Author Interviews, Dermatology, Pharmacology / 22.12.2015

MedicalResearch.com Interview with: Dr. Diana Lac, PhD Senior Scientist at BioPharmX Corporation. Dr. Lac received her PhD in Pharmacology and Toxicology from the University of California, Davis and currently focuses on the development of topical treatments for acne. MedicalResearch: What is the background for this study? What are the main findings? Dr. Lac: Acne affects almost 90% of people in western societies during their teenage years and may persist into adulthood. Currently, the oral tetracycline class of drugs dominates the acne treatment market. However, these treatments have been associated with a variety of adverse effects, such as headaches, dizziness, fatigue, nausea, photosensitivity, and severe itchiness. While a variety of acne treatments do exist, topical antibiotics particularly have had limited success due to formulation challenges. A topical minocycline formulation will provide a superior alternative for local treatment of acne, thereby limiting the amount of systemic exposure to the antibiotic and addressing the overall global antibiotic resistance problem. We believe that by directly delivering the drug to the skin we can decrease the amount of antibiotic exposure and also limit the off-target effects. We have developed a novel, stable minocycline gel formulation allowing for efficient delivery of minocycline directly to the pilosebaceous unit in the skin where Propionibacterium acnes typically reside. In this poster presentation we have demonstrated this effectively in live rats. A dose ranging study was conducted where drug delivery and safety of our novel formulation was assessed. A number of dose formulations were tested (up to 4% minocycline formulations) and were found to be non-irritating and safe for topical use. (more…)
Author Interviews, Dermatology, Technology / 21.12.2015

MedicalResearch.com Interview with: Christie Riemer MD Candidate-Class of 2016 Michigan State University College of Human Medicine Medical Research: What is the background for this study? What are the main findings? Response: Online physician rating sites allow patients to recommend, grade, and publicly comment on physician performance. Despite increases in physician rating website popularity, little information exists regarding the online footprint of dermatologists. Many physicians also remain wary of these websites for fear of malicious reviews. Our study aimed to investigate the patterns of dermatologist online ratings. We found the average ratings for dermatologists were high, >3.5 stars, on the top 5 websites (ZocDoc, Healthgrades, Yelp, RateMDs, and Vitals.com), we also searched for more specific geographic criteria such as including a location in our search for example a dermatologist in columbia sc, by doing this we found that the online ratings were not only national and but state wide too allowing us to look for local and national patterns of ratings. Most importantly, these ratings were consistently high across the 3 sites with the most dermatologist profiles. There were no differences in rating based on gender or subspecialty training. Four of the sites offer the option to write comments. ZocDoc had significantly fewer negative comments, and also had the most comments per dermatologist, there are also dermatologists in different areas of the United States, for example, there is a dermatologist in nyc that those who live in that area can look into. (more…)
Author Interviews, Dermatology, FDA, Melanoma, NYU / 19.12.2015

MedicalResearch.com Interview with: Dr. Jennifer Stein MD Associate Professor Department of Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What is the background for this FDA decision? What is the issue surrounding tanning beds? Dr. Stein:  This is an important proposal from the FDA because it restricts minors from tanning and requires adults to sign an acknowledgement stating they have been informed about the risks of tanning. There is clear evidence that indoor tanning significantly increases a person’s risk for skin cancer, including melanoma, a potentially deadly form of skin cancer. It is important to protect young people from the dangers of tanning beds, especially because many patients report that they started indoor tanning as teens. There are 1.6 million minors using tanning beds every year. MedicalResearch: What is the problem with tanning?  Isn't a tan better than a sunburn? Dr. Stein: Tanning beds deliver intense amounts of UVA. We know that UVA penetrates deep into the skin and causes mutations that lead to skin cancers, including melanoma. Tanning is a sign that skin cells have been damaged by UV light. (more…)
Author Interviews, Dermatology, Pediatrics / 16.12.2015

MedicalResearch.com Interview with: Dr Alison Cooke PhD, MRes, BMidwif (Hons), RM Lecturer in Midwifery (Teaching and Research) School of Nursing, Midwifery & Social Work The University of Manchester Oxford Road Manchester  Medical Research: What is the background for this study? What are the main findings? Dr. Cooke: The use of topical oils for the management of newborn dry skin or for massage is a common practice across the globe. In the UK, olive oil and sunflower oil are commonly recommended by maternity service health professionals for baby dry skin, yet there is no evidence to support this practice. The OBSeRvE study was conducted to investigate the effect of these two oils on healthy term newborn baby skin barrier function. The study found that both oils impeded the development of the skin barrier function from birth. (more…)
Author Interviews, Cancer Research, Chemotherapy, Dermatology, JAMA / 11.12.2015

