Professor Marie-Aleth Richard
EADV Communications Committee Chair
Professor, University Hospital of La Timone
Marseille, France
MedicalResearch.com: What is the background for this Roundtable event? Would you describe the mission of the European Commission’s Beating Cancer Plan?
Response: Europe’s Beating Cancer Plan is the first, comprehensive EU strategy on cancer, aimed at tackling the disease through all key stages: prevention; early detection; diagnosis and treatment; and quality of life of cancer patients and survivors. The Plan also aims to create opportunities to improve cancer care through research and innovative projects, such as artificial intelligence, and to promote equal access to knowledge and treatments in cancer care across Europe.
The EADV seeks to create a bridge between the EU health policy agenda and scientific research, by engaging with policymakers, patient organisations and other stakeholders to support a patient centric-approach; tackling melanoma and non-melanoma skin cancers (NMSC) at all stages of the pathway, from prevention to follow-up care.
Through our Roundtable event, the EADV brought together these key stakeholders to evaluate the effectiveness of the EBCP on preventing both melanoma and NMSC, as well as identify joint recommendations that step-up measures towards this goal.
Dr. Garshick[/caption]
Michael S. Garshick, MD
Assistant Professor
Department of Medicine
Grossman School of Medicine
NYU
MedicalResearch.com: What is the background for this study?
Response: Patients with psoriasis have a 50% higher risk of cardiovascular disease when compared to patients without psoriasis, the mechanisms of which are still under investigation
Dyslipidemia is also highly prevalent in psoriasis including elevation in a variety of lipoproteins causal in atherosclerosis. Lipoprotein(a) is an LDL like particle which is associated with atherosclerosis, atherothrombosis, and the development of clinical cardiovascular disease. Traditionally lipoprotein(a) is felt to be inherited rather than acquired, but some evidence suggest that lipoprotein(a) is elevated in those with underlying inflammatory conditions and associated with systemic inflammation including circulating IL-6.
We therefore aimed to determine if lipoprotein(a) is elevated in psoriasis and associated with underlying systemic inflammatory profiles and biomarkers of cardiovascular risk.
Response: The COVID‐19 pandemic requires stringent adoption of hand hygiene practices. Health Care Workers (HCW) and the general population are at increased risk of irritation, dryness, redness and cracked hands (irritant dermatitis) due to frequent hand washing and the use of alcohol-based hand rubs. An effective hand sanitizer contains at least 60% alcohol to kill germs. Thus, it can be very drying to the skin. Transepidermal water loss (TEWL) is a way to measure the water lost from the skin. It is an essential parameter for characterizing skin hydration and protective function. Both of which are disrupted in irritant hand dermatitis.
This research study was conducted on 582 participants: 291 health care workers and 291 healthy individuals of the general population. Measurements of TEWL were made using a noninvasive, closed- chamber system (VapoMeter) in a standardized environment. The study participants were asked to identify the challenges to compliance in hand hygiene practice
Dr. Andersson[/caption]
Niklas Worm Andersson, MD
Department of Epidemiology Research
Statens Serum Institut,
Copenhagen Denmark
MedicalResearch.com: What is the background for this study?
Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used."
Dr. Yun Liu[/caption]
Yun Liu, PhD
Google Health
Palo Alto, California
MedicalResearch.com: What is the background for this study? Would you describe the system? Does it use dermatoscopic images?
Response: Dermatologic conditions are extremely common and a leading cause of morbidity worldwide. Due to limited access to dermatologists, patients often first seek help from non-specialists. However, non-specialists have been reported to have lower diagnostic accuracies compared to dermatologists, which may impact the quality of care.
In this study, we built upon prior work published in Nature Medicine, where we developed a computer algorithm (a deep learning system, DLS) to interpret de-identified clinical images of skin conditions and associated medical history (such as whether the patient reported a history of psoriasis). These clinical images are taken using consumer-grade hardware such as point-and-shoot cameras and tablets, which we felt was a more accessible and widely-available device compared to dermatoscopes.
