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Back for a new edition, Zoe Draelos' outstanding resource to cosmetic dermatology again provides a highly-illustrated, clinical guide to the full range of cosmetic skin treatments.Bringing together experts from research, industry, surgery and practice, it is structured in four distinct parts for easy navigation by the busy clinician:Basic Concepts - giving an overview of the physiology pertinent to cosmetic dermatology and the delivery systems by which treatments can take effect;Hygiene Products - evaluating cleansing and moisturising products;Adornment - looking at aesthetic techniques such as cosmetics, nail protheses and hair treatment;Antiaging - ie, injectables, resurfacing and skin contouring techniques, and the rapidly growing area of Cosmeceuticals.With over 300 high-quality images and key summary boxes throughout, this new edition incorporates the newest procedural innovations in this rapidly developing field. Perfect for all dermatologists, especially those specialising in cosmetic dermatology and whether hospital-based or in private practice, it provides the complete cosmetic regimen for your patients and will be an indispensable tool to consult over and over again.

Nursing home residents are often colonized with antibiotic-resistant bacteria. In this trial involving 28 nursing homes, decolonization with chlorhexidine and povidone–iodine reduced the risk of hospitalization for infection.

Background Halobacteria trueperi, an extremophilic microorganism thriving in high‐salt environments, produces extracellular polysaccharides with potential anti‐inflammatory and anti‐aging properties. However, its clinical efficacy in skin improvement remains unclear. This study focuses on H. trueperi TCI66207, isolated from the Pacific Ocean at a depth of 662 m near Hualien, and its potential to enhance skin parameters, aiming to develop a novel functional formulation for pharmaceutical and cosmetic use. Aims This sudy aims to evaluate the clinical efficacy of H. trueperi TCI66207 on various skin parameters and its potential for developing new functional cosmetic formulations. Patients/Methods A total of 40 subjects were recruited and randomly divided into two groups: the test group applied a serum containing H. trueperi TCI66207, while the placebo group used a basic serum. Subjects were instructed to apply the serum twice daily for 4 weeks. Skin parameters, including moisture, brightness, elasticity, pigmentation (spots and UV spots), texture, wrinkles, pores, and collagen density, were assessed before and after the 4‐week application period. Results After 4 weeks of using the H. trueperi TCI66207 serum, significant improvements were observed in all measured skin parameters compared to baseline, with notable enhancements in moisture, brightness, elasticity, texture, and collagen density, along with reductions in wrinkles, spots, and pore size. Conclusions Halobacteria trueperi TCI66207 serum demonstrates a clear ability to improve skin conditions and delay signs of aging, making it a promising candidate for the development of new cosmetic formulations with potent anti‐aging and skin‐rejuvenating properties.

To examine the impact of an educational approach incorporating behavioral modification and the Health Belief Model on the adherence to skin moisturizing care, itch severity, self-efficacy, and quality of life among individuals diagnosed with psoriasis vulgaris. A study involving 108 psoriasis vulgaris patients (November 2022–October 2023) utilized random allocation to form experimental and control groups. The control group received standard care, including medication guidance, general health education, and basic nursing support. In contrast, the experimental group underwent an enhanced intervention that combined behavior modification techniques and education based on the Health Belief Model. This included biweekly educational sessions, personalized behavioral assessments, and self-monitoring tools like self-supervision cards, which were not provided to the control group. Assessments pre- and post-intervention measured itchiness, self-efficacy, and quality of life. Comparative analyses included pruritus, self-efficacy, adherence, and quality of life using various scales. The study aimed to evaluate the impact of combined interventions on these parameters in psoriasis patients. Following the intervention, both groups exhibited improvements in itching degree, itching frequency, and affected areas compared to pre-intervention levels, with the experimental group showing superior outcomes over the control group. GSES scores in both groups increased post-intervention, with the experimental group surpassing the control group. Both groups demonstrated enhanced scores post-intervention across various aspects, including forgetting to use medication, willingness to use medication, influencing factors, medication timing, frequency, and quality of life (assessed by DLQI). Furthermore, MORISKY scores for medication timing, frequency, and self-discontinuation decreased in both groups post-intervention, with the experimental group recording lower scores than the control group. DLQI scores for symptom feelings, daily life, leisure and recreation, work and study, interpersonal relationships, and treatment were reduced in both groups after the intervention, with the experimental group showing lower scores than the control group. Combining behavior modification and health belief model education effectively improves adherence to skincare, relieves itching in psoriasis patients, and enhances self-efficacy and overall quality of life.