MedicalResearch.com Interview with: Chia-Yu Chu, MD, PhD Associate Professor, Department of Dermatology National Taiwan University Hospital Medical Research: What is the background for this study? What are the main findings? Dr. Chia-Yu Chu: It has been well known that EGFR TKIs could cause skin toxicities (acneiform eruptions, pruritus, xerosis and paronychia). However, incidences of these skin toxicities have varied according to the different clinical trials, some of which even simply use “skin rash” instead of specific cutaneous findings in the reports. Afatinib, in contrast to first generation EGFR TKIs like gefitinib and erlotinib, is a second generation EGFR TKI with irreversible inhibition to not only EGFR, but also HER2 and ErbB4. Whether afatinib cause more skin toxicities remained unknown. Many of our patients received 2 or even 3 different EGFR TKIs with adequate drug exposure and washout period. Therefore, we had an opportunity to compare skin toxicities in “same patients” receiving different EGFR TKIs, and we found that around 30% of patients receiving afatinib developed paronychia whereas only 10% in gefetinib or erlotinib. This was the only significant difference between the 3 drugs. We also found afatinib treated patients needed significantly more dermatologic visits within 180 days of treatments and the reason was due to higher incidence of afatinib-related paronychia. Interestingly, regardless of causative agents, once skin toxicities developed they could be managed effectively in the same manners. (more…)
Author Interviews, Dermatology, Genetic Research, JAMA, Melanoma / 10.12.2015

MedicalResearch.com Interview with: Susana Puig MD PhD Chief Dermatology Service Research Director "Melanoma: Imaging, genetics and immunology" at IDIBAPS Consultant & Assistant Professor Melanoma Unit, Dermatology Department Hospital Clinic, University of Barcelona Barcelona Spain  Medical Research: What is the background for this study? What are the main findings? Dr. Puig: CDKN2A is the main high-penetrance melanoma susceptibility gene. A rare functional variant in MITF, p.E318K (rs149617956), has been identified as a moderate risk allele in melanoma susceptibility and also predisposes to renal cell carcinoma. In this study MITF p.E318K was associated with an increased melanoma risk (OR=3.3, p<0.01), especially in patients with multiple primary melanoma (OR=4.5, p<0.01) and high nevi count (>200 nevi) (OR=8.4, p<0.01). Interestingly, two fast growing melanomas were detected among two MITF p.E318K carriers during dermatologic digital follow-up. Furthermore, we have detected a similar prevalence of MITF p.E318K in CDKN2A wild-type and mutated individuals. (more…)
Author Interviews, Dermatology, Telemedicine / 09.12.2015

MedicalResearch.com Interview with: Mirna Becevic, PhD, MHA Assistant Research Professor of Telemedicine University of Missouri - Department of Dermatology Missouri Telehealth Network  Medical Research: What is the background for this study? What are the main findings? Dr. Becevic: The Missouri Telehealth Network (MTN) at the University of Missouri has been providing outpatient clinical services to rural Missourians since 1995.  Over 29 specialties and subspecialties have been utilized to assist patients in 69 counties. We have learned a lot along the way, what works well and what does not, in terms of telehealth protocols, trainings, best practices, etc. The MTN holds bi-annual two day training conference for new sites to share these experiences and provide hands-on training in telemedicine.  Our main goal with this study was to reach all telehealth users on the Missouri Telehealth Network (patients, providers, and telehealth coordinators-patient presenters) and learn about their perceptions of and opinions regarding this form of health care delivery.  We also wanted to evaluate the overall accessibility and discernment of the MTN by telehealth coordinators, since we felt that they might need to have continuous support in order to successfully manage their telehealth programs. Our main findings indicated that all three surveyed groups had high satisfaction with telemedicine.  Patients were confident in their doctors’ medical skills, and lack of physical contact was not viewed as a barrier. Telehealth providers thought telehealth was an effective tool for providing care at a distance, but indicated that they did not prefer telehealth over in-person visits. (more…)
Annals Internal Medicine, Author Interviews, Dermatology, Gastrointestinal Disease, Immunotherapy / 09.12.2015

MedicalResearch.com Interview with: Isabelle Cleynen  PhD University of Leuven  Medical Research: What is the background for this study? What are the main findings? Dr. Cleynen : Ulcerative colitis and Crohn’s disease, together inflammatory bowel disease (IBD), are characterized by chronic inflammation of the gastrointestinal tract. Treatment for IBD usually involves drug therapy including anti-inflammatory drugs and immune system repressors, amongst which biologics as the anti-TNF antibodies used for patients with moderate to severe IBD. Although these TNF-blocking drugs are effective in many patients with immune-mediated disorders like psoriasis, rheumatoid arthritis and spondylarthropathies, and IBD, several case reports and series showed that some patients developed troubling skin problems (including psoriasis and eczema), causing them to stop the anti-TNF treatment. It is however not clear how often these skin problems develop in IBD patients treated with anti-TNF, and what could be the predisposing factors. In a retrospective cohort of 917 IBD patients initiated on anti-TNF therapy in a single center, we have studied which patients did and did not develop skin problems, what type of skin problems, how they were treated, and whether the lesions resolved upon treatment. We found that about one third of the patients developed skin problems while being treated with anti-TNF drugs. The most common type was psoriasiform eczema, often occurring in flexural regions, the scalp, and genitalia. The time between starting the TNF-blocking drug and the appearance of the skin problem varied from less than half a year to more than 4 years. Quite surprisingly, we found that the cumulative dose of the treatment, or drug serum levels were not different in skin and non-skin lesion patients. Skin lesion patients however seemed to be younger when diagnosed with IBD and when started on anti-TNF agents, more often had anti-nuclear and dsDNA antibodies (both auto-immune factors), and a higher number of skin-disease related genetic risk variants. Most patients had a good response to treatment of their skin problem. About 10% of the patients who developed skin problems, however, stopped the TNF-blocking treatment because of this issue. (more…)
Author Interviews, Dermatology, JAMA, Melatonin, Pediatrics, Sleep Disorders / 23.11.2015

