Correspondence 1567
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MP, eds), 2006. Available at: http://www.ncbi.nlm.nih.gov/ books/NBK1280/ (last accessed 21 October 2014). Eliason MJ, Leachman SA, Feng BJ et al. A review of the clinical phenotype of 254 patients with genetically confirmed pachyonychia congenita. J Am Acad Dermatol 2012; 67:680–6. Leachman SA, Kaspar RL, Fleckman P et al. Clinical and pathological features of pachyonychia congenita. J Investig Dermatol Symp Proc 2005; 10:3–17. Wilson NJ, Leachman SA, Hansen CD et al. A large mutational study in pachyonychia congenita. J Invest Dermatol 2011; 131:1018– 24. McLean WH, Hansen CD, Eliason MJ et al. The phenotypic and molecular genetic features of pachyonychia congenita. J Invest Dermatol 2011; 131:1015–17. Covello SP, Smith FJ, Sillevis Smitt JH et al. Keratin 17 mutations cause either steatocystoma multiplex or pachyonychia congenita type 2. Br J Dermatol 1998; 139:475–80. Cogulu O, Onay H, Aykut A et al. Pachyonychia congenita type 2, N92S mutation of keratin 17 gene: clinical features, mutation analysis and pathological view. Eur J Pediatr 2009; 168:1269–72. Feng YG, Xiao SX, Ren XR et al. Keratin 17 mutation in pachyonychia congenita type 2 with early onset sebaceous cysts. Br J Dermatol 2003; 148:452–5. Smith FJ, Corden LD, Rugg EL et al. Missense mutations in keratin 17 cause either pachyonychia congenita type 2 or a phenotype resembling steatocystoma multiplex. J Invest Dermatol 1997; 108:220–3. Kanda M, Natsuga K, Nishie W et al. Morphological and genetic analysis of steatocystoma multiplex in an Asian family with pachyonychia congenita type 2 harbouring a KRT17 missense mutation. Br J Dermatol 2009; 160:465–8.
Funding sources: none. Conflicts of interest: none declared.
Sunscreen adherence: proffer patient preference DOI: 10.1111/bjd.13136 DEAR EDITOR, Sattler et al.’s1 paper exploring the factors underlying the lack of patient adherence to sun protective measures, overlooks a potentially critical facet, that of patient preference. Shared decision-making and the promotion of patient choice are requisite to good practice, as discussed in a recent Editorial2 and stipulated in the U.K. Dermatology Specialty Training Curriculum.3 This is perhaps best illustrated in dermatology in the realm of emollients, where patient concordance with prescribed therapy is greater when patients are encouraged to select the emollient of their choice, with patients often preferring lighter cream-based emollients to greasier ointments.4 While previous work suggests that 81% of patients would prefer an emollient of their choosing over their currently prescribed medication, the majority (72%) had never been asked which emollient they would like to use.5 Shared decisionmaking mandates that patients are equipped with the resources
© 2014 British Association of Dermatologists
necessary to make informed choices. In the case of emollients or sunscreens, this can be readily facilitated by providing patients with small samples of various topical agents in the clinic. Patient preferences can be extrapolated to other domains of therapy, such as choosing systemic medications, which, albeit, may require additional time for patients to be taught about the available options and to read information sheets, before arriving at a measured decision. Where practical and possible, physicians should account for patient preference in the prescription of treatments: a marginally increased cost accounting for such choice may offset some of the apparent lack of adherence to therapy and the burden of wasted medications.
Dermatology Centre, University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, U.K. E-mail: [email protected]
F.R. ALI A. ASLAM J.T. LEAR
References 1 Sattler U, Thellier S, Sibaud V et al. Factors associated with sun protection compliance: results from a nationwide cross-sectional evaluation of 2215 patients from a dermatological consultation. Br J Dermatol 2014; 170:1327–35. 2 Anstey A, Edwards A. Shared decision making in dermatology: asking patients, ‘What is important to you?’. Br J Dermatol 2014; 170:759–60. 3 Joint Royal Colleges of Physicians Training Board. Specialty Training Curriculum for Dermatology. August 2010 (Amended August 2012). Available at: http://www.jrcptb.org.uk/trainingandcert/ST3-SpR/ Documents/2010%20Dermatology%20Curriculum%20(AMENDME NTS%202012).pdf (last accessed 26 April 2014). 4 Holden C, English J, Hoare C et al. Advised best practice for the use of emollients in eczema and other dry skin conditions. J Dermatolog Treat 2002; 13:103–6. 5 Aslam A. Children’s preference in selecting an emollient of their choice. Br J Dermatol 2009; 161 (Suppl. 1):116. Funding sources: No external funding. Conflicts of interest: J.T.L. has accepted honoraria for speaking at meetings, by Leo, Galderma, Almirall, Astellas and GSK.
Two cases of bilateral earlobe cutaneous pseudolymphoma DOI: 10.1111/bjd.13145 DEAR EDITOR, Allergic contact dermatitis to metals including gold is well recognized; however, pseudolymphoma reactions remain rare, with only a small number of cases reported in the literature. Cutaneous pseudolymphoma, also known as cutaneous lymBritish Journal of Dermatology (2014) 171, pp1555–1608
This document is a scanned copy of a printed document. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material.
