Author Interviews, Cancer Research, Dermatology, JAMA / 11.12.2019

MedicalResearch.com Interview with: Lily Wang Student at University of Toronto Toronto, Ontario, Canada  MedicalResearch.com: What is the background for this study? Response:  Impaired skin barrier and aberrant immune function in atopic dermatitis (AD) may impact immune response to malignancy. Conflicting data exist on the risk of cancer in patients with AD. The purpose of our study was to determine the risk of non-cutaneous and cutaneous cancers in patients with atopic dermatitis compared to the general population (i.e. without AD).  (more…)
Aging, Dermatology, JAMA / 26.11.2019

MedicalResearch.com Interview with: Christian Sell, PhD Associate Professor of Biochemistry and Molecular Biology Drexel University College of Medicine MedicalResearch.com: What is the background for this study? Response: In terms of background, the drug rapamycin targets a pathway that scientists know is critical for growth and development but is also a key regulator of lifespan in many model organisms such as worms, flies, and mice. This pathway is known as the mTOR pathway. Rapamycin is already in use clinically, it is given to people who have received organ transplants to prevent rejection and is also in trials to treat some forms of cancer, at very high doses. Many studies in mice have shown that rapamycin delays aging and prevents age-related disorders such as the decline in heart function and cognitive function. Based on this work, there is a strong expectation that these results will translate into humans, but no studies have been done due to concerns regarding potential side effects of rapamycin when the drug is given orally to prevent rejection. Our previous studies have shown that a very low dose of rapamcyin can reduce the aging of human cells and improve cell growth, while the high does used for organ transplant patients actually block cell growth.  We decided to test the impact of low dose rapamycin on aging in the skin because we could treat people safely. Previous studies have shown that the drug does not get into the blood stream when high doses were given topically to people with a rare genetic disorder, so we knew that the low doses used in our study would not get into the bloodstream and would be safe for the patients. (more…)
Author Interviews, Dermatology, Gender Differences, Pediatrics / 17.11.2019

MedicalResearch.com Interview with: Markus Boos, MD, PhD Member of the Society for Pediatric Dermatology. Attending pediatric dermatologist Seattle Children's Hospital Assistant Professor in the Department of Pediatrics University of Washington School of Medicine  MedicalResearch.com: What is the background for this study? Response: Our understanding of the cutaneous health of sexual and gender minority (SGM) individuals (lesbian, gay, bisexual, transgender, queer, asexual, intersex, nonbinary, etc.) remains nascent. This dearth of understanding of the unique needs of SGM children is even more pronounced. This 2-part review article provides practical advice on how to best engage with young SGM patients and serve the distinct needs of this minority population, with a specific emphasis on dermatologic conditions. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 17.11.2019

MedicalResearch.com Interview with: Jennifer M. Gardner, MD Clinical Assistant Professor of Dermatology University of Washington School of Medicine  MedicalResearch.com: What is the background for this study? Response: This study looked at age-specific differences of melanoma incidence in the United States. It was an observational study looking at population-based registry data extracted from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics (NPCR-SEER) database. The overall take home message from this study is that though melanoma incidence has continued to climb in the past decade for both men and women, most of the increase is seen in adults greater than age 40 years of age.  In contrast, melanoma incidence decreased in adolescents (ages 10-19 years of age) and young adults (ages 20-29) after peaking around 2004-2005. Melanoma is more common in males in older individuals (older than 50 years of age) but in younger individuals (<50 years of age), melanoma is more common in females.  According to a recently published JAMA-Otolaryngology paper by Bray and colleagues, there may be a subset of younger individuals where males are at a higher risk than females in regard to head and neck melanoma, and after that study was published we noted this to be true in our numbers, as well (we didn’t publish this in our study), further identifying a possibly “at risk” demographic within the younger age groups in addition to young women. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Dermatology, JAMA, Rheumatology / 09.11.2019

