It is known that children escaping political violence are likely to be vulnerable. This study provides early evidence concerning recently displaced children in refugee camps within Bangladesh.Large proportions of children had emotional symptoms and peer problems. The most vulnerable were those without parents.As well as urgent needs for shelter, food and preventive healthcare, children require immediate psychosocial support in emergency situations.

Introduction: Psoriasis Area and Severity Index (PASI) and Physician's Global Assessment (PGA) are the most widely used outcome measures in clinical trials of biologics to treat psoriasis; however, these outcome measures vary in both their reliability and validity. As newer biologics approach complete clearance of psoriasis, it becomes important to have standardized, reproducible forms of measure to accurately compare treatment efficacy. The aim of this study was to evaluate the extent of and reasons for variation between PASI and PGA scores used in clinical trials. Methods: A literature search was conducted of clinical trials meeting the inclusion criteria: phase 2 or 3, evaluation of treatment efficacy in reducing psoriasis severity, and use of PASI 90/100 and sPGA or PGA 0/1 as primary end points. Results: Among the analyzed studies, 8 of 45 trials had a PASI-PGA variance of \ 5%, 4 of 45 trials had a variance of 5-10%, and 33 trials had a variance of [ 10%. The IMMvent and AMA-GINE trials were the only two trials showing 0 variation between the PASI and PGA scores, testing adalimumab and brodalumab, respectively. Ustekinumab showed the highest variance of 61.9% in the IXORA-S trial. Limitations of this paper include a relatively low number of studies assessed because of the paucity of literature available. Conclusions: The use of both PASI and PGA as equivalent assessment tools for complete clearance is redundant and subject to high variability. Novel severity assessments should be developed that reduce calculation variation and take into account patient-oriented symptoms.

Acrokeratosis paraneoplastica (Bazex syndrome) is a rare paraneoplastic dermatosis associated with internal malignancies. Clinical presentation is characterized by erythematous or violaceous scaly plaques involving the digits, nose, ears, palms, and soles. Nail changes commonly present concurrently with cutaneous manifestations. In this review, we characterize nail changes associated with acrokeratosis paraneoplastica. A total of 48 cases were analyzed. Nail findings were nonspecific, with the most common being nail plate thickening, onycholysis, subungual hyperkeratosis, longitudinal ridging, discoloration, and nail plate loss. In most patients, nail changes involved the majority of fingernails and toenails and most often appeared prior to the diagnosis of malignancy. The most common associated underlying malignancies were squamous cell carcinomas of the head and neck. A diagnosis of acrokeratosis paraneoplastica should be considered in patients with onychodystrophy involving multiple nails with accompanying atypical psoriasiform dermatoses. Screening for internal malignancies may significantly decrease morbidity and mortality for these patients.

No abstract

Background: The field of dermatology is constantly evolving and expanding to accommodate for increased demand. In order to maximize future productivity, it is important to recognize and understand how the desires of patients and the nature of physician visits have changed over time.  Objective: To evaluate and provide evidence-based reasoning for the changes occurring in the field of dermatology. Methods: Analysis of the 1991-2016 National Summary Tables from the National Ambulatory Medical Care Survey (NAMCS) was performed in order to identify several trends relating to dermatology visits. Results: Annual visit rates to dermatologists have increased by 68%, while visit length has increased by 39%. Drug visits have increased by 86%, while drug mentions increased by 370.2%. Limitations: Limitations of this paper include limited a narrow timeline for data points. Conclusion: As the field of dermatology will continue to expand in the future, dermatologists can expect to be busier than ever before. We expect that more patients will seek care, physician visits will be longer, and chief complaints and treatment options will continue to expand and vary.