Author: Jason Curtis

Audit on the recognition and initial management of ovarian cancer in secondary care: Compliance with NICE CG122 & QS18 (2026)

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Type of publication:

Conference abstract

Author(s):

*Huda N.-U.; *Sahu B.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S41), 2026. Date of Publication: 01 Jun 2026.

Abstract:

Background: Ovarian cancer is the sixth most common cancer in women in the UK and is often diagnosed at an advanced stage due to non-specific early symptoms. NICE Clinical Guideline CG122 and Quality Standard QS18 provide recommendations for timely recognition, investigation, and referral. Objective(s): To evaluate whether women presenting with symptoms suggestive of ovarian cancer were investigated and managed in accordance with NICE CG122 and QS18 in our NHS Trust. Method(s): A retrospective audit was conducted on 20 women referred to the gynaecology department with suspected ovarian malignancy. Data collected included age, tumour markers (CA125), risk of malignancy index (RMI), imaging, tissue diagnosis, chemotherapy decisions, tertiary care involvement, and access to support services. Result(s): Most patients (95%) were over 40 years old. Advanced-stage disease was present in 65% of cases. Compliance with tumour marker testing and imaging was generally high, but RMI calculation and referral documentation were inconsistent. Ninety percent of advanced-stage patients had tissue diagnosis prior to chemotherapy. Definitive surgery was mainly performed in tertiary centres. Support needs were not routinely identified, and trial participation was limited. Delays in investigations and referral were noted in a minority of cases, and atypical presentations posed diagnostic challenges. Documentation regarding lymph node assessment during staging was incomplete. Recommendations: Enhance patient flagging to support services, provide targeted clinician education on NICE guidelines, and share audit feedback with tertiary partners. Conclusion(s): While most patients received appropriate investigations and referral, improvements are needed in early recognition, documentation, and holistic care planning. Ongoing audit and education are essential to optimise adherence to guidelines and improve outcomes in ovarian cancer management.

DOI: 10.1111/1471-0528.70281

Management of post-menopausal women who are high-risk HPV positive with normal, borderline, or mildly dyskaryotic cytology and unsatisfactory colposcopy (2026)

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Type of publication:

Conference abstract

Author(s):

Stout A.; *Sutherland D.; China S.; Byrom J.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S80-S81), 2026. Date of Publication: 01 Jun 2026.

Abstract:

Background: Unsatisfactory colposcopy is common, occurring in 10-20% of women. Post-menopausal women who are high-risk HPV positive with normal, borderline, or mildly dyskaryotic cytology and unsatisfactory colposcopy represent an increasing management dilemma. Currently, there is no guideline for this group. Management among UK colposcopists is thought to vary. Objective(s): Our survey aimed to collate opinions of BSCCP members regarding management of this patient group, and identify a consensus opinion. We sought to compare trends with a similar survey conducted in 2018, following the introduction of primary HPV screening. Method(s): All BSCCP members were invited to complete an online survey conducted between 29/01/2026 and 05/03/2026. Result(s): We received 141 responses from medical and nursing colposcopists, the majority being experienced practitioners. Management strategies varied considerably. 60.7% would perform see-and-treat LLETZ in all or high-risk patients, while 17.9% would never offer treatment at first review. If histology was not obtained initially, 52.9% recommended repeat cytology and colposcopy at 12 months. For persistent disease >24 months, 52.2% recommended LLETZ, with an additional 45.6% considering treatment based on patient preference or risk factors. Hysterectomy was offered by 84.9% in persistent cases with risk factors or on request. Compared with 2018, see-and-treat LLETZ was more common, follow-up intervals were longer, and MDT discussion less frequent. Conclusion(s): Practice among UK colposcopists in this patient group remains variable, and demand for national guidance is high. Our survey demonstrated variety in practise on initial presentation, with a preference for excisional treatment or hysterectomy in cases of persistent disease.

DOI: 10.1111/1471-0528.70281

Variation in antenatal anaemia guidelines across the NHS in the United Kingdom: A cross-sectional study (2026)

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Type of publication:

Journal article

Author(s):

Haynes S.; Balboula I.; Collins P.; *Parry-Smith W.; Fye H.; *Elsmore A.; Collis R.; De Lloyd L.; Churchill D.; Bell S.F.; Stanworth S.J.

