Patients with CLL Should Be Monitored for Skin Cancer, Including Melanoma

MedicalResearch.com Interview with:

Clive S. Zent MD Professor of Medicine Director of Lymphoma/CLL Program Wilmot Cancer Institute University of Rochester Medical Center Rochester NY

Dr. Zent


Clive S. Zent MD

Professor of Medicine
Director of Lymphoma/CLL Program
Wilmot Cancer Institute
University of Rochester Medical Center
Rochester NY

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

Response: Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have an increased risk of all skin cancers including malignant melanoma.

This study in a stable population of CLL patients managed by a regional referral center confirmed that melanoma was over 6 times more common in than in an age and sexed matched general population. Because of the proactive skin screening program at the University of Rochester Medical Center’s Wilmot Cancer Center, most melanomas (77%) were detected at earlier stages and were treated surgically with curative intent. One patient with CLL and metastatic melanoma had a sustained remission of both diseases on treatment with ibrutinib and pembrolizumab. Continue reading

More Evidence UV Filters in Sunscreens Affect Marine Life

MedicalResearch.com Interview with:
sunscreen creative commonsAdela J. Li, PhD

Research Affiliate
Wadsworth Center, Rm. D597
New York State Dept. of Health
Empire State Plaza
Albany, NY, 12201-0509
On the behalf of Dr. Kelvin Leung 

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

Response: Most people love the beach. In order to block the sun’s damaging UV radiation, people generally slather on a thick layer of sunscreen against sunburn and skin cancer. Sunscreen is suggested to be re-applied every few hours regarding its effectiveness as well as being washed off into the water. These UV filters have been detected in the environment but most studies concluded that individual sunscreen chemicals pose no/low risk to animals or human. However, UV filters constitute a heterogeneous group of chemicals in sunscreens. We are wondering if combination of UV filters would induce higher toxicity than individual compounds, and whether these chemical interactions would develop over time, becoming increasingly dangerous to the living systems.

Our study found seven of the nine UV filters in Shenzhen waters, China — a rapidly urbanized city with over 20 popular recreational beaches, surprisingly, a reservoir and tap water. After exposing artemia to three dominant UV filters and then feeding these artemia to zebrafish adults, concentrations in both were up to 4 times higher when exposed to the mixtures than when exposed to only a single UV filter. A short-term of 25-day dietary exposure to the zebrafish adults did not appear to significantly influence early life stage development of the second generation; however, relatively long exposure over 47 days had significant adverse effects on embryo development. Continue reading

Waiting Room App Uses Selfies To Show Patients Effects of Sun Damage

MedicalResearch.com Interview with:
Startup Screen Dermatology APPDr. med. Titus Brinker
Head of App-Development // Clinician Scientist
Department of Translational Oncology
National Center for Tumor Diseases (NCT)
Department of Dermatology
University Hospital Heidelberg
Heidelberg

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

Response: ​While everyone in the dermatologic community appears to agree on the importance of UV-protection for skin cancer prevention, busy clinicians often lack time to address it with their patients.

Thus, the aim of this study was to make use of waiting rooms that almost every patient visiting a clinic spends time in and address this topic in this setting by the means of modern technology rather than clinicians time.

We used our free photoaging app “Sunface” which shows the consequences of bad UV protection vs. good UV protection on the users’ own 3D-animated selfie 5 to 25 years in the future and installed it on an iPad. The iPad was then centrally placed into the waiting room of our outpatient clinic on a table and had the Sunface App running permanently. The mirroring of the screen lead to a setting where every patient in the waiting room would see and eventually react to the selfie taken by one individual patient which was altered by the Sunface App.

Thus, the intervention was able to reach a large proportion of patients visiting our clinic: 165 (60.7%) of the 272 patients visiting our waiting room in the seven days the intervention was implemented either tried it themselves (119/72,12%) or watched another patient try the app (46/27,9%) even though our outpatient clinic is well organized and patients have to wait less than 20 minutes on average. Longer waiting times should yield more exposure to the intervention. Of the 119 patients who tried the app, 105 (88.2%) indicated that the intervention motivated them to increase their sun protection (74 of 83 men [89.2%]; 31 of 34 women [91.2%]) and to avoid indoor tanning beds (73 men [87.9%]; 31 women [91.2%]) and that the intervention was perceived as fun (83 men [98.8%]; 34 women [97.1%]).

