Pediatric Melanoma Risk Increasing in Adolescents & Young Adults, Including in Non-Whites

MedicalResearch.com Interview with:

Susan M. Swetter, MDProfessor of DermatologyDirector, Pigmented Lesion & Melanoma ProgramPhysician Leader, Cancer Care Program in Cutaneous OncologyStanford University Medical Center and Cancer Institute

Dr. Swetter

Susan M. Swetter, MD
Professor of Dermatology
Director, Pigmented Lesion & Melanoma Program
Physician Leader, Cancer Care Program in Cutaneous Oncology
Stanford University Medical Center and Cancer Institute

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

Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma.

Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin.  Continue reading

Contact Allergic Reactions to Implanted Cardiac Devices

MedicalResearch.com Interview with:

Amber Reck Atwater, M.D.Dermatology Residency Program DirectorAssociate Professor of DermatologyDirector, Contact Dermatitis ClinicDuke Dermatology

Dr. Reck Atwater

Amber Reck Atwater, M.D.
Dermatology Residency Program Director
Associate Professor of Dermatology
Director, Contact Dermatitis Clinic
Duke Dermatology 

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

Response: We completed an evaluation of our Duke Dermatology patients who underwent patch testing for possible allergy to their cardiac devices – pacemakers and defibrillators.

From March 1, 2012 to September 15, 2017 we saw 11 patients with suspected allergy to their devices.  Concern for allergy, skin eruption, skin symptoms, and concern for infection were common. 73% of patients had erythema at their implant scars; pruritus and pain were also noted.  Six of our patients had relevant reactions, and the most common allergies were metals, silicone and rubber accelerators.  Continue reading

Psoriasis: No Difference Found in Cardiovascular Risk Between Ustekinumab vs TNF Inhibitor Therapy

MedicalResearch.com Interview with:

Seoyoung C. Kim, MD, ScD, MSCEDirector, Program in Rheumatologic, Immunologic, and Musculoskeletal PharmacoEpidemiology Associate Professor of MedicineDivision of Pharmacoepidemiology & PharmacoeconomicsDivision of Rheumatology, Immunology and Allergy Brigham and Women's Hospital, Harvard Medical School

Dr. Kim

Seoyoung C. Kim, MD, ScD, MSCE
Director, Program in Rheumatologic, Immunologic, and Musculoskeletal PharmacoEpidemiology
Associate Professor of Medicine
Division of Pharmacoepidemiology & Pharmacoeconomics
Division of Rheumatology, Immunology and Allergy
Brigham and Women’s Hospital
Harvard Medical School

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

Response: Given a high cardiovascular (CV) risk among patients with psoriasis and psoriatic arthritis, it is important to have more information with regard to potential effect of different treatment agents on CV risk.

As the number of treatment options for psoriasis and psoriatic arthritis has been rising over the few decades, it is even more crucial to have high-quality evidence on comparative safety of different treatment options so physicians and patients can choose an agent based on the benefit-risk profile of each drug they are considering.

Continue reading

Adult Atopic Dermatitis Linked to Anxiety and Depression, Often Undiagnosed

MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
northwesternu, Chicago, Illinois

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

Response: Atopic Dermatitis is characterized by chronic and often severe and debilitating itch, skin pain, sleep disturbances, skin lesions and multiple comorbid health conditions. The signs, symptoms and comorbidities of atopic dermatitis can lead to significant psychosocial distress and mental health burden

We performed a cross-sectional, population-based study of 2893 US adults. We found that adults with atopic dermatitis had more severe symptoms scores for anxiety and depression (Hospital Anxiety and Depression anxiety). Adults with atopic dermatitis also had higher prevalences of anxiety and depression. Mean symptom scores and prevalences of anxiety and depression were even higher in adults with moderate and severe atopic dermatitis compared to those with mild atopic dermatitis. All respondents with severe PO-SCORAD, POEM and PO-SCORAD-itch scores had elevated anxiety and depression scores.

Many adults with atopic dermatitis that had elevated anxiety and depression scores reported no diagnosis of anxiety or depression. 