MedicalResearch.com Interview with: Prof. Bor-Luen Chiang Vice Superintendent, National Taiwan University Hospital Professor of Graduate Institute of Clinical Medicine and Pediatrics National Taiwan University Attending Physician, Department of Medical research National Taiwan University Hospital and Yung-Sen Chang, MD MPH Attending physician, Department of Pediatrics, Taipei City Hospital Renai Br. Adjunct Attending Physician, Department of Pediatrics National Taiwan University Children’s Hospital Adjunct Instructor, School of Medicine, National Yang-Ming University Medical Research: What is the background for this study? Prof. Chang: Sleep disturbance is a common disorder in the children with atopic dermatitis (AD) (reported in 47 to 60%), but no effective way of managing this problem had been established. In our preceding study, we found that lower nocturnal melatonin level was significantly associated with sleep disturbance in the patients with AD. Melatonin is a hormone secreted by the pineal gland which plays an important role in sleep regulation. In addition to sleep-inducing effects, melatonin also has anti-inflammatory and immunomodulatory properties which might be helpful for the management o fatopic dermatitis. Furthermore, melatonin has an excellent safety profile with minimal adverse effects, making it a good choice for children. Therefore, we aimed to evaluate whether melatonin is effective for improving the sleep problems and the dermatitis severity in children with atopic dermatitis. Medical Research: What are the main findings? Prof. Chang: From our double-blind, placebo-controlled crossover study, we found that after melatonin treatment, the sleep onset latency shortened by 21.4 minutes compared with placebo (from a mean of 44.9 minutes to 21.6 minutes). The Scoring Atopic Dermatitis Index (higher scores representing more severe dermatitis) also decreased by 9.9 compared with placebo (from a mean of 49.1 to 40.2). No adverse events were reported throughout the study. (more…)
Author Interviews, Dermatology, Melanoma, NEJM, UCSF / 13.11.2015

MedicalResearch.com Interview with: Boris C. Bastian, MD, PhD Professor of Dermatology and Pathology Gerson and Barbara Bass Bakar Distinguished Professor in Cancer Research University of California, San Francisco Medical Research: What is the background for this study? What are the main findings? Dr. Bastian:  The cost of DNA sequencing has dropped substantially since the initial sequencing of the human genome in 2001. As a result, the most common cancer subtypes have now been sequenced, revealing the pathogenic mutations that drive them. A typical cancer is driven by 5-10 mutations, but we still do not understand the order in which these mutations occur for most cancers. Determining the order in which mutations occur is challenging for cancers that are detected at a late stage. Melanomas, however, lend themselves to this type of analysis because they are pigmented and found on the surface of the skin, allowing them to be identified early. Sometimes, melanomas are even found adjacent to their remnant precursor neoplasms, such as benign nevi (also known as common moles). We performed detailed genetic analyses of 37 cases of melanomas that were adjacent to their intact precursor neoplasms. We microdissected and sequenced the surrounding uninvolved normal tissue, the precursor neoplasm, and the descendent neoplasm. By comparing the genetic abnormalities in each of the microdissected areas, we were able to decipher the order of genetic alterations for each case. Our work reveals the stereotypic pattern of mutations as they occur in melanoma. Mutations in the MAPK pathway, usually affecting BRAF or NRAS, occur earliest, followed by TERT promoter mutations, then CDKN2Aalterations, and finally TP53 and PTEN alterations. Benign nevi typically harbor a single pathogenic alteration, whereas fully evolved melanomas harbor three or more pathogenic alterations. We also identified an intermediate stage of neoplasia with some but not all of the pathogenic mutations required for fully evolved melanoma. There has been a longstanding debate whether morphologically intermediate lesions, such as dysplastic nevi, truly constitute biological intermediates or whether they simply represent a gray zone of histopathological assessment. Our data indicates that these neoplasms are genuine biological entities. Finally, we observe evidence of UV-radiation-induced DNA damage at all stages of pathogenesis, implicating UV radiation in both the initiation and progression of melanoma. (more…)
Author Interviews, Dermatology, NYU / 11.11.2015