Continue reading

Sunscreen Use During Childhood Reduces Melanoma Risk

MedicalResearch.com Interview with:
“Sunscreen” by Tom Newby is licensed under CC BY 2.0Dr Caroline Watts  PhD

Post-doctoral Researcher
The University of Sydney.

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

Response: The study analysed data collected from nearly 1700 young Australians who participated in the Australian Melanoma Family Study, a population-based case-control-family study that focused on people who had a melanoma under 40 years of age and compared them with people the same age who did not have a melanoma.

We examined sunscreen use during childhood and adulthood and its association with melanoma risk and found that compared to people who did not use sunscreen, regular sunscreen use during childhood reduced melanoma risk by 30-40 per cent.  Continue reading

Gym Tanners More Likely To Show Signs of “Tanning Addiction.”

MedicalResearch.com Interview with:
Sherry Pagoto, PhD
Director, UConn Center for mHealth and Social Media
President, Society of Behavioral Medicine
UConn Institute for Collaboration in Health, Interventions, and Policy
Professor, Department of Allied Health Sciences
University of Connecticut
Storrs, CT 06268

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

Response: Recent research has shown that while physical activity is associated with reduced risk for many cancers, it is associated with an increased risk for melanoma. We are not sure why this is the case, however, we have noticed that popular gym chains (e.g., Planet Fitness) often offer tanning beds, which are carcinogenic.

We surveyed over 600 people who had used a tanning bed at least once in their life to see how many had used tanning beds in gyms. About one-quarter had used tanning beds in gyms and those folks actually tanned significantly more than people who had not tanned in gyms.  Gym tanners were also more likely to show signs of “tanning addiction.”  We also found an association between tanning and physical activity, such that the people who were the most physically active were the heaviest tanners.  Continue reading

Severe Skin Reactions TEN/SJS: Children Generally Do Better Than Adults

MedicalResearch.com Interview with:
CDC imageJames W. Antoon, MD, PhD

Pediatric Primary Care
University of Illinois Hospital

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis?

Response: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal skin conditions, most commonly caused by medications and infections. Early symptoms include fever, blistering and peeling of the skin and mucus membranes and can affect any organ system including the eyes, lungs, kidneys and intestines. While rare, the conditions often result in life-long effects. The rarity and severity of these diseases have made it a challenge for researchers and clinicians to study, especially in a pediatric population. As a result, much of the information used to drive our care for children is derived from adult studies.

MedicalResearch.com: What are the main findings? 

Response: Using the Pediatric Health Information System, a large pediatric database containing information from 45 U.S. children’s hospitals, we studied the treatment and outcomes of SJS and TEN in children. This is one of the first large-scale to benchmark clinical outcomes the conditions in children. We characterized outcomes such as cost of hospital care, length of hospital stay, mortality, recurrence, hospital readmission as well as short-term complications like kidney failure, respiratory failure and sepsis.

Overall, we found that these outcomes in children were better than in adults. We also found that children with SJS and TEN received different kinds of treatment and that treatment strategies varied by region of the country. Expensive or combination treatments did not necessarily result in better outcomes.

MedicalResearch.com: What should readers take away from your report?

Response: Overall, these findings suggest we can be cautiously optimistic about SJS and TEN outcomes in children. Mortality and short-term morbidity in children with SJS and TEN is lower than in adults. Our results also suggest we can potentially reduce the cost of care for families by selecting lower-cost treatments to achieve the same outcomes. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: We identified a large variation in the treatment kids with SJS and TEN received, yet outcomes did not differ between treatments. This usually indicates an area for improvement in the quality of care doctors provide. Further research focusing on strategies that reduce complications, hospital stays and the cost of care would help provide physicians with better evidence on how to treat these conditions. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The study was performed in collaboration with Drs. Jennifer Goldman and Brian Lee of Children’s Mercy Hospital and Clinic in Kansas City, Missouri, and Dr. Samir Shah of Cincinnati Children’s Hospital Medical Center. Dr. Goldman’s work was supported in part by a grant (KL2TR000119) from the National Center for Advancing Translational Sciences, part of the National Institutes of Health.

