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Biomedical subjects

Adrian C Lim

Publications and source records attributed to Adrian C Lim.

5 recordsLinked to original sources

Operational teledermatology in Broken Hill, rural Australia.

From January 2001 to January 2002, Broken Hill, New South Wales, served as a trial site for teledermatology as one method of access to dermatologists. Fourteen participating general practitioners referred 46 patients making up 48 teledermatology cases. The mean diagnostic agreement between general practitioners and dermatologists was 35% and 50% for primary and differential diagnoses, respectively. Teledermatology patients formed 12% of the collectively referred dermatology patients (outpatients and teledermatology). In this project, high patient and general practitioner acceptability and positive medical outcomes confirm the value of rural teledermatology. However, this project also revealed unexpected barriers and pitfalls in the effective operation of rural teledermatology. Lack of education of participants, inertia among potential users and patient inconvenience are issues that may adversely affect the effective implementation of rural teledermatology.

Dermatology↗

Assessing diagnostic skill in dermatology: a comparison between general practitioners and dermatologists.

This retrospective study was conducted to assess and compare the diagnostic accuracy between referring general practitioners and dermatologists with regard to skin conditions. Six hundred and fifty-six consecutive general practitioner referrals to a private dermatology practice and a dermatology outpatient department were assessed. The concordance rate in diagnoses from a wide spectrum of dermatological diseases was compared between general practitioners and dermatologists. Referring general practitioners agreed with dermatologists' clinical diagnosis and histology (when available) in 42% of cases. The concordance between general practitioners and dermatologists in the setting of non-biopsied cases is 45%. One hundred and fifty-one of 656 (23%) conditions had histological confirmation. Overall, general practitioners agreed with the histological diagnosis in 24% of cases and dermatologists agreed with the histological diagnosis in 77% of cases.

Clinical Competence↗

Imaging the skin.

Since the discovery of X-rays, the use of imaging technology has continued to play an important role in medicine. Technological advancements have led to the development of various imaging modalities, most of which have been used to image organs deep within the human body. More recently, attention has focused on the application of imaging technology for evaluation of the skin. A variety of techniques are currently being used to examine the skin and these include specialized photography, surface microscopy, ultrasound, laser Doppler perfusion imaging, confocal microscopy, and magnetic resonance imaging. These modalities can provide information that can assist in the management of skin problems. Although many of these techniques are still undergoing research, they are showing promise as useful clinical tools in dermatology.

Humans↗

Allergic contact dermatitis to an expired moisturiser.

A 64-year-old man developed an allergic contact dermatitis while using an expired sorbolene cream. Patch tests to the product ingredients were all negative. Repeated open application test to the expired product produced a strong reaction while an identical-brand non-expired product did not elicit a reaction, suggesting the presence of an unidentified degradation product or compound, acting as an allergen in the expired product. This case is intriguing in that it contrasts the ubiquitous use of over-the-counter topical agents with the exceedingly low incidence of contact dermatitis to expired topical products.

Administration, Topical↗

A granuloma annulare-like eruption associated with the use of amlodipine.

A granuloma annulare-like drug reaction is a rarely encountered clinical entity. A 64-year-old Caucasian female developed a granuloma annulare-like reaction 13 days after starting amlodipine and cleared within 3 months after drug cessation. The eruption consisted of multiple erythematous pruritic papules, distributed symmetrically over the lateral aspects of the legs and thighs, as well as on both palms. Histology showed focal collagen degeneration and significant interstitial histiocytic dermal infiltrate suggestive of granuloma annulare. We review previously reported cases of granuloma annulare-like drug reactions, in the context of a recently proposed classification for drug-induced interstitial granulomatous reactions.

Amlodipine↗