Author Interviews, Dermatology, Journal Clinical Oncology, Melanoma / 21.09.2016

MedicalResearch.com Interview with: Reza Ghiasvand, PhD Postdoctoral fellow, Department of Biostatistics, Faculty of Medicine, University of Oslo. Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: To date, findings from studies have been inconsistent. Some studies found a decreased risk of melanoma among sunscreen users, while others found no association or a higher risk of melanoma among sunscreen users. Several studies found that many sunscreen users do not apply sunscreens properly and do not reapply as recommended and stay longer in the sun after using sunscreen and as a result get sunburn and increase their risk of skin cancer. Our findings suggest higher UV exposure among sunscreen users compared to nonusers. However, those who used sunscreen with high SPF had 33% lower risk of melanoma compared to users of low SPF sunscreens. (more…)
Author Interviews, Dermatology, Genetic Research, Race/Ethnic Diversity / 11.09.2016

MedicalResearch.com Interview with: Khalaf Kridin, MD Department of Dermatology Rambam Health Care Campus Haifa Israel MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pemphigus shows an uneven geographic and ethnic distribution. A high incidence of pemphigus was observed in some ethnic groups, namely Ashkenazi Jews and those of Mediterranean origin. This observation has been shown to be strongly related to several HLA-class II genes; HLA-DRB1*04 and HLA-A*10 which have been more frequently found among Ashkenazi Jewish pemphigus patients. We sought to estimate trends in the incidence of pemphigus in northern Israel in the years 2000-2015, in relation to the major ethnic groups who inhabit the same geographic area and exposed to the same environmental elements. The overall estimated incidence of pemphigus in northern Israel was 7.2 per million inhabitants per year (95% CI, 6.2-8.3). The incidence in the Jewish population was 3-fold higher than that in Arabs; 9.6 vs. 3.2 cases per million per year, respectively, p<0.0001), and higher among women than men; 9 vs. 5.3 cases per million per year, respectively, p<0.0001). Patients of Arab ancestry tend to present with the disease at earlier age, in line with observations from Arab and Mediterranean countries. A declining trend in the incidence of pemphigus throughout the last 16 years in northern Israel was observed. (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 07.09.2016

MedicalResearch.com Interview with: William Ryan B.V.Sc. Ryan Mitchell Associates LLC Westfield, NJ and Bernard Cohen, MD Professor Dermatology and Ellen Koch, MD Division of Pediatric Dermatology Johns Hopkins Medicine, Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a group we were concerned about the misinformation that continues to be promulgated on the internet and through other sites. Importantly, the group consisted of experts with specific experience in the management of head louse infestations, from pediatric dermatology, pediatrics, school nursing and head louse research fields. Even information sources that we would have expected to be credible are outdated, unreliable or both, often continuing myths about head louse infestations and how they can be controlled.  We wanted to provide a balanced and informed perspective that would help physicians and parents recognize that head louse infestations do not present a serious problem, and can be well managed with an informed approach to treatment. The main findings are that over the counder products (permethrin/pyrethrins) are unlikely to be effective, and that that there are safe and effective products that are available by prescription. Interestingly, head lice do affect Indian and African children in their home countries, but virtually nonexistent in African Americans in North America. There has been speculation about hair grooming regimen or structure of African American hair but the cause is unknown.  In a study we performed assessing resistance to over the counter pediculicide components over a decade ago in Baltimore, we were not able to find a single African American child with head lice. We were not able to recruit any patients from the Baltimore City Schools. (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 07.09.2016

MedicalResearch.com Interview with: Prof. Alan Irvine DSc Consultant Dermatologist Our Lady’s Children’s Hospital Associate Professor of Dermatology Trinity College Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that atopic dermatitis (AD) has a close relationship with staphylococcus aureus (SA) colonisation, and this is known to drive flares or exacerbations of AD but before our report it was not known which came first-AD colonisation or atopic dermatitis? By following a cohort pf patients very carefully over a 1 year period and regularly sampling their skin microbiome we were able to show that SA colonisation did not precede development of AD and in fact that several non SA species of staphylococcus actually appeared to be protective for developing atopic dermatitis. This is an important new finding in the complex relationship between the microbiome and skin inflammation, suggesting that some commensal bacterial are anti-inflammatory or protective. (more…)
Author Interviews, Dermatology, Endocrinology, Fertility / 03.09.2016