Citation:

British Journal of Haematology. (no pagination), 2026. Date of Publication: 2026. [epub ahead of print]

Abstract:

Antenatal anaemia affects up to 30% of pregnant women in the United Kingdom and is a recognised clinical priority. National management guidance is published by the British Society of Haematology (BSH), but the extent to which local National Health Service (NHS) guidelines align with it is unknown. We conducted a cross-sectional document analysis of antenatal anaemia guidelines from 49 NHS sites across the United Kingdom, obtained through two national research programmes. Two reviewers independently extracted data on screening, diagnosis, treatment and monitoring, using the 2020 BSH guideline as the national reference standard. The included guidelines represented approximately 33% of annual UK births. Screening and diagnostic haemoglobin thresholds were broadly consistent with BSH guidance, whereas substantial variation was concentrated in treatment and monitoring: oral iron indications, dosing and duration; haemoglobin thresholds and clinical criteria for intravenous iron; and the timing, biomarkers and response definitions used after treatment. Ferritin thresholds, reassessment intervals and response criteria were frequently absent or divergent. Variation was greatest in domains where the underlying evidence base is least resolved. These findings characterise the nature and extent of guideline-level variation across NHS maternity care and identify priority areas for future research and national guideline development.

DOI: 10.1111/bjh.70780

Link to full-text [open access - no password required]

Temporal Trends and Demographic and Geographic Disparities in Stroke Mortality Among US Adults Aged 25-64 Years (1999-2020): A CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Analysis (2026)

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Type of publication:

Journal article

Author(s):

Farahmandian, Ronit; Kananyan, Mariam; Alonso, Jorge E; Saro-Naenwi, Naomi; Ajibade, Tolulope; Kaurani, Purvi; Gudapati, Vamsi Krishna; Gomez-Sauceda, E Lucano; Clarke, Cleve; Arra, Srihitha; Imam, Bashir; *Gupta, Anchal R; Makkieh, Yahya.

Citation:

Cureus. 18(8):e113934, 2026 Aug.

Abstract:

BACKGROUND: Stroke remains a major contributor to mortality in the United States. Understanding long-term temporal changes and demographic and geographic disparities in stroke mortality is essential for identifying high-risk populations and guiding targeted prevention strategies.

METHODS: This retrospective observational study analyzed stroke mortality among US adults aged 25-64 years from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Deaths with stroke recorded as the underlying cause were identified using International Classification of
Diseases, 10th Revision (ICD-10) codes I60-I64 and were analyzed collectively as overall stroke mortality. Age-adjusted mortality rates per 100,000 population were assessed overall and stratified by sex, race, US Census region, and urbanization level. Joinpoint regression was used to identify temporal changes and estimate the annual percent change (APC) for each temporal segment and the average annual percent change (AAPC) across the complete study period.

RESULTS: A total of 382,253 stroke deaths were identified. The overall age-adjusted mortality rate (AAMR) decreased significantly from 1999 to 2012 (APC, -2.41%; 95% CI, -2.77 to -2.21), remained statistically unchanged from 2012 to 2018, and increased significantly from 2018 to 2020 (APC, 4.36%; 95% CI, 1.51 to 6.06). The full-period AAPC was -1.23% (95% CI, -1.42 to -1.11). Men had higher AAMRs than women and experienced a significant increase during 2018-2020. Black or African American adults had the highest race-specific AAMR, the South had the highest regional AAMR, and noncore counties had the highest urbanization-specific AAMR. Full-period AAPCs were significantly negative across all examined subgroups; however, significant later-period increases occurred among men, American Indian or Alaska Native adults, White adults, residents of the
West, large fringe metropolitan counties, and noncore counties.

CONCLUSION: Premature stroke mortality declined substantially over the complete study period, but progress was uneven across demographic and geographic groups. Persistently elevated mortality and recent reversals in selected populations highlight the need for targeted prevention and continued surveillance.

