Author Interviews, Dermatology, JAMA, Sexual Health, Transplantation / 01.02.2018

MedicalResearch.com Interview with:

Dr. Christina Lee Chung, MD Associate Professor Department of Dermatology Drexel University

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: In early 2016, five years after the inception of our specialty medical-surgical transplant dermatology center, we realized our nonwhite transplant patients were developing skin cancer at higher rates and found interesting trends. These data were published in a previous manuscript. One of the more striking findings was that these patients were developing a high proportion of skin cancer in non-sun-exposed areas such as the genital region. There are no standard guidelines regarding genital skin evaluation and it is unclear how often it is performed in any capacity amongst dermatologists, including practitioners in our center, quite frankly. Our group was concerned that we could be missing skin cancers in this “hidden” area in our high-risk organ transplant population so we launched a quality improvement initiative that incorporated thorough genital skin evaluation as a standard part of post-transplant skin cancer screening.   

Fifteen months after we started this modified screening process, we decided to evaluate the results. To account for any variation in examination, we looked at the findings of a single practitioner. We found that genital lesions are common in the transplant population and include high rates of genital warts and skin cancer. However, patient awareness of the presence of genital lesions was alarmingly low. Nonwhite transplant patients, Black transplant recipients in particular, were disproportionately affected by both genital warts and genital skin cancer in our cohort. Similar to cervical cancer, high-risk HPV types were closely associated with genital squamous cell carcinoma development in our transplant population. (more…)

Author Interviews, Dermatology, Electronic Records / 29.01.2018

MedicalResearch.com Interview with: “Computer” by FullCodePress is licensed under CC BY 2.0Matilda W. Nicholas, MD, PhD Duke Dermatology Durham, North Carolina MedicalResearch.com: What is the background for this study? Response: I have found many physicians overwhelmed by the electronic messaging feature in Electronic Health Record systems (EHRs). I found there was very little published about this phenomenon, particularly for specialists. So, we set out to take a look at the volume and effect these systems have.  MedicalResearch.com: What are the main findings?  Response: We found that, on average, clinicians receive 3.24 messages per patient visit, for an average of about 50 messages per full day of clinic. The number of messages also correlated with poor reported work life balance for dermatologists. (more…)
Author Interviews, Dermatology, JAMA, Microbiome / 19.01.2018

MedicalResearch.com Interview with: Maja-Lisa Clausen MD, Ph.D.-fellow Department of Dermatology Copenhagen University Hospital Bispebjerg  MedicalResearch.com: What is the background for this study? Response: ​The human microbiome seems to play an important role in health and disease, by influencing host cells and contributing to host immunity. A balanced interplay between host cells and resident bacteria is important, and dysbiosis is linked to several diseases, including skin diseases like atopic dermatitis. Patients with atopic dermatitis suffer from ​frequent skin infections, and their skin microbiome is dominated by S. aureus. Frequent skin infections lead to frequent use of antibiotics, and with worldwide increase in resistant bacteria, a better understanding of the interplay between host and bacteria is paramount in order to develop new treatment strategies. (more…)
Author Interviews, Dermatology, Environmental Risks, Infections, Occupational Health / 16.12.2017

MedicalResearch.com Interview with: Lindsey Milich Rutgers School of Public Health studiesLindsey Milich Rutgers School of Public Health studies   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Much of the spotlight has been focused on hair and nail technicians, with the focus now shifting towards the health and safety of hair and nail salon clients. We wanted to assess perceived safety and health risks and prevalence of respiratory and dermal symptoms among hair and nail salon clients in New Jersey. Main findings include dermal/fungal symptoms being more prevalent among clients who visited salons three or more times within the past year, compared with those with fewer reported visits. Respiratory symptom prevalence was higher among clients with fewer salon visits, indicating a “healthy client effect”; clients with these symptoms may be less likely to return. (more…)
Abuse and Neglect, Dermatology, Pharmacology / 11.12.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systemic corticosteroids are commonly used as systemic treatments for atopic dermatitis. However, few studies assessed the efficacy and safety of systemic corticosteroids in atopic dermatitis. This systematic review sought to summarize the available evidence for their use in atopic dermatitis. Overall, 52 reviews and 12 studies were included in this systematic review. Most studies suffered from small sample size, low quality. In one of the only randomized-controlled trials performed, systemic corticosteroids were less effective than cyclosporine and led to more rebound flares. There were numerous safety and tolerability concerns with both short and long-term treatment with systemic corticosteroids. One study found that even short-term use of systemic corticosteroids was associated with increased sepsis, venous thromboembolism and fractures. (more…)
Author Interviews, Dermatology, Environmental Risks / 07.12.2017