MedicalResearch.com Interview with: Anders Rehfeld MD, PhD Student Faculty of Health and Medical Sciences Department of Cellular and Molecular Medicine University of Copenhagen Copenhagen Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Human fertility is declining in many areas of the world and the reason is largely unknown. Our study shows that 44% of the tested chemical UV filters can induce calcium signals in human sperm cells, thereby mimicking the effect of progesterone. Progesterone-induced calcium signals, and the sperm functions it triggers, is absolutely essential for the human sperm cell to normally fertilise the human egg. (more…)
Author Interviews, Dermatology, JAMA / 25.08.2016

MedicalResearch.com Interview with: Lisa Earnest Ishii, M.D. Associate Professor, Department of Otolaryngology-Head and Neck Surgery Division of Facial Plastic and Reconstructive SurgeryJohns Hopkins School of Medicine Baltimore Maryland 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hair transplantation for men suffering from male pattern hair loss is a common procedure to improve their appearance. However, to the best of our knowledge the impact of the procedure for men with hair loss had never been clearly demonstrated. We showed, for the first time, that men who undergo the procedure can have real improvements in attractiveness, age, and the appearance of successfulness as perceived by the casual observer in society. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH / 24.08.2016

MedicalResearch.com Interview with: Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Stanford / 22.08.2016

MedicalResearch.com Interview with: Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dysplastic nevi (DN) are frequently re-excised following initial biopsy due to concerns for malignant transformation; however, the long-term risk of melanoma developing in mildly or moderately dysplastic nevi with positive histologic margins is unknown. In this cohort study of 590 histologic DN that were followed over 20 years, 6 cases of melanoma (5 in situ) arose in the 304 DN with positive margins that were clinically observed, only 1 of which developed from an excisionally-biopsied dysplastic nevus. One melanoma in situ arose in the 170 cases that underwent complete excision at the outset. The risk of new primary melanoma at other sites of the body was over 9% in both groups. (more…)
Author Interviews, Dermatology, Pediatrics, Tobacco Research / 19.08.2016

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? Response: Some children with atopic dermatitis may have disease activity persist into adolescence and adulthood, although most children are thought to “grow out of it.” There have been a number of studies with varied results about how commonly atopic dermatitis actually persists later in life. Moreover, the risk factors for persistence of atopic dermatitis are unclear. We sought to systematically analyze the extant literature of research studies to determine the rates and predictors of atopic dermatitis persistence over time. (more…)
Author Interviews, Dermatology / 18.08.2016

MedicalResearch.com Interview with: Thomas Bold President and CEO RenovaCare Inc. MedicalResearch.com: What is the background for the CellMist™ System? How are the stem cells harvested and processed? Response: Our flagship CellMist™ System makes use of a patient’s own stem cells, which are sprayed onto wounds using our novel SkinGun™ device. For patients suffering severe burns and other wounds, the prospect of a quick-healing, gentle spray containing their own stem cells will be a promising alternative to conventional skin graft surgery, which can be painful, prone to complications like infections, and slow-to-heal. Based on preliminary case studies, CellMist™ System patients can be treated within 90 minutes of arriving in an emergency room; a patient’s stem cells are isolated, processed, and sprayed on to the wound sites for rapid healing. The CellMist™ Solution is a liquid suspension containing a patient’s own regenerative skin stem cells. A small sample (as small as a square inch) of the patient’s skin is quickly processed to liberate the stem cells from surrounding tissue. The resulting product is referred to as the ‘CellMist™ Solution’. The CellMist™ Solution is placed in the SkinGun™ and gently sprayed onto the patient’s wound. (more…)
Author Interviews, Dermatology, Pharmacology / 15.08.2016

MedicalResearch.com Interview with: Kin F. Chan, PhD Executive Vice President of Research and Technology BioPharmX Corporation MedicalResearch.com: What is the background for this study? What are the main findings? Response: There were two studies in this series.  The purpose is to get a better understanding of the blood plasma and skin levels of minocycline in a relevant animal model (minipig) for both the oral form of minocycline (Solodyn) and topical BPX-01, and to elucidate the same for oral minocycline only in a clinical study. The results provided valuable guidance and assurance to our upcoming Clinical Phase 2b dose-ranging study design. (more…)
Author Interviews, Dermatology, Technology / 11.08.2016

