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Professor Chris Bunker wins Sir Archibald Gray Medal

The British Association of Dermatologists (BAD) is pleased to announce that Professor Chris Bunker, past-president of the BAD (2012-2014), is the winner of the 2019 Sir Archibald Gray Medal.

Named after the founder of the BAD, the Sir Archibald Gray Medal is awarded as the BAD's ultimate accolade for outstanding services to dermatology.

Professor Bunker is a Consultant at the University College London Hospital. 

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36 per cent of top YouTube videos on eczema are potentially harmful

Thirty-six per cent of the most-viewed eczema YouTube videos are potentially harmful, according to a study presented at the British Association of Dermatologists’ Annual Meeting in Liverpool (2nd-4th July 2019).

Eczema, also known as atopic dermatitis, affects approximately 20 per cent of children and two per cent of adults worldwide making it one of the most common skin conditions. YouTube, the internet’s second most visited website*, hosts thousands of videos on the topic.

This study analysed the quality of information provided in the 100 most-viewed eczema-related videos on YouTube. These have a combined total of 8,527,624 views and a duration of seven hours and 52 minutes.

The quality of the videos was assessed using the Global Quality Scale (GQS) and the DISCERN instrument* and the videos were classified into ‘useful’, ‘misleading’ and ‘potentially harmful’. The number of viewers’ ratings (‘likes’) was correlated with the scores of the GQS and DISCERN.

The authors found that 46 per cent of the YouTube videos were misleading, and 36 per cent were found to disseminate content potentially dangerous to eczema patients.

For example, patients with eczema were not only encouraged to pursue unnecessary diets such as avoidance of dairy or gluten, but also to use harmful topical treatments and home-based phototherapies without any detailed information about the duration of the application and potential risks. Furthermore, conventional medicine and physician’s advice were discredited in various ways, while promising a “fast and easy cure”.

The two assessment tools, GQS and DISCERN, revealed that around two thirds of the videos were of poor or very poor scientific quality. The viewers’ ratings did not correlate with the results of the GQS and DISCERN analysis indicating that the viewers were not able to recognise good and poor quality of the videos.

Healthcare institutions and universities accounted for just 21 per cent and eight per cent of the videos, respectively, with private individuals and promotors of complementary and alternative treatments having posted 50 per cent of the videos analysed.

Dr Simon Mueller of University Hospital Basel, Switzerland, and lead author of the study, said:

“Social media is a continually growing source of medical information for patients, particularly for young people. This information often doesn’t undergo review for scientific accuracy or quality and as our research shows, it has the potential to be heavily biased or even harmful.

“We hope that our research will make people think twice about the medical information they get from social media. The internet is a powerful and often helpful research tool, but where you source your information from is important. We do not advise against this kind of lay research, but we clearly advise against decision making based on YouTube videos only. We rather encourage to discuss the content of the videos with a doctor of trust to avoid adverse outcomes.”

Holly Barber of the British Association of Dermatologists, said:

“With so much information about eczema available online, it can be hard to know who and what to trust. This study highlights that the number of views and likes a video has does not necessarily match up with the quality and accuracy of information presented.

“It’s really important that individuals and organisations are responsible about the information they share on social media. For members of the public looking for information, be sceptical of extraordinary claims made without evidence, and make use of reputable bodies such as the National Eczema Society, the NHS, or the British Association of Dermatologists.”

-Ends-

Notes to Editors:

* Alexa Internet, January 2019

** Two repeatedly used quality assessment tools known as the DISCERN instrument and the Global Quality Score (GQS) were applied to evaluate the medical quality of the posted videos. The DISCERN instrument measures a video’s quality of information about treatment choices. Composed of 16 questions, reliability (questions 1-8), quality of health information (questions 9-15) and overall quality of a publication (question 16) can be evaluated by assigning 1-5 points to each question. The GQS is based on a 5-point scale measuring the quality of the video, its flow and value as a source of information for medical lay people. For both tools, the higher the accomplished value, the higher the quality of the video clip.

Study details

If writing about this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.

The conference will be held at the ACC Liverpool from July 2nd to 4th 2019 and is attended by approximately 1,300 UK and international dermatologists.

