bluuebunny/crossref_metadata_2025_split huggingface dataset:
P45 An analysis of infantile haemangioma referrals and comparison with the infantile haemangioma European task force’s ‘infantile haemangioma referral score’
Authors: Fagan Nicole , Dhonncha Eilis Nic , Sadlier Muriel 
Published: June 2023

Abstract
Infantile haemangiomas (IHs) are common. Timely referral and treatment can minimize complications in high-risk lesions. The IH European Task Force developed the Infantile Haemangioma Referral Score (IHRes) in 2020 (Léauté-Labrèze C, Torres EB, Weibel L et al. The Infantile Hemangioma Referral Score: a validated tool for physicians. Pediatrics 2020; 145:e20191628). This is a simple, easy-to-access validated screening tool that can assist physicians in deciding which IHs to refer to an expert centre. The aim of this study was to assess the quality of IH referrals to a national care centre. Data were retrospectively collected from a random sample of patients over a 13-month period between January 2019 and February 2020. Fifty-six patients were included. Eighty-six per cent had a solitary haemangioma (n = 48); 52% of IHs were located on the head (n = 29). Sixteen patients (29%) were referred between 5 and 8 weeks of age (29%); five patients (9%) were referred before 5 weeks of age. The majority of referrals came from primary care (55%; n = 31). Seventy-three per cent of referrers did not specify the urgency of the referrals (n = 41); 59% were subsequently triaged as urgent by a consultant dermatologist (n = 33). Most referrals did not specify the size of the IH (43%; n = 24), if it was actively growing (48%; n = 27), ulcerated (93%; n = 52) or potentially function threatening (84%; n = 47). Nine per cent included a photograph of the lesion (n = 5). Seventy-five per cent of referrals satisfied the IHRes six major criteria or had scores &gt; 4, warranting a referral (n = 42). Fifteen patients (27%) were started on propranolol at first appointment and a further 12 were monitored in a return appointment. Our results show that use of the IHReS tool could improve clinical outcomes by identifying children that require specialist referral earlier and facilitate easier triage of referrals.
P51 A national analysis of demographic features associated with spindle cell melanoma
Authors: Wu Xinxin , Al Kurnas Mohammed , Liu Adam , Silberstein Peter 
Published: June 2023

Abstract
Spindle cell melanoma (SCM) is a rare morphological subtype of melanoma, characterized histologically by atypical, spindled, malignant melanocytes (Weissinger SE, Keil P, Silvers DN et al. A diagnostic algorithm to distinguish desmoplastic from spindle cell melanoma. Mod Pathol 2014; 27:524–34). SCM often manifests as a broad metastatic illness, is frequently amelanotic and can arise nearly anywhere on the body, making diagnosis challenging (Xu Z, Shi P, Yibulayin F et al. Spindle cell melanoma: incidence and survival, 1973–2017. Oncol Lett 2018; 16:5091–9). Given the rarity of SCM, the epidemiology is not yet well explored. The National Cancer Database (NCDB) is a nationwide oncology outcome database for &gt; 1500 commission-accredited cancer programmes in the US and Puerto Rico. This study aimed to investigate the demographic factors associated with patients diagnosed with SCM by analysis of the NCDB. A retrospective cohort analysis utilizing data from the NCDB from 2004 to 2020 included patients diagnosed with histologically confirmed SCM (n = 7556). Sociodemographic factors (sex, age, race, Hispanic status, insurance type, urban/rural designation, facility location, facility type, education, income, distance from residence to facility and Charlson–Deyo score) were analysed using Pearson χ2-tests, and multivariate analysis was performed via binary logistic regression. Since 2004, an average (SD) of 480.8 (63.7) cases have been diagnosed annually. Most patients were male (66.5%), White (97.6%), not Hispanic (95.2%) and insured by Medicare (56.3%) and lived in an urban area (98.5%). Mean (SD) age at diagnosis was 67.9 (14.5) years, with an average (SD) Charlson–Deyo comorbidity score of 0.3 (0.6) and a mean (SD) distance of 37.3 (113.4) miles from the patient’s residence to the hospital. The most common primary site for SCM was the skin of the upper limb and shoulder (22.6%), followed by skin of the scalp and neck (19.0%), skin of other and unspecified parts of face (17.9%), and skin of the trunk (17.3%). On multivariate analysis, males were more likely than females to be diagnosed at an older age [69.3 vs. 65.3 years, 95% confidence interval (CI) 0.979–0.990; P &lt; 0.001], receive treatment at an academic facility (45.9% vs. 42.7%, 95% CI 1.018–1.270; P = 0.023) and have a Charlson–Deyo score of ≥ 3 (2.1% vs. 1.3%, 95% CI 0.374–0.924; P = 0.21). Given the lack of literature on SCM, this study serves as a valuable tool for understanding the demographic factors associated with the diagnosis. Future studies within the laboratory aim to determine the effect of these factors on overall survival with propensity score matching for other variables to identify disparities.
P53 Incidence of merkel cell carcinoma in the Republic of Ireland (1994–2019)
Authors: Doyle Claire , Blasco Marta Costa , McFeeley Orla , Beatty Paula , O’Mahoney Sarah , Murphy Lisa , Andrawis Madonna , Tobin Anne Marie 
Published: June 2023

Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive, neuroendocrine cutaneous malignancy most commonly observed in those aged over 65 years. MCC is twice as common in males as in females and is 25 times more common in those with fair skin than in those with darker skin types. Solid organ transplant recipients have a 24-fold increased risk of developing MCC. There has been a 95% increase in the incidence of MCC in the USA from 2000 to 2013, with further increases predicted. The aim of this study was to investigate the trends of incidence of MCC in the Republic of Ireland. Age-standardized rates were calculated using the 2013 European standard population. There were 447 histologically confirmed MCCs diagnosed between 1994 and 2019. Forty-nine per cent of cases (n = 220) were in males. Median age was 80 years (range 15–19 to 95+). The median age for males was 78 years and the median age for females was 82 years. On average, there were seven cases of MCC diagnosed annually between 1994 and 1998 vs. 27 cases of MCC annually diagnosed between 2015 and 2019—almost a quadrupling of case numbers. The age-adjusted incidence rate of MCC for both male and females is detailed in Table 1. Previous literature has indicated that MCC is twice as common in males than in females. Our cohort differed in that there was a slight female predominance in patients diagnosed with MCC. This is in keeping with published literature from Northern European groups, which have also demonstrated a female predominance in MCC. While the absolute number of MCC diagnosed in Ireland has increased in both males and females, the age-adjusted incidence rate is increasing in males, but there has not been a significant change in females. Other Northern European groups have also demonstrated an increase in the incidence of MCC in males that was not observed in females. This study adds to the body of epidemiological data on MCC.Table 1Age-adjusted incidence rates of Merkel cell carcinoma (MCC)Cases of MCCAge-standardized rate (per 100 000 person years)SE95% confidence intervalMales1994–1999230.520.130.27–0.772000–2004210.370.080.21–0.532005–2009350.790.150.50–1.082010–2014661.190.160.88–1.502015–2019751.050.120.81–1.29Females1994–1999260.360.070.22–0.502000–2004440.670.100.47–0.872005–2009540.790.110.57–1.012010–2014450.570.090.39–0.752015–2019580.650.090.47–0.83
P69 Baseline characteristics of patients with physician-diagnosed hidradenitis suppurativa: results from a retrospective observational study using data from the Clinical Practice Research Datalink database
Authors: Shams Kave , Rashidghamat Ellie , Brown Annette , Pamies Paula , Ingram John R 
Published: June 2023

Abstract
Hidradenitis suppurativa (HS) is a difficult-to-treat, painful, chronic inflammatory skin disorder characterized by nodules, abscesses and skin tunnels. Delay in diagnosis increases disease severity and overall disease burden. In England, HS is associated with a high healthcare resource use, with an estimated prevalence of 1.2% in the general UK population (Ingram JR, Jenkins-Jones S, Knipe DW et al. Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. Br J Dermatol 2018; 178:917–24). Improved understanding of HS patient profiles in England will help optimize patient care and treatment outcomes. This study aimed to characterize the patient profiles, journey, treatment pathways and treatment outcomes of patients with HS in England using data from the Clinical Practice Research Datalink database. Here, we present the baseline characteristics of patients with HS from this database. Overall, 39 860 patients with physician-diagnosed HS were identified from 1 January 2009 to 31 March 2021. The mean (SD) age at diagnosis was 34.49 (13.07) years, and the majority were female (73.8%). Twenty-seven per cent of patients were White, 7.5% were Asian, 5.0% were Black and 27.9% were of mixed race, while 2.1% were from other races and the race was unknown for 30.7%. Overall, 44.6% were current smokers and 12.7% were ex-smokers. Depression (31.7%), anxiety (21.5%) and acne (20.6%) were the most commonly reported comorbidities related to HS. Chronic pulmonary disease was reported in 26.2% of patients; this may, in part, be attributed to relatively high rates of smoking in the HS population. The most frequently prescribed medications prior to HS diagnosis were pain medication, especially ‘non-opioid’ analgesics (21.8%) and opioids (19.8%); oral antibiotics, particularly tetracyclines (15.7%); combined contraceptive pills (7.2%) and metformin (4.8%). Only a few patients (&lt; 0.05%) received a biologic prior to their HS diagnosis for other chronic inflammatory conditions. The various comorbidities, including psychiatric, metabolic, cardiovascular, gynaecological and pulmonary and associated treatments, observed in this real-world study in England suggest that optimal management should involve a multidisciplinary approach to improve outcomes in patients with HS.
P75 Are ‘hypoallergenic’ personal care products truly safe?
Authors: Hiranput Siwaporn , Smith Lucy , Yesudian Paul Devakar 
Published: June 2023