Citation:

J Allergy Clin Immunol Pract. 2018 May 30. pii: S2213-2198(18)30346-5. doi: 10.1016/j.jaip.2018.05.024. [Epub ahead of print]
A Retrospective Cohort Study of the Management and Outcomes of Children Hospitalized with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis.
Antoon JW1, Goldman JL2, Shah SS3, Lee B4. 

Jul 16, 2018 @ 8:24 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Shining Sunlight on Sunscreens and Sunburns

MedicalResearch.com Interview with:
Dr. Janet Prystowsky, MD

Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.  In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.

Dr. Prystowsky

Dr. Prystowsky is a leading board-certified dermatologist in
New York City.  

In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.
http://www.janetprystowskymd.com/

MedicalResearch.com: Are all sunscreens created equally? 

Response: Not all sunscreens are created equally. Always choose a broad-spectrum sunscreen that is water resistant if you are planning outdoor sports (with sweating) or swimming. Water resistance is a must when you are swimming or sweating (and who isn’t sweating on a hot summer day?)

However, you do not need water resistance if you are walking a few blocks in moderate temperatures. In that situation, a moisturizer sunscreen that is not water resistant is OK and may feel more comfortable on your skin.

As far as ingredients go, your best choice is a mineral based sunscreen with zinc oxide and/or titanium dioxide.

Sunscreens that are not broad spectrum may protect you from sunburns but will not protect you from photodamage that can lead to premature aging and skin cancer.

Mineral based sunscreens are preferable over chemical sunscreens because the long-term effects of chemical sunscreens aren’t well understood. What we do know is that chemical sunscreens can absorb into our bloodstream and potentially have hormonally disruptive effects.  Continue reading

What is the Role of Diet in Psoriasis and Psoriatic Arthritis?

MedicalResearch.com Interview with:

Adam Ford, BS Research fellow with Dr. April Armstrong Keck School of Medicine University of Southern California

Adam Ford

Adam Ford, BS
Research fellow with Dr. April Armstrong
Keck School of Medicine
University of Southern California

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

Response: Our psoriasis patients have long asked us about the role of diet on psoriasis. Previously, there was a lack of evidence synthesis on the relationship between psoriasis and diet. As such, providers were mostly unable to address their patients questions on the role of diet on psoriasis.

This pivotal effort from the National Psoriasis Foundation has been a few years in the making. We looked at the role of diet on psoriasis and psoriatic arthritis based on a careful synthesis of the scientific studies available to us currently.

Continue reading

Melanoma Compromises Quality of Life, especially in Later Stages

MedicalResearch.com Interview with:

Eugene R. Semenov, MD, MA Washington University School of Medicine

Dr. Semenov

Eugene R. Semenov, MD, MA
Washington University School of Medicine

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

Response: Melanoma is an aggressive type of skin cancer which has traditionally carried a poor prognosis. Over the past decade, many new therapies have become available that have improved long-term survival rates in patients with metastatic melanoma. However, these drugs have been associated with serious side effects, such as pancreatitis and hepatitis. Our goal was to study how melanoma diagnosis, disease stage, and treatment status impact patient quality of life (QoL).

Continue reading

Racial Disparities in Prurigo Nodularis (Extremely Itchy Lumps)

MedicalResearch.com Interview with:

Prurigo Nodularis credit: Johns Hopkins Medicine

Prurigo Nodularis
credit: Johns Hopkins Medicine

Dr. Shawn Kwatra MD
Assistant Professor of Dermatology
Johns Hopkins University School of Medicine 

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by prurigo nodularis? 

Response: Prurigo nodularis is a skin condition where patients develop extremely itchy nodules throughout the body. Little is known about why this happens or which groups of people are predisposed to develop this condition.

MedicalResearch.com: What are the main findings?

Response We found that prurigo nodularis disproportionately affects African-Americans as compared to the general population. Diabetes, Hepatitis C, chronic kidney disease, and HIV are also more common in patients with prurigo nodularis than the general population or patients with other inflammatory skin diseases studied, such as atopic dermatitis and psoriasis.

We also found that people with prurigo nodularis are more likely to be depressed than patients with other inflammatory skin diseases, such as atopic dermatitis or psoriasis. 

