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Found 27 results
  1. News Article
    Rhiannon Kennedy-Chapman’s early twenties could hardly be described as the best years of her life. Covered in grazes, open sores and dry skin, she was at a loss as to why her body was continuously failing her, despite her efforts to follow medical advice and take her steroid medication. Having used both steroid cream and oral tablets since suffering from eczema as a child, she had little concern about the medication when she was once again prescribed it for small patches of eczema. “It worked for a bit and then it would stop working. The GP would give me a higher dose and the pattern went on for many months. I went through four different strengths – it would work for a short period of time and when I stopped using it, it would come back even fiercer. Little did she know that she was suffering from topical steroid withdrawal (TSW), a rare skin condition caused by the repeated use and cessation of steroid creams. A 2021 report by the Medicines and Healthcare Products Regulatory Agency (MHRA) gave guidance on the risks of TSW and it is now included as patient information for all prescribed topical steroids. Patients can now also report their suspected reactions to topical steroids via the MHRA’s “yellow card scheme” and eczema charities have called for further research into the causes and long-term effects of TSW. Andrew Proctor, chief executive of the National Eczema Society, said it was calling on the UK medicines regulator, the MHRA, to introduce clearer strength and potency labelling of topical steroids to support their safe and effective use. “This change needs to happen and is supported by patients and healthcare professional bodies,” he said. Read full story Source: The Independent, 5 September 2023
  2. News Article
    A trust has been accused of presiding over the deterioration of a key service amid communication problems between senior leaders and a ‘worrying series of resignations’ which has left the department with ‘no doctors’. The British Association of Dermatologists wrote to Worcestershire Acute Hospitals Trust on 13 July to request an urgent meeting with the provider’s management to discuss the matter. The letter, seen by HSJ, outlines fundamental patient safety and staffing concerns about the trust’s dermatology service and accuses the trust of putting “continued communication barriers” between clinicians and management. The letter, signed by BAD president Mabs Chowdhury, says there are now “no doctors in the department” after two consultants and a locum consultant resigned “due to apparent unhappiness with the running of services [and in] a continuation of a worrying series of resignations”. Read full story (paywalled) Source: HSJ, 19 July 2023
  3. Content Article
    In 2022, an illustration of a Black foetus in the womb by Nigerian medical illustrator and medical student Chidiebere Ibe, went viral. The image sparked an important conversation around representation in medical imagery and the impact this has on health outcomes for patients who are Black, Indigenous and people of colour (BIPOC). Research showed that only 5% of medical images show dark skin and only 8% of medical illustrators identified as BIPOC. A collaboration between Chidiebere Ibe, Deloitte and Johnson & Johnson, Illustrate Change aims to build the world's largest library of BIPOC medical illustrations for use in medical education and training. So far, the library contains images relevant to the following specialties: Dermatology Eye disease General health Haematology Maternal health Oncology Orthopaedics
  4. Content Article
    Little information is available about the effect of childhood atopic dermatitis (AD) on family function. The aim of this study was to identify the areas of family life most affected and their perceived importance. Intensive qualitative interviews with 34 families were conducted and 11 basic problem areas were identified. 
  5. Content Article
    The Dermatitis Family Impact (DFI) questionnaire is a disease‐specific measure to assess the impact of atopic eczema on the quality of life (QoL) of the parents and family members of affected children. The authors set out to review the published literature and to collate data on the clinical and psychometric aspects of the DFI questionnaire from its development in 1998–2012, in order to create a single source of reference for users of the DFI.
  6. News Article
    Artificial intelligence (AI) systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests. The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts. NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or “train” AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin. Dr David Wen, first author of the study from the University of Oxford, said: “You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you’re only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use." “Alternatively, if the regulators are a bit more relaxed and say: ‘OK, you can use it [on all patients]’, the algorithms may not perform as accurately on populations who don’t have that many images involved in training.” That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said. Read full story Source: The Guardian, 9 November 2021
  7. News Article
    At least 18 serious cases are being investigated by NHS bosses after GP and dermatology services were stripped from private medical company. The Kent and Medway Clinical Commissioning Group (CCG) confirmed on Monday an independent review was taking place. It will see if delays to treatment for thousands of patients using DMC Healthcare services "caused harm". The NHS removed contracts worth £4.1m a year from the private firm in July. DMC was responsible for nearly 60,000 patients at nine surgeries in Medway, and skin condition services in other parts of Kent, the Local Democracy Reporting Service said. In north Kent, there were 1,855 patients needing urgent treatment and a further 7,500 on the dermatology service waiting list. Of those, 700 had been waiting more than a year. Nikki Teesdale, from Kent and Medway's CCG, said it was "too early" to reach definitive conclusions around the 18 serious cases. Speaking to Kent and Medway's joint health scrutiny committee on Monday she said of the 18, five had been waiting "significant periods of time" for cancer services. "Until we have got those patients through those treatment programmes, we are not able to determine what the level of harm has been," she added. Read full story Source: BBC News, 29 September 2020