MedicalResearch.com Interview with: Emily S. Ruiz, MD, MPH Director, High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women’s Cancer Center Assistant Professor, Harvard Medical School, Dermatology Brigham And Women's Faulkner Hospital  MedicalResearch.com: What is the background for this study? Response: Innovation in oncology has led to increased development and market entry of anticancer drugs. For example, from 2009 to 2013, the US FDA approved 51 oral and systemic anticancer drugs for 63 indications. Prices for anticancer drugs have risen faster than inflation over time, especially for older drugs, and prices in the US have largely been set by market forces rather than novelty or efficacy. Understanding the evolving cancer economic landscape requires consideration of annual and cumulative rates of change for key metrics, such as total spending, drug cost per beneficiary, out-of-pocket cost, and utilization. This study sought to weigh the proportional impacts of rising drug costs and utilization on increased Medicare Part D spending for a cohort of oral anticancer drug utilized from 2013-2017.  (more…)
Author Interviews, Dermatology / 25.10.2019

MedicalResearch.com Interview with: Dr. Stephan Weidinger, MD, MaHM Professor of Dermatology Christian-Albrechts-Universit Kiel  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Relatively little is known about the epidemiology and burden of Atopic Dermatitis (AD) in children, adolescents and adults, however, there is increasing evidence that the disease is highly prevalent also in these age groups. Further, very little is known about the disease severity strata. Severity, however, largely defines treatment needs. The EPI-CARE (EPIdemiology of Children with Atopic dermatitis Reporting on their Experience) study was a cross-sectional web-based study of the prevalence and burden of AD in both children and adolescents. It was performed globally across Europe, North America (US, Canada), Latin America (Argentina, Brazil, Colombia, Mexico), Asia (Japan, Taiwan), the Middle East (Israel, Kingdom of Saudi Arabia, Turkey, the United Arab Emirates) and Russia, and used very stringent definitions of AD and the same methodology across age groups. We first analyzed the adolescent data, and it turned out that the prevalence of active Atopic Dermatitis is higher than expected, ranging from 9.29% in the US and 14.7% in Europe. Of note, almost 50% of the adolescents with current AD reported an overall moderate to severe disease activity, and the majority reported a multidimensional burden that includes not only the skin symptoms associated with AD, but also sleep disturbances, symptoms of anxiety/depression, and reductions in quality‐of‐life and productivity. Adolescents also reported a high burden of coexisting atopic diseases that increased with AD severity – 68.6% of those with moderate AD and 81% of those with severe AD reported at least one coexisting atopic disease. atopic dermatitis substantially affects the life of patients and their families, and this burden is higher with greater AD severity. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 21.10.2019

MedicalResearch.com Interview with: https://skin-analytics.com/about-us/ Dr. Helen Marsden PhD Skin Analytics Limited London, United Kingdom MedicalResearch.com: What is the background for this study? Response: In this technology age, with the explosion of interest and applications using Artificial Intelligence, it is easy to accept the output of a technology-based test - such as a smartphone app designed to identify skin cancer - without thinking too much about it. In reality, technology is only as good as the way it has been developed, tested and validated. In particular, AI algorithms are prone to a lack of “generalisation” - i.e. their performance drops when presented with data it has not seen before. In the medical field, and particularly in areas where AI is being developed to direct a patient’s diagnosis or care, this is particularly problematic. Inappropriate diagnosis or advice to patients can lead to false reassurance, heightened concern and pressure on NHS services, or worse. It is concerning, therefore, that there are a large number of smartphone apps available that provide an assessment of skin lesions, including some that provide an estimate of the probability of malignancy, that have not been assessed for diagnostic accuracy. Skin Analytics has developed an AI-based algorithm, named: Deep Ensemble for Recognition of Malignancy (DERM), for use as a decision support tool for healthcare providers. DERM determines the likelihood of skin cancer from dermoscopic images of skin lesions. It was developed using deep learning techniques that identify and assess features of these lesions which are associated with melanoma, using over 7,000 archived dermoscopic images. Using these images, it was shown to identify melanoma with similar accuracy to specialist physicians. However, to prove the algorithm could be used in a real life clinical setting, Skin Analytics set out to conduct a clinical validation study. (more…)
Author Interviews, Dermatology, Nature, Stanford / 18.10.2019