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Port Wine Stain Birthmarks in Infants Safely Treated Without Need for General Anesthesia

MedicalResearch.com Interview with:

Roy G. Geronemus, M.D.Director, Laser & Skin Surgery Center of New YorkClinical Professor of DermatologyNew York University Medical CenterNew York, NY 10016

Dr. Geronemus

Roy G. Geronemus, M.D.
Director, Laser & Skin Surgery Center of New York
Clinical Professor of Dermatology
New York University Medical Center
New York, NY 10016

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

Response: We made the observation in clinical practice that port wine stain birthmarks can be safely and effectively treated in early infancy without the need for general anesthesia. This observation is particularly important because of the FDA warnings regarding multiple exposures to general anesthesia under the age of 3 and the potential impact on neurocognitive development as these patients require multiple treatments.
Continue reading

Actinic Keratosis: What is the Best Treatment for Pre-Skin Cancers?

One example of actinic keratoses on hands DermNZ

MedicalResearch.com Interview with:
Maud Jansen, MD | Resident Dermatology | PhD candidate
Dermatologie, Maastricht

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

Response: Actinic keratosis is the most frequent premalignant skin disease in the white population and is caused by exposure to ultraviolet radiation. With a prevalence of 37.5% among whites 50 years of age or older, actinic keratosis is one of the most frequent reasons for patients to visit a dermatologist. If left untreated, actinic keratosis may develop into squamous cell carcinoma.

Current guidelines provide no clear recommendations about which treatment approach is preferred. Currently, the choice of treatment often depends on the preferences of patients and their treating physicians. Evidence from randomized trials with direct comparison between treatments and with long-term follow-up is scarce.

Frequently prescribed and studied field-directed treatment approaches are 5-fluorouracil cream, imiquimod cream, photodynamic therapy (PDT), and ingenol mebutate gel.

We investigated the effectiveness of these four frequently used field-directed treatments (for multiple lesions in a continuous area). Over 600 patients in four different hospitals (Maastricht UMC+, Zuyderland (Heerlen), VieCuri (Venlo and Venray) en Catharina (Eindhoven)participated in the study. Patients were randomly assigned to one of the four treatments.

The main result of our study was that we found that after 12 months of follow-up, 5% fluorouracil cream was the most effective treatment in the treatment of patients with multiple actinic keratosis lesions. Moreover, patient satisfaction and increase in health-related quality of life were highest in the 5-fluorouracil group. Continue reading

Oracea® Capsules + Soolantra Cream Effective for Inflammatory Rosacea

MedicalResearch.com Interview with:

Dr. James Q. Del Rosso, D.O., FAOCD, DermatologistResearch Director and Principal InvestigatorDel Rosso Dermatology Research Center, Las Vegas, NVGalderma Consultant

Dr. Del Rosso

Dr. James Q. Del Rosso, D.O., FAOCD, Dermatologist
Research Director and Principal Investigator
Del Rosso Dermatology Research Center, Las Vegas, NV
Galderma Consultant

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

  • The ANSWER study, a 12-week, randomized, multicenter, Phase 4, Phase 3b in Canada and Europe clinical trial, is the first study of its kind to compare the efficacy and safety of combination therapy with Oracea® (doxycycline, USP) 40 mg Capsules + Soolantra® (ivermectin) Cream, 1% versus Soolantra® (ivermectin) Cream, 1% monotherapy in 273 adults with severe papulopustular rosacea (IGA 4) at clinical trial sites in the United States, Canada and Europe (Czech Republic, Poland, Hungary and Germany).
  • Results showed the combination therapy with Oracea Capsules + Soolantra Cream was well tolerated and effective with a faster onset of action than Soolantra Cream given as monotherapy. Key highlights of the study include:
  • The mean reduction in percentage of inflammatory lesions from baseline to Week 12 was significant with combination therapy compared to monotherapy (80.29% vs. 73.56%, respectively; p=0.032).
  • 5 times as many patients taking combination therapy achieved 100% clearance of inflammatory lesions by Week 12 compared with monotherapy (17.8% vs. 7.2%, respectively; p=0.006).
  • Over 2 times as many patients taking combination therapy achieved 100% clear (IGA 0) by Week 12 compared with monotherapy (11.9% vs. 5.1%, respectively; p=0.043).
  • Combination therapy was generally well tolerated and no discontinuation of treatments due to side effects.

