bluuebunny/crossref_metadata_2025_split huggingface dataset:
GD08 A retrospective study of skin diversity and disease, in the depiction of protagonists vs. antagonists, in popular global animations
Authors: Tang Edwina , Dubash Faisal 
Published: June 2024

Abstract
Our retrospective study explores skin conditions and diverse skin phenotypes in the depiction of protagonists vs. antagonists, within popular global animations. Animations throughout media, across continents, can influence younger audiences and societal perspectives. These inevitably impact self-perception and a patient’s personal experience of skin disease, for example acne portrayed in a cartoon villain. Shan Yu, Disney’s villain in Mulan, is portrayed with darker skin, a distinct beard and scars. The choice to associate skin colour and disorders with negatively portrayed characters drives cognitive assignment of a character’s morality, which thus may drive societal prejudice. We collected data assessing skin colour and dermatological characteristics of heroes or villains, in animations worldwide. The top 10 most popular animations for each major continent were identified and analysed from rankings obtained from the Internet Movie Database (IMDB) website. Animations were collected from Asia, Australasia, Africa, Europe, North America and South America. Major blocs of Asia included the top 10 most popular animations from India, China, Japan, the Middle East and South East Asia. Skin tones were captured and put into four categories: grey-hued, pallor, darker than ‘normal’ phenotype and fairer than ‘normal’ phenotype. For example, a character is classified as darker than ‘normal’ if their skin tone is darker than the majority skin colour for that region. While grey-hued and pale complexions are consistently utilized to portray popular villains, there was a global pattern of using contrasting skin colour, depending on the continent. In Europe and Australia, villains with darker skin colours were more common. Acne, warts and scarring were commonly portrayed in villains. In contrast, African villains with distinct skin tone were fairer, whereas their animated African heroes had a skin tone representative of the majority population. Interestingly, in India, more than half of villains were portrayed with darker skin. Sociocultural and colonial-rooted influence of skin tone in Indian society could explain why over half of its popular villains are darker in skin tone. The availability of skin whitening products aligns with postcolonial bias, suggesting that lighter skin symbolizes power, status and beauty. Skin colour and skin disorders in character portrayal may push the notion of ‘good guys’ vs. ‘bad guys’, thus driving prejudice against particular ethnic groups. Colonial media narratives ‘othering’ ethnic groups exemplify how discrimination and hatred may develop. We propose that animators carefully consider the negative impact of their work, including perpetuation of stigma in society, prior to release into the public domain.
H07 Skin, science and suffrage: the trailblazing history of Agnes Blackadder
Authors: Dyson Maya 
Published: June 2024

Abstract
Agnes Blackadder, born in Dundee on 4 December 1875, is widely credited as the first female consultant dermatologist in Britain. In 1895 she graduated from St Andrews University, the first woman to do so, with a Master of Arts. Following this she matriculated at Queen Margaret College in Glasgow, going on to obtain her medical degree in 1901. She was known to be a particularly voracious learner, taking multiple subjects simultaneously during her time at St Andrews, resulting in her graduating prematurely. Furthermore, during her medical education she obtained prizes across multiple fields, such as surgery, midwifery and ophthalmology. In 1907 Blackadder moved to London, where she was appointed as a consultant dermatologist at St John’s Hospital for Skin Diseases. Not only is she considered to be the first female consultant dermatologist in Britain, but she was among the first female physicians to be appointed as a consultant in a hospital serving both male and female patients. Her very presence within the medical community was, at the time, considered to be radical. Moreover, her interest in dermatology, radiology and electrotherapeutics diverged from those considered to be more acceptable for female physicians, namely paediatrics and women’s health. Central to Blackadder’s life was her advocacy for gender equality, frequently highlighting the persistent gender disparities in the fields of both medicine and academia. In 1912 she worked as part of the medical team who assessed the impact of force feeding of imprisoned suffragettes participating in hunger strikes. She published her findings, describing this practice as ‘severe physical and mental torture’, and strongly advised against its use. During World War I she served at Royaumont Hospital in France, working as a radiographer. Her research interests continued to be both progressive and wide ranging; she was among the first to identify the radiographic appearances of gas gangrene, and used this to help improve diagnostic accuracy. She observed the impact of music on health and documented its therapeutic implications. She published Music, Health and Character soon after her return to London, and this resulted in the formation of the Council for Music in Hospitals. The exceptional career of Blackadder spanned over 50 years and she continued to practise medicine into her eighth decade before she passed away in 1964, aged 88. Her legacy has left an indelible mark on both medicine and women’s rights. She succeeded in creating space for women in the fields of dermatology and academia, paving the way for subsequent generations to pursue their aspirations.
H10 Extramammary Paget disease: from the 19th century to now – where ‘Paget’ meets the scrotum and beyond
Authors: Frimpong-Manso Honey Brandy , Venables Zoe C , Levell Nick J 
Published: June 2024