MedicalResearch.com Interview with: Prof. Dr. Mauricio S. Baptista Chemistry Institute (IQ-USP) University of São Paulo Brazil  “Tanning in the sun” by S B is licensed under CC BY 2.0MedicalResearch.com: What is the background for this study? What are the main findings? Response: This research started around 7 years ago. Our lab had a lot of previous experience in studying how photosensitizers (molecules that absorb light and transfer energy to others in its surroundings) used for Photodynamic Therapy, behave in the intracellular environments. We realized that most scientific work that defined the effects of sun in skin did not really consider looking into the properties of the molecules that are naturally found in skin and that absorb light. We also realized that very likely natural photosensitizers present in the skin behaves similarly when excited by either UVA or visible light. It all depends on which molecule absorb light and how the subsequent excited states behave. The work started by looking at melanin and melanocyte cells (Chiarelli-Neto et al Free Radic Biol Med 2011, 51, 1195; Chiarelli-Neto O et al. PLoS ONE, 2014  9(11): e113266). More recently we start looking at keratinocytes  and liposfucin (Tonolli et al Journal of Investigative Dermatology 2017, 137, 2447). (more…)
Author Interviews, Dermatology, Genetic Research / 04.12.2017

MedicalReseaerch.com Interview with: Alicia R. Martin PhD, Postdoc Department of Genetics Stanford University Department of Medicine, Massachusetts General Hospital and Harvard Medical School Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA and Brenna M. Henn, Phd, Assistant Professor Department of Ecology and Evolution SUNY Stony Brook, NY  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin pigmentation varies more in Africa than in any other continent, and yet genetic studies of this and other traits are massively underrepresented there. Previous Eurasian study biases have instead focused on populations that vary less and have fewer variants contributing to baseline skin color. In our study, we compiled quantitative skin color measurements from a large, globally diverse set of individuals and populations to show that pigmentation varies more closer to the equator than in high latitude populations. We focused on the ‡Khomani San and Nama populations from South Africa, which diverged early along the modern human lineage from other populations and have lighter skin than equatorial Africans. We showed that skin pigmentation is roughly 100% heritable, but that previously identified genes make up a tiny fraction (~10%) of the variation present in these populations. We identified both known and new genes contributing to this variability. (more…)
Author Interviews, Bone Density, Dermatology, Endocrinology, Osteoporosis, Pediatrics / 03.12.2017

MedicalResearch.com Interview with: Diana L. Cousminer, PhD Division of Human Genetics Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Osteoporosis is a significant public health burden, with origins early in life. Later puberty and lower adolescent bone mineral density are both risk factors for osteoporosis. Geneticists have identified hundreds of genetic variants across the genome that impact pubertal timing, and we found that collectively this variation also plays a role in bone mineralization during adolescence. Additionally, we found that later puberty caused lower adult bone density. (more…)
Author Interviews, Cognitive Issues, Dermatology, Infections, Mental Health Research, Neurological Disorders, NIH / 23.11.2017

MedicalResearch.com Interview with:   Byron Caughey, Ph.D. Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories Hamilton, MT      MedicalResearch.com: Would you briefly explain what is meant by Creutzfeldt-Jakob disease? Response: Creutzfeldt-Jakob disease (CJD) is an incurable—and ultimately fatal—transmissible, neurodegenerative disorder in the family of prion diseases. Prion diseases can be found in many mammalian species and are due to the conversion of normally harmless prion protein molecules into abnormally folded, aggregated and self-propagating clusters and filaments in the brain. The accumulation of these clusters has been associated with tissue damage that often leaves dying neurons and microscopic sponge-like holes in the brain. In the sporadic and genetic forms of CJD this pathogenic process appears to arise spontaneously in the patient. However, the transfer of the prion protein aggregates from a Creutzfeldt-Jakob disease patient into another human or experimental animal can initiate the pathogenic process in the recipient. These infectious forms of prion protein are called prions. Human prion diseases include fatal insomnia; kuru; Gerstmann-Straussler-Scheinker syndrome; and variant, familial and sporadic CJD. Sporadic CJD is the most common human prion disease, affecting about one in one million people annually worldwide. Other prion diseases include scrapie in sheep; chronic wasting disease in deer, elk and moose; and bovine spongiform encephalopathy (BSE), or mad cow disease, in cattle. (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA, Medicare / 22.11.2017

