Ninety-FIFTH issue
OCTOBER 1, 2025
Mediterranean diet and patients with psoriasis: The MEDIPSO randomized clinical trial
JAMA Dermatology
JAMA Dermatology
A dose of diet: a Mediterranean makeover for psoriasis.
Psoriasis (PSO) is a chronic, inflammatory skin condition affecting more than 60 million people worldwide. While biologics and topical anti-inflammatory treatments dominate therapy, diet has been largely overlooked as an adjunctive strategy. The MEDIPSO randomized control trial investigated whether the Mediterranean diet, known for its anti-inflammatory benefits, could improve outcomes in patients with mild to moderate psoriasis.
What did they find?
Main Takeaway: This randomized control trial found that following a structured Mediterranean diet for 16 weeks significantly improved psoriasis severity and patient well-being, suggesting that diet may be a powerful adjunct to standard therapy.
Psoriasis (PSO) is a chronic, inflammatory skin condition affecting more than 60 million people worldwide. While biologics and topical anti-inflammatory treatments dominate therapy, diet has been largely overlooked as an adjunctive strategy. The MEDIPSO randomized control trial investigated whether the Mediterranean diet, known for its anti-inflammatory benefits, could improve outcomes in patients with mild to moderate psoriasis.
What did they find?
- The Mediterranean diet group showed a significant reduction in PASI compared with controls (-3.4 vs. 0.0; P < .001).
- Within the intervention group, 68% achieved PASI 50, 47% PASI 75, and 26% PASI 90, versus <11% in the control group.
- Patients following the Mediterranean diet reported better quality of life (DLQI -3.1), less insomnia (ISI -2.5), reduced anxiety (HADS-A -2.8), and lower HbA1c (-4.1 mmol/mol) compared with controls.
Main Takeaway: This randomized control trial found that following a structured Mediterranean diet for 16 weeks significantly improved psoriasis severity and patient well-being, suggesting that diet may be a powerful adjunct to standard therapy.
Antidepressant use and postoperative outcomes after BCC surgery: A propensity-matched cohort study
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Pre-op cheer, but post-op fear: surgical consequences of antidepressant use
Antidepressant (ADP) use is common in the general population, including among patients undergoing surgery for basal cell carcinoma (BCC). However, little is known about how ADP use affects surgical outcomes. In this large retrospective cohort study of over 6 million patients in the TriNetX database, researchers compared 90-day postoperative outcomes between propensity-matched cohorts of 3,197 BCC patients with and without recent antidepressant use.
What did they find?
Main Takeaway: Antidepressant use was associated with higher postoperative complications, opioid use, and health care utilization following BCC surgery, even after matching for comorbidities. These findings highlight the need for careful preoperative risk assessment and perioperative management in patients on ADPs.
Antidepressant (ADP) use is common in the general population, including among patients undergoing surgery for basal cell carcinoma (BCC). However, little is known about how ADP use affects surgical outcomes. In this large retrospective cohort study of over 6 million patients in the TriNetX database, researchers compared 90-day postoperative outcomes between propensity-matched cohorts of 3,197 BCC patients with and without recent antidepressant use.
What did they find?
- Opioid prescriptions were nearly doubled in the ADP group (34.7% vs. 17.5%; P < 0.001)
- Surgical complications were more common, including surgical site infection (1.7% vs. 0.9%; P = 0.003) and wound disruption (1.4% vs. 0.6%; P = 0.001)
- Hospital utilization was higher across all measures: readmissions (8.3% vs. 2.5%), inpatient hospitalizations (9.9% vs. 3.3%), and ED visits (9.2% vs. 4.4%) (P < 0.001 for all)
- Sepsis occurred more frequently in the ADP group (1.0% vs. 0.3%; P = 0.002)
Main Takeaway: Antidepressant use was associated with higher postoperative complications, opioid use, and health care utilization following BCC surgery, even after matching for comorbidities. These findings highlight the need for careful preoperative risk assessment and perioperative management in patients on ADPs.
Chronic inflammatory skin conditions can negatively impact patients' sexual health and quality of intimate relationships
British Journal of Dermatology
British Journal of Dermatology
The itch that can complicate intimacy…
Previous research has shown that patients living with chronic skin disease often face poorer psychosocial outcomes. While conditions such as acne and eczema are known to reduce quality of life, the impact on sexual activity and intimacy is rarely addressed. This study quantitatively measured and qualitatively described how chronic inflammatory skin conditions affect sexual health, intimacy, and dating in young adult patients through surveys and interviews.