Continue reading

Lipomas: Deoxycholic Acid (Kybella®) Can Shrink Tumors Before Removal

MedicalResearch.com Interview with:

Hooman Khorasani, M.D. Cosmetic Surgeon & Mohs Skin Cancer Surgeon Icahn School of Medicine at Mt. Sinai

Dr. Khorasani

Hooman Khorasani, M.D.
Cosmetic Surgeon & Mohs Skin Cancer Surgeon
Icahn School of Medicine at Mt. Sinai

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

Response: Lipomas are tumors composed of mature fat cells located just beneath the skin surface. They are the most common soft tissue tumor and are estimated to occur in 1% of the population. These benign tumors are more common in overweight individuals, diabetics, patients with elevated serum cholesterol, and those suffering from familial multiple lipomatosis. Most of these tumors are treated for cosmetic reasons; however, large lipomas can also cause significant functional impairment. Traditional treatment includes surgical removal and / or liposuction.

Deoxycholic acid is a member of the bile acid family that assists in the breakdown of fat. We investigated the use of deoxycholic acid injections to reduce the size of large lipomas prior to surgical removal.

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African American Patients with Psoriasis at Even Greater Risk of Atherosclerotic Heart Disease

MedicalResearch.com Interview with:

Francis Alenghat, MD, PhD Assistant Professor of Medicine Section of Cardiology University of Chicago

Dr. Alenghat

Francis Alenghat, MD, PhD
Assistant Professor of Medicine
Section of Cardiology
University of Chicago

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

Response: Psoriasis has been associated with higher rates of atherosclerotic cardiovascular disease (ASCVD), potentially due to higher-than-normal levels of systemic inflammation. Whether this association varies by race was unknown. Also, it was unclear whether patients with psoriasis have more frequent ASCVD because of higher rates of traditional cardiovascular risk factors (smoking, diabetes, hypertension, hyperlipidemia) or because of components intrinsic to psoriasis itself.

We found that, amongst a large population of patients with psoriasis, patients of both sexes and most ages had elevated ASCVD rates compared to those without psoriasis. Overall, African American patients with psoriasis had a 15% ASCVD prevalence, whereas it was 10% in white patients with psoriasis. Increased ASCVD associated with psoriasis occurred at earlier ages in African American patients compared to white patients.

Traditional cardiovascular risk factors were common in patients with psoriasis and appeared to play a large role in the driving the higher rates of ASCVD in these patients, but even in patients with psoriasis but without any documented traditional risk factors, ASCVD rates were elevated compared to patients without psoriasis.  Continue reading

Superficial Radiation Therapy For Non-Melanoma Skin Cancers in the Elderly

MedicalResearch.com Interview with:

William I. Roth MD Dermatology and Dermatological Surgery Boynton Beach, FL

Dr. Roth

William I. Roth MD
Dermatology and Dermatological Surgery
Boynton Beach, FL

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

  • This retrospective study reviewed medical records of patients with biopsy-proven, primary cutaneous basal and squamous cell carcinoma (BCC and SCC) lesions on the lower extremities. These patients were treated with the Sensus Healthcare’s Superficial Radiation Therapy SRT-100 Unit between 2011 and 2014. The SRT-100 is most amenable for treating non-melanoma skin cancer (NMSC) in patients aged 65 and older although many younger patients are treated as well when a non-scarring method is desired.
  • The types of skin cancers treated included superficial, well differentiated and moderately differentiated squamous cell carcinomas, squamous cell carcinoma in situ and basal cell carcinomas including infiltrative basal cell carcinomas. Higher energy linear accelerator radiation units have been reported to have a high incidence of healing problems. With the SRT-100 the radiation is concentrated primarily in the higher layers of the skin where the skin cancer is located and thus the treatments are well tolerated.

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Mutations Linked to Scarring Hair Loss in African American Women Identified

MedicalResearch.com Interview with:

Cicatricial Alopecia Courtesy of Dr. Amy McMichael MD The Department of Dermatology Wake Forest Baptist Medical Center Winston-Salem, North Carolina 

Cicatricial Alopecia
Courtesy of Dr. Amy McMichael MD
The Department of Dermatology
Wake Forest Baptist Medical Center
Winston-SalemNorth Carolina

Eli Sprecher MD PhD
Professor and Chair, Division of Dermatology
Deputy Director General for R&D and Innovation
Tel Aviv Sourasky Medical Center
Frederick Reiss Chair of Dermatology
Sackler Faculty of Medicine
Tel Aviv University, Tel Aviv, Israel and

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

Response: Central centrifugal cicatricial alopecia (CCCA) is a form of hair loss (alopecia) which is extremely common and affects one in every 20 women of African origin. It starts usually during the fourth decade of life. Because it can be inherited from mothers to their children, it is thought to have a genetic basis. On the other hand, it is known to mainly affect women who use to groom their hair intensively. Thus it was thought that the disease stems from some form of inherited susceptibility to the damage incurred to the hair follicle by grooming habits.

