bluuebunny/crossref_metadata_2025_split huggingface dataset:
GD02 (P46) A step towards zero leprosy: experiences of Nepal in leprosy data verification
Authors: Baskota Rabindra , Baral Rashmi 
Published: June 2023

Abstract
Records and reports are the sources of data for health programme planning, monitoring and evaluation. Accurate and timely data are crucial to ensure quality leprosy services, including drug supply, complication management and disability prevention. Data verification and validation are the initial steps to achieve the global goal of zero leprosy. The objectives of leprosy data verification were to strengthen the reporting system, to update personal health records and to provide on-site training to leprosy focal persons. Leprosy data verification was conducted in 15 endemic districts of Nepal by a team of national leprosy programme managers, leprosy focal persons, statisticians, dermatologists, paramedic health workers and World Health Organization consultants. The team visited health facilities that provide leprosy services and their corresponding municipalities from August 2021 to December 2021. The team examined the completeness and accuracy of data and information on the patient card, treatment register and monthly reporting form. Data were then compared with the municipal and national database, edited, cleaned and verified for duplications, and on-site coaching was provided to the leprosy focal persons. Verification of 1210 health records of 15 districts from four provinces was conducted. The number of new leprosy cases was found to be under-reported by 5.5%. Likewise, under-reporting was observed in released-from-treatment cases (19.2% variation) and transfer-out cases (21.4% variation). Over-reporting was observed in re-treatment cases (7% variation), defaulter cases (10.6% variation) and new paediatric cases (38% variation). Common reasons for data variation were error in counting while reporting, error in compiling data from health facilities and lack of training of focal persons in data recording and reporting. A limitation of the data verification study was that it was conducted in the selected 15 endemic districts and municipalities only. The study suggested that verification, validation and on-site coaching are effective approaches to obtaining quality data on leprosy. Such programmes can be conducted routinely or even during the integrated monitoring and supervision visits of experts from the centre to the local health facilities but should be carried out at the data entry site.
GD03 Identifying core outcome domains and development of a cutaneous leishmaniasis core outcome measure for use in clinical practice and trials
Authors: Senarathne Sujai , Ranasinghe Shalindra , Kahawita Indira , Somaratne Vijani , Wickramasinghe Amila , Parkash Vivak , Lacey Charles , Kaye Paul , Layton Alison 
Published: June 2023

Abstract
Cutaneous leishmaniasis (CL) is caused by an intracellular protozoan parasite transmitted through a sand fly bite. A review of clinical trials examining different treatment modalities for CL found studies to be deficient in design, execution, analysis and reporting. Core outcome sets (COS), including agreed domains and measures, have been developed for several dermatological disorders. The aims of this study were to reach consensus on the most important core outcome domains to measure when assessing CL, agree on parameters to measure the domains and develop a clinical tool to assess CL. Potential outcome domains for CL were identified through a collaborative international approach involving virtual discussions and e-consultations with stakeholders, including teams caring for CL from Sri Lanka, India, Brazil and the UK. A subsequent judgement process was then undertaken, using the multidisciplinary stakeholder panel of international experts, adhering to nominal group technique to reach final agreement on the core outcome domains. Clinicians presented cases representing the clinical and psychosocial impact of CL to ensure the patient’s perspective was considered. Established core outcome domains included signs and symptoms (objective and subjective), treatment efficacy, treatment impact, clinical sequelae (scarring and pigment) and health-related quality of life (HRQoL). For each core outcome domain, a review of previous approaches to measure the domain was considered. Items to measure the domains were then evaluated by multiple rounds until the panel of experts reached consensus. It was agreed that ‘signs and symptoms’ should capture clinical morphology, diameter and induration of an index lesion with the aid of a palpability score; ‘treatment efficacy and impact’ should capture patient and investigator views through visual analogue scores, percentage change in size of the lesion and re-epithelialization compared with baseline. Sequelae assessment rated pigment, as well as atrophic and hypertrophic/keloid scars. Two open-ended questions were included as a means of capturing some aspects of HRQoL. CutLeishCOM was then generated to capture demographic details, reflect the core outcome domains and assess outcome measurements in each patient. CutLeishCOM has been validated in a small cohort in this study; further validation is required. A specific patient-reported outcome measure should also be considered to ensure adverse effects from treatments, and negative impacts are captured when assessing CL, thus enabling a patient-focused and empathic approach to management.
GD04 Patient education for all! Skin of colour ­under-represented again
Authors: Long Amy , Long Alison , Feighery Cliona 
Published: June 2023