Background L‐glutamine and linoleic acid (LA) can suppress inflammatory cytokine expression; however, studies on their simultaneous application are limited due to polarity differences. Aims To investigate the effect of glutamine linoleate vesicles (QLAsomes) on skin sensitization by assessing their impact on sensitization‐related protein expression, bacterial growth, and clinical efficacy in relieving skin itchiness. Methods After synthesizing and analyzing QLAsomes, their inhibitory effects on capsaicin‐induced cytokine expression and Staphylococcus aureus growth were evaluated. In a double‐blind clinical trial, 24 participants (ages 22–63) with sensitized skin applied 10 wt% QLAsome cream on one side and a vehicle or no cream on the other twice daily for 2 weeks. Itchiness in the elbow area was assessed using a visual analog scale and expert evaluation. Skin barrier changes were measured using transepidermal water loss (TEWL), skin erythema, and stratum corneum (SC) hydration. Results QLAsomes, formed by L‐glutamine and LA through hydrogen bonding, were spherical vesicles (164.6 ± 3.1 nm). Based on the inhibitory effects of L‐glutamine and LA on inflammation‐related factors, QLAsomes inhibited the capsaicin‐induced expression of these factors more effectively than the individual components. IL‐4 inhibition was improved by over 26%. Matrix metalloproteinase‐1, which degrades collagen, showed 32% and 23% improvements compared to L‐glutamine and LA, respectively. In a clinical evaluation, 10 wt% QLAsome cream reduced itching by 45% compared to before application, which is a 67% improvement compared to placebo. Skin evaluations revealed improvements in erythema (12%), TEWL (15%), and SC hydration (19%), suggesting that QLAsomes enhance the skin barrier function. Conclusions QLAsomes showed up to 32% higher expression inhibition of key skin sensitization‐related factors than individual components, and based on this, improved pruritus by 67% more than placebo. As nanovesicles with skin‐soothing properties, they are effective for drug encapsulation and managing skin sensitivity in pharmaceutical and cosmetic industries.

Purpose To profile the prescription for and adherence to breast cancer-related lymphedema (BCRL) self-care modalities among breast cancer (BrCa) survivors with BCRL in a 12-month randomized weightlifting trial. Methods We developed a questionnaire that assessed prescription for and adherence to 10 BCRL self-care modalities that included physical therapy exercise, pneumatic compression pump, medication, lymphedema bandaging, arm elevation, self-administered lymphatic drainage, therapist-administered lymphatic drainage, compression garments, skin care, and taping. We measured prescription for and adherence to BCRL self-care modalities at baseline, 3, 6, and 12 months. Longitudinal logistic regression was used to estimate the odds ratio (OR) and 95 % confidence interval (95 % CI) associated with prescription for and adherence to BCRL modalities over time. Results This study included 141 BrCa survivors with BCRL. Women were prescribed an average of 3.6 ± 2.1 BCRL self-care modalities during the study. The prescription for therapist-administered lymphatic drainage (OR = 0.92, 95 % CI 0.88–0.96), pneumatic compression pump use (OR = 0.94, 95 % CI 0.89–0.98), and bandaging (OR = 0.96, 95 % CI 0.93–0.99) decreased over 12 months of follow-up. No other prescribed BCRL self-care modalities changed during the study. Over 12 months, the average adherence to all BCRL self-care modalities varied with 13, 24, 32, and 31 % of women reporting <25, 25–49, 50–74, and ≥75 % adherence, respectively. Over 12 months, there was a noticeable change from high to low adherence in self-administered lymphatic drainage, such that there was a 15 % increased likelihood of adherence <25 % compared to ≥75 % (OR = 1.15 (95 % CI 1.05–1.26); p  = 0.002). The adherence patterns of all other modalities did not change over follow-up. Conclusions Our findings suggest the prescription for BCRL self-care modalities is variable. The average adherence to BCRL self-care was non-optimal. Future research is necessary to prepare BrCa survivors with the knowledge, skills, abilities, and resources necessary to care for this lifelong condition.

PurposeTo assess the effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy (CDT) on the management of patients with a breast cancer-related lymphedema (BCRL).MethodsFifty outpatients (average age of 56.2 ± 2.7 years, range 28–71) with a BCRL were enrolled for this study. Patients were randomly assigned (1:1 ratio) to receive either CDT consisting of skin care, manual lymphatic drainage, remedial exercises, and elastic compression garment (control group, n = 25) or CDT plus Linfadren® (study group, n = 25). Patients were evaluated before and after treatment and 3 months after the end of treatment. Primary outcomes were reduction of upper limb excess volume (EV) and percentage reduction of excess volume (%REV). Secondary outcomes were improvement in Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and patient’s perception of treatment effectiveness (PPTE).ResultsAddition of Linfadren® to CDT yielded an additional reduction of primary outcomes both after treatment (EV, − 521 ml vs. − 256 ml, P < 0.0001; %REV, − 66.4% vs. − 34%, P = 0.02) and at 3-month follow-up (EV, − 59 ml vs. + 24 ml, P < 0.0001; %REV, − 73.6% vs. − 31.4%, P = 0.004). Moreover, statistically significant differences were found between the two groups for the secondary outcomes after treatment (QuickDASH, P = 0.006; PPTE, P = 0.03) and at 3-month follow-up (QuickDASH, P = 0.006; PPTE, P = 0.02). No patient showed adverse events.ConclusionsLinfadren® in addition to CDT was a safe and effective therapy for reducing BCRL and was better than CDT alone.

