Case and Research Letter
DermaComp: A Pharmaceutical Compounding iPhone® Application for Dermatologists Designing Personalized Topical Medications
Dermacomp: aplicación para iPhone® para el diseño de medicamentos tópicos individualizados dirigido a dermatólogos
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Abarca Lachén, Y. Gilaberte" "autores" => array:2 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Abarca Lachén" "email" => array:2 [ 0 => "edgarabarcalachen@hotmail.com" 1 => "eabarca@usj.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Y." "apellidos" => "Gilaberte" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Facultad de Farmacia, Universidad San Jorge, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Dermatología, Hospital San Jorge, Huesca, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto Aragónes de Ciencias de la Salud, Zaragoza, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermacomp: aplicación para iPhone<span class="elsevierStyleSup">®</span> para el diseño de medicamentos tópicos individualizados dirigido a dermatólogos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1309 "Ancho" => 1501 "Tamanyo" => 253213 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dermacomp screenshots relating to: (A) active ingredients and dose ranges and (B) lesion site.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Smartphone applications (apps) are of particular interest to dermatologists, and some 229 already exist in the categories of general dermatology, self-surveillance/diagnosis, disease guides, patient education, sun protection, calculators, teledermatology, dermoscopy, etc.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1–3</span></a> All of these apps are potentially very useful, although the use that dermatologists and patients make of them has not yet been studied.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The design and preparation of personalized medication solutions or compounds requires training and practice on the part of both the dermatologist and the pharmacist. The dermatologist must specify the quantity and quality of the active ingredients and the most appropriate excipients depending on the characteristics of the patient's skin disease. The pharmacist must prepare the medication using the best available technique.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">To aid clinicians in this task, we have developed Dermacomp, an iPhone application that helps the dermatologist to create a customized medication using a quick, easy, and intuitive process that facilitates the design of the formula. Dermacomp also does the following: <span class="elsevierStyleItalic">1)</span> improves the exchange of information between the dermatologist and the compounding pharmacist, including a large amount of information not normally found in traditional compounding prescriptions (such as, for example, patient characteristics, site of application, and vehicle type); <span class="elsevierStyleItalic">2)</span> achieves better therapeutic results because it adapts the drug to the specific needs of each patient; and <span class="elsevierStyleItalic">3)</span> displays the most appropriate active ingredients and vehicles for each disease and site, increasing the safety of dosing ranges and optimizing consultation time.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Dermacomp was designed to run on devices using the iOS operating system (version 7 or higher) and is optimized for iPhone 4, 5, and 6. The scientific content was created by a dermatologist and a compounding pharmacist, and the app was developed using the Objective-C object-oriented language and Apple Xcode development tools. Management and storage of data is handled with Apple Frameworks and version control with the GIT system. Finally, the app was validated on several Apple devices.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">When the dermatologist opens Dermacomp, the app displays a list of the 5 skin disorders for which compounded medications are most often used: psoriasis, alopecia, oral and genital mucosal disorders, rosacea, and seborrheic dermatitis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Once the appropriate disorder has been selected, the user only has to complete 6 rapid and intuitive steps:</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 1</span>. Introduce patient characteristics, including age, drug allergies or adverse reactions and, in the case of a woman, pregnancy status, Based on this information, the app will exclude any active ingredients or vehicles unsuitable for the patient and adjust maximum concentration levels, especially in the case of children and pregnant women.