{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T02:56:00Z","timestamp":1717124160316},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2012,9]]},"abstract":"Objectives:<\/jats:title>To identify the dermatological conditions affecting British troops in Afghanistan, understand how they are treated and identify potential areas for improvement.<\/jats:p><\/jats:sec>Methods:<\/jats:title>Data was collected from the Defence Analytical Services and Advice agency and the Operational Emergency Department Attendance Register via the Disease and Non Battle Injury working group. Additional data was collected from J4 \u2013 Medical Permanent Joint Headquarters. Treatment information from Clinical Guidelines on Operations (CGOs), Medics\u2019 protocols, and primary care module composition was reviewed.<\/jats:p><\/jats:sec>Results:<\/jats:title>Dermatological conditions accounted for 1 in 5 attendances to a Role 1 Medical Treatment Facility during the study period. They were consistently in the top five reasons for working days lost, and had a comparatively high hospital admission rate (0.3\/1000 Population at Risk (PAR)\/month) and a repatriation rate similar to other medical specialties such as respiratory and neurology (0.1\/1000 PAR\/month). Treatment appeared to be adequate based on declining return attendance numbers, although CGOs were found to lack dermatological protocols and medic protocols were eight years old and not specific to the current operational requirements.<\/jats:p><\/jats:sec>Conclusions:<\/jats:title>Although treatments are working for dermatological conditions, areas for optimisation of health care have been identified, such as updating medic protocols to include campaign specific information and latest guidelines in the CGOs. Pre-deployment dermatologist-devised treatment plans and tele-consults may also help keep soldiers with pre-existing skin complaints in theatre.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jramc-158-03-18","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T23:43:32Z","timestamp":1363736612000},"page":"232-237","source":"Crossref","is-referenced-by-count":6,"title":["Dermatology on Operation HERRICK"],"prefix":"10.1136","volume":"158","author":[{"given":"Jamie","family":"Driver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Wall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TG","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,9,1]]},"reference":[{"key":"ref_1","article-title":"The Official History of the Great War","author":"Mitchell, T.J.","year":"1924","unstructured":"Mitchell TJ. The Official History of the Great War. 1st Edn. London: HMSO, 1924.","edition":"1st Edn"},{"key":"ref_2","article-title":"History of the Second World War: Casualties and Medical Statistics","author":"Mayne, H.G.","year":"1972","unstructured":"Mayne HG. History of the Second World War: Casualties and Medical Statistics. 1st Edn. London: HMSO, 1972.","edition":"1st Edn"},{"issue":"1","key":"ref_3","first-page":"42","article-title":"250 years of military dermatology: the British Army experience","volume":"3","author":"Smith, H.R.; Hepburn, N.C.","year":"1997","unstructured":"Smith HR, Hepburn NC. 250 years of military dermatology: the British Army experience. Vesalius 1997; 3(1): 42-5.","journal-title":"Vesalius"},{"key":"ref_4","first-page":"29","article-title":"Dermatology and Skin Disease in the American Civil War","volume":"20","author":"Cropley, T.G.","year":"2008","unstructured":"Cropley TG. Dermatology and Skin Disease in the American Civil War. Derm Nursing 2008; 20: 29-33.","journal-title":"Derm Nursing"},{"key":"ref_5","first-page":"264","article-title":"Update: Cutaneous Leishmaniasis in U. S. Military Personnel \u2013 Southwest\/Central Asia, 2002-2004","volume":"53","author":"Centres for Disease Control and Prevention","year":"2004","unstructured":"Centres for Disease Control and Prevention. Update: Cutaneous Leishmaniasis in U.S. Military Personnel \u2013 Southwest\/Central Asia, 2002-2004. MMWR. 2004; 53: 264-5.","journal-title":"MMWR"},{"issue":"1","key":"ref_6","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/jramc-133-01-08","article-title":"A study into medical wastage or recruits","volume":"133","author":"Lynch-Blosse, R.H.","year":"1987","unstructured":"Lynch-Blosse RH. A study into medical wastage or recruits. J R Army Med Corps 1987; 133(1): 43-9.","journal-title":"J R Army Med Corps"},{"key":"ref_7","article-title":"Chapter 3 The Influence of Particular 10. Mechanical Injury to Skin of the Feet in Croatian Soldiers During (Skin diseases)","volume":"346","author":"of Defence, Ministry","unstructured":"Ministry of Defence. JSP346 Chapter 3 The Influence of Particular 10. Mechanical Injury to Skin of the Feet in Croatian Soldiers During (Skin diseases). Accessed on http:\/\/defenceintranet.diiweb.r.mil.uk."},{"key":"ref_8","first-page":"796","article-title":"War in Croatia 1991-1992","volume":"173","year":"2008","unstructured":"War in Croatia 1991-1992. Mil Med 2008; 173: 796-800.","journal-title":"Mil Med"},{"key":"ref_9","article-title":"Medic\u2019s Primary Health Care Treatment Protocols 11","author":"Morgan-Jones, D.","year":"2003","unstructured":"Morgan-Jones D. Medic\u2019s Primary Health Care Treatment Protocols 11. 4th Draft 1st Edn. MOD, 2003.","edition":"1st Edn."