dermatology Tag
22 Mar Apremilast -Otezla -May Be Cost Effective For Psoriasis Treatment
MedicalResearch.com Interview with: Steven R. Feldman, M.D., Ph.D. Professor of Dermatology Wake Forest Baptist Medical Center Winston-Salem, NC Medical Research: What is the background for this study? What are the main findings? Response: Results show that introducing apremilast into the treatment pathway prior to biologics is cost-saving and confers a cost and quality of life benefit. Over 10 years, apremilast was estimated to provide an additional 0.74 years (5.00 vs. 4.26 years) in which patients achieved a 75% reduction from baseline in PASI score, compared to a pathway of biologics only. It was also found to be less costly, mainly due to less time spent on more expensive biologic therapy (costs reduced by $9,072.39 over 10 years).08 Mar Gene Signature May Predict Risk of Metastases and Death From Melanoma
MedicalResearch.com Interview with:
Pedram Gerami MD
Associate Professor of Dermatology and Pathology
Northwestern University
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Gerami: The outcomes for patients with cutaneous melanoma are highly variable and there are limitations to the conventional staging system for melanoma. For example while the status of the sentinel lymph node biopsy is considered the strongest prognosticator, approximately 2/3 of cutaneous melanoma patients that ultimately die from their melanoma will have a negative sentinel lymph node biopsy result. In this study we showed that using a technique known as mRNA expression profiling to determine which genes are highly active and which are not that a molecular prognostic assay with accuracy could be developed. This assay can accurately classify patients based on their gene signature as having a high or low risk for metastasis and death from their melanoma. In an independent validation cohort, patients with a class I or low risk signature had a 5 year disease free survival rate of 97% while those with a class II or high risk signature had a 5 year disease free survival rate of only 31%.
23 Feb Wound Healing: Better Understanding of How Skin Cells Close Gaps
MedicalResearch.com Interview with:
Chwee Teck (C.T.) LIM PhD
Provost’s Chair Professor, Deputy Head, Department of Biomedical Engineering & Department of Mechanical Engineering
Principal Investigator, Mechanobiology Institute
Faculty Fellow, Singapore-MIT Alliance for Research & Technology (SMART) National University of Singapore
Medical Research: What is the background for this study? What are the main findings?
Professor Chwee Teck Lim: Epithelial cells have a natural tendency to close gaps and this feature plays a crucial role in many biological processes such as embryological development and wound healing. For example, skin does consist of epithelial cells that when wounded, will elicit closure to initiate healing. How epithelial cells close such gaps has always fascinated researchers from across many disciplines. It is generally accepted that two major mechanisms exist that underlie such a closure. The first is a "cell-crawling" mechanism wherein cells at the edge of the gap actively send protrusions or lamellipodia and use them as footholds to migrate over the gap. However, such a migration requires that the gap is conducive for cells to attach and form adhesions or footholds. The second mechanism is based on a coordinated contraction of multiple bundles of cellular cytoskeletal components (bundles of actin) in a manner similar to that of a "purse-string".
Despite many studies, it has always been difficult to understand and characterize these processes separately since most often they co-exist. In this study, we show that keratinocyte monolayers have a tendency to close circular non-adhesive gaps (gaps that have been coated with a polymer that does not allow cells to adhere or form foot-holds) through contraction of bundles of actin within cells at the edge of the gap. We find that such as closure is strongly affected by the size of the gap (gaps more than 150 um in diameter have a tendency to close only partially), curvature of the gap (gaps with high curvature show better closure), and strength of intercellular adhesion (poor intercellular adhesion completely inhibits closure of non-adhesive gaps).
