Author Interviews, Cost of Health Care, Dermatology, JAMA / 08.09.2022

MedicalResearch.com Interview with: Jane M. Zhu, M.D., M.P.P., M.S.H.P. Assistant Professor of Medicine Division of General Internal Medicine and Geriatrics School of Medicine Oregon Health & Science University Portland, Oregon MedicalResearch.com: What is the background for this study? Response: Private equity (PE) acquisitions of physician practices are accelerating across many specialties, but there is still little robust evidence on the effects of these acquisitions. Concerns about PE involvement is predicated on the fact that these firms expect high annual returns, which require either reducing costs or increasing revenue, or both. Using PE acquisition data from 2016-2020, linked to commercial claims data, we sought to understand what common mechanisms of revenue generation were being adopted after private equity acquisition of physician practices. (more…)
Author Interviews, Dermatology, Infections / 15.07.2022

MedicalResearch.com Interview with: Dr Dilip Kachhawa, MD Department of Skin & Venereal Disease Dr Sampurnanand Medical College Jodhpur, Rajasthan, India MedicalResearch.com:  What are the main findings? Response: Molluscum Contagiosum (MC) is an infection caused by molluscipoxvirus. It is difficult to study since the virus only survives in human skin, and therefore there isn’t an animal or cell model to study potential treatments. Molluscum lesions appear as raised, domed shaped skin-colored lesions and can occur anywhere on the body but are most common on the face, neck, arms, legs, and abdomen. Sometimes there are few lesions, but clusters of several lesions can appear. Children are the most likely to get molluscum, and the virus is highly contagious, transmitted by direct contact with infected skin or contaminated objects, like towels, linens and toys. Scratching can cause autoinoculation which is when a person reinfects themself. MC is very common, impacting an estimated 6 million adults and mostly children in the US each year. In 2010, there was an estimated 122 million cases worldwide. It occurs primarily in humid and warm climates, and transmission via swimming pools and bathtubs may be possible. Therefore, molluscum is often called “water warts.” Many physicians may take a “watch and wait” approach since the virus may clear on its own. However, it can take months to up to 5 years for some to experience complete clearance, In the meantime, the person is still highly contagious and may spread the virus to others, particularly children. Lesions can be bothersome, causing itching and sometimes a secondary infection. There is also a psychosocial component. In a recent study, 1 in 10 children with molluscum experienced a major quality of life issue. Berdazimer Gel, 10.3% is a potential first-in-class topical controlled-nitric oxide releasing medication containing Berdazimer (sodium), a new chemical entity, and the active ingredient in berdazimer gel 10.3%. The mechanism of action of berdazimer in the treatment of molluscum is unknown, but in vitro lab studies show that the nitric oxide, released when berdazimer is combined with a hydrogel, may impede viral replication and perhaps help body’s natural immune response against molluscum. (more…)
Author Interviews, Dermatology, Race/Ethnic Diversity / 28.04.2022

MedicalResearch.com Interview with: Dr. Neelam Vashi MD Director of the Boston University Center for Ethnic Skin Dermatologist at Boston Medical Center, and Dr. Henriette De La Garza MD Research fellow Boston University School of Medicine   MedicalResearch.com:  What is the background for this study?  Response: The COVID-19 pandemic abruptly shifted many of our daily activities to an online world, dramatically increasing the use of electronic devices. Although visible light exposure from screens is small compared with the amount of exposure from the sun, there is concern about the long-term effects of excessive screen time. Recent studies have demonstrated that exposure to light emitted from electronic devices, even for as little as 1 hour, may cause reactive oxygen species generation, apoptosis, collagen degradation, and necrosis of skin cells. Visible light increases tyrosinase activity and induces immediate erythema in light-skinned individuals and long-lasting pigmentation in dark-skinned individuals. In recent years, tinted sunscreens have been rising in popularity because they are an effective and convenient way to protect against high-energy visible light while providing cosmetic benefits. The purpose of this analysis was to study current available options and product factors that may influence consumer preference when choosing a tinted sunscreen so dermatologists can improve their familiarity with available products and tailor their recommendations to patients with all skin tones. (more…)
Author Interviews, Nutrition / 05.04.2022

MedicalResearch.com Interview with: Dorothy Klimis-Zacas, MS, PhD, FACN Professor of Clinical Nutrition School of Food and Agriculture Graduate Faculty School of Biomedical Sciences Associate Faculty, Institute of Medicine Fulbright Fellow University of Maine Orono, Maine 04469  MedicalResearch.com:  What is the background for this study?  Response: Bioactive compounds such as polyphenols have been documented to have wound healing properties . In the Klimis-Zacas laboratory, phenolic extracts (PE) from wild blueberries (WB) were reported to promote angiogenesis in HUVEC cells via cell migration, angiogenesis, through VEGF/P13K/AKT pathway documented that the PE, primarily composed of chlorogenic acid significantly promoted cell migration and closure speed of wound by 38% above the control as well as angiogenesis and gene expression for proteins critical for cell movement while the anthocyanin fraction inhibited the above processes (5,6).  (more…)
Author Interviews, Dermatology, Diabetes / 22.02.2022