MedicalResearch.com Interview with: Alexander Golberg, PhD Senior Lecturer Head of Environmental Bioengineering Laboratory Porter School of Environmental Studies Tel Aviv University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wound care costs the U.S. healthcare system more than $20 billion each year, and care required to combat skin scarring represents an additional $12 billion burden. Hypertrophic scarring after trauma and burn injury remains a major clinical challenge that leads to physical, aesthetic, functional, psychological, and social stresses in thousands of patients. This is a stubborn clinical problem very difficult to solve. Inspired by previous works that pulsed electric fields kill cells precisely in tissue (procedure called irreversible electroporaiton, developed by UC Berkeley group of Boris Rubinsky and Rafael Davalo) and these ablated tissues regenerate with minimal scarring, we decided to test whether pulsed electric fields can reduce the scar formation if we treat the wound during healing. We found that partial irreversible electroporation using 200 pulses of 250 V and 70 µs duration, delivered at 3 Hz every 20 days during a total of five therapy sessions after the initial burn injury resulted in a 57.9% reduction of the scar area in comparison with untreated scars and structural features approaching those of normal skin. Noteworthy, unlike humans, rats do not develop hypertrophic scars. Therefore, the use of a rat animal model is the limiting factor of this work. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Science, Technology / 28.07.2016

MedicalResearch.com Interview with: Mei X. Wu, Ph.D. Associate Professor Wellman Center for Photomedicine Massachusetts General Hospital Dermatology Department Harvard Medical School MedicalResearch.com: What is the background for this study? Response: An abnormally low count of platelets, a disorder called thrombocytopenia, is life-threatening owing to a high risk of uncontrollable bleeding. The disorder can be caused by a variety of conditions like trauma, an autoimmune disorder that attacks platelets, side-effects of some drugs especially chemotherapeutic drugs, and in premature newborns and patients with HIV-infection or a genetic defect leading to insufficient platelet generation. Platelet transfusion is the most effective modality to treat the disorder, but it is associated with complications including allergic reaction, fever, infection, and immunosuppression and limited only to the most severe patients. Several FDA-approved drugs are currently used in the clinics or clinical trials to increase platelet levels, which however must be carefully dosed to avoid excessive platelet production that is also dangerous and are not suitable to many forms of thrombocytopenia. (more…)
Author Interviews, Dermatology, JAMA / 22.07.2016

MedicalResearch.com Interview with: G. Thomas (Tom) Ray Division of Research, Kaiser Permanente 2000 Broadway Oakland, CA 94612-2304 MedicalResearch.com: What is the background for this study? Response: Basal cell carcinoma (BCC) is the most common cancer in the United States. BCCs tend to develop on sun-exposed areas such as the head and neck and are typically treated with various surgical techniques in an outpatient setting. Although BCCs are rarely fatal, they have been estimated to be among the most costly cancers in the Medicare population due to their high incidence. Yet because these cancers are not tracked by national registries the way, for example, melanoma is, basal cell carcinomas have been difficult to study. Incidence rates in the past have tended to rely on surveys such as those by the National Cancer Institute. And studies using disease codes have, until recently, been difficult because the codes used for basal cell carcinoma and squamous cell carcinoma were the same. Since 1997, Kaiser Permanente Northern California (KPNC) has had computerized pathology results that allowed us to develop an internal registry of BCC cancers. In addition to having detailed information about basal cell cancer patients, we also had detailed information on the underlying population - KPNC members – which allowed us to determine incidence rates of BCC by age, sex, and most importantly for this study, by geographic location. This is because we know the residential location of all KPNC members at any given time – both those that get basal cell cancer and those who do not. This combination of a validated BCC registry with a well-defined population at-risk gave us the unique ability to investigate the spatial distribution of BCC in Northern California and assess whether there existed geographic clustering of basal cell cancers. Although the investigation of spatial clustering of other cancers is fairly common, no such analyses have been performed for basal cell cancer in the United States. (more…)
Author Interviews, Dermatology / 22.07.2016

MedicalResearch.com Interview with: Charareh Pourzand, MSc, MPhil, PhD/DSc Senior lecturer and Associate Professor in Biopharmaceutics Department of Pharmcay and Pharmacology University of Bath Bath United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Exposure of skin cells to Ultraviolet A (UVA) component of sunlight provokes oxidative damage to the vital subcellular organelles, mitochondria, leading to ATP depletion and necrotic cell death. The presence of high level of potentially harmful ‘labile’ iron in mitochondria is thought to make these organelles highly susceptible to oxidative damage caused by UVA. Therefore, we designed a highly specific iron trapping compound that could directly target mitochondria and protect the organelles against UVA-induced iron damage and the ensuing cell death. The results of the study demonstrate an unprecedented level of protection afforded by these compounds against damage caused by high doses of solar UVA radiation, equivalent to up to 140 min sun exposure at sea level. (more…)
Author Interviews, Dermatology, Science / 20.07.2016