Abstract
It is estimated that one-fifth of the general population may have allergic contact dermatitis (ACD) to common environmental allergens. Skincare companies are increasingly advertising their products as ‘hypoallergenic’, targeting consumers who seek personal care products (PCPs) that are less likely to cause an allergic reaction. However, there are no Food and Drug Administration standards to regulate the use of the term hypoallergenic, allowing manufacturers to use the term freely. We evaluated PCPs marketed as hypoallergenic from two health and beauty retailers in the UK for the presence of allergens in the British Society of Cutaneous Allergy (BSCA) baseline series. Product and ingredient lists were obtained from www.boots.com and www.superdrug.com in November 2022 using the term hypoallergenic in the search box. PCPs without the term hypoallergenic in the product description, unrelated products (plasters, jewellery, sanitary towels, tampons, clothing, facial brushes) and duplicates (same products in different sizes) were excluded. In total, 208 PCPs met the inclusion criteria: 47 (22.6%) were rinse-off and 161 (77.4%) were leave-on products. At least one substance from the BSCA baseline series was an ingredient in 79 (38.0%) PCPs. Of these, 54 (26.0%) had 1 potential allergen, 21 (10.2%) had 2, and 4 (1.9%) had 3 potential allergens from the series. The frequently encountered allergens were cetearyl alcohol and paraben mix, found in 42 (20.4%) and 37 (18.0%) of products, respectively. Other BSCA baseline series allergens identified in PCPs included 2-bromo-2-nitropropane-1,3-diol, lanolin, decyl glucoside, diazolidinyl urea, methylisothiazolinone, limonene and linalool. In addition, PCPs had chemicals that were related to and may cross-react with allergens in the BSCA baseline series. Parfum/fragrance, which can cross-react with fragrance mix I and II, was found in 85 (41.3%) PCPs. Sodium benzoate and/or benzoic acid, often used as preservatives in PCPs, were found in 66 (32.0%) products. Forty (19.4%) PCPs had ingredients that belong to the Asteraceae family and therefore may trigger an ACD in those with positive reaction to Compositae and/or sesquiterpene lactone mix. Twenty-three (11.2%) PCPs contained cetyl alcohol and/or stearyl alcohol, the two major components of cetearyl alcohol. Overall, 153 (74.3%) of 206 PCPs marketed as hypoallergenic contained BSCA baseline series allergens or ingredients that may cross-react with them. This highlights the need to increase public awareness and education about the potential dangers of purchasing ‘hypoallergenic’ PCPs.
P83 Biologic and Janus kinase inhibitor therapy outcomes for severe psoriasis in trisomy 21
Authors: O’Connor Cathal , Byrne Berbie , Roche Darren , O’Connell Garret , O’Connell Michael , Murphy Michelle , Bourke John , Lynch Maeve , Bennett Mary 
Published: June 2023

Abstract
Trisomy 21 (T21) is strongly associated with autoimmune disease, including psoriasis. Little is known about biologic outcomes for severe psoriasis in T21. T21-associated immune dysregulation has implications for efficacy, safety and drug survival of biologic medications. The aim was to review the outcomes of patients with T21 and severe psoriasis treated with biologic agents or Janus kinase inhibitors (JAKi) in our region. Patients were identified via databases of the regional dermatology departments in the province of Munster, Ireland. Information on demographics, comorbidities, previous and current therapies and response to therapies was retrospectively collated. Adequate treatment response was defined as a physician global assessment score of zero (indicating clear skin), or one (indicating almost clear skin). Twenty-one patients were identified (mean age 24.7 years). Most (76%) did not have a first-degree relative with psoriasis. One-third (33%) of patients had arthritis, but all children (n = 6) had arthritis. Ninety per cent (n = 18/20) of trials of tumour necrosis factor (TNF)-α inhibitors failed. Almost two-thirds (n = 7/11) of patients achieved adequate response with ustekinumab. All three patients treated with tofacitinib achieved adequate response following at least three biologic failures. The mean number of biologic/JAKi therapies received was 2.1, with an overall biologic/JAKi survival rate of 36%. Overall, 81% (n = 17/21) of patients required a switch from their index biologic treatment due to failure. The four patients who remained on their index biologic all received ustekinumab. In patients with T21 and severe psoriasis, failure of TNF-α inhibition is common, and ustekinumab therapy should be considered first line. There is an emerging role for JAKi.
P88 Higher socioeconomic status is associated with psoriasis
Authors: Dagan Or 
Published: June 2023

