Homeless status and associations with treatment disparities for common skin conditions

Abstract

Study limitations include the retrospective design, data obtained from a single centre possibly being biased for patients with more severe AGA, lack of blinding and proper control, and operator-dependent variation in hair counting. Although PRP is reported as a monotherapy for AGA, it is likely that patients are using multiple treatment modalities by the time they or their physician decide to pursue adjuvant PRP. Hair specialists disagree on the number of PRP treatments needed before assessing clinical efficacy; 1,3 however, these arguments are often based on anecdotes. Our data reveal that it is possible to use quantitative trichoscopy to stratify therapeutic response to adjuvant PRP after two treatment sessions (i.e. 2 months after initial PRP injections). Many factors affecting PRP efficacy and treatment response (e.g. platelet and growth factor concentration, leucocyte content, platelet activation, centrifugation protocols, total treatment sessions, duration between sessions, and maintenance therapy) are unknown, and it is possible that initial 'nonresponders' may respond to PRP therapy with continued sessions. Future directions include further characterization of patient response to adjuvant PRP based on response to prior AGA therapies, disease duration prior to PRP initiation, and the amount of PRP delivered per treatment. We hope our findings will help physicians counsel patients on the therapeutic benefit(s) of adjuvant PRP, and inform patient decisions regarding further treatment.

Understanding Dermatologic Concerns Among Persons Experiencing Homelessness: A Scoping Review and Discussion for Improved Delivery of Care

“…76 A study describing treatment disparities for common skin conditions among PEH compared to the non-homeless population demonstrated a pattern of less diagnostic inquiry, less aggressive intervention and fewer recommendation for follow-up for common skin conditions, despite the same dermatologists treating the same groups. 75…”

A survey of dermatologic health-related quality of life and resource access in patients experiencing homelessness

“…Although limited by sample size, self-reporting bias, and generalizability to homeless populations outside of Utah, we identify important demographics and barriers to dermatologic care in this homeless population. As homelessness rates continue to increase and we continue to highlight disparities in dermatologic care, 4,5 dermatologists should recognize the impact of skin disease on HRQL and the resource limitations specific to this medically vulnerable population. z Chronic homelessness was defined as being homeless for longer than 1 year or having lived in 3 or more nonpermanent housing arrangements in the past year.…”

Resource-Limited Management of Presumptive Pyoderma Gangrenosum in an Unsheltered Patient

“…Dermatological conditions are some of the most common complaints seen in unsheltered homeless (USH) individuals [ 1 ]. These are often chronic and untreated and usually present in later stages when there is significant morbidity present.…”