MedicalResearch.com Interview with: Dr. Devin M. Barry, PhD, postdoc fellow Center for the Study of Itch,. Department of Anesthesiology Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Our group is interested in understanding the molecular and cellular mechanisms that underly itch sensation. Our study focused on peripheral sensory neurons of the DRG that mediate responses to itch-inducing stimuli, in particular the inflammatory mediator histamine and the antimalarial drug chloroquine. It has been shown that histamine and chloroquine activate distinct G protein–coupled receptors (GPCRs) in sensory neurons innervating the skin. Two members of the transient receptor potential (TRP) family of ion channels, TRPV1 and TRPA1, have been found to be important mediators of histamine- and chloroquine-induced itch signaling, respectively. (more…)
Author Interviews, Dermatology, Infections, Technology / 19.07.2016

MedicalResearch.com Interview with: Dr. Kerry Zang Founder of the Arizona Institute of Footcare and Dr. Robert Sullivan Clinical Director, Midleton Foot Clinic MedicalResearch.com Editor's note: Dr. Zang and Dr. Sullivan discuss the recent announcement of FDA approval of the Lunula Laser for the treatment of Onychomycosis. MedicalResearch.com: What is the background for this new technology? Response: “For two decades, Erchonia Corporation studied the clinical utility of low-level laser devices for the treatment of numerous medical ailments. Dr. Sullivan and I worked with Erchonia on the Lunula laser to revolutionize the way the medical community treats onychomycosis. Lunula underwent four independent clinical investigations for the treatment of onychomycosis. More than 500 subjects participated with increasingly effective results and each completed without a single adverse event.” - Dr. Kerry Zang Response: “There has never been a non-pharmaceutical treatment for onychomycosis. When I became aware that there was a small study completed by Dr. Zang, I became interested in the potential of this new technology. Erchonia was very helpful in bringing me up to speed with what this technology may do. The results of my extended study were unbelievable.” -Robert Sullivan (more…)
Author Interviews, Dermatology, JAMA, OBGYNE, Sexual Health, Social Issues, UCSF / 29.06.2016

MedicalResearch.com Interview with: Tami Rowen MD MS Obstetrics, Gynecology and Reproductive Sciences UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to answer the question of which women are engaging in genital grooming and understand their motivations. Prior studies have been limited by geography and age thus our goal was to provide a nationally representative sample of women. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 29.06.2016

MedicalResearch.com Interview with: June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 1 million patients with a history of melanoma live in the US. They are at risk to develop a second melanoma. The risk is elevated for up to 20 years and is 10 times greater than the risk of a first melanoma in the general population. This is the first randomized clinical trial to examine partner- assisted skin self-examination (SSE) . A 30 minute structured training intervention was provided to the melanoma patients and their partners with reinforcement every 4 months . The 494 pairs in the intervention performed significantly more skin self-examination  than those in the control group at 4,12 and 24 months after the education and skills training. The pairs were accurate in finding early melanoma and did not have unnecessary visits to the dermatologists. (more…)
Aging, Author Interviews, Dermatology / 28.06.2016

MedicalResearch.com Interview with: Dr. Ava Shamban MD Assistant Clinical Professor of Dermatology UCLA-Geffen School of Medicine MedicalResearch.com Editor’s note: Dr. Ava Shamban, a dermatologist frequently featured on CBS’ The Doctors as the skin maven on ABC’s Extreme Makeover discusses the recent announcement of the 20th Global Anniversary of Restylane. MedicalResearch.com: Would you briefly explain what Restylane® is? What are the main indications for the Restylane® portfolio of products? Response: Restylane is a non-animal, stabilized hyaluronic acid (NASHA), a unique patented HA stabilization technology which contains pure hyaluronic. The Restylane family of products can be used to design individualized treatments with natural-looking results and long-lasting effects. With 190 scientific publications and 150 clinical studies, and more than 3,000 patients in clinical studies, the Restylane family of products are safe and effective products that have been FDA approved based on extensive clinical data. Restylane® is one of the world’s most studied wrinkle fillers and has been used in more than 65 countries worldwide in over 28 million treatments. The main indications for the Restylane portfolio products is to improve the overall appearance of the aging face. Whether you’re young or old, whether you have a fine line or wrinkle or a deeper fold there is a product in this portfolio that can improve the appearance of your face and reverse signs of aging. (more…)
Author Interviews, Dermatology, Infections / 21.06.2016