</p><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 2.</span> Mark the site of the lesion(s) on a graphic representation of a human figure (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 3.</span> Depending on the diagnosis selected, the app asks the dermatologist to specify either the type of skin disease to be treated (in the case of alopecias or mucosal disorders, for example) or the characteristics of the lesion (in the case of a psoriatic lesion, for example, which can be more or less hyperkeratotic).</p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 4.</span> In this step the dermatologist has 2 options:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0050" class="elsevierStylePara elsevierViewall">To choose from 1 or 2 predefined formulas designed for each disorder, which take into account the site and lesion type. This is a good option for specialists who do not have enough experience in the design and prescription of customized medications. These preset options do not, however, take into account the patient's age, intolerance, or pregnancy status.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0055" class="elsevierStylePara elsevierViewall">To design a suitable medication using the app's decision-making algorithm. In this case, the app displays the active ingredients that can be used in the formula depending on the disease specified (except those excluded in step 1 by the age and intolerance criteria or the patient's pregnancy status). Possible incompatibilities between active ingredients were also taken into account and exhaustively assessed in the design of this app. The app can accept up to 6 active ingredients. For each ingredient the dermatologist must choose the desired concentration within a predefined range.</p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 5.</span> Specify frequency of application, duration of treatment, and the percentage of body surface area affected.</p><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Step 6.</span> Vehicle selection, which is determined by the criteria established by the prescriber in the earlier steps. In this way, the app greatly reduces the range of possibilities for the dermatologist so that the decision is guided to a large extent by the ideal choice of vehicle.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The application then proposes 2 formulas and the possible vehicles, which are compatible with the criteria entered throughout the 6 previous steps.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The app was tested in a pilot study under conditions of normal use in clinical practice by 8 dermatologists with training and experience in compounding.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> After using the app, each dermatologist assessed it using a specifically designed questionnaire made up of 4 blocks of questions on the following topics: content, navigation, design, and usefulness. All the respondents reported that the content and services offered by Dermacomp were useful in their everyday clinical practice, and 72% thought that the app could improve their ability to prescribe personalized medications. Moreover, 43% considered that the final formulation proposed by the app was complete and included all the necessary information; in response to a question asking for possible improvements they said that the app should also provide price and dosage information (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Dermatologists can consult all the features of the app and download it to a mobile from the website <a href="http://www.dermacomp.com/">www.dermacomp.com</a>.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">The Dermacomp app was financed by the Instituto Aragonés de Ciencias de la Salud (IACS), a body that manages research activities within the health service of the Autonomous Community of Aragon. However, in terms of content the app is totally independent and the IACS did not intervene in any way in the process of its development.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Abarca Lachén E, Gilaberte Y. Dermacomp: aplicación para iPhone<span class="elsevierStyleSup">®</span> para el diseño de medicamentos tópicos individualizados dirigido a dermatólogos. Actas Dermosifiliogr. 2016;107:622–624.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1309 "Ancho" => 1501 "Tamanyo" => 253213 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dermacomp screenshots relating to: (A) active ingredients and dose ranges and (B) lesion site.