},{"key":"ref_10","first-page":"1002","article-title":"Military Aeromedical Evacuations from","volume":"44","author":"McGraw, T.A.; Norton, S.A.","year":"2005","unstructured":"McGraw TA, Norton SA. Military Aeromedical Evacuations from 2005; 44: 1002-1005."},{"key":"ref_11","first-page":"165","article-title":"A survey of Health Care at a Arch Dermat","volume":"145","author":"Hawksley, O.J.; Jeyanathan, J.; Mears, K.","year":"2009","unstructured":"Hawksley OJ, Jeyanathan J, Mears K. A survey of Health Care at a Arch Dermat 2009; 145: 165-170."},{"key":"ref_12","article-title":"Med Corps 2010; 156: 3. The problem of a large number of dermatological DNBI cases was first identified in the Medical Force Protection Audit of 2009 [2] and consequently the Defence Disease and Non Battle Injury Working Group directed that further work be done in this area. DACOS Med PJHQ then sponsored this work","author":"Army, J.R.","unstructured":"J R Army Med Corps 2010; 156: 3. The problem of a large number of dermatological DNBI cases was first identified in the Medical Force Protection Audit of 2009 [2] and consequently the Defence Disease and Non Battle Injury Working Group directed that further work be done in this area. DACOS Med PJHQ then sponsored this work."},{"key":"ref_13","article-title":"Such manifestations have frequently been seen in military outbreaks. Bearing in mind the other risk factors for PVL-SA such as poor hygiene, closed communities etc. it would not be surprising to see more cases of PVL-SA than currently recorded. We suggest that further research into this specific dermatological disease on HERRICK should be considered. We also question whether fungal foot infections and other dermatological conditions really do have a significant impact on working days lost. Whilst dermatological conditions may account for the highest number (and rate) of first attendances, they accounted for less than 8% of reported days light duties and less than 2% of reported working days lost for HERRICK 14 [4]. It would be interesting to see more in depth analysis of the hospital data quoted in the paper of 0.3\/1000\/month. Where did the cases come from? Was this the primary cause of admission or a secondary finding? What were the skin conditions which required hospital admission? Our experience from the Med FP Audits of 2009, 2010 and 2011 was that whilst a common problem the operational impact was limited","unstructured":"Such manifestations have frequently been seen in military outbreaks. Bearing in mind the other risk factors for PVL-SA such as poor hygiene, closed communities etc. it would not be surprising to see more cases of PVL-SA than currently recorded. We suggest that further research into this specific dermatological disease on HERRICK should be considered. We also question whether fungal foot infections and other dermatological conditions really do have a significant impact on working days lost. Whilst dermatological conditions may account for the highest number (and rate) of first attendances, they accounted for less than 8% of reported days light duties and less than 2% of reported working days lost for HERRICK 14 [4]. It would be interesting to see more in depth analysis of the hospital data quoted in the paper of 0.3\/1000\/month. Where did the cases come from? Was this the primary cause of admission or a secondary finding? What were the skin conditions which required hospital admission? Our experience from the Med FP Audits of 2009, 2010 and 2011 was that whilst a common problem the operational impact was limited."},{"issue":"3","key":"ref_14","first-page":"232","volume":"158","author":"Driver, J.M.; Simpson, R.; Wall, C.; Nelson, T.G.","unstructured":"Driver JM, Simpson R, Wall C, Nelson TG. Dermatology on Operation HERRICK. J R Army Med Corps 158 (3): 232-7","journal-title":"Dermatology on Operation HERRICK. J R Army Med Corps"},{"key":"ref_15","article-title":"Medical Force Protection Audit \u2013 Operation HERRICK 9","author":"Gill, R.; Ross, D.A.","unstructured":"Gill R, Ross DA. Medical Force Protection Audit \u2013 Operation HERRICK 9. MOD."},{"issue":"11","key":"ref_16","first-page":"483","article-title":"How to prevent transmission of MRSA in the open community?","volume":"9","author":"Vandenesch, F.; Etienne, J.","year":"2004","unstructured":"Vandenesch F, Etienne J. How to prevent transmission of MRSA in the open community?. Euro Surveill. 2004;9(11):pii=483. Available online: http:\/\/www.eurosurveillance.org\/ViewArticle.aspx?ArticleId=483","journal-title":"Euro Surveill"},{"key":"ref_17","article-title":"Disease and Non Battle Injury (DNBI) Analysis of Op HERRICK 14. Unpublished data","year":"2011","unstructured":"Disease and Non Battle Injury (DNBI) Analysis of Op HERRICK 14. Unpublished data. DASA. 2011","journal-title":"DASA"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-158-03-18","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:29:04Z","timestamp":1716186544000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-158-03-18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2012,9,1]]},"published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1136\/jramc-158-03-18"],"URL":"https:\/\/doi.org\/10.1136\/jramc-158-03-18","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}