DOI: 10.7759/cureus.113934

Link to full-text [open access - no password required]

The Role of Neuroinflammation in Chronic Dermatological Disorders: A Psychodermatological Perspective (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 95), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Chronic dermatological conditions such as psoriasis, atopic dermatitis, and hidradenitis suppurativa exhibit a complex interplay between neuroinflammation and psychological distress. The bidirectional relationship between cutaneous inflammation and psychiatric morbidity suggests that systemic inflammatory mediators play a pivotal role in exacerbating both dermatological and psychiatric symptoms. This abstract explores existing literature on neuroinflammation in psychodermatology, highlighting its impact on disease progression and mental health comorbidities. Material(s) and Method(s): A comprehensive review of peer-reviewed literature from PubMed, Scopus, and Embase was conducted to assess the role of neuroinflammatory pathways in dermatological conditions. Studies analyzing inflammatory biomarkers, neuroimmune interactions, and psychodermatological interventions were included. The review focused on the correlation between inflammatory markers and psychiatric distress in patients with chronic skin disorders. Result(s): Existing studies indicate a significant association between elevated inflammatory markers (interleukin-6, tumor necrosis factor-alpha, C-reactive protein) and increased psychiatric distress in chronic skin conditions. Psychological interventions such as cognitive-behavioral therapy and stress-reduction techniques demonstrate potential in modulating inflammation and improving patient-reported outcomes. Emerging therapeutic approaches targeting the neuroimmune axis, including biologic agents and psychoneuroimmunological interventions, are also discussed. Conclusion(s): This review highlights the integral role of neuroinflammation in psychodermatology and underscores the need for a multidisciplinary approach to managing chronic dermatological disorders. Future research should explore targeted neuroimmune therapies and integrative mental health interventions to optimize patient care and quality of life in psychodermatology.

Hidradenitis Suppurativa: Addressing the Hidden Psychological Burden Beyond Skin Lesions (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 94), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with profound psychological consequences. Patients experience significant social stigma, depression, and reduced quality of life due to recurrent painful lesions and scarring. This abstract reviews the current literature on the psychological burden of HS and the importance of incorporating mental health care in disease management. Material(s) and Method(s): A review of published studies from PubMed and Embase was conducted to assess the psychological impact of HS. Research on depression, anxiety, social withdrawal, and dermatology life quality index scores in HS patients was analyzed. The review also explored potential benefits of psychodermatological interventions. Result(s): Studies highlight that 40%-50% of HS patients experience moderate-to-severe depression, with a high incidence of anxiety and social isolation. HS is associated with an increased risk of suicidal ideation compared to other dermatological conditions. Multidisciplinary management incorporating dermatologists, psychologists, and pain specialists has shown promise in improving patient outcomes. Conclusion(s): The psychological burden of HS is often overlooked in standard dermatological care. Early screening for mental health conditions and the inclusion of psychotherapeutic support should be prioritized in HS management. Future research should focus on the efficacy of integrated psychodermatology approaches to improve quality of life in HS patients.

Digital Media, Acne Dysmorphia and Social Anxiety: The Emerging "Filter Dysmorphia" Epidemic (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 153), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: The increasing prevalence of social media has contributed to heightened appearance-related anxiety and unrealistic beauty standards, leading to a phenomenon known as "filter dysmorphia". This abstract explores existing literature on the impact of digital media on acne dysmorphia, social anxiety, and dermatological self-perception. Material(s) and Method(s): A literature review was conducted on studies examining the psychological impact of social media exposure on skin-related concerns. Research on acne dysmorphia, social anxiety disorder, and the influence of digital filters on self-image was analyzed. Result(s): Evidence suggests that excessive social media engagement correlates with increased acne-related anxiety, negative self-perception, and a higher likelihood of seeking unnecessary dermatological interventions. Filter dysmorphia appears to contribute to an increase in perceived acne severity, despite objective clinical findings remaining unchanged. Conclusion(s): Dermatologists should be aware of the psychological influence of digital media on patient self-perception and incorporate screening tools for acne dysmorphia and social anxiety in clinical practice. Future research should explore the role of media literacy programs and psychological interventions in mitigating the negative impact of digital media on dermatological concerns.

