Aging, Author Interviews, Cancer Research, Dermatology, Frailty, JAMA / 08.09.2021

MedicalResearch.com Interview with: Marieke van Winden MD MSc PhD candidate Dermatology Radboud Institute for Health Sciences Department of Dermatology Radboud University Medical Center Nijmegen, the Netherlands MedicalResearch.com: What is the background for this study? What underlying conditions would factor in a decision for Watchful Waiting?  Response: Basal cell carcinomas are frequently treated because of the risk for progression, which can cause a significant morbidity due to local tissue invasion and destruction. However, most BCCs are characterized by a relatively indolent nature, growing slowly and frequently asymptomatically. Because patients with a limited life expectancy might not live long enough to develop symptoms from basal cell carcinoma progression, they might not live long enough to benefit from treatment. Underlying conditions that determine life expectancy should therefore be considered when weighing BCC management options. When life expectancy is expected to be relatively short, and the consequences of  watchful waiting (WW) are relatively low risk (low tumor burden expected within the remaining lifespan), WW should be considered. (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, 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, Brigham & Women's - Harvard, Cancer Research, Dermatology, JAMA / 14.08.2020

MedicalResearch.com Interview with: Maryam M. Asgari, MD MPH Professor Department of Dermatology, Massachusetts General Hospital Department of Population Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? What are Topical Calcineurin Inhibitors used for?  Response: Topical calcineurin inhibitors (TCIs) are FDA approved for the treatment of atopic dermatitis (though they are used off-label to treat a wide range of inflammatory conditions of the skin, including psoriasis, seborrheic dermatitis, and contact dermatitis).  There are currently two drugs available – tacrolimus and pimecrolimus – both of which carry a black box label warning users about the potential for increased skin cancer risk.  The risk associated with keratinocyte carcinoma, the most common cancer (defined as basal cell carcinoma and squamous cell carcinoma), remains poorly defined because findings from large-scale post-marketing surveillance studies are lacking.  (more…)
Author Interviews, Cancer Research, Dermatology, JAMA / 19.02.2020

MedicalResearch.com Interview with: Nikolai Dyrberg Loft MD, Ph.D.-fellow Department of Dermatology and Allergy Gentofte Hospital Hellerup MedicalResearch.com: What is the background for this study? Response: Epidemiological studies examining the association between psoriasis or psoriatic arthritis and cancer have reported conflicting results. Some studies report an increased risk of cancer in individuals with psoriasis or psoriatic arthritis and others do not. Whether individuals with psoriasis or psoriatic arthritis have an increased risk of cancer is important as this might help guiding in clinical practice. In order to determine if there is an increased risk of cancer and the magnitude of this risk, a systematic review of the literature and meta-analysis is needed.  (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA / 22.01.2020

Comments from the FDA on this JAMA Dermatology study: Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial  Sunscreen CDC Phil imageMedicalResearch.com: What is the background for this study? Response: A prior pilot study published in JAMA in May 2019 demonstrated the systemic absorption of 4 sunscreen active ingredients; additional studies are needed to determine the systemic absorption of additional active ingredients, and how quickly absorption occurs.  This study assessed the systemic absorption of the 6 active ingredients (avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate) in 4 sunscreen products under single and maximal-use conditions.  (more…)
Author Interviews, Dermatology, Education, Gender Differences, JAMA, Race/Ethnic Diversity / 08.01.2020

MedicalResearch.com Interview with: Imam Xierali, PhD Associate Professor / UT Southwestern Medical Center Dallas, Texas MedicalResearch.com: What is the background for this study? Response: Despite the continued efforts in academic medicine to increase the representation of women and minorities underrepresented in medicine (URM), there is a lack of information on trends in dermatology department faculty diversity and how they compare with those in other clinical departments. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 17.11.2019