Continue reading

Blackcurrant Extract Developed As New Natural Hair Dye

MedicalResearch.com Interview with:

Dr. Richard S. Blackburn

Dr. Blackburn

Dr. Richard S. Blackburn
BSc (Leeds), PhD (Leeds), CCol FSDC
Associate Professor in Coloration Technology
Head of Sustainable Materials Research Group
University of Leeds

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

Response: I’ve been working with my colleague Professor Chris Rayner at The University of Leeds for over 10 years in the field of anthocyanins, which are pigments that provide colour to most berries, flowers, and many other fruits and vegetables. We have developed techniques to isolate these compounds from food waste, characterise the chemistry of the extracts, and use these natural pigments in various applications. In this work, anthocyanins extracted from blackcurrant waste created during the manufacture of blackcurrant cordial (Ribena) have for the first time been used in an effective new hair dyeing technology.

Why hair dyeing? The global hair coloration industry is worth more than $10 billion a year, with the number of people colouring their hair in professional salons and at home on the increase, but some of the ingredients found in commonly-used synthetic hair dyes, are known irritants and can trigger severe allergic reactions. There is also much debate about whether these ingredients also cause cancer. Dyes that some may consider ‘natural’ – such as those including henna – usually escape scrutiny when it comes to health concerns, but the main natural colorant in henna is lawsone, which the EU Scientific Committee on Consumer Safety states is toxic. What is more, it is thought up to 95% of all dyes end up washed down the drain; their effect on the environment is unknown.

Because of issues and concerns around conventional dyes, we wanted to develop sustainable, biodegradable alternatives using green chemistry processes that minimise potential risks to health and offer consumers a different option.

Continue reading

Organ Transplant Recipients Require Vigilant Sun Protection

MedicalResearch.com Interview with:
“Sunscreen” by Tom Newby is licensed under CC BY 2.0Rebecca Ivy Hartman, M.D
Instructor in Dermatology
Brigham and Women’s Hospital
Boston MA 02115

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

Response: Organ transplant recipients (OTR) are at 100-fold higher risk to develop certain skin cancers compared to the general population due to immunosuppression, and thus preventing skin cancer in this population is critical.

Our study found that in a high-risk Australian OTR population, only half of patients practiced multiple measures of sun protection regularly.

However, after participating in a research study that required dermatology visits, patients were over 4-times more likely to report using multiple measures of sun protection regularly. Patients were more likely to have a positive behavioral change if they did not already undergo annual skin cancer screening prior to study participation.

Continue reading

Painless Laser Reduces Sweating in Axillary Hyperhidrosis

MedicalResearch.com Interview with:

Bruce E. Katz, M.D.  Clinical Professor Icahn School of Medicine at Mt Sinai Director, Juva Skin & Laser Center Past Director, Cosmetic Surgery & Laser Clinic Mt Sinai Hospital New York, N.Y. 10022

Dr. Katz

Bruce E. Katz, M.D. 
Clinical Professor
Icahn School of Medicine at Mt Sinai
Director, Juva Skin & Laser Center
Past Director, Cosmetic Surgery & Laser Clinic
Mt Sinai Hospital
New York, N.Y. 10022 

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

Response: Axillary hyperhidrosis  is estimated to affect 1.4% of the U.S. population.  Newer treatments such as microwave technology, botulinum toxin injections and lasers have emerged as effective methods.

In this pilot study we examine the use of a non-invasive 1060nm diode laser, SculpSure,  for the treatment of axillary hyperhidrosis. SculpSure focuses energy at the level of the sweat glands so we believed it would work for hyperhidrosis. After two SculpSure treatments, there was a long lasting resolution of hyperhidrosis.

Continue reading

TREMFYA® (guselkumab) Successfully Treats Difficult Psoriasis Areas

MedicalResearch.com Interview with:

Andrew Blauvelt, M.D., M.B.A. President Oregon Medical Research Center 

Dr. Blauvelt

Andrew Blauvelt, M.D., M.B.A.
President
Oregon Medical Research Center 

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

Response: This new paper focuses on treatment of psoriasis in classically difficult-to-treat areas of the body, which include the scalp, the palms/soles, and the fingernails.

We show that guselkumab, which is a new biologic therapy that selectively targets IL-23 (a key pro-inflammatory cytokine in psoriasis pathogenesis), works well in these areas affected by psoriasis.