MedicalResearch.com Interview with: Stephen J. Galli, MD Mary Hewitt Loveless, MD Professor Professor of Pathology and of Microbiology and Immunology Department of Pathology Stanford University School of Medicine Center for Clinical Sciences Research Stanford, CA and Nicolas Gaudenzio PhD Unité de Différenciation Epithéliale et Autoimmunité Rhumatoïde INSERM, Université de Toulouse Toulouse, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: We took a lead from existing clinical data showing that patients with moderate to severe atopic dermatitis, an increasingly common disorder producing skin pathology, also have elevated levels of neuropeptides in their blood, particularly one neuropeptide, named “substance P”, whose level is correlated with disease severity. These patients also have high levels of mast cell-specific proteases in the blood, indicating that mast cells, which are innate immune cells present in the skin, and which can be activated when exposed to substance P, might play an essential role in modulating inflammatory and allergic processes. Based on these observations, our teams (Galli Lab at Stanford University, USA and Gaudenzio Lab at Inserm Toulouse, France) decided to focus on the possible interactions between sensory neurons, which are a source of substance P, and mast cells. The results of this work have now been published in the journal Nature Immunology. (more…)
Author Interviews, Dermatology, Environmental Risks, General Medicine, JAMA, Melanoma, Stanford / 07.10.2019

MedicalResearch.com Interview with: Eleni Linos MD MPH DrPH Professor of Dermatology and Epidemiology Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know that tanning beds are harmful: people who use tanning beds are more likely to get skin cancer. Sexual minority men are much more likely to use tanning beds and also more likely to get skin cancer. In a separate study we discovered that one reason sexual minority men use tanning beds is if it is convenient: e.g. if close to home, cheap, and easy. (https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17684). Recent research showed that tobacco retailers cluster in LGB neighborhoods: https://sph.unc.edu/sph-news/more-tobacco-retailers-in-lgbt-neighborhoods-may-explain-smoking-disparities/. This made us wonder if tanning salons also cluster in neighborhoods with more gay men.  (more…)
Author Interviews, Dermatology / 06.10.2019

MedicalResearch.com Interview with: Peter C. Friedman, M.D., Ph.D. Diplomate of the American Academy of Dermatology www.skincenterderm.com MedicalResearch.com: What is the background for this study and case series? Would you describe nonthermal atmospheric pressure plasma? Response: Plasma is essentially ionized gas, the fourth state of matter: molecules or atoms move freely in gas state but in a higher energy state atoms shed electrons and both electrons and ions then move freely and independently. If this material has a temperature close to room temperature, we call it non-thermal atmospheric pressure plasma, or cold plasma. It has been established in countless in vitro and animal experiments that cold plasma has a significant effect on living cells and tissues, for example: selective destruction of cancer cells, helping normal tissue development, inhibiting bacterial, fungal and even viral proliferation. In the handful of clinical trials it could improve wound healing, treat nail fungus. Our group was able to cure precancerous actinic keratosis lesions in a number of patients in a prior study. Based on some of the basic science data regarding the specific molecular and intracellular effects of cold plasma, we theorized that it may be able to cure warts, which are caused by human papilloma virus infection. (more…)
Allergies, Author Interviews, Brigham & Women's - Harvard, CMAJ, Dermatology, Heart Disease / 30.09.2019

MedicalResearch.com Interview with: Hyon K. Choi, MD, DrPH Professor of Medicine, Harvard Medical School Director, Gout and Crystal Arthropathy Center Director, Clinical Epidemiology and Health Outcomes Division of Rheumatology, Allergy, and Immunology Department of Medicine, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Allopurinol is a very common and generally safe medication prescribed to lower serum urate levels, most commonly to patients with gout. However, it can be associated with very rare but serious cutaneous adverse events which includes Stevens-Johnson syndrome and toxic epidermal necrolysis. Prior studies have demonstrated several risk factors for these types of cutaneous adverse events, including presence of chronic kidney disease, older age, female sex, higher initial dose of allopurinol, and the HLA-B*5801 allele, which is more commonly found in Asians and Black patients. A prior study in Taiwan suggested that heart disease (ischemic heart disease and heart failure) may also be associated with an increased risk of hospitalizations for these cutaneous adverse reactions related to allopurinol. Thus, our goal was to investigate this association using a general population cohort from Canada. Using Population Data BC, we found that heart disease was in fact independently associated with an increased risk of hospitalization for these cutaneous adverse reactions. (more…)
Author Interviews, Dermatology, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Hal Flowers MD Assistant Professor of Dermatology University of Virginia Dr. Flowers specializes in autoimmune connective tissue disease (rheumatologic dermatology), phototherapy and blistering skin diseases  MedicalResearch.com: What is the background for this study? Response: Unfortunately, there really is not much literature at all addressing the treatment of atopic dermatitis with apple cider vinegar (ACV), even though we know that this is something our patients are doing. ACV is appealing as a “natural therapy” for treatment of skin disease. Since it’s an acid, it can theoretically correct the loss of acidity that occurs in the skin of our eczema patients. Plus, we know that high enough concentrations will kill certain bacteria that promote eczema, particularly Staphylococcus aureus. There are plenty of blogs and anecdotes as well as physicians who recommend this treatment, but as of yet, we don’t know the best concentration, safety or the benefit of ACV.  (more…)
Author Interviews, Dermatology, Environmental Risks / 19.09.2019

