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  • 1
    Electronic Resource
    Electronic Resource
    Tropical diphencyprone therapy in alopecia totalis (1988)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 119 (1988), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1988.tb05339.x
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  • 2
    Electronic Resource
    Electronic Resource
    The British Association of Dermatologists therapeutic guidelines: can we AGREE? (2003)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 148 (2003), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2003.05241.x
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  • 3
    Electronic Resource
    Electronic Resource
    4 A cost-effectiveness rationale for the selection of antimicrobial therapy in acne: a randomized controlled trial (2002)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 146 (2002), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background This NHS/HTA-funded study aimed to rank five commonly used antimicrobial therapies for acne in order of their clinical effectiveness and cost-effectiveness. We also wanted to identify which agents are less likely to promote resistance and those which are effective in patients who harbour high numbers of resistant Propionibacterium acnes strains. Methods From surgeries and colleges in the Nottingham and Leeds areas, 649 patients with mild to moderate facial acne were recruited. The two primary outcome measures were patient self-assessment of improvement in overall acne severity and reduction in inflamed lesion count, measured at 18 weeks. Secondary outcome measures included two acne severity scores, assessors' global estimation of improvement, quality of life and utility scores, enumeration of antibiotic resistant propionibacteria, and the incidence of adverse events. Results and Conclusions The most effective treatments (percentage with at least moderate improvement according to patients, mean change in lesion count) were the topical Benzamycin® b.d. (66%, − 27) and its components given separately (topical erythromycin o.d. + 5% benzoyl peroxide o.d.) (63%, − 26), followed by 5% benzoyl peroxide b.d. (60%, − 23). The least effective were oral oxytetracycline (55%, − 18) and minocycline (54%, − 22). The most cost-effective treatment was benzoyl peroxide and least cost-effective was minocycline. In terms of quality of life, benzoyl peroxide moved down the rankings and minocycline moved up. The two topical erythromycin-containing regimens produced the largest reductions and the oral treatments the smallest in the prevalence and population density of cutaneous propionibacteria. Prior bacterial colonisation did not affect outcome in the topical groups. Efficacy of both oral preparations was influenced by tetracycline resistant P. acnes strains. Disclaimer The views and opinions expressed are those of the authors and do not necessarily reflect those of the Department of Health.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2002.302744.x
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  • 4
    Electronic Resource
    Electronic Resource
    The Nottingham Eczema Severity Score: preliminary refinement of the Rajka and Langeland grading (2000)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 142 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A method for assessing disease severity of atopic dermatitis (AD) in children has been developed for population-based research. Based on an index first described by Rajka and Langeland in 1989, disease severity is determined by evaluating the three elements of clinical course, disease intensity and extent of examined AD. This paper describes development of the index for use in epidemiological studies based on a community-based study of 290 pre-school children (aged 1–5 years). Construct validity of the index was evaluated with respect to clinical severity assessment according to a dermatologist, parental severity assessment, use of topical corticosteroids and impairment of quality of life. The severity distribution of AD in this community-based sample of children was: mild 82% (n = 237), moderate 12% (n = 36) and severe 6% (n = 17) according to this new index. In this sample 24% of children had suffered from AD of more than 9 months duration in the preceding 12 months, 4·5% had experienced significant sleep loss (6 or more nights of average sleep loss per week over 12 months) and 11% had experienced widespread extent of involvement (more than 10 body sites involved). Construct validity of the index was demonstrated for clinical and patient-derived severity assessment. This included a comparison between the new index and a global severity assessment by a dermatologist in which exact agreement was achieved in 88% of the cases. A small subgroup of children suffering from persistent localized forms of AD (discoid pattern, hand/foot dermatitis, perioral dermatitis), who reported considerable morbidity, was identified using quality of life measures of severity; they would otherwise have been misclassified by the dermatologist or new index. Preliminary use of the Nottingham Eczema Severity Score would support further development as a research tool for a simple assessment of disease severity that could be used in epidemiological studies. Further validation is required with respect to use in older children, administration by researchers/health professionals and development as a wholly questionnaire-based assessment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2000.03300.x
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  • 5
    Electronic Resource
    Electronic Resource
    The British Association of Dermatologists audit of atopic eczema management in secondary care. Phase 2: audit of service process (2000)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 142 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An audit of atopic eczema management, conducted on behalf of the British Association of Dermatologists, examined service structure (phase 1), process (phase 2) and outcome (phase 3). In phase 2, an on-site case-note audit was conducted in 19 hospital dermatology departments randomly selected from the original sample of 187 centres across the U.K. In total, 630 sets of notes were examined for completeness of: (i) information given to general practitioners (GPs) in clinic letters and (ii) facts relevant to the management of atopic eczema recorded in the patients’ notes. In general, the information given to GPs in the clinic letters was good, with the recording of diagnosis, treatment and follow-up approaching the 100% working standard. Factual information such as site and severity of eczema (83% and 74%), and presence or absence of asthma (53%) were better recorded than quality of life issues such as sleep loss secondary to itching (21%) and effect on school, work or social life (6%). On average, only 51% of all audit measures were recorded across all centres, with slight variation between centres (41–61%). The centre with the best recording had a purpose-designed data sheet for doctors to complete when seeing new patients with atopic eczema. Such data sheets may help improve case-note recording. Similar data sheets for patients to complete may be more time-efficient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2000.03297.x