More specifically, after 6 months of treatment with guselkumab, approximately 85%, 80%, and 60% of patients achieved complete or near complete clearance of psoriasis in their scalp, palms/soles, and fingernails, respectively. 

Continue reading

SKINDER App Teaches Intuitive Visual Diagnosis of Melanoma

MedicalResearch.com Interview with:

SKINDER APP

Image from SKINDER APP

Michael SKolodneyMD, PhD
Section of Dermatology, Department of Medicine
West Virginia University

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

Response: Melanoma is easily curable if recognized early.   Dermatologists are good at spotting melanomas because they develop an innate sense of how melanomas appear after examining thousands of malignant and benign lesions.  In contrast, most medical students are relatively disadvantaged by their limited dermatology exposure. We felt that too little experience, rather than lack of knowledge of the rules, is the primary barrier to development of pattern-recognition and intuition as a reliable tool for melanoma diagnosis in non-experts.  To remedy this problem, we developed a novel web-based application to mimic the training of a dermatologist by teaching medical students intuitive melanoma diagnosis in a highly condensed period of time.

Our application, which we call Skinder, teaches intuitive visual diagnosis of melanoma by quickly presenting the learner with thousands of benign and malignant skin lesions.  The user makes rapid binary decisions, by swiping right for benign or left for malignant, and receives instant feedback on accuracy. With this application, the learner can amass a mental repository of diagnostic experience in a short amount of time. To determine if intuitive visual diagnosis training is superior to a traditional rule-based approach, we compared our web-based application to a rules based approach, the publicly available INFORMED Skin Education Series.

Medical students were tested on the ability top differentiate melanomas from benign pigmented lesions before and after training with either Skinder of the Informed Skin Education Series. The pre-test mean for the Skinder group was 75% correct, compared to 74.7% correct for the INFORMED group. The post-test mean for the skinder application group was 86.3% correct, compared to 77.5% correct for the INFORMED group which was highly signifcant.

Continue reading

New Focus for Inflammatory Skin Disease and Psoriasis: Topical Glucose Transport Inhibitors

MedicalResearch.com Interview with:

Richard Wang, M.D., Ph.D.  Assistant Professor Dermatology UT Southwestern Medical Center 

Richard Wang, M.D., Ph.D. 
Assistant Professor Dermatology
UT Southwestern Medical Center 

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

Response: Targeting cellular metabolism is currently being explored as a new way to diagnose and treat diseases. In particular, there has been increasing interest in specifically targeting metabolic pathways are preferentially altered in disease states, like cancer.  Although an increased dependence on glucose transport and metabolism has been well established for rapidly proliferating cells, attempts to target this conserved pathway have been limited by concerns about the high potential for side effects from the systemic inhibition of glucose transport.

To investigate the feasibility of targeting glucose transport in skin diseases, we investigated the effect of inhibiting glucose transport in the skin by deleting the primary glucose transporter in the skin, Glut1, in mouse keratinocytes. We confirmed that the Glut1-deficient keratinocytes showed metabolic and oxidative stress and impaired proliferation. However, the keratinocyte-specific ablation of Glut1 did not compromise mouse skin development and barrier function. Metabolomic profiling revealed sphingolipid, hexose, amino acid, and nucleotide adaptations in Glut1-deficient keratinocytes. However, Glut1 deficient skin did show defects in both proliferation and migration after physiologically relevant stressors like excisional wounds and UV-B irradiation.

Given its importance during stressors, we further tested whether Glut1 was important in the pathogenesis of psoriasis models. Notably, both the genetic and pharmacological inhibition of Glut1 decreased hyperplasia in mouse and human organic models of psoriasis. Moreover, the topical application of a Glut1 inhibitor further decreased inflammation in these models. The ability to deliver glucose transport inhibitors specifically to the skin may limit the adverse effects from the systemic inhibition of glucose transport and suggests that the topical inhibition of glucose transport may be a novel approach to treat hyperproliferative and inflammatory skin diseases.  Continue reading

Dermatologist Discusses Tattoo Removal from Dark Skin

MedicalResearch.com Interview with:

Roy G. Geronemus, M.D Director of the Laser & Skin Surgery Center of New York®,

Dr. Geronemus

Roy G. Geronemus, M.D
Director of the Laser & Skin Surgery Center of New York®

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

Response: The incidence of tattoos in types V and VI skin is increasing and the number of patients seeking removal has increased as well.