MedicalResearch.com Interview with: Adewole Adamson, MD, MPP Department of Dermatology UNC – Chapel Hill North Carolina  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nurses practitioners and physician assistants, collectively known as non-physician clinicians (NPCs), provide many dermatology services, some which are billed for independently. Little is known about the types of these services provided. Even less is known about where these independently billed services are provided. Given that there is a purported shortage of dermatologists in the United States (US),  NPCs have been suggested as way to fill in the gap. In this study, we found that NPCs independently billed for many different types of dermatology associated procedures, including surgical treatment of skin cancer, flaps, grafts, and billing for pathology. Most of these NPCs worked with dermatologists. Much like dermatologists, NPCs were unevenly distributed across the US, concentrating mostly in non-rural areas. (more…)
Author Interviews, Dermatology / 20.11.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bleach baths have become widely used in clinical practice for the treatment of atopic dermatitis (AD). However, there have been conflicting results about the efficacy of bleach baths across different studies. We performed a systematic review and meta-analysis to determine whether bleach baths are consistently effective in decreasing the severity of atopic dermatitis. Bleach baths were shown to be effective at reducing AD severity in all 4 of the included studies. However, when comparing bleach baths vs. regular water baths, only 2 found significantly greater decreases in atopic dermatitis severity with bleach baths, 1 found greater decreases with water baths, and 1 found no significant differences. There were 15 different severity assessment evaluations across studies at 4 weeks: only 3 assessments demonstrated that bleach baths were more effective than water baths, 11 reported no difference, and 1 reported regular water baths to be more effective. In pooled meta-analyses, there were no significant differences observed between bleach vs water baths at 4 weeks vs baseline for the Eczema Area and Severity Index or body surface area. Finally, there were no differences of Staphylococcus aureus density, other bacteriological assessments or skin infection rates between bleach vs. water baths. (more…)
Asthma, Author Interviews, Dermatology, Pediatrics / 20.11.2017

MedicalResearch.com Interview with: “Eczema” by NIAID is licensed under CC BY 2.0Malcolm R. Sears, MB ChB Firestone Institute for Respiratory Health St Joseph's Healthcare and McMaster University Ontario Canada.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Canadian Healthy Infant Longitudinal Development (CHILD) Study was initiated in 2008, funded by AllerGen NCA and CIHR, to determine root causes of allergy and asthma. We recruited 3623 pregnant mothers in 4 centers across Canada and are following 3495 eligible children from pregnancy to age 5 years. In this paper we describe some of the findings in early childhood, namely that children who develop skin conditions generally called eczema or atopic dermatitis, who are also sensitized to food allergens (milk, egg, peanut) at 1 year are at high risk of developing subsequent asthma, whereas those with these skin conditions but not sensitized are not at such risk. (more…)
Author Interviews, Dermatology, J&J-Janssen, Pharmaceutical Companies, Rheumatology / 13.11.2017

MedicalResearch.com Interview with: Atul A. Deodhar, MD, MRCP, FACP, FACR Professor of Medicine Division of Arthritis & Rheumatic Diseases Medical Director, Rheumatology Clinics Medical Director, Immunology Infusion Center Oregon Health & Science University (OHSU)  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Phase 2, randomized, double-blind, placebo–controlled, multicenter trial was designed to evaluate the efficacy and safety of guselkumab (Tremfya®) compared with placebo in adults with active psoriatic arthritis, despite having received treatment with standard-of-care therapies, including anti-tumor necrosis factor (TNF)-alpha agents. In an observed analysis presented at ACR 2017, more than 70 percent of patients receiving guselkumab achieved at least a 20 percent improvement in signs and symptoms of disease (ACR 20) at week 56.  Findings also showed that improvements in tender and swollen joints, skin clearance, pain and physical function, and patient-reported quality of life outcomes reported at week 24, were maintained through week 56 in patients receiving guselkumab maintenance therapy (subcutaneous injections every eight weeks).  (more…)
Author Interviews, Dermatology, Infections, Johns Hopkins / 09.11.2017

MedicalResearch.com Interview with: Lloyd S. Miller, M.D., Ph.D. Vice Chair for Research, Department of Dermatology Associate Professor of Dermatology, Infectious Diseases, Orthopaedic Surgery & Materials Science and Engineering Faculty Member, Cellular and Molecular Medicine (CMM) and Pathobiology Graduate Programs Johns Hopkins Department of Dermatology Baltimore, MD 21231  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Staphylococcus aureus is a common bacterial skin pathogen and its abundance is greatly increased on affected skin of eczema patients, especially during disease flares. However, how S. aureus induces skin inflammation and exacerbates the skin inflammation is incompletely understood. In this study, we found that S. aureus exposure of mouse skin induced skin inflammation through an inflammatory mediator known as IL-36. (more…)
Author Interviews, CDC, Dermatology, Environmental Risks, JAMA, Pediatrics / 08.11.2017

