bluuebunny/crossref_metadata_2025_split huggingface dataset:
DE03 Using the British Association of Dermatologists’ medical student app to promote a better representation of skin of colour in undergraduate education
Authors: Patel Chirag , Teo Daryl , Scorer Matthew , Helbling Ingrid 
Published: June 2023

Abstract
It was exactly 10 years ago, in Liverpool, that the ‘BAD medical student app’ was launched. At a time when digital learning was becoming popular, a platform that is accessible globally, on your phone, which provides evidenced-based information to aid medical students’ educational needs in undergraduate dermatology, was born. In the wake of the need for promoting fair medical education, the General Medical Council, in their ‘2021–25 corporate strategy’, stipulated a requirement for an increased focus on equality, diversity and inclusion in medical education. Furthermore, medical students lack training on how skin disease presents differently in patients who have darker skin tones (Adelekun A. Skin color in dermatology textbooks: an updated evaluation and analysis. J Am Acad Dermatol 2021; 84:194–6). A 2018 study of general medicine texts found that &lt; 5% of images included dark skin tones. Louie and Wilkes (Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med 2018; 202:38–42) discovered that in general medicine texts commonly used by medical students, &lt; 5% of the images included darker skin tones. The effects of the COVID-19 pandemic and the semipermanent transition to using virtual learning methods have required medical students to become more autonomous in supplementing what is learnt in lectures. Furthermore, the under-representation of skin of colour in primary medical texts will lead to students connecting diagnosis with a one-dimensional presentation and, in turn, hesitation in diagnosing skin diseases in darker skin tones. Understanding the existence of this limitation and recognizing the value of using the British Association of Dermatologists’ medical student app to reach out to medical students, we embarked upon a project to diversify education on cutaneous diseases in darker skin tones. The app, which contains didactic clinical information, as well as picture quizzes designed to challenge a student’s ability to make a spot diagnosis, has been expanded to include a larger proportion of images of darker skin tones. Where cutaneous diseases present significantly differently in lighter and darker skin tones, we have included contrasting images to illustrate this. We hope these structural changes to the app will complement higher initiatives to improve equity in skin-of-colour image representation in undergraduate medical education on cutaneous diseases.
DE06 Application of the virtual flipped classroom as low-fidelity simulation in dermatology undergraduate education
Authors: Golenya Rebecca , Campbell Fiona , Warburton Katharine , Guckian Jonathan 
Published: June 2023

Abstract
Since the COVID-19 pandemic, the zeitgeist of teaching has evolved with virtual platforms becoming increasingly popular among both learners and institutions. Educators have had to adapt delivery methodologies to this constantly evolving digital landscape. The flipped classroom methodology is a methodology whereby learners receive information prior to the class. This enables learners to process information, increasing time for higher-level learning and problem-solving during session time. A previous scoping review demonstrated that this methodology has rarely been employed in dermatology teaching. We aimed to evaluate integration of a flipped classroom approach within a digital undergraduate setting, specifically assessing the impact on self-directed learning and written skills. Sessions involved the provision of three ready-made dermatology clinical cases, steeped in realism via inclusion of simulated referral letters, recording of patient actor histories and photographs of rashes. Students were instructed to document, request tests and prescribe as if they were a doctor, in their own time, and send requests to the educator. In total, 115 third-year medical students rotated through dermatology and were emailed online evaluation forms. Consent was sought prior to completion of the questionnaire. Sixty-three students responded. Ninety-seven per cent undertook the required prework. Ninety per cent of students felt motivated to undertake the prework, with 87.3% agreeing that the prework was an effective use of their time. Students agreed that their problem-solving skills (90.5%), analytic skills (90.5%), written skills (77.8%), self-directed learning ability (87.3%) and ability to communicate dermatology diagnoses (93.7%) improved. The session was received well by the students, as 94.9% agreed that the session was enjoyable and preferential to lecture-based material (82.5%). Qualitative data included themes of novelty, ability to visualize oneself as a doctor and intrinsic motivation. The flipped classroom methodology is rarely used within dermatology medical student teaching. This methodology was well received by students, and benefits included the development of independent learning and essential written skills. This format of a flipped classroom approach may provide benefits for professional identity formation in the context of digital environments that otherwise seem unrealistic to undergraduates.
GD06 The grass is always greener on the nearer side
Authors: Murphy Lisa , Tobin Anne-Marie 
Published: June 2023