Abstract
Sir James Paget (1814–1899), born in Great Yarmouth, Norfolk, and a surgeon at St Bartholomew’s Hospital in London, first described Paget disease of the breast in 1874. He identified 15 women with chronic nipple lesions described as ‘eczematous ulcerative or vesicular lesions with clear yellowish exudate’. All these cases later developed into malignant lesions and this condition was subsequently termed mammary Paget disease. In 1887, Henry Radcliffe Crocker (1846–1909) documented the first case of what is today known as extramammary Paget disease (EMPD). Crocker was a dermatologist at University College Hospital. He was a founding member of the Dermatological Society of London in 1899 and president of the Dermatological Society of Great Britain and Northern Ireland. In ‘Paget’s disease, affecting the scrotum and penis’, published 1889, Crocker detailed a 60-year-old man presenting with an ‘oozing, well-defined area of superficial ulceration’ on the front, left side of the scrotum and under the surface of the penis. He described similarities to eczema but that the lesion was much deeper and well defined. Many treatments and remedies had no effect. Two nodules later appeared in the affected area, suggesting malignancy. This case was presented by Crocker at the Dermatological Society of London, where members identified similarities to mammary Paget disease. Sir James Paget reviewed the patient and agreed with the similarities, suggesting excision of the affected area. Cancerous cells were seen on microscopic investigation of the nodules. Crocker described the sweat coils and ducts forming a cancerous structure, in keeping with the known pathophysiology of EMPD primarily affecting apocrine-rich areas. Darier and Coulillaud reported a patient with perianal manifestation of Paget disease in 1893. These cases identified this rare but significant skin condition associated with underlying malignancy. Today, EMPD represents approximately 6.5% of all cutaneous Paget disease. The management of EMPD has changed little since it was first described in the 19th century, with identification and treatment of an associated malignancy and surgery remaining the mainstay of treatment.
H11 The pioneer of dermatology in Northern Ireland: what a legacy!
Authors: Yong Ji Fung , Griffin Laoise 
Published: June 2024

Abstract
Henry Samuel Purdon (1843–1906) was the pioneer of dermatology in Northern Ireland. Born into a family of doctors, Purdon qualified as a physician in Scotland, earning an M.D. (Glasglow) and an L.R.C.P. (Edinburgh). His interest in dermatology started under the influence of McCall Anderson’s dermatological teaching in Glasglow. After his return to Belfast, he quickly gained the public approval in an open meeting at 12 Wellington Place, resulting in the establishment of ‘The Belfast Dispensary for Diseases of the Skin’ in 1865. With creativity, he made wax models of skin diseases to gain financial support to fund the institute. The models included lupus vulgaris, which was very prevalent during that time. With the steady increase in attendance, the dispensary was renamed ‘The Belfast Hospital for Diseases of the Skin’ in 1866. In 1868, the Belfast Charitable Society funded the construction of a new hospital in Regent Street, which was opened in 1869. This new building provided mainly outpatient facilities with consultation rooms and an operating theatre, which were deemed sufficient, in addition with eight inpatient beds. Despite hectic clinical commitments, in 1870 Purdon became the editor of the Journal of Cutaneous Medicine, which invited articles from the USA, and from Europe and the UK. Further, Purdon published three dermatology textbooks, titled On Neurotic Cutaneous Disease, Including Erythema (1869), Classification, Correct Dietary, and Treatment of Diseases of the Skin: as Practised at the Belfast Hospital of the Skin (1889) and A Treatise on Cutaneous Medicine and Disease of the Skin (1875), which recorded his clinical experience. With Purdon’s famous reputation in dermatology, the need of the service had drastically increased. His fame attracted funding of £4000 from philanthropist Edward Benn, to build a new skin hospital on Glenravel Street in 1873. The Benn Skin Hospital was opened in 1875. This hospital was fully furnished with the finest amenities, with 30 hospital beds and a suite of baths to meet service demand. Purdon was elected president of Benn’s hospital and held this position until his death, at the age of 62. Purdon’s legacy in dermatology was carried down by his son, Elias Bell Purdon, until the hospital was destroyed by a Luftwaffe bomb during the Belfast Blitz in 1941. In 1957, ‘The Purdon Skin Ward’ in the Royal Victoria Hospital Belfast was established to recognize Purdon’s service to dermatology.
H12 A history of evidence-based medicine and dermatology as an early adopter
Authors: Binns Hannah 
Published: June 2024