MedicalResearch.com Interview with: “Dymchurch Beach - May 2012 - Sunburn with Matching Bikini” by Gareth Williams is licensed under CC BY 2.0Dawn M. Holman, MPH Behavioral Scientist Division of Cancer Prevention and Control Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Scientific evidence clearly shows that even one sunburn during adolescence can increase a person’s chances of developing skin cancer as an adult. Surprisingly, little research has been done to understand the factors associated with sunburn during this phase of life. The CDC wanted to examine beliefs, behaviors, and demographic characteristics that might be associated with adolescent sunburns in hopes that the findings could inform future intervention efforts. We used data from the 2015 YouthStyles survey (adolescents aged 12 to 17 years) to explore this research question (more…)
Author Interviews, Dermatology / 03.11.2017

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, a number of studies have examined associations between atopic dermatitis and various comorbidities.  However, although comorbidities are extensively being examined, cause-specific mortality in patients with atopic dermatitis has not been examined. We examined 8,686 adults with atopic dermatitis, and compared these with 86,860 age- and sex-matched individuals from the general population. In total, patients with atopic dermatitis had a 27% higher relative risk of all-cause mortality over a five-year period. Specific causes of death were due to infectious-, cardiovascular-, and urogenital diseases, respectively. (more…)
Author Interviews, Dermatology, JAMA / 01.11.2017

MedicalResearch.com Interview with: Eliot N. Mostow, MD, MPH Professor & Chair, Dermatology Section Department of Internal Mediciine Northeast Ohio Medical University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is my continued interest in what is sometimes called health services research. That is, how do we improve our ability to deliver optimal medical care from a healthcare system perspective? Simply put, one of the most frequent criticisms about getting a dermatologist to see if patient is that there are delays in scheduling (wait times are too high). I’m not sure this is really justified, as it seems to take a long time to get into psychiatrists, gynecologists, and other specialists in our community as well. That being said, since I’m in the dermatology community and our community has been utilizing physician assistants and nurse practitioners more frequently for many years now, we thought it was worthwhile to explore whether this was having an impact on wait times to get a visit in a dermatologist’s office. (more…)
Author Interviews, Dermatology, Environmental Risks, Pediatrics / 26.10.2017

MedicalResearch.com Interview with: Erik Stratman, MD Chairman, Department of Dermatology Marshfield Clinic, WI MedicalResearch.com: What is the background for this study? What are the main findings? Response: The United States Food and Drug Administration has classified tanning beds as cancer-causing. Tanning bed exposure has been linked with increased risk of melanoma, a deadly form of skin cancer that preferentially affects young people.  While no current federal ban exists on indoor tanning of minors, there have been over 40 states (43) and the District of Columbia that passed laws limiting the use of tanning beds for minors.  Despite these laws, nearly 1.9 million high school students in the United States are tanning in tanning salons. In this study, researchers posed as minors called 427 tanning salons in 42 states and the District of Columbia.  Following a script that included questions like ‘would my mom have to come with me? I was hoping to come after school.’ Salons were randomly selected by zip code, with 10 salons selected for each state.  Overall, 37.2% of tanning salons were out of compliance with state legislation. Illinois, New Hampshire, and Oregon were the only states scoring 100% compliant with the state law for those tanning salons contacted.  Alabama scored the lowest with 0% compliant for those tanning salons contacted.  Statistically significant decreases in compliance were found for rural, independently owned, and Southern US tanning salons. (more…)
Author Interviews, Dermatology / 17.10.2017

