Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 19.07.2018

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.  (more…)
Author Interviews, Dermatology, Environmental Risks, Exercise - Fitness, JAMA / 18.07.2018

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.  (more…)
Author Interviews, Dermatology, Environmental Risks / 10.07.2018

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. 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.  (more…)
Author Interviews, Dermatology, JAMA, Nutrition, UCLA / 27.06.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Melanoma / 26.06.2018

MedicalResearch.com Interview with: 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). (more…)
Author Interviews, Dermatology, Johns Hopkins / 15.06.2018

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Dermatology, Technology / 13.06.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Environmental Risks, Melanoma, Transplantation / 08.06.2018

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. (more…)
Author Interviews, Dermatology, Technology / 30.05.2018

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 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. (more…)
Author Interviews, Dermatology, JAMA / 30.05.2018

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Dermatology, Education, JAMA, Melanoma / 17.05.2018

MedicalResearch.com Interview with: Michael S. Kolodney, MD, 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. (more…)
Author Interviews, Dermatology, UT Southwestern / 06.05.2018

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.  (more…)
Author Interviews, Cancer Research, Dermatology, JAMA, Melanoma, Primary Care, University of Pittsburgh / 18.04.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Dermatology / 21.03.2018

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. 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. 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.  (more…)
Author Interviews, CDC, Dermatology, Environmental Risks, JAMA / 15.03.2018

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. (more…)
Allergies, Author Interviews, Dermatology, Inflammation, Pediatrics / 07.03.2018

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.  (more…)
Author Interviews, Boehringer Ingelheim, Dermatology, Pulmonary Disease, Rheumatology / 05.03.2018

MedicalResearch.com Interview with: 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. Many less fortunate people in developing countries have to deal with this on a daily basis and only have the support of Orphan Drug Distributors and charities and I'm so thankful that people like this are available to support these people! 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. (more…)
Allergies, Author Interviews, Dermatology, JAMA, Stanford, Technology / 03.03.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Dermatology, Herpes Viruses, Pediatrics / 12.02.2018

MedicalResearch.com Interview with:

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.  (more…)
Author Interviews, Depression, Dermatology / 09.02.2018

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. (more…)
Author Interviews, Dermatology, JAMA, Sexual Health, Transplantation / 01.02.2018

MedicalResearch.com Interview with:

Dr. Christina Lee Chung, MD Associate Professor Department of Dermatology Drexel University

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

Response: In early 2016, five years after the inception of our specialty medical-surgical transplant dermatology center, we realized our nonwhite transplant patients were developing skin cancer at higher rates and found interesting trends. These data were published in a previous manuscript. One of the more striking findings was that these patients were developing a high proportion of skin cancer in non-sun-exposed areas such as the genital region. There are no standard guidelines regarding genital skin evaluation and it is unclear how often it is performed in any capacity amongst dermatologists, including practitioners in our center, quite frankly. Our group was concerned that we could be missing skin cancers in this “hidden” area in our high-risk organ transplant population so we launched a quality improvement initiative that incorporated thorough genital skin evaluation as a standard part of post-transplant skin cancer screening.   

Fifteen months after we started this modified screening process, we decided to evaluate the results. To account for any variation in examination, we looked at the findings of a single practitioner. We found that genital lesions are common in the transplant population and include high rates of genital warts and skin cancer. However, patient awareness of the presence of genital lesions was alarmingly low. Nonwhite transplant patients, Black transplant recipients in particular, were disproportionately affected by both genital warts and genital skin cancer in our cohort. Similar to cervical cancer, high-risk HPV types were closely associated with genital squamous cell carcinoma development in our transplant population. (more…)

Author Interviews, Dermatology, Electronic Records / 29.01.2018

MedicalResearch.com Interview with: “Computer” by FullCodePress is licensed under CC BY 2.0Matilda W. Nicholas, MD, PhD Duke Dermatology Durham, North Carolina MedicalResearch.com: What is the background for this study? Response: I have found many physicians overwhelmed by the electronic messaging feature in Electronic Health Record systems (EHRs). I found there was very little published about this phenomenon, particularly for specialists. So, we set out to take a look at the volume and effect these systems have.  MedicalResearch.com: What are the main findings?  Response: We found that, on average, clinicians receive 3.24 messages per patient visit, for an average of about 50 messages per full day of clinic. The number of messages also correlated with poor reported work life balance for dermatologists. (more…)
Author Interviews, Dermatology, JAMA, Microbiome / 19.01.2018

MedicalResearch.com Interview with: Maja-Lisa Clausen MD, Ph.D.-fellow Department of Dermatology Copenhagen University Hospital Bispebjerg  MedicalResearch.com: What is the background for this study? Response: ​The human microbiome seems to play an important role in health and disease, by influencing host cells and contributing to host immunity. A balanced interplay between host cells and resident bacteria is important, and dysbiosis is linked to several diseases, including skin diseases like atopic dermatitis. Patients with atopic dermatitis suffer from ​frequent skin infections, and their skin microbiome is dominated by S. aureus. Frequent skin infections lead to frequent use of antibiotics, and with worldwide increase in resistant bacteria, a better understanding of the interplay between host and bacteria is paramount in order to develop new treatment strategies. (more…)
Author Interviews, Dermatology, Environmental Risks, Infections, Occupational Health / 16.12.2017