17 Feb How Much Does Specialized Melanoma Screening Cost?
MedicalResearch.com Interview with: Caroline Watts| PhD Candidate Cancer Epidemiology and Services Research | Sydney School of Public Health The University of Sydney MedicalResearch: What is the background for this study? What are the main findings? Response: A clinic for people at high risk of melanoma was established at the Royal Prince Alfred Hospital, Sydney in 2006 to look at the impact of surveillance regime which included regular full body skin examination supported by dermoscopy and total body photography at 6 monthly intervals. If a suspicious lesion was identified, the lesion was either removed or sequential digital dermoscopy was performed and the patient returned in 3 months for review. This study aimed to estimate the costs associated with surveillance in this type of specilaised clinic. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]) and mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710). Diagnosis of melanoma or non-melanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for skewed health system costs.15 Feb Hand Dermatitis Increases In Health Care Workers Due To Hand Washing Measures
MedicalResearch.com Interview with: Dr Jill Stocks PhD, Research Fellow Centre for Occupational and Environmental Health, Centre for Epidemiology; NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care Institute of Population Health, University of Manchester, UK. Medical Research: What is the background for this study? What are the main findings? Dr. Stocks: Reducing healthcare-associated infections has been a priority in the UK over recent decades; and this has been reflected in interventions and guidelines focussing on improving hygiene procedures. During 2004 to 2008 the Cleanyourhands campaign promoted hand hygiene in all NHS trusts. There was anecdotal evidence from dermatologists and occupational physicians that irritant contact dermatitis was on the increase in healthcare workers, and that it was caused by hand hygiene. We investigated whether or not there was an increase in the incidence of irritant contact dermatitis in healthcare workers due to hand hygiene or other types of hygiene coinciding with the interventions and guidelines promoting hygiene. We used reports made by dermatologists to the Occupational and Health reporting network, a voluntary surveillance scheme collecting reports of work-related ill-health. Trends in incidence of irritant contact dermatitis due to hygiene in healthcare workers were compared with trends in control groups (irritant contact dermatitis in workers with other jobs) using a quasi-experimental (interrupted time series) design. We found a 4.5 fold increase in irritant contact dermatitis due to hand hygiene and hygiene in general in healthcare workers between 1996 and 2012. The results also suggested a steepening of the increase in incidence during the rollout period of the Cleanyourhands campaign but the limitations of the data made this less clear cut.11 Feb Study Examines Malpractice Risk Of Mohs Surgery For Skin Cancer
MedicalResearch.com Interview with:
Omar A. Ibrahimi, M.D., Ph.D
Connecticut Skin Institute
Founding Medical Director
Stamford, CT 06905
www.ctskindoc.com
Medical Research: What is the background for this study? What are the main findings?
Dr. Ibrahimi: The delivery of healthcare in a efficient and cost effective fashion is one of the largest themes in medicine today. Malpractice lawsuits have steadily increased with the cost of healthcare delivery. Mohs surgery involves the surgical removal, the tissue analysis and the reconstruction of a skin cancer all in a single visit that bundles multiple procedures in a cost effective manner that is proposed to be the gold standard for treating certain skin cancers.
Information regarding malpractice involving Mohs surgery is lacking. The only previous study that has been done was a survey of Mohs surgeons looking at how many had been involved in lawsuits and the reasons for being involved. Our study examined a legal database to identify all the lawsuits involving Mohs surgery and skin cancer. We were surprised to find that the majority of lawsuits involved non-Mohs surgeons as the primary defendant, mostly due to a delay of or failure in diagnosis, cosmetic outcome issues, lack of informed consent, and a delay of or failure in referral to a Mohs surgeon.
29 Jan Lab Turns Stem Cells Into Hair Bulbs That Grow Hair
MedicalResearch.com Interview with:
Alexey Terskikh, Ph.D. Associate Professor
Department of Developmental and Stem Cell Biology
Sanford-Burnham Medical Research Institute
La Jolla, CA
Medical Research: What is the background for this study? What are the main findings?
Dr. Terskikh: Hair loss is a wide spread human condition with an unmet need for hair replacement. In the United States alone, over 40 million men and 21 million women are affected by hair loss. I have been interested in the differentiation of human pluripotent stem cells into various cell including neural crest cells. In-vivo neural crest cells give rise to a multitude of cell types, including dermal papilla cells, which populate the bulb of hair follicles and regulate hair growth. We have established new method to differentiate human pluripotent stem cells into dermal papilla-like (DP-like) cells, with a goal of inducing hair growth. To find out whether DP-like cells induce hair growth we transplanted these cells under the skin of mice (which have a small amounts of white hair) along with the skin cells from dark-haired mice. We observed the growth of new black hairs suggesting the induction of hair growth by transplanted human DP-like cells.