Abstract
Climate change is becoming a significant matter of concern, and ways to reduce our impact on the environment are becoming an increasing priority. We assessed the difference in carbon emissions when patients attended our peripheral dermatology clinic rather than the tertiary centre. Our objective was to establish the reduction in carbon emissions when patients attended satellite clinics instead of a tertiary service. The addresses of patients attending clinics over a month-long period were compiled, and distances to both hospitals were measured. These were compared, and the difference was used to calculate the reduction in carbon emissions. The emissions produced by staff members were added to the total of emissions produced by patients travelling to peripheral clinics. In total, 245 patients were included in the study. The total distance travelled by patients for a round trip to the satellite clinic was 10 105.9 km, and the equivalent for the tertiary centre was 14 775 km. The mean distance travelled by patients to and from the peripheral clinic was 41.25 km. The mean distance travelled by patients to and from the tertiary hospital was 84.69 km. The amount of carbon emissions produced by the patients travelling to the peripheral hospital was 1.87 tonnes. The amount of carbon emissions of patients travelling to the tertiary hospital was 2.73 tonnes. This was a saving of 0.86 tonnes over a 1-month period. Annually, this amounts to a difference of 10.32 tonnes of carbon emissions. The provision of peripheral dermatology clinics has a significant positive impact on the environment and greatly reduces the distances travelled by patients. Our study suggests that satellite clinics could reduce carbon emissions by 10.32 tonnes annually. This equates to 138 flights from Dublin to London, or 12 900 takeaway coffees. This study has demonstrated that the provision of peripheral clinics can make healthcare more sustainable, by reducing the number of carbon emissions being produced.
GD08 Migrant dermatology
Authors: Costa Blasco Marta , Tobin Anne Marie 
Published: June 2023

Abstract
Conflict, war or economic hardship often causes refugees to flee their communities. The recognition of refugees as a diversified group from a medical aspect is one of importance as they have a range of health needs that differ from the native population. Based on a review of the published literature and cases we have reviewed in our dermatology department, we would like to outline an overview of the challenges associated with managing skin conditions for migrants and refugees, as well as key opportunities to improve care for this community. The initial barrier experienced is primarily related to communication difficulties. Healthcare providers meet obstacles in trying to communicate effectively with refugees as translation services are not always readily available and the waiting time involved for such services results in a further delay in patient management. It came to our attention that refugees often do not communicate all their issues or symptoms because of other complex social issues that take precedence over their symptoms. A separate, substantial issue arises given the lack of documentation regarding their medical background and previous and current treatments. Other challenges faced are the costs associated with accessing pharmaceutical products and not having primary care physicians. Furthermore, staying in temporary accommodation makes it more likely that they will not receive follow-up appointments, resulting in future missed appointments. Overall, refugees are a vulnerable cohort and a substantial multidepartment effort should be made to ease their integration into national healthcare ­systems.
H04 The sign of Leser–Trélat: an eponymous misnomer?
Authors: Salimi Maryam , Al-Kutubi Huda , Andrew Kashini , Patel Pooja , Orpin Stephen , Heagerty Adrian 
Published: June 2023

Abstract
The sign of Leser–Trélat is a paraneoplastic phenomenon consisting of a sudden eruption of seborrhoeic keratoses. It is credited to two surgeons, Edmund Leser (1853–1918) and Ulysse Trélat (1827–1890), who described cutaneous lesions associated with internal malignancies. Edmund Leser, the author of the Textbook of Special Surgery in 50 Lectures, initially studied law in Bonn before qualifying in medicine in Leipzig in 1880. He became Richard von Volkmann’s assistant at Martin Luther University. He was awarded his chair of surgery in 1894, 10 years after becoming a surgeon, and he practised in Goethe University, Frankfurt. Ulysse Trélat was born in Paris in 1827. His father was a republican political activist, Minister of Public Works and known as the founder of public hygiene in France. Ulysse Trélat was employed as an assistant anatomist in surgery at the ‘École Pratique’ 1 year before graduating high school in 1844. He finished his medical studies in 1854 and became a surgeon in 1857. In 1858, he was running the anatomy course in ‘École Pratique’. He replaced Paul Broca, well known for his research on Broca’s area in the frontal lobe, at Hospital Necker in 1880. In 1884, he was awarded a chair of surgery at ‘Hospital de la Charite’, replacing Leon Athanase Gosselin. Notable among his works is the description of the ‘Baizeau and Trélat method’ of surgical repair of cleft palate, and his book Clinique Chirurgicale. Leser and Trélat independently published papers describing skin lesions associated with mammary carcinoma and visceral malignancies. However, their description of cutaneous lesions was more in keeping with the appearance of senile angiomata or Campbell de Morgan spots. Therefore, the credit should go to Eugen Von Hollander (1867–1932), another German surgeon who accurately described the lesions in a paper published in 1900 titled ‘Contributions to the early diagnosis of intestinal carcinomas’. He observed skin changes associated with internal malignancies consisting of an eruption of flat, shiny, pigmented, glandular, epithelial growths similar to seborrhoeic warts or verrucae seniles in young patients with cancer. He hypothesized that there might be a link between abnormal epithelial proliferation in internal organs and skin keratinocyte proliferation. He is remembered for performing the first facelift, on a Polish aristocrat in 1912. The sign of Leser–Trélat is so deeply embedded in medical literature and the minds of modern practitioners that it is unlikely to ever be erased. However, the contribution of Eugen Von Hollander should not be forgotten.
H06 Beauty is pain: symmetries in the cosmetic practices of ancient Rome and the modern day
Authors: Elmansouri Ahmad 
Published: June 2023