Given such images of the skin condition as input, the DLS outputs a differential diagnosis, which is a rank-ordered list of potential matching skin conditions. In this paper, we worked with user experience researchers to create an artificial intelligence (AI) tool based on this DLS. The tool was designed to provide clinicians with additional information per skin condition prediction, such as textual descriptions, similar-appearing conditions, and the typical clinical workup for the condition.
We then conducted a randomized study where 40 clinicians (20 primary care physicians, 20 nurse practitioners) reviewed over 1,000 cases -- with half the cases with the AI-based assistive tool, and half the cases without. For each case, the reference diagnosis was based on a panel of 3 dermatologists.
Prof. Reich[/caption]
Prof. Kristian Reich, MD, PhD
Professor for Translational Research in Inflammatory Skin Diseases
Institute for Health Services Research in Dermatology and Nursing
University Medical Center Hamburg-Eppendorf
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Complete skin clearance is an important treatment goal for patients with psoriasis and is closely associated with treatment satisfaction and improved quality of life. However, it remains an unmet need for many patients.
The interleukin (IL)-17 isoforms IL-17A and IL-17F play central roles in psoriasis pathophysiology and are overexpressed in psoriatic tissues. Existing biologic therapies, such as secukinumab, inhibit IL-17A only. However, increasing evidence indicates that IL-17F contributes independently to the pathobiology of plaque psoriasis, and that blocking both IL-17A and IL-17F may lead to more complete suppression of inflammation and superior clinical outcomes, compared with blocking IL‑17A alone.
Bimekizumab is a humanized monoclonal IgG1 antibody that has been designed to selectively inhibit IL-17F in addition to IL-17A.
If your wound is bleeding profusely, seeking medical help immediately is crucial....
Future randomized controlled studies are needed to determine dosing, efficacy, and safety of medical marijuana for the treatment of various...
Dr. Liedtke[/caption]
Wolfgang Liedtke, M.D., Ph.D.
Professor (tenured) of Neurology, Anesthesiology and NeurobiologyMedicalResearch.com Interview with: [caption id="attachment_57059" align="alignleft" width="200"] Jill Sommerville[/caption] Jill Sommerville M.Sc. Director of Medical at WaterWipes MedicalResearch.com: What is the background for this...
Matt Spick[/caption]
Matt Spick, Post-Graduate Researcher
University of Surrey
Faculty of Engineering and Physical Sciences
Guildford, UK
MedicalResearch.com: What is the background for this study? Are you measuring lipids or the virus?
Response: In this study, we aimed to detect what the virus does to us, rather than the virus itself. The gold standard for detecting COVID-19 is the RT-PCR test, but by their nature, PCR tests only provide diagnostic information, and at times during the pandemic the availability of PCR tests has been a bottleneck for the identification of the disease. Our goal was to investigate a novel method for the diagnosis of COVID-19, at the same time as learning more about what the disease does to us through lipidomics.
Anne Cust[/caption]
Anne Cust | PhD, Professor of Cancer Epidemiology
The University of Sydney
Faculty of Medicine and Health
Sydney School of Public Health
MedicalResearch.com: What is the background for this study? Are the screeners specially trained, use full body photographs, dermoscopy etc?
Response: The Melanoma High-risk Clinic Study was developed to optimise the early detection of new melanomas in people at high risk of developing melanoma. A previous single-centre study observed fewer excisions and healthcare costs, thinner melanomas and better quality of life when surveillance of high risk patients was conducted in a melanoma dermatology clinic with a structured surveillance protocol involving 6-monthly full body examinations aided by total body photography (TBP) and sequential digital dermoscopy imaging (SDDI). The initial pilot study was performed in a single tertiary referral specialist centre using trained dermatologists who routinely used the diagnostic interventions.