Abstract
Disparities in healthcare provision have a detrimental impact on health outcomes, which have been suffered by many patient cohorts, whether they are defined socially, economically or by the colour of their skin (Buster KJ, Stevens EI, Elmets CA. Dermatologic health disparities. Dermatol Clin 2012; 30:53–9). In the field of dermatology, we rely hugely on visual presentations. As dermatologists, the visible manifestations of disease, and their evolution, are fundamental to how we formulate diagnoses and treatment strategies. Similarly, visual depiction is important for patients to garner a wider understanding of their condition. This study aimed to analyse skin colour representation in patient information resources for a number of inflammatory conditions, including acne, atopic dermatitis, hidradenitis suppurativa, psoriasis and rosacea. Resources from multiple dermatological bodies including the British Skin Foundation, Irish Skin Foundation, American Academy of Dermatology Association, Canadian Dermatology Association, Dermatology Society of South Africa and the Australasian College of Dermatology were reviewed. Hard-copy pamphlets published by the associations were analysed; where pamphlets were unavailable, websites pertaining to each inflammatory condition were included. Images were divided by Fitzpatrick skin type into two categories: Fitzpatrick skin types I–IV and Fitzpatrick skin types V/VI. There is no formal definition of skin of colour, and for the purposes of this study, we referred to Fitzpatrick skin types V/VI. In total, 115 images were reviewed. People with skin of colour were represented in 5% (n = 6) of the images. This stark over-representation of Fitzpatrick skin types I–IV highlights the lack of inclusivity in current patient education resources. Consequently, patients with skin of colour may feel overlooked. This may foster a poor rapport between patients and physicians and could lead to mistrust and reduced engagement with healthcare services. Dermatological communities must join the global effort to eliminate racial disparities. The first steps have already been taken by many, in publishing and medical education, including the British Journal of Dermatology, which aims to enhance resources to study, describe and improve care for people with skin of colour (Guckian J, Ingram JR, Rajan N, Linos E. Dermatology is finally talking about race. Br J Dermatol 2021; 185:875–6). Patient information resources are another facet of our practice that need focus and reform. We must improve approachability, inclusiveness and trust within our specialty and work towards the overarching aim of delivering healthcare that is racially just.
GD05 ‘Ghosts’: changing perceptions of people with albinism in Tanzania
Authors: Adeyemi Stephanie 
Published: June 2023

Abstract
Albinism, derived from the Latin word albus meaning white, is a rare genetic condition characterized by an absence of melanin leading to an individual having pale skin, eyes and hair. It is believed that Tanzania has the highest rate of albinism in Africa with the autosomal recessive gene being carried by one in 19 Tanzanians and the condition impacting one in 1400 people (Cruz-Inigo AE, Ladizinski B, Sethi A. Albinism in Africa: stigma, slaughter and awareness campaigns. Dermatol Clin 2011; 29:79–87). We aim to analyse the perception of individuals with albinism in Tanzania and strive to consider the future of those with albinism and reflect on the work being done. A recurring theme throughout the literature is the fact that those living with albinism in Tanzania are often shrouded in mysticism, stigma and violence. Referred to as ‘ghosts’, they are often on the fringes of society, ostracised by their communities and labelled as having supernatural powers. It is this superstition that has led to the brutal attack and murder of members of the disenfranchised albino population in Tanzania with the belief that their body parts, which can be sold for as high as $75 000, bring luck, as well as possessing powers. It is only in recent times that attention has been brought to their plight and work has begun to unravel these deeply entrenched beliefs. The United Nations (UN)-sanctioned International Albinism Awareness Day is on 13 June and aims to shed a light on the work being done to support people living with albinism globally. In 2013, the UN Human Rights Council adopted legislation to prevent violence against people with albinism, as well as a 2015 Mandate of an Independent Expert on the enjoyment of human rights by persons with albinism. A lot of work is being done on the ground by charitable organizations to empower people living with albinism in Tanzania through education and provision of safe shelter and resources. The role of dermatologists in the support of people with albinism in Tanzania cannot be ignored. Owing to decreased melanin levels in those with albinism, there is an increased risk of skin cancer due to a lack of protection against ultraviolent radiation. Dermatologists can play a crucial role, as part of a multidisciplinary team, in providing skin cancer prevention education, as well as providing education to reduce stigma against those living with albinism (McBride SR, Leppard BJ. Attitudes and beliefs of an albino population towards sun avoidance: advice and services provided by an outreach albino clinic in Tanzania. Arch Dermatol 2002; 138:629–32).
GD07 The role of the dermatologist in the fight against female genital mutilation
Authors: Adeyemi Stephanie 
Published: June 2023