Abstract
The role of several environmental risk factors such as stressful life events, smoking and overweight as triggers for psoriasis has been undoubtedly validated. Recent inquiries regarding the association between socioeconomic factors and psoriasis yielded contraindicating observations, and this relationship remains unclear. The aim was to measure the association between psoriasis and socioeconomic status (SES). We carried out a nationwide population-based cross-sectional study that included all patients insured by the Clalit healthcare organization (n = 4 604 994). Univariable and multivariable logistic regression analyses were conducted to explore the association between psoriasis and SES while controlling for potential medical and habitual confounders. The study population included 129 855 patients with psoriasis and 4 475 139 controls. The mean (SD) age of patients with psoriasis was 51.53 (19.96) years, and the proportion of females was 51.5%. Higher SES was associated with an increased prevalence of psoriasis. In a fully adjusted model, people within the highest socioeconomic level were 1.43-fold more likely to have psoriasis than those with the lowest SES [95% confidence interval (CI) 1.39–1.48; P &lt; 0.001]; people of medium SES were 1.2-fold more likely to have psoriasis than those of the lowest SES [95% CI 1.18–1.26; P &lt; 0.001 (P-value for linear trend &lt; 0.001)]. There is a positive correlation between SES and psoriasis prevalence. Further investigation is warranted to elucidate which biologic or behavioural factors contribute to these findings.
P89 Real-world effectiveness of guselkumab in patients with psoriasis with and without concomitant psoriatic arthritis: retrospective data from the British Association of Dermatologists Biologics and Immunomodulators Register
Authors: Shams Kave , Wang Xiayi , Gillespie Justin , Chauhan Bhavika 
Published: June 2023

Abstract
Guselkumab is a monoclonal antibody that inhibits interleukin (IL)-23 signalling by binding to its p19 subunit and is approved to treat adults with moderate-to-severe plaque psoriasis and active psoriatic arthritis (PsA). BADBIR collects UK and Eire real-world observational data and includes patients receiving biologic treatments for psoriasis, with PsA being one of the recorded comorbidities at the time of enrolment. Absolute PASI (aPASI) scores can be used to quantify treatment effectiveness in routine clinical practice, and it has been suggested that an aPASI ≤ 2 represents a relevant disease endpoint to inform treat-to-target psoriasis-management strategies. This retrospective analysis evaluated the 1-year, real-world effectiveness of guselkumab on aPASI response in patients with moderate-to-severe plaque psoriasis and the subset of patients with and without concomitant PsA within BADBIR. Analyses were carried out on data collected up to the September 2021 data cutoff. Data were obtained from patients who had initiated guselkumab treatment and had recorded measurements for aPASI at baseline and 12-month follow-up was analysed. Measures of treatment effect for psoriasis included mean aPASI response, as well as the proportion of patients achieving an aPASI score of ≤ 1, ≤ 2, ≤ 3 and ≤ 5. Incomplete data collection limited the sample size of patients available for analysis. Five patients receiving guselkumab were excluded due to stopping treatment prior to the 12-month cutoff. Stratified by diagnosis, 36 (30.8%) patients had a concomitant diagnosis of PsA vs. 81 (69.2%) who did not. In the overall guselkumab-treated cohort (n = 117), mean (SD) aPASI at baseline and the following 12 months of treatment were 11.85 (8.95) and 2.45 (4.24), respectively. Following 12 months of guselkumab treatment in the cohort of patients with psoriasis (without concomitant PsA), 48 (59.3%) achieved an aPASI ≤ 1, 56 (69.1%) an aPASI ≤ 2, 64 (79.0%) an aPASI ≤ 3 and 69 (85.2%) an aPASI ≤ 5. In the concomitant PsA group, 19 (52.8%) achieved an aPASI score of ≤ 1, 22 (61.1%) achieved an aPASI score of ≤ 2, 28 (77.8%) achieved an aPASI ≤ 3 and 30 (83.3%) achieved an aPASI ≤ 5. Over 50% of guselkumab patients achieved an aPASI ≤ 1 at 12 months, supporting the effectiveness of targeting IL-23 with guselkumab for the treatment of psoriasis over 1 year. These results demonstrate that comparable responses were achieved for the treatment of psoriasis with guselkumab in patients with and without a concomitant PsA diagnosis within a real-world cohort.
BC02 Efficacy and safety of picosecond Nd-YAG laser for tattoo removal in Asian patients: a way to look forward
Authors: Bansal Rohit , Sahu Priyadarshini 
Published: June 2023

