Academic Dermatology

Counseling for recreational drug use among patients with chronic inflammatory skin disease: A cross-sectional survey

2022-02-16T18:52:17+00:00

Multiple dermatologic diseases are associated with recreational drug use. Using a survey design, we approached patients with psoriasis, rosacea, and hidradenitis suppurativa to evaluate whether the patients had received counseling on drug use. In our sample, half of the patients with hidradenitis suppurativa were active smokers, and most had received smoking cessation counseling. Patients with psoriasis were also aware of an association with smoking yet not at the same rates as the hidradenitis suppurativa population. Future research is needed to corroborate this data in a larger sample, and to establish improved means to support lifestyle changes and interventions for dermatologic patients.

Peristomal Hidradenitis Suppurativa: A Case and Review of the Literature

2022-02-17T21:06:49+00:00

Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of apocrine gland-bearing skin that typically presents as deep, inflamed lesions in the axillary, inguinal, perineal, and mammary regions. We present a rare case of a man in his 60s with a history of HS who presented with a peristomal sinus tract, as well as non-healing, draining wounds around his stoma site that responded well to adalimumab therapy. A compounded clobetasol ointment with poly(ethelyene oxide) polymers (POLYOX^TM, Dupoont) was utilized to maintain stoma appliance adhesion, and his lesions effectively cleared with adalimumab.

Validation of Rash and Nonspecific Eruption Diagnoses Using ICD-9 and ICD-10 Codes

2022-04-13T11:16:50+00:00

Despite being common cutaneous findings in the hospital setting, cutaneous drug eruptions have not been thoroughly validated for administrative claims data. The purpose of this study was to validate primary discharge diagnoses for the ICD code rash or other nonspecific eruptions by finding the positive predictive value (PPV) and to determine how often it was used to indicate an eruption that was eventually determined to be a drug eruption. Two dermatologists independently examined each of 39 hospital patient encounters to assess the validity of the ICD code used by stating whether the code used was appropriate or inappropriate, per table 1 criteria. Since in most patients, a drug eruption was suspected, the Naranjo Adverse Drug Reaction Probability Scale was utilized to externally validate our findings. Our results yielded a PPV for nonspecific rashes of 94.87% (83.11-98.58%) for appropriateness of use. The mean Naranjo score for appropriately versus inappropriately coded cases was 5.7 versus 2.5, respectively, with a mean difference of 3.17568 (0.18833-6.16302), (pooled P-value = 0.0378). Out of the cases analyzed, 29/39 or 74% were confirmed to be drug-related. Our high PPV supports the validity of non-specific eruptions found in national patient databases and the high Naranjo criteria suggest that often, these eruptions are drug related, yet not confirmed at the point of discharge.

Study Protocol: Role of Intermittent Fasting on Disease Severity and Quality of Life in Psoriasis and Psoriatic Arthritis: A Single-Blind Parallel Group Randomized Control Trial

2023-01-01T19:52:35+00:00

BACKGROUND Psoriasis and psoriatic arthritis (PsA) have a strong association with obesity and metabolic syndrome. Despite patient interest in non-pharmacologic methods to treat psoriasis and manage overall health, there is insufficient data available to guide dietary counseling. OBJECTIVE This study aims to identify the role of a popular anti-inflammatory diet known as intermittent fasting (IF) in psoriasis and psoriatic arthritis (PsA). METHODS A single-blind parallel group randomized control trial will be performed in 60 patients who have been diagnosed with psoriasis or PsA. Patients will be assigned 1:1 to either the IF group or control group. Patients assigned to the IF group will follow a 16:8 fasting IF method for the first 12 weeks, followed by the resumption of their routine diet. Patients assigned to the control group will follow their routine diet for 24 weeks. RESULTS A total of 24 patients have been enrolled in our study, with a final enrollment goal of 60 patients. The final visit is foreseen for July 2023. CONCLUSIONS This study aims to identify the role of a popular anti-inflammatory diet known as intermittent fasting (IF) in the management of psoriasis and PsA. Publishing this data will allow all dermatologists and the National Psoriasis Foundation to provide a consistent, evidence-based recommendation for IF as a potential non-pharmacologic intervention for patients with psoriasis and psoriatic arthritis (PsA).