Abstract
In 1992, a search for evidence-based medicine (EBM) would have only yielded two articles. Now, searching this term in PubMed generates over 276 000 results. But how did the ‘era of evidence-based medicine’ begin and what were its foundations? The concept of using evidence to guide medical practice is thought to date back to Ancient Greece. However, it was not until the 20th century that it started to take hold in modern medicine. Social principles calling for effective healthcare for the masses were a driving force, with British clinical epidemiologist Archie Cochrane (1909–1988) being the first advocate of this practice. Predating Archie Cochrane’s work, the early 20th century’s advancement in statistics and development of the meta-analysis would form the building blocks for modern-day EBM. British statistician Karl Pearson was the first to propose the concept of combining results of individual studies to minimize random error. Later in the 1920s fellow Briton, Ronald Fisher laid the foundation for the systematic approach by developing the statistical method of meta-analysis, first called ‘Fisher’s combined probability test’. In 1976 American statistician Gene Glass coined the term ‘meta-analysis’. By 1989 meta-analysis was changing clinical practice. Sir Ian Chalmers demonstrated that a short course of corticosteroids could drastically reduce complications following delivery of preterm infants. His work, and that of others, highlighted that lives could be saved through the evidence-based approach of performing up-to-date systematic reviews of randomized clinical trials. Meanwhile, in Canada the EBM movement was starting. In 1981 a group led by David Sackett published the first of a series of articles on how to appraise medical literature, influencing the practice of a whole generation. The actual term EBM was announced by Sackett’s mentee Gordon Guyatt in 1992. The levels of evidence that we use today can be attributed to Sackett and his book Evidence-Based Medicine: How to Practice and Teach EBM, which gave clinicians the tools to adopt EBM into everyday practice. Dermatology was an early adopter of EBM. The Cochrane Skin Group (CSG) was founded by Hywel Williams in 1997, with the clear aim of disseminating evidence-based guidelines to prevent, diagnose and treat dermatological disease. The first CSG review was published in 1999, and to date there are 130 active systematic review titles. The work of the CSG elicits tangible effects on international health policy, contributing to national and international guidelines. The work of the CSG is bolstered by the UK Dermatology Clinical Trials Network at the Centre of Evidence Based Dermatology, a group that aims to explore research gaps identified by the CSG reviews.
H14 Francois Henri Hallopeau: pulling out the hair and picking out the spots
Authors: Yip Alphonsus , Roy Nandini , Natkunarajah Janakan 
Published: June 2024