Abstract
Picosecond neodymium-doped yttrium aluminium garnet (Nd-YAG) lasers have emerged as the leading technology for tattoo removal due to their shorter pulse lengths and are considered better than other nanosecond lasers. The aim was to study the efficacy and adverse effects of a picosecond quality-switched (QS) Nd-YAG laser in a case series of 15 Asian patients for tattoo removal. Fifteen patients with black- and blue-coloured tattoos were recruited for tattoo removal. All were treated with a 1064-picosecond QS Nd-YAG laser. A single session with one pass was performed using a spot size of 4 mm, a fluence of 0.5–1 J cm–2 and a frequency of 6–10 Hz. The parameters were adjusted based on the size and type of tattoo and the patient’s skin type. Patients were treated at 4–6-weekly intervals. The clearance of pigmentation and local reactions was evaluated based on clinical photographs and dermoscopy, done at each sitting. At the end, both patients and physician assessed the clearance of tattoo. For patient assessment, a visual analogue scale (VAS) was used. To assess the efficacy of laser treatment by the physician, the tattoo removal rate was scored on a 5-point (0–4) scale (4: ≥ 70% removal, excellent improvement; 3: ≥ 50% and &lt; 70%, marked improvement; 2: ≥ 30% and &lt; 50%, moderate improvement; 1: ≥ 10% and &lt; 30%, mild improvement and 0: &lt; 10%, no effect). Patients were asked to assess their satisfaction (0 = dissatisfactory, 10 = satisfactory) and pain (0 = no pain, 10 = worst pain) using the VAS. Clinical photographs were assessed both by the patients and the physicians. Four women and 11 men were included (aged 30–45 years). At the end of treatment, all patients had &gt; 75% clearance and seven obtained almost complete clearance. Thus, all patients had an excellent response. The average patient-reported score for satisfaction was 8.2 and 2.5 for pain. The average score was 4.4 for the number of sessions. A few adverse effects, including erythema, blistering and crusting, were observed. Picosecond lasers allow for the most effective delivery of thermal radiation to tattoo particles through more specific photothermal and photomechanical effects than traditional nanosecond lasers. They also have an additional effect of minimizing the collateral damage to the surrounding dermis and epidermis. Thus, a picosecond laser is a safe and effective method for tattoo removal in Asian people.
BC04 Burden of treatment in severe acne vulgaris
Authors: Kiely Lisa , O’Connor Cathal , Almoosa Aysha , Dight Emer , Murphy Michelle 
Published: June 2023

Abstract
Acne vulgaris is a common skin condition resulting in a significant personal burden to patients. Although the burden associated with the disease itself has been well reported, there is a paucity of data examining the burden of treatment (BOT) in acne. We performed a prospective single-centre study in a tertiary dermatology department in Ireland. Patients attending the dermatology department for acne management were invited to complete a validated BOT questionnaire with additional qualitative components, modified for use in acne. Fifty patients responded to the questionnaire. Sixty-eight per cent (n = 34) of respondents were female and 32% (n = 16) were male; mean patient age was 22.6 years (range 16–45). Eighty-two per cent (n = 41) of patients were on isotretinoin at the time of the study, with a further 18% (n = 9) on oral antibiotic therapy. The average BOT for antibiotics was 4.5/10 (range 2.5–6.9), and for isotretinoin, it was 3.8/10 (range 0.69–6.9). The greatest challenges reported with topical treatment were skin sensitivity and dryness and the lack of efficacy. The greatest challenges reported with antibiotic therapy were side-effects, including gastrointestinal upset, limited efficacy and the requirement for long-term treatment. Xerosis was described as the greatest challenge associated with isotretinoin; however, 58% of patients believed their overall BOT was decreased with isotretinoin, with statements such as ‘I really wish I’d started on isotretinoin a very long time ago’ provided. Acne results in a significant physical and psychosocial burden to patients. Patients on isotretinoin rated the BOT of isotretinoin as less than that of antibiotics and topical therapies. Prescribers should be aware of the BOT of various treatments to optimize treatment for acne.