Background
Although autologous non‐cultured melanocyte–keratinocyte transplantation is a treatment option for stable vitiligo, there is lack of long‐term maintenance data for this specific treatment.
Objective
To search for factors associated with long‐term maintenance of patients with stable vitiligo successfully treated with melanocyte–keratinocyte transplantation.
Methods
This was a single‐centre retrospective study including stable vitiligo patients who underwent successful melanocyte–keratinocyte transplantation in the National Center for Vitiligo, Riyadh, Saudi Arabia, between 1 January 2004 and 30 June 2015. Cox proportional hazard model was used to estimate factors associated with relapse at 6 years of followup. Co‐variates included, gender, type of vitiligo, age at vitiligo onset, age at surgical procedure, disease duration, disease stability, affected body surface area, treated surface area, fingertip involvement, type of recipient area treatment and recurrence defined as the onset of new lesions on previously untreated areas. The risk of developing relapse defined as re‐appearance of more than 10% depigmentation in a previously treated and repigmented site was considered as the main outcome.
Results
In total, 602 patients were included in the study of whom 410 (67%) were women. Mean age was 24.25 years [4.0–67.0]. Affected body surface area of less than 1% (adjusted HR = 0.37; P = 0.04) and mechanical dermabrasion (adjusted HR = 0.26; P = 0.03) were independently associated with lower rates of relapse. On the contrary, non‐segmental type of vitiligo (adjusted HR = 2.11; P = 0.03) and fingertip involvement (adjusted HR = 3.75; P = 0.01) were independently associated with higher rates of relapse.
Conclusions
Criteria for selecting patients with stable vitiligo for surgery should include careful assessment of vitiligo type including body surface area of vitiligo and involvement of fingertip before undergoing surgical procedure.
Social media have become the platform of choice for people seeking immediate access to information. They have become so ubiquitous and pervasive that many people are using them to research health care providers and communicate with them about their issues. This study looks into this phenomenon, focusing on how it affects people's thinking when deciding which doctor to see for skin-related concerns. Methodology A cross-sectional study was conducted among patients at Derma Clinic in Riyadh, Saudi Arabia. Data were collected using a validated self-administered questionnaire. A total of 365 patients were included in the analysis. Results Out of 365 participants, 44.9% visited the center for medical purposes, while 45.8% visited for cosmetic purposes. Sixty-six percent of the participants (n=241) went to a dermatologist they knew, and only 21% of those participants knew their dermatologist from social media (Twitter, Instagram, Snapchat, Facebook, and Telegram). About 44.54% preferred to know more about their dermatologists from Twitter, followed by Instagram 27.96%, Snapchat 24.64%, and Facebook 2.84%. A significant proportion of Instagram users came to the dermatology clinic for cosmetic purposes. Conclusion As per the findings of this study, we found the highest preferred way of knowing the doctor for medical or cosmetic purposes was through a friend, followed by a family member and social media. Although most of the participants still preferred to visit a dermatologist based on their friend's recommendation, social media offer patients a platform upon which to launch their search for a dermatologist. Among social media users, patients who visit dermatology clinics for medical reasons preferred Twitter, while those who came for cosmetic reasons preferred Instagram to follow their doctors, underlining the importance of aesthetic dermatology as a visual field.
Purpose
Vitiligo is a skin condition characterized by patchy depigmentation in the skin, affecting not just the physical well-being of patients, but also the mental, emotional, and social aspects of their lives. Social media provides a platform where patients can interact and share experiences, and for physicians and experts to disseminate knowledge on the disease. This study aimed to evaluate the accuracy and overall quality of vitiligo-related content on YouTube.
Methods
Thirty videos were screened by relevance according to the inclusion criteria. Videos were categorized as either healthcare or non-healthcare sources, and viewer engagement ratio was calculated for each. Three independent vitiligo experts rated the content using the following assessment tools: DISCERN, Accuracy in Digital-health Instrument (ANDI), and Global Quality Scale (GQS). Lastly, Cronbach’s alpha was used to estimate the inter-rater reliability and consistency.
Results
Most of the screened videos came from health-care sources (57%). Non-healthcare sources achieved a slightly higher viewer engagement ratio, although the difference is not statistically significant (
p
= 0.23). DISCERN score was low overall in most videos. However, DISCERN score was higher for health-care sources as compared to non-healthcare sources (30.5 ± 9.4 vs 22.7 ± 4,2,
p
= 0.009). Scores of ANDI and GQS were higher for health-care sources but not statistically significant. There was a good internal consistency in DISCERN rating among the evaluators (0.86).
Conclusion
Our study shows a low overall accuracy and quality of YouTube videos on vitiligo. It is recommended that health-care sources improve their information material in terms of quality and viewer engagement, as very little can be done to prevent non-healthcare sources in publishing their own videos. Efforts in educating the public on making distinction between evidence and non-evidence-based claims should also be taken.
Summary
Background
Imiquimod 5% cream is currently approved to treat several dermatologic conditions including actinic keratoses (AK), superficial basal cell carcinoma (sBCC), and genital warts. However, there are numerous studies published on the alternative off‐label uses of imiquimod cream. Photoaging of facial skin is an important use for topical skin treatments, yet few studies have evaluated the effect of imiquimod cream for this dermatological condition.
Methods
This was a prospective, noncomparative pilot study. We included 15 healthy subjects; out of them, 11 subjects completed the study. The subjects were instructed to apply imiquimod 5% cream to the periorbital area on three nonconsecutive days per week for eight consecutive weeks. Photographs were obtained at baseline and after 8 weeks of treatment. Improvement in overall periorbital skin appearance was assessed by an independent investigator who compared the baseline and post‐treatment clinical photographs. In addition, post‐treatment self‐assessment was completed by the subjects using a 5‐point Likert scale.
Results
Eleven of the 15 subjects completed the 8‐week regimen. Eight participants (72.7%) noticed at least a fair improvement in periorbital skin changes based on the self‐assessed 5‐point Likert scale. Quartile score was also assessed by the investigator which indicated that seven subjects (63.6%) had at least 26% improvement. Based on Fitzpatrick wrinkle‐scoring system, there was a significant reduction in the subjects' wrinkle severity following treatment (6.8 [mean] ± 1.7 [SD] vs 4.6 ± 2.5 [P < 0.005]).
Conclusions
Imiquimod 5% cream may be a safe alternative anti‐aging treatment. Larger scale studies are needed to confirm these results.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.