Our objective was to examine longer-term sustainability and expansion of the program to multiple practices including a primary care skin cancer clinic setting. The hypothesis was that the outcomes would be similar if using the same protocol and diagnostic tools. The participating doctors were trained to follow the protocol, which included instruction on how to respond and interpret changing lesions, but not in use of dermoscopy or skin examinations, which were routinely and consistently used in all clinics prior to the study commencing. There were 593 participants assessed as very high risk of melanoma who participated in the Melanoma High-risk Clinic Study from 2012-2018. Nearly all of the participants had had a previous melanoma and had additional melanoma risk factors. 57% were male and the median age at study entry was 58 years.
If you have low self-esteem you might be reluctant to try new things for fear it will make you feel...
Dr. Jonathan Silverberg[/caption]
Jonathan Silverberg, MD, PHD, MPH
Associate Professor
Director of Clinical Research
Director of Patch Testing
George Washington University School of Medicine and Health Sciences
Washington, DC
MedicalResearch.com: What is the background for this study?
Response: The COVID pandemic hit the Orthodox Jewish community in the United States particularly hard, especially in the early days when much was unknown. At that time of great loss, Jewish communities around the United States rallied to help the millions of other people impacted by the pandemic.
A partnership was established of local community organizations across 5 states with premier academic universities across the United States and Canada. Over a 10 day period in May 2020, more than 6500 people came out to participate in the The Multi-Institutional Study Analyzing anti-CoV-2 Antibodies (MITZVA) cohort. Participants completed surveys and donated blood in order to become potential convalescent plasma donors and help learn more about the science of COVID.
Dr. Orenstein[/caption]
Lauren A. V. Orenstein, MD | She/her/hers
Assistant Professor of Dermatology
[caption id="attachment_56716" align="alignleft" width="100"]
Dr. Swerlick[/caption]
Robert A. Swerlick, MD
Professor and Alicia Leizman Stonecipher Chair of Dermatology
Emory University School of Medicine
Atlanta, GA 30322
MedicalResearch.com: What is the background for this study?
Response: Financial incentives have the potential to drive provider behavior, even unintentionally. The aim of this study was to evaluate differences in clinic “productivity” measures that occur in outpatient dermatology encounters. Specifically, we used data from 2016-2020 at one academic dermatology practice to evaluate differences in work relative value units (wRVUs, a measure of clinical productivity) and financial reimbursement by patient race, sex, and age. 66,463 encounters were included in this study, among which 70.1% of encounters were for white patients, 59.6% were for females, and the mean age was 55.9 years old.
Jill Sommerville[/caption]
Jill Sommerville M.Sc
Director of Medical at WaterWipes
MedicalResearch.com: What is the background for this study? How prevalent is diaper dermatitis? Is it more severe in some babies?
Response: The Utah study is an independent clinical study conducted by the University of Utah Hospital NICU, Salt Lake City and recently published in Advances in Neonatal Care journal. It was a year-long study conducted between January 2018 – March 2019. The NICU staff were interested in exploring a new Perineal Skin Care Guideline in their unit, encompassing use of WaterWipes, to decrease the incidence of diaper dermatitis. Their stated aim was to reduce diaper dermatitis by 20% within a 1-year period. The study involved 1,070 premature babies, 11% of which were born at less than 30 weeks of gestational age. The inclusion criteria for the study were all babies who stayed for more than 1 day in the NICU.
Diaper dermatitis is known to cause discomfort and emotional distress in all babies and can be a possible source of infection among NICU babies. Diaper dermatitis remains prevalent, especially in preterm babies. The reported incidence varies from 21% to 25% among newborn intensive care babies. 1
Diaper dermatitis in pre term babies can be multifactorial especially as babies born early have a less well developed stratum corneum, the outer most layer of skin. NICU babies are often exposed to antibiotics and fortified milk to help them catch up growth. Other medical complications in addition can lead to altered gut flora and altered stool composition resulting in more frequency of stool.
