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  • 1
    Online Resource
    Online Resource
    International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS service evaluation
    Oxford University Press (OUP) ; 2023
    In:  British Journal of Surgery Vol. 110, No. 4 ( 2023-03-30), p. 462-470
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 110, No. 4 ( 2023-03-30), p. 462-470
    Abstract: Absorbable or non-absorbable sutures can be used for superficial skin closure following excisional skin surgery. There is no consensus among clinicians nor high-quality evidence supporting the choice of suture. The aim of the present study was to determine current suture use and complications at 30 days after excisional skin surgery. Methods An international, prospective service evaluation of adults undergoing excision of skin lesions (benign and malignant) in primary and secondary care was conducted from 1 September 2020 to 15 April 2021. Routine patient data collected by UK and Australasian collaborator networks were uploaded to REDCap©. Choice of suture and risk of complications were modelled using multivariable logistic regression. Results Some 3494 patients (4066 excisions) were included; 3246 (92.9 per cent) were from the UK and Ireland. Most patients were men (1945, 55.7 per cent), Caucasian (2849, 81.5 per cent) and aged 75–84 years (965, 27.6 per cent). The most common clinical diagnosis was basal cell carcinoma (1712, 42.1 per cent). Dermatologists performed most procedures, with 1803 excisions (44.3 per cent) on 1657 patients (47.4 per cent). Most defects were closed primarily (2856, 81.9 per cent), and there was equipoise in regard to use of absorbable (2127, 57.7 per cent) or non-absorbable (1558, 42.2 per cent) sutures for superficial closure. The most common complications were surgical-site infection (103, 2.9 per cent) and delayed wound healing (77, 2.2 per cent). In multivariable analysis, use of absorbable suture type was associated with increased patient age, geographical location (UK and Ireland), and surgeon specialty (oral and maxillofacial surgery and plastic surgery), but not with complications. Conclusion There was equipoise in suture use, and no association between suture type and complications. Definitive evidence from randomized trials is needed.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znad008
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2006309-X
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  • 2
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    Online Resource
    Reasons for delayed antiretroviral therapy (ART) initiation in the era of early ART initiation guidelines: a retrospective service evaluation
    SAGE Publications ; 2019
    In:  International Journal of STD & AIDS Vol. 30, No. 4 ( 2019-03), p. 415-418
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 30, No. 4 ( 2019-03), p. 415-418
    Abstract: Following changes in national antiretroviral therapy (ART) guidelines removing the CD4 threshold for initiation of ART, we evaluated the time to ART initiation and reasons for delayed or non-initiation. A retrospective notes review of 292 newly diagnosed HIV-positive individuals attending two London clinics between August 2015 and December 2016 was performed. Two hundred and fifty-four of 292 (87%) individuals started ART. Median time to ART initiation was 29 days (range: 0–514). Thirty of 292 (13%) did not start ART. Rates of virological suppression at six months were similar regardless of time to ART initiation. People who inject drugs (16.7% vs. 3.6%) (p = 0.009), having a higher median baseline CD4 cell count (500 vs. 388 cells/mm 3 , p = 0.001), and having gastrointestinal/liver co-morbidities (23% vs. 9%, p = 0.001) were associated with delayed ART initiation. The cohort not on ART had a higher median baseline CD4 cell count (500 vs. 388 cells/mm 3 , p  〈  0.001). Documented reasons for delayed or ART non-initiation included patient’s choice, prolonged adjustment periods, and difficulty leaving work. We conclude that delayed or non-initiation of ART was associated with injecting drug use and prolonged adjustment to a new HIV diagnosis. Clinician factors may include lack of urgency with higher baseline CD4 cell counts. Improved linkage to care and drug services pathways may encourage timely ART initiation.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462418814985
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2009782-7
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  • 3
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    Online Resource
    Erythematous tender nodules on the legs with oily exudate
    Oxford University Press (OUP) ; 2023
    In:  Clinical and Experimental Dermatology Vol. 48, No. 6 ( 2023-06-05), p. 714-716
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 48, No. 6 ( 2023-06-05), p. 714-716
    Abstract: This 70-year-old woman presented with multiple tender erythematous nodules on her legs with some breaking down and discharging an oily substance. Histology showed extensive active chronic inflammation of the dermis and lobular panniculitis.
    Type of Medium: Online Resource
    ISSN: 0307-6938 , 1365-2230
    URL: Article
    DOI: 10.1093/ced/llad065
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004506-2
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  • 4
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    Online Resource
    Menopause, skin and common dermatoses. Part 1: hair disorders
    Oxford University Press (OUP) ; 2022
    In:  Clinical and Experimental Dermatology Vol. 47, No. 12 ( 2022-12-01), p. 2110-2116
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 47, No. 12 ( 2022-12-01), p. 2110-2116
    Abstract: Menopause, which usually occurs between the age of 45 and 55 years, is associated with falling oestrogen levels due to ovarian follicle depletion. The impact on the cardiovascular system and bone density are well documented; however, further research required to establish the impact on the skin and hair. In this first part of a four-part review, we examine the effect of menopause on the hair. We performed a literature review on dermatology and hair in menopause. Androgens and oestrogens are involved with regulation of the hair cycle, with a reduction in anagen hairs seen in postmenopausal women. Female pattern hair loss and frontal fibrosing alopecia have both been associated with the perimenopausal and postmenopausal states. It is clear that menopause and the change in hormone levels have an impact on the hair cycle and common hair conditions. However, further research is required, particularly to understand the therapeutic targets and role of hormonal therapy.
