Publications by authors named "Harrison A Edwards"

6 Publications

  • Page 1 of 1

An Australian tertiary hospital analysis of outpatient dermatology clinical and demographic characteristics.

Australas J Dermatol 2021 Aug 16. Epub 2021 Aug 16.

School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Objectives: Literature on dermatology outpatient demographic and clinical data is limited, and the few studies on this topic are mainly conducted overseas, with medical systems and case mix different to Australia. This study presents demographic data relating to dermatology public outpatient referrals to a tertiary hospital in Brisbane, Australia, and determines what additional structured data should be collected to formulate and evaluate initiatives to address service issues such as referral quality, triage process and wait times.

Methods: A four-year retrospective audit was undertaken, summarising all referrals (n = 7140) and clinical dermatology encounters (n = 53 844) between January 2016 and December 2019 at Princess Alexandra Hospital (PAH), the largest hospital in Metro South Health (MSH), serving a population of one million. PAH has one of the two largest public dermatology clinics in Queensland and is the only dermatology service within MSH.

Results: Patient demographic data, wait time by triage category, referral rates over time and encounter durations were collected. Structured diagnostic data (e.g. ICD-10 coding) of the provisional diagnosis, comorbidities, medications and the final diagnosis are not collected in a structured format and would be a valuable addition.

Conclusions: The clinical burden of public dermatology is increasing. Both collection and analysis of structured data pertaining to the referrals and encounters are important to help formulate, implement and evaluate initiatives that aim to improve health service provision in this area.
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http://dx.doi.org/10.1111/ajd.13677DOI Listing
August 2021

Anatomic Distribution of Cherry Angiomas in the General Population.

Dermatology 2021 Jul 22:1-9. Epub 2021 Jul 22.

The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia.

Background: Cherry angiomas are common benign vascular skin lesions of unknown aetiology, found largely on the trunk. However, their exact anatomic distribution besides their truncal predisposition, and how they manifest in the general population, has not been characterised.

Methods: Three-dimensional (3D) total body imaging was obtained from 163 adult participants of a general population cohort study in Brisbane, Australia. Demographic, phenotypic, and sun behaviour characteristics were collected using a standard questionnaire along with history of melanoma and keratinocyte cancers. Cherry angiomas were identified using an automated classification algorithm with a sensitivity of 87% and a specificity of 99%, developed specifically for this study population.

Results: The 3D total body images of 163 participants were analysed. Participants had a median age of 57 years and 61% were male. On average, males had more angiomas than females (median of 16 vs. 12) and the number and size of cherry angiomas increased with age. In addition to male sex and age, an increase in angiomas was associated with Caucasian ancestry other than British/Irish only, fair skin colour opposed to medium/olive, having green/hazel eyes compared to blue/grey, and personal history of melanoma. The most common site for cherry angiomas was the front trunk, followed by the back. Interestingly, although males had more angiomas overall, females had more angiomas on the legs.

Conclusion: Describing the distribution of cherry angiomas by body site is an important step towards further understanding of the aetiology of angiomas. While personal history of melanoma is associated with an increased number of cherry angiomas, whether this association is prognostic, co-occurs with development of melanoma, or is merely fortuitous requires further investigation.
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http://dx.doi.org/10.1159/000517172DOI Listing
July 2021

Teledermatology Adaptations in the COVID-19 Era.

Front Med (Lausanne) 2021 26;8:675383. Epub 2021 May 26.

Princess Alexandra Hospital, Woolloongabba, QLD, Australia.

The COVID-19 pandemic has required health services worldwide to adapt to dramatically changing healthcare needs and risks across all medical specialties. In the dermatology department at Princess Alexandra Hospital, Brisbane, Australia, we developed and implemented a teledermatology system with 1 week's notice to help reduce infection risk bidirectionally, while saving patients many hours of travel and waiting time with acceptable technological substitutes for the clinical encounters. In this study, we report the efficacy and tolerability of our telephone consultation and store and forward imaging system, including patient experience from validated survey data. Our design, implementation and usage of a remote-default system provides experience and lessons to draw upon in developing future telemedicine systems to address dermatology service maldistribution - an issue affecting large areas of Australia - as well as preparedness for future infection mitigation requirements.
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http://dx.doi.org/10.3389/fmed.2021.675383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187587PMC
May 2021

A facility and community-based assessment of scabies in rural Malawi.

PLoS Negl Trop Dis 2021 Jun 1;15(6):e0009386. Epub 2021 Jun 1.

Department of Dermatology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain.

Background: Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme.

Methodology/principal Findings: From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit.

Conclusions/significance: Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control.
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http://dx.doi.org/10.1371/journal.pntd.0009386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195395PMC
June 2021

The cost of dupilumab treatment for severe atopic dermatitis is largely offset by broader health-care savings and improvement in quality of life.

Australas J Dermatol 2020 May 21;61(2):e273-e275. Epub 2020 Feb 21.

Department of Dermatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

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http://dx.doi.org/10.1111/ajd.13260DOI Listing
May 2020

Multidisciplinary management of periocular tumour excision repair.

Australas J Dermatol 2019 Feb 15;60(1):e73-e74. Epub 2018 May 15.

Skin Hospital, Sydney, New South Wales, Australia.

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http://dx.doi.org/10.1111/ajd.12844DOI Listing
February 2019
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