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Block \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Content \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- The graphic representations of the different sites are sufficiently clear and descriptive. (100%)<br>- The app includes all the pharmacological groups and active ingredients needed to ensure correct prescription. (86%)<br>- Handling of treatment regimens is clear and simple. (57%)<br>- The way the vehicle is selected works well. (100%)<br>- The final formulation suggested by the app is complete and includes all the necessary information. (43%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Navigation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- Navigation from screen to screen is simple and intuitive (100%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Design \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- The app is well designed. (100%)<br>- The order of the contents is appropriate. (100%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Usefulness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- The content and services provided by this app are useful in my daily clinical practice. (100%)<br>- This application could improve the prescription of customized medications. (72%)<br>- This tool is much more useful or considerably more useful than the other tools designed to aid the prescription of compounded medications. (100%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393477.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Main Results From the Assessment Questionnaire.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0040" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mobile applications in dermatology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.C. Brewer" 1 => "D.C. Endly" 2 => "J. Henley" 3 => "M. Amir" 4 => "B.P. Sampson" 5 => "J.F. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 11 | 20 |
| 2024 October | 71 | 65 | 136 |
| 2024 September | 75 | 40 | 115 |
| 2024 August | 93 | 99 | 192 |
| 2024 July | 83 | 34 | 117 |
| 2024 June | 85 | 27 | 112 |
| 2024 May | 80 | 28 | 108 |
| 2024 April | 62 | 19 | 81 |
| 2024 March | 79 | 29 | 108 |
| 2024 February | 50 | 29 | 79 |
| 2024 January | 52 | 32 | 84 |
| 2023 December | 45 | 18 | 63 |
| 2023 November | 51 | 21 | 72 |
| 2023 October | 47 | 15 | 62 |
| 2023 September | 46 | 28 | 74 |
| 2023 August | 33 | 17 | 50 |
| 2023 July | 67 | 29 | 96 |
| 2023 June | 48 | 21 | 69 |
| 2023 May | 44 | 22 | 66 |
| 2023 April | 39 | 16 | 55 |
| 2023 March | 49 | 24 | 73 |
| 2023 February | 39 | 20 | 59 |
| 2023 January | 30 | 19 | 49 |
| 2022 December | 40 | 27 | 67 |
| 2022 November | 23 | 25 | 48 |
| 2022 October | 32 | 22 | 54 |
| 2022 September | 34 | 33 | 67 |
| 2022 August | 52 | 29 | 81 |
| 2022 July | 55 | 25 | 80 |
| 2022 June | 35 | 39 | 74 |
| 2022 May | 68 | 30 | 98 |
| 2022 April | 45 | 26 | 71 |
| 2022 March | 57 | 36 | 93 |
| 2022 February | 36 | 21 | 57 |
| 2022 January | 62 | 44 | 106 |
| 2021 December | 43 | 35 | 78 |
| 2021 November | 44 | 40 | 84 |
| 2021 October | 39 | 33 | 72 |
| 2021 September | 28 | 39 | 67 |
| 2021 August | 25 | 19 | 44 |
| 2021 July | 16 | 18 | 34 |
| 2021 June | 23 | 16 | 39 |
| 2021 May | 38 | 31 | 69 |
| 2021 April | 118 | 45 | 163 |
| 2021 March | 76 | 20 | 96 |
| 2021 February | 73 | 23 | 96 |
| 2021 January | 37 | 12 | 49 |
| 2020 December | 27 | 22 | 49 |
| 2020 November | 27 | 22 | 49 |
| 2020 October | 12 | 12 | 24 |
| 2020 September | 32 | 12 | 44 |
| 2020 August | 22 | 11 | 33 |
| 2020 July | 21 | 12 | 33 |
| 2020 June | 25 | 28 | 53 |
| 2020 May | 25 | 25 | 50 |
| 2020 April | 32 | 18 | 50 |
| 2020 March | 52 | 13 | 65 |
| 2020 February | 12 | 0 | 12 |
| 2020 January | 4 | 0 | 4 |
| 2019 December | 8 | 0 | 8 |
| 2019 November | 4 | 0 | 4 |
| 2019 August | 4 | 0 | 4 |
| 2019 July | 8 | 0 | 8 |
| 2019 June | 4 | 0 | 4 |
| 2019 May | 7 | 0 | 7 |
| 2019 April | 2 | 4 | 6 |
| 2019 March | 2 | 1 | 3 |
| 2019 February | 2 | 0 | 2 |
| 2019 January | 4 | 0 | 4 |
| 2018 November | 3 | 0 | 3 |
| 2018 October | 1 | 0 | 1 |
| 2018 September | 3 | 0 | 3 |
| 2018 February | 18 | 6 | 24 |
| 2018 January | 17 | 4 | 21 |
| 2017 December | 42 | 13 | 55 |
| 2017 November | 25 | 6 | 31 |
| 2017 October | 39 | 6 | 45 |
| 2017 September | 19 | 4 | 23 |
| 2017 August | 26 | 4 | 30 |
| 2017 July | 22 | 13 | 35 |
| 2017 June | 21 | 6 | 27 |
| 2017 May | 25 | 8 | 33 |
| 2017 April | 23 | 8 | 31 |
| 2017 March | 12 | 7 | 19 |
| 2017 February | 21 | 7 | 28 |
| 2017 January | 18 | 4 | 22 |
| 2016 December | 29 | 20 | 49 |
| 2016 November | 35 | 14 | 49 |
| 2016 October | 27 | 19 | 46 |
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