MedicalResearch.com Interview with: Neelam A. Vashi, MD Assistant Professor of Dermatology Director, Boston University Center for Ethnic Skin Director, Cosmetic and Laser Center Boston University School of Medicine Boston Medical Center   Mayra B. C. Maymone, MD, DSc. Department of Dermatology Boston University , Boston   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Societal interest with beauty dates back centuries; Plato described the 3 wishes of every man to include beauty, good health, and riches.  Given this fascination, there are many people who have dedicated their entire lives to studying the concept of beauty and the implications it presents to society.  The ability to set ‘beauty’ as a standard of comparison has shown us the advantages of being deemed beautiful – those who are more beautiful being able to get jobs easier and go out on more dates.  Beautiful people are even more often attributed qualities such as likeability, social competence, and intelligence. The study and concept of beauty are quite fascinating yet complicated.  We have found that there are both biological/innate indicators and also subjective aspects.  As discussed in my article, the classical conception of beauty is a matter of mathematical conceptions and instantiating definite proportions.  However, this inflexible treatment of the concept of beauty as objective denies paying tribute to its many different aspects and the contributions of individuality, culture, and history.  From our study, we can see that beauty standards are evolving and slowly drifting from the rigid standards once set. We found that compared to 1990, celebrities rated beautiful in 2017 were older, more often women, and had a higher rate of darker skin types and mixed race. The study of beauty is a quite lengthy topic - I wrote a book on it:  https://www.amazon.com/Beauty-Body-Dysmorphic-Disorder-Clinicians/dp/3319361988/ref=sr_1_2?ie=UTF8&qid=1508076953&sr=8-2&keywords=neelam+vashi. (more…)
Author Interviews, Dermatology, Melanoma, Transplantation, University of Pennsylvania / 17.10.2017

MedicalResearch.com Interview with: Thuzar M.Shin MD, PhD Assistant Professor of Dermatology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Organ Procurement Transplant Network (OPTN) collects data on cancers that develop after organ transplantation. Previous studies have shown incomplete reporting to the OPTN for many cancers (including melanoma). Skin cancer is the most common malignancy in solid organ transplant recipients and the most common post-transplant skin cancer, cutaneous squamous cell carcinoma (cSCC), is not captured in standard cancer registries. We hypothesized that cSCC and melanoma are underreported to the OPTN. When compared to detailed medical record review obtained from the Transplant Skin Cancer Network database (JAMA Dermatol. 2017 Mar 1;153(3):296-303), we found that the sensitivity of reporting to the OPTN was only 41% for cSCC and 22% for melanoma. The specificity (99% for cSCC and 100% for melanoma) and negative predictive values (93% for cSCC and 99% for melanoma) were high. As a result, the OPTN database is unable to robustly and reliably distinguish between organ transplant recipients with and without these two skin malignancies. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Surgical Research / 05.10.2017

MedicalResearch.com Interview with: Adewole Adamson, MD, MPP Department of Dermatology UNC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Surgery is the primary intervention for the treatment of melanoma. Little is known about how delays for surgery, defined as the time between diagnosis and surgical treatment, among melanoma patient differ by insurance type. After adjustment of patient-level, provider-level, and tumor-level factors we found that Medicaid patients experience a 36% increased risk of delays in surgery for melanoma. These delays were 19% less likely in patients diagnosed and 18% less likely in patients surgically treated by dermatologists. Non-white patients also had a 38% increased risk of delays. (more…)
Author Interviews, Dermatology, JAMA, Surgical Research / 28.09.2017

MedicalResearch.com Interview with: P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a facial plastic surgeon with an interest in finding treatments for patients with facial paralysis, we are always looking for ways to improve the care that our patients receive. One of those treatments is to treat the effects of abnormal and asymmetric facial motion with botulinum, which decreases the deformity that results from facial nerve disorders by decreasing muscular hyperactivity. This study was based on the fact that there are three commercially available types of botulinum available for treatment of the face. There have been studies that have compared the different types of botulinum for cosmetic purposes, but there have not been any studies that specifically looked to see if there were any differences between the different types of botulinum when used for treatment of facial nerve disorders. The main finding of the study is that the three different types of botulinum are essentially equivalent with the exception being that one type of botulinum, incobotulinum toxin, was slightly less effective than the other two types of botulinum at the 4-week follow up point. Of note, all three types were equivalent at all other time points. (more…)
Allergies, Author Interviews, Dermatology, JAMA, Pediatrics / 28.09.2017

MedicalResearch.com Interview with: Elena Netchiporouk, MD, FRCPC, MSc Dermatology Resident - PGY5 and Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc McGill University MedicalResearch.com: What is the background for this study? Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA, Surgical Research / 11.09.2017