In the study we published, we searched for the genetic basis of CCCA.

In contrast with the common form of alopecia (androgenetic alopecia or female pattern alopecia), CCCA is associated with scarring of the scalp skin, which means that once hair is lost, it will likely not re-grow.

Continue reading

Lilly Announces Phase 3 Results for Atopic Dermatitis Treatment

MedicalResearch.com Interview with:

Lotus Mallbris, MD PhD Vice President, Head of Global Immunology Drug Development Platform Team Leader at Lilly

Dr. Mallbris

Lotus Mallbris, MD PhD
Dermatologist and Vice President, Head of Global Immunology Drug Development
Platform Team Leader at Lilly

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by atopic dermatitis? How common is this condition? 

Response:The BREEZE-AD1 and BREEZE-AD2 clinical trials are multicenter, randomized, double-blind, placebo-controlled, Phase 3 studies to evaluate the efficacy and safety of baricitinib monotherapy in adult patients with moderate to severe atopic dermatitis. These are two of five studies that will be part of the placebo-controlled data program intended to support global registrations.

Atopic dermatitis, a serious form of eczema, is a chronic, relapsing skin disease characterized by intense itching, dry skin and inflammation that can be present on any part of the body. It affects approximately 1-3 percent of adults worldwide.

Continue reading

Melanoma Rates Stable in Australia but Rising in US

MedicalResearch.com Interview with:

Melanoma CDC/ Carl Washington, M.D., Emory Univ. School of Medicine; Mona Saraiya, MD, MPH

Example of one type of melanoma

Dr. Catherine M. Olsen
Associate Professor
Cancer Control Group
QIMR Berghofer Medical Research Institute

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

Response: Melanoma incidence and mortality rates are increasing globally. Public health campaigns aiming to reduce sun exposure and use of sunbed have been implemented in many parts of the world, but there is significant variability in terms of the history and reach of these campaigns across countries. We examined melanoma incidence rates in eight different countries with different patterns of sun exposure and varying approaches to melanoma control.

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Skin Care Products Make Cotton Fabrics More Flammable

MedicalResearch.com Interview with:

Dr Sarah Hall PhD Senior Lecturer in Forensic Science Anglia Ruskin University

Dr. Hall

Dr Sarah Hall PhD
Senior Lecturer in Forensic Science
Anglia Ruskin University

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

Response: We initially started the study in collaboration with Essex Fire and Rescue Services, as we were already doing some research on the recovery of evidence from fire scenes. During a visit to their cold fire scene facility, they described a tragic fatality with extensive fire damage, which didn’t link with the main fuel in the room. Therefore they questioned if a skin cream, regularly used by the victim, could have contributed as a fuel or ignited to initiate the fire and asked if we would do some initial research. Now we are also working with West Yorkshire and Cambridgeshire Fire and Rescue Service, the London Fire Brigade, St Andrews Centre for Plastic Surgery and Burns and the National Fire Chiefs Council.

We initially started the study in collaboration with Essex Fire and Rescue Services, as we were already doing some research on the recovery of evidence from fire scenes. During a visit to their cold fire scene facility, they described a tragic fatality with extensive fire damage, which didn’t link with the main fuel in the room. Therefore they questioned if a skin cream, regularly used by the victim, could have contributed as a fuel or ignited to initiate the fire and asked if we would do some initial research. Now we are also working with West Yorkshire and Cambridgeshire Fire and Rescue Service, the London Fire Brigade, St Andrews Centre for Plastic Surgery and Burns and the National Fire Chiefs Council.

Continue reading

Safety of MRIs in Patients with Tattoos

MedicalResearch.com Interview with:

Dr. Martina Callaghan PhD Head of Physics & Senior Lecturer Wellcome Centre for Human Neuroimaging Institute of Neurology University College London London  

Dr. Callaghan

Dr. Martina Callaghan PhD
Head of Physics & Senior Lecturer
Wellcome Centre for Human Neuroimaging
Institute of Neurology
University College London
London

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

Response: As mirrors the situation in the general population, we found that an increasing number of volunteers who were seeking to enter cognitive neuroscience studies at our Centre had tattoos. However, the magnetic fields used in magnetic resonance imaging (MRI) pose a potential safety risk for people with tattoos. A number of case reports have described such incidents.  However, as these describe isolated cases retrospectively, there was not enough information to objectively assess the risk of tattoo-related adverse reactions for persons having an MRI scan.  Therefore, in 2011, we decided to embark upon this first prospective study to quantitatively assess this risk.