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: Psoriasis is associated with a number of potential risk factors for developing serious infections, including impaired skin-barrier function, immune dysregulation, use of systemic immunosuppressant and biologic treatments. We hypothesized that adults with psoriasis have higher rates of serious infections. We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that psoriasis was associated with multiple serious infections, including methicillin-resistant Staphylococcus aureus, cellulitis, herpes simplex virus infection, infectious arthritis, osteomyelitis, meningitis, encephalitis and tuberculosis. Rates of serious infections increased over all time. Significant predictors of serious infections in patients with psoriasis included non-white race, lower estimated income quartile, and Medicaid, Medicare, or self-pay insurance status. These findings suggest that poor access to adequate dermatologic care may be associated with higher rates of infections. (more…)
Author Interviews, Dermatology, Heart Disease / 09.06.2016

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? Dr. Egeberg: While psoriasis has been associated with an increased risk of cardiovascular disease (CVD), studies have generally neglected to adjust for family history of CVD which is a well-established cardiovascular risk factor. In a population-based study of young patients with psoriasis, we found an increased risk of CVD only in patients with a positive family history of CVD but not in those patients that did not have a positive family history. (more…)
ASCO, Author Interviews, Dermatology, Journal Clinical Oncology, Melanoma, Primary Care, University of Pittsburgh / 07.06.2016

MedicalResearch.com Interview with: Laura Ferris, M.D., Ph.D. Associate professor, Department of Dermatology University of Pittsburgh School of Medicine and Member of the Melanoma Program University of Pittsburgh Cancer Institute MedicalResearch.com: What is the background for this study? Dr. Ferris: Rates of melanoma, the most dangerous form of skin cancer, are on the rise, and skin cancer screenings are one of the most important steps for early detection and treatment. Typically, patients receive skin checks by setting up an appointment with a dermatologist. UPMC instituted a new screening initiative, which was modeled after a promising German program, the goal being to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their primary care physicians (PCPs). PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15 percent of the 333,788 eligible UPMC patients were screened in this fashion. (more…)
Author Interviews, Dermatology, Immunotherapy / 01.06.2016

MedicalResearch.com Interview with: Benjamin M. Perry, DO Silver Falls Dermatology Salem, OR 97302 MedicalResearch.com: What is the background for this study? Dr. Perry: Our interest in this subject developed when a patient came into our clinic with concern of multiple new nevi developing on palmoplantar surfaces following initiation of treatment with Rituximab. We conducted a review of the existing literature and found that this wasn’t a known adverse effect. From that point, we wanted to know the pathogenesis, prognosis, and management for eruptive nevi that developed in the setting of medication use. A collective review had not been previously performed on this subject. In essence, we had questions that were unanswered and set out to find the answers. (more…)
Author Interviews, Dermatology, Genetic Research / 28.05.2016

MedicalResearch.com Interview with: Ryuta Muromoto, Ph.D. Department of Immunology, Faculty of Pharmaceutical Sciences, Hokkaido University Sapporo, Japan MedicalResearch.com: What is the background for this study? Dr. Muromoto: Psoriasis is an immune-mediated chronic inflammatory skin disorder that affects some 125 million people worldwide. It is characterized by itchy, scaly skin plaques. It has been known that a cytokine IL-17A, which is produced by immune cells, plays a central role in the development and maintenance of clinical features of psoriasis. IL-17A acts on keratinocytes and up-regulates anti-microbial peptides and a set of chemokines, that are important for immune cell infiltration. This immune cell feedback amplifies psoriatic inflammation. Also, other inflammatory cytokines such as TNF-alpha and interferon-gamma are up-regulated, and have been implicated in pathogenesis of psoriasis. So, the interplay between cytokines appears to be important for development of psoriasis through keratinocyte activation. In this study, we sought to clarify the actual role of IL-17A and its interplay with other cytokines in keratinocyte activation. (more…)
Author Interviews, Cancer Research, Dermatology, Immunotherapy, Melanoma, NYU / 21.05.2016