MedicalResearch.com Interview with: Chih-Shan Jason Chen, MD, PhD Director, Dermatologic and Mohs Micrographic Surgery Unit Memorial Sloan Kettering Skin Cancer Center at Hauppauge Attending Mohs Surgeon, Dermatology Service Memorial Sloan Kettering Cancer Center Chief, Dermatologic Surgery Northport VA Medical Center Associate Professor of Clinical Dermatology Renaissance School of Medicine at Stony Brook University MedicalResearch.com:  What is the background for this study?    Response: Managing a surgical wound on the lower leg can be a challenge. Often, higher wound tension, atrophic skin, edema, and compromised circulation result in higher risks of wound dehiscence and infection, and significantly limit the capacity of wound closure post-surgically. Therefore, healing by secondary intention is a practical option for many lower leg Mohs defects. However, a secondary intention wound on the lower leg is expected to take a longer time to heal. Certain factors such as older age and health conditions of the host may adversely affect healing time. Timolol is a nonselective beta-adrenergic receptor antagonist that has FDA approval for the treatment of glaucoma. In addition to this FDA-approved indication, topical timolol has several off-label uses in dermatology, such as for the treatment of infantile hemangiomas, venous stasis ulcers, and refractory wounds. Although timolol solution has been used in chronic wounds, knowledges of the efficacy and utility of timolol in an acute post-surgical wound setting is lacking. (more…)
Author Interviews, Dermatology, Emory, JAMA, Race/Ethnic Diversity / 27.01.2022

MedicalResearch.com Interview with: Howa Yeung, MD MSc | He/him/his Assistant Professor of Dermatology Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com:  What is the background for this study?  Response: Asian Americans are the fastest growing racial group in the United States but are underrepresented in health research. Existing research often categorize Asian Americans into a single racial category, which may mask differences in health behaviors and outcomes subgroups. We sought to examine potential differences in skin cancer-related risk factors and screening among Asian Americans in a large, nationally representative study. (more…)
Author Interviews, Cancer Research, Dermatology, Lancet, Melanoma, Technology / 11.11.2021

MedicalResearch.com Interview with: Dr David Wen BM BCh NIHR Academic Clinical Fellow in Dermatology University of Oxford MedicalResearch.com: What is the background for this study? Response: Publicly available skin image datasets are commonly used to develop machine learning (ML) algorithms for skin cancer diagnosis. These datasets are often utilised as they circumvent many of the barriers associated with large scale skin lesion image acquisition. Furthermore, publicly available datasets can be used as a benchmark for direct comparison of algorithm performance. Dataset and image metadata provide information about the disease and population upon which the algorithm was trained or validated on. This is important to know because machine learning algorithms heavily depend on the data used to train them; algorithms used for skin lesion classification frequently underperform when tested on independent datasets to which they were trained on. Detailing dataset composition is essential for extrapolating assumptions of generalisability of algorithm performance to other populations. At the time this review was conducted, the total number of publicly available datasets globally and their respective content had not previously been characterised. Therefore, we aimed to identify publicly available skin image datasets used to develop ML algorithms for skin cancer diagnosis, to categorise their data access requirements, and to systematically evaluate their characteristics including associated metadata.   (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology, Respiratory / 06.10.2021

MedicalResearch.com Interview with: Lara van der Schoot  MD, PhD candidate Department of Dermatology Radboud University Medical Center Nijmegen, The Netherlands MedicalResearch.com: What is the background for this study? Response: Psoriasis is a chronic, immune mediated skin disease for which effective targeted biological agents have become available the past years. Inherent to their immunomodulatory mechanism of action, biologics might increase infections risk. We know from clinical trial data that respiratory tract infections are among the most common adverse events during biologic treatment, but real-world data is sparse. Regarding the risk of serious infections among biologic users, mostly defined as infections requiring hospitalization, previous studies provided different results and there is limited comparative data for the newer biologics available. The COVID-19 pandemic turned attention to the risk of infections among biologic users, especially for respiratory tract infections, as they might relate to susceptibility for viral respiratory tract infections such as COVID-19. In our study, the primary aim was to determine the risk of respiratory tract infections among real-world psoriasis patients treated with biologics, including the newer IL-17 and IL-23 inhibitors. The secondary aim was to assess risk of serious infections in this cohort. Additionally, rates of SARS-CoV-2 infections were assessed. (more…)
Author Interviews, Dermatology / 15.09.2021