Abstract
Francois Henri Hallopeau was born in Paris in 1842. He entered the Paris medical school aged 24, studying under Alfred Vulpian and Sigismond Jaccoud, eventually ranking second among a large cohort of candidates for medical internships. He received his doctorate aged 29, after submission of his thesis on convulsive symptoms in disorders of the spinal cord. Francois was affiliated with the hospitals of Tenon and St Antoine, before becoming a physician at the Hôpital Saint Louis in 1884, where he remained until he retired in 1907. At the Hôpital Saint Louis, he initially practised as a neurologist, before exclusively focusing his efforts on dermatology. The variety of the patients who he cared for enabled him to report a number of important descriptions on cutaneous diseases, which formed the basis of the first edition of his Practical Treatise on Dermatology. Hallopeau was the first to describe acrodermatitis continua of Hallopeau, a painful acral pustular disease characterized by sterile pustules on erythematous skin of the distal fingers and toes, in 1890. He is also credited as being the first to describe lichens planus atrophique, now known as lichen planus sclerosus et atrophicus sclerosis, in a clinical lecture in 1887. Since then, World Lichens Sclerosis Awareness Day is celebrated on his birthday – 17 January. Hair pulling has been widely described throughout history, first documented by Aristotle (4th century Bc), when he referenced plucking out hair in the context of self-control and vices in Nicomachean Ethics. In 1889, after encountering a young male patient who had torn out tufts of his hair, Hallopeau was the first to coin the term trichotillomania, derived from the Greek thrix (hair), tillein (pulling) and mania (madness). In 1890, he cofounded the French Society of Dermatology and Syphiligraphy, of which he eventually became secretary general in 1893. He also remained an established member of the Academy of Medicine from this point. In 1907, after his retirement from Saint Louis due to the age rule, he continued working as the consulting physician at the Maison Départmentale of Nanterre until 1918, when his sight among other comorbidities led him to fully retire. Francois Henri Hallopeau’s impact in the field of dermatology persists to this day, and he continues to be remembered for his descriptions featured in his collection of over 800 publications.
H23 A sailor went to C
Authors: Murphy Lisa 
Published: June 2024

Abstract
As modern fad diets and chronic illnesses have led to a re-emergence in the presentation of scurvy to dermatology services, we aimed to review the original cohort of patients that gave this condition notoriety – sailors. Scurvy is a disease process secondary to vitamin C deficiency. It has a number of dermatological manifestations, including petechiae, perifollicular haemorrhage, bruising and gingivitis. These presentations occur as vitamin C (ascorbic acid) plays a fundamental role in collagen synthesis. When this process is defective, impaired wound healing is seen. This condition became synonymous with the British and European sailing community during the age of exploration, and it is estimated that 2 million sailors died as a result between the 16th and 18th centuries alone. As ascorbic acid is not naturally produced by humans, we are reliant on external sources of vitamin C to replenish stores. Key sources of vitamin C include fresh fruit and vegetables, such as citrus fruits, spinach, potatoes, berries and tomatoes. Given that there were generally only nonperishable foods available on board these sailing ships, thousands of sailors fell victim to scurvy. James Lind played a notable role in the discovery of vitamin C as a therapeutic agent in the treatment of scurvy and is credited with being the father of the modern-day clinical trial as we know it. The first authenticated example of a therapeutic experiment with controls appears to have been James Lind’s trial in 1747 of the value of citrus fruits in treating scurvy in sailors. (Thomas DP. Sailors, scurvy and science. J R Soc Med 1997; 90: 50–4). Captain James Cook, the eminent sailor, was also one of the first to establish that the provision of fresh vegetables on board could prevent scurvy from developing while on long voyages of exploration. Even in the most severe and end-stage cases of scurvy, it was discovered that the disease process could be reversed with sufficient vitamin C supplementation. While this condition is often considered to be a historical disease, having once been referred to as the ‘plague of the seas’, it is one that dermatologists should continue to be cognizant of when treating patients in modern society.
PS03 Psychiatric comorbidity in patients with hidradenitis suppurativa: a retrospective review of a tertiary centre clinic
Authors: Webber Lucy , Clark Emma , King Natalie , Wainman Hannah , Sinha Aparna 
Published: June 2024