MedicalResearch.com Interview with: Lindsey Milich Rutgers School of Public Health studiesLindsey Milich Rutgers School of Public Health studies   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Much of the spotlight has been focused on hair and nail technicians, with the focus now shifting towards the health and safety of hair and nail salon clients. We wanted to assess perceived safety and health risks and prevalence of respiratory and dermal symptoms among hair and nail salon clients in New Jersey. Main findings include dermal/fungal symptoms being more prevalent among clients who visited salons three or more times within the past year, compared with those with fewer reported visits. Respiratory symptom prevalence was higher among clients with fewer salon visits, indicating a “healthy client effect”; clients with these symptoms may be less likely to return. (more…)
Abuse and Neglect, Dermatology, Pharmacology / 11.12.2017

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 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systemic corticosteroids are commonly used as systemic treatments for atopic dermatitis. However, few studies assessed the efficacy and safety of systemic corticosteroids in atopic dermatitis. This systematic review sought to summarize the available evidence for their use in atopic dermatitis. Overall, 52 reviews and 12 studies were included in this systematic review. Most studies suffered from small sample size, low quality. In one of the only randomized-controlled trials performed, systemic corticosteroids were less effective than cyclosporine and led to more rebound flares. There were numerous safety and tolerability concerns with both short and long-term treatment with systemic corticosteroids. One study found that even short-term use of systemic corticosteroids was associated with increased sepsis, venous thromboembolism and fractures. (more…)
Author Interviews, Dermatology, Environmental Risks / 07.12.2017

MedicalResearch.com Interview with: Prof. Dr. Mauricio S. Baptista Chemistry Institute (IQ-USP) University of São Paulo Brazil  “Tanning in the sun” by S B is licensed under CC BY 2.0MedicalResearch.com: What is the background for this study? What are the main findings? Response: This research started around 7 years ago. Our lab had a lot of previous experience in studying how photosensitizers (molecules that absorb light and transfer energy to others in its surroundings) used for Photodynamic Therapy, behave in the intracellular environments. We realized that most scientific work that defined the effects of sun in skin did not really consider looking into the properties of the molecules that are naturally found in skin and that absorb light. We also realized that very likely natural photosensitizers present in the skin behaves similarly when excited by either UVA or visible light. It all depends on which molecule absorb light and how the subsequent excited states behave. The work started by looking at melanin and melanocyte cells (Chiarelli-Neto et al Free Radic Biol Med 2011, 51, 1195; Chiarelli-Neto O et al. PLoS ONE, 2014  9(11): e113266). More recently we start looking at keratinocytes  and liposfucin (Tonolli et al Journal of Investigative Dermatology 2017, 137, 2447). (more…)
Author Interviews, Dermatology, Genetic Research / 04.12.2017

MedicalReseaerch.com Interview with: Alicia R. Martin PhD, Postdoc Department of Genetics Stanford University Department of Medicine, Massachusetts General Hospital and Harvard Medical School Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA and Brenna M. Henn, Phd, Assistant Professor Department of Ecology and Evolution SUNY Stony Brook, NY  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin pigmentation varies more in Africa than in any other continent, and yet genetic studies of this and other traits are massively underrepresented there. Previous Eurasian study biases have instead focused on populations that vary less and have fewer variants contributing to baseline skin color. In our study, we compiled quantitative skin color measurements from a large, globally diverse set of individuals and populations to show that pigmentation varies more closer to the equator than in high latitude populations. We focused on the ‡Khomani San and Nama populations from South Africa, which diverged early along the modern human lineage from other populations and have lighter skin than equatorial Africans. We showed that skin pigmentation is roughly 100% heritable, but that previously identified genes make up a tiny fraction (~10%) of the variation present in these populations. We identified both known and new genes contributing to this variability. (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA, Medicare / 22.11.2017

MedicalResearch.com Interview with: Adewole Adamson, MD, MPP Department of Dermatology UNC – Chapel Hill North Carolina  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nurses practitioners and physician assistants, collectively known as non-physician clinicians (NPCs), provide many dermatology services, some which are billed for independently. Little is known about the types of these services provided. Even less is known about where these independently billed services are provided. Given that there is a purported shortage of dermatologists in the United States (US),  NPCs have been suggested as way to fill in the gap. In this study, we found that NPCs independently billed for many different types of dermatology associated procedures, including surgical treatment of skin cancer, flaps, grafts, and billing for pathology. Most of these NPCs worked with dermatologists. Much like dermatologists, NPCs were unevenly distributed across the US, concentrating mostly in non-rural areas. (more…)