Abstract
In the 21st century, the application of toxins, hair removal and skin bleaching are just a small part of an industry standard set by an influential few. There is a surprising degree of symmetry between modern-day practices and those of our ancient ancestors. Although the first use of cosmetics can be traced back to ancient Egypt, the Roman Empire developed such intricate practices that they affected fashion, law and public health. Paleness of skin indicated higher social status in the Roman Empire (625 Bc–Ad 476): it suggested one could afford to remain indoors. Cerussa—sugar of lead—was used to this end. Firstly, vinegar was applied to white lead shavings. Once the lead had dissolved and dried, it was ground and formed into tablets. Despite popular belief, the Romans were aware of the dangers of lead just as we are aware of the toxic nature of mercury and other harmful bleaching agents used by people in modern times. Just as modern influencers are able to shape beauty trends, it is likely that ancient writers held similar sway. In Ad 77, Pliny the Elder wrote that one’s eyelashes fell out from excessive sex and, understandably, the affluent Roman would not want to be regarded in such a light. Eyeliner created from soot and ash was applied with a needle or stick to increase the appearance of thickness of eyelashes. The Italian word for makeup is trucco (trick), and this viewpoint was reflected in several accounts. The poet Juvenal recorded that ‘A woman buys scents and lotions with adultery in mind’. Unfortunately, there is an absence of accounts by women delineating the female attitude towards cosmetics at the time. The modern desire to remove bodily hairs is mirrored by ancient Roman practice. Romans in high society would normally remove hairs, using anything from tweezers to ancient razors made of flint, but they also used hair as a distinctive feature. The emperor Augustus grew his beard and hair out on hearing the devastating news of the defeat of Varus, to reflect his mental state. Much like the $380 billion-dollar cosmetic industry, luxury cosmetics attained by high society had economic consequences. In 189 Bc, when Rome experienced economic strain, the controversial law of LexOppia was introduced, limiting the maximum wealth of women and subsequently their use of these luxury cosmetics. A surprising number of similarities exist between modern cosmetic practices, trends and harms and ancient Roman ones.
H11 More cancer, better counting or better at diagnosis? The history of skin cancer registration
Authors: Apthorp Timothy , Venables Zoe C , Levell Nick J 
Published: June 2023

Abstract
Cancer registries help us to understand skin cancer cause, prevalence, treatment and prevention. They provide evidence to gain new healthcare resources. This paper studies the evolution of cancer registries and their relevance to dermatology. In the 16th century, ‘Bills of Mortality’, the first English healthcare registry, catalogued the number and causes of death in London parishes. Originally set up to track bubonic plague, it expanded to cover other diseases, including cancer. The 1728 London ‘General Census of Cancer’ was an early systemic study of cancer. In the 19th and early 20th centuries, hospital censuses often monitored cancers. These were superseded by population-based cancer registries, allowing continuous data collection. An early example is the Hamburg Cancer Registry (1926), which recorded names on a card-based registry and compared them with death certificates. The first national cancer registry was the Danish national cancer registry, formed in 1942. In the UK, the Scottish Cancer Registry was formed in 1958, the Welsh Cancer Intelligence & Surveillance Unit in 1972 and the Northern Ireland Cancer Registry in 1994. In England, eight regional registries were created, with the South West being the first in 1945. The Calman–Hine report (1995) highlighted a desire for a national cancer registry. In 2008, the National Cancer Intelligence Network enabled the assimilation and analysis of data sets from English registries. They merged in 2013, forming the National Cancer Registry and Analysis Service (NCRAS), England. Critically, the 2006 National Health Service act (section 251) allowed cancer data collection without formal consent. Although melanoma data were generally good quality, the inclusion and quality of nonmelanoma skin cancers (NMSCs) were historically less reliable, with improvement since 2013. Historically, the exclusion of NMSCs from published cancer data is common. Wales is the last UK registry to not routinely report NMSC. However, this is due to change in 2024. The ‘global burden of disease tool’ (1990) utilizes various sources, including cancer registry data, to model incidence, mortality and health implications of disease globally, including melanoma and NMSCs. In 2022, the British Association of Dermatologists joined with the NCRAS to develop the Get Data Out skin tool, an annually updated website featuring more granular epidemiological data on skin cancers. High-quality epidemiological data are essential to understanding skin cancer’s regional and chronological variations, and to ensure that resources for healthcare and research are allocated appropriately.
H18 James Clark White: a pioneer of American dermatology
Authors: Smith Lucy , Yesudian Paul Devakar 
Published: June 2023