What did they find?
Main Takeaway: Sexual health is significantly impacted by skin-related distress in patients with chronic inflammatory skin conditions. Intimacy concerns should be more openly addressed in routine clinical care.
Previous research has shown that patients living with chronic skin disease often face poorer psychosocial outcomes. While conditions such as acne and eczema are known to reduce quality of life, the impact on sexual activity and intimacy is rarely addressed. This study quantitatively measured and qualitatively described how chronic inflammatory skin conditions affect sexual health, intimacy, and dating in young adult patients through surveys and interviews.
What did they find?
- Participants with hidradenitis suppurativa and eczema reported greater impairment of sexual function and desire (scores: 3.7/5 and 2.9/5, vs. 1.0/5 in controls).
- Skin-related distress was higher among those experiencing itch (P = 0.008) or pain (P = 0.01), but genital involvement did not significantly increase distress (P = 0.07).
- 49% (26/53) of sexually active participants reported improved sexual function following perceived skin improvement.
- 55% (40/73) of participants stated they had no patient–physician discussion regarding intimacy.
Main Takeaway: Sexual health is significantly impacted by skin-related distress in patients with chronic inflammatory skin conditions. Intimacy concerns should be more openly addressed in routine clinical care.
An app that maps the plaques!
Body surface area (BSA) is a cornerstone of psoriasis severity scoring, guiding treatment escalation and even determining eligibility for biologics or insurance coverage in some regions. Despite its importance, BSA assessment remains slow, subjective, and prone to variability. In this study, researchers developed and validated an AI-based BSA model trained on 1,757 lesion images and integrated it into the WeChat Hefubao app to provide rapid, objective scoring and longitudinal tracking.
What did they find?
Main Takeaway: This study introduces the first AI-integrated mobile app to precisely measure BSA in psoriasis. By combining rapid segmentation, objective scoring, and longitudinal tracking, the Hefubao app provides an accessible tool for dermatologists and patients, especially in regions where treatment eligibility hinges on BSA thresholds.
Body surface area (BSA) is a cornerstone of psoriasis severity scoring, guiding treatment escalation and even determining eligibility for biologics or insurance coverage in some regions. Despite its importance, BSA assessment remains slow, subjective, and prone to variability. In this study, researchers developed and validated an AI-based BSA model trained on 1,757 lesion images and integrated it into the WeChat Hefubao app to provide rapid, objective scoring and longitudinal tracking.
What did they find?
- The AI-based BSA model achieved dermatologist-level accuracy (ICC 0.97) and had a processing time of 6 seconds per patient, compared to a processing time of 123 seconds for dermatologists
- The model was integrated into the WeChat Hefubao app, enabling real-time BSA tracking and treatment monitoring
- 92.9% of dermatologists rated it helpful in practice and 85.7% reported willingness to adopt
Main Takeaway: This study introduces the first AI-integrated mobile app to precisely measure BSA in psoriasis. By combining rapid segmentation, objective scoring, and longitudinal tracking, the Hefubao app provides an accessible tool for dermatologists and patients, especially in regions where treatment eligibility hinges on BSA thresholds.
Does melatonin use improve sleep in children with atopic dermatitis or add to their sleep disturbance?
Pediatric Dermatology
Pediatric Dermatology
Counting sheep, but still no sleep – Melatonin and AD might be a nightmare pair
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects sleep in up to 80% of children, contributing to delayed sleep onset, frequent nocturnal awakenings, and worsened disease severity. While melatonin is widely used as an over-the-counter sleep aid in children, concerns exist regarding its safety, variable supplement content, and increasing poison control reports. Although small RCTs outside the U.S. suggest melatonin may improve sleep quality and AD severity, evidence remains limited and inconsistent. This cross-sectional survey study examined the prevalence of melatonin use among children with AD and assessed caregivers’ perceptions of its effectiveness for sleep and nocturnal itch.
What did they find?
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects sleep in up to 80% of children, contributing to delayed sleep onset, frequent nocturnal awakenings, and worsened disease severity. While melatonin is widely used as an over-the-counter sleep aid in children, concerns exist regarding its safety, variable supplement content, and increasing poison control reports. Although small RCTs outside the U.S. suggest melatonin may improve sleep quality and AD severity, evidence remains limited and inconsistent. This cross-sectional survey study examined the prevalence of melatonin use among children with AD and assessed caregivers’ perceptions of its effectiveness for sleep and nocturnal itch.