MedicalResearch.com Interview with: Dr. Ke Cheng, PhD Professor, Department of Molecular Biomedical Sciences, NCSU Professor, UNC/NCSU joint Department of Biomedical Engineering MedicalResearch.com: What is the background for this study? What are exosomes? Response: People are developing lots cosmetic products to keep a healthy and young appearance, like antioxidants, growth factors, peptides and more recently, stem cell products. Also, people are seeking more effective solutions for better absorption, like lotion, mask, laser and fillers. What is used for the treatment and how to deliver it are vitally important to the final effect and lasting time. Exosomes are nano-sized small vehicles containing proteins, nucleic acids, and they are messengers for cell communication and regulation. Here we use skin cell-secreted exosomes to fight skin aging. (more…)
Author Interviews, Dermatology, Melanoma, Technology / 19.09.2019

SkinVision   MedicalResearch.com Interview with:  Andreea Udrea, PhD Associate Professor University Politehnica of Bucharest   MedicalResearch.com: What is the background for this study? The skin cancer incidence rate is increasing worldwide. Early diagnosis and prevention can reduce morbidity and are also linked to decreased healthcare costs. During the last years, efforts have been made in developing smartphone applications for skin lesion risk assessment to be used by laypersons. In parallel, as machine learning (ML) is on the rise, and medical image databases are increasing in size, a series of algorithms have been developed and compared in clinical studies to dermatologists for skin cancer diagnosis. The accuracy of the algorithms and experts were comparable. One drawback of these clinical studies is that they use images acquired by professionals in standardized conditions. So, there is little knowledge of what the accuracy will be when including an ML algorithm in an app and testing it in a non-clinical setup where the image quality may be lower, and the variability in image taking scenarios is higher as images are acquired by non-professionals using the smartphone camera. This study is one of the first that evaluates the accuracy of an app (SkinVision) when being used for risk assessment of skin lesions in the general population. (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 16.09.2019

MedicalResearch.com Interview with: Carrie C. Coughlin, MD Member of the Society for Pediatric Dermatology Assistant Professor, Dermatology Departments of Medicine and Pediatrics Washington University School of Medicine / St. Louis Children's Hospital   Cristopher C. Briscoe, MD Dermatology Resident, PGY-2 Washington University School of Medicine in St. Louis    MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Briscoe: Superinfection of atopic dermatitis (AD) in pediatric patients is a common complication. Our study sought to determine the best empiric antibiotic choice for these patients while a bacterial culture is pending. We retrospectively analyzed 182 skin cultures from pediatric atopic dermatitis patients seen in the outpatient setting over five years and found that 170 (93.4%) grew Staphylococcus aureus. Of these, 130 (76.5%) grew methicillin-sensitive S. aureus (MSSA), 37 (21.8%) grew methicillin-resistant S. aureus (MRSA), and 3 (1.8%) grew both MSSA and MRSA. There was no statistically significant relationship between age, sex, race, or dilute bleach bath usage and MRSA infection. Interestingly, as compared to a separate group of pediatric atopic dermatitis patients seen in the emergency room, our patients had lower rates of MSSA susceptibility to doxycycline and MRSA susceptibility to TMP-SMX. (more…)
Author Interviews, Dermatology, Environmental Risks / 28.08.2019