Abstract
James Clark White, a chemist, botanist and eminent dermatologist, was a born to a shipbuilder in Boston in 1833 and from a young age was fascinated by the natural world around him. White proceeded to study medicine at Harvard and spent a further year at the University of Vienna. He was taught by renowned dermatologists, including Ferdinand Von Hebra, whose detailed drawings and lectures in dermatology were pivotal to White’s interest in the field. White’s varied background in both chemistry and botany translated into his prolific academic work on environmental dermatoses. His famous Dermatitis Venenata: An Account of External Irritants Upon the Skin was the first to provide a collective resource of contact dermatitis, before the pathogenesis of these conditions was truly understood. Another instrumental piece, ‘A case of keratosis (ichthyosis) follicularis’ is now recognized as the first description of Darier disease, which was subsequently named Darier–White disease. White authored eight books and over 100 original articles that covered many areas of cutaneous disease. White returned to Massachusetts General Hospital where, after spending a few years in general practice, he devoted his career to skin disease. He developed the dermatology department into a centre of excellence and was ultimately appointed the first chair of dermatology. A founding member of the American Dermatology Society, and twice its chairman, he progressed to become the first full professor of dermatology in the USA. White spearheaded dermatological education at Harvard, extending the specialty training from 2 to 4 years and introduced an exit examination for residents. White is regarded as part of the vanguard that elevated American dermatology to European standards in the late nineteenth century. In his personal time, White was ardent collector of fine wines and china. He devoted much time reading and listing species of birds and plants that he encountered around his residence in Belfast, Maine. He died in September 1916. His family also had distinguished careers, including his son Charles J. White, who took over his practice to also become a professor of dermatology at Harvard Medical School; and a grandson, also named James C. White, a professor of neurosurgery at the same institution. Almost two centuries after his birth, White’s lifelong dedication to dermatology has produced many works that remain relevant and inspire the dermatologists of today.
H21 Acne treatments through the ages
Authors: Doyle Claire 
Published: June 2023

Abstract
The search for an effective treatment for acne dates back to 1550 Bc with the Ebers Papyrus, one of the oldest medical documents in the world, mentioning the application of raw honey and sulfur to affected areas. King Tutankhamun is widely believed to have suffered from acne as his tomb was filled with popular acne treatments of the time such as sulfur, sour milk, Aloe vera, myrrh and salt to rid him of his affliction in the afterlife. Much like the Egyptians, ancient Greek texts mention honey and sulfur for the treatment of acne. A Greek physician named Theodosius suggested that patients wipe their spots with a towel while watching a star falling from the sky as he suggested this would result in their spots falling from their faces. The Romans, in addition to the aforementioned honey and sulfur, trialled crocodile meat, cypress oil, sour cheese, leek leaves and cinnamon in their attempts to find a successful treatment. Thomas Bateman wrote in A Practical Synopsis of Cutaneous Disease that a patient reported that bruised parsley cleared her acne. He was also an advocate of remedies used by ancient civilizations. At the turn of the 20th century, American physician W.A. Pusay wrote about the use of ionizing radiation in the treatment of acne. Radiation was widely used in the treatment of acne until the 1960s, when concerns regarding associated secondary carcinogenesis led to the treatment falling out of favour. In the first half of the 20th century, phototherapy was a popular treatment for acne, and quartz mercury vapour lamps, in particular, were used. The most significant advancement in the treatment of acne was the discovery of the utility of synthetic vitamin A. In the 1960s, pharmaceutical company Roche trialled the compound 13-cis-retinoic acid as a treatment for skin cancer. This was ineffective, but it was demonstrated that it was efficacious in the treatment of acne. A study published in 1979 in the New England Journal of Medicine demonstrated that 13 of 14 patients with acne conglobate experienced clearance of their acne. In 1982, the US Food and Drug Administration granted approval for 13-cis-retinoic acid, or isotretinoin, as a treatment for acne. It was introduced in Europe in 1983. Isotretinoin has been a life-changing advance in the treatment of this disease, but its teratogenic effects mean it must be prescribed with education and care.