Abstract
Female genital mutilation (FGM) is a practice that the World Health Organization (WHO) estimates to affect 200 million women globally. The practice of FGM is often attributed to the Middle East, sub-Saharan Africa, North Africa and, to a lesser extent, Asia; however, it is now being witnessed in cities worldwide with high numbers of FGM-practising communities. The WHO defines FGM as ‘all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reason’. While FGM has no health benefits, in certain cultures, the practice confers upon women full social acceptability and integration into the community and serves as a rite of passage to womanhood and marriage (Mpinga EK, Marcias A, Hasselgard-Rowe J et al. Female genital mutilation: a systematic review of research on its economic and social impacts across four decades. Glob Health Action 2016; 4:9). This systematic review aimed to assess the dermatological impact of FGM on women and the role dermatologists can play in the fight against the practice. A systematic review was carried out in accordance with the PRISMA guidelines. PubMed (n = 98), Cochrane (n = 1), CINAHL (n = 8) and Embase (n = 38) were searched for articles published between January 1990 and January 2023 with the phrase ‘female genital mutilation and skin or dermatology’. A total of 148 studies were initially identified; following screening, 21 articles were deemed suitable for inclusion and analysed. The literature highlighted that the main dermatological consequences of FGM were severe keloid formation, hypertrophic scars, vitiligo lesions, clitoral neuromas and, most commonly, epidermal inclusion cysts (Dave AJ, Sethi A, Morrone A. Female genital mutilation: what every American dermatologist needs to know. Dermatol Clin 2011; 29:103–9). A study of women in Somalia who had been admitted to the hospital following complications due to FGM noted that 55.1% of women (n = 65/118) had developed epidermal inclusion cysts. The literature suggests women often feel shame approaching clinicians for help; however, without support, these women can experience years of dyspareunia, dysuria, pruritus, pelvic pain and obstetric complications, as well as increased transmission of sexually transmitted infections and HIV following damage to the vaginal epithelium. By analysing the literature, it is clear further research into the dermatological consequences of FGM is necessary so that a conversation can be had about the ways in which dermatologists can effectively support survivors of FGM. It is important that each woman is recognized as an individual with her own story to tell, her own lived experience and her own humanity.
H02 The Foundling-Chapel brawl 1804: Robert and Mary Willan, trial by social media
Authors: Millard Les 
Published: June 2023

