William Tuong

Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis.

To update the 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for the spectrum of manifestations affecting patients with psoriatic arthritis (PsA).

Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors.

This systematic review examines the effectiveness of videos in modifying health behaviors. We searched PubMed (1975–2012), PsycINFO (1975–2012), EMBASE (1975–2012), and CINAHL (1983–2012) for controlled clinical trials that examined the effectiveness of video interventions in changing health behaviors. Twenty-eight studies comprised of 12,703 subjects were included in the systematic review. Video interventions were variably effective for modifying health behaviors depending on the target behaviors to be influenced. Video interventions appear to be effective in breast self-examination, prostate cancer screening, sunscreen adherence, self-care in patients with heart failure, HIV testing, treatment adherence, and female condom use. However, videos have not shown to be effective in influencing addiction behaviors when they are not tailored. Compared to loss-framing, gain-framed messages may be more effective in promoting certain types of health behavior change. Also, video modeling may facilitate learning of new behaviors and can be an important consideration in future video interventions.

Melanoma: Epidemiology, Diagnosis, Treatment, and Outcomes

Melanoma is a skin cancer that arises from the malignant transformation of melanocytes. Although it is typically considered a pigmented lesion, the clinical presentation of melanoma can vary greatly. With increased efforts in screening and detection of early-stage melanoma, researchers and clinicians hope to improve clinical outcomes for patients with melanoma. Novel immunotherapies directed at specific molecular targets in the pathogenesis of melanoma usher in a new era of treatment of advanced melanoma.

Treatments for nail psoriasis: a systematic review by the GRAPPA Nail Psoriasis Work Group.

Nail involvement in psoriatic diseases causes significant physical and functional disabilities. Evaluating, measuring, and treating nail involvement is important in improving the health outcomes and quality of life among patients with psoriasis and psoriatic arthritis (PsA). We performed a systematic analysis of the literature on nail psoriasis to help inform an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

Effect of Automated Online Counseling on Clinical Outcomes and Quality of Life Among Adolescents With Acne Vulgaris: A Randomized Clinical Trial

IMPORTANCE Effective patient education is necessary for treating patients with acne vulgaris. Automated online counseling simulates face-to-face encounters and may be a useful tool to deliver education. OBJECTIVE To compare the effectiveness of a standard educational website with that of an automated-counseling website in improving clinical outcomes and quality of life among adolescents with acne. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between March 27, 2014, and June 27, 2014, including a 12-week follow-up in a local inner-city high school. Ninety-eight students aged at least 13 years with mild to moderate acne were eligible for participation. A per-protocol analysis of the evaluable population was conducted on clinical outcome data. INTERVENTIONS Participants viewed either a standard educational website or an automated-counseling website. MAIN OUTCOMES AND MEASURES The primary outcome was the total acne lesion count. Secondary measures included the Childrens Dermatology Life Quality Index (CDLQI) scores and general skin care behavior. RESULTS Forty-nine participants were randomized to each group. At baseline, the mean (SD) total acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (21.33 [10.81] vs 25.33 [12.45]; P = .10). Improvement in the mean (SD) acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (0.20 [9.26] vs 3.90 [12.19]; P = .10). The mean (SD) improvement in CDLQI score for the standard-website group was not significantly different from that of the automated-counseling-website group (0.17 [2.64] vs 0.39 [2.94]; P = .71). After 12 weeks, a greater proportion of participants in the automated-counseling-website group maintained or adopted a recommended anti-acne skin care routine compared with the standard-website group (43% vs 22%; P = .03). CONCLUSIONS AND RELEVANCE Internet-based acne education using automated counseling was not superior to standard-website education in improving acne severity and quality of life. However, a greater proportion of participants who viewed the automated-counseling website reported having maintained or adopted a recommended anti-acne skin care regimen. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02031718.

Polyphenols as novel treatment options for dermatological diseases: A systematic review of clinical trials.

Abstract Background: Polyphenol phytochemicals demonstrate biological properties in vitro and in vivo that have led to the development of novel treatments for certain dermatological conditions. Objective: We sought to provide clinicians with an overview of clinical trials evaluating the effectiveness of polyphenol-based therapies and highlight novel treatments and the evidence available supporting their use. Methods: PubMed and Embase databases were systematically searched to 4 July 2014. Two independent reviewers reviewed published abstracts for inclusion. References were also manually searched for relevant studies. Data were extracted independently from eligible studies and discrepancies were adjudicated by consensus. Results: Our search yielded 356 unique abstracts, of which 17 studies met inclusion and exclusion criteria. Polyphenols were used in topical and oral forms. High-quality evidence suggests that green tea polyphenols may be effective in treating anogenital warts. Limited available evidence indicates that polyphenols may also benefit patients with alopecia, acne vulgaris, fungal infections, hyperpigmentation or photoaged skin. Conclusions and relevance: Evidence-based knowledge regarding the effectiveness, indications and side effects of polyphenol-based phytochemicals is needed as their clinical use increases within dermatology. We qualitatively conclude that polyphenols may be effective in treating certain dermatological conditions. Additional rigorously conducted clinical trials are needed to further evaluate efficacy.

