Objective: With the growth and popularity of the internet, physician review websites are being utilized more frequently by patients to learn about and ultimately select their provider. These sites allow patients to comment on the care they received in a public forum for others to see. With outcome and "quality" measures being used to dictate reimbursement formulas; online patient reviews may affect a physician's compensation in the near future. Therefore, it is of paramount importance for physicians to understand how best to portray themselves on social media and other internet sites. Methods: In this retrospective study, we identified 145 arthroplasty surgeons via the AAHKS database. Then, surgeon data was collected from Healthgrades (HG) and Vitals (V). We identified if the surgeon had social media (SM) accounts by using google search. The number of ratings and comments, overall rating, reported wait-times and physician SM presence were analyzed with univariate, bivariate and multivariate analyses. Results: 64% of surgeons had a SM presence, and younger surgeons with SM had lower distribution of wait-times. A SM presence correlated with significantly higher frequency of total ratings and comments. Both review sites showed that younger physicians with a SM presence had increased frequency of ratings and comments and a quicker office wait-times. SM presence did not impact the overall scores on either website. Conclusion: Having SM presence is correlated with increased number of ratings and comments on physician review sites, possibly revealing an increased likelihood of these physicians encouraging their patients to engage with them via the internet. SM presence did not correlate with higher review scores, displaying that there are many complex factors that go into a physician score outside of SM and internet appearance. Future studies should explore patient comments on these sites to understand additional factors that may optimize a patient's experience.

Keloids are scars that extend beyond the margins of an insulting cutaneous injury. Keloids are often thought to be primarily a cosmetic issue, as they are typically quite raised and pigmented. However, these scars also present with functional symptoms of pruritus and pain that significantly impact quality of life. The symptom of pruritus is frequently overlooked by dermatologists, and treatments are often primarily focused on the gross appearance of the scar. This review describes the prevalence and importance of pruritus in keloids. In addition, the putative mechanisms underlying the development of keloid pruritus, which include neuronal and immunological mechanisms, are discussed. Furthermore, this review describes keloid treatments that have been shown to reduce pruritus, treatments that specifically target the itch, and emerging therapies.

While there is a vast array of aetiologies that may lead to chronic pruritus, recent data suggests that many of these conditions share similar interactions between keratinocytes, nerves, and the immune system. Specifically, the type 2 immune response, including Th2 T Cells and their related cytokines, has been noted to play a major role in the development of pruritus in a variety of itchy conditions. To date, atopic dermatitis is the most striking example of this pathogenesis. However, the body of literature supporting its role in many other itchy conditions, including other inflammatory, bullous, as well as systemic diseases, continues to grow. In addition, new treatments targeting this type 2 immune system continue to be developed and investigated. In the current review, we present the current body of literature supporting the role of the type 2 immune response in itchy conditions beyond atopic dermatitis as well as potential therapeutic options that target this pathway for chronic itch.

No abstract

No abstract