MedicalResearch.com Interview with: Elena Ezhkova, PhD Professor, Department of Cell, Developmental, and Regenerative Biology Professsor, Dermatology Lab Head,The Black Family Stem Cell Institute Icahn School of Medicine at Mount Sinai New York Meng-Yen Li, PhD Postdoctoral Fellow The Black Family Stem Cell Institute MedicalResearch.com: What is the background for this study? Response: The epidermis is the primary barrier and the first line of defense to combat environmental stressors. The sun's ultraviolet (UV) is one of the main environmental stressors that our body is exposed to daily. UV produces DNA damage in epidermal cells and is a leading cause of skin cancers. To protect from the damaging effects of UV, epidermal cells become pigmented by melanocytes, pigment-producing cells. Taken up by epidermal cells, the melanin pigment absorbs UV light and reduces DNA damage. How the epidermis senses UV and how it leads to epidermal pigmentation is poorly understood. (more…)
Author Interviews, Dermatology, JAMA, Race/Ethnic Diversity / 16.08.2021

MedicalResearch.com Interview with: Joerg Albrecht, MD, PhD Dermatologist, Internist, Clinical Pharmacologist Division of Dermatology, Department of Medicine Attending Dermatologist, Chair Division of Dermatology Chair system-wide Pharmacy & Therapeutics Committee Cook County Health Chicago, IL  60612 MedicalResearch.com: What is the background for this study? Response: The study was stimulated by data that suggested that an unusually large proportion of inpatient with Hidradenitis suppurativa (HS) were African American. HS is an underdiagnosed disease and the total numbers of inpatients with HS in the year we looked at initially seemed small. So we wanted to test whether this finding held up when the period of observation was extended. Point estimates can be unreliable and we had followed another finding in the data that did not hold up when we looked at other years, so we felt one year was not enough to confirm a trend (more…)
Author Interviews, Dermatology, Geriatrics, Sleep Disorders / 07.08.2021

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Associate Professor Director of Clinical Research Director of Patch Testing George Washington University School of Medicine and Health Sciences Washington, DC  MedicalResearch.com: What is the background for this study? Response: Atopic dermatitis affects people of all ages, including geriatric patients. Previous studies found age-related differences in the clinical manifestations of atopic dermatitis between children and adults. Though, few studies examined whether there are age-related differences of AD severity between geriatric and younger adults. We performed a cross-sectional real-world observational study and found that geriatric age (≥65 years) was not associated with atopic dermatitis severity. However, geriatric age was associated with increased sleep disturbances, delays falling asleep and nighttime awakenings from itch, as well as fatigue. (more…)
Author Interviews, Cancer Research, Dermatology, NEJM / 20.07.2021

MedicalResearch.com Interview with: Jane Fang, MD Clinical Athenex, Inc. MedicalResearch.com: What is the background for this study? Response: Tirbanibulin is a first-in-class synthetic molecule that has potent anti-proliferative activity by inhibiting tubulin polymerization and disrupting src kinase signaling. It has been formulated as an ointment for the treatment of actinic keratosis, a very common precancerous condition of UV-damaged skin that affects over 50 million people in the US. The most commonly adopted management approach is to remove AK lesions as it is hard to predict which lesion will become cancerous. Lesion-directed treatment like cryotherapy can effectively remove lesions one at a time but does not treat larger field of cancerization. Also, it is limited by associated pain and long term complication such as scarring. Currently approved topical treatments involve cumbersome application courses of weeks or months, and induce considerable local skin reactions that were not well tolerated by patients. The Phase 3 studies demonstrated that a short 5-day once daily course of tirbanibulin ointment 1% is an efficacious and safe topical treatment of actinic keratosis. (more…)
Author Interviews, Cancer Research, Dermatology, Melanoma / 02.06.2021

MedicalResearch.com interview with: Professor Marie-Aleth Richard EADV Communications Committee Chair Professor, University Hospital of La Timone Marseille, France MedicalResearch.com: What is the background for this Roundtable event? Would you describe the mission of the European Commission’s Beating Cancer Plan? Response: Europe’s Beating Cancer Plan is the first, comprehensive EU strategy on cancer, aimed at tackling the disease through all key stages: prevention; early detection; diagnosis and treatment; and quality of life of cancer patients and survivors. The Plan also aims to create opportunities to improve cancer care through research and innovative projects, such as artificial intelligence, and to promote equal access to knowledge and treatments in cancer care across Europe. The EADV seeks to create a bridge between the EU health policy agenda and scientific research, by engaging with policymakers, patient organisations and other stakeholders to support a patient centric-approach; tackling melanoma and non-melanoma skin cancers (NMSC) at all stages of the pathway, from prevention to follow-up care. Through our Roundtable event, the EADV brought together these key stakeholders to evaluate the effectiveness of the EBCP on preventing both melanoma and NMSC, as well as identify joint recommendations that step-up measures towards this goal. (more…)
Author Interviews, Dermatology, PNAS / 01.06.2021

