Past and Present Smoking Raises Risk of Dermatology Surgery Complications

MedicalResearch.com Interview with:

Ian A. Maher, MD Department of Dermatology St Louis University, St Louis, Missouri

Dr. Maher

Ian A. Maher, MD
Department of Dermatology
St Louis University, St Louis, Missouri 

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

Response: One of our wonderful trainees at Saint Louis University was interested in the role of smoking in flap failures.  Dogma has been that smoking was a major risk factor for flap failures.  Looking at our database as well as published data, flap failures are a rare event, so rare as to be difficult to definitively associate with anything.  We decided to look more broadly at complications both acute (infections failures) and chronic (mainly cosmetic scarring associated) in flaps and grafts. Continue reading

Vitiligo: Off Label Topical Calcineurin Inhibitors Help Some Patients

MedicalResearch.com Interview with:

Dr-Jung Min Bae

Dr. Jung Min Bae

Jung Min Bae, MD, PhD
Associate Professor, Department of Dermatology
St. Vincent’s Hospital
College of Medicine, The Catholic University of Korea 

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

Response: Vitiligo is a common chronic skin disease affecting 1% of the population, and it causes low self-esteem and social stigma. To date, there are no approved drugs for the treatment of vitiligo, even though growing evidence indicates favorable therapeutic responses of topical calcineurin inhibitors (TCIs) including tacrolimus and pimecrolimus.

In this study, we conducted a systematic review and meta-analysis of all relevant prospective studies (n = 46) and identified remarkable therapeutic responses of TCI monotherapy and TCI plus phototherapy for vitiligo. Continue reading

Depression May Be a Driver of Alopecia Areata

MedicalResearch.com Interview with:

Isabelle Vallerand, PhD Epidemiologist, MD Student Department of Community Health Sciences Cumming School of Medicine University of Calgary

Dr. Vallerand

Isabelle Vallerand, PhD
Epidemiologist, MD Student
Department 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: It is well known that patients with alopecia areata, a form of autoimmune hair loss, are at a higher risk of suffering from depression than the general population. But in practice, we often hear patients tell us that they believe their hair loss developed as a result of stress or problems with mental health – certainly the phrase “so stressed your hair is falling out” is something most people have heard of. Despite this, there has actually been very little research investigating the role that mental health may have on development of alopecia areata.

Interestingly, depression has recently been associated with increased systemic inflammatory markers, so there is biologic plausibility that depression could increase the risk of alopecia areata. Our group was interested in addressing this question, and used a large population-level health records database with up to 26 years of follow-up to study it. We ultimately found that not only does depression increase one’s risk of alopecia areata, but that it increases their risk by nearly 90% compared to people who have never had depression. We also found that using antidepressants can significantly decrease the risk of developing alopecia areata in patients with depression. So there appears to be an important link between mental health and development of hair loss from alopecia areata.

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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.

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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

Psoriasis Patients More Likely To Have Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Psoriasis

Psoriasis

Prof Ching-Chi Chi, MD, MMS, DPhil 
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Guishan Dist, Taoyuan

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

Response: Previous studies have shown common genotypes, clinical course, and immunological features shared by psoriasis and inflammatory bowel disease.

However, the relationship between psoriasis and inflammatory bowel disease was largely unclear.

In this study, we found when compared to the general population, psoriatic patients are more likely to have concomitant inflammatory bowel disease.  Continue reading

Dysplastic Moles Not Necessarily Precursor to Melanoma But Indicate Increased Risk

MedicalResearch.com Interview with:

Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215

Dr. Kim

Caroline C. Kim, M.D.
Associate Professor, Department of Dermatology
Harvard Medical School
Director, Pigmented Lesion Clinic
Associate Director, Cutaneous Oncology Program
Beth Israel Deaconess Medical Center
Boston, MA 02215

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

Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin.

Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular.

In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma.

Continue reading

Psoriasis Patients Have Higher Risk of Sexual and Erectile Dysfunction

MedicalResearch.com Interview with:

Severe Psoriasis; penn medicine

Severe Psoriasis

Alejandro Molina-Leyva, MD PhD
Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain

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

Response: Psoriasis is a frequent  chronic inflammatory skin disease characterized by the presence of erythematous papulosquamous lesions that can affect any part of the body. The modification of body image and the subjective symptoms associated like itch or even pain can produce an important impairment of quality of life.

Sexuality is a major aspect of life that can be impaired by chronic disease but it is usually an overlooked topic during medical consultations maybe because of lack of knowledge or embarrassment. There is a increasing scientific evidence supporting the relationship between psoriasis and sexual dysfunction.

The aim of our study is to synthesize this scientific evidence in order to help dermatologists to understand the burden of the problem, to identify patients at higher risk and the available therapeutic options.

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

Response: Patients with psoriasis present a higher risk of sexual and erectile dysfunction compared to general population. Approximately 50% of patients with psoriasis experience some degree of sexual dysfunction. Anxiety or depression, genital psoriasis or psoriasis arthritis increase the risk of sexual dysfunction among patients with psoriasis, special attention should be given to these patients. The improvement of psoriasis associated with biologic drugs have demonstrated to improve sexual dysfunction.

Psoriasis patients should be inquired about sexual problems during routine consultation, especially those that present risk factors. The presence of sexual or erectile dysfunction could be considered as an additional severity factor  for treatment decision.

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

Response: Future research should point towards to investigate the role of systemic inflammation and pro-inflammatory cytokines and psoriasis. We recommend researchers the use specific validated tool to assess sexual dysfunction. Upcoming clinical trials of new drugs for psoriasis should include specific analyses regarding sexual and erectile dysfunction. 

Citation:

Molina-Leyva A, Salvador-Rodriguez L, Martinez-Lopez A, Ruiz-Carrascosa JC, Arias-Santiago S. Association Between Psoriasis and Sexual and Erectile Dysfunction in Epidemiologic StudiesA Systematic ReviewJAMA Dermatol. Published online October 10, 2018. doi:10.1001/jamadermatol.2018.3442

Oct 11, 2018 @ 1:29 pm

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