MedicalResearch.com Interview with: Arielle Nagler MD Instructor, Department of Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What are some of the best ways to keep our skin healthy? Dr. Nagler: Sun protection is the single, most important step you can take to keep your skin healthy. Sun protection can help to prevent many of the signs of aging including wrinkles, changes in skin texture, and uneven pigmentation. Also sun protection has been shown to prevent certain types of skin cancer, which may save you from the distress and scarring of treatment. While we should all be careful in the sun, sun protection doesn’t mean that you have to avoid all outdoor activities and deprive yourself of outdoor fun. If you have any issues with your skin, or want more information, you might want to look into someone like this Ava MD cosmetic dermatologist or dermatologist local to you. However, you can take steps to protect your skin. Here are a couple of tips:
  • Limit activities that require noon time sun exposure.
  • Wear sunscreen with broad UV coverage (including UVA and UVB). Physical blockers such as zinc oxide and titanium dioxide are ideal.
  • Buy a stylish wide brimmed hat.
  • There is an enlarging retail space for UV protective clothing. Check them out!
Follow these simple tips and your skin will thank you later. Medical Research: How can dry skin be managed at home? Dr. Nagler: As we enter into winter and the air gets cold and dry, more people will be suffering from dry skin or “xerosis.” Although warm showers are a pleasant treat during the winter, they actually can make your dry skin worse. Ideally, when your skin is dry, you should aim to take short, luke-warm showers. Frequent moisturizing is also extremely important, particularly immediately after a shower. Moisturizers without fragrances are the most well-tolerated. Thick moisturizers that are packaged in tubs and tubes are often more hydrating than lotions in pumps, which tend to be water based. Additionally, some people find humidifiers to be helpful. (more…)
Author Interviews, Cost of Health Care, Dermatology / 10.11.2015

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 Medical Research: What is the background for this study? What are the main findings? Dr. Silverberg: We previously showed that adults with eczema are more likely to smoke cigarettes, drink alcohol and have sedentary lifestyle. We wondered whether chronic eczema might negatively impact upon other health behaviors, such as seeking preventive care and vaccinations. On the other hand, previous studies from our group and others found that both children and adults with eczema have a number of comorbid medical and mental health conditions. One potential reason for this is detection bias from since eczema patients are “plugged into” the healthcare system because of their skin disease, which allows them to be diagnosed more frequently with other health problems. We sought to understand the routine and preventive healthcare behaviors of children and adults with eczema. We found that adults with eczema were more likely to be vaccinated for tetanus, influenza, hepatitis A and B viruses, human papilloma virus and pneumonia. Moreover, they were more likely to undergo age-appropriate health screenings, such as blood pressure and cholesterol checks, but not cancer screening. Adults with eczema were more likely to interact with a variety of general doctors and specialists. Similarly, childhood eczema was associated with higher rates of vaccination for influenza, well child checkups and interaction with most types of healthcare providers. (more…)
Author Interviews, Dermatology / 10.11.2015

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 Medical Research: What is the background for this study? What are the main findings? Dr. Silverberg: There were several motivating factors for this study. First, I anecdotally encountered many patients in my eczema clinic that reported having profound language and speech difficulties during eczema flares. Second, previous studies from our group found that children with eczema were more likely to interact with speech therapists than children without eczema. We hypothesized that chronic eczema negatively impacts children’s neurocognitive and/or speech development. We sought to determine whether childhood eczema is in fact associated with higher rates of speech disorders. Indeed, children with eczema were more likely to have a speech or language disorder. Severe eczema was associated with even higher odds of speech disorders than mild eczema. Children with eczema who also had either attention deficit (hyperactivity) disorder or sleep disturbances were at greatest risk for having a speech disorder. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA / 05.11.2015

