
RESULTS: Transcriptomic and cytokine profiling analyses in the skin glycation model demonstrated multiple biological changes, including extracellular matrix catabolism, skin barrier function impairment, oxidative stress and subsequently the inflammatory response. Darkness and yellowness of skin tone observed in the in vitro skin glycation model correlated well with the degree of glycation stress.
CONCLUSIONS: The newly developed skin glycation model in this study has provided a new technological dimension in screening antiglycation properties of topical pharmaceutical or cosmeceutical formulations. This study concomitantly provides insights into skin ageing mechanisms driven by glycation stress, which could be useful in formulating skin antiageing therapy in future studies.
OBJECTIVES: To generate consensus among dermatologists on the content of an outpatient discharge checklist, to create one and to seek clinicians' opinions on its usefulness.
METHODS: Seventeen consultant dermatologists from five National Health Service trusts completed a 72-item Delphi questionnaire. A five-point Likert scale was used to rate each item for importance in contributing to a high-quality discharge decision. Eighteen clinicians completed a questionnaire evaluating checklist use.
RESULTS: Consensus was determined when ≥ 75% of consultants rated an item 'very important' or 'important'. There was strong inter-rater reliability (intraclass correlation coefficient = 0·958) and fair inter-rater agreement (Fleiss kappa = 0·269). There were 26 consensus-agreed items, condensed to 13 that formed the 'traffic-light' checklist. These are disease-related issues (diagnostic certainty, disease severity, treatment appropriateness, patient manageable in primary care, patient's benefit from follow-up), patient empowerment issues (understanding diagnosis and treatment outcome, having a clear plan, treatment side-effects, ability to self-manage) and addressing concerns (patient concerns, easy reaccess to secondary care, whether patient and clinician are happy with the decision). Twelve clinicians (67%) found the checklist useful, 11 (61%) wanted to use it in future, 10 (56%) thought it was useful for training and three (17%) said it helped their thinking. Clinicians suggested its use for auditing and for training clinicians and administrators.
CONCLUSIONS: Items were identified to create an outpatient discharge information checklist, which demonstrated high acceptability.