    Type of Medium: Online Resource
    ISSN: 1365-2230 , 0307-6938
    URL: Article
    DOI: 10.1111/ced.15327
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2004506-2
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  • 5
    Online Resource
    Online Resource
    Focal alopecia associated with a plaque
    Oxford University Press (OUP) ; 2023
    In:  Clinical and Experimental Dermatology Vol. 48, No. 3 ( 2023-03-01), p. 272-275
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 48, No. 3 ( 2023-03-01), p. 272-275
    Abstract: We report the case of a 65-year-old woman presenting with a 15-month history of recurrent episodes of focal alopecia at the site of a bluish plaque on the vertex of her scalp. Histopathological examination revealed an admixture of focally nested oval, dendritic or epithelioid melanocytes together with slender spindle cells and occasional melanocytes. The spindle cells were positive for S100 and focally positive for epidermal membrane antigen, while the melanocytes were positive for S100 and Melan A.
    Type of Medium: Online Resource
    ISSN: 0307-6938 , 1365-2230
    URL: Article
    DOI: 10.1093/ced/llac030
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004506-2
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  • 6
    Online Resource
    Online Resource
    Menopause, skin and common dermatoses. Part 2: skin disorders
    Oxford University Press (OUP) ; 2022
    In:  Clinical and Experimental Dermatology Vol. 47, No. 12 ( 2022-12-01), p. 2117-2122
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 47, No. 12 ( 2022-12-01), p. 2117-2122
    Abstract: In this second part of a four-part review, we examine the effect of menopause on the skin. Menopause and the associated hypo-oestrogenic state have implications for the structure and function of the skin. We performed a literature review to investigate the impact of the menopause on common dermatoses. There is evidence that oestrogen is implicated in transepidermal water loss and reduction in dermal collagen. There are associations with menopause and multiple common dermatoses, including xerosis and pruritus, hidradenitis suppurativa and psoriasis. Menopause has a clear impact on the skin and common dermatological conditions. Further research to understand the mechanisms and explore therapeutic options is needed.
    Type of Medium: Online Resource
    ISSN: 1365-2230 , 0307-6938
    URL: Article
    DOI: 10.1111/ced.15308
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2004506-2
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  • 7
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    Online Resource
    Menopause, skin and common dermatoses. Part 4: oral disorders
    Oxford University Press (OUP) ; 2022
    In:  Clinical and Experimental Dermatology Vol. 47, No. 12 ( 2022-12-01), p. 2130-2135
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 47, No. 12 ( 2022-12-01), p. 2130-2135
    Abstract: The physiological impact of declining oestrogen levels during menopause has been well documented. We conducted a literature review to assess the impact of menopause on oral health. Falling oestrogen levels are associated with adverse effects on the gingival, oral and buccal epithelia. The symptoms prevalent in perimenopausal and postmenopausal women range from dry mouth to immune-mediated mucocutaneous disease and burning mouth syndrome. Our review has highlighted the need for further research into potential treatments for oral symptoms in menopause, particularly with regard to hormone replacement therapy.
    Type of Medium: Online Resource
    ISSN: 1365-2230 , 0307-6938
    URL: Article
    DOI: 10.1111/ced.15341
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2004506-2
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  • 8
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    Online Resource
    Menopause, skin and common dermatosis. Part 3: genital disorders
    Oxford University Press (OUP) ; 2022
    In:  Clinical and Experimental Dermatology Vol. 47, No. 12 ( 2022-12-01), p. 2123-2129
    Details
    In: Clinical and Experimental Dermatology, Oxford University Press (OUP), Vol. 47, No. 12 ( 2022-12-01), p. 2123-2129
    Abstract: Oestrogen plays a vital role in maintaining a normal vulvovaginal epithelium, vaginal lubrication, as well as a healthy microbiome to ensure an acidic pH. The decrease in oestrogen levels in women going through menopause results in both physiological and physical changes of the genitourinary system, and more specifically the vulva. We conducted a literature review on the effects of low oestrogen levels on the physiology and function of the vulva and the vulvovaginal epithelium. ‘Genitourinary syndrome of menopause’ (GSM) is the term used to describe the signs and symptoms of a low oestrogen state. The symptoms and signs of GSM can overlap or coexist with other vulval dermatoses. Expert opinion is needed to diagnose and manage vulval dermatoses in menopause. This article will discuss the signs and symptoms of GSM, as well as the different management options available. Other vulval dermatoses that can be affected by hypo-oestrogenism are also reviewed.
    Type of Medium: Online Resource
    ISSN: 1365-2230 , 0307-6938
    URL: Article
    DOI: 10.1111/ced.15400
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2004506-2
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