18 Jan Eczema and Atopic Dermatitis Linked To Increased Cardiovascular Risk
MedicalResearch.com Interview with:
Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois
Medical Research: What is the background for this study? What are the main findings?
Dr. Silverberg: There is a growing body of literature supporting an association between psoriasis and increased cardiovascular risk. We hypothesized that these associations are not specific to psoriasis. Rather, they likely occur in other chronic inflammatory skin disorders, namely eczema. We studied two large-scale US population-based studies and found that adults with eczema were more likely to smoke cigarettes, drink alcohol and were less physically active. In turn, they also have higher rates of obesity, high blood pressure, prediabetes and type 2 diabetes and high cholesterol. Of note, eczema was associated with these disorders even after controlling for smoking, alcohol consumption and physical activity. This suggests that chronic inflammation and/or other factors related to eczema may also drive increased cardiovascular risk.
01 Dec Rash and Blisters May Accompany Ebola Infection
MedicalResearch.com Interview with:
Victoria Vaughan
Medical College of Georgia, Augusta, Georgia
Medical Research: What is the background for this study? What are the main findings?
Response: The Global Mortality of Skin Disease study compares age adjusted mortality of disease with skin manifestations between developing and developed countries for the years 1990 and 2010. The main findings were that mortality from infectious conditions was greater in the developing world while melanoma contributed to mortality in the developed world. Ebola Virus Disease has cutaneous manifestations and affects the developing world preferentially. As of November 27, 2014, the mortality in West Africa totals 5444 according to the CDC. However, the United States has had only two deaths from Ebola Virus Disease.
28 Nov Healthy Skin Guards Against Infection By Constant Immune Surveillance
MedicalResearch.com Interview with:
Univ.-Prof. Dr. med. Tilo Biedermann
Klinikdirektor
Klinik und Poliklinik für Dermatologie und Allergologie
der Technischen Universität München
Biedersteinerstr. München
Medical Research: What is the background for this study? What are the main findings?
Prof. Biedermann: The skin is constantly exposed to microbes and skin developed during evolution under the constant influence of microbes. Tightly regulated communication between microbes and the skin can be expected and levels of regulation still needed to be explored. We found that Gram-positive bacteria when sensed by one certain innate immune receptor (hetero dimer TLR 2-6 suppresses immunity both in animal models and in humans. Following the sensing of lipoproteins by toll like receptor 2-6) skin produces high levels of InterleukinL6 that induce the accumulation of so called myeloid-derived suppressor cells. These cells can be found in the blood but also migrate to the skin suppressing T-cell-immunity allowing infections to spread on the skin.
21 Oct Even Thin Melanomas Can Be Fatal
MedicalResearch.com Interview with:
Prof. David Whiteman
Group leader, Cancer Control Group
QIMR Berghofer
Herston, Queensland
Medical Research: What are the main findings of the study?
Dr. Whiteman: Mortality from melanoma has continued to rise in Queensland, Australia, the jurisdiction with the world’s highest incidence of this disease. We analysed more than 4000 deaths from melanoma over the last 2 decades, and calculated mortality rates according the thickness of the primary lesion.
10 Oct Chronic Contact Dermatitis May Promote Skin Cancer Development
MedicalResearch.com Interview with:
Shawn Demehri, M.D., Ph.D.
Instructor of Medicine
Division of Dermatology
Washington University in St. Louis and
Wayne M. Yokoyama, M.D.
Howard Hughes Medical Institute
Rheumatology Division
Washington University Medical Center
St. Louis, MO 63110-1093
MedicalResearch: What are the main findings of the study?
Research: This bedside to bench research has clearly demonstrated a cause and effect relationship between chronic allergic contact dermatitis and skin cancer development. This research originated from a clinical case of invasive skin cancer that developed in the context of chronic allergic contact dermatitis to a nickel-containing metal implant. Using animal models, we have demonstrated that chronic exposure to a contact allergen creates an inflammation that drive skin cancer development.