Abstract
Hidradenitis suppurativa (HS) is closely linked to psychiatric comorbidities, elevated suicide risk, stigmatization and body image impairment (Patel K, Lee, H, Rastogi S et al. Association between hidradenitis suppurativa, depression, anxiety, and suicidality: a systematic review and meta-analysis. J Am Acad Dermatol 2020; 83: 737–44). We conducted a retrospective review of the first 100 patients referred to our tertiary HS service from August 2020 to identify those receiving psychiatric input. We assessed patient characteristics, underlying mental health diagnoses, treatment, mental health and HS severity scores, and referral outcomes. Among the 100 patients, 25 were referred to a tertiary psychodermatology service and 6 were already receiving psychiatric care. Of these 31 patients, 81% were female, the average age was 34 years and the mean body mass index was 35.6 kg m−2. Overall, 60% currently smoked and 93% had Hurley scores of 2 or 3. Compared with those not referred for psychiatric input, these 31 patients exhibited higher baseline abscess and inflammatory nodule (AN) counts of &gt; 5 (50% vs. 28%), severe pain scores &gt; 7 out of 10 (48% vs. 21%), severe General Anxiety Disorder-7 (GAD-7) scores &gt; 15 (44% vs. 37%), severe Patient Health Questionnaire-9 (PHQ-9) scores &gt; 20 (40% vs. 21%) and high Dermatology Life Quality Index (DLQI) scores &gt; 10 (81% vs. 68%). Of those referred for or already receiving psychiatric care, 94% had received a formal mental health diagnosis, with 62% having more than one diagnosis. The most common diagnosis was anxiety and depression, followed by post-traumatic stress disorder, eating disorders and emotionally unstable personality disorder. One-third reported thoughts of suicide or self-harm, with 19% of patients experiencing this on several days and 10% nearly every day. While no significant difference in systemic or biologic therapy usage was observed, treatment led to improved AN counts, and reductions in GAD-7, PHQ-9 and DLQI scores. No change was noted in severe pain scores (47% vs. 48%). Of the 25 patients referred for psychiatric input, 8 were seen, 3 did not attend and 14 await review. Overall, 55% (17 of 31) were encouraged to self-refer for psychological support, including National Health Service talking therapies, cognitive behavioural therapy and bereavement support. Identifying underlying mental health diagnoses and addressing psychological burden alongside medical treatment are essential to comprehensively manage HS. Many HS services do not have links to psychiatry, and the demand for psychological support for patients with HS exceeds available capacity. The introduction of HS-specific community interventions could enhance patients’ access to timely and effective psychological care while increasing our understanding of patients’ needs.
BT23 Artificial intelligence generation of patient information leaflets can have a useful role in the dermatology clinic
Authors: Verran Callum , Ardern-Jones Michael R , Seccombe Ella 
Published: June 2024

Abstract
Provision of information to patients via written patient information leaflets (PILs) is an important component of clinical care. The British Association of Dermatologists (BAD) PILs follow a consistent template and undergo quality testing with input from experts and nonmedical reviewers, and therefore they are time-consuming and costly to generate. Hence, existing PILs cover a limited range of skin conditions and treatments. General-language AI can use existing knowledge to infer, synthesize and summarize information and output this in any number of styles, including lay language. The aim of this study was to evaluate whether AI offers a useful function in generation of new PILs. ChatGPT (v3.5) was tasked to generate eight PILs where a BAD-produced PIL was not available. AI-generated PILs were reviewed by eight dermatologists and five nonmedical reviewers using a five-point Likert scale to assess document structure, accuracy, relevance and utility. Dermatologist responses varied based on PIL subject and were positive for structure, relevance and accuracy in 98%, 88% and 65% of responses, respectively, for condition-related PILs, whereas positive responses were seen in only 81%, 38% and 25% for medication-related PILs. While 64.6% of condition-related PILs were considered acceptable for patient distribution, this was only 12.5% for medication-related PILs. Nonmedical reviewers were more uniformly positive about the AI-generated PILs, with a majority of positive responses to presentation (97%), structure (97%), and language and content (97%) for condition-related PILs, and 70%, 70% and 70% of responses, respectively, for medication-related PILs. Our data show that dermatologists and nonmedical reviewers are positive towards the structure and relevance of condition-related PILs, but less so towards their content accuracy, and to medication-related PILs as a whole. We highlight the potential use of AI in clinical practice for PIL generation but recommend caution on content checking before publication and distribution, especially for medication-related information.