Safe removal has historically been an issue with higher risks of scarring or pigmentary change than is seen in lighter skin types.

MedicalResearch.com: What are the main findings? 

Response: Excellent removal or lightening of black tattoos in dark skin can take place without side effects. 

MedicalResearch.com: What should readers take away from your report?

Response: Tattoos can be safely removed in dark skin type. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Perhaps improved methods for faster removal. 

Disclosures:  I am an investigator for Cynosure. 

Citations:

ASLMS 18 abstract 

Clinical Evaluation of a 1064nm Picosecond Laser for Removal of Black Tattoos in Patients with Dark Skin Types 

http://www.aslms.org/annual-conference-2018/explore/corporate-partner-opportunities/exhibit-opportunities/2018/04/11/default-calendar/aslms-2018-the-38th-annual-conference

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

PAs Do More Biopsies, Find Less Early Melanoma than Dermatologists

MedicalResearch.com Interview with:

Laura Korb Ferris, MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, Department of Dermatology University of Pittsburgh Medical Center

Dr. Laura K. Ferris

Laura K. Ferris MD, PhD
Associate Professor, University of Pittsburgh Clinical and Translational Science Institute
Director of Clinical Trials, UPMC Department of Dermatology
University of Pittsburgh

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

Response: Dermatology is one of the greatest utilizers of physician extenders, including physician assistants (PAs) in medicine. The scope of practice of PAs has also expanded over time from a role in assisting the dermatologist to taking a more independent role and many PAs now do skin cancer screening examinations and make independent decisions about which lesions are suspicious for skin cancer and need to be biopsied.

Our main findings were that, overall, in comparison to board-certified dermatologists, PAs were more likely to perform biopsies of benign lesions. For every melanoma that they found, PAs biopsied 39 benign lesions whereas dermatologists biopsied 25.

In addition, PAs were less likely than dermatologists to diagnose melanoma in situ, the earliest and most curable, but also hardest to identify and diagnose, form of melanoma. However, PAs had a similar rate of diagnosing the more clinically-obvious forms of skin cancer, including invasive melanoma, basal cell carcinoma, and squamous cell carcinoma.

Continue reading

What is Dandruff and What Can I Do About It?

MedicalResearch.com Interview with:

Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.  In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.

Dr. Prystowsky

Dr. Janet Prystowsky, MD
Dr. Prystowsky is a leading board-certified dermatologist in
New York City. 

In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.
http://www.janetprystowskymd.com/

MedicalResearch.com: Would you describe what dandruff looks like on most people? 

Dr. Prystowsky: Normal dandruff looks like tiny white flakes or dust in your hair. These flakes are a buildup of dead skin cells mixed with skin oils.

dandruff wikipedia image

Dandruff
Wikipedia image

MedicalResearch.com: Is dandruff the same as seborrheic dermatitis? How does it differ from psoriasis or eczema? Do scientists understand what causes dandruff? Is it caused by stress, diet or fatigue? 

Dr. Prystowsky: Normal dandruff is caused by the accumulation of dead skin cells and skin oils (sebum) that are a part of normal scalp function. Sebum is produced in hair follicle oil glands, and skin cells slough from the scalp surface just as they do from the rest of your body. It is a part of normal skin cell turnover.

However, you may also get excessive dandruff if you have scalp skin diseases such as psoriasis, eczema, and seborrheic dermatitis.  Skin infections with fungus (tinea capitus), head lice, or Staph. Aureus may also trigger excessive flaking. 

Continue reading

Study Finds Adults Who Used Sunscreen Slightly More Likely To Get Sunburned

MedicalResearch.com Interview with:
“Sunburn” by Beatrice Murch is licensed under CC BY 2.0Dawn Holman, MPH
Behavioral Scientist Division of Cancer Prevention and Control
CDC

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

Response: Sunburn at any age increases a person’s chances of developing skin cancer in the future. Using a combination of strategies including staying in the shade, wearing clothing that covers the arms and legs, wearing a hat with a wide brim, and wearing sunscreen (SPF 15+) on exposed skin can protect skin from sun damage and reduce risk of sunburn.