Abstract
The social media of the late 18th and early 19th centuries was no less humorous, critical and potentially personally destructive than now, despite its form, distribution and time frame being quantitatively different. Cartoons and prints, broadsheets, leaflets and pamphlets were widely distributed by hand for sale cheaply, being passed on for maximal effect. Gillray, Rowlandson and the Cruikshanks were the masters of these media, but others were prolific and no less accomplished at targeting royalty, religions, politicians and individuals of particular merit, such as physicians. One such satirical caricaturist and pamphleteer was James Sayers (1748–1823), a favourite of Prime Minister William Pitt. In 1804, he wrote a verse satire, attacking Dr Robert Willan (1757–1812) and his wife Mary (1770–1844) after an incident in the Chapel at The Foundling Hospital (Nichols RH, Wray FA. History of the Foundling Hospital. Oxford: Oxford University Press, 1935), where his sister Elizabeth was in dispute with them over the occupancy of a pew (pews were rented by the hospital governors on an annual basis). They were both subjected to a clever—not always subtle—diatribe for some 2 years about their personal and professional integrity, including their religion. Willan was described as a ‘learned leech’, with the implication that this successful physician was not just bleeding patients therapeutically, but also financially. His patients were ‘scabby’ and therefore detestable, and he was a lesser man because he was no longer a Quaker. For Mary, there were intimations about her temperament, her motives for marriage and her personal hygiene. The recently married couple had moved from 14 Bloomsbury Square to nearby number 10, with her two daughters by her previous marriage. There, their son Richard was born in 1802. Robert Willan withdrew from his work at the Carey Street Dispensary in 1803. Re-reading this rare publication by Sayers, which may seem a negative satire, inadvertently provides clues to the personal and social context of the Willan’s early married life.
H03 Madam C.J. Walker and her wonderful hair grower
Authors: Doyle Claire 
Published: June 2023

Abstract
Madam C.J. Walker was born Sarah Breedlove in December 1867 in Louisiana, USA. She was the first child in her family born to freedom following the abolition of slavery in the USA in 1865. She was orphaned at the age of 7 years and began working as a domestic servant at the age of 10 years. She married when she was 14 years old and became the sole parent of a 2-year-old daughter following the death of her husband in 1887. Seeking a way out of poverty, in 1889, she moved to St Louis, Missouri, where her four brothers were barbers. During the 1890s, she developed significant hair loss. In an attempt to tackle the said hair loss, she consulted her brothers for advice and experimented with many homemade remedies and store-bought products. In 1906, she married Charles Joseph Walker and became known as Madam C.J. Walker. By this time, she had developed her own formula to heal scalps and spur hair growth specifically for Black women who had been overlooked by the beauty and haircare industries. The initial product was known as ‘Madam Walker’s Wonderful Hair Grower’, which she began selling in 1907. Ingredients included precipitated sulfur, copper sulfate, beeswax, petroleum jelly, coconut oil and a violet extract perfume to cover the sulfur smell. At the time, sulfur was commonly used to treat dandruff. Along with her hair grower, Walker’s early products included Glossine (a pressing oil) and a vegetable shampoo. She urged clients to shampoo more often and to follow her ‘Walker System’, using the hair grower, oil and hot combs to make ‘lacklustre and brittle hair become softer’. Her products became widely used and her strong customer base led her to becoming the USA’s first self-made female millionaire. She died due to kidney failure in 1919. Her company still exists under the name Madam C.J. Walker Beauty Culture. Madam C.J. Walker was not a dermatologist and was not medically trained, but she was one of the first people to pay attention to the issue of hair loss experienced by Black women. Over 100 years later, the field of dermatology is still trying to address the lack of attention and research given to presentations in those with skin of colour.
H05 Jean-Nicolas Marjolin (1780–1850): a name to remember
Authors: Andrew Kashini , Al-Kutubi Huda , Salimi Maryam , Patel Pooja , Orpin Stephen , King-Stokes Natalie 
Published: June 2023