MedicalResearch.com Interview with: Dr. Brad A. Bryan Ph.D Assistant Professor Biomedical Sciences Texas A&M University Health Science Center, Houston, TX Department of Biomedical Sciences Texas Tech University Health Sciences Center Medical Research: What is the background for this study? What are the main findings? Dr. Bryan: In 2008 it was serendipitously discovered that the beta blocker propranolol was effective in treating a common benign pediatric vascular tumor called infantile hemangioma.  Over the past few years, my lab has been working on elucidating the molecular mechanisms underlying this pediatric tumor and part of this research involved uncovering how propranolol selectively inhibited these tumors.  At the same time these studies were taking place, other members of my lab were working on pre-clinical drug development for a malignant vascular tumor called angiosarcoma.  Patients with angiosarcoma are faced with very few effective treatment options and abysmal survival rates, so we decided to see if the efficacy of beta blockade observed in infantile hemangiomas transferred to angiosarcomas.  Using preclinical in vitro and in vivo assays, we demonstrated that propranolol was very effective at inducing cell death, blocking migration, and inhibiting tumor growth in our angiosarcoma models.  This work was subsequently published in Plos One (Stiles et al., 2013).  I then collaborated with Dr. William Chow from San Francisco to test propranolol off-label (propranolol is FDA approved to treat high blood pressure, heart dysrhythmias, thyrotoxicosis, and essential tremors) in a patient suffering from a rapidly expanding angiosarcoma covering a large portion of his face.  In the window between diagnosis of the tumor and the start of chemotherapy, we placed the patient on oral propranolol.  The redness of the tumor very rapidly lessened and remarkably by only one week of treatment the tumor margins appeared to significantly shrink.  We examined biospies of the tumor before and after only one week of propranolol and found that the proliferation of the tumor cells was markedly decreased following beta blockade.  After a combination of propranolol, chemotherapy, and radiation that lasted several months, the patient had no detectable metabolically active tumor or distant metastases. We published these findings in JAMA Dermatology (Chow et al., 2015). (more…)
Antibiotic Resistance, Author Interviews, Dermatology, NYU, Pharmacology / 30.10.2015

MedicalResearch.com Interview with: Arielle Nagler MD Instructor, Department of Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What is the background for this study of acne patient who eventually require isotretinoin? Dr. Nagler: Isotretinoin is a highly effective medication for the treatment of severe acne. In fact, it is the only medication that has been shown to provide patients with a durable cure for acne. However, its use is limited by its known teratogenicity as well as controversies regarding its relationship with psychiatric disturbances and inflammatory bowel disease. For many patients, systemic antibiotics provide an effective treatment for inflammatory acne. However, antibiotics do not provide the long term clearance that isotretinoin provides. Moreover, antibiotics are getting increasing attention due to fears of emerging bacterial resistance. There has been a recent emphasis on limiting antibiotic use in acne. As a result, this study sought to understand antibiotic use patterns amongst patients who eventually received isotretinoin.  (more…)
Alcohol, Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology / 26.10.2015

MedicalResearch.com Interview with: Shaowei Wu, MD, PhD Department of Dermatology, Warren Alpert Medical School Brown University, Providence, Rhode Island Department of Dermatology Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts Medical Research: What is the background for this study? What are the main findings? Response: Basal cell carcinoma (BCC) of the skin is the most prevalent cancer in the US, and is responsible for substantial morbidity and billions of dollars of health care expenditures. Knowledge on the modifiable risk factors of BCC is required for targeted prevention of cancer incidence. Alcohol consumption is a well-known risk factor for human cancer and has been linked to a number of cancers, including breast, prostate, pancreatic, and colon cancers. Interestingly, a large epidemiological study has reported a positive association between alcohol consumption and increased prevalence of severe sunburn, an established skin cancer risk factor. It is hypothesized that metabolites of alcohol (e.g., acetaldehyde) can serve as photosensitizers and promote skin carcinogenicity in the presence of UV radiation. However, epidemiological evidence for the association between alcohol consumption and BCC risk has been limited and a few previous studies on this topic have yielded conflicting results. Therefore we conducted a comprehensive prospective study to investigate this question using data from three large cohorts including the Nurses’ Health Study (1984-2010), Nurses’ Health Study II (1989-2011), and Health Professionals Follow-up Study (1986-2010). We documented a total of 28,951 incident Basal cell carcinoma cases over the study follow-up. We found that increasing alcohol intake was associated with an increased Basal cell carcinoma risk in both women and men. In the combined analysis with all 3 cohorts, those who consumed 30 grams or more alcohol per day had a 22% higher risk of developing BCC when compared to nondrinkers. This increased risk was consistent in people with different levels of sun exposure. We also found that BCC risk was associated with alcohol intake levels more than a decade ago, suggesting that alcohol may have a lagged effect that can persist for a long-term period. Among the individual alcoholic beverages, white wine and liquor were positively associated with Basal cell carcinoma risk whereas red wine and beer were not associated with BCC risk. This difference may be due to some other chemicals accompanying alcohol in the specific beverages. For example, red wine contains higher amounts of phenolic compounds compared to white wine, and these compounds have antioxidant activities which may be beneficial for counteracting the potential carcinogenic properties of alcohol and its metabolites. (more…)
Author Interviews, Dermatology, Melanoma, Primary Care / 24.10.2015

MedicalResearch.com Interview with: Simone Ribero,  M.D., Ph.D.  University of Turin Department of Medical Sciences Italy & King’s College London Department of Twin Research and Genetic Epidemiology St Thomas’ campus London, UK Medical Research: What is the background for this study? What are the main findings? Dr. Ribero: The total body naevus count is the principal risk factor for melanoma. having more than 100 moles increases  6 times the risk of developping a melanoma. In our study we described a model to predict the total number naevus count with the count of one arm. (more…)
AHA Journals, Author Interviews, Dermatology, Heart Disease, NIH / 12.10.2015