This study used national data to examine how often US adults used these sun protection strategies when outdoors in the sun for an hour or longer and how many US adults got sunburned in 2015.

Among adult women, staying in the shade and using sunscreen were the most common sun protection methods. About 40% of women regularly used these strategies. Women were less likely to wear a wide-brimmed hat (14%) or wear clothing covering their arms (11%) and legs (23%).

Among adult men, wearing pants or other clothing covering their legs and staying in the shade were the most common sun protection methods. Just over 30% of men regularly used these strategies. Men were less likely to use sunscreen (22%), wear a wide-brimmed hat (14%) or wear a shirt with long sleeves (13%).

About one-third of US adults got sunburned in 2015. Sunburn was even more common among certain groups. For example, about half of individuals with sun-sensitive skin and about half of adults aged 18-29 got sunburned.

Certain behaviors and health conditions were related to sunburn. For example, adults who used sunless tanning products to darken their skin, binge drank, engaged in aerobic activity, or were overweight or obese were more likely to get sunburned compared to other adults. Adults who regularly stayed in the shade when outdoors or avoided long periods of time in the sun were slightly less likely to get sunburned compared to other adults.

Adults who regularly used sunscreen were slightly more likely to get sunburned. Continue reading

Inflammatory Cells That Suppress Skin Allergic Reactions Identified

MedicalResearch.com Interview with:
elstarNidhi Malhotra PhD

Boston Children’s Hospital
Division of Allergy and Immunology
Senior Scientist at Elstar Therapeutics Inc.

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

Response: Allergies such as Atopic Dermatitis (AD) are rampant in the industrialized nations. Why are we more predisposed to developing hypersensitive reactions to innocuous proteins (allergens) is not well understood. To gain better understanding and to develop better therapies, we need to first delve deeper into how our immune system regulates homeostasis in tissues such as skin. The main cell types that thwart inflammatory reactions are known as regulatory T cells. These cells are generated in thymus and reside in secondary lymphoid tissues but they are also prominent at tissue sites such as in dermal layer of skin. In this study, I focused on understanding how Tregs resident in skin are distinct from the Tregs in secondary lymphoid organs such as lymph nodes (LNs). I uncovered that functioning of Tregs in skin is underpinned by a distinct set of genes. One main gene that I found to be highly expressed in skin Tregs but not in LN Tregs is Rora, which encodes for the transcription factor ROR alpha (RORa).

This observation was intriguing as previous studies had elucidated the requirement of RORa in the development of inflammatory type-2 innate lymphoid cells (ILC2s) and it has been considered the antagonizing RORa functioning would curb allergic responses. However, I observed that Tregs require RORa to suppress allergic responses. In particular, RORa regulates the expression of a TNF receptor family member DR3, which binds to the cytokine TL1A. TL1A has a role in enhancing suppressive activity of Tregs while also enhancing type-2 cytokine production from ILC2s. Hence, in the absence of DR3 in Tregs, we believe more TL1A is available to ILC2s resulting in unrestrained allergic responses.  Continue reading

Global Initiative Highlights Inspirational Stories of People Living With Scleroderma

MedicalResearch.com Interview with:

Donald Zoz, MD Senior Associate Director Clinical Development & Medical Affairs IPF/ILD Boehringer Ingelheim Pharmaceuticals, Inc.

Dr. Zoz

Donald Zoz, MD
Senior Associate Director
Clinical Development & Medical Affairs IPF/ILD
Boehringer Ingelheim Pharmaceuticals, Inc.

MedicalResearch.com: What is the background for this platform? Would you briefly explain what is meant by scleroderma? How does it affect a person’s skin and ability to function? Whom does this disease primarily affect? 

Response: “More Than Scleroderma™: The Inside Story” is Boehringer Ingelheim’s new global initiative highlighting real-life, inspirational stories of people living with the rare disease scleroderma. The new effort, created with support from the Scleroderma Foundation in the U.S., aims to raise awareness of the disease, dispel misperceptions and provide important resources to support and guide those on their journey with scleroderma. The initiative’s website http://www.morethanscleroderma.com/us/ features a powerful and inspiring collection of diverse photographs and video profiles of 10 people across the U.S. living with scleroderma and sharing their ‘inside story.’ Each tells their unique and moving experience with scleroderma through diagnosis to learning to live with the disease and manage it.