MedicalResearch.com Interview with: Haley Steele Graduate Student Researcher Georgia Institute of Technology  MedicalResearch.com: What is the background for this study? Response: Chronic itch is a debilitating symptom that arises from a broad range of etiologies including skin disease, systemic disease, and as a common side-effect of medication. While in the last few decades significant advances in our understanding of the mechanisms underlying chronic itch have been made, a large majority of those advancements were restricted to studies in hairy skin. Conditions such as plantar and palmar psoriasis, dyshidrosis, and cholestasis, however, are known to exhibit chronic itch restricted primarily to glabrous skin (found on the palms of hands and soles of feet). This is an area that is considered to be particularly debilitating. Therefore, in this study we investigated the role three previously identified pruriceptive neurons (MrgprA3+, MrgprD+, and MrgprC11+) play in mediating acute and chronic glabrous skin itch. (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology / 11.05.2021

MedicalResearch.com Interview with: Dr Monisha Madhumita Father Muller Medical College India MedicalResearch.com: What is the background for this study? hand-washing-eczema-dermatologyResponse: The COVID‐19 pandemic requires stringent adoption of hand hygiene practices. Health Care Workers (HCW) and the general population are at increased risk of irritation, dryness, redness and cracked hands (irritant dermatitis) due to frequent hand washing and the use of alcohol-based hand rubs. An effective hand sanitizer contains at least 60% alcohol to kill germs. Thus, it can be very drying to the skin. Transepidermal water loss (TEWL) is a way to measure the water lost from the skin. It is an essential parameter for characterizing skin hydration and protective function. Both of which are disrupted in irritant hand dermatitis. This research study was conducted on 582 participants: 291 health care workers and 291 healthy individuals of the general population. Measurements of TEWL were made using a noninvasive, closed- chamber system (VapoMeter) in a standardized environment. The study participants were asked to identify the challenges to compliance in hand hygiene practice (more…)
Author Interviews, Dermatology, JAMA, OBGYNE, Pediatrics / 09.05.2021

MedicalResearch.com Interview with: Niklas Worm Andersson, MD Department of Epidemiology Research Statens Serum Institut, Copenhagen Denmark  MedicalResearch.com: What is the background for this study? Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used." (more…)
Author Interviews, Dermatology, JAMA, Technology / 28.04.2021

MedicalResearch.com Interview with: Yun Liu, PhD Google Health Palo Alto, California MedicalResearch.com: What is the background for this study? Would you describe the system?  Does it use dermatoscopic images? Response: Dermatologic conditions are extremely common and a leading cause of morbidity worldwide. Due to limited access to dermatologists, patients often first seek help from non-specialists. However, non-specialists have been reported to have lower diagnostic accuracies compared to dermatologists, which may impact the quality of care. In this study, we built upon prior work published in Nature Medicine, where we developed a computer algorithm (a deep learning system, DLS) to interpret de-identified clinical images of skin conditions and associated medical history (such as whether the patient reported a history of psoriasis). These clinical images are taken using consumer-grade hardware such as point-and-shoot cameras and tablets, which we felt was a more accessible and widely-available device compared to dermatoscopes. Given such images of the skin condition as input, the DLS outputs a differential diagnosis, which is a rank-ordered list of potential matching skin conditions. In this paper, we worked with user experience researchers to create an artificial intelligence (AI) tool based on this DLS. The tool was designed to provide clinicians with additional information per skin condition prediction, such as textual descriptions, similar-appearing conditions, and the typical clinical workup for the condition. We then conducted a randomized study where 40 clinicians (20 primary care physicians, 20 nurse practitioners) reviewed over 1,000 cases -- with half the cases with the AI-based assistive tool, and half the cases without. For each case, the reference diagnosis was based on a panel of 3 dermatologists.  (more…)
Author Interviews, Dermatology, NEJM / 28.04.2021

MedicalResearch.com Interview with: Prof. Kristian Reich, MD, PhD Professor for Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg-Eppendorf MedicalResearch.com: What is the background for this study? What are the main findings? Response: Complete skin clearance is an important treatment goal for patients with psoriasis and is closely associated with treatment satisfaction and improved quality of life. However, it remains an unmet need for many patients. The interleukin (IL)-17 isoforms IL-17A and IL-17F play central roles in psoriasis pathophysiology and are overexpressed in psoriatic tissues. Existing biologic therapies, such as secukinumab, inhibit IL-17A only. However, increasing evidence indicates that IL-17F contributes independently to the pathobiology of plaque psoriasis, and that blocking both IL-17A and IL-17F may lead to more complete suppression of inflammation and superior clinical outcomes, compared with blocking IL‑17A alone. Bimekizumab is a humanized monoclonal IgG1 antibody that has been designed to selectively inhibit IL-17F in addition to IL-17A. (more…)