Victoria Harris

The aetiology of chronic vulval pain and entry dyspareunia: a retrospective review of 525 cases

There are few published data about the incidence of diagnoses or treatment outcomes, for chronic vulval pain.

Modern management of acne.

Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen‐induced increased sebum production; altered keratinisation; bacterial colonisation of hair follicles on the face, neck, chest and back by Propionibacterium acnes; and an inflammatory response in the skin. The exact way these processes interact and the order in which they occur in the pathogenesis of acne are still unclear. Scarring that occurs from acne, particularly severe acne, can persist a lifetime and have long lasting psychosocial effects. Depression, social isolation and suicidal ideation are frequent comorbidities in acne. Despite the plethora of topical and systemic treatments available for acne, there is a relative lack of quality evidence for its application. Of the systemic treatments available, oral isotretinoin remains the most effective well established treatment for acne that targets all the aetiological factors. Current guidelines for the treatment of acne are based largely on expert consensus and advocate a combination of topical agents in mild to moderate cases and reserve the use of systemic therapies for moderate to severe or refractory cases of acne. However, given the psychosocial impacts of acne, there is a strong argument for early, effective treatment with systemic therapy when topical and general measures have failed.

Evaluation of the influence of family and friends, and the Internet on patient perceptions of long-term topical corticosteroid use

Abstract Background: Topical corticosteroids (TCS) are key to managing chronic inflammatory dermatoses (CID). Parents/patients cite TCS phobia as an impediment to treatment adherence. Family/friends and the Internet are a source of misinformation on TCS which can negatively impact perceptions of TCS safety. Purpose: To assess information from family/friends and the Internet, as related to and reported by patients/parents using long-term TCS. Methods: A multicenter cross-sectional survey of patients (aged >18 years) and parents of patients (aged <18 years) with a history of CID requiring long-term (≥1 month) TCS use assessing messages about TCS received from family/friends and the Internet. Results: A total of 123 patients and 78 parents completed the survey (n = 201). Parents/patients were more likely to be informed by the Internet “[having] my [child’s] skin condition means that [I/he/she] will need to use topical corticosteroids” (p < .001) and that “inflamed skin conditions will improve with the topical corticosteroids” (p = .007). Family/friends were more likely to recommend parents/patients “try non-prescription creams/ointments before resorting to the use of prescription topical corticosteroids” (p = .014). Conclusions: High rates of messages about TCS “risk” from family/friends and the Internet may affect patient/parent understanding about TCS safety. This may contribute to treatment non-adherence.

Atopic dermatitis: the new frontier.

Atopic dermatitis (AD) is the most common inflammatory skin condition in adults and children. AD is a chronic disease that has a considerable negative impact on the quality of life of patients and their families. Most cases of AD may be effectively treated with topical therapies that are directed at decreasing cutaneous inflammation and alleviating pruritus. These therapies include emollients, antihistamines, topical corticosteroids, topical calcineurin inhibitors and antimicrobial and antiseptic measures; more refractory cases may require additional oral immunosuppression (eg, cyclosporine, azathioprine, methotrexate and mycophenolate). Improved understanding of the immune pathogenesis of AD, including the role of T helper cells and the inflammatory pathways involved, has led to breakthrough translational clinical research and treatment. New targeted immunotherapies, such as inhibitors of interleukin (IL)-4, IL-13, IL-31, Janus associated kinase and phosphodiesterase, have had promising results from phase 2 and 3 trials for patients with moderate to severe AD.

Assessment of Sun-Protective Attitudes and Behaviours of Australian Medical Students

Skin cancer is a major public health concern in Australia and around the world, and UV radiation exposure is accepted as the most readily modifiable risk factor for the disease1. The attitudes and behaviours of young adults towards sun protection play an important role in their future risk of skin cancer, and are thus an important target for sun-safety messaging. A cross-sectional study aiming to investigate the sun-protective behaviours and attitudes of Australian medical students during both everyday outdoor activities and while travelling for leisure was conducted via an online questionnaire. This article is protected by copyright. All rights reserved.

Changing trends in the incidence of invasive melanoma in Victoria, 1985–2015

Objectives: To estimate the incidence of cutaneous malignant melanoma in Victoria; to examine trends in its incidence over the past 30 years. Secondary objectives were to examine the anatomic location and thickness of invasive melanoma tumours during the same period.