Scleroderma, also known as systemic sclerosis, is a rare disease characterized by thickening and scarring of the skin, lungs and other organs. Scleroderma affects fewer than 200,000 people in the U.S. and typically affects women in the prime of their lives, between the ages of 25 and 55 taking a marked toll just as they are building their careers and bearing the responsibility of caring for their family. Nearly all people with scleroderma (more than 90%) will develop some skin symptoms including skin thickening, tightened skin around the joints, small red spots on the face and hands and hard lumps on pressure points and joints. Most people with the disease will also develop some degree of lung scarring, or interstitial lung disease (ILD). When the disease’s signature thickening and scarring develops in vital organs, such as the lungs, there are potentially debilitating and life-threatening consequences.  Continue reading

AI Trained Computer Program Can Monitor Health Forums To Detect Adverse Drug Reactions

MedicalResearch.com Interview with:

Kavita Sarin, M.D., Ph.D.

Dr. Sarin

Kavita Sarin, M.D., Ph.D.
Assistant Professor of Dermatology
Stanford University Medical Center

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

Response: Drug reactions occur in the majority of patients undergoing cancer therapies. Half of serious drug reactions are detected after market approval which can result in painful complications and interruption in therapy. Post-market drug surveillance platforms such as FDA monitoring rely on medical publications and physician reporting and take time to identify trends. We sought to determine if we could identify trends in patient discussions in internet health forums to more rapidly identify chemotherapeutic drug reactions. We chose skin reactions as a proof-of-principle because patients can more easily describe what they see on their skin.

Julia Ransohoff, a medical student, and Azadeh Nikfarham, an informatics postdoctoral fellow trained a computer to recognize when a patient undergoing anti-cancer treatment with PD-1 antagonists or EGFR-inhibitors described a drug reaction in their internet forum posts.

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Shingles Can Occur At Chickenpox Vaccination Site in Healthy Children

MedicalResearch.com Interview with:

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.
“Dew-drop on a rose petal pattern” CDC image

Hannah Song, BA
Medical studen
Harvard Medical School and
Jennifer T. Huang, MD
Division of Immunology, Dermatology Program
Boston Children’s Hospital
Boston, MA

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

Response: Infection with the varicella-zoster virus leads to chickenpox, or primary varicella. The virus then lies dormant and can later reactivate as shingles, or herpes zoster.  Varicella-zoster vaccine is made of an attenuated live virus that prevents most people from getting chicken pox, but rarely can reactivate and cause shingles.

There were several pediatric patients who presented to our clinics with shingles/herpes zoster that was localized to one extremity. My hunch was that the extremity where the patients had shingles could be the same limb where they had received vaccination. We called the patient’s pediatricians because pediatricians typically document the extremity where the vaccination is given, and confirmed the theory that shingles in vaccinated children may be more likely to occur at the site of vaccination. Importantly, vaccination may modify the classic appearance of shingles, and you might see pink and red papules and pseudovesicles, rather than classic grouped fluid-filled vesicles on a red base.  Continue reading

Acne Sufferers At Increased Risk of Depression

MedicalResearch.com Interview with:
“Young man with acne” by Sergey Sudeykin (Russian, Smolensk 1882–1946 Nyack) via The Metropolitan Museum of Art is licensed under CC0 1.0Isabelle Vallerand, Ph.D.
Epidemiologist, MD Student
Dept. of Community Health Sciences
Cumming School of Medicine
University of Calgary

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

Response: Over the past few years, there have been numerous reports that an acne drug called isotretinoin (Accutane) has been linked to psychiatric disorders. We recently published a systematic review on this topic and did not find an increased risk of psychiatric disorders among people treated with isotretinoin, so we wondered if acne itself may be contributing to mental illness. While it is well known that acne can have negative effects on mood, we wanted to assess if there was an increased risk of true clinical depression using medical records data.

Therefore, we conducted the current study and found that acne increased the risk of developing clinical depression by 63% in the first year following an acne diagnosis and that this risk remained elevated for 5 years after the initial acne diagnosis.

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