MedicalResearch.com Interview with: Jennifer M. Gardner, MD Clinical Assistant Professor of Dermatology University of Washington School of Medicine  MedicalResearch.com: What is the background for this study? Response: This study looked at age-specific differences of melanoma incidence in the United States. It was an observational study looking at population-based registry data extracted from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics (NPCR-SEER) database. The overall take home message from this study is that though melanoma incidence has continued to climb in the past decade for both men and women, most of the increase is seen in adults greater than age 40 years of age.  In contrast, melanoma incidence decreased in adolescents (ages 10-19 years of age) and young adults (ages 20-29) after peaking around 2004-2005. Melanoma is more common in males in older individuals (older than 50 years of age) but in younger individuals (<50 years of age), melanoma is more common in females.  According to a recently published JAMA-Otolaryngology paper by Bray and colleagues, there may be a subset of younger individuals where males are at a higher risk than females in regard to head and neck melanoma, and after that study was published we noted this to be true in our numbers, as well (we didn’t publish this in our study), further identifying a possibly “at risk” demographic within the younger age groups in addition to young women. (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Surgical Research, Weight Research / 30.10.2019

MedicalResearch.com Interview with: Magdalena Taube, PhD Institute of Medicine, Dept of Molecular and Clinical Medicine Sahlgrenska Academy at Gothenburg University Wallenberg laboratory Gothenburg Sweden  MedicalResearch.com: What is the background for this study? Response: Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery and skin cancer is limited. In this study we used data from the Swedish Obese Subjects (SOS) study– a prospective controlled intervention trial examining bariatric surgery outcomes – to analyze the impact of bariatric surgery on skin cancer incidence. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 21.10.2019

MedicalResearch.com Interview with: https://skin-analytics.com/about-us/ Dr. Helen Marsden PhD Skin Analytics Limited London, United Kingdom MedicalResearch.com: What is the background for this study? Response: In this technology age, with the explosion of interest and applications using Artificial Intelligence, it is easy to accept the output of a technology-based test - such as a smartphone app designed to identify skin cancer - without thinking too much about it. In reality, technology is only as good as the way it has been developed, tested and validated. In particular, AI algorithms are prone to a lack of “generalisation” - i.e. their performance drops when presented with data it has not seen before. In the medical field, and particularly in areas where AI is being developed to direct a patient’s diagnosis or care, this is particularly problematic. Inappropriate diagnosis or advice to patients can lead to false reassurance, heightened concern and pressure on NHS services, or worse. It is concerning, therefore, that there are a large number of smartphone apps available that provide an assessment of skin lesions, including some that provide an estimate of the probability of malignancy, that have not been assessed for diagnostic accuracy. Skin Analytics has developed an AI-based algorithm, named: Deep Ensemble for Recognition of Malignancy (DERM), for use as a decision support tool for healthcare providers. DERM determines the likelihood of skin cancer from dermoscopic images of skin lesions. It was developed using deep learning techniques that identify and assess features of these lesions which are associated with melanoma, using over 7,000 archived dermoscopic images. Using these images, it was shown to identify melanoma with similar accuracy to specialist physicians. However, to prove the algorithm could be used in a real life clinical setting, Skin Analytics set out to conduct a clinical validation study. (more…)
Author Interviews, Dermatology, Infections, JAMA / 19.06.2019

MedicalResearch.com Interview with: Richard Brindle DM FRCP Honorary Reader, University of Bristol, UK  MedicalResearch.com: What is the background for this study? Response: This review is an update of the 2010 Cochrane Review of Interventions for cellulitis and erysipelas (DOI: 10.1002/14651858.CD004299) but focusing on antibiotics.  It provides a valuable resource for clinicians in summarizing current best evidence and highlighting gaps in the research. This review will inform the production of evidence-based guidelines covering antibiotic choice, route of administration, duration of treatment and the role of combinations of antibiotics. (more…)
Author Interviews, Dermatology, JAMA, Smoking, Surgical Research / 14.06.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Dermatology, JAMA / 01.06.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Depression, Dermatology, JAMA, Mental Health Research / 21.01.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Dermatology, Diabetes, JAMA / 15.01.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Dermatology, Education / 13.01.2019

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.  (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA / 25.10.2018

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

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 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. (more…)