A novel case of a brush with discomfort: allergic contact dermatitis caused by mercaptobenzothiazole in rubber components of a toothbrush: DO NOT BRUSH OFF CONTACT DERMATITIS

Conflict of Interest: On behalf of all authors, the corresponding author states that there is no conflict of interest. had a history of nickel allergy, confirmed with patch testing. Her lips improved, without resolution, with topical methylprednisolone aceponate ointment and petroleum jelly as a barrier ointment, and were further exacerbated by chilli, curry, wind and, possibly, coffee. Clinically, there was mild general dryness and slight scaling of the lips, with a focus of mild erythema in the cornices of the mouth. Irritant or allergic contact dermatitis was suspected, and patch testing was arranged. The patient was patch tested with the Australian baseline series, plus the cheilitis and toothpaste series. Epicutaneous tests were applied on the upper back, with allergens from Chemotechnique (Vellinge, Sweden) and AllergEAZE Chambers (AllergEAZE, Chatsworth, Australia), and checked at day (D) 2 and D4. Readings were performed according to the ESCD guideline (1). Reactions scored +, ++ or +++ were considered to be positive, and reactions scored ?+ were considered to be doubtful. The first patch test reading showed reactions to nickel (++), mercaptobenzothiazole (MBT) (++), mercapto mix (+), and thiomersal (?+). The second patch test reading showed reactions to nickel (+++), MBT (++), mercapto mix (+), thiomersal (+), and palladium chloride (+).

Recurrent orogenital erythema multiforme and vulval neutrophilic dermatosis

ing a mean of 3.5 sections, compared with 4.2 sections for oculoplastic repair (Table 2). The anatomical distribution of tumours presented in Table 3 replicates the finding by O’Halloran and colleagues in that the lower eyelid was the most common tumour site (46%), and the medial canthus was the most common site repaired by Mohs surgeons (51% of all cases repaired by Mohs surgeons). In addition, our data replicates the finding that tumours located in upper eyelid were the least common tumour site (7%), which, as discussed by O’Halloran and colleagues, differs from the literature, which describes the lateral canthus as the least common site. A notable difference in the repair statistics is that our data show that 18% of all cases (and 42% of cases repaired by Mohs surgeons) were primary repairs; a repair type that is not reported by O’Halloran and colleagues. In summary, we present data that corroborates the previously described trends and supports the demonstrated benefit of multidisciplinary management of periocular nonmelanoma skin cancer.

Nickel hypersensitivity following closure of atrial septal defect: A case report and review of the literature

We present an unusual case where symptoms of headache and chest pain persisted for 3 years following the implantation of a septal occluder device for an atrial septal defect despite endothelialisation of the device. The patient was found to have nickel hypersensitivity on patch testing. Following the removal of the device the patient had complete resolution of headaches and chest pain up to 10 months post‐explantation.

Vulvo-vaginal rejuvenation: Fact or fiction? Fractional carbon dioxide laser for genitourinary syndrome of menopause

1. Chap S, Vu M, Robinson AJ et al. Treatment of cutaneous iatrogenic Kaposi sarcoma with topical timolol. Australas. J. Dermatol. 2017; 58: 242–3. 2. Meseguer-Yebra C, Carde~ nosoAlvarez ME, Bordel-G omez MT et al. Successful treatment of classic Kaposi sarcoma with topical timolol: report of two cases. Br. J. Dermatol. 2015; 173: 860–2. 3. Alc antara-Reifs CM, Salido-Vallejo R, Garnacho-Saucedo GM et al. Classic Kaposi’s sarcoma treated with topical 0.5% timolol gel. Dermatol. Ther. 2016; 29: 309–11. 4. Sainz-Gaspar L, Su arez-Pe~ naranda JM, Pousa-Mart ınez M et al. Topical timolol for treatment of penile Kaposi sarcoma in HIVnegative patient. Dermatol. Ther. 2017; 30: 10.1111/dth.12519. 5. Abdelmaksoud A, Filoni A, Giudice G et al. Classic and HIVrelated Kaposi sarcoma treated with 0.1% topical timolol gel. J. Am. Acad. Dermatol. 2017; 76: 153–5. 6. McAllister SC, Hanson RS, Manion RD. Propranolol decreases proliferation of endothelial cells transformed by Kaposi’s sarcoma-associated herpesvirus and induces lytic viral gene expression. J. Virol. 2015; 89: 11144–9.