MedicalResearch.com Interview with: Melissa A. Wilson, MD, PhD Assistant professor of Medical Oncology NYU Langone Perlmutter Cancer Center MedicalResearch.com: What are the most common types of skin cancer? Dr. Wilson: Basal cell carcinoma, squamous cell carcinoma and melanoma. With rare exception, all are related to sun exposure. MedicalResearch.com: Are some types of skin cancer more serious than others? Dr. Wilson: Melanoma is the most serious form of skin cancer, with the highest risk of developing into metastatic disease. Most basal cell and squamous cell carcinomas are superficial and not as invasive, so removal is the treatment. Rarely, these can cause invasive and metastatic disease, but this occurs infrequently. Melanoma is much more serious. Of course, the earlier melanoma is detected and the earlier stage that it is, is more predictive of a favorable outcome. MedicalResearch.com: Who is most prone to skin cancer? Dr. Wilson: Persons with excessive sun exposure, fair skin, light hair and blue eyes - although it can certainly occur in anyone. (more…)
Author Interviews, Dermatology, JAMA, Telemedicine, UCSF / 16.05.2016

MedicalResearch.com Interview with: Jack Resneck, Jr, MD Professor and Vice-Chair of Dermatology Core Faculty, Philip R. Lee Institute for Health Policy Studies UCSF School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Resneck: Telemedicine, when done right, can improve access and offer convenience to patients.  We have seen proven high-quality care in telemedicine services where patients are using digital platforms to communicate with their existing doctors who know them, and where doctors are getting teleconsultations from other specialists about their patients.  But our study shows major quality problems with the rapidly growing corporate direct-to-consumer services where patients send consults via the web or phone apps to clinicians they don’t know. Most of these sites aren’t giving patients a choice of the clinician who will care for them or disclosing the credentials of those clinicians – patients should know whether their rash is being cared for by a board-certified dermatologist, a pain management specialist, or a nurse practitioner who usually works in an emergency department.  Some of these sites are even using doctors who aren’t licensed in the US.   We also found that these sites were regularly missing important diagnoses, and prescribing medications without discussing risks and side-effects, putting patients at risk.  We observed that if you upload photos of a highly contagious syphilis rash but state that you think you have psoriasis, most clinicians working for these direct-to-consumer sites will just agree with your self-diagnosis and prescribe psoriasis medications, leaving you with a contagious STD. Perhaps the biggest problem with many of these sites is the lack of coordinating care for patients – most of them didn’t offer to send records to a patient’s existing local doctors.  And when patients end up needing in-person care if their condition worsens, or they have a medication side-effect, those distant clinicians often don’t have local contacts, and are unable to facilitate needed appointments. (more…)
Author Interviews, Dermatology, JAMA, Technology, Telemedicine / 05.05.2016

MedicalResearch.com Interview with: Lori Uscher-Pines, PhD RAND Corporation Arlington, Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many communities in the U.S. are underserved by dermatologists, access is particularly limited among Medicaid patients. Teledermatology may be one solution to improve access. Our goal with this study was to assess the effect of a novel teledermatology initiative on access to dermatologists among enrollees in a Medicaid Managed Care Plan in California’s Central Valley. Among all patients who visited a dermatologist after the introduction of teledermatology from 2012-2014 (n=8614), 49% received care via teledermatology. Among patients newly enrolled in Medicaid following Medicaid expansion in 2014, 76% of those who visited a dermatologist received care via teledermatology. Patients of primary care practices that engaged in teledermatology had a 64% increase in the fraction of patients visiting a dermatologist (vs. 21% in other practices) (p<.01). Compared with in-person dermatology, teledermatology served more patients under age 17, male patients, nonwhite patients, and patients without comorbid conditions. Conditions managed across settings varied; teledermatology physicians were more likely to care for viral skin lesions and acne whereas in-person dermatologists were more likely to care for psoriasis and skin neoplasms. (more…)
Author Interviews, Dermatology, Heart Disease, Rheumatology / 04.05.2016

MedicalResearch.com Interview with: Lihi Eder, MD, PhD Assistant Professor of Medicine University of Toronto Scientist, Women’s College Research Institute,Room  6326 Women’s College Hospital Toronto, ON, Canada  MedicalResearch.com: What is the background for this study? Dr. Eder: Psoriasis is a chronic immune-mediated skin disease affecting 2-3% of the general population. Psoriatic arthritis (PsA) affects 15-30% of patients with psoriasis. Until recently, only few studies assessed the risk of developing cardiovascular events in patients with PsA and while most studies found a higher cardiovascular risk in these patients, others reported cardiovascular rates that were similar to the general population. (more…)