Background In geriatric and long-term care settings, intertrigo seems to be common, but generalizable epidemiological estimates are lacking. Aim of this study was to measure the prevalence of intertrigo in aged nursing home residents and to identify possible relationships with demographic and health characteristics. Methods A cross-sectional prevalence study was conducted between September 2014 and May 2015 in a random sample of ten institutional long-term care facilities in Berlin, Germany. In total 223, aged long-term care residents were included. Mean age was 83.6 (SD 8.0) years and mean Barthel score was 45.1 (SD 23.8). Board certified dermatologists and study assistants performed skin assessments and measurements according to standard operating procedures. Mean differences and odds ratios between residents with and without intertrigo were calculated. Results The prevalence of intertrigo was 16.1% (95% CI 11.6 to 21.2%). The submammary fold was most often affected (9.9%), followed by the inguinal region (9.4%), axilla (0.5%) and abdominal region (0.5%). Increased age was statistically significantly associated with the presence of intertrigo (OR 1.05; 95% CI 1.00 to 1.10). Care dependency in bathing activities was associated with intertrigo. Obesity, sex and skin functional parameters were not associated with intertrigo. Conclusions Every sixth nursing home resident was affected by intertrigo indicating the high load of this skin condition in this population. Older age seems to be associated with intertrigo. Care dependency in bathing activities was likely to be associated with intertrigo. Structured skin care regimens are needed to prevent and treat intertrigo in this population. Trial registration This study is registered at https://clinicaltrials.gov/ct2/show/NCT02216526 . Registration date: 8th November 2014.

Background Pressure ulcers/injuries (PrUs), a critical concern for nursing homes (NH), are responsible for chronic wounds, amputations, septic infections, and premature deaths. PrUs occur most commonly in older adults and NH residence is a risk factor for their development, with at least one of every nine U.S. NH residents experiencing a PrU and many NHs having high incidence and prevalence rates, in some instances well over 20%. PrU direct treatment costs are greater than prevention costs, making prevention-focused protocols critical. Current PrU prevention protocols recommend repositioning residents at moderate, high, and severe risk every 2 h. The advent of visco-elastic (VE) high-density foam support-surfaces over the past decade may now make it possible to extend the repositioning interval to every 3 or 4 h without increasing PrU development. The TEAM-UP (Turn Everyone And Move for Ulcer Prevention) study aims to determine: 1) whether repositioning interval can be extended for NH residents without compromising PrU incidence and 2) how changes in medical severity interact with changes in risk level and repositioning schedule to predict PrU development. Methods In this proposed cluster randomized study, 9 NHs will be randomly assigned to one of three repositioning intervals (2, 3, or 4 h) for a 4-week period. Each enrolled site will use a single NH-wide repositioning interval as the standard of care for residents at low, moderate, and high risk of PrU development ( N  = 951) meeting the following criteria: minimum 3-day stay, without PrUs, no adhesive allergy, and using VE support surfaces (mattresses). An FDA-cleared patient monitoring system that records position/movement of these residents via individual wireless sensors will be used to visually cue staff when residents need repositioning and document compliance with repositioning protocols. Discussion This study will advance knowledge about repositioning frequency and clinically assessed PrU risk level in relation to PrU incidence and medical severity. Outcomes of this research will contribute to future guidelines for more precise preventive nursing practices and refinement of PrU prevention guidelines. Trial registration Clinical Trial Registration: NCT02996331 .

Background Radiotherapy of breast cancer can be associated with dermatitis. Grade ≥2 radiation dermatitis can be painful and impair the patients’ quality of life. To reduce the risk of this complication, patients have to perform skin care several times each day. This may require a considerable level of compliance. This randomized DAI-BREAC trial investigates whether a mobile application reminding the patients four times per day to perform skin care (reminder app) will contribute to reduction of grade ≥2 radiation dermatitis. Methods This multinational, randomized, active-controlled, parallel-group, multicenter trial compares standard skin care supported by a reminder app (Arm A) versus standard skin care alone (Arm B) regarding grade ≥2 radiation dermatitis in patients receiving adjuvant radiotherapy for breast cancer. The effect of the app will be considered clinically relevant, if the rate of grade ≥2 radiation dermatitis is reduced from 25.4% (rate identified in a preceding study) to 15%. A total of 134 patients per arm including drop-outs are required. Secondary aims include pain (visual analogue scale), patient satisfaction with the app (questionnaire), impact of the app on the use of health technology (questionnaire), and benefit from support (coaching) by staff members regarding the use of the app (questionnaire). Discussion If the reminder app contributes to a decrease of grade ≥2 radiation dermatitis in patients irradiated for breast cancer, it will likely become a useful instrument for these patients. Trial registration Clinicaltrials.gov (NCT06483477; URL: https://clinicaltrials.gov/show/NCT06483477 ). Registered on 1st of July, 2024. First patient was included in December 2024.