Nehal Mehta, M.D., M.S.C.E., F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIHMedicalResearch.com Interview with: Nehal Mehta, M.D., M.S.C.E., F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIH Medical Research: What is the background for this study? What are the main findings? Dr. Mehta: Psoriasis increases cardiovascular disease (CVD), and this study shows for the first time that the amount of psoriasis on the skin is mirrored in the blood vessels by increasing blood vessel inflammation. Medical Research: What should clinicians and patients take away from your report? Dr. Mehta: Even one plaque may be too many if we are seeing a relationship between skin disease severity and vascular inflammation. (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA / 12.10.2015

Pinar Karaca-Mandic, PhD on behalf of the authors Associate Professor Division of Health Policy and Management University of MinnesotaMedicalResearch.com Interview with: Pinar Karaca-Mandic, PhD on behalf of the authors Associate Professor Division of Health Policy and Management University of Minnesota  Medical Research: What is the background for this study? What are the main findings? Dr. Pinar Karaca-Mandic: Lymphedema is a common disease affecting several million people in the U.S, in particular cancer patients. The disease is associated with edema, recurrent cellulitis, loss of physical function, stress, and of course diminished quality of life. It is also associated with high health care costs. While there is no cure for lymphedema currently, it can be managed well with proper care. Pneumatic compression devices offer a valuable lymphedema self-management option. However, there is limited information on the effectiveness of these devices using data from real world settings.   In this paper, we used administrative and claims-based data from a major national insurer to examine the effectiveness of an advanced pneumatic compression device. We examined health economics costs as well as clinical health utilization outcomes associated with the use of the device. We found that the receipt of the device is associated with large declines in cellulitis rates. For example, among the cancer patients, cellulitis infection rates by 79% (from 21% to 4.5%). We saw similar reductions for patients without cancer (75%). We also observed large reductions in the use of manual therapy and in lymphedema related outpatient hospital visits. Finally, lymphedema related outpatient costs decreased substantially – for example for the cancer patients, they halved reducing from about $1,500 to $700 among cancer patients, and they declined by 65% from about $1,700 to $600 for patients without cancer. Among cancer patients, total lymphedema-related costs per patient, excluding medical equipment, declined by 37% and declined by 36% in patients without cancer. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 12.10.2015

Eleni Linos, MD DrPH, MPH Assistant Professor UCSF School of MedicineMedicalResearch.com Interview with: Eleni Linos, MD DrPH, MPH Assistant Professor UCSF School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Linos: Google offers a remarkable service for non-profit organizations-in our case we used AdWords, Google’s keyword-specific advertising service, to disseminate skin cancer prevention messages to people searching for tanning. Our question was simple: can we send a skin cancer prevention message to someone who is searching for information about tanning beds online? From this preliminary data we found that it is possible to use online advertising to reach a large, targeted audience with specific health messages. Or Online advertising for prevention is a brand new concept. It builds on the knowledge of online advertisers and marketers-and uses this knowledge for good. We hope other social media and technology companies will join this effort to provide precise, tailored health messages to those who need them the most. Marketing is a powerful tool when it comes to getting the message out to a larger audience. As we are thinking of using Google Ads for our services, we were recommended to compare Adwords software and tools, as it would make the decision of finding the right software a lot easier. As technology becomes apparent within businesses, it makes sense for us and other companies to use this to their advantage. (more…)
Author Interviews, Cancer Research, Dermatology / 06.10.2015

Nirmala Pandeya, PhD Post Doctoral Research Fellow Faculty of Medicine and Biomedical Sciences, School of Public Health Herston campus The University of QueenslandMedicalResearch.com Interview with: Nirmala Pandeya, PhD Post Doctoral Research Fellow Faculty of Medicine and Biomedical Sciences, School of Public Health Herston campus The University of Queensland Medical Research: What is the background for this study? Dr. Pandeya: Basal cell carcinoma (BCC) is the most common cancer. Although BCC is curable and has low mortality, its high occurrence in the population causes significant healthcare and financial burdens to the community. Hence exploring preventive strategies for this cancer is important in reducing the burden. To date few chemopreventives for BCC have been identified. In many cancer cells, inflammatory biomarkers such as cyclooxygenase-2 (COX-2) and its product prostaglandin E2 are increased and basal cell carcinoma is no exception. Anti-inflammatory drugs, suppressing COX-2 activity, have been shown to reduce the risk of various cancers including squamous cell carcinoma of the skin, so they also have a potential to prevent BCC. But to date research evidence on the benefit of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) on basal cell carcinoma has been inconsistent. So we reviewed and synthesized all published epidemiological studies on NSAIDs and BCC to combine results and estimate the overall pooled effect. Medical Research: What are the main findings? Dr. Pandeya: After thorough evaluation, we identified eleven studies that were relevant and pooling showed a 10% reduction in risk of BCC among those using any kind of NSAIDs. Aspirin and non-aspirin NSAIDs analysed separately suggested a reduced risk of basal cell carcinoma, but were not statistically significant likely due to lack of power. Our research found strongest risk reduction of BCC by the use of NSAIDs among those with either a history of skin cancers or high prevalence of actinic keratosis. (more…)
Author Interviews, Dermatology, Pain Research / 18.09.2015