The Role of Psych Dermatology in Patients Undergoing Treatment for Autoimmune Bullous Dermatoses: A Neglected Domain (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 96), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Autoimmune bullous dermatoses (ABD), including pemphigus vulgaris and bullous pemphigoid, are associated with significant physical and psychological distress. The chronic nature of these conditions, coupled with the adverse effects of long-term immunosuppressive treatment, places a considerable burden on mental health. This abstract reviews the role of psychodermatology in the holistic management of ABD patients and the need for integrated psychological support. Material(s) and Method(s): A literature review was conducted using PubMed and Scopus databases to analyze studies evaluating the psychological impact of ABD. Research on anxiety, depression, and quality-of-life measures in patients undergoing long-term immunosuppressive therapy was included. The review also assessed interventions such as psychotropic medications, cognitive-behavioral therapy, and patient support groups. Result(s): Findings indicate a high prevalence of psychiatric comorbidities among ABD patients, including depression (35%-50%) and anxiety (30%-45%). Psychological distress contributes to reduced treatment adherence and worsened disease prognosis. Evidence suggests that integrating psychodermatological care, including psychotherapy and psychiatric evaluation, improves patient-reported outcomes and treatment compliance. Conclusion(s): Despite the significant psychological burden in ABD patients, psychodermatology remains underutilized in their management. Future research should explore standardized screening for psychiatric distress in ABD and assess the long-term benefits of psychodermatological interventions. Dermatologists should consider integrating mental health support into routine care to enhance patient well-being.

Trichotillomania and Psychogenic Hair Loss: A Review of Integrated Treatment Strategies (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 96), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Trichotillomania (TTM) and stress-related hair loss significantly impact quality of life and are often resistant to conventional dermatological treatments. Understanding the psychological mechanisms underlying compulsive hair-pulling and stress-induced alopecia is essential for improving patient outcomes. This abstract presents a review of literature on integrated treatment approaches for TTM and psychogenic alopecia. Materials and Methods: A literature review of PubMed and Cochrane databases was conducted, focusing on treatment modalities combining dermatological and psychological interventions. Studies assessing cognitive-behavioral therapy (CBT), mindfulness-based therapies, and pharmacological interventions for TTM were included. The review also examined adjunctive dermatological therapies such as low-level laser therapy and platelet-rich plasma. Result(s): Studies indicate that CBT and habit-reversal training are among the most effective psychological treatments for TTM. Emerging evidence suggests that mindfulness techniques and pharmacological agents, such as selective serotonin reuptake inhibitors, can complement dermatological therapies. Integrated management strategies, incorporating both psychiatric and dermatological interventions, show superior outcomes compared to monotherapy. Conclusion(s): Multimodal treatment approaches addressing both the psychological and dermatological aspects of TTM and psychogenic hair loss yield better patient outcomes. Dermatologists should consider collaborative care models incorporating psychiatric support to optimize treatment efficacy. Further research into novel therapeutic interventions is warranted.

Cosmetic Dermatology and Body Dysmorphic Disorder: A Clinical Review of Screening and Management Strategies (2025)

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 142), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Body dysmorphic disorder (BDD) is a psychiatric condition with a significant impact on cosmetic dermatology. The increasing accessibility of aesthetic procedures has led to concerns regarding undiagnosed BDD in patients seeking cosmetic enhancements. This abstract explores the literature on the prevalence, screening methods, and management strategies for BDD in cosmetic dermatology settings. Material(s) and Method(s): A systematic review of literature from PubMed and Embase was conducted to evaluate validated screening tools for BDD in dermatological practice. Studies examining the psychological impact of aesthetic interventions on BDD patients were analyzed. The review also assessed proposed multidisciplinary management strategies incorporating psychiatry and dermatology. Result(s): Findings suggest that BDD is underdiagnosed in dermatology settings, with prevalence rates ranging between 9-15% in cosmetic patients. Psychological distress often worsens post-intervention in untreated BDD cases. Screening tools such as the BDD Questionnaire and structured psychiatric assessments can improve early detection. Multidisciplinary collaboration between dermatologists and mental health professionals is essential for optimizing patient outcomes and preventing unnecessary procedures. Conclusion(s): Recognizing BDD in cosmetic dermatology is crucial to avoid worsening psychological distress in vulnerable patients. Implementing routine screening and referral pathways for psychiatric assessment can improve patient care. Future research should focus on standardized screening protocols and therapeutic interventions tailored to dermatology patients with suspected BDD.