Masters Degrees (Dermatology)

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Browsing Masters Degrees (Dermatology) by Subject "Dissertation (M.Med. (Dermatology))--University of the Free State, 2021"

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    A cross-sectional study of the practice, knowledge and perception of suncreen use among dermatology patients at Universitas Academic Hospital
    (University of the Free State, 2021-02) Maepa, Jeannett Reabetswe; Maruma, Frans
    Background: Sunscreens are produced to protect the skin from cutaneous acute and chronic adverse effects of ultraviolet radiation. Their correct use is pivotal in determining their efficacy. Objectives: To assess the practice, knowledge, and perception or understanding with regards to sunscreen use in dermatology patients visiting Universitas dermatology clinic in Bloemfontein, Free State province; by comparing patients with personal skin cancer history and/or risk factors and the group of patients that do not have skin cancer history or risk factors. Methods: Using a questionnaire as a data collection tool, a cross-sectional study was carried out on the days of adult clinic over a period of three weeks. All new and old patients attending the Universitas Academic hospital dermatology clinic, aged 18 years and older, and agreeing to participate, were included in the study. Different parameters were used to measure the practice, knowledge, and perception regarding sunscreen use and its benefits. Results: 131 out of 150 completed questionnaires qualified to be included in the data analysis. Majority of the respondents were female (64. 6%) and >60 years of age (46.9%). Risk factors for developing skin cancer were used to classify the high risk group which had a total number of 74 respondents (56.5%). The high risk group was compared with the lowrisk group when analysing response data for the practice, knowledge, and perception of sunscreen use. The study revealed that 46 respondents (62.2%) from the high risk group wear sunscreen in comparison with 19 respondents (45.2%) in the low risk group. A significant number of respondents from both groups (21% from the high risk group versus 14.1% from the low risk group) do not use sunscreen correctly. Assessment of the knowledge about sunscreen use demonstrated that 46.7% of the high risk group had slightly more knowledge on proper use of sunscreen as compared to 30% of the low risk group. Although both groups had differing opinions on whether sunscreen is a an over-the-counter drug or merely a cosmetic product, they both acknowledged its protective benefits to the skin. Conclusion: Assessment on the practice and knowledge of sunscreen use highlighted the suboptimal and inappropriate use of sunscreen by dermatology patients, as well as inadequate knowledge about correct use of sunscreen in contrast to having a good perception regarding the protective role of sunscreen against skin cancer. There is a dire need for more education or counselling of all dermatology patients on regular and correct use of sunscreen, particularly for the reduction of skin cancer in high risk individuals.
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    Stevens-Johnson syndrome and toxic epidermal necrolysis at Universitas Academic Hospital: a 4-year review
    (University of the Free State, 2021-11) Moosa, Fatima; Armour, Claire; Van Rooyen, Cornel
    Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening dermatologic conditions that are part of the same disease spectrum. Drugs are the main inciting factor of this delayed (type IV) hypersensitivity reaction which produces epidermal and mucosal detachment. Despite morbidity and mortality being high, there are limited data available on SJS and TEN in South Africa. The objective of this study was to characterise patient demographics, aetiology and implicated drugs, treatment, and outcome in patients with SJS and TEN at a tertiary academic hospital in the Free State, South Africa. Methods: A retrospective, cross-sectional descriptive single centre study which included participants managed at Universitas Academic Hospital, South Africa between 2016 and 2020 was performed. Results: Fifty-five cases meeting the inclusion and exclusion criteria were included in this study. The cohort comprised TEN, SJS-TEN and SJS (n=40, n=10 and n=5 respectively). The mean age of the cohort was 37-years (range: 21- 67). Seventy percent were HIV-infected. Antibiotics (58%) and antiretroviral therapy (30%) were the most common drug classes implicated, with trimethoprim-sulfamethoxazole (22%) and nevirapine (16%) being identified as the most commonly implicated drugs. The major complication in the cohort was sepsis (42%). Supportive care formed the mainstay of treatment and the mortality rate was 14.5%. Conclusion: The majority of the patients in this cohort were HIV infected, with antiretroviral therapy (specifically nevirapine) and antibiotics (specifically trimethoprim-sulfamethoxazole, used for prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in the HIV-infected population) being commonly implicated causes of SJS and TEN. In resource-limited settings such as our facility, supportive care forms the predominant mode of treatment with a relatively good outcome.