MedicalResearch.com Interview with: Guy German PhD Associate Professor Director of Graduate Studies Department of Biomedical Engineering Binghamton University Binghamton, NY 13902  MedicalResearch.com: What is the background for this study? Response: Photoageing from the sun is widely known to occur. The most obvious result of it is early onset of wrinkles. However we are trying to understand if solar light can degrade the mechanical integrity of human skin. Moreover, while solar ultraviolet (UV) light is considered to have the most damaging effect on the skin, the UV range that is most harmful remains a topic of significant debate. This research studies how different UV ranges and dosages impacts the mechanical integrity of the outermost layer of skin, called the stratum corneum. This tissue layer sits above the layers of melanin in skin, the pigment responsible for tanning. When stratum corneum ruptures, it stops working as a barrier to the outside world and can increase the risk of infections. (more…)
Author Interviews, Dermatology, Microbiome, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: Zhe-Xue Quan, PhD Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering Institute of Biodiversity Science School of Life Sciences, Fudan University Shanghai, China  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The maturation of skin microbial communities during childhood is important for the skin health of children and development of the immune system into adulthood. This necessitates a better characterization of the environmental and genetic factors influencing these microbiome dynamics. We investigated the skin microbiota of children (158 subjects between 1 and 10 years old) and their mothers using 16S rRNA gene amplicon sequencing. Sample location and age were the primary factors determining a child’s skin bacterial composition. Relative abundances of Streptococcus and Granulicatella were negatively correlated with age, and the alpha diversity at all body sites examined increased during the first 10 years of life, especially on the face. The facial bacterial composition of 10-year-old children was strongly associated with delivery mode at birth.  (more…)
Author Interviews, Cancer Research, Dermatology / 14.08.2019

MedicalResearch.com Interview with: Dr Alessia Visconti, PhD Department of Twin Research King's College London, London MedicalResearch.com: What is the background for this study? Response: We know from previous studies that the body site where melanoma skin cancer develops varies according to sex, with men having melanoma more often on the head, neck, and trunk, and women on the legs. The body site where moles, a major risk factor for melanoma development, are more abundant also varies according to sex, at least in childhood, with boys having more moles on the head, neck, and trunk, and girls on the legs. (more…)
Author Interviews, Dermatology, Weight Research / 12.08.2019

MedicalResearch.com Interview with: Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford) Department of Dermatology Chang Gung Memorial Hospital, Linkou Taiwan MedicalResearch.com: What is the background for this study?   Response: Psoriasis has been associated various inflammatory comorbidities including diabetes mellitus, coronary artery disease, etc. Moreover, obesity is prevalent among psoriasis patients and has been considered as an independent risk factor for occurrence and worsening of psoriasis by promoting systemic inflammation. Notably, body weight (BW) gain of psoriasis patients after biologics use has been observed. However, there are inconsistent reports on whether biological therapy relates to BW gain.  (more…)
Author Interviews, Dermatology / 11.08.2019

MedicalResearch.com Interview with: Hong Liang Tey MBBS, FRCP Head of Research Division and Senior Consultant, National Skin Centre, Singapore Adj Assoc Prof., Yong Loo Ling School of Medicine, National University of Singapore Asst Prof., Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore  MedicalResearch.com: What is the background for this study? We developed dissolving microneedles embedded with a medication, triamcinolone, as a novel treatment option for patients with keloids and evaluated its efficacy and safety in a clinical trial.  Background: Keloids are a common skin disorder and itch and pain afflicts up to 80% of patients. The first-line and typically the only treatment option is multiple repeated intra-lesional corticosteroid injections by dermatologists or specially-trained nurses. However, many patients are unable to undergo this treatment. Typically, such patients
  • Are unable to tolerate the pain of conventional intra-lesional injection, as keloids are inherently hypersensitive. The problem is exacerbated by the fact that repeated monthly injections are required to achieve a response. In addition, children cannot tolerate pain and cannot undergo such injections.
  • Have keloids on the mid facial region, where injection carries a risk of causing blindness.
  • Are unable to afford the time and cost of repeated travelling to see a dermatology doctor or nurse for the injections. These include patients residing or working overseas.
  • Have mid-sternum protrusive scars after cardiac arterial bypass surgery, and painful injections may trigger another heart attack.
(more…)
Author Interviews, Dermatology, JAMA / 01.08.2019