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  • 6
    Electronic Resource
    Electronic Resource
    Reply (1999)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 141 (1999), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1999.03228.x
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  • 7
    Electronic Resource
    Electronic Resource
    Validation of the U.K. diagnostic criteria for atopic dermatitis in a population setting (1996)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 135 (1996), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary One reason why so little is known about the epidemiology of atopic dermatitis (AD) is lack of suitable diagnostic criteria. A simple list of diagnostic criteria for AD for use in epidemiological studies has recently been developed by a U.K. working party. These have performed well in hospital validation studies of subjects with skin diseases. This study sought to validate the newly proposed criteria for AD in a population setting by conducting a cross-sectional survey of 695 schoolchildren aged 3–11 years in three randomly selected primary schools in West Lambeth, London. As a point prevalence measure, the U.K. criteria had a sensitivity of 70%, a specificity of 93%, and a positive predictive value of 47% when compared with a dermatologist's examination findings. Subsequent analysis suggested that most children classified as false positives had suffered from AD in the last year, but were inactive at the time of examination. When adjusted for these cases, the sensitivity and specificity increased to 80 and 97%, respectively, corresponding to positive and negative predictive values of 80 and 97%, respectively. The U.K. diagnostic criteria for AD appear to work well as a 1-year period prevalence measure in London schoolchildren. Further validation in adults and other countries are needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1996.d01-925.x
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  • 8
    Electronic Resource
    Electronic Resource
    Dissecting cellulitis of the scalp: response to isotretinoin (1996)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 134 (1996), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report three patients with dissecting cellulitis of the scalp. Prolonged treatment with oral isotretinoin was highly effective in all three patients. Furthermore, long-term post-treatment follow-up in two of the patients has shown a sustained therapeutic benefit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1996.d01-911.x
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  • 9
    Electronic Resource
    Electronic Resource
    The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation (1994)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 131 (1994), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In order to qualify as a case of atopic dermatitis, we propose that an individual must have an itchy skin condition plus three or more of the following: history of flexural involvement, a history of asthma/hay fever, a history of a generalized dry skin, onset of rash under the age of 2 years, or visible flexural dermatitis. When tested in an independent sample of 200 consecutive dermatology outpatients of all ages, this arrangement of the diagnostic criteria achieved 69% sensitivity and 96% specificity when validated against physician's diagnosis. Based on the findings of this first exercise, minor modifications in the wording of the criteria were undertaken, and these were tested on a sample of 114 consecutive children attending out-patient paediatric dermatology clinics. Overall discrimination improved, with a sensitivity of 85% and specificity of 96%. The simplified criteria are easy to use, take under 2 min per patient to ascertain, and do not require subjects to undress. These two independent validation studies suggest that the newly proposed criteria for atopic dermatitis perform reasonably well in hospital out-patient patients. Further validation in community settings and in developing countries is needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1994.tb08532.x
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  • 10
    Electronic Resource
    Electronic Resource
    Inadequate size of ‘negative’ clinical trials in dermatology (1993)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 128 (1993), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fifty-eight clinical trials with negative conclusions, published in three British dermatological journals over the last 4 years, were reviewed to determine the risk of their having missed an effective treatment. All but one of the 44 evaluable trials had a greater than 1 in 10 risk of missing a 25% relative treatment difference (median risk 81%), and 31 of the trials (70%) were so small that they had a greater than 1 in 10 risk of missing a 50% relative treatment difference (median risk 42%). The ‘negative’ trial result was compatible (within 95% confidence limits) with a 25% beneficial relative treatment effect in 36 studies (82%), and a 50% treatment benefit in 22 studies (50%). Only one study used confidence intervals to describe the main findings, and only three studies (7%) mentioned the basis for sample size estimation at the outset of the study. Of particular concern was that in half (23/44) of the studies there was an incorrect interpretation of the findings.It is worrying to observe such a profusion of clinical trials in dermatology which are too small to answer the questions being posed, especially when this is coupled with misreporting of results. Apart from ethical concerns, many treatments compatible with a considerable treatment benefit may have been erroneously discarded as a result of such studies.We recommend the use of confidence intervals to summarize clinical trial findings, so that readers can quickly decide whether clinically important treatment effects are plausible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1993.tb00178.x
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