psoriasis foundationMedicalResearch.com Interview with: Alexander Egeberg, MD Department of Cardiology Herlev and Gentofte Hospital Hellerup, Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Egeberg: Psoriasis is a common chronic skin disease, with a strong inflammatory component. Within the last decade, our understanding of psoriasis have advanced significantly, and psoriasis is now widely regarded as a systemic disease, where the skin is a direct marker of disease activity. The inflammatory pathways in psoriasis have also been implicated in several central nervous system diseases such as depression, uveitis, and multiple sclerosis. Moreover, pain generation and sensitization can occur as a result of the pro-inflammatory mediators which are upregulated in psoriasis. In the present study, we investigated the association between psoriasis and psoriatic arthritis, and the risk of new-onset migraine. The main finding was a psoriasis-severity dependent increased risk of new-onset migraine, and patients with severe skin psoriasis, and psoriatic arthritis appeared to have the highest risk. (more…)
Author Interviews, Dermatology, Genetic Research / 12.09.2015

Thomas N. Darling, MD, PhD Department of Dermatology Uniformed Services University of the Health Sciences Bethesda, MD 20814 MedicalResearch.com Interview with: Thomas N. Darling, MD, PhD Department of Dermatology Uniformed Services University of the Health Sciences Bethesda, MD 20814 Medical Research: What is the background for this study? What are the main findings? Dr. Darling: Many people with tuberous sclerosis complex (TSC) have skin tumors that can bleed or cause distress. Only surgical approaches were useful for treating these skin tumors in the past. Recently, drugs called mTOR inhibitors, including sirolimus, were shown to shrink internal tumors in those affected by tuberous sclerosis complex. We wanted to document what happens to the skin tumors in those being treated with oral sirolimus. We found that most patients taking oral sirolimus showed improvement in their skin tumors, and that these effects were maintained during a couple years of treatment. We did not observe any evidence for the skin tumors becoming resistant to the drug. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 03.09.2015

Simone Ribero, M.D., Ph.D. University of Turin Department of Medical Sciences Turin Italy and King’s College London Department of Twin Research and Genetic Epidemiology St Thomas’ campus London, UKMedicalResearch.com Interview with: Simone Ribero,  M.D., Ph.D.  University of Turin Department of Medical Sciences Turin Italy and King’s College London Department of Twin Research and Genetic Epidemiology St Thomas’ campus London, UK Medical Research: What is the background for this study? What are the main findings? Response: The histologic regression is a discussed feature and its prognostic role is debated in literature. Our group has previously described a favorable prognostic role of histological regression in stage I-II melanoma patients. Some clinicians still perform Sentinel Lymph Node biopsy on the basis of regression in thin melanoma considering this feature as able to underestimate Breslow Thickness. In this study we described in a metanalyses with more then 10000 melanoma patients that histological regression is inversely associated with Sentinel Lymph Node positivity. (more…)
Author Interviews, Case Western, Dermatology, Genetic Research / 27.08.2015

Nely Aldrich, MD Department of Dermatology University Hospitals Case Medical CenterMedicalResearch.com Interview with: Nely Aldrich, MD Department of Dermatology University Hospitals Case Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Aldrich:   To our knowledge, no formal studies have been performed on the genetic vs. environmental factors that lead to the development of rosacea. Our department has the unique opportunity to attend the Twins Days festival in Twinsburg, Ohio. This is a yearly festival where thousands of twin pairs come from all over the world. This was the perfect setting to ask our research question. Our main finding was that there is an approximately 50% contribution of genetics to rosacea and the other 50% can be attributed to environmental factors. Sun exposure, smoking, alcohol use, skin cancer history, and heart disease were also found to be correlated with a higher rosacea severity. (more…)
Author Interviews, Dermatology, Endocrinology / 27.08.2015

Abdulmaged Traish; Photo by Vernon Doucette for Boston University Photography MedicalResearch.com Interview with: Abdulmaged M. Traish, MBA, Ph.D. Professor of Biochemistry Professor of Urology Boston University School of Medicine Boston, MA 02118   Medical Research: What is the background for this study?  Dr. Traish: This study was undertaken to evaluate the data in the contemporary literature on the use of finasteride and dutasteride for treatment of ( benign prostatic hypertrophy) BPH and androgenetic alopecia (AGA). These drugs were proven effective in management of patients withy BPH andandrogenetic alopecia; however, these drugs inhibit a family of enzymes widely distributed in many tissues and organs and therefore may have undesirable effects. Most importantly, few studies have been undertaken to evaluate the effects of these drugs on the central nervous system. The adverse impact of these drugs on sexual function and well-being in a subset of patients raised the questions that we do not know much about the safety of such drugs. Medical Research: What are the main findings?  Dr. Traish: The main findings of this study is that these agents, while useful in treatment of BPH and androgenetic alopecia, exert undesirable side effects on sexual function and well-being. More importantly, limited data is available on the impact of these agents on the central nervous system. (more…)
Author Interviews, Depression, Dermatology, NYU / 26.08.2015