MedicalResearch.com Interview with: Eunyoung Cho, Sc.D. Associate Professor Director of Research, Department of Dermatology The Warren Alpert Medical School of Brown University Associate Professor, Department of Epidemiology Brown School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Cutaneous squamous cell carcinoma (SCC) is a common skin cancer in people with fair skin. Vitamin A is a fat-soluble vitamin that is naturally present in many foods such as green leafy vegetables, fruits including cantaloupe, apricots, and mangos, and dairy products. We studied whether vitamin A intake is beneficial against SCC risk because there are few ways to prevent skin cancer. (more…)
Author Interviews, Dermatology, NIH / 19.07.2019

MedicalResearch.com Interview with: Mark Hoon, PhD Senior Investigator,Molecular Genetics Unit Sensory Biology NIH NIDCR, Bethesda, MD MedicalResearch.com: What is the background for this study? Response: Itch is a condition that at some point effects all people. For most of us itch is not a major problem, but for some people with certain chronic conditions it severely effects their quality of life. Examples of diseases which cause chronic itch are atopic dermatitis, psoriasis, and renal failure. However, current therapies for chronic itch are mainly ineffective and there is a unmet clinical need. (more…)
Author Interviews, Dermatology, Duke / 15.07.2019

MedicalResearch.com Interview with: Luis Garza, M.D., Ph.D. Associate Professor of Dermatology Johns Hopkins University School of Medicine. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to find out what might stimulate regeneration in mice and humans. We find that in both species during wounding, released “loose” dsRNA induces production of retinoic acid that stimulates regeneration. (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA / 11.07.2019

MedicalResearch.com Interview with: Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford) Department of Dermatology Chang Gung Memorial Hospital, Linkou Guishan Dist, Taoyuan 33305 Taiwan MedicalResearch.com: What is the background for this study? Response: Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) are inflammatory diseases that share common clinical manifestations, genetic susceptibility, and immunologic features. For example, both diseases have similar clinical manifestations in the skin and gut, characterized by sterile abscesses in perineal and inguinal areas, scarring, and sinus tract formation. Both diseases have been associated with an increased prevalence of spondyloarthropathy, have common risk factors (smoking and obesity), and respond well to tumor necrosis factor-inhibitors. Some studies have suggested a link between HS and IBD, but data on the association of HS and IBD remain inconsistent and unclear. Therefore, we conducted a meta-analysis to investigate the association of hidradenitis suppurativ with IBD. (more…)
Author Interviews, Dermatology, University of Pennsylvania / 08.07.2019

MedicalResearch.com Interview with: John Barbieri, MD, MBA Hospital & Health Care University of Pennsylvania  MedicalResearch.com: What is the background for this study? Would you briefly describe the type of acne treated with Isotretinoin? Response: Isotretinoin is often used to treat moderate to severe acne or acne that has been unresponsive to other treatments. It is also used for patients with scarring acne. While highly effective for acne, due to concerns about medication related side-effects, patients are often monitoring with frequent blood tests, sometimes up to once per month. However, there have been several studies over the past two decades questioning the value of these frequent blood tests for patients on isotretinoin for acne. The purpose of this study was to examine whether blood test monitoring has been decreasing over time in response to these studies. We also evaluated the frequency of blood test abnormalities for patients being treated with isotretinoin. (more…)
Author Interviews, Dermatology, HPV, Yale / 20.06.2019

MedicalResearch.com Interview with: Richard J. Antaya, MD, FAAD, FAAP Professor, Dermatology and Pediatrics Yale University School of Medicine  MedicalResearch.com: What is the background for this study? Response: Localized hyperthermia has been reported to hasten the resolution of warts and treat both benign and malignant neoplasms. Numerous clinical studies employing various methods to increase the cutaneous surface temperature, including: infrared radiation, radiofrequency, Nd:YAG laser, moxibustion, warm water immersion, ultrasound, and exothermic heat patches, have all yielded positive results. We published a proof-of-concept, open-label trial, representing the largest experience to date employing chemical reaction induced exothermic heat patches for the treatment of warts. Localized hyperthermia from all sources currently has a low level of evidence and strength of recommendation because of the lack of well-designed, sufficiently powered studies.  (more…)
Author Interviews, Dermatology, Infections, JAMA / 19.06.2019