Continue reading

Prions from Brain Detectable in Skin Earlier Than Brain Damage

MedicalResearch.com Interview with:

Wenquan Zou, MD, PhD Associate Professor Departments of Pathology and Neurology Director of CJD Skin Project Associate Director National Prion Disease Pathology Surveillance Center Institute of Pathology Case Western Reserve University School of Medicine Cleveland, Ohio 44106

Dr. Wen Quan Zou

Wenquan Zou, MD, PhD
Associate Professor
Departments of Pathology and Neurology
Director of CJD Skin Project
Associate Director
National Prion Disease Pathology Surveillance Center
Institute of Pathology
Case Western Reserve University School of Medicine
Cleveland, Ohio 44106

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

Would you briefly explain the significance of prion-induced diseases and why they have been difficult to diagnosis?

Response: Our previous study has demonstrated that infectious prions are detectable in the skin samples of patients with sporadic Creutzfeldt-Jakob disease (sCJD), the most common form of human prion disease, at the terminal stage by the highly sensitive real-time quaking-induced conversion (RT-QuIC) assay and animal-based bioassay.

The prion-induced diseases are significant because they are infectious diseases that can be transmitted inter-species and intra-species. For instance, mad cow disease, a prion disease in cattle, has been documented to transmit to humans. Currently, there are no cures for these fatal diseases.

The definite diagnosis of prion diseases is difficult because it mainly depends on the availability of brain tissues obtained either by biopsy or autopsy for detection of prions. Brain biopsy is highly invasive and it is difficult to be accepted by patients and their families. Even for brain autopsy, it is not always feasible because of religious and cultural limitations in some regions or countries.  Continue reading

Could Keloids Suggest Increased Risk of Breast Cancer?

MedicalResearch.com Interview with:

Lamont R. Jones, MD, MBA Vice Chair Department of Otolaryngology HNS Henry Ford Hospital Facial Plastic and Reconstructive Surgery Director Cleft and Craniofacial Clinic Otolaryngology Service Chief Henry Ford West Bloomfield Hospital

Dr. Jones

Lamont R. Jones, MD, MBA
Vice Chair
Department of Otolaryngology HNS
Henry Ford Hospital
Facial Plastic and Reconstructive Surgery
Director Cleft and Craniofacial Clinic
Otolaryngology Service Chief
Henry Ford West Bloomfield Hospital

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

Response: The objective of this study was to explore the potential link between keloid development and clinical outcomes of African American women with breast cancer.

MedicalResearch.com: Would you briefly explain what is meant by a keloid?

Response: A keloid is a benign fibrorproliferative tumor of the skin which is more common in African Americans which results from injury such as surgery, ear piercing, burns or infection.

MedicalResearch.com: What are the main findings?

Response: Keloid status of an individual may be indicative of a risk to be diagnosed with early-onset, late staged breast cancer. In addition, it was a distinguishing factor among African American women, which may point to a pathological/molecular pathway that predicates their unique cancer risk.

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

Response: The research results are preliminary. However, because keloids disproportionately affect African American patients, it may serve as a model to better understand how their tissue microenvironment. Moreover, insights into keloid formation may help to identify ancestry specific biomarkers that may be used as future therapeutic targets to treat cancers in African Americans.

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

Response: Larger prospective or case control studies may provide more information and better determine the potential correlation of keloid status and breast cancer outcomes. 

Citation:

https://www.henryford.com/news/2019/01/keloids-linked-to-early-onset-and-late-stage-breast-cancer

Jan 30, 2019 @ 2:18 pm

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Increase Risk of Blistering Disorder with Diabetes Medication

MedicalResearch.com Interview with:

Example of Bullous Pemphigoid Derm NZ image

Example of Bullous Pemphigoid
Derm NZ image

Dong Hyun Kim M.D.
Associate professor
Department of Dermatology
CHA Bundang Medical Center
CHA University School of Medicine

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

Response: As a dermatologist, we see many patients with newly diagnosed with bullous pemphigoid (BP), many of whom have diabetes.