19 Sep Hidradenitis Suppurativa Linked To Increased Risk of Metabolic Syndrome
MedicalResearch.com Interview : Iben Marie Miller, MD Department of Dermatology Roskilde Hospital, Roskilde Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Medical Research: What are the main findings of the study? Dr. Miller: Using a cross-sectional design based on data from a Hidradenitis Suppurativa (HS) group recruited from the hospital (32 individuals), an HS group recruited from the general population (326 individuals) and 14,851 individuals without Hidradenitis Suppurativa, we investigated a possible association of Hidradenitis Suppurativa and the metabolic syndrome. We found that the HS groups had 2 to 4 times odds of having the metabolic syndrome when compared to individuals without HS leaving Hidradenitis Suppurativa patients at a high cardiovascular risk. Furthermore, we found that the odds were higher for the HS group from the hospital in comparison to the Hidradenitis Suppurativa group from the general population.11 Sep Study Examines Risk of Alopecia Areata and Vitiligo in Stem Cell Recipients
MedicalResearch.com Interview with: Rena Zuo, BA MD Candidate at Duke University School of Medicine and Edward W. Cowen, MD, MHSc Senior Clinician Head, Dermatology Consultation Service Dermatology Branch Center for Cancer Research National Cancer Institute National Institutes of Health MedicalResearch: What are the main findings of the study? Answer: Chronic graft-vs-host disease (cGVHD) is a debilitating multisystem disease that occurs in patients receiving allogeneic hematopoietic stem cell transplantations as treatment for hematologic disorders. Although the diverse clinical presentations of cGVHD frequently mimic other autoimmune diseases such as Sjögren syndrome and systemic sclerosis, and low-titer antibodies are commonly found in patients with cGVHD, the exact pathogenesis and role of autoimmunity in cGVHD are incompletely understood. Our study is the first to characterize and identify risk factors associated with the development of two uncommon autoimmune phenomena, specifically alopecia areata and vitiligo, in the setting of cGVHD. Laboratory markers, including 11 antibodies, transplant-related factors, and other cGVHD systemic manifestations were analyzed. Several particularly interesting results were found:- Among 282 patients with cGVHD, 15 demonstrated vitiligo (14 of 282; 4.9%) and/or alopecia areata (2 of 282; 0.7%).
- Female donor and female donor to male recipient sex mismatch, in particular, are significantly associated with the development of vitiligo and/or alopecia areata.
- Positive anti-cardiolipin (ACA) IgG was also significantly associated with development of vitiligo and/or alopecia areata.
11 Sep Isotretinoin Associated With Lower Risk of Inflammatory Bowel Disease
MedicalResearch.com Interview with:
Shadi Rashtak, MD
Department of Dermatology
Mayo Clinic College of Medicine
Rochester, Minnesota
Medical Research: What are the main findings of the study?
Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD.
01 Aug Do Dermatologists Find Thinner Melanomas?
MedicalResearch.com Interview with: Estee L. Williams, MD SUNY Downstate Medical Center, Brooklyn, New York Madfes Integrated Dermatology, New York, New York williams.estee@gmail.com Medical Research: What are the main findings of the study? Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.13 Feb Teledermatololgy As Triage Tool For Dermatology Hospital Consultation
MedicalResearch.com Interview with:
Dr. Misha A. Rosenbach
Assistant Professor of Dermatology Hospital of the University of Pennsylvania Section Editor,
JAMA Dermatology Patient Page
MedicalResearch.com: What are the main findings of the study? Dr. Rosenbach: There is strong agreement between teledermatologists and in-person dermatologists when evaluating inpatients at a tertiary care academic hospital. The primary aim of this study was to assess telederm as a triage tool. Many dermatologists are not full-time hospitalists, but work in private practice or clinics which may be remote from affiliated hospitals. The goal was to evaluate whether teledermatology could help those providers assess the acuity of inpatient consults. There was strong concordance.