MedicalResearch.com Interview with: Richard Brindle DM FRCP Honorary Reader, University of Bristol, UK  MedicalResearch.com: What is the background for this study? Response: This review is an update of the 2010 Cochrane Review of Interventions for cellulitis and erysipelas (DOI: 10.1002/14651858.CD004299) but focusing on antibiotics.  It provides a valuable resource for clinicians in summarizing current best evidence and highlighting gaps in the research. This review will inform the production of evidence-based guidelines covering antibiotic choice, route of administration, duration of treatment and the role of combinations of antibiotics. (more…)
Author Interviews, Dermatology, JAMA, Smoking, Surgical Research / 14.06.2019

MedicalResearch.com Interview with: Ian A. Maher, MD Department of Dermatology St Louis University, St Louis, Missouri  MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of our wonderful trainees at Saint Louis University was interested in the role of smoking in flap failures.  Dogma has been that smoking was a major risk factor for flap failures.  Looking at our database as well as published data, flap failures are a rare event, so rare as to be difficult to definitively associate with anything.  We decided to look more broadly at complications both acute (infections failures) and chronic (mainly cosmetic scarring associated) in flaps and grafts. (more…)
Author Interviews, Dermatology, FDA / 06.06.2019

MedicalResearch.com Interview with: Stephanie L. Kuschel, MD Indiana University School of Medicine Indianapolis, IN, 46202 Robert Dellavalle, MD, PhD, MSPH Professor of Dermatology and Public Health University of Colorado School of Medicine Colorado School of Public Health Chief, Dermatology Service US Department of Veterans Affairs Eastern Colorado Health Care System Denver, CO 80220  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physicians can serve as external experts and voting members of FDA advisory committee panels, which help determine if a drug is acceptable for the US market. Considering that financial conflicts of interest (FCOI) have been shown to influence voting member habits, the FDA has regulations in place to minimize these FCOI. However, the FDA can grant waivers for some financially conflicted individuals if they meet certain requirements (like offering key insights that may out-weigh the risk of a possible FCOI). Additionally the FDA does not make stipulations regarding post-advisory role financial relationships. In fact, many former FDA committee advisors later engage in financial relationships with pharmaceutical companies. Some worry these post-hoc financial relationships could pose an ethical dilemma whereby future FDA advisory members are incentivized to alter their voting habits in expectation of future rewards. Others argue the situation may be more complex than expected. For example, the author of one study, found that while there was evidence for a pro-industry voting bias among committee members with exclusive financial relationships to the sponsoring manufacturer (of the drug under review), this was not the case for members with nonexclusive financial ties to both the sponsor and its competitors 1. Furthermore, the author found that advisors with many corporate ties were (on average) actually more likely than their peers without any financial ties to vote against the sponsor. The author argued that these advisors were more likely to be experienced researchers, and their voting habits may reflect their experience evaluating medical research. While this author and others have offered valuable insights into financial relationships of advisors during their advisory role, unfortunately little information is available regarding post-advisory role financial relationships and whether these relationship have any influence on the integrity of the voting process. The purpose of our study was to review Open Payment data on industry payments to former physician FDA dermatologic drug committee members.  (more…)
Author Interviews, Dermatology, JAMA / 01.06.2019

MedicalResearch.com Interview with: Jung Min Bae, MD, PhD Associate Professor, Department of Dermatology St. Vincent's Hospital College of Medicine, The Catholic University of Korea  MedicalResearch.com: What is the background for this study? Response: Vitiligo is a common chronic skin disease affecting 1% of the population, and it causes low self-esteem and social stigma. To date, there are no approved drugs for the treatment of vitiligo, even though growing evidence indicates favorable therapeutic responses of topical calcineurin inhibitors (TCIs) including tacrolimus and pimecrolimus. In this study, we conducted a systematic review and meta-analysis of all relevant prospective studies (n = 46) and identified remarkable therapeutic responses of TCI monotherapy and TCI plus phototherapy for vitiligo. (more…)