The presence of urine and frequent stools necessitates regular cleaning which can result in excessive rubbing of the skin or the use of wipes containing harsh ingredients that can damage the skin.
One example of actinic keratoses on scalp
Dr. Kim[/caption]
Brian Kim, MD
Associate Professor of Dermatology
Co-Director, Center for the Study of Itch & Sensory Disorders
John T. Milliken Department of Internal Medicine
Washington University in St. Louis
MedicalResearch.com: What is the background for this study?
Response: Patients with eczema suffer from chronic itch due to the rashes they have on their body. However, as a physician, I have always noticed that patients with eczema will have sudden flares of their itching all over there body that is often triggered by what appear to be allergens – being around a cat, pollen, mold in a house, etc. Eczema is in the family of allergic diseases such as food allergy, asthma, and hay fever. All of these conditions are noted for patients being reactive to allergens by way of an antibody called IgE that coats a cell called the mast cell. Upon IgE binding an allergen, mast cells produce tons of histamine which can cause symptoms like itching. So we speculated that perhaps because patients with eczema have such misbehaving IgE, that exposure to allergen is what triggers this kind of severe itch flare that we see in patients.
Dr. Jonathan Silverberg[/caption]
Jonathan Silverberg, MD, PHD, MPH
Associate Professor
Director of Clinical Research
Director of Patch Testing
George Washington University School of Medicine and Health Sciences
Washington, DC
MedicalResearch.com: What is the background for this study
Response: Chronic hand eczema was previously shown to be associated with higher rates of allergic contact dermatitis. Yet, little is known about recent trends in North America with respect to the clinical presentation and allergen profile in chronic hand eczema. This study sought to determine the clinical characteristics and etiologies of hand eczema in a large North American cohort of adults referred for patch testing. The patients in the study were patch tested using the North American Contact Dermatitis Group’s allergen screening series.
Dr. Gernand[/caption]
Jeremy M. Gernand, PhD, CSP, CRE
Associate Professor
Environmental Health and Safety Engineering
Department of Energy and Mineral Engineering
MedicalResearch.com: What is the background for this study?
Response: Given concern in the public about exposure to nanoparticles in cosmetics, we decided to investigate the exposure potential for inhaling nanoparticles during the application of aerosol mineral-based sunscreens that are typically marketed as safer for children. We choose three commercially available sunscreens to test in the lab in a manner intended to capture the amount of inhaled particles that would typically occur during application of sunscreen to the mid-point of one’s own arm.
Dr. Rork[/caption]
Jillian F. Rork, MD
Assistant Professor of Dermatology
Dartmouth-Hitchcock Medical Center at Manchester and
The Geisel School of Medicine
Society for Pediatric Dermatology Member
MedicalResearch.com: What is the background for this study? Would you briefly explain the genetic condition of Down syndrome?
Response: Down syndrome is the most common chromosomal abnormality, occurring in approximately 1 in 700 newborns in the United States. Trisomy of chromosome 21 can result in multisystem involvement such as hearing loss, heart defects, autoimmune conditions and dementia.
This study focuses on how trisomy 21 affects one of the body’s largest organs, the skin. Current literature addressing dermatologic conditions associated with Down syndrome is limited. There is often emphasis on rare skin conditions such as elastosis perforans serpiginosa, milia-like idiopathic calcinosis cutis, and eruptive syringomas. There is lack of consensus on incidence of more common disorders. We performed a retrospective chart review of 101 patients with Down syndrome in our dermatology practice at the University of Massachusetts to better describe associated skin conditions.
Dr. Estrada[/caption]
Sarah I. Estrada, M.D., FCAP
Laboratory Director
Affiliated Dermatology®
www.affderm.com
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As a dermatopathologist who makes diagnoses on lesions that may be melanoma, I’m faced with the reality that my accurate interpretation of biopsy tissue is key for the patient to be treated most effectively. Often histopathological evaluation is straightforward but not as often as I would like.