  8. News Article
    A website is helping healthcare professionals and the public recognise whether a rash could be a sign of COVID-19. The covidskinsigns site carries more than 400 images of rashes collected via the COVID Symptom Study app, which was set up during the first wave of the pandemic to gather information from the public about the signs and symptoms of virus. According to the British Association of Dermatologists, which developed the website, the most common skin rashes are urticaria (a hive-like rash), a ‘prickly heat’ or chickenpox-type rash, and redness that looks like chilblains on the fingers or toes. Rash was added as a sign to the app, which has been downloaded by 4 million people in the UK – reports emerged last spring of rashes in patients admitted to hospital with COVID-19. In August 2020, Mid Yorkshire Hospitals NHS Trust vascular nurse consultant Leanne Atkin warned discoloured toes could be a sign of COVID-19. She spoke out following a rise in the number of patients presenting to vascular clinics with signs that could be attributable to arterial disease. However, Dr Atkin said these patients often go on to test positive for COVID-19. Dubbed ‘COVID toe’, the condition can have a similar appearance to chilblains, which commonly cause swelling and redness at the ends of toes and fingers, and was first identified as a sign of COVID-19 by podiatrists in Spain in April 2020. Read full story Source: Nursing Standard, 29 January 2021
  9. News Article
    Google has unveiled a tool that uses artificial intelligence to help spot skin, hair and nail conditions, based on images uploaded by patients. A trial of the "dermatology assist tool", unveiled at the tech giant's annual developer conference, Google IO, should launch later this year, it said. The app has been awarded a CE mark for use as a medical tool in Europe. A cancer expert said AI advances could enable doctors to provide more tailored treatment to patients. The AI can recognise 288 skin conditions but is not designed to be a substitute for medical diagnosis and treatment, the firm said. Read full story Source: BBC News, 18 May 2021
  10. Content Article
    Patients and providers often don't recognise skin cancer on darker skin. Medical school faculty and students are trying to change that.
  11. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Kathy tells us about the importance of breaking down barriers to share patient safety tools, and talks about changes she has implemented to make surgery safer.
  12. News Article
    One of the NHS’s biggest hospital trusts has declared its cancer waiting list is now at an ‘unmanageable size’. Mid and South Essex Foundation Trust leaders set out the stark judgement in a paper for its July board meeting, held last week. The report said: “The 62-day [referral to treatment backlog as of 3 July] has increased for the second consecutive week to 1,055. “[The cancer patient tracking list] is getting bigger and has reached an unmanageable size. Referral rates have plateaued from March 2021 [but] treatment rates have not increased in line with PTL growth. “This points to a noisy PTL, where the hospital is extremely busy managing patients who do not have cancer.” The paper also said NHS England had recognised the trust’s 62-day cancer target needed to be delivered “in more realistic and achievable stages”. It highlighted particular concerns around a “serious” demand and capacity problem in its dermatology department which contributed to almost half of its 62-day backlog. The trust had 445 62-day RTT cancer breaches in dermatology alone in May, the latest data reported. Read full story (paywalled) Source: HSJ, 22 July 2022
  13. News Article
    More men are dying from melanoma skin cancer than women in the UK, Cancer Research UK is warning as the country's heatwave continues. Rates of the cancer, which can develop in sun-damaged skin, have been rising in both men and women in recent years. Late diagnosis may be part of the reason why men are faring worse. Melanoma is treatable if it is diagnosed early - the charity is urging people to take care in the sun and get any unusual skin changes checked. Melanoma death rates have improved for women in the last 10 years, but not for men. Michelle Mitchell, chief executive of Cancer Research, says the figures "drive home the importance of sun safety". "We all need to take steps to protect ourselves from the sun's harmful UV rays. Getting sunburnt just once every two years can triple your risk of skin cancer," she adds. Read full story Source: BBC News, 15 July 2022
  14. News Article
    Commissioners have begun a ‘serious incident review’ across their integrated care system after early indications showed patients may have suffered harm due to long waits for cancer treatment. The review has been launched by Somerset Integrated Care Board into dermatology services after an initial review found five of 50 patients had seen their skin lesions increase in size since being referred to hospital by their GPs. ICB board papers stated “potential patient harm has been identified” for those patients, who were on the two-week wait pathway to be seen by a specialist following a referral by their GP. Read full story (paywalled) Source: HSJ, 3 February 2023
  15. Content Article
    This article in the American Journal of Nursing provides basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure the performance of effective skin assessments in all patients.