The use of DPP-4 inhibitors is a common treatment for diabetes, we have noted previous case reports that DPP-4 inhibitors may be the cause of BP. For this reason, we started this study.

The most important thing in my article is DPP-4 inhibitors, particularly vildagliptin, may be associated with the development of bullous pemphigoid in male patients with diabetes. We have confirmed these points based on the nationwide, population-based study. It is very meaningful because there have been few studies using large sample sizes so far.

Continue reading

Why Are There So Few Minority Dermatologists?

MedicalResearch.com Interview with:
Yssra-SolimanYssra S. Soliman, BA
Division of Dermatology, Department of Internal Medicine
Albert Einstein College of Medicine
Bronx, New York

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

Response: As the population of the United States becomes increasingly diverse, certain fields within medicine have not followed this trend. Dermatology is the least diverse field after orthopedics. We wanted to understand what barriers prevent medical students from applying to dermatology and whether these barriers differed based on students’ racial, ethnic or socioeconomic backgrounds.

The main findings of this study are that certain groups are more likely to cite specific barriers than non-minority students. These barriers are significant deterrents to applying to dermatology and include the lack of diversity in dermatology, negative perceptions of minority students by residency programs, socioeconomic barriers such as lack of loan forgiveness and poor accessibility to mentors.  Continue reading

Scabies: For Community Control, Exam of Just Arms and Legs May Be Sufficient

MedicalResearch.com Interview with:
Michael Marks MRCP DTM&H PhD
Clinical Research Department, Faculty of Infectious & Tropical Diseases
London School of Hygiene and Tropical Medicine
Hospital for Tropical Diseases
London, United Kingdom
Twitter @dr_michaelmarks
Daniel Engelman MBBS; BMedSci; MPHTM; FRACP; PhD
Centre for International Child Health, University of Melbourne,
Tropical Diseases Research Group
Murdoch Children’s Research Institute
Melbourne, Australia
Twitter @Dan_Engelman

The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies.

The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies.CDC image

 

 

 

 

 

 

 

 

 

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

MM: Scabies is extremely common. Globally in the region of 100-200 million people are believed to be affected by scabies annually.

Recently the WHO has recognised Scabies as a ‘Neglected Tropical Disease’ in response to this burden of disease. There has been increasing interest in using Mass Drug Administration (treating whole communities) as a strategy to control scabies in communities. In order to make this practical countries need an easy mechanism for establishing if scabies is a significant problem in their communities. In general when treating an individual, clinicians would conduct a full body examination to diagnose scabies – however this may not be practical or necessary when making decisions about whether to treat whole communities.

DE: Despite the fact that Scabies is a very common condition that causes a great deal of health problems, it has been largely neglected by health, research and funding agencies – but pleasingly, the WHO has now started to take action on scabies control, starting with the recognition of scabies as a “Neglected Tropical Disease”

Continue reading

Dapsone Found Effective As Second Line Treatment for Hives

MedicalResearch.com Interview with:

Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York

Dr. Nicholas Soter

Nicholas A. Soter, MD
The Ronald O. Perelman Department of Dermatology
New York University School of Medicine
New York, New York

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

Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines.

However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails.  Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent.

Continue reading

Dermatologist Discusses Personalized Approach to Skin Cancer Treatment

MedicalResearch.com Interview with:

Dr. Kristine A. Romine MD CEO and Founder of Camelback Dermatology & Skin Surgery Phoenix, AZ

Dr. Romine

Dr. Kristine A. Romine MD
CEO and Founder of Camelback Dermatology & Skin Surgery
Phoenix, AZ

MedicalResearch.com: Would you give a brief overview of the different types of skin cancer?

Response: There are multiple types of skin cancer, including: melanoma, basal cell carcinoma, squamous cell carcinoma, and actinic keratosis. Known as the deadliest form of skin cancer, melanoma develops when irreparable DNA damage results in malignant transformation of melanocytes. This type of skin cancer is most commonly caused by intense UV exposure from the sun or tanning beds, which activate mutations that lead skin cells to rapidly multiply and form malignant tumors. Melanoma can range in color from dark brown to black and are rarely red or even skin colored. They are usually irregular and asymmetrical. In 2018, there were an estimated 91,270 new cases of melanoma (American Cancer Society, 2018).