The study presented here offers a new test that can be used in conjunction with my evaluation to determine if a questionable lesion is in fact melanoma. The test was developed to take into account the gene expression of the lesion which may factor in characteristics that I cannot visually observe. The test was validated and has shown very promising accuracy metrics.
Example of one type of squamous cell skin cancer: DermNetNZ image[/caption]Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time.
MedicalResearch.com: What are the main findings?
Response: In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade.
Dr. Maslin[/caption]
Dr. Douglas Maslin, MPhil, MB BCHir
Dermatologist and Pharmacologist
Addenbrooke's Hospital
Cambridge, UK
MedicalResearch.com: What is the background for this study?
Response: I’d like to answer this question in three parts:
Firstly, the background to Evelo and the therapeutic EDP1815: Evelo is developing orally administered biologic medicines based on a new understanding of how systemic inflammation is controlled. Evelo’s medicines are selected for their ability to modulate the small intestinal axis, or SINTAX, a network of anatomical and functional connections that has evolved to connect the small intestine with the rest of the body. SINTAX links small intestinal mucosal immunology with systemic inflammation and is now accessible with oral medicines. This inflammatory control pathway may enable a new class of products which are effective, safe, and can be manufactured affordably at large scale.
EDP1815 is a non-live pharmaceutical preparation of a strain of the bacterium Prevotella histicola isolated from the duodenum of a human donor. Its pharmacodynamic effect is through interactions with the immune cells within the small intestine and it has no systemic absorption. These local interactions in the small intestine then downregulate systemic inflammation. In fact, the inflammatory control afforded by targeting the small intestinal axis appears to result in the coordinated downregulation of multiple inflammatory pathways without immunosuppression, mimicking the body’s normal physiological processes of inflammation resolution.
Secondly, there is the key and exciting background pre-clinical data on EDP1815 – the details of which have been published today at the EADV conference. For example, oral administration of EDP1815 to mice has been shown to lead to striking therapeutic effects in in vivo models of delayed-type hypersensitivity, imiquimod-induced skin inflammation, fluorescein isothiocyanate cutaneous hypersensitivity, collagen-induced arthritis, and experimental acute encephalomyelitis (EAE).
The consistency of effect and dose shows that EDP1815 can coordinately resolve systemic inflammation across TH1, TH2 and TH17 pathways. This suggests the potential for clinical benefit across multiple diseases.
And, thirdly, there is the clinical unmet need for an oral, safe, effective treatment specifically for mild and moderate psoriasis patients, who have very limited treatment options outside of the poorly tolerated topical therapies, and these patients are reported to be dissatisfied with treatment options and therefore are often under-treated.
These three points explain the background to EDP1815 and the reason for progressing forward into the phase 1b in psoriasis.
Dr. Stein Gold[/caption]
Dr. Linda Stein Gold MD
Director of Dermatology Clinical Research at Henry Ford Health System
Detroit, Michigan
Division Head of Dermatology
Henry Ford Health System in West Bloomfield, Michigan
MedicalResearch.com: What is the background for this study?
Response: Halobetasol and Tazarotene work by complimentary mechanisms of action in treating psoriasis and also have been shown to counteract the side effects associated with the other medications.
In prior studies using tazarotene as monotherapy, there was a maintenance of effect even after the drug was discontinued. We investigated to see if there was a maintenance of treatment effect in patients who achieved clear skin after using the fixed combination of halobetasol propionate 0.01%/tazarotene 0.045% lotion for 8 weeks of daily treatment.
I served as lead author on the study, which was presented Fall Clinical Dermatology Conference this weekend in a poster titled, “Long-term management of moderate-to-severe plaque psoriasis: maintenance of treatment success following cessation of halobetasol propionate 0.01%/tazarotene 0.045% lotion.”