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5
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MP, eds), 2006. Available at: http://www.ncbi.nlm.nih.gov/ books/NBK1280/ (last accessed 21 October 2014). Eliason MJ, Leachman SA, Feng BJ et al. A review of the clinical phenotype of 254 patients with genetically confirmed pachyonychia congenita. J Am Acad Dermatol 2012; 67:680–6. Leachman SA, Kaspar RL, Fleckman P et al. Clinical and pathological features of pachyonychia congenita. J Investig Dermatol Symp Proc 2005; 10:3–17. Wilson NJ, Leachman SA, Hansen CD et al. A large mutational study in pachyonychia congenita. J Invest Dermatol 2011; 131:1018– 24. McLean WH, Hansen CD, Eliason MJ et al. The phenotypic and molecular genetic features of pachyonychia congenita. J Invest Dermatol 2011; 131:1015–17. Covello SP, Smith FJ, Sillevis Smitt JH et al. Keratin 17 mutations cause either steatocystoma multiplex or pachyonychia congenita type 2. Br J Dermatol 1998; 139:475–80. Cogulu O, Onay H, Aykut A et al. Pachyonychia congenita type 2, N92S mutation of keratin 17 gene: clinical features, mutation analysis and pathological view. Eur J Pediatr 2009; 168:1269–72. Feng YG, Xiao SX, Ren XR et al. Keratin 17 mutation in pachyonychia congenita type 2 with early onset sebaceous cysts. Br J Dermatol 2003; 148:452–5. Smith FJ, Corden LD, Rugg EL et al. Missense mutations in keratin 17 cause either pachyonychia congenita type 2 or a phenotype resembling steatocystoma multiplex. J Invest Dermatol 1997; 108:220–3. Kanda M, Natsuga K, Nishie W et al. Morphological and genetic analysis of steatocystoma multiplex in an Asian family with pachyonychia congenita type 2 harbouring a KRT17 missense mutation. Br J Dermatol 2009; 160:465–8.
Funding sources: none. Conflicts of interest: none declared.
Sunscreen adherence: proffer patient preference DOI: 10.1111/bjd.13136 DEAR EDITOR, Sattler et al.’s1 paper exploring the factors underlying the lack of patient adherence to sun protective measures, overlooks a potentially critical facet, that of patient preference. Shared decision-making and the promotion of patient choice are requisite to good practice, as discussed in a recent Editorial2 and stipulated in the U.K. Dermatology Specialty Training Curriculum.3 This is perhaps best illustrated in dermatology in the realm of emollients, where patient concordance with prescribed therapy is greater when patients are encouraged to select the emollient of their choice, with patients often preferring lighter cream-based emollients to greasier ointments.4 While previous work suggests that 81% of patients would prefer an emollient of their choosing over their currently prescribed medication, the majority (72%) had never been asked which emollient they would like to use.5 Shared decisionmaking mandates that patients are equipped with the resources
© 2014 British Association of Dermatologists
necessary to make informed choices. In the case of emollients or sunscreens, this can be readily facilitated by providing patients with small samples of various topical agents in the clinic. Patient preferences can be extrapolated to other domains of therapy, such as choosing systemic medications, which, albeit, may require additional time for patients to be taught about the available options and to read information sheets, before arriving at a measured decision. Where practical and possible, physicians should account for patient preference in the prescription of treatments: a marginally increased cost accounting for such choice may offset some of the apparent lack of adherence to therapy and the burden of wasted medications.
Dermatology Centre, University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, U.K. E-mail: [email protected]
F.R. ALI A. ASLAM J.T. LEAR
References 1 Sattler U, Thellier S, Sibaud V et al. Factors associated with sun protection compliance: results from a nationwide cross-sectional evaluation of 2215 patients from a dermatological consultation. Br J Dermatol 2014; 170:1327–35. 2 Anstey A, Edwards A. Shared decision making in dermatology: asking patients, ‘What is important to you?’. Br J Dermatol 2014; 170:759–60. 3 Joint Royal Colleges of Physicians Training Board. Specialty Training Curriculum for Dermatology. August 2010 (Amended August 2012). Available at: http://www.jrcptb.org.uk/trainingandcert/ST3-SpR/ Documents/2010%20Dermatology%20Curriculum%20(AMENDME NTS%202012).pdf (last accessed 26 April 2014). 4 Holden C, English J, Hoare C et al. Advised best practice for the use of emollients in eczema and other dry skin conditions. J Dermatolog Treat 2002; 13:103–6. 5 Aslam A. Children’s preference in selecting an emollient of their choice. Br J Dermatol 2009; 161 (Suppl. 1):116. Funding sources: No external funding. Conflicts of interest: J.T.L. has accepted honoraria for speaking at meetings, by Leo, Galderma, Almirall, Astellas and GSK.
Two cases of bilateral earlobe cutaneous pseudolymphoma DOI: 10.1111/bjd.13145 DEAR EDITOR, Allergic contact dermatitis to metals including gold is well recognized; however, pseudolymphoma reactions remain rare, with only a small number of cases reported in the literature. Cutaneous pseudolymphoma, also known as cutaneous lymBritish Journal of Dermatology (2014) 171, pp1555–1608
This document is a scanned copy of a printed document. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material.