Basal cell carcinoma (BCC) is the most common type of skin cancer and cancer diagnosed. BCCs arise in the skins’ outermost layers. BCCs resemble open sores, red or pink plaques, pearly nodules with telangiectasia, or scars. It is estimated that 4.3 million BCCs are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018).

Squamous cell carcinoma (SCC), the second most common type of skin cancer, arises from the squamous cells in the skin that have been exposed to UV over long periods of time. SCCs appear as scaly red or pink macules, papules, or plaques. They can be crusted and appear eroded and can commonly arise within a solar keratosis. More than 1 million cases of SCC are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018).

Lastly, actinic keratoses (AKs) are the most common pre-cancerous skin growth that can develop into a SCC if left untreated. Similar to all other types, AKs are caused by exposure to UV light and, in rare cases, high exposures to x-rays. AKs can appear on sun-exposed areas, including the face, scalp, ears, shoulders, and legs. They resemble pink, scaly rough patches on the skin.

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Visual Inspection Alone Can Miss Some Skin Cancers

MedicalResearch.comInterview with:

polarized-light-dermatoscope-wikipedia-image

Jac Dinnes PhD, MSc, MA, PGDip
Senior Researcher
Test Evaluation Research Group
Institute of Applied Health Research
University of Birmingham

MedicalResearch.com:  What is thebackground for this study? Would you briefly explain the benefits of dermoscopy?

Response: This systematic review was one of a series of Cochrane Reviews of studies evaluating different tests for diagnosing skin cancer. Within creasing rates of skin cancer and an increasing number of more specialised tests becoming available in both primary care and in specialist settings, a thorough review of all available evidence was timely.

The diagnosis of melanoma and other skin cancers fundamentally relies on clinical examination, including history taking, and visual inspection of the concerning skin lesion (mole or patch of skin) and surrounding skin (and other lesions). A dermatoscope is a handheld device using visible light (such as from incandescent or LED bulbs), that allows more detailed examination of the skin compared to examination by the naked eye alone.

Knowing the diagnostic accuracy of dermoscopy added to visual inspection alone, across a range of observers and settings, is critical to understanding its contribution for the diagnosis of melanoma and to future understanding of the potential role of the growing number of other high-resolution image analysis techniques.

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Using of Big Data to Estimate Prevalence of Defective DNA Repair Variants in the US

MedicalResearch.com Interview with:

Kenneth H. Kraemer,M.D.
Chief DNA Repair Section
Laboratory of Cancer Biology and Genetics, Center for Cancer Research
National Cancer Institute

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

Response: At the National Cancer Institute, we have been examining patients with xeroderma pigmentosum (XP), a rare, recessively inherited, cancer-prone disease for many years. Therefore, with the increasing use of exome sequencing, we decided to see how closely”big data” corresponded with our clinical observations.  

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Machine Learning Program Superior to Humans in Non-Pigmented Skin Lesions

MedicalResearch.com Interview with:
Philipp Tschandl, MD PhD, Priv.Doz. Department of Dermatology Medical University of ViennaPhilipp Tschandl, MD PhD, Priv.Doz.
Assistant Professor
Department of Dermatology
Medical University of Vienna

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

Response: Dermatoscopy is a non-invasive imaging technique, where the surface of the skin is rendered translucent and additional important morphologic features become visible from deeper layers. This is achieved through use of immersion fluid or cross-polarised light – equivalent to the effect when using a pair of goggles to look underwater, or polarised sunglasses to reduce glare on glass surfaces. After the first description of “Dermatoskopie” almost 100 years ago by a German dermatologist (Johann Saphier), this technique has evolved to a successful, low-cost, state-of-the-art technique for clinical skin cancer detection in the last decades.

Convolutional neural networks (“CNN”) are powerful machine learning methods, and frequently applied to medical image data in the recent scientific literature. They are highly accurate for basic image classification tasks in experimental settings, and found to be as good as dermatologists in melanoma recognition on clinical or dermatoscopic images. In this study we trained a CNN to diagnose non-pigmented skin lesions (where melanomas are only a minority) through analysis of digital images, and compared the accuracy to >90 human readers including 62 board-certified dermatologists. This study expands knowledge in the following ways compared to previous work:

– We applied the network for the detection of non-pigmented skin cancer, which is far more common in the (caucasian) population than melanoma.

– We created a prediction model that combines analysis of a dermatoscopic and clinical image (“cCNN”) which is able to further increase diagnostic accuracy.

– We compared accuracy not only to experts, but users with different level of experience Continue reading