Roger S. Ho, MD, MS, MPH, FAAD Assistant Professor The Ronald O. Perelman Department of Dermatology NYU Langone Medical CenterMedicalResearch.com Interview with: Roger S. Ho, MD, MS, MPH, FAAD Assistant Professor The Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Ho: In recent years, the impact of psoriasis on quality of life has come to light. We have seen several studies show that patients with psoriasis experience worse quality of life because of their disease. Few studies however have examined the association between psoriasis and mental illness, specifically depression. Many chronic diseases are known to be associated with depression. As more and more evidence supports the relationship between psoriasis and cardiovascular disease, it is important to examine the relationship between psoriasis and depression, while controlling for cardiovascular comorbidity. In our study of a nationally-representative population of US patients, we found that patients with psoriasis had twice the odds of having depression than patients without psoriasis, even after adjusting for major confounders including a history of myocardial infarction, stroke, and diabetes that may independently be associated with depression. The risk of depression did not depend on extent or severity of psoriatic disease. (more…)
Author Interviews, Dermatology / 25.08.2015

William W. Huang, MD, MPH Assistant Professor and Program Director Wake Forest School of Medicine Department of Dermatology Winston-Salem, NC 27104MedicalResearch.com Interview with: William W. Huang, MD, MPH Assistant Professor and Program Director Wake Forest School of Medicine Department of Dermatology Winston-Salem, NC 27104 Medical Research: What is the background for this study? What are the main findings? Dr. Huang: This particular study was an update of a previous study our group had published in 2008 (JAAD, 6/08). As the use of biologics in dermatology has increased dramatically in recent years, we wanted to evaluate the evidence for the screening and monitoring tests that are routinely performed for patients with psoriasis and psoriatic arthritis on biologic agents. We found that current guidelines for screening and monitoring tests varied among various national organizations (Table 1) including the American Academy of Dermatology, Japanese Dermatology Association, European Academy of Dermatology and Venerology, and the British Association of Dermatologists. Using evidence grading based on methods developed by the US Preventative Services Task Force (USPSTF), we found that the evidence was strongest (Grade B) for tuberculosis screening. High level evidence was in general lacking for other routine screening and monitoring tests except in select populations (Table 2, Table 3). (more…)
Author Interviews, Dermatology, Emory, JAMA, Sexual Health / 23.08.2015

MedicalResearch.com Interview with: Howa Yeung, MD PGY3, Emory Dermatology Emory University Medical Research: What is the background for this study? What are the main findings? Dr. Yeung: Indoor tanning is a well-established and preventable cause for melanomas and non-melanoma skin cancers. Public health efforts in curbing indoor tanning have focused on known high-risk populations, such as young, college-aged, White women. However, other demographic risk factors for indoor tanning remain unknown. As our nation increasingly focuses on addressing and improving the health of lesbian, gay, bisexual, and transgender (LGBT) individuals, more and more evidence demonstrates that various LGBT subpopulations face higher rates of cancer-related behavior risk factors, such as smoking, alcohol use, obesity, etc. We wanted to find out whether risk factors for skin cancer, such as indoor tanning, disproportionately affected LGBT populations. Our study showed higher rates of indoor tanning among gay and bisexual men, with 1.8-fold and 3.6-fold higher odds of tanning bed use within the past year, compared to straight men, after adjusting for sociodemographic factors. Disparities in frequent tanning, defined as using tanning bed 10 or more times within the past year, are even more prominent among gay and bisexual men. In contrast, no significant sexual orientation disparities were noted among women after adjusting for sociodemographic factors. (more…)
Author Interviews, Dermatology / 22.08.2015

MedicalResearch.com Interview with: Erika Hagstrom, M.D., M.A. Preliminary Internal Medicine PGY-1 Loyola University Medical Center  Medical Research: What is the background for this study? What are the main findings? Dr. Hagstrom: Allocation of funding dollars to research is a critical and daunting task. While many factors may impact research-funding decisions, establishing a transparent priority-setting exercise is paramount. This is particularly important for the National Institutes of Health, which invests over $30 billion for medical research each year. Diseases that have the greatest impact on our population warrant increased research dollars to reduce disease burden. The Global Burden of Disease Study (GBD) is an epidemiological effort to quantify the global burden of disease in a universal metric called disability-adjusted life years (DALYs). Focusing on our particular interest of dermatology, we investigated the 2012-2013 NIH funding for 15 skin diseases and matched this to the corresponding DALY metrics. (more…)