YouTube on atopic dermatitis: fiction, falsehoods and few facts

S.M. Mueller,1 V.N. Hongler,1 P. Jungo,1 L. Cajacob,1 S. Schwegler,1 E. Steveling,1 S. Hogg,2 A. Navarini,1 O. Brandt1 and K.S. Hofmeier1

1University Hospital Basel, Basel, Switzerland

2The Manchester Academic Health Science Centre, Manchester, U.K.

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin condition affecting approximately 20% of children and 2% of adults worldwide. In recent years, the role of social media in patient education has grown considerably. In particular, YouTube, the second most visited website in existence, has become a recognized source of medical information for healthcare consumers, including dermatology patients. In addition to the advantages that YouTube offers in this context, there are also potential dangers as videos may contain unscientific, misleading or even harmful information. As little is known about YouTube as a source of information on AD, we aimed to investigate the quality of AD-related videos and how these videos are perceived. The quality of the 100 mostviewed AD-related videos, with a total of 8 527 624 views and 7:52 h of duration, was assessed using the Global Quality Scale (GQS) and the DISCERN instrument. Videos were classified into ‘useful’, ‘misleading’ and ‘potentially harmful’ and the viewers’ ratings (‘likes’) were correlated with the scores of the GQS and DISCERN. According to the GQS and DISCERN, 68% and 62% of the videos were of poor or very poor scientific quality, respectively. Overall, 46% of the videos were classified as misleading and 36% as potentially dangerous. The major topics addressed in the videos were topical treatments, (non)pharmaceutical advertisements, patient education, nutrition and complementary and alternative treatments (CAM). The viewers’ ratings did not correlate with the scores of the GQS and DISCERN (Spearman’s correlation rho = 0.17, P = 0.08 and rho = 0.12, P = 0.25 respectively). In total, 50% of the videos were posted by private individuals and promotors of CAM, whereas videos by healthcare institutions accounted for 21% and universities for 8% only. Our in-depth study demonstrates that two-thirds of the AD-related videos we analysed were of (very) poor scientific quality, and many were found to be disseminating misleading or even dangerous content. Subjective anecdotal and unscientific content is overrepresented and viewers do not appear to recognize the quality of the videos. As stated elsewhere, strategies by professional dermatological organizations are urgently needed to improve their presence and visibility on YouTube.

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk

About us:

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk

The British Association of Dermatologists publishes two world-renowned dermatology journals, both published by Wiley-Blackwell. The British Journal of Dermatology is one of the top dermatology journals in the world, and publishes papers on all aspects of the biology and pathology of the skin. https://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2133  

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Pet products a hidden health risk for owners and their animals

Pet products are a hidden source of potential allergens, according to research being presented at the British Association of Dermatologists’ Annual Meeting in Liverpool (2nd-4th July 2019).

The lack of regulation around animal care products, such as shampoos and deodorising sprays, is exposing pets and their owners to ingredients which would be banned in equivalent products for people. This has led to concerns that these products have the potential to cause new allergies or trigger pre-existing ones. 

The researchers from the Royal United Hospital, Bath, surveyed 62 cosmetic products intended for use on dogs. Twenty-seven of these products were classified as ‘leave-on’, meaning that they are not washed off after use, and 35 were classified as ‘rinse-off’, meaning that they are washed off after use.

Twenty-six per cent of leave-on products and 51 per cent of rinse-off products contained the preservatives methylisothiazolinone (MI) and/or methylchloroisothiazolinone (MCI). EU regulations ban these ingredients from use in leave-on products and limit their use in rinse-off, as they are well known allergens, but this ban does not extend to cosmetics aimed at animals.

Fragrance allergy is very common, yet 56 per cent of leave-on products and 83 per cent of rinse-off products contained known fragrance allergens.

The EU also requires ingredients to be labelled in cosmetics, but again, this does not apply to pet products. Six of the 62 products had vague or no ingredient listings.

Dr Lucy Howard of the Royal United Hospital, Bath, said:

“Our study has highlighted a number of well-known allergens contained in pet cleaning products. Sometimes their presence is concealed by labelling with a different name, and it may be concealed by no labelling at all. These chemicals have the potential to cause allergic skin reactions in pet owners caring for their animals.