What did they find?
- 27.5% of children with AD had a history of melatonin use, with significantly higher rates among those with behavioral or psychological comorbidities (56.3% vs. 22.1%; P = 0.012) and by age group (highest in 5–9 and 14–17 years; P = 0.01).
- Children with AD had significantly elevated PROMIS sleep disturbance scores compared to population norms (ages 6–17: P < 0.0001; ages 1–5: P = 0.045).
- Children with a history of melatonin use had higher PROMIS Peds Sleep Disturbance scores than non-users (P < 0.001), though no significant differences were seen for PROMIS EC Sleep Disturbance (P = 0.649), PROMIS EC Daytime Impairment (P = 0.144), or POEM scores (P = 0.34).
- On the CSHQ, melatonin users were less likely to go to bed at the same time each night compared to non-users (P = 0.039).
We can’t just ~scratch the surface~ of the issue of infectious skin disease in immigrant populations
Infectious skin diseases are a major but often overlooked health concern among refugee and immigrant populations, who face heightened vulnerability due to displacement and global mobility. These conditions stem from a combination of pre-migration exposures, poor transit conditions, and post-migration challenges, all worsened by overcrowding, poor hygiene, and limited healthcare access. Beyond harming individual quality of life, infectious skin diseases also strain host healthcare systems and pose public health risks for the broader community. This systematic review of 63 studies analyzed the prevalence, risk factors, and treatment outcomes of infectious skin conditions among refugees and immigrants.
What did they find?
Infectious skin diseases are a major but often overlooked health concern among refugee and immigrant populations, who face heightened vulnerability due to displacement and global mobility. These conditions stem from a combination of pre-migration exposures, poor transit conditions, and post-migration challenges, all worsened by overcrowding, poor hygiene, and limited healthcare access. Beyond harming individual quality of life, infectious skin diseases also strain host healthcare systems and pose public health risks for the broader community. This systematic review of 63 studies analyzed the prevalence, risk factors, and treatment outcomes of infectious skin conditions among refugees and immigrants.
What did they find?
- This review included 5,210 immigrant patients across 73 origin countries and 23 destination countries.
- Overall, 3,647 patients were diagnosed with some form of infectious skin disease, and 2,772 patients had a specified diagnosis.
- The most common infectious skin diseases were fungal infections (39.1%), leprosy (25.9%), leishmaniasis (14.3%), scabies (6.0%), and parasitic infections (4.5%).
- The most frequently reported risk factor was immigration from endemic regions.
- Additional risk factors included overcrowding, poor hygiene, low socioeconomic status, limited healthcare access, immunosuppression, and other medical comorbidities.
Utilization of a large language model for automated note generation in Mohs micrographic surgery
Innovation/Scoop
Innovation/Scoop
No Mo(hs) documentation with automated note generation
Mohs micrographic surgery (MMS) often relies on pen-and-paper mapping that is later transcribed into electronic medical records (EMRs), a process that can be tedious and time consuming. This study evaluated whether artificial intelligence (AI) could automate this documentation by generating operative notes directly from Mohs maps. A standardized template including patient information, tumor type, repair method, and post-operative instructions was created, and the OpenAI GPT-4.0 model was trained on 35 Mohs maps to produce text for tumor removal and defect repair. The algorithm was then tested on 25 additional cases, with AI-generated notes compared against surgeon-written documentation to assess accuracy and feasibility.
What did they find?
Mohs micrographic surgery (MMS) often relies on pen-and-paper mapping that is later transcribed into electronic medical records (EMRs), a process that can be tedious and time consuming. This study evaluated whether artificial intelligence (AI) could automate this documentation by generating operative notes directly from Mohs maps. A standardized template including patient information, tumor type, repair method, and post-operative instructions was created, and the OpenAI GPT-4.0 model was trained on 35 Mohs maps to produce text for tumor removal and defect repair. The algorithm was then tested on 25 additional cases, with AI-generated notes compared against surgeon-written documentation to assess accuracy and feasibility.
What did they find?
- The algorithm achieved an overall 92.1% accuracy with an average runtime of 80.7 seconds per case
- The most frequent errors were due to incorrect or incomplete character detection
- 36% of all errors resulted from the model refusing to perform tasks
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Copyright © 2025 - All Rights Reserved.