  16. News Article
    The adverts promise beautiful legs, zero risk, and treatment in as little as 15 minutes. But unregulated injections to “eliminate” varicose veins are putting clients at risk of serious health complications, surgeons have warned. Vein removal treatments costing as little as £90 a session are being offered by beauticians without medical supervision across the UK, Observer analysis has found. Promoted with dramatic before and after photos and billed as a quick fix, microsclerotherapy involves the injection of a chemical irritant to disrupt the vein lining. This causes the vein walls to stick together, making it no longer visible on the skin. When performed correctly on finer veins, known as “thread” or “spider” veins, the procedure is generally considered safe, provided no underlying issues are present. But beauticians and other non-healthcare professionals are also offering vein treatments for people with varicose veins, which can signify underlying venous disease, analysis of promotional materials shows. In such cases, treatments should be performed by practitioners in a regulated clinic, where specialists first use ultrasound scans to assess the area. Conducting vein removal incorrectly or when there are underlying problems can lead to complications including leg ulcers, nerve damage, blood clots, stroke, allergic reactions and scarring, the Joint Council for Cosmetic Practitioners (JCCP) said. Even in cases where only thread veins are visible, other problems may be present. Prof Mark Whiteley, a consultant venous surgeon and chair of the Whiteley chain of clinics, said he had seen cases of women with leg ulcers and permanent scarring after treatment for varicose veins from non-medics. In other cases, people had paid for treatment but saw no effect because the underlying cause was not tackled. “It’s totally disgraceful,” he said. Read full story Source: The Guardian, 20 November 2022
  17. News Article
    A private company carrying out dermatology services has had its contract suspended by the NHS over concerns about patients safety. DMC Healthcare ran the service which oversaw the care of almost 2,000 patients in north Kent and Medway for more than a year. NHS bosses says those patients may have been harmed and the contract was suspended in June. A helpline has been set up to ensure affected patients are seen by GPs and follow-up treatment can be arranged. Paula Wilkins, Chief Nurse at Kent and Medway Clinical Commissioning Group, said: "In mid-June we suspended most of DMC's dermatology service when we became concerned about patient safety." "I'm very sorry to say, we now know there have been delays in appointments, including for the diagnosis and treatment of cancers, and that has exposed people to the risk of harm." Read full story Source: BBC News, 21 July 2020
  18. Content Article
    This webpage by the British Association of Dermatologists contains a selection of resources about skin cancer and sun safety for patients. it describes the different types of skin cancer, how to get moles checked and how to stay safe in the sun.
  19. Content Article
    Potassium permanganate is routinely used in the NHS as a dilute solution to treat weeping and blistering skin conditions, such as acute  weeping/infected eczema and leg ulcers. It is not licensed as a medicine. Supplied in concentrated forms, either as a ‘tablet’ or a solution, it  requires dilution before it is used as a soak or in the bath. These concentrated forms resemble an oral tablet or juice drink and if ingested are highly toxic; causing rapid swelling and bleeding of the lips and tongue, gross oropharyngeal oedema, local tissue necrosis, stridor, and gastrointestinal ulceration. Ingestion can be fatal due to gastrointestinal haemorrhage, acute respiratory distress syndrome and/or multiorgan failure. Even dilute solutions can be toxic if swallowed. A Patient Safety Alert issued in 20142 highlighted incidents where patients had inadvertently ingested the concentrated form, and the risks in relation to terminology and presenting tablets or solution in receptacles that imply they are for oral ingestion, such as plastic cups or jugs. A review of the National Reporting and Learning System over a two-year period identified that incidents of ingestion are still occurring. One  report described an older patient dying from aspiration pneumonia and extensive laryngeal swelling after ingesting potassium permanganate tablets left by her bedside. Review of the other 34 incidents identified key themes: healthcare staff administering potassium permanganate orally patients taking potassium permanganate orally at home, or when left on a bedside locker potassium permanganate incorrectly prescribed as oral medication. The British Association of Dermatologists (BAD) ‘Recommendations to minimise risk of harm from potassium permanganate soaks’ includes advice on formulary management, prescribing, dispensing, storage, preparation and use, and waste.
  20. Content Article
    Skin cancer is one of the most common cancers worldwide, with one in five people in the US expected to receive a skin cancer diagnosis during their lifetime. Detecting and treating skin cancers early is key to improving survival rates. This blog for The Medical Futurist looks at the emergence of skin-checking algorithms and how they will assist dermatologists in swift diagnosis. It reviews research into the effectiveness of algorithms in detecting cancer, and examines the issues of regulation, accessibility and the accuracy of smartphone apps.
  21. Content Article
    Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world.
  22. Content Article
    Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
  23. Content Article
    This website has been created by the British Association of Dermatologists to provide images of possible skin signs of COVID-19, collected by the COVID Symptom Study App, to help increase understanding of the disease.
  24. Content Article
    A blog highlighting the barriers in healthcare faced by patients due to the colour of their skin.
  25. Content Article
    In this article for Forbes, Dana Brownlee looks at individuals who are promoting inclusion in healthcare in practical, tangible ways. She looks at the work of Nigerian medical illustrator Chidiebere Ibe, who is depicting black skin in his medical illustrations, and of Toby Meisenheimer, who developed a business selling plasters of different skin tones. She highlights the importance of individuals who disrupt the norms of healthcare to make it more representative of the populations it serves. She also talks about the dangers to patient safety caused by lack of representation, particularly in fields such as dermatology that rely on images of skin for accurate diagnosis.
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