Abstract
Jean-Nicolas Marjolin was born in Ray-sur-Saone, in eastern France, in 1780. His education was sponsored by his mother as his father had died when he was 1 year old, leaving them impoverished. He studied Medicine at The Commercy Hospital, north-eastern France, before he left for Hôtel-Dieu hospital in Paris where he met Guillaume Dupuytren, who recruited him to the ‘Societe Anatomique’, a society created to promote the study of clinical anatomy. He became, successively, an assistant in anatomy (1805), a prosector (1806) and a doctor (MD) in 1808. He even established his own medical school in 1810. It was very popular as he admitted students from less privileged backgrounds to study medicine for free. His brilliant teaching style caused conflict with his ambitious mentor Dupuytren, who saw him as a threat after he was hired as Dupuytren’s assistant at Hôtel-Dieu. Marjolin was also a member of the Académie de Médecine, and surgeon to Louis-Philippe I, the French king at the time. His son René also became a surgeon and married Cornelia Scheffer, the daughter of the famous painter Ary Scheffer. In 1828, Marjolin described four types of ulcers that he named ‘ulcere verruqueux’ in Mimoires de l’Acadimie de Chirurgie, which was a manual of anatomy at that time. However, he did not specify whether the ulcers were malignant or associated with longstanding ulcers. In 1850, the year that Marjolin died, Robert Smith, Professor of Surgery at Trinity College, Dublin, described locally destructive ulcers that developed in scars following burns, floggings and lacerations as the ‘warty ulcers’ of Marjolin. After Smith’s death in 1873, Marjolin was again forgotten until 30 years later, when John Chalmers DaCosta, Professor of Surgery at Jefferson Medical College, Philadelphia, described two cases of carcinomatous change in chronic varicose leg ulcers as examples of Marjolin ulcers. John Fordyce, an American dermatologist, subsequently described a chronic ulcer undergoing malignant change as a Marjolin ulcer in 1907. These definitions of Marjolin ulcer by DaCosta and Fordyce included malignancy developing in sinuses, as well as malignancy in scars and persistent ulcers. These declarations defined the term ‘Marjolin ulcer’ in modern usage and preserved Marjolins’ name for future generations. Currently ‘Marjolin ulcer’ refers to a rare malignant transformation within chronic ulcers or scars with squamous cell carcinoma as the commonest subtype. Its exact cause remains unknown, despite being described by Jean-Nicolas Marjolin almost 200 years ago.
H08 The Crimson Chronicles of acne rosacea: a fascinating tale of medicine and culture
Authors: Adeyemi Stephanie , Gupta Sachi 
Published: June 2023

Abstract
Acne rosacea is a common skin condition that affects people with Fitzpatrick skin types I–III and is characterized by flushing, erythema, telangiectasia, pustules, papules and phyma (Jansen T. Clinical presentations and classification of rosacea. Ann Dermatol Venereol 2011; 138:3). This condition has been around for centuries and is referred to in literature and art throughout history. The earliest reference to acne rosacea can be traced back to the third century Bc, where it was mentioned in the writings of Greek poet Theocritus. It has also been referred to in various forms of literature, including the character of Summoner in Chaucer’s Canterbury Tales and Bardolf in Shakespeare’s Henry VI (Cribier B. Histoires de visages rouges. Ann Dermatol Venereol 2011; 138:2). In art, the condition is famously depicted in Italian Renaissance painter Domenico Ghirlandaio’s ‘The Old Man and His Grandson’, now housed in the Louvre. The colour red, a prominent characteristic of acne rosacea, has had a significant role in literature, symbolizing everything from love and passion to anger and violence. French novelists Balzac and Proust used it as a motif in ‘The Red Face’ or ‘Le Visage Rouge’ to denote violence and as a marker of the working classes. In the 14th century, French surgeon Guy de Chauliac was the first to document clinically the condition, referring to it as goutterose or ‘pink droplet’. It was in the 18th and 19th centuries that significant strides were made in understanding the nature of acne rosacea. Dr Jean Astruc, known as the father of venereal diseases, characterized the condition as ‘erythematous, varicose and scaly’. In 1812, the official term ‘acne rosacea’ first appeared in a medical text by English dermatologist Dr Thomas Bateman. Further references to the condition can be found in the 1817 publication On Cutaneous Diseases by dermatology pioneer Dr Robert Willan. In 1834, physician Robert Macnish explicitly linked acne rosacea to alcohol consumption in his book Anatomy of Drunkenness. The differentiation between acne vulgaris and acne rosacea was firmly established following the work of Austrian dermatologist Hebra and French dermatologist Darier. In the past, treatments for acne rosacea included salves containing mercury, sulfur, bull’s blood, blood-letting and leeches. Today, topical and oral antibiotics are the standard treatments, a far cry from the remedies of yesteryear. In conclusion, the history of acne rosacea, which is so much more than just le visage rouge, is a captivating journey that spans centuries, from its earliest references in literature and art to the contemporary understanding and treatment of the condition.