MedicalResearch.com Interview with: Matthew Q. Miller, MD Department of Otolaryngology–Head and Neck Surgery University of Virginia Health System, Charlottesville  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer is the most common type of cancer worldwide. In the United States, 3.3 million people are diagnosed with a new skin cancer annually and many of these individuals will have more than one cancer. The face is the most common place for skin cancers to develop. Mohs micrographic surgery (often referred to as Mohs surgery) is the standard of care for some skin cancers on the face. Once the cancer is removed, the skin defect is usually repaired by the Mohs surgeon but many require referral to a reconstructive surgeon. We were intrigued by a recent publication that noted an increased risk in complications when repair of Mohs defects is delayed beyond 2 days. While most patients that will require referral for reconstruction can be predicted and scheduled accordingly in concert with the Mohs surgery, it is not infrequent that a Mohs procedure requires multiple, unexpected passes to excise the entire cancer and the patient is then left with an unexpectedly large defect requiring reconstruction. These large defects often require more OR time and planning and, therefore, reconstruction cannot be easily completed within 2 days of the Mohs procedure. (more…)
Author Interviews, Dermatology, JAMA / 08.09.2017

MedicalResearch.com Interview with: Kaveri Korgavkar, MD Department of Dermatology Brown University Providence, Rhode Island  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Photodamage refers to premature skin aging from long-term UV exposure. Topical fluorouracil cream, typically used in the treatment of actinic keratosis, has been suggested for use in treating photodamage due to clinical and histological findings. However, in our ad hoc secondary analysis of a large randomized clinical trial, a standard course of topical fluorouracil did not result in detectable improvement of photodamage. (more…)
Author Interviews, Dermatology, Melanoma / 06.09.2017

MedicalResearch.com Interview with: Riccardo Pampena MD and Caterina Longo, MD, PhD Dermatology Unit University of Modena and Reggio Emilia Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: High heterogeneity has been reported in previous studies on the ratio of melanoma associated with moles (nevus-associated melanomas). Despite this heterogeneity, researchers agree that some melanomas may develop in conjunction with a pre-existing mole. We know that nevus-associated melanomas are usually located on the trunk and more frequently occur in younger patients than de novo melanomas (not nevus-associated). Defining the risk for a melanoma to arise in association with a pre-existing mole is important in order to define the best strategies for early melanoma diagnosis. The main finding of our study is that only one third of melanomas arose from a pre-existing mole, in fact the majority were de novo. We also found that nevus-associated melanomas were less aggressive than de novo. (more…)
Author Interviews, Dermatology, University of Pennsylvania / 03.09.2017

MedicalResearch.com Interview with: Megan H. Noe MD, MPH Clinical Instructor and Post-Doctoral Research Fellow University of Pennsylvania, Department of Dermatology Perelman Center for Advanced Medicine Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that patients with psoriasis have higher rates of hypertension, diabetes, cardiovascular disease and chronic kidney disease that may put them at an increased risk of death. Our research found that patients with psoriasis covering more than 10% of their body had almost double the risk of death than people of the same age with similar medical conditions, but without psoriasis. (more…)
Author Interviews, Dermatology, Infections / 02.09.2017

MedicalResearch.com Interview with: Kyle T. Amber, MD Department of Dermatology UC Irvine Health Irvine, CA 92697  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with autoimmune blistering diseases often requires significant immunosuppression in order to control their diseases. Pneumocystis pneumonia is an opportunistic infection that occurs in immunocompromised patients.  This study was borne out of my observation that most European experts in the treatment of autoimmune blistering disease did not give routine prophylaxis for pneumocystis. Among American dermatologists, there was far more disagreement. This was a collaborative effort of several international tertiary care centers. We demonstrated that the incidence of pneumocystis in 801 patients with autoimmune blistering disease was only 0.1%, which fell well below previous recommendations in the literature suggesting an incidence of 3.5% in order to justify prophylaxis. (more…)
Author Interviews, Dermatology, Heart Disease / 21.08.2017

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Kildegårdsvej 28 2900 Hellerup Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: The majority cardiovascular events in psoriasis occur in patients at low risk by traditional cardiovascular risk calculators. It has been speculated that long-term exposure to systemic inflammation may increase the risk of adverse cardiovascular outcomes. Therefore, clinically available historical features such as disease duration may identify those at higher risk for cardiovascular disease. Using a translational epidemiological approach, combining 18F-fluorodeoxyglucose positron emission tomography computed tomography scanning with nationwide epidemiological data of more than four million individuals, we provide the first convincing evidence to suggest a detrimental effect of psoriasis duration on cardiovascular disease beyond traditional cardiovascular risk factors, even in patients deemed “low-risk” by conventional risk scores. We found a 1% increase in future major adverse cardiovascular event risk per additional year of disease duration. This finding has an effect size similar to smoking, a well-established cardiovascular risk factor. (more…)