Effectiveness of a novel interactive health care education tool on clinical outcomes and quality of life in acne patients: A randomized controlled pilot study

Abstract Background: We developed an Internet-based education tool (My Personalized Application for health Care Education, MyPACE) to promote patient comprehension about acne. Objective: To determine if MyPACE improves clinical outcomes and quality of life in acne patients. Methods: Modeling the spaced education approach, 50 participants received weekly multiple-choice questions for 12 weeks. Those randomized to the intervention group received acne-related questions, while those in the control group received non-dermatologic health-related questions. Acne lesion counts and Dermatology Life Quality Index (DLQI) scores were recorded at initial enrollment and at 12 weeks. Results: Within-group analysis for the intervention group showed a significant mean change in inflammatory and non-inflammatory acne lesions per person (−3.2 ± 1.3, p = 0.0219; −4.4 ± 1.8, p = 0.0267, respectively). The control group only demonstrated a significant mean change in inflammatory lesions (−2.8 ± 0.80, p = 0.0040). Both groups had statistically significant improvement in DLQI score. Compared with participants in the control group, those receiving acne-related questions experienced greater improvement in clinical outcomes and quality of life. Limitations: The small sample size limited our ability to detect statistically significant differences. Conclusion: Internet-based, disease-specific, spaced education tools may be more effective than non-targeted tools for improving clinical outcomes and quality of life.

Photoprotective effect of botanicals and vitamins: A systematic review of clinical trials.

Abstract Background: Overexposure to solar radiation is a major contributor to skin cancer development and premature skin aging. Botanical extracts and vitamins may represent novel photoprotective agents. Objective: We sought to systemically review clinical evidence for the use of botanically derived agents and vitamins as photoprotective agents. Methods: We systematically searched Embase and PubMed databases. Two independent reviewers reviewed abstracts for inclusion. Additional relevant studies were identified by a manual review of reference lists. Data from eligible studies were extracted independently and discrepancies were resolved by consensus. Results: A total of 51 studies met inclusion criteria. Limited available evidence indicates that several botanical agents and vitamins in topical or oral forms may have promising photoprotective effects. However, generalizability of results is limited by small sample sizes. Conclusion and relevance: Botanical extracts and vitamins may add to the armamentarium of sun-protective agents. Additional high-quality trials are needed to strengthen support for their use.

Scalp Psoriasis: Clinical Features and Assessment

Many patients with psoriasis have involvement of the nails. Nail psoriasis can range from asymptomatic, limited involvement to being physically and functionally debilitating. Psoriatic lesions affecting the nail matrix can lead to pitting, leukonychia, red spots on the lunula, and nail plate crumbling. Moreover, nail bed lesions may result in onycholysis, splinter hemorrhages, oil drop discoloration, or nail bed hyperkeratosis. Clinical assessment of disease severity can be performed through various tools and may help clinicians track progress and response to treatment.

Novel Use of Terpenoids for Treatment of Dermatologic Diseases: A Systematic Review of Clinical Trials

BACKGROUND/OBJECTIVE Terpenoids demonstrate pharmacologic activities that address important mechanisms underlying the pathogenesis of several cutaneous diseases. This review evaluated clinical trials of dermatology-specific terpenoid-based treatments. METHODS PubMed and EMBASE were reviewed on July 8, 2014. Two independent reviewers reviewed studies for inclusion and extracted data for studies meeting eligibility criteria. References were manually reviewed for potentially relevant studies. RESULTS The search yielded 437 unique abstracts, of which 13 met inclusion and exclusion criteria. High-quality evidence suggests that ingenol mebutate may be effective in treating actinic keratosis. Limited available evidence indicates that terpenoids may benefit patients with nonmelanoma skin cancers, cutaneous candidiasis, hyperpigmentation, photoaging, and wounds. CONCLUSIONS Terpenoids appear to be effective in treating specific dermatologic conditions. However, additional rigorously conducted clinical trials are needed to better ascertain efficacy.