“There is no specific legislation regulating these ingredients in the same way that there is for human cosmetics. Clinicians should consider this when patients present with hand dermatitis, and pet owners should be able to expect the same standards for their pets as they do for themselves.”

Matthew Gass of the British Association of Dermatologists, said:

“We hope that this research will highlight the lack of specific legislation for the regulation of animal cosmetics, despite the risk to pet owners and their animals. After all, it is not as if dogs apply their own shampoo.

“If you are a pet owner and you are suffering from hand eczema, then it is possible that your pet products are the source of this issue. If you go for tests, then it is something worth mentioning to your doctor.”

Since 2013, the British Association of Dermatologists has issued several warnings about the rate of MI/MCI allergies. In 2016, the EU banned MI from leave-on cosmetics, following rules in 2015 that only allowed the mixture of MCI and MI as a preservative in rinse-off cosmetic products at a maximum concentration of 0.0015% (15ppm) in a ratio 3:1 of the two substances.

-Ends-

Notes to editors:

If writing about this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Meeting.

The conference will be held at the ACC, Liverpool from July 2nd – 4th 2019, and is attended by approximately 1,300 UK and international dermatologists.

Dogs: a hidden source of exposure to common allergens

L. Howard, N. Mansoor and D.A. Buckley

Royal United Hospital, Bath, U.K.

Consumers are protected from direct cutaneous exposure to common allergens such as preservatives and fragrances by European Union (EU) legislation, which bans certain allergens from leave-on products, limits the concentration of others and mandates statutory product labelling using International Nomenclature of Cosmetic Ingredients (INCI) names. No such legislation applies to products intended for direct application to animals. However, animal lovers may become sensitized to these preparations, or such products may unknowingly act as elicitants in previously sensitized patients. We undertook a survey of cosmetic products intended for use on dogs. All items were on the shelves of U.K. pet stores and garden centres in December 2018, or available for online purchase. In total, 62 products were surveyed: 27 leave-on (detangling and deodorizing sprays and leave-on shampoos) and 35 rinse-off (shampoos and conditioners). Of the 27 leave-on products, 19 (70%) were manufactured in the U.K., seven in the U.S.A. or China, and one did not state the country of manufacture. Seven (26%) contained methylisothiazolinone (MI) and/or methylchloroisothiazolinone (MCI), which in three cases was labelled only as Kathon CG. Fifteen (56%) contained fragrance; two of these contained hydroxyisohexyl cyclohexene carboxaldehyde (Lyral). Two of the 27 were labelled only as containing ‘preservative blend’, while one had no ingredient listing and one contained methyldibromoglutaronitrile. Of the 35 rinse-off products, 18 (51%) were manufactured in the U.K., 16 in the U.S.A. or China, and one did not state the country of manufacture. Eighteen (51%) contained MI and/or MCI, which in four cases was labelled only as Kathon CG. Twenty-nine (83%) contained fragrance. Two of the 35 productswere labelled only as containing ‘preservative blend’ and one had no ingredient listing. All seven items labelled as Kathon CG were manufactured in the U.S.A. and all four labelled ‘preservative blend’ were manufactured in the U.K. Four leave-on products containing MI and/or MCI were manufactured in the U.K. The EU Cosmetics Directive 1223/2009 (30.12.2009) states that it relates only to cosmetic products and not to medicinal products, medical devices or biocidal products. Ingredients must be labelled on the packaging, or as an enclosed leaflet. Despite the increasing production of cosmetics for animals, there is no specific legislation for the regulation of such products (safepetcosmetics.eu). Pet owners with hand dermatitis should be questioned specifically about direct skin contact with animal cosmetics, and non-INCI names of any positive allergens should be provided after patch testing. 

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk

About us:

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk

The British Association of Dermatologists publishes two world-renowned dermatology journals, both published by Wiley-Blackwell. The British Journal of Dermatology is one of the top dermatology journals in the world, and publishes papers on all aspects of the biology and pathology of the skin. https://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2133

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